Boulder Community Health Remote jobs

- 38 jobs

Mammography Supervisor
Boulder Community Health 4.4
Boulder, CO jobs
Mammography Supervisor Boulder Community Health, Boulder, CO 80303 $38.39#- $57.59#an hour - Full-Time Days, 40 hours per week Boulder Community Health is seeking a Mammography Supervisor who will ensure the accomplishments of the department#s mission and goals, including responsibility for maintaining and/or exceeding percentage goals set by the hospital for Patient and Employee Satisfaction and Safety in their areas. Supervisors will act as primary leaders, mentors, and role models in their departments. Each Supervisor will spend at least 60% of their time in their respective work areas performing exams and working side by side with their employees while representing staff through growth, change, and conflict resolution. Benefits: #Health insurance, including a FREE employee only option #Dental and Vision insurance #BCH paid Life Insurance; Spouse and Dependent Life Insurance plans #Short-term and Long-term disability coverage #Health and Dependent Care Flexible Spending Accounts #Retirement plan with BCH matching contributions, and discretionary lump sum contribution #Paid Time Off #Education assistance program #Voluntary Wellness programs, to include biometrics, wellness team challenges, and much more #Staff Support Initiatives such as Sound Baths, Meditation, Massages, and Reiki #Free one-on-one retirement planning sessions# #Employee Assistance Program offering 8 free, confidential counseling sessions for you and your family Qualifications# #American Registry of Radiologic Technologist (ARRT) registered in #Radiologic Technology #(RT) plus,# a. Registered in every sub-specialty that is supervised, including Computerized Tomography, (CT), Magnetic Resonance Imaging (MRI), Nuclear Medicine (Nuc Med), , Registered Diagnostic Medical Sonographer (RDMS), Certified Nuclear Medicine Technologist (CNMT) and Dexa is preferred, or b. A minimum of registration in every sub-specialty that is supervised within one year (with the Imaging Manager managing the technical aspects of sub-specialty until the Imaging Supervisor completes the Competency Based Orientation (CBO) #Basic Life Support (BLS) required by end of conditional period #One year of supervisory experience is preferred #Three years of technical experience in all sub-specialty areas is preferred Responsibilities #Actively participates in the development of corrective action plans, communicates and deals with unacceptable behavior or performance, provides clear documentation and assists the employee in changing behavior in accordance with hospital standards.# #Respond after hours to hospital needs in order to maintain efficient supervision of their areas.# #Accomplish routine administration tasks during work hours without needing to work from home. #Completes annual competency review on assigned staff, to assure direct feedback from supervisor.# #Identifies issues, recognizes needs and recommends innovative changes, offers suggestions for improvement and participates in the budget process. Suggesting items for capital purchase and departmental needs.# #Completes the interview process and makes hiring decisions.# #Maintains knowledge of hospital and department policies, standards and procedures. Participates in development of new standards as needed.# #Is pivotal in creating a work place that supports and achieves a high morale among the staff, this includes physician, and patient relationships.# #Works cohesively with other department to resolve issues and build systems between units. #Establishes open communication with staff, shares information, and listens to concerns. #Develops relationships with patient and families to teach, listen and assure participation in care About Boulder Community Health and Boulder, Colorado Boulder Community Health (BCH) is a not-for-profit healthcare organization based in Boulder, Colorado. It provides comprehensive medical services to the Boulder County community, including acute care, emergency services, psychiatric services, and outpatient care. BCH operates several facilities, including the flagship Boulder Community Hospital, and offers a wide range of specialties such as cardiology, oncology, orthopedics, maternity, and mental health care. The organization is known for its commitment to high-quality care, patient-centered services, and a focus on wellness and prevention. Boulder Community Health is dedicated to improving the health of the local community by integrating advanced medical technology, evidence-based practices, and personalized care. The healthcare system also emphasizes collaboration with local physicians, wellness programs, and community outreach initiatives. BCH is recognized for its strong ties to the local population and its role in supporting public health initiatives, promoting healthy lifestyles, and addressing health disparities. Boulder Community Health is a Certified Level II Trauma Center and has received incredible accolades for the wonderful care that we provide, including: Newsweek- #America#s Best-in-State Hospital 2025#; U.S. News and World Report- #Best Hospitals for Maternity Care 2025#; 5280 Magazine-#21 BCH physicians among 2024 list of the region#s best doctors#; Daily Camera People#s Choice Awards 2024- Honorable mention, Best Physical Therapy Center; and American Heart Association- Quality Stroke Care 2024. As an employee at Boulder Community Health, you will enjoy working in state-of-the-art facilities with competitive compensation and benefits, including health/dental/life, tuition reimbursement and an on-site fitness center. You also have access to an incredible Employee Wellness and Support program, employee activities, discounts and more! EOE/Affirmative Action/Drug-free workplace.# BCH will never conduct interviews or ask for employment documents via text. This position has no close date. Applications will be accepted until the position is filled. Mammography Supervisor Boulder Community Health, Boulder, CO 80303 $38.39 - $57.59 an hour - Full-Time Days, 40 hours per week Boulder Community Health is seeking a Mammography Supervisor who will ensure the accomplishments of the department's mission and goals, including responsibility for maintaining and/or exceeding percentage goals set by the hospital for Patient and Employee Satisfaction and Safety in their areas. Supervisors will act as primary leaders, mentors, and role models in their departments. Each Supervisor will spend at least 60% of their time in their respective work areas performing exams and working side by side with their employees while representing staff through growth, change, and conflict resolution. Benefits: * Health insurance, including a FREE employee only option * Dental and Vision insurance * BCH paid Life Insurance; Spouse and Dependent Life Insurance plans * Short-term and Long-term disability coverage * Health and Dependent Care Flexible Spending Accounts * Retirement plan with BCH matching contributions, and discretionary lump sum contribution * Paid Time Off * Education assistance program * Voluntary Wellness programs, to include biometrics, wellness team challenges, and much more * Staff Support Initiatives such as Sound Baths, Meditation, Massages, and Reiki * Free one-on-one retirement planning sessions * Employee Assistance Program offering 8 free, confidential counseling sessions for you and your family Qualifications * American Registry of Radiologic Technologist (ARRT) registered in Radiologic Technology (RT) plus, a. Registered in every sub-specialty that is supervised, including Computerized Tomography, (CT), Magnetic Resonance Imaging (MRI), Nuclear Medicine (Nuc Med), , Registered Diagnostic Medical Sonographer (RDMS), Certified Nuclear Medicine Technologist (CNMT) and Dexa is preferred, or b. A minimum of registration in every sub-specialty that is supervised within one year (with the Imaging Manager managing the technical aspects of sub-specialty until the Imaging Supervisor completes the Competency Based Orientation (CBO) * Basic Life Support (BLS) required by end of conditional period * One year of supervisory experience is preferred * Three years of technical experience in all sub-specialty areas