Title: SENIOR TRIAL COURT STAFF ATTORNEY - 22011998

Location: PORT SAINT LUCIE, FL, US, 34984

Workplace: Full Time

Department: Legal

Job Description:

Requisition No: 859110 

Agency: State Courts System

Working Title: SENIOR TRIAL COURT STAFF ATTORNEY - 22011998

 Pay Plan: State Courts System

Position Number: 22011998 

Salary:  $76,040.16 Annually ($64,999.44 if less than 5 years experience) 

Position Number 22011998

Position Title

Sr. Trial Court Staff Attorney

Job Location

19th Judicial Circuit Courts; Port St. Lucie, FL. (Remote Eligible Position also travels to other locations within the Judicial Circuit and must be available for onsite training.)

Salary Range

$76,040.16 Annually ($64,999.44 if less than 5 years experience)

Job Description

The essential function of the position within the organization is to assist the judiciary with case management, pending litigation, processing of criminal and civil appeals, and a variety of issues. The assigned work involves considerable interpretation and judgment of legal issues in the area(s) of criminal, civil, appellate, and/or administrative law. The position is responsible for drafting memoranda, opinions, orders, and conducting legal research; reviewing briefs and case files; and advising judges on pending litigation. This position works under the supervision of the Supervising Trial Court Staff Attorney.

Education and Training Guidelines

Education – Juris Doctor degree from an accredited law school required. Additional relevant experience may be substituted for the recommended educational level on a year-for-year basis.

Experience – Five years of work experience in the practice of law or as a law clerk in an appellate or trial court.

Certification and Special Requirements – Requires membership in Good Standing in the Florida Bar within one year of hire. Valid Florida Driver’s License required.

Applicants should email a complete application package with the following materials to [email protected]

1. Cover letter and resume

2. Two (2) writing samples from within the past two (2) years

3. Copies of law school transcripts (originals may be required upon hire)

4. State of Florida Application - visit www.circuit19.org/about-courts/employment-opportunities to download the application.

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

If you are a person with a disability who requires special accommodation to participate in the application

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

Title: GUARDIAN AD LITEM OFFICE, 2ND CIRCUIT- SENIOR ATTORNEY - 21020016

Location: TALLAHASSEE, FL, US, 32303

Workplace: Full Time

Department: Legal

Requisition No: 861862 

Agency: Justice Administrative Commission

Working Title: GUARDIAN AD LITEM OFFICE, 2ND CIRCUIT- SENIOR ATTORNEY - 21020016

 Pay Plan: Justice Admin Comm.

Salary:  $66,979.84 

Total Compensation Estimator Tool 

Hybrid, Senior Attorney

STATEWIDE GUARDIAN AD LITEM OFFICE

(This position has the ability to be flexible for a remote work schedule after successful onboarding.)

ABOUT THE ORGANIZATION AND THE OPPORTUNIT

The Statewide Guardian ad Litem Office is Florida’s award-winning, state-funded child advocacy organization that provides independent legal representation to abused, abandoned and neglected children in Florida’s dependency court proceedings.  The Office upholds the highest standards of integrity, excellence and child-centered representation. Guardian ad Litem Attorneys are assigned by the Office to represent children as part of a multi-disciplinary team that includes a child welfare professional and hopefully a community volunteer or pro bono attorney.  In addition, dependency judges rely on the Guardian ad Litem to provide them with thorough and accurate information regarding the children under the court’s jurisdiction.  More information about the Statewide Guardian ad Litem Office can be found at www.guardianadlitem.org.

BENEFITS PACKAGE

As an employee with the State of Florida, your benefits are a significant part of your compensation with 19 percent of your total compensation coming from the benefits that the State offers. Total compensation inclusive of the benefits listed below is valued at a minimum of $93,137.24.  Actual total compensation will vary based on insurance and retirement elections

As a full-time employee, your insurance rate will be significantly low due to the contribution of the State of Florida. In fact, single coverage is as low as $8.34 per month with family coverage costing only $30 per month. While the rates are higher for half-time employees, health insurance options are still available to you as long as you are in a salaried position.

EMPLOYMENT BENEFITS: 

• State of Florida Retirement package – Pension or investment plan (3% employee contribution required)
• (9) Paid state holidays
• (1) Paid personal holiday
• (13) Paid sick leave days
• (176) Annual leave hours
• Life insurance $25,000 is provided by the state at no cost to you for all FTE positions.  Employee may purchase additional coverage
• Additional supplemental insurances are available such as dental, vision, disability, etc. 
• Florida Bar annual dues are paid for by the Agency, contingent upon agency approval
• Public Loan Forgiveness Program
• No State of Florida income tax for residents of Florida
• No mandatory night/weekend/holiday scheduled work
• State Tuition Waiver Program
• Introductory training on guardianship practice, dependency law and practice fundamentals as well as best practice guidance for attorneys communicating with and representing children.
• Ongoing live in-person trainings and webinars on case law, evidence, legal writing, trial skills, and ethics which fulfills CLE requirements.  Annual advanced litigation skills training. 
• Online training academy with a catalog of introductory and advanced courses on topics to include dependency law, child abuse and neglect, substance abuse, psychotropic medications, independent living, developmental disabilities, trauma, human trafficking, educational advocacy, and more.
• Lexis Nexis legal research search engine access.

ABOUT THE WORK

• This position has the ability to be flexible for a remote work schedule after successful onboarding.
• Work is performed under the supervision of the Managing Attorney or his or her designee.
• Guardian ad Litem Attorneys are assigned by the Office to represent children and work as part of a multi-disciplinary team, representing each child with a focus on timely achievement of permanency and normalcy for the child.
• The work involves contact with people in stressful situations, and the incumbent must exercise discretion in dealing with confidential and extremely sensitive issues before the court. 
• The incumbent reviews case files to identify legal issues, conducts an independent investigation of the facts of the case, researches and develops legal strategies for the cases, files pleadings, and motions, and attends court proceedings including, but not limited to, hearings, depositions, and mediations, and meets with Guardian ad Litem staff, witnesses, collateral contacts pertinent to the case, and the children represented by the Office.
• The Senior Attorney represents, advocates, and negotiates for the assigned children inside and outside the courtroom. Senior Attorneys assist other Guardian ad Litem Attorneys in developing and implementing case strategies. The incumbent also performs other duties assigned by management.
• Incumbents in this class report directly to the Managing Attorney of their assigned Circuit for all activities related to the practice of law; and also works under the operational and administrative supervision of the Circuit Director.

ABOUT THE KNOWLEDGE, SKILLS AND ABILITIES

• Possession of legal skills and knowledge sufficient to represent the children appointed to the Office as evidenced by admission to The Florida Bar. Ability to advocate effectively in court on behalf of the child.
• Knowledge of juvenile law, including relevant rules of procedure and evidence, and guardian ad litem legal representation for children.
• Ability to communicate effectively and deal tactfully with iniduals involved in litigation and stressful situations. Ability to work with iniduals from culturally and economically erse backgrounds.
• Ability to utilize a personal computer, including software programs such as Word, Excel, PowerPoint, and Outlook.

ABOUT THE EDUCATION AND EXPERIENCE REQUIREMENTS

• A valid Florida Driver’s License is required.
• Graduation from an accredited law school, membership in the Florida Bar and two years of experience in the practice of dependency or related law.  Candidates may be considered pending admission to The Florida Bar if granted by the Executive Director or his designee.  Strong trial skills preferred.
• An exception for the required experience may be granted by the Executive Director or their designee.
• IMPORTANT! – Please navigate to the following website:  www.guardianadlitem.org to apply for this position:
• Click on the “Career Opportunities” icon.
• Scroll down to the link, “Submit Your Guardian ad Litem Employment Application Here.”
• Complete the “mini” job application and attach your current resume.
• Select LEON COUNTY for the job location

OR

• Email your mini application and resume directly to [email protected]

 If you are a retiree of the Florida Retirement System (FRS), please check with the FRS at 1-844-377-1888 on how your current benefits may be affected if you are re-employed with the State of Florida.  Your current retirement benefits may be canceled, suspended, or deemed ineligible depending upon the date of your retirement.

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

Location:  

TALLAHASSEE, FL, US, 32303

Title: Product Marketing Manager

-MDVC

Location: USA NJ - Franklin Lakes

Job Description:

Job Description Summary

The Product Marketing Manager – MDVC ( Medication Delivery and Vascular Care Solutions) is responsible for leading the development and execution of product marketing deliverables to support the platform’s marketing and business objectives. This role requires a strong understanding of healthcare audiences and regulatory environments, along with the ability to translate complex clinical concepts and insights into clear and effective positioning to ensure that products resonate with target audiences and drive commercial success. The ideal candidate is a strategic thinker and skilled communicator who thrives in a collaborative, fast-paced setting.

Job Description

We are the makers of possible 

BD is one of the largest global medical technology companies in the world. Advancing the world of health™ is our Purpose, and it’s no small feat. It takes the imagination and passion of all of us—from design and engineering to the manufacturing and marketing of our billions of MedTech products per year—to look at the impossible and find transformative solutions that turn dreams into possibilities. 

We believe that the human element, across our global teams, is what allows us to continually evolve. Join us and discover an environment in which you’ll be supported to learn, grow and become your best self. Become a maker of possible with us.

Key Responsibilities:

• Product Marketing Deliverables:

  • Lead development of product marketing plans and deliverables, including behavior-based segmentation, customer personas, insights, brand positioning statements, benefit ladders, and differentiated claims, to support launches, drive adoption, and accelerate growth across key markets

  • Craft clinically accurate, compelling value propositions that resonate with healthcare professionals, administrators, and patients in targeted regions

  • Translate customer, competitive, and market data into actionable insights that guide product launches, adoption, and lifecycle management

  • Lead development and validation of differentiated product claims in collaboration with legal, regulatory, and medical teams to ensure strategic alignment and compliance

  • Equip regional partners with tools, training, and messaging frameworks to drive customer engagement and conversion

  • Oversee the lifecycle of product messaging and positioning assets, ensuring timely updates and strategic relevance

  • Ensure accuracy, strategic clarity, and brand consistency across all product marketing deliverables, in alignment with regulatory standards.

• Team & Vendor Coordination:

  • Manage product marketing timelines and workflows to maintain alignment with business priorities

  • Lead cross-functional teams through the process of developing product marketing deliverables, leveraging outside agencies and consultants as necessary.

• Performance Analysis:

  • Conduct message testing and market validation to ensure product positioning is compelling, differentiated, and actionable

  • Collaborate with regional partners to monitor and evaluate content performance

  • Leverage insights and commercial feedback to refine product marketing strategy, improve ROI, and enhance market impact.

• Cross-functional Collaboration:

  • Collaborate with cross-functional partners to gather insights and ensure relevance and effectiveness of product positioning and messaging

  • Ensure consistent product messaging across all customer touchpoints

Education and/ or Experience Required:

• Associates Degree

• 3–5 years of experience in product marketing or a closely related role

• Exceptional writing, editing, and storytelling skills

• Strong grasp of core product marketing principles, including:

  • Customer personas, behavior-based segmentation, and targeting

  • Insight generation, brand positioning statements, and benefit ladders

  • Creative briefs and messaging frameworks

  • Differentiated marketing claims

• Proficiency with content management systems (CMS) and digital publishing tools

• Proven ability to manage multiple projects and meet deadlines in a fast-paced environment

• Experience collaborating across cross-functional teams, including sales, product, and regulatory

• Applicants must be authorized to work for ANY employer in the US. We are unable to sponsor or take over sponsorship of employment Visa at this time.

At BD, we prioritize on-site collaboration because we believe it champions creativity, innovation, and effective problem-solving, which are essential in the fast-paced healthcare industry. For most roles, we require a minimum of 4 days of in-office presence per week to maintain our culture of excellence and ensure smooth operations, while also recognizing the importance of flexibility and work-life balance. Remote or field-based positions will have different workplace arrangements which will be indicated in the job posting.

For certain roles at BD, employment is contingent upon the Company’s receipt of sufficient proof that you are fully vaccinated against COVID-19. In some locations, testing for COVID-19 may be available and/or required. Consistent with BD’s Workplace Accommodations Policy, requests for accommodation will be considered pursuant to applicable law.

Why Join Us?

A career at BD means being part of a team that values your opinions and contributions and that encourages you to bring your authentic self to work. It’s also a place where we help each other be great, we do what’s right, we hold each other accountable, and learn and improve every day.  

To find purpose in the possibilities, we need people who can see the bigger picture, who understand the human story that underpins everything we do. We welcome people with the imagination and drive to help us reinvent the future of health. At BD, you’ll discover a culture in which you can learn, grow, and thrive. And find satisfaction in doing your part to make the world a better place.  

To learn more about BD visit https://bd.com/careers 

Becton, Dickinson, and Company is an Equal Opportunity Employer. We evaluate applicants without regard to race, color, religion, age, sex, creed, national origin, ancestry, citizenship status, marital or domestic or civil union status, familial status, affectional or sexual orientation, gender identity or expression, genetics, disability, military eligibility or veteran status, and other legally-protected characteristics.

Required Skills

Optional Skills

Primary Work Location

USA NJ - Franklin Lakes

Additional Locations

Work Shift

At BD, we are strongly committed to investing in our associates—their well-being and development, and in providing rewards and recognition opportunities that promote a performance-based culture. We demonstrate this commitment by offering a valuable, competitive package of compensation and benefits programs which you can learn more about on our Careers Site under Our Commitment to You.

Salary or hourly rate ranges have been implemented to reward associates fairly and competitively, as well as to support recognition of associates’ progress, ranging from entry level to experts in their field, and talent mobility. There are many factors, such as location, that contribute to the range displayed. The salary or hourly rate offered to a successful candidate is based on experience, education, skills, and any step rate pay system of the actual work location, as applicable to the role or position. Salary or hourly pay ranges may vary for Field-based and Remote roles.

Salary Range Information

$114,500.00 - $189,100.00 USD Annual

Title: Associate Director Access & Reimbursement

Job Description:

Job Description Summary

Location: Remote- Las Vegas, NV

Job Description

Major Accountabilities:

• Interact with large, complex accounts to support patient access within their aligned therapeutic area product(s), proactively provide face-to-face education on programs to providers and staff in order to support integration of those products into office processes and workflows.
• Address customer questions for issues related to NPC policies on therapeutic area products ordering, payment, inventorying, and product returns & replacement in offices.
• Work with key members of therapeutic area offices (e.g., executives, providers, administrators, billing and coding staff, claims departments, revenue cycle managers) in order to appropriately support patient access to products.
• Ability to analyze problems and offer solutions. Understand specifics and support questions associated with patient reimbursement and provide support on reimbursement is-sues with third party payers at the provider-level. Analyze account reimbursement issues (as needed). Identifies trends at a local, regional and national level and partner with purpose internally and externally to support patient access to Novartis medicines
• Supports pull through on local coverage decisions to enable meaningful patient access within the system. Proactively communicate policy changes or issues that could potentially affect other departments.
• Accountable for informing customers on NVS-sponsored patient support programs to help enable patients starting and staying on therapy (i.e., Co-pay).
• Maintain expertise in regional and local access landscape, anticipating changes in the healthcare landscape, and act as their aligned therapeutic area product(s) reimbursement expert (as needed).
• Interface with Patient Support Center (hub) and Access & Reimbursement Managers on important matters related to patient case management, including tracking cases, issue resolution, reimbursement support, and appropriate office staff education.
• Collaborate with aligned cross-functional associates within NPC (see above) to share in-sights on customer needs and barriers for their aligned therapeutic area product(s) related to access and reimbursement.
• Maintain a deep understanding of NPC policies and requirements and perform all responsibilities with integrity and in a manner consistent with company guidance and prescribed Values and Behaviors. Handle Patient Identifiable Information (PII) appropriately (under-stand and ensure compliance with HIPAA and other privacy laws and regulations and in-ternal Company compliance guidelines).
• Responsible for identifying and reporting adverse events via the established Novartis systems as per applicable processes.

Buy and Bill Specific

• Assess access situation within the assigned geography and develop appropriate Plan of Action (POA). Communicate POA to appropriate personnel.
• Responsible for educating HCPs using approved materials regarding acquisition path-ways for Novartis products. Educate on buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and de-centralized acquisition, and use of alternative channels such as white bagging, clear bag-ging, brown bagging, and alternate site of care for administration.
• Educates relevant stakeholders on logistics related to ordering, payment, inventory, and product returns & replacement.
• Analyze reimbursement issues, anticipating changes in the healthcare landscape, and act as the designated reimbursement expert for offices and field teams.
• Accountable for engagement with non-prescribers in regards to Novartis medicines, for example pharmacy, system leadership, financial counselors, office administrators, reve-nue cycle managers, etc.

Key Performance Indicators

• Overall customer satisfaction and awareness related to designated therapeutic area products programs and reimbursement support.
• Education of key customers in therapeutic area offices (i.e. specialists, billing staff, reimbursement staff) in order to assist with therapeutic area products integration and improve patient access in a manner consistent and compliant with company policies and requirements.
• Ensure customers on assigned target list and within assigned geography are aware of and know how to utilize available programs to support therapeutic area products access for patients.
• Adherence with NPC policies, laws and regulations.

Education

• Bachelor’s Degree required. Business and/or biological science education preferred. Advanced degree preferred.

Minimum Requirements

• 5+ Years of experience in pharmac
• euticals / biotech industry focused in Patient Services, Market Access, Sales, and/or account management. With 2 of those years being in a Patient Services practice support role for a specialty product(s).
• Experience working with highly complex practices and/or health systems to establish access and acquisition pathways.
• Strategic account management experience using a proactive approach to anticipate access hurdles impacting accounts and patient access.
• Deep expertise and experience integrating manufacturer-sponsored patient support pro-grams.
• Experience with specialty products acquired through Specialty Pharmacy networks
• Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail)
• Possess a strong understanding of Commercial payers, Medicare plans and state Medicaid in geographic region.
• Must live within assigned territory.
• Ability to travel and cover geography, at least 50% travel required, based on geography and territory / targeting make up.
• Driving is an essential function of this role, meaning it is fundamental to the purpose of this job and cannot be eliminated.
• Because driving is an essential function of the role, you must have a fully valid and unre-stricted driver’s license to be qualified for this role.
• The company provides reasonable acco
• mmodations for otherwise qualified iniduals with medical restrictions if an accommodation can be provided without eliminating the essential function of driving.

Preferred Qualifications:

• Experience leading and delivering presentations to C-level account executives.
• Strong ability to work cross functionally with such functions as Field Sales, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management and applicable third-party affiliates.
• Expertise in therapeutic area practice dynamics and common reimbursement and product program support-related needs.
• Strong capabilities in the areas of customer focus, collaboration, business acumen, commu-nication, and presentation skills.
• This position requires significant use of a company provided vehicle and maintaining good driving record
• This is a field-based customer engaging position
• Control business expenses related to field activities (i.e. travel, customer meetings) and pro-vide timely expense reports to manager.

Novartis Compensation and Benefit Summary: The pay range for this position at commencement of employment is expected to be between $160,300.00 and $297,700.00/year; however, while salary ranges are effective from 1/1/25 through 12/31/25, fluctuations in the job market may necessitate adjustments to pay ranges during this period.  Further, final pay determinations will depend on various factors, including, but not limited to geographical location, experience level, knowledge, skills and abilities. The total compensation package for this position may also include other elements, including a sign-on bonus, restricted stock units, and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment. If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to inidual performance, Company or inidual department/team performance, and market factors. 

Field roles with a dedicated training period only:  

The inidual hired for this role will be required to successfully complete certain initial training, including home study, in eight (8) or fewer hours per day and forty (40) or fewer hours per week. 

Driving is an essential function of this role, meaning it is fundamental to the purpose of this job and cannot be eliminated. Because driving is an essential function of the role, you must have a fully valid and unrestricted driver’s license to be qualified for this role. The company provides reasonable accommodations for otherwise qualified iniduals with medical restrictions if an accommodation can be provided without eliminating the essential function of driving. 

EEO Statement:

The Novartis Group of Companies are Equal Opportunity Employers. We do not discriminate in recruitment, hiring, training, promotion or other employment practices for reasons of race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, marital or veteran status, disability, or any other legally protected status. 

Accessibility and reasonable accommodations

The Novartis Group of Companies are committed to working with and providing reasonable accommodation to iniduals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or to perform the essential functions of a position, please send an e-mail to [email protected] or call +1(877)395-2339 and let us know the nature of your request and your contact information. Please include the job requisition number in your message.

Salary Range

$160,300.00 - $297,700.00

Skills Desired

Access And Reimbursement Strategy, Analytical Skill, Analytical Thinking, Cross-Functional Work, Customer-Centric Mindset, Employee Development, Finance, Go-to-Market Strategies, Healthcare Policies, Healthcare Sector Understanding, Health Economics, Health Technology Assessment (HTA), Innovation, Inspirational Leadership, Market Access Strategies, Negotiation, People Management, Process Management, Public Affairs, Real World Evidence (RWE), Regulatory Compliance, Risk Management, Speed and Agility Training (Inactive), Value Propositions, Waterfall Model

Title: Director Network & Physician Contracting

Location: Hopewell, NJ - Remote

Job Description:

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health.  For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience.  Our members are our neighbors, our friends, and our families.  It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. 