is preferred Responsibilities * Actively participates in the development of corrective action plans, communicates and deals with unacceptable behavior or performance, provides clear documentation and assists the employee in changing behavior in accordance with hospital standards. * Respond after hours to hospital needs in order to maintain efficient supervision of their areas. * Accomplish routine administration tasks during work hours without needing to work from home. * Completes annual competency review on assigned staff, to assure direct feedback from supervisor. * Identifies issues, recognizes needs and recommends innovative changes, offers suggestions for improvement and participates in the budget process. Suggesting items for capital purchase and departmental needs. * Completes the interview process and makes hiring decisions. * Maintains knowledge of hospital and department policies, standards and procedures. Participates in development of new standards as needed. * Is pivotal in creating a work place that supports and achieves a high morale among the staff, this includes physician, and patient relationships. * Works cohesively with other department to resolve issues and build systems between units. * Establishes open communication with staff, shares information, and listens to concerns. * Develops relationships with patient and families to teach, listen and assure participation in care About Boulder Community Health and Boulder, Colorado Boulder Community Health (BCH) is a not-for-profit healthcare organization based in Boulder, Colorado. It provides comprehensive medical services to the Boulder County community, including acute care, emergency services, psychiatric services, and outpatient care. BCH operates several facilities, including the flagship Boulder Community Hospital, and offers a wide range of specialties such as cardiology, oncology, orthopedics, maternity, and mental health care. The organization is known for its commitment to high-quality care, patient-centered services, and a focus on wellness and prevention. Boulder Community Health is dedicated to improving the health of the local community by integrating advanced medical technology, evidence-based practices, and personalized care. The healthcare system also emphasizes collaboration with local physicians, wellness programs, and community outreach initiatives. BCH is recognized for its strong ties to the local population and its role in supporting public health initiatives, promoting healthy lifestyles, and addressing health disparities. Boulder Community Health is a Certified Level II Trauma Center and has received incredible accolades for the wonderful care that we provide, including: Newsweek- "America's Best-in-State Hospital 2025"; U.S. News and World Report- "Best Hospitals for Maternity Care 2025"; 5280 Magazine-"21 BCH physicians among 2024 list of the region's best doctors"; Daily Camera People's Choice Awards 2024- Honorable mention, Best Physical Therapy Center; and American Heart Association- Quality Stroke Care 2024. As an employee at Boulder Community Health, you will enjoy working in state-of-the-art facilities with competitive compensation and benefits, including health/dental/life, tuition reimbursement and an on-site fitness center. You also have access to an incredible Employee Wellness and Support program, employee activities, discounts and more! EOE/Affirmative Action/Drug-free workplace. BCH will never conduct interviews or ask for employment documents via text. This position has no close date. Applications will be accepted until the position is filled.
$38.4-57.6 hourly 32d ago
Home Base Veteran Outreach Coordinator
Brigham and Women's Hospital 4.6
Boston, MA jobs
Site: The General Hospital Corporation 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. Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds - including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service - for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research. The Home Base Veteran Outreach Coordinator is a point of contact for veterans and their families seeking care and/or education regarding Post Traumatic Stress (PTS), Traumatic Brain Injury (TBI) and other combat-related stress. When not assigned to the Intensive Clinical Program, the Veteran Outreach Coordinator role changes to educate and provide outreach to New England-based veterans and their families about Post Traumatic Stress (PTS), Traumatic Brain Injury (TBI), and encourages the community to take advantage of services available through the Home Base Program. The Coordinator is an employee of MGH and works alongside a team of world class medical professionals to help educate veterans, their families, social workers, employers, community service providers, veterans' groups, and others as to how to recognize symptoms of PTS/TBI and the ways in which they or their loved ones can seek help. The Veteran Outreach Coordinator guides veterans through the treatment evaluation process in the Home Base Clinic and works closely with the clinical staff in the Home Base Program around patient case management and ongoing monitoring of patient needs. The Coordinator provides active patient outreach, including phone, email, in-person meetings and text messaging. Job Summary Summary Responsible for community outreach, engagement, and support to enhance access to behavioral health programs. The Outreach Coordinator collaborates with community partners, healthcare professionals, and social service agencies to promote mental health awareness and address the behavioral health needs of individuals. Does this position require Patient Care? Yes Essential Functions * Conduct proactive outreach within the community to identify individuals in need of behavioral health services. * Establish relationships with community organizations, schools, primary care providers, and other relevant stakeholders to enhance outreach efforts. * Conduct initial assessments to identify the behavioral health needs of individuals. * Provide information and referrals to appropriate behavioral health services and resources. * Respond to crisis situations and provide immediate support and intervention. * Collaborate with crisis intervention teams, law enforcement, and emergency services as needed. * Advocate for individuals with behavioral health needs to ensure they receive timely and appropriate care. * Conduct community education and awareness programs on mental health topics. Qualifications Education Bachelor's Degree preferred Experience * minimum of 1-3years of military experience with at least one deployment preferred but not required * must have honorable discharge (proof of DD 214 required). Knowledge, Skills and Abilities * Strong knowledge of behavioral health services, resources, and crisis intervention techniques. * Excellent communication, interpersonal, and organizational skills. * Ability to work independently and collaboratively within a team. * Sensitivity to the understanding of the social determinants of health. * Proficiency in using electronic health records and documentation systems. * Valid driver's license and reliable transportation for community outreach. Additional Job Details (if applicable) Physical RequirementsStanding Frequently (34-66%) Walking Frequently (34-66%) Sitting Occasionally (3-33%) Lifting Frequently (34-66%) 35lbs+ (w/assisted device) Carrying Frequently (34-66%) 20lbs - 35lbs Pushing Occasionally (3-33%) Pulling Occasionally (3-33%) Climbing Rarely (Less than 2%) Balancing Frequently (34-66%) Stooping Occasionally (3-33%) Kneeling Occasionally (3-33%) Crouching Occasionally (3-33%) Crawling Rarely (Less than 2%) Reaching Frequently (34-66%) Gross Manipulation (Handling) Frequently (34-66%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) Remote Type Hybrid Work Location One Constitution Wharf Scheduled Weekly Hours 40 Employee Type Regular Work Shift Rotating (United States of America) Pay Range $20.43 - $29.21/Hourly Grade 4 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: The General Hospital Corporation 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 individuals 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. 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.
$20.4-29.2 hourly Auto-Apply 29d ago
Coding Education Specialist, Remote
Brigham and Women's Hospital 4.6
Somerville, MA jobs
Site: Mass General Brigham Incorporated 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 Responsible for developing, delivering, and managing comprehensive coding education and quality improvement programs for professional and hospital coding staff. This role ensures coders are equipped with the knowledge, skills, and resources needed to accurately assign medical codes, maintain compliance with national guidelines, and support overall revenue cycle performance. The position collaborates closely with Coding Operations, Quality Assurance, Central Auditing, Group Practice Management, and Revenue Integrity to improve coding accuracy, strengthen documentation practices, and reduce avoidable denials * Design, develop, and maintain coding education curriculum based on current CPT, ICD-10-CM/PCS, HCPCS, payer guidelines, and regulatory updates. * Deliver training through multiple modalities (live sessions, virtual sessions, workshops, on-demand modules, and job aids) to support clinical providers, coders, QA staff, and related stakeholders. * Create and manage e-learning materials using multimedia tools, learning platforms, and adult learning best practices. * Provide individualized coaching and hands-on support to coders to improve coding accuracy, documentation interpretation, and guideline application. * Collaborate with Quality Assurance, CDI, and Coding Operations to identify trends, close knowledge gaps, and develop targeted education plans. * Participate in or conduct coding audits; analyze findings; develop corrective education; and track coder progress over time. * Support provider education efforts by identifying documentation improvement needs and partnering with clinical teams to clarify best practices. * Monitor industry changes, regulatory updates, and payer policy changes to proactively adjust training materials and inform coding leadership. * Contribute to reducing avoidable denials by educating staff on documentation, coding accuracy, and compliance requirements. * Promote compliance with coding ethics, organizational standards, and fraud/waste/abuse prevention Qualifications Education Bachelor's Degree Health Information Management required or bachelor's degree Related Field of Study required Can this role accept experience in lieu of a degree? Yes Licenses and Credentials CPC/CPMA CCS (I/P) RHIT RHIA Experience Coding Experience 2-3 years required, and Teaching Experience 1-2 years preferred Knowledge, Skills and Abilities * Strong instructional skills, including the ability to engage learners, present complex concepts clearly, and adapt teaching methods to various learning styles. * In-depth understanding of coding guidelines, compliance regulations, and industry standards. * Excellent communication skills, both written and verbal, to deliver training content effectively and interact with diverse learners. * Strong analytical skills to evaluate coding accuracy, identify training needs, and measure training effectiveness. * Ability to collaborate effectively with clinicians, coding staff, trainers, managers, and other stakeholders. Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $62,400.00 - $90,750.40/Annual Grade 6 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 Incorporated 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 individuals 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. 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.
$62.4k-90.8k yearly Auto-Apply 13d ago
Assistant Billing Manager
Brigham and Women's Hospital 4.6
Somerville, MA jobs
Site: Mass General Brigham Incorporated 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. This role will be covering oral maxillofacial/ dental. This is a fully remote position. Job Summary Summary: Assists Manager with the Patient Billing Office's client relationship and coordinate the processing, reporting and analysis of key revenue cycle activities. Provides research support to the manager and assigned practices related to accounts receivable management, patient customer service complaints and Third Party Requests for information. Does this position require Patient Care? No Essential Functions: Assists the Manager in completing tasks including, but not limited to, report review and distribution, billing account inquiries, charge reconciliation and research of missing charges, procedure code dictionary maintenance, and other essential Master files. * Analyze information on trends for practice groups; this may involve account research and downloading or inputting information into spreadsheets. * Provides research and follow-up for inquiries from Customer Service. * Pulls monthly rejection details. The role is responsible for pivoting rejections and analyzing rejections prior to RCAM review. * Work EPIC work queues and resolve edits in compliance with GPM Service standards for assigned billing areas. * Review accounts referred for write-off and document collection efforts prior to transferring for write-off approval. * Assist with the orientation and training of new staff. Qualifications Education High School Diploma or Equivalent required Experience Revenue, billing and related experience 2-3 years required Knowledge, Skills and Abilities * Strong knowledge of medical billing and payer requirements. * Excellent leadership and team management skills. * Proficiency in billing software and electronic health records (EHR) systems. * Strong analytical and problem-solving abilities. * Exceptional communication and interpersonal skills. * Ability to handle multiple tasks and work under pressure. * Ability to work with a high degree of accuracy. Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $62,400.00 - $90,750.40/Annual Grade 6 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 Incorporated 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 individuals 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. 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.