Lead the development, negotiation, management, and maintenance of provider contracts for physician organizations, hospital, and ancillary facilities across the payment spectrum. Responsible for achieving the Enterprise Unit Cost Trends which is critical in the Enterprise meeting its Annual Financial and Strategic Plan.

Responsibilities:

• Oversee budgeting and forecasting initiatives for product lines to network costs and provider contracts. 

• Draft hospital, professional and ancillary contract terms to ensure they conform with all regulatory, accreditation and enterprise requirements while advancing Horizon’s strategic and business objectives. 

• Manage negotiations and contracting with all providers for all payment arrangements, including FFS and value-based primary and specialty programs.

• Negotiate, execute, and renew contracts for all providers and all payment arrangements.  Maintain contract standards and policies.

• Collaborate with the payment strategy team on contracting parameters and provider experience team on relationships. 

• Recruit and contract with out-of-network providers.

• Development and execution of the network contracting strategy, including methods to adopt value-based contracting for providers operating under fee-for-service models, minimize special arrangements, and align to enterprise affordability objectives.

• Develop and implement provider contracting policies and procedures that are consistent with industry best practices and regulatory requirements.

• Accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance all lines of business. Coordination across network management for the submission of hospital, ancillary and professional rate loads, pricing configurations, DRG updates and contract storage.

• Ensures accurate implementation of contracts in addition to working with other departments to assure contract and special arrangement reporting, provider file maintenance requests, claims stops and new hospital implementation. Adjudication of technical inefficiencies as it relates to system wide claims, configuration, and provider mapping discrepancies. Conducts research, identify root cause analysis and work fall out reports causing operational deficiencies.

• Ensures effectiveness and efficiencies of operations which includes management of contract inventory and adherence to all regulatory requirements and internal policies and procedures. Understands the impact of provider contract provisions on claims payment accuracy and timeliness and presents solutions to minimize unnecessary deviation and supports auto-adjudication.

• Identifying and achieving multi-million-dollar medical cost savings by introducing innovative industry initiatives and programs.

• Achieve the Enterprise Unit Cost Trends.

• Accountable for all hospital, professional and ancillary unit cost financial forecasts.

• Achieving all regulatory, accreditation and enterprise network adequacy requirements.

• Meet all geo-access standards.

• Oversees the maintenance of all provider contract language and templates and ensures that all negotiated contracts can be configured into the core systems.

• Collaborate with Legal and Compliance Leadership as needed to modify provider contract templates to ensure compliance with all regulatory, accreditation and enterprise requirements.

• Understand the Enterprise Strategic and Financial Plan

• Understand Value Based Programs including the financial, quality, and operational aspects.

• Understand the credentialing and recredentialing process, provider directory maintenance, and regulatory standards.

• Collaborate across departments to ensure that provider services are aligned with the needs of members and the organization. 

• Keep the provider network integrated with the organization’s objectives.

• Assist the team with skills, knowledge, and resources needed to effectively manage the provider network and achieve team goals.

• Evaluate and negotiate contracts in compliance with Horizon reimbursement standards, and other key controls.

• Represent the organization at industry conferences, webinars, and other events.  Ensures that Horizon is well-positioned to identify and capitalize on emerging trends and opportunities in Horizon’s market.

• Manage, develop and train staff; develop and monitor goals; conduct annual performance reviews, and administers salaries for the staff.

Disclaimer:

Education/Experience:

• High School Diploma/GED required.

• Bachelor degree in business, finance, accounting, health administration or any other related field preferred or relevant experience in lieu of degree.

• Master’s degree in health or business preferred.

• Requires a minimum of 10 years of experience in complex environments within healthcare, healthcare consulting or managed care as well as experience in hospital or healthcare finance and/or managed care network development.

• Requires a minimum of 10 years of progressive experience in Healthcare Administration, Managed Care and or Provider Contracting.

• Requires a minimum of 8 years demonstrated experience to facilitate negotiations with health care executives, provider’s and accreditation and regulatory personnel.

• Requires a minimum of 8 years demonstrated in-depth knowledge and experience in contract finance and reimbursement. methodologies including FFS, Medicare DRG and APC’s, Medicaid pricing, capitation, full risk, shared savings and incentive arrangements.  

• Requires a minimum of 8 years demonstrated experience in health care cost data analysis and technical document writing.

• This director will have a demonstrated track record of developing and managing successful network contracting strategies, with experience negotiating complex contracts with healthcare executives and providers.

• Requires knowledge of quality measurement approaches applied in measuring insurance, HMO, hospital, and physician practice performance.

• Requires a minimum of 5 years management and supervisory experience.

Skills and Abilities:

• Excellent negotiation, communication and leadership skills are needed as this director will work with a range of executive stakeholders both internally and externally.

• Strong negotiator with the ability to facilitate the resolution of barriers utilizing business contacts negotiations and skills.

• Demonstrated health care financial acumen including budget setting and forecasting.

• Demonstrates ability to create, develop, and maintain business relationships.

• Proven analytical, business case and product design skills a must.

• Proven ability to exercise sound judgment.

• Proven ability to ask probing questions and obtain thorough and relevant information.

• Must be detail oriented with strong organizational skills. Proven ability to follow detailed instructions is essential, along with proven problem-solving skills.

• Demonstrates flexibility and adapts to multiple responsibilities encompassing multiple areas within the organization.

• Must demonstrate the ability to effectively present information and respond to questions from groups of managers, clients, customers.

• Must have effective verbal and written communication skills and demonstrate the ability to work well within a team.

• Demonstrated ability to deliver highly technical information to less technical iniduals.

• Able to interact and create positive working relationships with all levels of internal and external constituents and staff.

• Willingness to work closely with in-house counsel as well as outside counsel to complete agreements.

• Requires an attention to details, contractual and quality monitoring details often prescribed through law or credentialing organizations.

Knowledge:

• Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint); Should be knowledgeable in the use of intranet and internet applications.

• Requires knowledge of Principals of Health Care contracting.

• Requires knowledge of health care industry or health insurance industry.

• Requires knowledge of the hospital and physician communities in the state of New Jersey.

• Requires knowledge of laws and regulations regulating insurance, HMO hospital and physician practice.

Travel:

• Moderate travel up to 60% required. Must be willing to travel to various healthcare facilities.

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Salary Range:

$152,500 - $208,110

​This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.  This range has been created in good faith based on information known to Horizon at the time of posting.  Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

Disclaimer:

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an inidual with a disability and any other protected class as required by federal, state or local law.  Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

Title: Oracle Health Test Engineer II

Location: USA MD Home Office (MDHOME)

Job Description:

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

SSBI (T5)

Job Family:

Professional Engineering

Job Qualifications:

Skills:

Collaborating, Oracle Health, Test Case Design, Test Scripts

Certifications:

None

Experience:

5 + years of related experience

US Citizenship Required:

No

Job Description:

GDIT is looking to fill multiple Test Engineer II positions to join our team supporting the Indian Health Service (IHS) Electronic Health Record Modernization Program known as Patients at the Heart (PATH) EHR. Your efforts will serve to improve the patient experience and quality of care for over 600 facilities across 37 states serving the American Indian and Alaska Native populations.

As a Test Engineer II, you will be responsible for planning, creating, maintaining, and executing test scripts based on documented requirements and published acceptance criteria. The scope of testing will focus primarily on System-to-System Interfaces, Interop, and Data Migration. You will collaborate with other workstreams, sub-contractors, and vendors to provide complete testing coverage and ensure successful site implementations.

How a Test Engineer II will make an impact:

• Develop, document, and maintain functional test scripts and other test artifacts

• Execute test scripts, provide testing evidence, and evaluate testing results within the implementation timeline

• Hold and facilitate test plan/script reviews with cross-functional team members

• Support all aspects of end user test execution by the customer

• Identify, report, and validate issues found during testing

• Maintain the integrity of test scripts for localized implementations across multiple environments

• Work with sustainment to provide validation of domain updates as needed

Required Qualifications:

• Bachelor’s degree or equivalent combination of education and experience

• 5+ years of experience in developing and executing Healthcare IT application tests

• Must have knowledge of Oracle Health’s EHR suite

• This role requires you to obtain and maintain an in-depth Public Trust Level 5. This investigation will review personal and criminal behavior, financial conduct, foreign influence, as well as other adjudications.

Preferred Qualifications and Experience

• Previous testing experience of Oracle Health’s solution suite

• Experience supporting Federal EHR programs

• Knowledge of Medical Device interoperability and validation

GDIT IS YOUR PLACE:

• Full-flex work week to own your priorities at work and at home.

• 401K with company match.

• Comprehensive health and wellness packages.

• Internal mobility team dedicated to helping you own your career.

• Professional growth opportunities including paid education and certifications.

• Cutting-edge technology you can learn from.

• Rest and recharge with paid vacation and holidays.

#IHSJobs

#FedHealth

#GDITFedHealthJobs

#GDITHealthSystems

The likely salary range for this position is $85,000 - $115,000. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours:

40

Travel Required:

10-25%

Telecommuting Options:

Remote

Work Location:

Any Location / Remote

Additional Work Locations:

Total Rewards at GDIT:

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.

Join our Talent Community to stay up to date on our career opportunities and events at

gdit.com/tc.

Equal Opportunity Employer / Iniduals with Disabilities / Protected Veterans

Title: Oracle Site Implementation Testing Coordinator

Job Description:

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

SSBI (T5)

Job Family:

Program Delivery and Execution

Job Qualifications:

Skills:

Deliverables Management, Health Information Technology (HIT), Oracle, Test Planning

Certifications:

None

Experience:

5 + years of related experience

US Citizenship Required:

No

Job Description:

Join the growing Team at GDIT as a Testing Coordinator to support the Indian Health Service (IHS) Electronic Health Record Modernization Program known as Patients at the Heart (PATH) EHR. Your efforts will serve to improve the patient experience and quality of care for over 600 facilities across 37 states serving the American Indian and Alaska Native populations.

The Testing Coordinator will partner with GDIT Leadership as well as IHS, Oracle Health, and S&P associates to help coordinate, manage, and drive testing efforts crucial to the successful implementation of the PATH EHR at Pilot and Cohort sites.

How a Testing Coordinator will make an impact:

• Assisting the Validation Lead in developing, maintaining, and executing the Master Test Plan

• Planning and oversite of testing events for Pilot, and Cohort implementations

• Creation of testing deliverables throughout the program lifecycle

• Translating requirements into testing tasks

• Identifying and coordinating resources needed to accomplish testing tasks

• Identifying and mitigating risks through all phases of the program

• Maintaining and publishing testing metrics and artifacts both internally and to the customer

Required Qualifications:

• Bachelor’s degree or equivalent combination of education and experience

• 5+ years of experience in Healthcare IT application testing

• Must have knowledge of Oracle Health’s EHR suite

• Must have experience managing multiple resources and complex projects

• This role requires you to obtain and maintain an in-depth Public Trust Level 5. This investigation will review personal and criminal behavior, financial conduct, foreign influence, as well as other adjudications.

Preferred Qualifications and Experience

• Previous experience implementing Oracle Health’s solution suite

• Experience supporting Federal EHR programs

• Knowledge of Medical Device interoperability and validation

GDIT IS YOUR PLACE:

• Full-flex work week to own your priorities at work and at home.

• 401K with company match.

• Comprehensive health and wellness packages.

• Internal mobility team dedicated to helping you own your career.

• Professional growth opportunities including paid education and certifications.

• Cutting-edge technology you can learn from.

• Rest and recharge with paid vacation and holidays.

#IHSJobs

#FedHealth

#GDITFedHealthJobs

#GDITHealthSystems

The likely salary range for this position is $89,250 - $120,750. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours:

40

Travel Required:

10-25%

Telecommuting Options:

Remote

Work Location:

Any Location / Remote

Additional Work Locations:

Total Rewards at GDIT:

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.

Join our Talent Community to stay up to date on our career opportunities and events at

gdit.com/tc.

Equal Opportunity Employer / Iniduals with Disabilities / Protected Veterans

Title: Attorney

Location: United States - Newton - Massachusetts

Job Description:

When our values align, there's no limit to what we can achieve.

Each of us, no matter what we do at Parexel, contributes to the development of a therapy that ultimately will benefit a patient. We take our work personally, we do it with empathy and we're committed to making a difference.

Parexel has an excellent opportunity for an attorney with 0 - 3 years’ experience to join our global legal and risk management team as an Attorney.   Our team is committed to mentoring and training legal talent.

The ideal candidate has first-rate legal and business acumen, excellent leadership and customer service skills, and a positive “can-do” attitude. The Attorney is primarily responsible for drafting and negotiating a variety of commercial contracts, with an emphasis on revenue-generating customer agreements. The Attorney will also provide legal advice and counsel to Parexel’s various business units and contribute to the ongoing review and improvement of Parexel’s guidelines and processes.

This is a client-facing position, and it is expected that the Attorney will establish highly collaborative, productive relationships with Parexel clients, internal clients and other business partners. The work requires effective, enthusiastic and thoughtful cross-functional collaboration within Parexel.  The ability to understand risks, balance competing interests, and provide rapid, practical, and appropriate legal advice is critical to success in this role. 

The Attorney will:

• Analyze complex business and legal issues/risks to achieve practical solutions.

• Manage and prioritize multiple and varied negotiations with enthusiasm and attention to detail.

• Collaborate with internal and external stakeholders to successfully drive negotiations.

• Consistently meet internal and external timelines.

• Have excellent interpersonal, verbal and written communication skills.

• Lead by example, bringing positivity and professionalism to the workplace.

• Take initiative and exercise ingenuity in problem-solving.

This is a hybrid position that requires a minimum of two days per week in our Newton office.

Education and Qualifications

• J.D. and Bar Admission; however, Bar admission is waived for recent law graduates planning to take or awaiting Bar results, in which case long term employment is conditioned upon being admitted to a Bar.

Minimum Work Experience

• For practicing attorneys, preference for experience in a large multi-national law firm and/or in-house experience supporting commercial operations and negotiating key transactions for a global corporation, ideally in the life sciences.

• For recent law graduates, preference for prior experience in a legal capacity (e.g., legal analyst, legal intern or paralegal) and/or knowledge of and interest in the life sciences industry.

EEO Disclaimer

Title: Care Manager Transition of Care

Location: Remote-AZ

Job Description:

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a ersified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Compact license required

Hospital Discharge planning and coordination preferred

Position Purpose: Performs care management duties to assess, plan and coordinate aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality and cost effective care. Completes medication review for pre-admission and post-discharge reconciliation. Works with the care management and coordination teams to identify transition support services.

• Evaluates the needs of the member by completing post discharge assessments for members transitioning from healthcare facilities
• Evaluates medication and performs reconciliation between pre-admit and post-discharge medications
• Develops a care/service plan and collaborates with discharge planners, providers, specialists, and interdisciplinary teams to support member transition and discharge needs
• Assesses member current health status, resource needs, services, and treatment plans and provides appropriate interventions
• Facilitates the transition into active care management based on member needs
• Provides or facilitates education and resource materials to members, authorized caregivers, and providers to promote wellness activities to improve member overall quality of care
• Facilitates services between Primary Care Physician (PCP), specialists, medical providers, and non-medical resources as necessary to meet the medical and socio economic needs of members
• May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
• Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulations
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
• Other duties or responsibilities as assigned by people leader to meet business needs
• Performs other duties as assigned
• Complies with all policies and standards

Requires Arizona Residency

Compact license required

Hospital Discharge planning and coordination preferred

Education/Experience: Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.

• LISW, LCSW, LMSW, LMFT, LMHC, LPC, or RN required

Pay Range: $55,100.00 - $99,000.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an inidual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to ersity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Title: Oracle Health Interop Testing Coordinator

Location: Any Location / Remote

time type Full time

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

SSBI (T5)

Job Family:

Program Delivery and Execution

Job Qualifications:

• Skills: Application Testing, Collaborating, Interop, Oracle Health EHR, Test Planning
• Certifications: None
• Experience: 5 + years of related experience

US Citizenship Required: No

Job Description:

Join the growing Team at GDIT as an Interop Testing Coordinator to support the Indian Health Service (IHS) Electronic Health Record Modernization Program known as Patients at the Heart (PATH) EHR. Your efforts will serve to improve the patient experience and quality of care for over 600 facilities across 37 states serving the American Indian and Alaska Native populations.

The Interop Testing Coordinator will partner with GDIT Leadership as well as IHS and Oracle Health associates to help coordinate, manage, and drive testing efforts for device integration, mobile capabilities, and system-to-system interfaces crucial to the successful implementation of the PATH EHR at Pilot and Cohort sites.

How an Interop Testing Coordinator will make an impact:

• Assisting the Validation Lead in developing and maintaining testing strategies for device integration, mobile capabilities, and system-to-system interfaces documented in the Master Test Plan
• Collaborating with Oracle Health associates and third-party vendors to develop specific test plans
• Planning and overseeing validation projects for Pilot, and Cohort implementations
• Creation of testing deliverables throughout the program lifecycle
• Identifying and coordinating resources needed to accomplish testing tasks
• Identifying and mitigating risks through all phases of the program
• Maintaining and publishing testing metrics and artifacts both internally and to the customer

Required Qualifications:

• Bachelor’s degree or equivalent combination of education and experience
• 5+ years of experience in Healthcare IT application testing
• Knowledge of Oracle Health’s EHR suite
• Experience building, maintaining, and testing Foreign System Interfaces (FSI), end-user and medical devices, and/or mobile device applications within the Oracle Health EHR
• This role requires you to obtain and maintain an in-depth Public Trust Level 5. This investigation will review personal and criminal behavior, financial conduct, foreign influence, as well as other adjudications.
• Preferred Qualifications and Experience
• Previous experience implementing Oracle Health’s solution suite
• Experience supporting Federal EHR programs

GDIT IS YOUR PLACE:

• Full-flex work week to own your priorities at work and at home.
• 401K with company match.
• Comprehensive health and wellness packages.
• Internal mobility team dedicated to helping you own your career.
• Professional growth opportunities including paid education and certifications.
• Cutting-edge technology you can learn from.
• Rest and recharge with paid vacation and holidays.

#IHSJobs

The likely salary range for this position is $89,250 - $120,750. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours: 40

Travel Required: 10-25%

Total Rewards at GDIT:

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire.

The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.

Equal Opportunity Employer / Iniduals with Disabilities / Protected Veterans

Title: Care Manager (RN)

Location: Remote-GA

Full-time

Job Description:

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a ersified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

PLEASE NOTE: ***POSITION IS REMOTE;  CANDIDATE MUST RESIDE IN THE STATE OF GEORGIA AND HAVE AN ACTIVE RN COMPACT LICENSURE***

*** EXPERIENCE IN CASE MANAGEMENT AND/OR HOME HEALTH CARE IS IDEAL***

Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.

• Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome
• Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs
• Identifies problems/barriers to care and provide appropriate care management interventions
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services
• Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs
• Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate
• Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services
• May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
• Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
• Other duties or responsibilities as assigned by people leader to meet business needs
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 – 4 years of related experience.

License/Certification:

• RN - Registered Nurse - State Licensure and/or Compact State Licensure required

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an inidual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to ersity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Title: Community Resource Coordinator III

Location: Chicago - 200 E Randolph, Ste 3600 (10419)

Job Description:

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a ersified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Preference will be given to applicants who are bilingual in Spanish and English (position 2 only) and have experience in the following areas: home visits, community events, social services.

LOCATIONS NEEDED:

• Position 1- Evanston, Rogers Park (other nearby cities include: Lincoln Park, Edgewater, Winnetka, Glencoe, Wheeling, Prospect Heights, Glenview, Morton Grove, Skokie, Albany Park, Logan Square, Bucktown)
• Position 2- Humboldt Park, Austin (other nearby cities include: Oak Park, Broadview, Northlake, Rosemont, Elk Grove Village, Rolling Meadows, Palatine, Mt Prospect, Forest Glen, Niles, Portage Park)
• Position 3- West Englewood (other nearby cities include: Englewood, Marquette Park, West Lawn, Brighton Park, Lower Westside, South Loop, Streeterville, West Town, Wicker Park)

Additional Details:

• Department:  MED-Medical Affairs // Health Equity- IL

• Business Unit: Illinois Health Plan

• Schedule: 8-4:30 pm; 30 minute lunch – Monday-Friday. Some weekend or evening hours for events **** 

Position Purpose: Works with care management team on community resource connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and works with the care team to identify member community support and provide health education as appropriate.

• Provides ongoing support to members to connect them to known community and care resources in a cost-effective manner
• Supports the coordination of community outreach resources available to members and promotes awareness of care/services
• Serves as experienced support for members on community and care resource inquiries and opportunities available to members
• Utilizes in-depth knowledge of community resource connection activities and resource opportunities
• Supports member related correspondence and educational materials to assist in the facilitation of a successful community connection
• Works with care management team on escalating community resource requests and inquiries to management and identifying member community support
• Documents and maintains community resources to ensure standards of practice and policies are in accordance with health plan requirements
• Provides support to the clinical team of nurses and social workers with activities including, but not limited to outreach, community education, evidence-based guidance, and member support
• Conduct non-clinical general health assessments in order to refer members to appropriate services, resolve concerns on member’s behalf, and gather information for medical providers and staff working within the organization
• Conduct non-medical assessments such as home safety, assessment of the community/environment resources, transportation, employment, and others to be able to refer to appropriate services, resolve concerns on member’s behalf, and gather information for medical providers in staff working within our organization
• Conduct telephonic and/or in-person outreach to locate iniduals and families in the community who are hard to reach
• May make visits to inidual homes and/or community organizations
• Working Knowledge of Social Determinants of Health (SDOH) barriers
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Requires a High School diploma or GED

Pay Range: $20.00 - $34.03 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an inidual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to ersity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Title: Care Manager

(State)

Location: Remote-CA

Job Description:

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a ersified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

 Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) preferred

Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.

• Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs
• May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
• Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders
• Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
• Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
• Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
• Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.

• Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required

Pay Range: $26.50 - $47.59 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an inidual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to ersity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Manager, Medical Education (REMOTE)

• 12115
• Miami Lakes, Florida
• Marketing
• Yes

Job Description

Responsibilities

Job Summary 

The Medical Education Manager is responsible for designing, implementing, and evaluating clinician training programs to support the safe and effective adoption of the Cordis cardiovascular portfolio in the United States. Reporting to the Director, Medical Education, this role serves as a subject matter expert in clinical education and adult learning principles, ensuring that programs meet high standards of scientific accuracy, regulatory compliance, and clinical relevance. The Manager partners cross-functionally with Clinical, Regulatory, Marketing, and Commercial teams, while maintaining direct engagement with physician faculty and lab staff. 

Job Responsibilities 

• Design and deliver medical education programs (workshops, proctoring pathways, virtual learning, symposia) that align with product and procedural needs. 

• Develop clinical training content, including curricula, procedural guides, and competency assessments. 

• Collaborate with physician faculty and KOLs to organize peer-to-peer educational initiatives. 

• Provide field support for key training events and live case demonstrations. 

• Evaluate program effectiveness through participant feedback, assessments, and defined KPIs. 

• Partner with cross-functional stakeholders (Clinical, Marketing, Regulatory, Quality) to ensure content accuracy and compliance. 

• Support the Director in building scalable learning frameworks and training platforms. 

• Manage logistics and vendor relationships for assigned programs and events. 

• Contribute to budget planning and monitor spend for assigned initiatives. 

• Serve as a resource for internal teams on training methodologies and educational best practices.

Qualifications

Required Qualifications

• 8+ years of experience in medical education, clinical education, or field clinical roles within the medical device or procedural healthcare industry (combined education/experience considered).
• Bachelor’s degree required; advanced degree in education, instructional design, or business preferred.

Care Manager

Location: New York, NY United States

Hybrid

Job Description:

Overview

As a Care Design New York Care Manager, you will help people with intellectual and/or development disabilities identify and realize their long-term and short-term goals by developing, implementing, and monitoring their person-centered Life Plans. These plans help our members live their best life - so we'll count on your best relational and organizational skills. Our Care Managers may come from different walks of life, but all receive the best training in the profession. You will plug your passion for service into our model of care to deliver the highest standard of service to our members.

This dynamic position is performed in a hybrid environment that includes required visits with members you support and their families in their home, attending periodic trainings and meetings in the office, and working from home. If you support our members outside of New York City, you will need a driver's license, reliable transportation and appropriate insurance.

Our membership is erse and so is our workforce. We welcome bilingual candidates who can support that ersity and we may provide ADDITIONAL COMPENSATION for fluency in English and languages such as Spanish, Korean, Mandarin, Cantonese, Russian, Hindi, Bengali, Urdu, Yiddish, Hebrew, and ASL.

All full-time positions come with generous benefits including: health, vision and dental insurance, paid time off, $3000 tuition reimbursement per calendar year, and up to $250 of professional development courses! CDNY is also a qualifying employer under the Public Service Loan Forgiveness (PSLF) program.

Responsibilities

• Responsible for advocating for and with our members to ensure informed decision making, informed consent, and appropriate guardianship.
• Responsible for scheduling, leading and actively collaborating with our members and their interdisciplinary team to conduct meetings and assessments ensuring the development of a comprehensive, person-centered Life Plan that reflects the person's needs and desired life goals.
• Implement, update, and monitor Life Plans and facilitate inidualized Life Plan reviews and approval processes.
• Ensure integration of all needed and preferred supports and services (i.e., medical, behavioral, social, habilitation, dental, psychosocial, and community-based, and facility-based long-term supports and services, etc.).
• Maintain ongoing contact with the critical people in a member's life.
• Ensure timely submission of all documentation (Life Plan, Progress notes, etc.)
• Assist our members with maintaining benefits such as Social Security, Supplemental Security Income, Medicaid and Medicare coverage, and Food Stamps.
• Assist members to resolve problems in living such as housing, utilities, the judicial system, and general safety.
• Report abuse or neglect immediately when observed or reported.
• A comprehensive job description may be provided during the interview process

Qualifications

Care Managers who serve iniduals with I/DD must meet the following qualifications:

• A Bachelor's degree with 2+ years of relevant experience, OR

• A License as a Registered Nurse with 2+ years of relevant experience, which can include any employment experience and is not limited to case management/service coordination duties, OR

• A Master's degree with 1+ year of relevant experience.

• Strong communication skills, including verbal and written communication skills, along with strong interpersonal and organizational skills also required.

• Excellent organizational, interpersonal, and verbal and written communication skills required.

Care Design NY and Partnership Solutions provide equal employment opportunities to all. We celebrate the qualities that make each of us unique and greatly value how they enrich the work we do. As such, we welcome candidates of color, candidates who identify as gender erse, neuroerse candidates, and candidates of all ages with erse lived experiences and perspectives to apply.

Salary starting at $27.75 / hour

Salary up to $30.19 / hour

Title: Lead Visitation Supervisor

Location: Mount Vernon United States

Job Description:

Job Type

Full-time

At Caritas we believe every life deserves LOVE! If you agree, then please consider joining our team!! Caritas Family Solutions is seeking a talented leader to serve as our Lead Visitation Supervisor. This important position is perfect for strong professionals with proven supervisory skills, and a passion for helping children. As a visitation supervisor, you'll have an AMAZING support team behind you, and be able to end every workday knowing you made a positive impact in the lives of your staff and the children you serve! If you're ready to make a difference, please apply today!!

At Caritas, we know we're competing with other employers for your services, and we want to win! It is our goal to offer competitive compensation and affordable benefits to all eligible employees. Caritas currently offers the following benefits to full-time employees:

• 403 B Retirement Plan (5% Employer Match)
• Generous Paid Time Off
• Health, Dental and Vision Insurance Coverage
• 12 Employer Paid State & Federal Holidays
• Telehealth Services
• Employer Paid Life Insurance
• Health Saving Account
• Employer Paid Short- & Long-Term Disability
• Tuition Assistance Program
• Real Work/Life Balance

Remote Work: Allowed (work arrangement can change depending on performance and/or needs of Caritas).

Description of Typical Work Schedule: M-F, 8:30-5:00; Schedule can vary as they may be required to work evenings and weekends on occasion (Hours set based on necessity of department or office.)

PURPOSE: The Lead Visitation Supervisor directly supervises the Foster Care Case Assistants and is responsible for the overall management of the Case Assistant team, foster care related visits, addressing personnel issues with case assistants, and responsible for the upkeep of the visiting areas. This position is designed to enhance permanency through acting as a liaison with foster care case managers and engaging families in visitations to enhance reunification efforts. This position reports to the Assistant Program Director.

REPORTING STRUCTURE: Refer to the updated organizational chart for reporting structure and responsiblities.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• Interviews applicants, completes new hire onboarding, trains, and mentors new Case Assistants.
• Provides supervision to Foster Care Case Assistants
• Aids in resolution of any visitation discrepancies
• Ensures staff are trained in TBRI and utilizing TBRI techniques in their interactions with clients
• Monitors quality of parent child visits through observation, document reviews, client conversations, and/or any other means needed.
• Monitors staffing needs
• Provides consultation/supervision with supervisors regarding visitation needs, issues, or concerns.
• Ensures agency is meeting the DCFS minimum requirements for number of parent/child visits.
• Collaborates with case manager/supervisors/APD/other program staff on how to increase parent child visitation.
• Assists OFM in providing oversight regarding the use and maintenance of agency vehicles.
• Participates in additional safety training and serves as a trainer of such (i.e., Certified Car Seat Technician, CPR Instructor, etc.)
• Ensures all agency and/or Department paperwork is completed per policy & procedure

Requirements

QUALIFICATION REQUIREMENTS: To perform this job successfully, an inidual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE REQUIRED/PREFERRED

Degree/Field Required: Bachelor's Degree or 5 years child welfare experience, with some training or experience in human services, education, early childhood, or family services. (Related fields will be considered.)

Degree/Field Preferred: Bachelor's Degree or 5 years child welfare experience, with some training or experience in human services, education, early childhood, or family services. (Related fields will be considered.)

Additional Fields of Knowledge Important for the Role: Administration and Management - Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources. Administrative - Knowledge of administrative and office procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and workplace terminology. Psychology - Knowledge of human behavior and performance; inidual differences in ability, personality, and interests; learning and motivation; psychological research methods; and the assessment and treatment of behavioral and affective disorders. Sociology and Anthropology - Knowledge of group behavior and dynamics, societal trends and influences, human migrations, ethnicity, cultures, and their history and origins.

Experience Required: Minimum 5 years of child welfare experience is required with some training or experience in human services, education, early childhood, or family services. Experience with supervision and general understanding of foster care environment. (For positions that manage staff, the years specified need to be progressive years of management experience. For all positions, the years required can be interchanged with equivalent experience from an advanced degree related to this job and/or with other relevant experience verified by applicant/incumbent).

Licenses/Certifications Required: Child Passenger Safety (CPS) Technician within 6 months of employment and maintain certification at all times.

Licenses/Certifications Preferred: N/A

SKILLS REQUIRED

Manager-specific: Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to effectively present information to top management, public groups, and/or boards of directors.

Basic: Active Learning - Understand the implications of new information for both current and future problem-solving and decision-making. Active Listening - Give full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times. Critical Thinking - Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems. Learning Strategies - Select and using training/instructional methods and procedures appropriate for the situation when learning or teaching new things. Monitoring - Monitor/Assess performance of yourself, other iniduals, or organizations to make improvements or take corrective action. Reading Comprehension - Understand written sentences and paragraphs in work-related documents. Speaking - Talk to others to convey information effectively. Writing - Communicate effectively in writing as appropriate for the needs of the audience. Language - Able to read and write in English.

Social: Coordination - Adjust actions in relation to others' actions. Instructing - Teach others how to do something. Negotiation - Bring others together and trying to reconcile differences. Persuasion - Persuade others to change their minds or behavior. Service Orientation - Look for ways to help people. Social Perceptiveness - Be aware of others' reactions and understanding why they react as they do.

Problem Solving/Decision-making: Complex Problem Solving - Identify complex problems and review related information to develop and evaluate options and implement solutions. Time pressure decision-making - Make decisions without much analysis or time to consider alternatives. Time pressure planning - Plan and be responsible for regularly meeting strict deadlines. Judgment and Decision Making - Consider the relative costs and benefits of potential actions to choose the most appropriate one ensuring that decisions made have an impact on others, the image/reputation of Caritas, and/or the financial resources. Systems Analysis - Determine how a system should work and how changes in conditions, operations, and the environment will affect outcomes. Systems Evaluation - Identify measures or indicators of system performance and the actions needed to improve or correct performance, relative to the goals of the system.

Resource Management: Management of Financial Resources - Determine how money will be spent to get the work done, and accounting for these expenditures. Management of Material Resources - Obtain and see to the appropriate use of equipment, facilities, and materials needed to do certain work. Management of Personnel Resources - Motivate, develop, and direct people as they work, identifying the best people for the job. Personal Time Management - Manage one's own time and the time of others. Direct Report's Time Management - Manage the time of others.

Technical: N/A

Trauma-informed: Must display a willingness to adopt trauma informed interventions, principles, and practices as well as commitment to ongoing development of their capacity for application of trauma informed care. Realizes the prevalence of trauma among persons served by Caritas and the general population. Recognizes how trauma affects everyone involved-including clients, their families, staff, and community; and impacts behaviors. Responds to trauma by actively implementing the guiding principles of trauma informed care into their daily practice. Resists re-traumatization of persons served and staff providing services, by creating safe, welcoming, and supportive environments.

Proficient Computer Skills In: Outlook, Word, Database Management Software

Expert Computer Skills In: Outlook, Word, Database Management Software

MENTAL EFFORT/COGNITIVE ABILITIES REQUIRED: Concentration/intensity - Focus on higher order mental functions at average to high intensity when performing the majority of job tasks. Have limited opportunities for breaks. Deductive Reasoning - Apply general rules to specific problems to produce answers that make sense. Fluency of Ideas - Come up with a number of ideas about a topic (the number of ideas is important, not their quality, correctness, or creativity). Inductive Reasoning - Combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events). Information Ordering - Arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations). Memory - Remember information such as words, numbers, pictures, and procedures. Performance of job tasks rely on memorization of tasks or sequences of events. Consider amount and type of information. Number Facility - Add, subtract, multiply, or ide quickly and correctly. Oral Comprehension - Listen to and understand information and ideas presented through spoken words and sentences. Oral Expression - Communicate information and ideas in speaking so others will understand. Perceptual Speed - Quickly and accurately compare similarities and differences among sets of letters, numbers, objects, pictures, or patterns. The things to be compared may be presented at the same time or one after the other. This ability also includes comparing a presented object with a remembered object. Problem Sensitivity - Tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing that there is a problem. Selective Attention - Concentrate on a task over a period of time without being distracted. Speed of Closure - Quickly make sense of, combine, and organize information into meaningful patterns. Written Comprehension - Read and understand information and ideas presented in writing. Written Expression - Communicate information and ideas in writing so others will understand.

PHYSICAL REQUIREMENTS: Light work. Exert up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.

PHYSICAL ACTIVITIES REQUIRED: Reaching - Extend hand(s) and arm(s) in any direction. Fingering/Grasping - Pick, pinch, type or otherwise work, primarily with fingers rather than with the whole hand as in handling. Applying pressure to an object with the fingers and palm. Feeling - Perceive attributes of objects, such as size, shape, temperature or texture by touching with skin, particularly that of fingertips. Standing - Particularly for sustained periods of time. Walking - Move about on foot to accomplish tasks, particularly for long distances or moving from one work site to another. Sitting - Particularly for sustained periods of time. Speech Clarity/Talking - Express or exchange ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly. Includes the ability to understand the speech of another person. Hearing - Perceive the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound. Repetitive motion - Substantial movements (motions) of the wrists, hands, and/or fingers. Coordination, including eye/hand, hand/feet.

VISUAL ACUITY: The worker is required to have close visual acuity to perform an activity such as: analyzing data; transcribing; viewing a computer terminal; extensive reading; visual inspections; inspect machines.

WORK CONTEXT/ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions.

Subject to environmental conditions. Protection from weather conditions but not necessarily from temperature changes. Subject to noise - There is sufficient noise to cause the worker to shout in order to be heard above ambient noise level.

Other PPE Required: N/A

VEHICLE RELATED REQUIREMENTS:

Access to reliable transportation to get to/from work: Required.

Access to a reliable automobile: Required.

Must provide proof of auto liability insurance (and continue to while working in this position): Required.

Must possess a valid driver's license: Required.

Additional license requirements that are necessary: Child Passenger Safety Technician certification

Additional considerations for this position: N/A

Drug Free Workplace:

Caritas Family Solutions is dedicated to maintaining a safe, healthy, and productive environment for our clients and employees. As part of this, a strict drug-free workplace policy is maintained.

Salary Description

$45,000.00 Annual Salary

Insurance Billing Representative - Hybrid (must be located within commuting distance to Flagstaff)

Job Locations: US-AZ-Flagstaff

Days

Telecommute

Regular full-time

Overview

This is a hybrid position which requires some time onsite at Flagstaff Medical Center.  Applicants should be within commuting distance to Flagstaff.

Responsible for two aspects of billing, collection, credit, payments, and/or reconciliations. Billing responsibilities include manual re-bills as well as electronic submission to payers. Follow-up includes telephone calls to payers and/or patients, as well as accessing payer websites, and resolving complex accounts with minimal or no assistance necessary.

Responsibilities

Billing

• Demonstrates knowledge of editing and submitting claims to insurance clearing house by electronic or paper submission.
• Demonstrates knowledge of when to send a claim to the auditor or coder for corrections.
• Reviews and make corrections to rejected claims and resubmits to payers.
• Open communication on Updates-CPT codes and ICD-10 codes, as needed. Works with Billing Manager to maximize revenue potential based for services and providers.

Claim follow up

• Corrects, edits and manages denied claims through work queues, correspondence and emails: May consist of Invalid CPT, Invalid DX, Missing Modifier, Bill another Carrier, Invalid Eligibility, Authorization/Referral, Documentation Required or Other open tasks requiring intervention.
•  Enters encounter notes, regarding rejections and follow up activities performed to enable others to review claim history on all encounters.
• Performs account adjustments or write-offs as needed in accordance with the 'Write-Off' policy.
• Handles internal communications with the health centers related to insurance billing and collections.
• Requests medical records from health centers as requested by the contracted insurance plans.
• Corresponds with and assists vendors involved with patient accounts.

Compliance/Safety

• Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.
• Maintains confidentiality of all department, patient, and billing matters.
• Completes all company mandatory modules and required job specific training in the specified time frame.
• Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility.

Qualifications

Education

Experience

• Medical Insurance Billing/Collections- Preferred
• Medical/Hospital Billing- Preferred
• Knowledge UB04- Preferred
• Knowledge of Explanation of Benefits (EOB)- Preferred
• Healthcare is a rapidly changing environment and technology is integrated into almost all aspects of patient care. Computers and other electronic devices are utilized across the organization and throughout each department. Colleagues must have an understanding of computers, and competence in using computers and basic software programs.

Title: Sr. Engineer, Quality and Metrology

Location: Exton United States

Job Description:

This is a hybrid position requiring the team member to be onsite a minimum of 3 days per week in Exton, PA. No relocation is provided for this opportunity.

Who We Are:

At West, we're a dedicated team that is connected by a purpose to improve patient lives that has been at the center of our Company for more than a century. Our story began when Herman O. West solved the problem of supplying penicillin in mass quantities to the US Government during World War 2. Through our work to deliver thousands of life-saving and life-enhancing injectable medicines to millions of patients daily, West's indelible mark on the healthcare industry has just begun. A name started our story. How will yours help write our future?

There's no better place to join an inclusive community of professionals with opportunities for lifelong learning, growth and development. Supported by benefit programs, we empower the physical, mental, emotional and financial health of our team members and their families.

We believe in giving back to help those in need in the communities where we live and work. And are equally committed to creating a healthier environment and planet through our sustainability efforts.

Job Summary

• In this role, you will liaise with manufacturing facilities, customers, and suppliers on new and existing metrology & quality projects.
• Plan, schedule, execute, & communicate metrology & quality projects.
• Contribute or lead workstreams allocated to Quality or dimensional measurement system development for customer focused initiatives associated with new product development or optimization of existing product.
• Participate in steering committees which originate from both corporate and manufacturing facilities.
• Conduct data trend analysis to identify short and long-range patterns to affect continuous improvement.
• Support improvement activities by evaluating products, processes, and materials to develop control or improvement strategies intended to improve the customer's experience.
• Support the training of metrology operators.