$62.4k-90.8k yearly Auto-Apply 9d ago
Health Plan Medical Director
Brigham and Women's Hospital 4.6
Somerville, MA jobs
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 Medical Director Qualifications Education: MD or DO required Licenses and Credentials: * Physician - Massachusetts active full license required Experience: * 3-5 years of Health Plan experience * at least 5 years of clinical practice experience Knowledge, Skills and Abilities: * Utilization Management experience * Excellent written and oral communications skills * Proficient in basic computer skills, use of EHR's, digital tools * Multitasking abilities * Adaptable to change due to business growth Job Description: * Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities * Reviews clinical services and quality incidents when sufficiently serious to merit physician involvement * Coverage of medical necessity determinations to support special investigations/fraud waste and abuse cases * Collaborates on health plan medical policy development * Assesses new, emerging, and existing technologies to determine appropriateness of health plan coverage * Partners with clinical leaders to ensure medical service expenditures remain within budget * Collaborates with business development, quality, finance and medical management teams to promote improvements in the quality and cost efficiency of care throughout the MGB Health Plan provider network * Delivers consultation to network management staff and deployment of education programs for network clinicians * Develops and delivers presentations for clinical staff on current topics relevant to MGB Health Plan members and network * May represent MGB Health Plan at a variety of external forums and committees * Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees * Monitors performance metrics and audits to identify areas for continuous improvement and ensure compliance * Anticipates and meets or exceeds internal and/or external customer expectations and requirements; establishes and maintains positive relationships with customers and gains their trust and respect * Build strong relationships and infrastructure that designate MGB Health Plan as a people-first organization * Ensure diversity, equity and inclusion are integrated as a guiding principle * Other duties as assigned with or without accommodation Additional Job Details (if applicable) * Primarily remote position, exempt * In person meetings as requested for business needs * M-F 830-5pm EST; Participates in after hours and weekend call rotation as assigned * Ensures that all assigned work is completed within regulatory timelines * Checks and addresses assigned work queues, email, Teams messages during assigned work hours Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) 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 individuals 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. 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.
$179k-266k yearly est. Auto-Apply 13d ago
EPIC Payor Reimbursement Analyst - FT - Days - Remote Optional
Mary Washington Healthcare 4.8
Fredericksburg, VA jobs
Start the day excited to make a difference…end the day knowing you did. Come join our team. EPIC Payor Reimbursement Analyst must have strong proficiency and knowledge application of providing analytic expertise in the following areas: Epic HB/PB contract build and modeling functions, healthcare financial and payor software systems, payor financial impact/trend analysis reports and managed care contracting knowledge. This role will require extensive knowledge of internal financial systems, ability to manipulate/present a wide data range upon request and understanding of financial impacts of managed care contracting to organization budgets. This position must demonstrate a commitment of quality service to our patients, the community, and our internal/external customers. ***At this time, this position is open to candidates located in and authorized to work in the United States who reside in one of the following states: VA, NC, SC, GA, FL, NE, TX, WI, LA, ME, WV, TN, LA, NH, IA and OH*** Essential Functions & Responsibilities Epic HB Resolute Function: Understanding and analysis of contracts, components, component groups, selection extensions, pricing extensions, hospital billing rules and many more items within the resolute Interpretation and loading of multiple fee schedules used within HB contracting Epic PB Resolute Function: Interpretation and loading multiple fee schedules used within PB contracting Epic HB/PB Resolute Function: Optimization of previously built contracts and creation of “new” contracts within the epic Contract Maintenance Build contracts within Epic that reimburse by DRG, percentage of billed charges, grouper rates, case rates, global case rates, per diem and contain lesser of and stop bill language, for utilization in expected reimbursement calculations Analyze, build, test, deploy and maintain Payor Relations contracts/fee schedules and system related functions Monitor, analyze and test interface projects and upgrades to ensure contract pricing and language are appropriate Utilizes contract modeling/cost accounting software to analyze/model the impact of contract rate proposals between MWHC and Payors Maintain knowledge in technical workflow and identify/communicate trends Payor Relations Function: Analyzes and produces payor financial impact analysis for all contract proposals for HB/PB Performs retrospective impact analysis against organization budget to ensure contractual financial results meet set financial targets Analyzes the reimbursement impact of changes in government regulations, regulatory code changes/deletions/revisions, key managed care contracts, and third-party billing policies or requirements and reports financial impact to Manager. Utilize Excel to do the data analysis; data comes from Epic Performance of other duties assigned Qualifications and Certifications: Required Minimum 3 years relevant experience Certified in applicable Epic application and/or certified within six months of hire Strong understanding of payor reimbursement coding (e.g., DRG, CPT, RC, HCPCS, OPPS, APC) Strong understanding of HB/PB workflows, analytics and technology Ability to prioritize multiple projects Strong verbal, written and presentation skills Ability to maintain professionalism and work within a team environment across multiple disciplines and teams Preferred Certified in Healthcare Financial Professional (CHFP) Strong understanding of HB/PB revenue cycle functions and payor contracting Strong computer skills relevant to position; extensive experience using Excel, Access Database, knowledge of Lawson and Siemen's systems and DSS/Managed Care contract modeling software As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
$51k-66k yearly est. Auto-Apply 60d+ ago
Remote Radiology Operations Coordinator | Sanford Health Virtual Care
Sanford Health 4.2
Lily, SD jobs
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: 8 Hours - Varied Shifts (United States of America) Scheduled Weekly Hours: 40Salary Range: $32.50 - $52.00 Union Position: No Department Details “Join our team to work 100% remotely and play a key role in developing Sanford's new Virtual Care program, designed to support the needs of our organization across four states.” Summary Exercises professional judgment in the clinical coordination of operations within the radiology department. Accountable for the success and performance of the daily physician operations. Supports technical staff, med students, support staff and Radiologists within the department. Plays an integral part to the operational/administrative functions of the department. Job Description Consistently projects a friendly, cooperative impression and positive image of the institution when dealing with medical staff members. Possesses excellent communication skills, positive and professional attitude, and establishes and maintains good interpersonal relationships. Demonstrates leadership qualities to provide direction and serve as a resource to staff and customers. Possesses self-direction with a high level of accountability and the ability to work with minimal to no supervision. Deals discreetly with sensitive confidential information. Ability to operate and troubleshoot: Picture Archiving and Communication System Quality (PACS), computers, monitors, and other radiology equipment. Provides internal support for all systems necessary to the operation of the radiology department, to include but not limited to, the electronic medical record, PACS system dictation systems, image sharing programs, etc. Ability to act in a supervisory capacity as needed for oversight of image quality, radiation protection, and patient flow. Maintains an active program of professional development related to individual, professional, and institutional needs. Provides input to capital requests. Assists with cross-market standardization. Flexible and responsive to coordinating changes to staffing within the department. Performs other duties as assigned. Qualifications Completion of formal radiographic technology training in an American Medical Association (AMA) or Joint Review Committee on Education in Radiologic Technology (JRCERT) approved school is required. Minimum of three years' radiographic experience required; previous supervisory experience in a healthcare setting is preferred. Possesses a thorough understanding of diagnostic radiographic principles. Registration with the American Registry of Radiologic Technologists (ARRT) is required. If working in North Dakota and performing medical imaging or radiation therapy procedures, licensure with the North Dakota Medical Imaging and Radiation Therapy Board (NDMIRT) is required. Basic Life Support (BLS) certification within six weeks of employment and re-certification as necessary is required. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