Essential Duties and Responsibilities

• Collaborate with cross-functional teams to coordinate project execution and ensure that project objectives and success criteria are met.
• Provide Quality Engineering direction to multiple concurrent product development programs to ensure product and process compliance to all applicable regulatory and cGMP requirements, including ensuring all relevant safety procedures are employed.
• Meet company and departmental goals in the continuous improvement of all products, services and processes, including the West QMS.
• May support quality assurance improvement activities by evaluating products, processes, and materials in order to develop control or improvement strategies intended to improve the customer's experience.
• Lead the identification and development of innovative solutions to measure product dimensions in accordance with product drawings.
• Work independently and with project teams to develop design control deliverables including quality plans, manufacturing & inspection documentation, test methods, and necessary records for compiling design history file.
• Liaise with customers and suppliers on new and existing metrology & quality projects.
• Chair customer meetings reviewing measurement processes, data analysis, and inspection reports.
• Contribute to or lead workstreams for quality and dimensional measurement system development for customer focused initiatives associated with new product development or optimization of existing processes.
• Support improvement activities by evaluating products, processes, and materials to develop control or improvement strategies intended to improve the customer's experience.
• Work with interdisciplinary teams to perform root cause analysis and implement corrective and preventive actions.
• Conduct data trend analysis to identify short and long-range patterns to support continuous improvement and satisfy customer requirements.
• Provide quality reports and review data trends as needed.
• Design and perform DOE's (Design of Experiments) to improve and optimize new and existing processes, work instructions, and job protocols.
• Lead & support the training of operators.
• Meet company and departmental goals in the continuous improvement of products, services, and processes.
• Abide by all regulations, policies, work procedures, instruction, and safety rules.
• Drive a culture of continuous improvement and lean operations.
• Author protocols, procedures, work instructions, and other quality & process documentation.
• Other duties as assigned.

Education

• BS degree preferably in a technical discipline such as Engineering, Chemistry, Physics, etc or equivalent work experience.

Work Experience

• Proficiency in standard project management tools and software (e.g. Microsoft Project, Excel) for planning, tracking, and reporting project activities, and proficient in statistical software, Windows OS, Microsoft Office Suite including Word, Excel, and Power Point.
• Minimum 3years of experience in applied field.

Preferred Knowledge, Skills and Abilities

• Experience with MasterControl, SAP, Share Point.
• LSS Green Belt or Black Belt.
• Quality\Certified Quality Technician-ASQ (CQE or CQA) .
• Graduate Degree (MS).
• Knowledge of ISO/ASME GD&T requirements, interpreting 2D engineering drawings and 3D models.
• Proven experience of Measurement System Analysis (MSA) development, Minitab, and statistical packages.
• Strong problem solving and critical thinking skills to troubleshoot issues and identify root cause.

Travel Requirements

20%: Up to 52 business days per year

Physical Requirements

Light-Exerting up to 20lbs/9kg of force frequently, and/or negligible amount of force frequently constantly to move objects.

Additional Requirements

• Be aware of all relevant SOPs as per Company policy as they relate to this role
• Able to comply with the company's safety and quality policies at all time

#LI-DJ1 #LI-HYBRID

West embraces ersity and equality of opportunity. We foster an environment where all iniduals are safe, treated fairly, valued and respected. We do not discriminate on the basis of race, religion, color, national origin, gender, sex, gender identity, sexual orientation, age, marital status, veteran status, disability status or other applicable legally protected characteristics. Where permitted by law, employment with West Pharmaceutical Services, Inc. or any of its subsidiary or affiliate companies, is contingent upon the satisfactory completion of post-offer background screening and/or drug screening.

Title: Registered Nurse, Care Manager

Location: Dallas United States

Job Description:

Premise's mission is to help people get, stay, and be well. We hope you will join us in our mission and experience why amazing health starts with amazing healthcare. For more information, visit www.jobs.premisehealth.com.

As a Full Time Registered Nurse, Care Manager, you'll provide care to AT&T employees in the Premise Health Center located in Dallas, TX.

Join Our Team - Achieve True Work/Life Balance!

Schedule: Full-Time | Hybrid Option Available

Hours: Monday-Thursday 8:00 AM-5:30 PM | Friday 8:00 AM-1:00 PM

• Excellent Work/Life Balance with early Fridays and hybrid work options

• Competitive Pay

• Outstanding Benefits including: Comprehensive Health Coverage, Generous PTO, Robust Retirement Plan

• Supportive Environment with the tools and resources you need to succeed

If you're passionate about helping others live healthier lives and want to work in a supportive, flexible environment - we'd love to hear from you!

What You'll Do

• Develops personalized treatment plans using provider care plans and member preferences using a coach approach and the pillars of Lifestyle Medicine
• Supports a proactive, multidisciplinary team approach directed toward prevention, education and health promotion
• Establishes supportive relationship with members
• Assesses member's educational/clinical/social needs, prioritizing care based on elicited information from the member, Epic, and data analysis
• Acts as resource for members
• Documents touchpoints and progress into the electronic medical record
• Collaborates with the full scope of clinical team members to arrange for further medical treatment when needed
• Provides support and tools needed to help members take control of their health
• Delivers exceptional member experiences and engaging members in their healthcare journeys
• Improves health outcomes and better management of any chronic condition
• Lowers healthcare costs while improving outcomes
• Consults with other members of the healthcare team to solve problems and seek advice
• Works closely with client's vendors as appropriate to support member's needs where appropriate
• Identifies emergency situations and provides care within legal scope of practice
• Maintains member privacy and confidential member information
• Participates in outreach/follow-up phone calls and follow-up member visits
• Provides condition specific self-care education to client employee enrolled in the various condition management programs
• Serves as member advocate
• Acts as facilitator of Care Team meetings.
• Coaches effectively virtually using video and phone
• Collaborates with health center staff to coordinate and promote health and wellness programs
• May require other duties as assigned
• What You'll Bring
• Currently licensed Registered Nurse in state of practice
• Current certification AHA or ARC Basic Life Support for health care providers
• Bachelor's degree (BSN) from four-year college or university (preferred)
• At least three years' experience as a Registered Nurse caring for members with any of the following conditions: Type 2 diabetes, asthma, heart disease, heart failure or hypertension.
• Experience in Condition Management, Certificate in Case Management, Care Coordination, Certified Diabetes Educator (CDE) Certified Diabetes Care and Education Specialist (CDCES) a plus

Work-life balance is at the foundation of how decisions are made and where Premise is headed. We can only help people get, stay, and be well if we do the same for ourselves. In addition to competitive pay, Premise offers full-time team members benefits including medical, dental, vision, life and disability insurance, a 401(k) program with company match, paid holidays and vacation time, a company-sponsored wellness program, EAP, access to virtual primary care and virtual behavioral health at no cost for team members and their dependents. Additional benefits can be viewed here: https://jobs.premisehealth.com/benefits.

Premise is an equal opportunity employer; we value inclusion and do not discriminate based on race, color, religion, creed, national origin or ancestry, ethnicity, sex (including pregnancy and related conditions), gender identity or expression, sexual orientation, age, physical or mental disability, genetic information, past, current or prospective service in the uniformed services, or any other characteristic protected under applicable federal, state, or local law.

Care Manager

Location: Schenectady, NY, United States

Hybrid

Job Description:

Overview

As a Care Design New York Care Manager, you will help people with intellectual and/or development disabilities identify and realize their long-term and short-term goals by developing, implementing, and monitoring their person-centered Life Plans. These plans help our members live their best life - so we'll count on your best relational and organizational skills. Our Care Managers may come from different walks of life, but all receive the best training in the profession. You will plug your passion for service into our model of care to deliver the highest standard of service to our members.

This dynamic position is performed in a hybrid environment that includes required visits with members you support and their families in their home, attending periodic trainings and meetings in the office, and working from home. If you support our members outside of New York City, you will need a driver's license, reliable transportation and appropriate insurance.

Our membership is erse and so is our workforce. We welcome bilingual candidates who can support that ersity and we may provide ADDITIONAL COMPENSATION for fluency in English and languages such as Spanish, Korean, Mandarin, Cantonese, Russian, Hindi, Bengali, Urdu, Yiddish, Hebrew, and ASL.

All full-time positions come with generous benefits including: health, vision and dental insurance, paid time off, $3000 tuition reimbursement per calendar year, and up to $250 of professional development courses! CDNY is also a qualifying employer under the Public Service Loan Forgiveness (PSLF) program.

Responsibilities

• Responsible for advocating for and with our members to ensure informed decision making, informed consent, and appropriate guardianship.
• Responsible for scheduling, leading and actively collaborating with our members and their interdisciplinary team to conduct meetings and assessments ensuring the development of a comprehensive, person-centered Life Plan that reflects the person's needs and desired life goals.
• Implement, update, and monitor Life Plans and facilitate inidualized Life Plan reviews and approval processes.
• Ensure integration of all needed and preferred supports and services (i.e., medical, behavioral, social, habilitation, dental, psychosocial, and community-based, and facility-based long-term supports and services, etc.).
• Maintain ongoing contact with the critical people in a member's life.
• Ensure timely submission of all documentation (Life Plan, Progress notes, etc.)
• Assist our members with maintaining benefits such as Social Security, Supplemental Security Income, Medicaid and Medicare coverage, and Food Stamps.
• Assist members to resolve problems in living such as housing, utilities, the judicial system, and general safety.
• Report abuse or neglect immediately when observed or reported.
• A comprehensive job description may be provided during the interview process

Qualifications

Care Managers who serve iniduals with I/DD must meet the following qualifications:

• A Bachelor's degree with 2+ years of relevant experience, OR

• A License as a Registered Nurse with 2+ years of relevant experience, which can include any employment experience and is not limited to case management/service coordination duties, OR

• A Master's degree with 1+ year of relevant experience.

• Strong communication skills, including verbal and written communication skills, along with strong interpersonal and organizational skills also required.

• Excellent organizational, interpersonal, and verbal and written communication skills required.

Care Design NY and Partnership Solutions provide equal employment opportunities to all. We celebrate the qualities that make each of us unique and greatly value how they enrich the work we do. As such, we welcome candidates of color, candidates who identify as gender erse, neuroerse candidates, and candidates of all ages with erse lived experiences and perspectives to apply.

Salary starting at $23.75 / hour

Salary up to $26.07 / hour

Title: Senior Director, TTR Global Marketing

Location: United States

Job Description:

Overview

We are seeking a visionary Global Senior Director to continue the momentum for the global launch of our flagship AMVUTTRA brand in a highly competitive ATTR-CM market. This critical role will refine our global positioning strategy as we aspire to strengthen our leadership in this growing and dynamic category both in the short and long term.

This role reports to VP, AMVUTTRA Global Brand Lead and is a hybrid role based in Cambridge, MA, with 2-3 days/week onsite.

Key Responsibilities

• Lead the evolution of AMVUTTRA global brand positioning to drive significant business growth in a highly competitive market.
• Identify emerging trends, customer needs, and competitive opportunities to inform and shape the evolving brand strategy.
• Lead end to end creation of updated HCP campaign, from insight generation to creative execution and launch.
• Define, track, and communicate attitudinal and behavioral metrics associated with brand positioning and brand performance across markets, in partnership with analytics teams
• Partner closely with markets to ensure programs meet the needs of all markets - in particular the US
• Ensure campaign(s) adhere to global regulatory and ethical standards.
• Understand and proactively monitor competitive environment (current and future) to predict impact and develop proactive data-driven response plans.
• Lead collaboration with key stakeholders to proactively monitor competitor activity (including new data) and market trends
• Lead the cross functional team that synthesizes and drive strategic application of competitor insights to shape brand strategies, influence tactical execution, and maintain a competitive edge
• Synthesize competitive information into clear, actionable insights for commercial, medical, market access, and leadership teams.
• Drive proactive planning of TTR Franchise actions in preparation for/response to competitor activity.
• Partner effectively and appropriately manages Agency of Record and/or other external partners.

Qualifications

• BS/BA degree with over 15 years of pharmaceuticals experience.
• Global and US brand marketing experience is essential, including proven successes in launch and in-line brand management in highly competitive environments.
• Exceptional strategic planning, analytical and communication skills
• Demonstrable ability to work collaboratively in a dynamic and high-pressure environment.
• Strong cross-functional leadership skills, and the ability to navigate business challenges.
• Deep experience of building ambitious brand positioning based on customer insights.
• Proven record of leadership. Demonstrated impact leading matrixed teams with high level of accountability and engagement.
• Ability to foster a culture of innovation, accountability and performance in cross functional global teams.
• Data and insight driven - proven ability to use market research, segmentation, and analytics to guide creative development as well as measure impact of activities.
• Deep understanding of HCP behaviors, evidence-based marketing, and regulatory-compliant promotion
• Proven ability to develop integrated campaigns from concept to execution.
• Able to align and inspire cross-functional teams and markets around a shared strategy.
• Strong strategic thinking skills, ability to take learnings and competitive insights and synthesize into clear implications and actions.
• Clinical acumen (ideally commercial development or research experience) to drive brand and category leadership in partnership with medical affairs.
• Proven ability to pivot quickly in response to clinical data shifts, competitive threats, or market events - anticipate problems/opportunities and have a plan.

U.S. Pay Range

$239,700.00 - $324,300.00

The pay range reflects the full-time base salary range we expect to pay for this role at the time of posting. Base pay will be determined based on a number of factors including, but not limited to, relevant experience, skills, and education. This role is eligible for an annual short-term incentive award (e.g., bonus or sales incentive) and an annual long-term incentive award (e.g., equity).

Alnylam's robust Total Rewards package is designed to support your overall health and well-being. We offer comprehensive benefits including medical, dental, and vision coverage, life and disability insurance, a lifestyle reimbursement program, flexible spending and health savings accounts and a 401(k)with a generous company match. Eligible employees enjoy paid time off, wellness days, holidays, and two company-wide recharge breaks. We also offer generous family resources and leave. Our commitment to your well-being reflects our belief that caring for our people fuels the impact we create together.

Learn more about these and additional benefits offered by Alnylam by visiting the Benefits section of the Careers website: https://www.alnylam.com/careers

About Alnylam

We are the leader in RNAi therapeutics - a revolutionary approach with the potential to transform the lives of people with rare and common diseases. Built on Nobel Prize-winning science, Alnylam has delivered the breakthroughs that made RNAi therapeutics possible and are just at the beginning of what's possible. Our deep pipeline, late-stage programs, and bold vision reflect our core values: fierce innovation, passion for excellence, purposeful urgency, open culture and commitment to people. We're proud to be a globally recognized top employer, where an authentic, inclusive culture and breakthrough thinking fuel one another.

At Alnylam, we commit to an inclusive recruitment process and equal employment opportunity. Qualified applicants will receive consideration for employment without regard to their sex, gender or gender identity, sexual orientation, race, color, ethnicity, national origin, ancestry, citizenship, religion, creed, physical or mental disability, pregnancy status or related conditions, genetic information, veteran or military status, marital or familial status, political affiliation, age, or any other factor protected by federal, state, or local law. Alnylam is an E-Verify Employer.

Title: Quality Document Systems Management Engineer

Location: Durham United States

Job Description:

Job Description Summary

We have an immediate opening for a highly motivated, results-focused professional to join our team as a Quality Document Systems Management Specialist. The primary responsibilities are to verify template versions and required approvers for Design Control DHF Releases, lead monitoring of ECO workflows, manage the end-to-end change lifecycle, and drive continuous improvements to the quality and efficiency of the change management process. The position also serves as QMS Tool Administrator for Confluence, ARAS, and supports system verification.

Job Description

We are the makers of possible

BD is one of the largest global medical technology companies in the world. Advancing the world of health is our Purpose, and it's no small feat. It takes the imagination and passion of all of us-from design and engineering to the manufacturing and marketing of our billions of MedTech products per year-to look at the impossible and find transformative solutions that turn dreams into possibilities.

We believe that the human element, across our global teams, is what allows us to continually evolve. Join us and discover an environment in which you'll be supported to learn, grow and become your best self. Become a maker of possible with us.

The Quality Document Systems Management Engineer/Specialist is a key member of the Quality organization and is responsible for technical oversight and continuous improvement of document and change management processes within the Quality Management System (QMS). This position ensures that document control, change management, and system administration principles are applied to new and sustaining quality processes. The role supports broader QMS activities including compliance, audit readiness, and process optimization.

Responsibilities:

• Quality Leadership: Take ownership of all quality dimensions within our document control ecosystem-from strategic quality planning to meticulous validation of documentation and proactive risk management.
• Compliance Navigator: Serve as the go-to expert for teams seeking clarity on our quality system, with specialized knowledge in document controls and change management processes.
• Documentation Guardian: Apply your keen eye for detail when reviewing document artifacts, ensuring they not only align with QMS standards but also follow impeccable documentation practices before final release.
• Strategic Partner: Collaborate closely with program and project managers to ensure timely delivery of document deliverables that support both core team initiatives and sustaining activities.
• Relationship Builder: Actively engage with multi-functional partners to build consensus and resolve complex issues efficiently-before they become problems.
• Audit Readiness Champion: Maintain complete, visible document technical files and change histories that can withstand the most rigorous audits.
• Innovation Catalyst: Lead continuous improvement initiatives by facilitating, directing, and collaborating with erse teams across the organization.
• Data Storyteller: Generate insightful reports using QMS applications and tools that transform document and change control data into actionable intelligence.
• Change Orchestrator: Oversee the day-to-day management of Engineering Change Orders (ECOs) and implementation tasks with precision and foresight.
• System Guardian: Serve as QMS Tool Administrator for critical platforms like Confluence and ARAS, while ensuring ongoing system integrity verification.
• Knowledge Mastery: Demonstrate comprehensive understanding of document control and change management policies, principles, and industry standards.
• Regulatory Expertise: Apply in-depth knowledge of applicable regulatory requirements and international standards for document and change control with minimal supervision.
• Quality Attitude: Leverage your sophisticated understanding of quality concepts throughout the entire document management lifecycle.
• Risk Management: Proactively identify potential risks, collaborate with program teams to document them, and develop robust mitigation strategies that protect organizational interests.

Required Qualifications:

• Bachelor's degree in a relevant degree field (engineering, quality, or related).
• 8 years' experience with emphasis on document control, change management, and QMS administration.

At BD, we prioritize on-site collaboration because we believe it fosters creativity, innovation, and effective problem-solving, which are essential in the fast-paced healthcare industry. For most roles, we require a minimum of 4 days of in-office presence per week to maintain our culture of excellence and ensure smooth operations, while also recognizing the importance of flexibility and work-life balance. Remote or field-based positions will have different workplace arrangements which will be indicated in the job posting.

For certain roles at BD, employment is contingent upon the Company's receipt of sufficient proof that you are fully vaccinated against COVID-19. In some locations, testing for COVID-19 may be available and/or required. Consistent with BD's Workplace Accommodations Policy, requests for accommodation will be considered pursuant to applicable law.

Why Join Us?

A career at BD means being part of a team that values your opinions and contributions and that encourages you to bring your authentic self to work. It's also a place where we help each other be great, we do what's right, we hold each other accountable, and learn and improve every day.

To find purpose in the possibilities, we need people who can see the bigger picture, who understand the human story that underpins everything we do. We welcome people with the imagination and drive to help us reinvent the future of health. At BD, you'll discover a culture in which you can learn, grow, and thrive. And find satisfaction in doing your part to make the world a better place.

To learn more about BD visit https://bd.com/careers

Becton, Dickinson, and Company is an Equal Opportunity Employer. We evaluate applicants without regard to race, color, religion, age, sex, creed, national origin, ancestry, citizenship status, marital or domestic or civil union status, familial status, affectional or sexual orientation, gender identity or expression, genetics, disability, military eligibility or veteran status, and other legally-protected characteristics.

Required Skills

Optional Skills

.

Primary Work Location

USA NC - Durham - Roche Drive

Additional Locations

Work Shift

Title: Senior Medicare Coverage Analyst

Location: Lexington United States

Job Description:

Job Summary

Shape the Future of Clinical Research Administration at the University of Kentucky

Wildcat Wisdom, Kentucky Innovation - Supporting Discoveries, Transforming Outcomes!

Why Join Us?

The University of Kentucky's Clinical Research Support Office (CRSO) is seeking a dedicated and skilled Medicare Coverage Analyst Sr (Clinical Trials Coverage Analyst Sr). This vital role supports and enables groundbreaking clinical research across the University.

About the Role:

This position is eligible to be fully remote.

This position performs detailed reviews of complex study protocols, budgets, informed consent forms, contracts, FDA documents, and other relevant study documents to determine qualifying status according to Medicare Clinical Trial Policy, and conducts a comprehensive coverage analysis for all applicable study protocols across the enterprise. It determines what items of service are billable after reviewing Medicare Benefits Policy, relevant National Coverage Decisions (NCDs), Local Coverage Decisions (LCDs), Code of Federal Regulations, state law, professional practice guidelines, and, when necessary, consulting with the Medicare Administrative Contractor (MAC) for the region. This role is responsible for developing and delivering professional coverage analysis and financial calendars where the coverage analysis is not applicable, according to national patient care services billing standards. The position will provide guidance to study teams about proper coding and billing for procedures in the Epic system within the context of clinical research and based on the state and national standards. The role is responsible for following the UK established policies for patient care services, including documentation in the medical record and documenting coverage analysis justifications.

Under the direct supervision of the Director of Clinical Research Administration and Billing Integrity, the Research Coverage Analyst helps develop and refine processes to integrate the coverage analysis workflow with UKHC and UK related processes and teams. The role performs its work collaboratively with investigators, study teams, clinical research coordinators, and other research staff while serving as a resource on coverage analysis as an integral component to maintaining proper billing integrity and compliant standards. This role will also cross-train on clinical trial budget development and charge review process.