$34k-40k yearly est. Auto-Apply 52d ago
Home Base SOF Admissions Social Worker
Brigham and Women's Hospital 4.6
Boston, MA jobs
Site: The General Hospital Corporation 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. LCSW: starting pay rate $68,224 LICSW: starting pay rate $92,227 SIGN ON BONUS AVAILABLE for eligible Non-MGB employees: $3,000 FOR LCSW, $10,000 FOR LICSW/LMHC, Please ask about the details! Job Summary Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds - including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service - for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research. The Massachusetts General Hospital seeks a dynamic Licensed Clinical Social Worker (LCSW)/Licensed Independent Clinical Social Worker (LICSW) to serve on the Special Operations Team. In this role, the LCSW/LICSW will provide and oversee the provision of psychiatric, psychosocial, and overall mental health services and referrals for military Special Operators into the Home Base program. They will also be dedicated to supporting the Special Operations Forces (SOF) program and will provide coverage to other clinical operations as needed. The LCSW/LICSW may help cover approximately 2-3 weekend shifts per year. Summary This position will collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs as part of the interdisciplinary team. They work collaboratively with all healthcare team members to develop and implement treatment plans that support patient-centered plans of care for both individual patients and the medical community. Does this position require Patient Care? Yes Essential Functions * Provides psychosocial assessments of patients and families with social, emotional, interpersonal, and/or environmental issues. Formulates biopsychosocial assessment, disposition, and treatment plans. * Collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs as part of the interdisciplinary team. * Monitor, evaluate, and record client progress according to measurable goals described in the treatment and care plan. * Coordinate care for Special Operations Forces (SOF) veterans and military-connected family members seeking care at Home Base with the appropriate internal or external clinicians in a multi-disciplinary team, coordinated care model. * Serve as a contact point for accepting and triaging SOF referrals from internal clinicians, outside clinicians and self-referred patients. * Serve as primary case manager for patients in SOF admissions process in collaboration with Admissions Coordinator, including, but not limited to, the following responsibilities: conduct pre-screening to assess treatment and evaluation needs for SOF patients referred; coordinate signing of Release of Information forms, acquire relevant medical records, and coordinate with SOCOM where applicable; serve as point of contact for ongoing questions from the patient as they arise. * Monitor patient's status in admissions process using appropriate documentation. * May be asked to collaborate with SOF/ComBHaT team, patients, clinical team, and Resource Specialist to identify clinical and psychosocial needs in patients' home communities and identify appropriate resources. * May provide direct clinical services to Veterans and/or family members, which may include group or individual therapy. * May provide psychoeducation regarding PTSD, TBI, and related conditions to Veteran patients and family members as clinically appropriate within the context of the Intake and triage duties. * Collaborate with an inter-disciplinary team of clinical staff (social workers, psychologists, nurses, psychiatrists, physiatrists, physical therapists, etc.) to coordinate patient care and plan for discharge/aftercare when needed. * Consult with team to facilitate mandated assessments when abuse is suspected (child, disabled adult, elder), and safety assessment when violence is reported. Collaborates with MGH resources (HAVEN and Child Protection Team). * May assist with crisis intervention and management. * Documents timely and relevant information in patient electronic medical record and Home Base database. * Provide coverage for social work responsibilities in Outpatient Clinic as needed. * For LICSWs: provide clinical supervision to LC-level and/or MSW students as needed. * Additional responsibilities as assigned. Qualifications Education Master's Degree Social Work required or Master's Degree Mental Health & Behavioral Medicine required Can this role accept experience in lieu of a degree? No Licenses and Credentials Current professional licensure in Massachusetts (LCSW required, LICSW preferred). Experience Clinical Social Worker I Clinical Experience in a medical setting 0-1 years required Clinical Social Worker II Clinical Experience in a medical setting 2-3 years required Knowledge, Skills and Abilities * Excellent organizational and time management skills. * Excellent crisis intervention skills. * Good problem solving and conflict resolution skills. * Ability to work well collaboratively and independently. * Strong written and verbal communication skills. * Knowledge of community resources and the aging process. * Demonstrates basic foundational skills, showing fundamental knowledge and a commitment to the application of professional values and ethics. * Demonstrates fundamental skills in formulation, assessment of risks, crisis intervention completion of psychosocial treatment plans, and appropriate documentation. * May need assistance and guidance in ensuring the patient's needs, safety measures, and concerns are brought forward. Emerging knowledge of internal and external resources. * Developing and demonstrating interpersonal collaboration in a medical setting- inpatient or outpatient. * May need coaching/guidance in this area. * May provide some assistance and support with onboarding for new team members. * Aware of opportunities in department/service initiatives; participates in initiatives at an entity level. Uses data to measure progress. * Demonstrate fundamental skills under supervision. May need assistance in promoting collaboration among healthcare team members, other colleagues, and the organization to support and enhance patient care. Additional Job Details (if applicable) Physical Requirements * Standing Frequently (34-66%) * Walking Frequently (34-66%) * Sitting Occasionally (3-33%) * Lifting Frequently (34-66%) 35lbs+ (w/assisted device) * Carrying Frequently (34-66%) 20lbs - 35lbs * Pushing Occasionally (3-33%) * Pulling Occasionally (3-33%) * Climbing Rarely (Less than 2%) * Balancing Frequently (34-66%) * Stooping Occasionally (3-33%) * Kneeling Occasionally (3-33%) * Crouching Occasionally (3-33%) * Crawling Rarely (Less than 2%) * Reaching Frequently (34-66%) * Gross Manipulation (Handling) Frequently (34-66%) * Fine Manipulation (Fingering) Frequently (34-66%) * Feeling Constantly (67-100%) * Foot Use Rarely (Less than 2%) * Vision - Far Constantly (67-100%) * Vision - Near Constantly (67-100%) * Talking Constantly (67-100%) * Hearing Constantly (67-100%) Remote Type Hybrid Work Location One Constitution Wharf Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $56,992.00 - $82,992.00/Annual Grade 6 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: The General Hospital Corporation 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 individuals 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. 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.
$57k-83k yearly Auto-Apply 13d ago
Insurance Representative - Remote IA, MN, ND, SD
Sanford Health 4.2
Remote
**Careers With Purpose** **Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.** **Facility:** Remote ND (Central Time) **Location:** Remote, ND **Address:** **Shift:** Day **Job Schedule:** Full time **Weekly Hours:** 40.00 **Salary Range:** $16.00 - $25.50 **Department Details** Flexible scheduling after training is completed. Fully remote/work from home. **Job Summary** The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement. Must understand and be able to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Proactively identifies and performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials. Uses advanced knowledge and understanding to process payer rejections. Conducts trend analyses, appeals and resolves low payment or underpaid accounts. Provides input for payer-specific meetings. Handles difficult account situations and resolves issues delaying or preventing payments from payers. Performs miscellaneous job related duties as requested. Consistently demonstrates accuracy in correcting (identified through pre-edits) and submitting claims to payers. Ensures accounts are billed in timely manner. Consistently reports to a manager any accounts that cannot be finished in a timely manner. When claims are disputed, consistently utilizes the correct resources to ensure the completion of the claim. Accurately and completely follows claim through entire billing process. Ensures all claims consistently meet compliance regulations. Demonstrates accountability by consistently using appropriate resources and channels to problem solve issues. Consistently demonstrates ability to input data accurately into the computer system. Consistently answers the telephone courteously. Maintains and updates computer skills as needed for work assignments. Demonstrates the ability to utilize software applications for maximum efficiency. Consistently ensures verbal communication is courteous, complete, and professional whether using phone or personal contact. Consistently ensures written communication is accurate, complete and professional in presentation whether word processing or using email. Identifies and promptly resolves billing complaints. Directs issues to supervisor when unable to resolve. Documents in computer system all contacts regarding patient accounts. Depending on location, may verify demographics, identify appropriate third-party insurance/payers, set up insurance, initiate patient financial assistance. Contact the insured or financially responsible party to obtain missing information. Verify, create or update patient accounts for billing, prepare insurance claims forms or related documents, and verify completeness and accuracy. **Qualifications** High school diploma or equivalent preferred; post-secondary or trade courses in accounting, business, and communications would be helpful for this position. Six months' related work experience required. Computer skills essential. When applicable and if desired, leadership may require related experience to the Associate Insurance Representative at Sanford Health for internal applicants. **Benefits** Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit *********************************** . Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************ . Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment. **Req Number:** R-0242737 **Job Function:** Revenue Cycle **Featured:** No
$16-25.5 hourly 8d ago
Senior Cyber Security Engineer - Network Security
Sanford Health 4.2
Remote
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: Scheduled Weekly Hours: 40Salary Range: $40.00 - $66.00Pay starts at $40 and increases according to years of applicable experience. Union Position: No Department Details ***Working remotely is an option if you currently live in SD, ND, MN, IA, NE or WI. Required Skills and Qualifications: Strong communication skills to explain complex concepts to various stakeholders Excellent documentation skills for development of diagram, requirements, process mapping and overall design solutions Strong team player with curious and flexible nature. Strong understanding of network protocols (TCP/IP, OSI model) and network security concepts Expertise in network switch, routing, and security technologies (firewalls, VPNs, IDS/IPS, etc.) Experience with security frameworks and standards (NIST, CIS, ISO 27001) Proficiency in scripting languages (Python, Perl, PowerShell) Strong problem-solving and analytical skills Excellent communication and interpersonal skills Summary Responsible for the technical and operational delivery of enterprise cybersecurity solutions. Focuses on the development and implementation of processes and tools for identifying, evaluating, implementing, troubleshooting, and maintaining technical security controls for the organization. These controls are designed to prevent, detect, and contain security threats; enabling Sanford to be productive while maintaining a secure environment that optimizes Sanford's return on investment. Job Description Lead the building, configuring, and maintaining of cybersecurity systems to ensure our operational environments stay compliant and secure. Implements security controls using industry best practices across numerous technologies including, but not limited to SIEM, email filtering, web and content filtering, firewall, IPS/IDS systems, identity and access management, SSO/MFA, vulnerability management, and data protection. Skillfully maintains the existing security systems, including implementing new features, performing upgrades, and managing technical configurations/policies across a variety of business-critical systems. Proficiently monitors and responds to security system health alerts. Respond to day-to-day operational work such as managing security tools while simultaneously multitasking with strategic project initiatives. Provide security consulting services to other Sanford health groups. Provide assistance to a 24x7 team of dedicated security engineers focused on maintaining operational stability while reducing risk. Build and maintain key vendor and supplier relationships. Lead strategic project initiatives ensuring the processes and procedures are well defined and documented. Recognize both internal and external threats and understand/communicate risks to Sanford Assets. Make strategic recommendations to enhance and improve overall security posture. Advise on methods to increase efficiency of current toolsets (such as script automation or process improvement recommendations). Mentor others within the team as well as receive instruction and guidance from others within the team. Write documentation that can be used by all team members and other employees. Identify gaps in established/documented process and update as needed. Works under limited guidance due to previous experience/breadth of knowledge of processes and organizational knowledge. Acts independently to determine methods and procedures on new assignments. Regularly presented with new assignments and projects that require the application of independent judgement/interpretation of policies/practices. Checks own work and the work of other team members. Qualifications Bachelor's degree in cyber security or an information technology related field. Minimum of 4 years experience working in Cyber Security field. Security Certifications (CISSP, CISA, CISM, Security+, CEH, etc.) are highly desired Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
$40-66 hourly Auto-Apply 15d ago
Patient Access Representative | Home Based | 40 hrs/wk
Sanford Health 4.2
Fargo, ND jobs