The University of Kentucky uses equivalencies in determining if a potential applicant meets the minimum education and experience. Related experience can be substituted for education. Click here for more information about equivalencies: http://www.uky.edu/hr/employment/working-uk/equivalencies

Why Clinical Research Professionals Choose University of Kentucky

• Top 10% of Academic Medical Centers Nationwide: Recognized as a leader in research excellence and innovation.
• Forbes' Best Large Employers: Ranked among the Top 100 Employers Nationwide in 2024 and named one of Kentucky's Best Employers on Forbes' America's Best-In-State Employers list.
• 1 of 34 Universities Nationwide: Holds the prestigious trifecta of research designations in cancer, aging, and translational science.
• Flexible Remote Work Options: Enjoy the convenience of fully remote or hybrid roles while supporting groundbreaking research.
• Professional Development Opportunities: Engage in interdisciplinary collaborations, virtual conferences, and training programs to advance your career.

Want to learn more about the Department?

The Clinical Research Support Office (CRSO) provides support to investigators and study teams conducting clinical research, including clinical trials. Services provided by the CRSO include maintaining a clinical trial management system (CTMS), conducting coverage analysis, developing study budgets, negotiating payment terms with sponsors, and regulatory services. More information can be found at: https://research.uky.edu/clinical-research-support-office.

Interested in what UK Benefits have to offer?

The University of Kentucky is proud to offer a benefits package that helps us recruit and retain the very best faculty and staff. In addition to your take-home pay, your benefits package is a major component of your total compensation at UK. These benefits include our 200 percent match on eligible retirement contributions; competitive health, dental, and vision coverage; tuition benefits for classes at UK, and much more. To learn more about these benefits, please visit: https://hr.uky.edu/employment/our-benefits.

Ready to Make a Difference in Clinical Research Administration?

Are you ready to take the next step in advancing clinical research and innovation? Join us in UK's Clinical Research Support Office as the next dedicated Medicare Coverage Analyst Sr (Clinical Trials Coverage Analyst Sr) and play a pivotal role in supporting groundbreaking projects that shape the future.

Driving Clinical Research Excellence - Apply Today!

Skills / Knowledge / Abilities

Clinical Trial Protocol knowledge, medical coding or billing, medical terminology, attention to detail, ability to work independently, collaboration, strong competency in Microsoft Office programs, detailed understanding of the Epic billing system, proficient in OnCore MCA and Calendar consoles

Does this position have supervisory responsibilities? No Preferred Education/Experience

It is preferred that the candidate have work experience in a clinical setting that includes research coverage analysis, clinical research budgeting, clinical research management, and/or medical coding or billing. Candidates with coding knowledge in specific disease areas including oncology, cardiology, neurology, etc. are preferred.

CA certification or training in OnCore, Epic or coding is also preferred.

We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco & Drug Free campus.

The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status.

Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Title: EHR Applications Analyst 3

Location: US

Job type: Remote

Job Description:

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

The EHR Applications Analyst 3 is responsible for delivering world-class support services across all Beth Israel Lahey Health, Inc. (BILH) entities and its affiliates. The EHR Applications Analyst 3 is responsible for identifying, evaluating, analyzing, and recommending changes in support of assigned applications/systems including ongoing production maintenance and trouble-shooting. Supports the planning, design, development, build, and/or configuration of assigned applications/systems. Leads and/or coordinates conversions, application/system testing, and documentation of system procedures. Participates and provides input in training design and development and assists in training execution in relation to assigned projects. Provides go-live support and serves as the primary point of contact for ongoing maintenance/support and troubleshooting

Job Description:

Essential Duties & Responsibilities including but not limited to: 

Competencies:

Minimum Qualifications: 

• Two (2) years of experience implementing, designing, and/or managing a variety of EHR and clinical systems using multiple software programs and network applications.
• Experience working in a clinical setting.
•  Experience working with clinical information systems or system implementation teams for complex projects and/or application development.
• Experience in full implementation software development cycle.
• Experience managing small projects with defined duration and scope.

Skills, Knowledge & Abilities:    

• Ability to multi-task- Self-starter and motivator
• Excellent problem-solving and written and oral communication skills
• Candidate will have a proven track record of producing quality deliverables on time, taking ownership and accountability of assignments, and demonstrating a strong work ethic
• Willingness to address issues and take ownership, knowing when and how to escalate issues. Ability to understand and document business processes
• Creative approach to process redesign
• Proficient in Microsoft Office suite programs; specifically Excel and PowerPoint
• Knowledge of HL7 coding standards
• Knowledge of process redesig

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled

Title: Surgical Account Manager (Southern MD)

Location: Annapolis, Maryland, United States of America

District of Columbia, United States of America

Job Description:

At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You’ll lead with purpose, breaking down barriers to innovation in a more connected, compassionate world.

A Day in the Life

We are seeking a committed professional to join our team. While this is a remote position not located at a physical Medtronic site, the candidate hired will be required to reside within the territory and drive to multiple accounts throughout the region. A valid driver's license is essential for this role.

Careers that Change Lives

Bring your sales talents to a leader in medical technology and healthcare solutions.  Rooted in our long history of mission-driven innovation, our medical technologies open doors. We support your growth with the training, mentorship, and guidance you need to own your future success. Join us for a career in sales that changes lives.

A Day in the Life

The Surgical Account Manager will be responsible for driving surgeon demand across the full Surgical COT portfolio, including Stapling, Energy, Suture, Electrosurgery, Situate, and Access &Instrumentation. This role focuses on developing and executing strategic sales plans, identifying practice trends, and cultivating key customer relationships to drive market growth and adoption. The ideal candidate will work closely with clinical and administrative stakeholders to expand business opportunities, execute business reviews, and contribute to regional and national conversion efforts.

Job Responsibilities:

• Serve as the main point of contact across MDT account teams, including District Managers (DM), Sales Area Directors (SAD), Sales Operations Specialists (SOS), and teams specializing in GYN and Hernia portfolios.

• Lead the creation and execution of account-level contractual strategies.

• Optimize contracts and drive category expansion across Surgical.

• Own and execute quarterly Customer Business Reviews to evaluate performance and identify growth opportunities.

• Develop and maintain strong relationships with key economic and clinical stakeholders.

• Drive adoption and utilization of all Surgical Center of Technology (COT) products, including:

• Stapling

• Energy

• Wound Closure

• Electrosurgery

• Situate

• Access & Instrumentation (A&I)

• Cultivate and strengthen relationships with field distribution partners.

• Maximize partnership programs and leverage account intelligence to increase market share.

Key Performance Metrics:

• Achieve/exceed disposable quota (strategic & core).

• Achieve/exceed hardware quota.

• Expand contract categories.

• Improve opportunity management and forecasting accuracy.

Must Have: Minimum Requirements

• Bachelor’s degree

• Minimum of 2 years of sales experience

• Field-based role that requires 50% travel within the territory

Nice to Have

• Proven track record in sales within the medical device or healthcare industry, preferably in the surgical or related fields.

• Strong understanding of clinical environments and the ability to communicate complex product information to erse stakeholders.

• Experience in building and managing key customer relationships with decision-makers in both clinical and administrative roles.

• Ability to analyze business trends and use insights to develop actionable strategies.

• Excellent organizational and time-management skills.

• Strong communication and interpersonal skills.

• Ability to work independently and collaboratively within a team environment.

• Proficiency with CRM software (e.g., SF.com) and Microsoft Office Suite.

Physical Job Requirements

The physical demands described within the Responsibilities section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions. 

• While performing the duties of this job, the employee is regularly required to be independently mobile.

• The employee is also required to interact with a computer and communicate with peers and co-workers via a variety of media including telephone, email, instant message and in-person

Contact your manager or local HR to understand the Work Conditions and Physical requirements that may be specific to each role. (ADA-United States of America)

#surgicalsales

Physical Job Requirements

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position, but they are not an exhaustive list of all the required responsibilities and skills of this position. 

The physical demands described within the Responsibilities section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions. For Office Roles: While performing the duties of this job, the employee is regularly required to be independently mobile. The employee is also required to interact with a computer, and communicate with peers and co-workers. Contact your manager or local HR to understand the Work Conditions and Physical requirements that may be specific to each role.

Benefits & Compensation

Medtronic offers a competitive Salary and flexible Benefits Package

Salary ranges for U.S (excl. PR) locations (USD):$75,000 - $75,000

The base salary range is applicable across the United States, excluding Puerto Rico and specific locations in California. The offered rate complies with federal and local regulations and may vary based on factors such as experience, certification/education, market conditions, and location. Compensation and benefits information pertains solely to candidates hired within the United States (local market compensation and benefits will apply for others).

In addition to Base Salary, this position is eligible for a Sales Incentive Plan (SIP), which provides the opportunity to earn significant incentive compensation for achieving or exceeding your goals.

The following benefits and additional compensation are available to those regular employees who work 20+ hours per week: Health, Dental and vision insurance,Health Savings Account,Healthcare Flexible Spending Account,Life insurance, Long-term disability leave,Dependent daycare spending account,Tuition assistance/reimbursement, andSimple Steps (global well-being program).

The following benefits and additional compensation are available to all regular employees:Incentive plans, 401(k) plan plus employer contribution and match,Short-term disability,Paid time off,Paid holidays,Employee Stock Purchase Plan,Employee Assistance Program,Non-qualified Retirement Plan Supplement (subject to IRS earning minimums), andCapital Accumulation Plan (available to Vice Presidents and above, or subject to IRS earning minimums).

Regular employees are those who are not temporary, such as interns.  Temporary employees are eligible for paid sick time, as required under applicable state law, and the Employee Stock Purchase Plan. Please note some of the above benefits may not apply to workers in Puerto Rico.

Further details are available at the link below:

Medtronic benefits and compensation plans

About Medtronic

We lead global healthcare technology and boldly attack the most challenging health problems facing humanity by searching out and finding solutions.

Learn more about our business, mission, and our commitment to ersity here.

It is the policy of Medtronic to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Medtronic will provide reasonable accommodations for qualified iniduals with disabilities.

If you are applying to perform work for Medtronic, Inc. (“Medtronic”) in any position which will involve performing at least two (2) hours of work on average each week within the unincorporated areas of Los Angeles County, you can find here a list of all material job duties of the specific job position which Medtronic reasonably believes that criminal history may have a direct, adverse and negative relationship potentially resulting in the withdrawal of a conditional offer of employment. Medtronic will consider for employment qualified job applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

Title: Senior Applications Scientist

Location: Remote-AZ

time type

Full time

job requisition id

R-5013

Onto Innovation is a leader in process control, combining global scale with an expanded portfolio of leading-edge technologies that include: 3D metrology spanning the chip from nanometer-scale transistors to micron-level die-interconnects; macro defect inspection of wafers and packages; metal interconnect composition; factory analytics; and lithography for advanced semiconductor packaging. Our breadth of offerings across the entire semiconductor value chain helps our customers solve their most difficult yield, device performance, quality, and reliability issues. Onto Innovation strives to optimize customers’ critical path of progress by making them smarter, faster and more efficient.

Job Summary & Responsibilities

Primary Purpose of the Role:

The purpose of this position is to support customers in the application and optimization of Onto Innovation’s Optical Critical Dimension (OCD) metrology solutions. This includes deploying OCD tools in advanced semiconductor manufacturing environments, troubleshooting process integration challenges, and driving adoption of new measurement capabilities. The role involves both on-site and remote support, including training customers to maximize the performance and value of OCD systems. The Applications Engineer/Scientist will also collaborate with account teams to provide technical insights and help expand business opportunities.

Responsibilities:

1. Deliver technical presentations and perform system demonstrations, including OCD recipe development and sample measurements.

2. Provide on-site and remote applications support for OCD tools, including process integration and metrology optimization.

3. Assist customers in solving complex process control problems using OCD techniques such as scatterometry and modeling.

4. Collaborate with the Applications Lab to design and execute customer test plans and benchmarking studies.

5. Interface with customers and internal teams to define tool specifications and measurement strategies.

6. Support final acceptance of new OCD tool installations and conduct comprehensive customer training.

7. Analyze and report results from experiments, including interpretation of OCD data and model fitting.

8. Contribute to the development of new OCD capabilities or enhancements to existing systems based on customer feedback.

9. Apply strong problem-solving skills to address metrology challenges and improve measurement accuracy and robustness.

10. Build strong relationships with customers and provide feedback to sales teams on emerging business opportunities.

11. Gather and share market intelligence to strengthen Onto Innovation’s competitive positioning in OCD metrology.

12. Travel up to 30% domestically and internationally to support cross-regional customer engagements.

Qualifications

1. Master’s or Ph.D. degree in Physics, Electrical Engineering, Materials Science, or a related field is preferred; relevant industry experience may be considered instead of a degree.

2. Ideally, 3+ years of hands-on experience with Optical Critical Dimension (OCD) metrology tools or related semiconductor process control technologies.

3. Strong written and verbal communication skills are essential for effective collaboration and customer interaction.

4. Ability to work independently with minimal supervision and proactively solve technical challenges.

5. Comfortable operating in a fast-paced, dynamic environment and collaborating across cross-functional teams.

Onto Innovation Inc. offers competitive salaries and a generous benefits package, including health/dental/vision/life/disability, PTO, 401K plan with employer match, and an Employee Stock Purchase Program (ESPP) along with health & wellness initiatives. We provide a collaborative working environment along with resources, and state-of-the-art tools & equipment to promote success; and a welcoming, inclusive corporate culture where iniduals are recognized for their contributions.

Onto Innovation Inc. is an Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, genetic information, age, disability, veteran status, or any other legally protected basis.

For positions requiring access to technical data, Onto Innovation Inc., Inc. may have to obtain export licensing approval from the U.S. Department of Commerce - Bureau of Industry and Security and/or the U.S. Department of State - Directorate of Defense Trade Controls. As such, applicants for this position – except US Citizens, US Permanent Residents, and protected iniduals as defined by 8 U.S.C. 1324b(a)(3) – may have to go through an export licensing review process.

Title: Employee Training Specialist - Hybrid

Location:

Remote

time type

Full time

Job Description:

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full.  Below, you’ll find other important information about this position. 

This position will be responsible for development, design of training programs, special projects, quality assurance, and compliance training. Administer proficiency tests. Involvement with testing and installation of system upgrades. This position will be responsible for conducting training classes, course development with appropriate materials, and coordination and planning of new and refresher training courses.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High School Diploma or equivalent.

EXPERIENCE:

1. Two (2) years’ experience in revenue cycle (patient financial services/patient access).  

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelors in Business, Education, or Health Care related field.

EXPERIENCE:

1. One (1) year experience in Training/Organizational Development or employee training activities.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Provides education and training for revenue cycle operations applications throughout the healthcare organization.

2. Demonstrates thorough knowledge of hospital scheduling and patient access systems, patient accounting, and quality monitors.

3. Maintains comprehensive knowledge of 3rd party billing requirements and reimbursement principles.

4. Coordinates and provides appropriate training of new employees and re-training for current employees to assure appropriate to assure appropriate revenue cycle processing and patient experience including patient registration, schedule management, insurance eligibility, and Point of Service Collections

5. Generates schedules and educational tracking records for on-going employee education.

6. Provides education to all staff responsible for patient access and patient accounting processing activities throughout the organization.

7. Ability to coordinate and schedule on-the-job training with employees and management staff along with new and refresher programs.

8. Delivers training using lecture, demonstration, case studies, simulation, practical experience, and other interactive methods.

9. Coordinates education and training sessions with skill assessments with ongoing quality and productivity monitoring.

10. Follows a training plan in coordination with a plan for testing system applications with IT.

11. Administers competency assessment and skills checklist.

12. Collaborates with Revenue Cycle Trainer in determining the continuing education and professional growth needs of staff

13. Utilizes appropriate training materials for education and team building techniques.

14. Participates in development of employee performance capabilities and provides input into the performance management process.

15. Routinely Monitors Quality and Productivity.

16. Participates in revenue cycle management quality audit and reports back findings and recommendations.

17. Routinely informs appropriate management of problems and concerns relating to staff training and or quality of work.

18. Participated in design of training curriculum and methods to improvement effectiveness.

19. Maintains current knowledge of performance improvement processes as it applies to healthcare.

20. Attends courses in PI activities, system design, technical training, statistical analysis and other appropriate health related educational courses.

21. Participates in meeting the objectives of the work unit and goals of the department.

22. Promotes and contributes positively to the teamwork of the department by assisting co-workers, contributing ideas and problem-solving with co-workers as observed by supervisor.

23. Participates in performance improvement through planning and implementing change and maintaining and improving productivity through attendance and participation in staff meetings, committees, tasks forces, cross-functional groups, projects and discussion with hospital and medical staff as observed by supervisor.

PHYSICAL REQUIREMENTS:  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements utilized in performing duties through the work shift.

2. Ability to stand for long periods of time.

3. Must be able to sit for extended periods of time.

4. Visual acuity must be within normal range.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions.

1. Office type environment.

SKILLS AND ABILITIES:

1. Good oral and written communication skills.

2. Ability to problem solve and make appropriate decisions. 

3. Demonstrated ability to produce course outlines and handout materials.

4. Ability to use personal computers including knowledge of Microsoft Office products.

5. Knowledge of adult learning principles and educational theory.

6. Must have an excellent working knowledge in all areas of the patient access positions and a solid understanding of their role in the entire revenue cycle.

Additional Job Description:

Travel to the Charleston, Princeton, Summersville WVU Medicine locations as needed.

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

545 SYSTEM Patient Access

Title: Senior Manager Public Programs and Quality

Location: Chicago Office

Pay or shift range: $81,159 USD to $101,448.75 USD

Department: Professional Affairs

Professional Affairs

Full-Time

Requisition #: SENIO001832

Job Description:

Who We Are: It all starts with purpose.

We are a purpose-driven nonprofit with a dynamic staff culture.

With a meaningful purpose, motivated staff, and excellent benefits, working here will definitely have you smiling! The ADA’s headquarters is located just steps from Chicago’s Magnificent Mile and close to public transportation. With more than 400 colleagues, the ADA Staff are some of the most talented people in the Chicago, Washington D.C., and Maryland area.

Job Responsibilities:

The Senior Manager Public Programs and Quality role will help plan, implement, and evaluate tools, or activities, policies, and products that touch upon access to care or Medicaid dental benefits. This inidual would lead any subgroups of relative Councils dedicated to public programs or access to care and identify strategic actions to advance Medicaid dental benefits. These activities include but are not limited to ADA policy analysis, quantitative and qualitative data analysis, providing technical assistance to internal and external oral health stakeholders, and supporting community oral health advocacy. This position will lead the Dental Quality Alliance (DQA) Measure Development and Maintenance Committee (MDMC) to conceptualize, test and develop evidence-based quality measures. The position with oversee the DQA’s consultants, author and review scientific test reports.

Must Have:

• Masters degree in public health, health policy administration, or a related field.
• 8 years of experience working in public health and/or community health and/or health care administration.
• Some experience in quality improvement/assurance in healthcare
• Knowledge of access to care issues and health disparities.
• Ability to perform policy and data analysis.
• Facilitation, presentation, collaboration, and prioritization skills
• Excellent analytical, planning and oral/written communication skills
• Effective public speaking and project management skills
• Proficiency in MS Office (365)
• Travel twice per year to conferences and meetings to present information on the ADA programs or DQA measurement development and implementation
• Position may require more than the standard number of hours of work within a workweek; Position may require before or after hours work; Position may require weekend work

Nice to Have:

• Experience working with governmental health agencies, community clinics or health centers, academic institutions or the private sector on projects on health disparities, improving access to care or quality measurement
• Previously engaged in multi-sector collaborations for population health improvement

Just a few of the benefits offered to employees:

• Promotes Work/Life Balance
• Hybrid Work Schedule (2-3 days from home)
• Health insurance/ dental reimbursement plan
• Ample Paid time off
• 401(k) 
• Pension
• Flexible Spending Account
• Life insurance
• Tuition reimbursement
• Paid Parental Leave
• Pet Insurance
• Student Loan Refinance
• 2 days off to work at a charity event of your choice

The ADA values a variety of backgrounds and experiences and is committed to providing equal employment opportunities to qualified job candidates. The ADA is an equal opportunity employer of protected veterans and iniduals with disabilities. All qualified applicants will receive consideration for employment in open positions without regard to race, ethnicity, gender, color, religion, sex, age, marital status, ancestry, citizenship, physical or mental disability, medical condition, veteran status or any other characteristic.

Title: Infant Feeding & Lactation Expert

Location: New York, NY (Hybrid Manhattan)

Job Description:

Who We Are

Good Inside is redefining parenting - not as something that should “just come naturally,” but as a skill to learn and practice. Founded by Dr. Becky Kennedy and Dr. Erica Belsky, we combine sturdy leadership with innovative technology to give parents personalized guidance, AI-powered support, and a global community.

Our mission: help parents raise resilient, confident kids in a changing world. We’ve already reached millions, and we’re just getting started.  We’re refining our product and expanding our reach to empower even more families.

We’re looking for bold, high-ownership problem-solvers who want to build something new, tackle big challenges, and be at the forefront of change.

The Opportunity

We’re looking for a leader who is clinically sharp and deeply human to expand how Good Inside supports expecting and new parents. In this role, you will work closely with our Founders as one of our first experts in the Baby category. You will help parents make feeding decisions that work for them - whether breastfeeding, formula, or both. You will go beyond “how-to” questions and support parents emotionally through the messy, identity-shifting experience of having a baby. Most importantly, you’ll help parents let go of the pressure to feed a certain way, and decouple parental identity with feeding decisions. 

The right fit is someone who lights up when helping parents, embraces an inclusive, non-judgmental approach, and feels energized by creating content that reaches families at scale. Much of your impact will come through video workshops and courses, where your warmth and expertise will help parents feel seen, understood, and never alone.

This is a part-time, remote role averaging 10–20 hours per week (minimum 10).

What You'll Own

• Serve as a trusted expert in infant feeding & lactation, supporting parents across all of Good Inside’s channels — membership, social, podcast, and beyond
• Build a best-in-class content library in your area of expertise, keeping it fresh by weaving in the latest research and parent feedback.
• Create engaging content for Gi Baby social channels and digital platforms.
• Host live events, workshops, and podcasts and represent Good Inside at select speaking engagements.
• Support member retention by creating regular touchpoints that help families feel consistently seen, understood, and supported.
• Explore longer-term opportunities, such as co-authored books, branded products, and other ways to grow together.

Who You Are

• Are an International Board Certified Lactation Consultant (IBCLC), with meaningful clinical experience. 
• Can take complicated information and make it usable, human, and emotionally accessible for parents.
• Feel natural and grounded on camera and in live settings.
• Don’t need to have a social following now — but are excited to grow one with our support.
• Can be located anywhere in the U.S. (with flexibility for monthly travel to New York). Based in or near New York is a plus.

What We Offer

• Compensation transparency.  This is an hourly position starting at $80/hour
• Hybrid work environment + Flexible schedule 
• A high-ownership, high-performance, high-collaboration culture

Equal Employment Opportunity

Good Inside is an equal opportunity employer and as such, we do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other characteristic protected by applicable laws.

We are dedicated to growing a erse team of highly talented people. As much as we believe in focusing on the parent behind the parenting and the child behind the behavior, we believe in focusing on the person behind the job. We’re dedicated to building a workplace where we give each other the strategies, support, and space we each need to thrive—believing in and bringing out the good inside of everyone..

If you require any accommodations during the recruitment process, whether it be alternate forms of material, accessible meeting rooms, etc., please let us know and we will work with you to meet your needs.

Title: Pro Fee Coder - Cardiology

Location: - USA

Job type:Remote

Job Description:

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE)

The Pro Fee Coder will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement. Coder I may validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals. The Coder I performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder I may interact with client staff and providers.

DUTIES AND RESPONSIBILITIES:

• Select and sequence ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Ancillary (Diagnostic)/ Recurring; Hospital, Clinic; Physician Pro Fee; Technical Fee or Evaluation and Management, any associated chart capturing with any patient type.
• Review and analyze facility records to ensure that APC assignments and/or Evaluation and Management codes accurately reflect the diagnoses/procedures documented in the clinical record.
• Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
• Complete assigned work functions utilizing appropriate resources.  May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
• Maintain strict patient and provider confidentiality in compliance with all HIPPA Guidelines.
• Participate in client and Savista staff meetings, trainings, and conference calls as requested and/or required.
• Maintain current working knowledge of ICD-10 and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.
• Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.

SKILLS AND QUALIFICATIONS:

• Candidates must successfully pass pre-employment skills assessment. Required:
• An active AHIMA (American Health Information Association) credential including but not limited to RHIA, RHIT, CCS, CCA, or an active AAPC (American Academy of Professional Coders) credentials COC (formerly CPC-H), CCS-P, or CPC or related specialty credential.
• Two years of recent and relevant hands-on coding experience
• Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD-10 and CPT/HCPCS code sets
• Ability to consistently code at 95% threshold for quality while maintaining client-specific and/or Savista production and/or quality standards
• Proficient computer knowledge including MS Office including the ability to enter data, sort and filter excel files, (Outlook, Word, Excel)
• Must display excellent interpersonal and problem-solving skills with all levels of internal and external customers

PREFFERED SKILLS:

• Recent and relevant experience in an active production coding environment strongly preferred
• Associates degree in HIM or healthcare-related field, or combination of equivalent education and experience
• Experience using Rcx, Cerner, Optum (a plus)

Note: Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $22.08 - $34.69 an hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.

SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

Title: Regional Director of Clinical Services - Behavioral Health Division

Job Description:

About Universal Health Services

One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

The Candidate that is chosen will support a large portfolio of facilities from our Behavioral Health Division nationwide.

This exciting position is critical to the clinical integrity and regulatory compliance of our facilities. As a corporate senior leader, you will support, train and consult your facilities' clinical and regulatory support teams and staff. We are seeking a clinical/nursing professional that is interested in sharing his/her expertise in a consultative manner to ensure the success of Behavioral Health Division. This is a hybrid opportunity that requires travel, as generally three weeks each month will be spent traveling to and supporting our facilities.

The successful Regional Director of Clinical Services will:

• Facilitate, coordinate and oversee Joint Commission/CARF accreditation processes, to ensure satisfactory completion, and to improve compliance.
• Assure that the facility is compliant with the regulations of all federal, state, local and other regulatory bodies with jurisdiction over its clinical activities.
• Assist in the development of Performance Improvement practices in facilities and maintenance of same including analysis of data and prioritization of efforts-HBIPS; Outcome Measures
• Set expectations, develops plans, and manages processes to measure, assess and improve the quality of clinical programs and/or regulatory/accreditation compliance by measurable results in assigned facilities.
• Seek methods to improve current facility practices/processes/clinical products by identifying problems and proposing solutions, as necessary to include program review and clinical systems review.
• Investigate, in collaboration with the hospital any quality concerns such as those received from state and federal agencies including the Corporate Compliance program. Prepare, in collaboration with appropriate disciplines, action plans and submits responses within designated time frame.
• Work collaboratively with corporate staff, physicians, risk management, and other corporate leaders to address performance improvement and safety issues.
• Ensure that JC Sentinel Event Alerts are addressed and changes implemented as necessary. Presents alert information in applicable committees.
• Act as a quality/clinical resource to the facilities, other Divisional staff, and the Corporate office.
• Coordinate efforts with Corporate Risk Management, Corporate Loss Control regarding implementation of Best Practices.
• Provide orientation and ongoing education/training for facility clinical and quality leadership as needed.
• Provide timely and thorough verbal and written feedback from site visits to facilities and appropriate Regional VPs/Group Directors and facility CEOs
• Maintain regular communication with clinical/leadership staff at assigned facilities regarding clinical and regulatory/accreditation issues.
• Provide oversight and coordination for assigned special projects

Total Benefits & Rewards for our Senior Leaders include:

• Paid Holidays
• Tuition savings to continue your nursing education with Chamberlain University
• In-house Psychiatric Nurse Residency Transition-to-Practice Orientation (20 CEUs)
• Career development opportunities across UHS and our 300+ locations!
• Diverse programming to expand your experience
• HealthStream online learning catalogue with plenty of free CEU courses
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• Pet Insurance
• SoFi Student Loan Refinancing Program
• More information is available on our Benefits Guest Website: uhsguest.com

If you would like to learn more before applying, please contact Scott Errickson, Divisional Director-Clinical Recruitment at (484) 584-2725, or via email at [email protected]

Qualifications

Requirements for this position include:

• Five to ten years of regulatory/accreditation experience in a free-standing mental health hospital setting, with a working knowledge of regulatory standards, team development, clinical services and quality tools (preferably healthcare) required.
• Licensed as a Registered Nurse, LCSW, LPC or related with Master's Degree in appropriate field of study.
• Knowledge of performance improvement principles including data analysis required.
• Knowledge of risk management principles required.
• Knowledge of psychiatric clinical programming required
• Experience with various treatment environments and regulations including inpatient, outpatient, and residential preferred
• Highly developed organizational, interpersonal, management and communication skills required.
• Strong skills in oral and written communication and proficiency in Microsoft Office is required.
• This position requires moderate national travel, typically Monday-Thursday three weeks/month.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of iniduals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Title: AR II Specialist - Hybrid Position

Location: Dallas United States

Job Description:

Full time

job requisition id

JR1000029136

Hours of Work :

40

Days Of Week :

Monday through Friday

Work Shift :

Job Description :

Your Job:

We are seeking an experienced Accounts Receivable II (AR II) Specialist specializing in Professional Billing to join our team at our Central Business Office (CBO) location. The ideal candidate will possess a strong background in A/R follow up for family and multi-specialty claims, able to identify, address, and resolve no response claims, denied claims, and correspondence. As an AR II Specialist, you will play a crucial role in optimizing revenue flow by effectively managing outstanding accounts receivable and ensuring timely reimbursement.

Your Job Requirements:

• High School Diploma required
• College degree preferred
• Two to four years of experience in healthcare revenue cycle management.
• Proficiency in medical billing software EPIC and electronic health record (EHR) systems.
• Strong knowledge of healthcare billing processes, medical terminology, CPT, ICD-10 coding, and billing regulations.
• Excellent analytical skills with the ability to identify patterns, trends, and discrepancies in claims.
• Effective communication and interpersonal skills, with the ability to interact professionally with internal and external stakeholders.
• Detail-oriented with a focus on accuracy and thoroughness in claim analysis, documentation, and reporting.
• Ability to prioritize tasks, meet deadlines, and work efficiently in a fast-paced environment.
• Certification in medical coding (e.g., CPC) or revenue cycle management (e.g., CRCR) is a plus.
• Position requires 6 months probationary period to be successfully completed before being approved to work from home. WFH schedule based on business needs.

Your Job Responsibilities:

• Analyze and review outstanding claims, focusing on those with no response or denials. Identify and rectify errors, discrepancies, and missing information to resubmit claims promptly and accurately.
• Investigate and address claim denials promptly. Utilize knowledge of payer policies, medical coding guidelines, and billing regulations to appeal denials and secure rightful reimbursement.
• Manage all incoming correspondence related to accounts receivable, including explanation of benefits (EOBs), remittance advice (RA), and other payer communications. Take necessary actions based on correspondence received, such as claim corrections, appeals, or adjustments.
• Conduct thorough follow-up on aging accounts receivable, prioritizing those with no response or denied claims. Utilize various communication channels to contact payers, patients, and other relevant parties to resolve outstanding balances and secure payment.
• Stay up-to-date with changes in healthcare regulations, coding guidelines, and billing requirements. Ensure compliance with HIPAA, CMS, and other regulatory standards governing healthcare billing and reimbursement.
• Collaborate closely with internal departments, including providers, coders, and billing staff, to resolve complex billing issues and streamline revenue cycle processes. Communicate effectively with external stakeholders, such as payers and patients, to facilitate resolution of outstanding accounts receivable.
• Be accountable for your performance.
• Always look for ways to improve the patient experience
• Take initiative for your professional growth
• Be engaged and eager to build a winning team

Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for health and wellness. Named one of the fastest-growing health systems in America by Modern Healthcare, Methodist has a network of 12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Methodist has more than two dozen clinics located throughout the region, renowned teaching programs, innovative research, and a strong commitment to the community. Our reputation as an award-winning employer shows in the distinctions we’ve earned:

• TIME magazine Best Companies for Future Leaders, 2025
• Great Place to Work® Certified™, 2025
• Glassdoor Best Places to Work, 2025
• PressGaney HX Pinnacle of Excellence Award, 2024
• PressGaney HX Guardian of Excellence Award, 2024
• PressGaney HX Health System of the Year, 2024

Location: West Point United States

Job Description:

Piper Companies is seeking a Quality Assurance Specialist to join a cutting-edge company that produces medicines, vaccines and biologic therapies. This position is located in West Point, Pennsylvania. The Clinical Supplies Quality Specialist position revolves around detailed working of clinical packaging, labeling and distribution activities and associated regulatory submissions for Investigational New Drug applications and Clinical Trial Applications.

Responsibilities of the Quality Assurance Specialist include:

• Evaluation and disposition of clinical supplies with assurance of following government regulations. Along with coordination of preparation of procedures and processes and quality improvements
• Assist in coordinating significant quality events including fact finding and investigation support
• Collaborate across IPT functional and business areas to ensure continuous improvement
• Actively using and championing the use of Lean Six Sigma (LSS) and production system- both used in day-to-day operational tasks

Qualifications for the Quality Assurance Specialist include:

• Minimum 2 years' experience in Pharmaceutical or industry Good Manufacturing Practice, or related field such as, engineering, quality or operations
• Familiarity with batch disposition activities
• Strong written and verbal communication skills, problem-solving skills, and demonstrated ability to work independently as well as in a team environment
• Attention to detail, flexibility, and awareness of production and quality control problems
• Bachelor's degree in engineering, science or related field

Compensation for the Quality Assurance Specialist include:

• Pay Rate: $33-$43/hr.
• Hybrid work schedule
• Long-term contract (with strong possibility of extension)
• Comprehensive Benefits: Comprehensive Benefits: Medical, Dental, Vision, 401K, Sick Leave if required by law

Keywords: Quality Assurance Specialist, Quality Specialist, document review, rights and well-being of patients, data, clinical supplies, batch documentation, clinical packaging, labeling and distribution, regulatory, Investigation New Drug applications, Clinical Trial Applications, full-time, pharma, pharmaceutical manufacturing, drug manufacturing, process validation, sampling, testing

#LI-KG2 #LI-Hybrid

Title: Clinical Trial Project Manager

Location: Remote,  United States

Full time

job requisition id: RQ4037842

Job Description:

Site: Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise.

We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.

The Clinical Trial and Utilization Program Specialist plays a critical role in supporting the Utilization Management (UM) and Medical Policy teams by developing, implementing, and maintaining policies and procedures that govern clinical trial oversight and utilization management. This position ensures compliance with regulatory standards, ethical guidelines, and organizational policies, while facilitating cross-functional collaboration to enhance operational efficiency and clinical integrity.

Essential Functions:

• Conduct daily reviews of inpatient and outpatient utilization cases using InterQual criteria and internal policies.
• Collaborate with physician reviewers as needed to ensure clinical appropriateness.
• Partner with Care Management and Appeals & Grievance teams to ensure seamless coordination and resolution of member cases.
• Serve as a liaison between medical directors, policy developers, and UM staff.
• Design, implement, and monitor workflows for clinical trial review and documentation.
• Track protocol statuses, regulatory submissions, and trend analyses.
• Contribute to the creation and revision of medical policies based on clinical evidence and regulatory updates. Support the Medical Policy Committee by preparing materials and facilitating discussions.
• Participate in planning and development of system upgrades and enhancements to support UM and clinical trial processes.
• Lead the development, implementation, and ongoing maintenance of policies and procedures related to clinical trials and utilization management.

Qualifications

Education

• Bachelor's Degree required

Experience

• At least 3-5 years of progressively more responsible experience in a research-related field required
• Prior Supervisory experience preferred
• At least 3 years of experience in a managed care setting is highly preferred
• Experience with clinical trial management is highly preferred
• Utilization Management experience highly preferred

Knowledge, Skills, and Abilities

• Expertise in clinical inpatient and outpatient utilization management reviews utilizing InterQual, company policies and procedures, and other resources as determined by review, including physician reviews as needed.

• Expertise in clinical inpatient and outpatient care.

• Proficiency in policy and procedure development.

• Deep understanding of clinical trial protocols and compliance.

• Excellent communication and interpersonal skills.

Additional Job Details (if applicable)

Working Conditions

• This is a remote role that can be done from most US states

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$62,004.80 - $90,750.40/Annual

Grade

7

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all iniduals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Dosimetrist - Radiation Oncology

Location: Schaumburg United States

Regular Full-Time

Job Description:

Overview

Full-time

Hours: Monday- Friday, Hybrid; Four - 10hr shifts

Location: Brand New location in Schaumburg; May have to travel to Lisle at time based on volume/need

Benefits:

• Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance and medical coverage at 100% (after deductible) when utilizing a Duly provider.
• Employer provided life and disability insurance.
• $5,250 Tuition Reimbursement per year.
• Immediate 401(k) match.
• 40 hours paid volunteer time off.
• A culture committed to community engagement and social impact.
• Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.

Responsibilities

Under the direction of the Manager of Radiation Oncology and the clinical direction of the Radiation Oncology Medical Director, the dosimetrist is responsible for developing computer generated radiation dose distribution plans and calculating monitor units to deliver radiation as prescribed by the radiation oncologist. The Dosimetrist will conduct quality assurance reviews and quality checks on various equipment. Provides treatment and education consistent with patient's age and cultural needs. Responds to all patient inquiries, prioritizing responses and routing urgent situations to appropriate iniduals. Maintains accurate and appropriate documentation and follows patient privacy in accordance with HIPAA and Duly policies and procedures. Acts as a role model for all other care givers in coordination of patient care. Maintains a high level of initiative, dependability and motivation. Communicates effectively and exhibits sound judgement in patient safety and treats all iniduals with professionalism and respect.

Qualifications

• Bachelor's degree preferred, specifically in Radiation Therapy, Math, or Physics.
• Board certified preferred, and if not, must be board eligible. If not certified, certification as a Medical Dosimetrist by the MDCB is required within 1 year of becoming a Medical Dosimetrist at our facility.
• Certified radiation therapist with two or more years on the job training as a Medical Dosimetrist preferred but may consider new graduate under specific circumstances.
• Maintains CPR certification

The compensation for this role includes a base pay range of $99,848-149,772 with the actual pay determined by factors such as skills, experience, education, certifications, geographic location, and internal equity. Additional compensation may be available through shift differentials, bonuses, and other incentives. Base pay is only a portion of the total rewards package.

Title: Nurse Practitioner

Location:

Iowa

Texas

Arizona

Job Description:

Position Title:

Nurse Practitioner 100% Virtual, CareBridge

Job Description:

CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable iniduals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services.

Advance Practice Provider - Nurse Practitioner

• $5,000 Sign-on Bonus
• Seeking Nurse Practitioner candidates that have an active, unrestricted Nurse Practitioner license in either of the following states: Kansas, Arizona, Iowa and/or Texas AND must have an active RN Compact license.

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Shift: Monday-Friday, 8:00am-5:00pm (CST) and rotating on-call

The Advanced Practice Provider, Nurse Practitioner is responsible for collaborating with company providers and their family members to develop complex plans of care in accordance with the patient's health status and overall goals and values. Provides clinical and non-clinical support to patients presenting with acute care needs virtually.

How you will make an impact:

• Provides urgent health care via telephone and tele video modalities to patients who receive home and community-based services through state Medicaid programs, dual eligible members and other membership as assigned by our MCO partners.
• Develops and implements clinical plans of care for adult patients facing chronic and complex conditions (e.g., co-morbid medical and mental health diagnoses, limited personal resources, chronic medical conditions.).
• Gathers history and physical exam and diagnostics as needed, and then develops and implements treatment plans given the patient's goals of care and current conditions.
• Identifies and closes gaps in care.
• Meets the patient's and family's physical and psychosocial needs with support and input from the company's inter-disciplinary team.
• Educates patients and families about medication usage, side effects, illness progression, diet and nutrition, medical adherence and crisis anticipation and prevention.
• Maintains contact with other clinical team members and other medical providers to coordinate optimal care and resources for the patient and his or her family in a timely basis and consistent with state regulations and company health standards and policy.
• Maintains patient medical records and medical documentation consistent with state regulations and company standards and policy.
• Participates in continuing education as required by state and certifying body.
• Prescribes medication as permitted by state prescribing authority.

Minimum Requirements:

• Requires an MS in Nursing.
• Requires an active national NP certification.
• Requires valid, current, active and unrestricted Family or Adult Nurse Practitioner (NP) license in either one of the following states: Kansas, Iowa, Arizona or Texas.
• Active, unrestricted RN Compact license is required.
• Requires 2 years + of experience in managing complex care cases.
• Experience working with Electronic Medical Records (EMR).

Preferred Skills, Capabilities and Experiences:

• Possession of DEA registration or eligibility preferred.
• Experience in managing complex care cases for developmental disabilities and chronically ill patients strongly preferred.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

MED > Licensed/Certified - Other

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Pharmacist Clinical

Location: Tampa United States

locations

OH-MASON, 4361 IRWIN SIMPSON RD

IN-INDIANAPOLIS, 220 VIRGINIA AVE

FL-TAMPA, 5411 SKY CENTER DR

KS-OVERLAND PARK, 5901 COLLEGE BLVD STE 275

NC-WINSTON-SALEM, 5650 UNIVERSITY PKWY

time type

Full time

Job Description:

Position Title:

Pharmacist Clinical

Job Description:

Pharmacist Clinical

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Pharmacist Clinical is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS and formulary management.