Careers With Purpose Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Facility: Remote ND (Fargo) Location: Fargo, ND Address: Shift: 8 Hours - Day Shifts Job Schedule: Full time Weekly Hours: 40.00 Salary Range: $16.25 - $23.00 Department Details M-F 8-5 WFH with 6 months in clinic. Job Summary Join our Sanford Patient Access Family and Grow the Good! As a Patient Access Representative, your primary responsibility will be providing extraordinary customer service to patients with every interaction. With being the first point of contact, you will have the opportunity to provide a positive patient experience by creating a welcoming and safe environment, either on the phone or in the clinic. Apply today to learn more about the opportunities available to grow your career at Sanford. REGISTRATION * Greet patients & verifies demographics * Creating, scanning & routing documents or electronic forms * Inform patients what the document is & capture signatures on necessary paperwork * Establishes and assigns financial responsibility and assists with arrangements while adhering to appropriate policies and procedures * Collects co-payments, pre-payments, and payments on account balances * May work through the registration work queue to address and resolve registration errors or denied insurance claims SCHEDULING * Work with nursing team & providers to coordinate & schedule appointments to meet patient's needs, coordinate provider schedule * Obtain and coordinate referrals & conduct pre-authorization * Arrange interpreter services * Check patients in/out * Operate multi-line phone * May resolve work queue issues, manage recall and waitlists, & serve as switchboard operator calling codes and paging providers ADDITIONAL DUTIES MAY INCLUDE * Preparation & coordination of charts * Organize supporting provider documents * Initiation & collaboration of patient financial assistance * Track patient visits & health information management on patient accounts * Compile, distribute, administer, and score assessments * Coordination of Telemed appointments * Reminder calls for appointments * Hospital admission * Office duties, such as make copies or send faxes Qualifications High school diploma or equivalent preferred. Post-secondary education helpful. One year of work experience, preferably in a medical office setting. Medical terminology helpful; customer service skills essential. Six months' customer service experience desired. May require BLS for certain locations and/or settings. Benefits Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit *********************************** . Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************ . Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment. Req Number: R-0242333 Job Function: Revenue Cycle Featured: No
$16.3-23 hourly 3d ago
Physician - Remote Emergency Radiologist
Sanford Health 4.2
Marshfield, WI jobs
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Physician - Remote Emergency RadiologistCost Center:201641261 System Radiology-ProfScheduled Weekly Hours:40Time Type:Full time Job Description: Marshfield Medical Center is looking for a BC/BE Radiologist to join our ED section in Wisconsin. Fellowship training in Body, Neuro, ED or MSK is required. Must be comfortable with all emergent diagnostic imaging modalities including Neuro CTA/perfusion, trauma (including MRI), Ultrasound (including OB), pediatrics and occasional musculoskeletal MRI/CT. No CVIR, nuclear medicine or mammography. Choose to work remote as a Non-Associate on a casual contract or may have the option to work locally at one of our centers as an Associate physician with additional salary and benefits. If working onsite, you will need to be comfortable with and will be responsible to occasionally perform some local minor procedures. Service coverage includes a level 2 soon to be level 1 trauma center and stroke center as well as additional regional hospitals and urgent care centers. Coverage needed for afternoons and evenings. No midnight shifts required. Yearly work requirement is 182 shifts a year - typically 7 on/7 off schedule/26 weeks per year Compensation/Benefits: Competitive Salary Flexible shift based model Health, Dental, Life, and Occurrence Based Malpractice insurance Relocation support available if working onsite Marshfield Clinic Health System is a non-profit 501(c)(3) organization. This may qualify you for additional state and/or federal education loan forgiveness programs. MCHS strongly encourages our physicians to be involved in medical education and research to continue building our strong foundation of patient care, research, and education for years to come. Marshfield Clinic Research Institute: ********************************** Marshfield Clinic Division of Education: ****************************************** Marshfield, Wisconsin Nestled in the heart of Wisconsin, Marshfield is a safe, clean community with a population of about 20,000 people. The region boasts a solid economy and a low cost of living, which includes below national average costs for housing and transportation. Community pride is evident in the private and city funds invested in making Marshfield a great place to live. Located one mile outside of town, you will have access to 6,500 acres for hiking, biking, hunting, canoeing, cross-country skiing, berry picking, and wildlife or bird watching or simply enjoying the fresh air. With excellent schools and high school graduation rates high above the national average, Marshfield is committed to offering and preparing students for top-notch educational opportunities. Those of us that have chosen to call Marshfield home have come to enjoy the benefits of short commutes, safe and friendly neighborhoods, fresh air and water, bountiful nature, and so much more. Come and see for yourself. Fun Fact: Marshfield is known as the HEART of Wisconsin! Marshfield Clinic Health System physicians and staff are motivated by our mission to enrich lives. We serve more than 350,000 unique patients each year through accessible, high quality health care, research and education. With more than 1,600 providers in 170 medical specialties and subspecialties as well as over 13,000 employees in 65 clinical locations in 45 communities serving Wisconsin and Michigan's Upper Peninsula, Marshfield Clinic Health System is nationally recognized for innovative practices and quality care. The Marshfield Promise Motivated by our mission to enrich lives, we use common values to ensure those we serve feel supported in their healthcare journey and staff and providers are actively engaged with one another. Together through our actions, we promise to deliver compassionate, safe and expert care to everyone. The Marshfield Promise is centered around 5 core values; Patient-Centered, Trust, Teamwork, Excellence and Affordability. For more information, please contact: Lindsay Becker, Physician and Advanced Practice Clinician Recruiter Phone: ************ *********************************** Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
$282k-517k yearly est. Auto-Apply 60d+ ago
Risk Adjustment Revenue Manager (Remote)
Sanford Health 4.2
Marshfield, WI jobs
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Risk Adjustment Revenue Manager (Remote) Cost Center:682891390 SHP-Strategic FinanceScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; 8:00 am - 5:00 pm (United States of America) Job Description: The Risk Adjustment Revenue Manager is responsible for risk adjustment strategy and related revenue management for Security Health Plan's Medicare, Affordable Care Act and Medicaid business. This individual provides development and implementation of programs and initiatives to improve the accuracy of the coding, including education; retrospective and prospective review processes; and vendor contract management; accountability for preparation for and management of the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Services (DHS) auditing processes; management of encounter data processes; and management of applicable state and federal guidance. The Risk Adjustment Revenue Manager works collaboratively with Security Health Plan executives and leadership as well as Marshfield Clinic Health System (MCHS) executives and leadership to lead risk adjustment strategy and process. JOB QUALIFICATIONS EDUCATION Minimum Required: Bachelor's Degree in Business Administration, Finance, Health Care Administration, Management or related field required. Preferred/Optional: Post graduate degree(s) desirable. EXPERIENCE Minimum Required: Five years of experience in risk adjustment or related area. Three years of experience in a management or leadership role and experience in the healthcare industry. Demonstrate a broad understanding of healthcare and health insurance. Demonstrate proficiency with verbal and written communication, strategic planning and business acumen. Preferred/Optional: Working knowledge of CMS and/or Medicaid risk adjustment methodologies. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: Certifications in professional coding and risk adjustment coding from American Academy of Professional Coders. State of Wisconsin driver's license with an acceptable driving record. Preferred/Optional: None Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