How you will make an impact:

• Researches and synthesizes detailed clinical data related to pharmaceuticals.

• Prepares and presents therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee.

• May review and approve or deny coverage for pharmaceuticals (as permitted by state/federal law or state/federal program contracts) based on medical necessity criteria, and coordinates with internal stakeholders or health plan medical directors as needed.

• Serves as a clinical resource to other pharmacists on areas such as prospective, inpatient and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions.

• Prepares information for network physicians.

Minimum Requirements:

• Requires BA/BS in Pharmacy.

• Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or any combination of education and experience, which would provide an equivalent background.

• Requires a registered pharmacist. Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).

Preferred Skills, Capabilities, and Experiences:

• PharmD strongly preferred.

• Experience with Pharmacy prior authorization, denials, and appeals strongly preferred.

• Registered Pharmacist (RPh) licensing for Indiana, Kansas, North Carolina, or South Carolina preferred.

• Experience managing multiple cases at various stages and deadlines, with accurate record-keeping strongly preferred.

• Previous experience in high-volume operations preferred.

Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US, unless they are command-sanctioned activities.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

MED > Licensed/Registered Pharmacist/Pharmacy Technician

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Title: Senior Director, Transactional Attorney

Location:  United States, Parsippany, New Jersey

• Hybrid
• Legal & Compliance
• 2376

Job Description:

Overview

About Pacira

Pacira BioSciences, Inc. is a leading provider of non-opioid pain management and regenerative health solutions dedicated to improving outcomes for health care practitioners and their patients. Our in-depth knowledge of non-opioid pain management, coupled with our passion for advancing patient care, drives our commitment to providing solutions that address unmet medical needs and improve clinical results.

Why work with us?

Rarely do you have an opportunity to do work that really matters. What drives us is our mission. What makes us successful are our people. At Pacira, you are part of an inclusive culture that fosters collaboration, growth, and innovative thinking - a place where you can make an impact and help change the standard of care in non-opioid pain management. Be part of our movement, let's pursue excellence together.

Summary:

The purpose of this position is to support the Chief Legal Officer and Senior Management in managing certain legal functions of the company including transactions, contracts, and M&A.

Responsibilities

Essential Duties & Responsibilities:

• Support our Oversee and take ownership of the daily contracting function including, drafting, reviewing, and negotiating contracts, with a heavy emphasis on Business Development and M&A. May also be given an opportunity to take on litigation, employment, regulatory, and other legal matters.
• Become a strategic partner with Regulatory, Finance, IT, Clinical, Manufacturing, Medical, and Commercial Groups to assist them with their various legal needs.
• Review, draft, and implement corporate policies and procedures.
• Advise Senior Management on legal issues and risk.
• Assist General Counsel on other legal projects on as-needed basis.

Supervisory Responsibilities:

This position may have supervisory responsibilities.

Interaction:

Will work closely with the Chief Legal Officer and customers, vendors, outside counsel and consultants. Business areas supported include: research and development, clinical trials (commercial products and potential pipeline products), medical affairs, market access, corporate communications, global supply chain and quality, manufacturing, commercial sales and marketing to healthcare providers, patients and payers (including U.S. Federal Government), business development, procurement, finance, compliance, and human resources.

Qualifications

Education and Experience:

Requirements:

• JD and a State Bar admission
• Minimum 10 years of major law firm or in-house experience. Three years of in-house experience with a major pharmaceutical and/or biotech company is preferred but not necessary.

Qualifications:

To perform this job successfully, an inidual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable iniduals with disabilities to perform the essential functions.

Knowledge, Skills, and Abilities:

• Exceptional English communication skills written and verbal, organizational abilities, decision making, and proven attention to detail.
• Strong Microsoft Office skills: Word; Excel; Outlook.
• Demonstrated ability to work effectively within a team environment.
• Demonstrated ability to multi-task and produce quality work product in a fast-paced, stimulating environment.
• Demonstrated excellent business judgment and the ability to form strong working relationships with internal clients while maintaining adherence to legal standards.
• Proven depth of knowledge of corporate legal issues, particular to the pharmaceutical and/or Biotech industry including contracts and compliance.

Physical Demands:

While performing the duties of this job, the employee is regularly required to sit, talk, move between spaces, reach with hands and arms. Close vision and the need to focus on computer screen, use of hands, fingers, and wrist to type on keyboard and manipulate mouse.

Work Environment:

Typical office setting, office' will be a cubicle, noise level is moderate with consistent printer, telephone ringing, and conversation. Hybrid work environment and employee is required to work in the Pacira office at least three days a week (no exception).

Benefits

• Medical, Prescription, Dental, Vision Coverage
• Flexible Spending Account & Health Savings Account with Company match
• Employee Assistance Program
• Mental Health Resources
• Disability Coverage
• Life insurance
• Critical Illness and Accident Insurance
• Legal and Identity Theft Protection
• Pet Insurance
• Fertility and Maternity Assistance
• 401(k) with company match
• Flexible Time Off (FTO) and 11 paid holidays
• Paid Parental Leave

Pay Transparency

The base pay range for this role is $203,000 per year to $265,000 per year The range is what we reasonably expect to pay for this role. The range considers a wide range of factors that are considered in making compensation decisions, including but not limited to: geographic markets, business or organizational needs, skill sets, experience, training, licensure, and certifications

EEO Statement

EEO Statement: Pacira is proud to be an Equal Opportunity Employer and does not discriminate against applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age (40 or older), veteran status, disability or genetic information, or any other characteristic protected under applicable federal, state, or local law. At Pacira we are committed to intentionally cultivating a culture of inclusion where all feel welcomed and valued for their background, perspectives, and experiences. We hold one another accountable to promote trust and transparency in support of our communities and collective purpose.

Agency Disclaimer: Pacira Biosciences, Inc. (Hereafter, Pacira) does not accept unsolicited resumes from recruiters or employment agencies in response to the Pacira Careers page or a Pacira social media post. Pacira will not consider or agree to payment of any referral compensation or recruiter fee relating to unsolicited resumes. Pacira explicitly reserves the right to hire said candidate(s) without any financial obligation to the recruiter or agency. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Pacira.

Title: Sr Research Scientist

Location: Boston United States

Full time

Job Description:

About the Opportunity

Join a mission-driven team developing advanced cybersecurity platforms that protect hospitals and clinics from cyber threats. The Sr Research Scientist will contribute full-time to building Whole-Hospital Simulations that emulate realistic healthcare environments and Vulnerability Mitigation Platforms that safeguard medical devices and both clinical and non-clinical networks. The work will directly impact patient safety and digital resilience in vulnerable healthcare settings. Success in this role will help revolutionize the healthcare penetration testing marketplace by shifting the focus from compliance to how gracefully a hospital system can fail and recover under attack. The platforms will also shape the evolution of medical device security regulatory frameworks by moving evaluations from inidual device compliance to whole-hospital system security.

As part of the responsibilities of the Sr Research Scientist, out-of-the-area and overnight travel is often required to accompany the Principal Investigator and/or research staff on visits to each sub awardee site across the country, as well as to attend sponsor-mandated events. Travel is typically expected one to two times per month throughout the duration of the award, depending on the schedule of events. No travel is currently anticipated in December, though this is subject to change based on sponsor priorities. The energy and ability to travel is required. The laboratory is located in the Boston area, and this position is hybrid in person and work from home.

This position is 100% externally funded and will be reappointed on an annual basis based on the continued availability of funding.

Key Responsibilities & Accountabilities:

(40%) Research Project Leadership: Lead and direct research projects in healthcare and medical device cybersecurity. Define research objectives, contribute to requirements engineering, direct research tasks in alignment with tasks and milestones, design and lead evaluation studies, analyze results, and disseminate findings through publications and presentations.

(25%) Mentoring and Student Supervision: Mentor, supervise, and direct graduate students engaged in whole hospital simulation, vulnerability management platforms, penetration testing, vulnerability assessment, systems evaluation, and related technical areas. Provide direct feedback to support their technical growth, academic progress in publishing in top conferences, and professional development.

(20%) Technical report writing: Prepare project reports and technical documentation for whole hospital simulation and vulnerability management platforms. Patent applications. Locate and identify opportunities to secure additional funding and present project outcomes.

(10%) Collaboration and External Engagement: Lead evaluation of security of hospital-scale simulators and medical devices with healthcare providers, regulators, and industry partners. Represent the lab at conferences, workshops, and industry events.

(5%) Grant proposal writing and related proposal writing. Manage small-scale budgets and tasking milestone planning related to project expenditures, including procurement of test equipment, simulation resources, and laboratory supplies, in coordination with administrative staff.

This role involves close leadership with technical leads and organizational leadership on a single, high-impact cybersecurity platform for healthcare. While you'll receive support and guidance, you're expected to take leadership of your work and contribute independently.

• Lead feedback on technical work and project progress, ensuring adherence to research best practices, laboratory safety, and project timelines. Take ownership of research publication processes.

• Report to the PI and lead technical work in collaboration with the Project Manager, students, faculty, staff, and subaward recipients to achieve programmatic objectives and goals.

• Lead discussions and project planning with sub awardees and organizational leadership on a high-impact cybersecurity platform for healthcare.

• Take ownership of work and contribute independently, while receiving support and guidance as needed.

• Lead cross-functional teams and make technical decisions to ensure alignment with project goals.

As you grow in the role, you'll take the lead on key technical decisions.

We're looking for someone who thrives in a leadership role, focused, mission-driven environment and can balance autonomy with teamwork.

Core Qualifications:

PhD in computer science, electrical engineering, biomedical engineering, or a closely related field. Strong citation record in embedded systems security, medical device cybersecurity, healthcare technology security, or a closely related subfield. Strong written and verbal communication skills. Demonstrated ability to lead interdisciplinary research teams, healthcare partners, and industry collaborators. Demonstrated ability to mentor and direct students to ensure alignment to a mission-driven research program.

Experience with requirements engineering, penetration testing, or systems evaluation is highly desired. While programming skills are valuable, the Principal Research Scientist position is not intended for software development but will involve close collaboration with software development team members. A strong candidate will provide letters of reference from three faculty members who can address these qualifications and offer comparisons with peers.

Position Type

Research

Additional Information

Northeastern University considers factors such as candidate work experience, education and skills when extending an offer.

Northeastern has a comprehensive benefits package for benefit eligible employees. This includes medical, vision, dental, paid time off, tuition assistance, wellness & life, retirement- as well as commuting & transportation. 

All qualified applicants are encouraged to apply and will receive consideration for employment without regard to race, religion, color, national origin, age, sex, sexual orientation, disability status, or any other characteristic protected by applicable law.

Compensation Grade/Pay Type:

111S

Expected Hiring Range:

$86,490.00 - $122,163.75

With the pay range(s) shown above, the starting salary will depend on several factors, which may include your education, experience, location, knowledge and expertise, and skills as well as a pay comparison to similarly-situated employees already in the role. Salary ranges are reviewed regularly and are subject to change.

Title: VP, Market Development - West Region (Remote)

Location: United States

Job Description:

March of Dimes leads the fight for the health of all moms and babies. We are advocating for policies to protect them. We are working to radically improve the health care they receive. We are pioneering research to find solutions. We are empowering families with programs, knowledge and tools to have healthier pregnancies. By uniting communities, we are building a brighter future for us all.

We are dedicated to hiring a erse workforce that fosters opportunities for personal and professional development. We provide a collaborative and supportive environment built upon our fundamental core principles where each employee is valued. Join us in the fight for healthy moms and strong babies.

Join Us

At March of Dimes, we lead the charge to ensure every mom, baby, and family gets the best possible start. As we grow our impact across the country, we’re seeking a visionary and results-driven Vice President of Market Development to lead strategic fundraising initiatives across the West Region. This is a unique opportunity to make a lasting difference in maternal and infant health while shaping a high-performing development team. 

Your Impact

As the Vice President of Market Development, you will drive revenue growth, expand donor engagement, and lead a dynamic team behind historic campaigns, mission investment, and principle and planned giving. You’ll bring together corporate, community, and inidual partners to support our lifesaving mission while cultivating a culture of excellence, collaboration, and bold innovation.  This leader is managing nine market teams of development and mission staff.  Market teams included in the West region are: Phoenix, California, Hawaii, Minneapolis/Milwaukee, St. Louis, Omaha, Oklahoma/Arkansas, TX, Seattle/Portland.

Key Responsibilities

• Lead and Grow Revenue
  Personally accountable for growing a XM revenue portfolio annually.  Design and execute a comprehensive fundraising strategy focused on sustainable growth in total and unrestricted revenue. Inspire a high-performance culture that consistently meets or exceeds goals through all revenue portfolios.
• Build and Inspire Teams
  Recruit, develop, and mentor a strong team of fundraising professionals within 26 markets. Foster a culture that thrives on collaboration, accountability, and shared purpose.  Lead creatively in a virtual environment to create team synergy and dynamic motivation of others.  Held accountable for talent retention and engagement.  Responsible for onboarding and developing all market leaders.
• Lead by Example
  Personally manage relationships with top donors and partners. Be a face of March of Dimes in your community and in those you support in leadership —creating visibility, building trust, and driving mission impact. This include managing top donors, boards, and key relationships during vacancies.
• Ensure Operational Excellence
  Monitor performance, analyze data, and uphold donor data integrity. Ensure financial and compliance standards are consistently met. Accountable for region budget and all expense management.
• Collaborate Across Departments
  Actively build trusted relationships with business partners across departments to ensure a collaborative work culture for your region staff and to support reaching collective goals.  Serve as an extension of the national strategic vision when working with all staff regardless of department or role.

Who You Are

• A strategic thinker with a track record of exceeding fundraising goals and scaling donor engagement.
• A goal-driven development professional that thrives in a culture which sets the bar high and energizes others to join . 
• A people-first leader with experience developing high-performing teams and building strong internal culture.
• A relationship builder with the ability to recruit and activate executive-level volunteers and corporate supporters.
• A mission-driven professional with passion for health equity and a desire to make measurable change.

Qualifications

• Bachelor's degree or equivalent work experience.
• Minimum 10 years of relevant fundraising, development, or sales experience, with at least 5 years in a leadership/supervisory role.
• Demonstrated success in revenue generation, strategic planning, volunteer engagement, peer to peer fundraising, sponsorship recruitment, major gifts cultivation, as well as consistently meeting or exceeding goals.
• Growth mindset with a desire to innovate and manage change.
• Excellent communication and influencing skills across stakeholders and sectors.
• Large territory management experience, especially multi-state understanding cultural differences.
• Ability to travel within your region and nationally; access to reliable transportation; access to a regional airport.

Preferred Skills

• Familiarity with nonprofit health organizations in the maternal & infant health space, particularly March of Dimes or similar national organizations.
• Deep understanding of nonprofit standards, donor stewardship, and campaign operations.
• Virtual leadership experience.

Ready to lead with purpose?

March of Dimes provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.

Equal Opportunity Employer

Title: Utilization Management Specialist-Remote within 50 miles of Cincinnati, OH

Location: Cincinnati United States

 Quality & Safety

Job Id: JR213813

Job Type: Full time

Job Description:

JOB RESPONSIBILITIES

• Utilization Management- Utilization Management: Independently working more complex prospective, retrospective and concurrent review and processing of authorization requests for inpatient admissions, outpatient procedures, homecare services and durable medical equipment. Generates required correspondence, including denial letters, based on medical necessity and administrative review process while maintaining productivity and turnaround time.

• Quality- Work with management team to ensure 100% correct letter and less than 2% error rate are met. Uses independent judgement to ensure templates are compliant with Federal, State and Regulatory requirements. Identify and refer appropriate members for care management and quality issues to Quality Improvement. Recommends process improvements and provides documentation for processes to the department.

• Discharge Planning- Document, identify and communicate with Health Partners, Care Managers and Discharge Planners to establish safe discharge planning needs and coordination of care in a timely and cost-effective manner. Interfaces with physician reviewers to optimize the written communication to members and referring providers.

• Compliance- Meet third-party payer standards and requirements. Maintains knowledge of changes as impacts regulatory/accrediting compliance for reimbursement. Assist Director in the reporting of information as set forth in the PI plan, i.e., appropriateness of admissions and continued stay reviews including when known, the over and underutilization of resources. Participate in interdepartmental meetings to promote knowledge, troubleshoot, problem shoot and resolve issues as relates to utilization management. Serves as an educational and communications resource to Administration, Department heads, physicians and other necessary groups regarding the utilization management activity and process. Keep the department manager informed of problems, as necessary.

• Leadership- Provide guidance to and assist with oversight of non-clinical staff, including training and education of Specialist I. Act as a primary point of contact for the Utilization Management team. Answers questions and provide guidance for difficult reviews and processes.

Responsible for required correspondence. Using professional education independently documents, identifies and communicates with Health Partners, Care Managers and Discharge Planners to establish safe discharge planning needs and coordination of care in a timely and cost-effective manner.

JOB QUALIFICATIONS

• Bachelor of Science in Nursing or Master's Degree in Social Work, Counseling, or related field

• 3+ years of work experience in a related job discipline.

• Current, unrestricted Registered Nurse (RN), Social Work or Clinical Counselor Licensure in state(s) of practice

Primary Location

Remote

Schedule

Full time

Shift

Day (United States of America)

Department

PS HealthVine UM

Employee Status

Regular

FTE

1

Weekly Hours

40

• Expected Starting Pay Range
• Annualized pay may vary based on FTE status

$67,537.60 - $86,112.00

Market Leading Benefits Including*:

• Medical coverage starting day one of employment. View employee benefits here.

• Competitive retirement plans

• Tuition reimbursement for continuing education

• Expansive employee discount programs through our many community partners

• Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions

• Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group

• Physical and mental health wellness programs

• Relocation assistance available for qualified positions

• Benefits may vary based on FTE Status and Position Type

Title: Hematology, Oncology Specialist 

Location: Remote United States

**Job ID;**2025-2369

 # of Openings;1

 Category; Commercial

 Type; Regular Full-Time

Job Description:

Role Overview & Key Functions:

The Hematology-Oncology Specialist maintains strong professional relationships in the patient care continuum and represents the integrity of Karyopharm Therapeutics by providing approved disease and product information and resources to key decision makers and stakeholders within the oncology community practice setting.

RESPONSIBILITIES:

• Develop business plans, market analysis, and strategy that link to strong business results and execute accordingly
• Position on-label benefits for appropriate patients to key customer stakeholders to achieve or exceed forecasted sales goals
• Resolve issues at account level to ensure access to therapy
• Coordinate with colleagues in cross-functional areas including Market Access, Clinical Education, and Medical Affairs to facilitate customer and patient access to Karyopharm product(s) and information
• Provide customer feedback to internal stakeholders, sharing best practices, unmet needs, and business opportunities
• Assist Marketing function in identifying and inviting appropriate healthcare professionals (HCPs) to promotional and educational events or programs
• Develop and maintain mastery of clinical and technical knowledge related to product(s) promoted, the oncology marketplace, and disease management
• Foster and develop relationships with Key Opinion Leaders (KOLs), decision makers, influencers, and key stakeholders within the oncology community
• Deliver clinical and technical value at medical meetings by staffing promotional booths, as requested
• Comply with all laws and regulations and adhere to company compliance guidelines, policy and procedures
• Acts with a sense of urgency on behalf of patients and customers

Candidate Profile & Requirements:

• Bachelor's degree, required
• 5+ years of pharmaceutical sales experience, with a documented history of success
• 2+ years' oncology or rare disease pharmaceutical sales experience, including product launch(es)
• Experience in Hematology and/or Multiple Myeloma preferred
• Existing relationships with oncology practices in territory, preferred
• Strong business acumen
• Must reside in close proximity to the geography or be willing to relocate to it
• Valid driver's license and the ability to travel as necessary

At Karyopharm, base pay is one part of a competitive total rewards package that includes comprehensive benefits (medical, dental, vision, 401(k), and more), equity and the potential to receive annual target bonuses. Actual pay is based on factors such as location, experience, skills, education, and internal equity. We maintain broad salary ranges to reflect market conditions and the specialized nature of our work. The anticipated base salary range for this position is $170 K - $210 K USD.

Our Value Proposition:

At Karyopharm, we live and demonstrate our ICARE values every day! If you want to do something that matters, this work matters. Patients drive our passion to pioneer novel cancer therapies. That's why we've built an environment centered around support, flexibility, and a shared mission.

Creating and delivering medicine for cancer can only be done through focus, dedication, and heart. We hire exceptional people and trust each other to work in whatever way lets us, be us - whether that's onsite, from home, or anywhere in between.

What do you get when you pair an extraordinary mission with a culture of flexibility and empowerment? We invite you to find out and join us on this incredible mission.

Check out our Culture Video!

What We Offer:

In addition to our exciting, supportive, and intellectually challenging global workspaces(s), team members enjoy a comprehensive and generous benefits package (active on day one) that makes them more productive and contributes directly to the development of their professional skills.

• A culture of employee engagement, ersity, and inclusion
• Competitive salary, bonus, and generous equity offerings (RSU's at time of offer and annual awards) - we are partners in prosperity!
• Peace of mind through best in class medical (deducible paid by KPTI), dental, vision, disability, and life insurance, parental leave, a matching 401k program (immediate vesting), ESPP and tuition reimbursement.
• Wellness Program with a monthly stipend.
• Generous PTO and Holidays - we encourage you to recharge and spend time with family and friends.
• Ample opportunities to learn and take on new responsibilities in a fast-paced, and patient focused company. (tuition reimbursement, management development & mentoring programs, and a variety of reward and recognition programs)
• Cell phone allowance

Title: Chart Auditor

Location: Fort Worth United States

Hybrid

Requisition Number: 41478

Job Category: Patient Care Support

Job Description:

Who We Are

JPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital a Level I Trauma Center, Tarrant County's only psychiatric emergency center, and the largest hospital-based family medical residency program in the nation. The health network employs more than 7,200 people.

Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance

outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time.

Why JPS?

We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is to make sure the people of our community get the care they need and deserve. As community stewards, we abide by three Rules of the Road:

1. Own it. Everyone who wears the JPS badge contributes to our journey to excellence.

2. Seek joy. Every day, every shift, we celebrate our patients, smile, and emphasize positivity.

3. Don't be a jerk. Everyone is treated with courtesy and respect. Smiling, laughter, compassion - key components of our everyday experience at JPS.

When working here, you're surrounded by passion, ersity, and dedication. We look forward to meeting you!

ACCLAIM ADMIN SERVICES

Compensation Type:

Salaried

Job Category:

Patient Care Support

Hours Worked:

M-F 8AM-5PM - Hybrid

Location:

Acclaim Magnolia

Shift Worked:

Day

Job Description:

Job Summary: The Chart Auditor will be responsible for performing clinical reviews to determine the accuracy of ICD-10 codes listed on forms from payors, performing interactive outreach for the Transition of Care program, pending outstanding patient orders, validating ED high utilization patient attribution, and reviewing gap in care reports to address outstanding patient health risks. This job involves accessing proprietary systems to audit medical records, accurately documenting findings, and providing forms to the clinic providers.

Essential Job Functions & Accountabilities:

• Reviews and interprets medical records and compares against forms for accuracy of presumed diagnoses.
• Documents decisions and rationale to justify review findings.
• Pend orders to address outstanding patient care gaps.
• Performs interactive outreach for patients discharged from Inpatient stays.
• Assists management with training any new Chart Auditor.
• Maintains current knowledge of clinical criteria guidelines to maintain a clinical license.
• Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.
• Actively cross-trains to perform reviews of multiple payor types and requirements and understand the documentation needs.
• Recommends, tests, and implements process improvements, new audit concepts, and technology improvements that will enhance production, quality, and client satisfaction.
• Reviews payor gap in care reports to validate patient medication adherence compliance.
• Validates and facilitates care management for high ED utilizing patients.
• Job description is not an all-inclusive list of duties and may be subject to change with or without notice. Staff are expected to perform other duties as assigned.

Qualifications:

Required Qualifications:

• Associate's Degree from an accredited school of professional nursing. OR Medical School graduate.
• If a Registered Nurse, current licensure by the Board of Nurse Examiners for the State of Texas or proof of reciprocity of licensure between the State of Texas and another state. Must be maintained throughout employment.

Preferred Qualifications:

• Bachelor's Degree in Nursing from an accredited school of professional nursing.
• 2 plus years of claims auditing or value-based care work.

Title: Global Regulatory Affairs CMC Lead

Job Description:

Job Title: Global Regulatory Affairs CMC lead

Location: Framingham, MA, Morristown, NJ

About the Job

Are you ready to shape the future of medicine? The race is on to speed up drug discovery and development to find answers for patients and their families. Your skills could be critical in helping our teams accelerate progress.

As GRA CMC Lead within our GRA CMC & GRA Device Organization, you'll drive global regulatory strategies for pharmaceutical and vaccine products, collaborate with cross-functional teams to navigate complex regulatory landscapes, optimize product development and manufacturing processes, and directly influence the success of drug approvals through strategic negotiations with health authorities worldwide.

Within Sanofi's Global Regulatory Affairs (GRA) CMC organization, the CMC Lead role offers the opportunity to drive regulatory strategy for pharmaceutical products and vaccines across their lifecycle. Working at the intersection of science and compliance, you'll develop CMC strategies, conduct risk assessments, and serve as the primary liaison with regulatory authorities including FDA and EMA. You'll collaborate across R&D, Manufacturing, and Quality teams while preparing high-quality regulatory submissions, managing compliance, and anticipating regulatory trends-all contributing directly to bringing innovative therapies to patients worldwide

About Sanofi

We're an R&D-driven, AI-powered biopharma company committed to improving people's lives and delivering compelling growth. Our deep understanding of the immune system - and innovative pipeline - enables us to invent medicines and vaccines that treat and protect millions of people around the world. Together, we chase the miracles of science to improve people's lives.

The Global Regulatory Affairs (GRA) CMC & Device Organization within Sanofi R&D serves as a critical strategic partner within Sanofi's regulatory framework, providing expert guidance on Chemistry, Manufacturing, and Controls (CMC) and medical device regulatory requirements across the product lifecycle. Our department bridges the gap between technical development, manufacturing operations, and global regulatory authorities to ensure compliance while optimizing product approval pathways. The team develops and implements global regulatory strategies for pharmaceutical products, biologics, vaccines, and combination products, working closely with cross-functional partners to navigate complex regulatory landscapes. With a commitment to Sanofi's "Take the Lead" values, particularly in "Leading Together" and "Being Bold," our mission is to secure timely approvals while maintaining the highest standards of quality and compliance, ultimately supporting Sanofi's goal of bringing innovative healthcare solutions to patients worldwide.

We are an innovative global healthcare company with one purpose: to chase the miracles of science to improve people's lives. We're also a company where you can flourish and grow your career, with countless opportunities to explore, make connections with people, and stretch the limits of what you thought was possible. Ready to get started?

Main Responsibilities:

Develop and implement global regulatory CMC strategies

• Create strategies for development and marketed products

• Focus on chemical entities, biological entities, and/or vaccine products

• Execute and adapt strategies as needed

Serve as the primary point of contact for regulatory authorities

• Act as direct liaison with agencies like US FDA and EMA

• Develop positive relationships with regulators

• Support strategic negotiations with worldwide Regulatory Health Authorities

Manage CMC documentation and submissions

• Write, prepare, review, and approve regulatory CMC dossiers

• Ensure dossiers meet quality standards

• Comply with regulatory requirements

• Maintain documentation accuracy and completeness

Lead cross-functional collaboration

• Work closely with R&D Functions

• Collaborate with Manufacturing & Supply Functions

• Coordinate with GRA Regulatory Operations

• Ensure effective implementation of regulatory strategies

• Facilitate resolution of CMC issues

Identify and manage regulatory risks

• Assess regulatory CMC opportunities and risks

• Develop risk mitigation strategies

• Communicate implications to project teams

• Articulate risk/benefit components to stakeholders

Contribute to regulatory science and policy activities

• Monitor local and international Health Authority regulations and guidelines

• Participate in the review process for new regulations

• Anticipate potential regulatory paradigm shifts

• Track and communicate current Health Authority thinking and trends

About You

• Experience: 4+ years of CMC regulatory experience with contributions to regulatory filings and implementation of regulatory strategies; experience responding to Health Authority questions.

• Regulatory Expertise: Experience preparing regulatory documentation and familiarity with standard submission processes

• Technical Knowledge: Understanding of pharmaceutical development, manufacturing processes, and regulatory requirements in major markets.

• Collaboration Skills: Ability to work effectively in a matrix environment, engaging cross-functionally with R&D, Manufacturing, and Quality teams.

• Education: Bachelor's degree in a scientific discipline (Chemistry, Biology, Pharmacy, or related field).

• Communication: Strong written and verbal communication skills, with fluency in English.

• Adaptability: Capability to manage multiple projects in a fast-paced, hybrid work environment (60% on-site), with openness to learning and growth.

Why Choose Us?

• Bring the miracles of science to life alongside a supportive, future-focused team.

• Discover endless opportunities to grow your talent and drive your career, whether it's through a promotion or lateral move, at home or internationally.

• Enjoy a thoughtful, well-crafted rewards package that recognizes your contribution and amplifies your impact.

• Take good care of yourself and your family, with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14 weeks' gender-neutral parental leave.

• Play a crucial role in bringing innovative therapies to millions worldwide, working at the forefront of drug discovery and development with a patient-centric approach.

• Leverage advanced AI, data, and digital platforms to push the boundaries of pharmaceutical science and regulatory strategy.

• Engage with erse teams spanning scientific, clinical, and digital fields, fostering breakthroughs through cross-functional collaboration.

• Benefit from structured career paths offering both scientific and leadership advancement opportunities, including bold moves and short-term projects to expand your expertise.

• Join a workplace that prioritizes ersity, equity, and inclusion, with programs that celebrate every voice and perspective.

• Enjoy a supportive R&D environment that values work-life balance, offering flexible working options (60% on-site) and comprehensive well-being programs.

• Influence global regulatory strategies, interact with key health authorities, and stay at the forefront of evolving industry trends and regulations.

Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally erse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law.

#GD-SA

#LI-SA

#LI-Onsite

#vhd

Pursue progress, discover extraordinary

Better is out there. Better medications, better outcomes, better science. But progress doesn't happen without people - people from different backgrounds, in different locations, doing different roles, all united by one thing: a desire to make miracles happen. So, let's be those people.

At Sanofi, we provide equal opportunities to all regardless of race, colour, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, ability or gender identity.

Watch our ALL IN video and check out our Diversity Equity and Inclusion actions at sanofi.com!

US and Puerto Rico Residents Only

Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally inclusive and erse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; natural or protective hairstyles; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law.

North America Applicants Only

The salary range for this position is:

$122,250.00 - $176,583.33

All compensation will be determined commensurate with demonstrated experience. Employees may be eligible to participate in Company employee benefit programs. Additional benefits information can be found through the LINK.

Title: (VP) Senior Director Biologics Drug Discovery

Location

South San Francisco, CA

Employment Type

Full time

Department

Drug Discovery

Job Description:

The Opportunity

The heart of insitro's strategy is the combination of novel, cutting edge methods in machine learning, biology at scale and modality independent drug discovery that address key bottlenecks in the drug development pipeline. To accomplish that, we have put together an incredible team of highly talented drug discovery scientists who want to make a difference to these significant problems. In this key role, you will build and lead the Biologics Therapeutics capabilities at insitro within the Drug Discovery department.

You will be joining a well funded AI biotech that has established a pipeline of therapeutic candidates but yet is very much in formation, providing many opportunities for significant impact. You will work closely with a very talented team of Data and Machine Learning scientists, TA biologists and a growing CMC organization, learn a broad range of skills, and help shape insitro's culture, strategic direction, and outcomes. You will report to the Chief Scientific Officer and can be either onsite (3 days per week) in our South San Francisco office or hybrid (~1 week per month) in our office. Additional travel may be needed to relevant medical and translational science conferences and health authorities.

Join us, and help make a difference to patients!

Responsibilities

• Guide therapeutic biologics efforts in projects as project team leader and subject expert

• Build insitro's biologic therapeutic capabilities through extensive CRO and/or industry collaborations

• Work cross-functionally to drive biologics projects through different stage gates towards clinical development candidates

• Deeply engage cross-functionally to evaluate the suitability of new targets for prosecution by the biologics modality

• Lead a Protein Sciences and Structural Biology team that can enable discovery biology and both large and small molecular modalities

• Partner with Business Development and External R&D to evaluate new biotherapeutics technologies

About You

• PhD in biochemistry, chemistry or cell biology with 10+ years of industry experience in drug discovery, and with 5+ years of direct experience in biologics drug design

• Deep understanding of the biotherapeutic drug discovery process

• Demonstrated track record of leadership advancing biologics projects through different stages of drug discovery and early-stage process and clinical development

• Significant experience in enabling programs with protein reagents and structural biology

• Proven leadership capabilities in cross-functional teams as a project team leader

• First hand experience in using CROs and industry partner for biologics drug discovery

• Experience in or exposure to computational approaches across the biologics design and bioprocess value chain

• Track record of innovation and impact on projects through peer-reviewed publication and/or patent applications

• Excellent written and verbal communication skills across multi-functional teams

• Intellectual curiosity to push the boundaries of drug discovery

Compensation & Benefits at insitro

Our target starting salary for successful US-based applicants for this role is $247,000 - $316,000. To determine starting pay, we consider multiple job-related factors including a candidate's skills, education and experience, market demand, business needs, and internal parity. We may also adjust this range in the future based on market data.

This role is eligible for participation in our Annual Performance Bonus Plan (based on company targets by role level and annual company performance) and our Equity Incentive Plan, subject to the terms of those plans and associated policies.

In addition, insitro also provides our employees:

• 401(k) plan with employer matching for contributions

• Excellent medical, dental, and vision coverage as well as mental health and well-being support

• Open, flexible vacation policy

• Paid parental leave of at least 16 weeks to support parents who give birth, and 10 weeks for a new parent (inclusive of birth, adoption, fostering, etc)

• Quarterly budget for books and online courses for self-development

• Support to attend professional conferences that are meaningful to your career growth and role's responsibilities

• New hire stipend for home office setup

• Monthly cell phone & internet stipend

• Access to free onsite baristas and cafe with daily lunch and breakfast for employees who are either onsite or hybrid

• Access to free onsite fitness center for employees who are either onsite or hybrid

• Access to a free commuter bus and ferry network that provides transport to and from our South San Francisco HQ from locations all around the Bay Area

insitro is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

We believe ersity, equity, and inclusion need to be at the foundation of our culture. We work hard to bring together erse teams–grounded in a wide range of expertise and life experiences–and work even harder to ensure those teams thrive in inclusive, growth-oriented environments supported by equitable company and team practices. All candidates can expect equitable treatment, respect, and fairness throughout the interview process.

#LI-Hybrid

About insitro

insitro is a drug discovery and development company using machine learning (ML) and data at scale to decode biology for transformative medicines. At the core of insitro’s approach is the convergence of in-house generated multi-modal cellular data and high-content phenotypic human cohort data. We rely on these data to develop ML-driven, predictive disease models that uncover underlying biologic state and elucidate critical drivers of disease. These powerful models rely on extensive biological and computational infrastructure and allow insitro to advance novel targets and patient biomarkers, design therapeutics and inform clinical strategy. insitro is advancing a wholly owned and partnered pipeline of insights and therapeutics in neuroscience and metabolism. Since launching in 2018, insitro has raised over $700 million from top tech, biotech and crossover investors, and from collaborations with pharmaceutical partners.

Accounts Receivable Specialist

Location: Newtown Square United States, Newtown Square, Pennsylvania, United States

New Billing/Collections

ID 78435

Job Description:

Could you be our next Accounts Receivable Specialist at Ellis Preserve in Newtown Square? This role 100% remote.  

• Make an Impact! Tracking insurance payments in EPIC and resolving payment issues is a really important role at our organization. Our Accounts Receivable Specialists don’t just track numbers; they work on process improvements, appeals, and account resolutions. If you’re good with numbers and attention to detail, and a results-driven problem solver, this may be the perfect role for you! 
• Develop and Grow your Career! Invest in furthering your education through seeking certifications or advanced degrees by taking advantage of our Tuition Reimbursement! This position is eligible for up to $6,000 per year based upon your Full or Part Time status. 
• Join the Team! Like our patients, the Main Line Health Family encompasses a wide range of backgrounds and abilities. Just as each of our patients requires a personalized care plan, each of our employees, physicians, and volunteers, bring distinctive talents to Main Line Health. Regardless of our unique design, we all share a purpose: providing superior service and care. 
• Position-Specific Benefits include: You are eligible for up to 120 hours of paid time off per year based on your Full or Part Time status. We also offer a number of employee discounts to various activities, services, and vendors... And employee parking is always free!
  Position: Accounts Receivable Specialist- 40 hours/week
  Shift: Day shift- Monday- Friday 
  Experience: 
  1. Two/Three years healthcare billing experience and/or accounts receivable experience utilizing automated patient accounting systems (Epic Resolute desirable) preferred. 
  2. Microsoft Office applications experience. Intermediate Excel proficiency required. 
  3. Knowledge of insurance contracts, billing regulations and medical terminology preferred. 
  4. Knowledge of HCPCS/CPT/ICD-10 and revenue codes preferred.
  Education: 
  HS Diploma or Equivalent 
  Licensures/Certifications: 
  Certified Revenue Cycle Specialist (CRCS)/American Association of Healthcare Administrative Management (AAHAM), or Certified Revenue Cycle Representative (CRCR)/Healthcare Financial Management Association desirable

Additional Information

• Requisition ID: 78435
• Employee Status: Regular
• Schedule: Full-time
• Shift: Day Job
• Pay Range: $20.73 - $32.11
• Job Grade: 206

Main Line Health (MLH) with over 10,000 employees, is suburban Philadelphia's most comprehensive health care resource, offering a full range of healthcare services. Learn more about us.

Main Line Health is committed to the health and wellness of our employees. We offer competitive salaries, comprehensive benefits,  generous paid time off, 403b savings plan, lucrative pension plan, tuition reimbursement, and more! Learn more about our benefits.

We are an EOE/Veterans/Disabled/LGBTQ employer. Main Line Health celebrates our differences and our similarities. Learn more about our Diversity and Inclusion culture.

Title: RN Clinical Appeals

Location: United States

Job type: Remote

Job Description:

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!

O.N.E Purpose:

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.

• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

• Striving for Excellence: Execute at a high level by demonstrating our "Best in KLAS" Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity:

CAREER OPPORTUNITY OFFERING:

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement
• This position pays between $56,800.00 - $108,900.00 based on experience

This inidual will be responsible for reviewing denials and performing root cause analysis while partnering with the Denial Prevention Nurse Manager to improve process and reduce denials.

The RN Clinical Appeals performs all appeals for clinically related claim denials across Ensemble Health Partners, or in a role that primarily assists with analyzing and reviewing records to prevent future denials, provide clinical records to payers, and prepare for provider-to-provider (P2P) reviews. Job duties include, but are not limited to, contacting insurance plans to determine reasons claims were denied, analyzing the claims and determining if appeal is necessary, preparing the appeal materials which may include correcting and resubmitting claims, gathering additional information, including reviews of medical records, acting as a liaison between healthcare providers for any additional medical documentation or clarification, and submitting appeals in a timely manner. In addition, the Specialist will work closely with other departments, such as Case Management, HIM, Physician Advisory, Clinical Denials, Denial Prevention, Accounts Receivable, Bedded Inpatient Authorization and Virtual Utilization review, to ensure denial trends and outcomes are communicated in a timely manner. The Specialist will perform these duties while meeting the mission of Ensemble Health Partners, as well as meeting the regulatory compliance requirements.

Essential Job Functions:

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
• Striving for Excellence: Execute at a high level by demonstrating our "Best in KLAS" Ensemble Difference Principles and consistently delivering outstanding results.
• Contacting insurance plans to determine reasons claims were denied, analyzing the claims and determining if appeal is necessary, preparing the appeal materials which may include correcting and resubmitting claims, gathering additional information, including reviews of medical records, acting as a liaison between healthcare providers for any additional medical documentation or clarification, and submitting appeals in a timely manner. In addition, work closely with the Case Management Department and HIM Department to ensure denial trends and outcomes are communicated in a timely manner.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.

Employment Qualifications:

• Current unrestricted license to practice nursing (LPN, RN)
• CRCR or other approved professional certification required with 9 months of date of hire

Job Experience:

• 1 to 3 Years

Desired Education Level:

• Associates Degree or Equivalent Experience

Preferred Area of Study:

• Nursing

Other Preferred Knowledge, Skills and Abilities:

• 4 year/ Bachelors Degree
• Preferred Minimum Education - Specialty/Major: Registered Nurse (RN) or relevant discipline
• Minimum Years and Type of Experience: 2 years of denials, utilization review, or case management experience strongly preferred

Other Knowledge, Skills and Abilities Required:

• Proficient computer skills, including Microsoft Suite
• Experience in hospital operations, chart audit/review, and provider relations.

Join an award-winning company

Five-time winner of "Best in KLAS" 2020-2022, 2024-2025

Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024

22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024

Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024

Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023

Energage Top Workplaces USA 2022-2024

Fortune Media Best Workplaces in Healthcare 2024

Monster Top Workplace for Remote Work 2024

Great Place to Work certified 2023-2024

• Innovation

• Work-Life Flexibility

• Leadership

• Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

• Associate Benefits - We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.

• Our Culture - Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.

• Growth - We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.

• Recognition - We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role's range.