$72k-94k yearly est. Auto-Apply 57d ago
Compliance Auditor
Sanford Health 4.2
Remote
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: Scheduled Weekly Hours: 40Salary Range: 19.00 - 30.50 Union Position: No Department Details Summary Responsible for conducting internal audits and monitors to ensure that the organization's processes and operations are in compliance with laws, corporate guidelines, best practices, and contractual agreements. Job Description Knowledgeable of general audit concepts and techniques, including the type of audits, the approaches and processes, and the subsequent activities, as they relate to internal audits. Demonstrates the ability to interpret Federal rules and regulations. Demonstrates the ability to research regulation from various data sources. Demonstrates an advanced knowledge and skill in analyzing patient records to identify non-conformances in Current Procedural Terminology (CPT), International Classification of Diseases, Tenth Edition (ICD-10), and Healthcare Common Procedure Coding System (HCPCS) code assignment. Demonstrates both knowledge and application of Sanford Health Systems, policies, procedures, and guidelines. Demonstrates commitment to continuous learning for themselves and performs as a role model to other coding staff. Qualifications High school diploma or equivalent preferred. Advanced diploma or degree in Health Information Management or healthcare related field is preferred. Prior relevant compliance work experience is preferable. Two years' experience is required. Certification in one of the following is required: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC) or an equivalent. Certified Healthcare Auditor (CHA) certification to be completed within one year of employment is preferred. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
$49k-58k yearly est. Auto-Apply 29d ago
Patient Financial Services Representative I
Johns Hopkins Medicine 4.5
Saint Petersburg, FL jobs
Johns Hopkins All Children's Hospital is a premiere clinical and academic health system, providing expert pediatric care for infants, children and teens with some of the most challenging medical problems. Ranked in multiple specialties by U.S. News & World Report, we provide access to innovative treatments and therapies. With more than half of the 259 beds in our teaching hospital devoted to intensive care level services, we are the regional pediatric referral center for Florida's west coast. Physicians and community hospitals count on us to care for critically ill patients and perform complex surgical procedures. Join us in making a difference in the lives of our littlest patients. Apply today! What Awaits You? * Free onsite parking * Career growth and development * Tuition Assistance * Diverse and collaborative working environment * Comprehensive and affordable benefits package POSITION SUMMARY: The Patient Financial Services Representative I is responsible for a variety of roles, including but not limited to customer service, claim processing, and cash posting. Assists with all facets of the hospital billing process to meet deadlines and to be timely in reducing unbilled inventory, accounts receivable, cash posting, and account inquiries. Work Hours: Full-Time, Monday-Friday, 8:00 AM - 4:30 PM No weekend work required This position is 90% work from home; occasional on-site work as needed KEY ACCOUNTABILITIES: * Handles assigned business office related functions of straightforward, low complexity; including intermediate focused level problem solving, in a timely and efficient manner to ensure individual, departmental and organizational quality and productivity goals are met * Takes appropriate action on matters and/or escalates to designated party for timely resolution. Continued follow-up as appropriate matter is resolved * Performs data entry functions consistent with department requirements to ensure individual and departmental goals are met * Reviews assigned work to validate and reconcile accuracy to ensure quality and integrity of information handled * Researches information for proper resolution within designated timeframes to complete assigned responsibilities. * Effectively plans daily workload to ensure maximum productivity consistent with individual and departmental requirements QUALIFICATIONS: * A minimum of a High School diploma, GED, Certificate of Completion or equivalent achievement. * 1 year of relevant work experience with basic understanding of medical, billing and coding terminology for physician and/or hospital facility * Ability to read, write, speak and understand English * Basic computer skills, working in multiple systems and proficient in Microsoft Office Applications * Applicant must live local to Johns Hopkins All Children's Hospital, St. Petersburg, FL Salary Range: Minimum 16.05/hour - Maximum 25.69/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins! Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices. Johns Hopkins Health System and its affiliates are drug-free workplace employers.
$27k-33k yearly est. 3d ago
Clinical Research Regulatory Coordinator I
Brigham and Women's Hospital 4.6
Boston, MA jobs
Site: Mass General Brigham Incorporated 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 General Summary/Overview Statement: The Clinical Research Regulatory Coordinator I (CRRCI) works under general supervision to ensure the regulatory requirements for clinical trials are met. This position involves working with clinical teams, Institutional Review Boards (IRB), clinical trial sponsors and federal regulatory agencies. The CRRCI will be trained on the institutional and federal regulations governing clinical research. This position does not involve patient contact. Principal Duties and Responsibilities: The following regulatory duties will be performed under general supervision by the Clinical Research Manager: * Maintain and organize study specific regulatory binders * Prepare and submit protocol amendments, continuing reviews, and safety reports to the IRB * Revise informed consent documents to include new risk information and/or updated protocol requirements through the course of the study * Manage adverse event and deviation/violation/exception documentation for all enrolled patients and report to the sponsor and IRB as required * Submit Data and Safety Monitoring Reports * Maintain source documentation of correspondence with the IRB, investigators, and sponsors throughout the clinical trial process * Collect, complete, and submit essential regulatory documents to various regulatory entities * Participate in monitoring visits and file all monitoring visit correspondence * Ensure appropriate documentation of delegation and training for all study staff members * Maintain screening and enrollment logs Skills/Abilities/Competencies Required * Careful attention to detail * Good organizational skills * Ability to follow directions * Good communication skills * Computer literacy * Working knowledge of clinical research protocols Qualifications Education: Bachelor's Degree Related Field of Study required Can this role accept experience in lieu of a degree? Yes Licenses and Credentials: n/a Experience: Knowledge, Skills and Abilities: * Careful attention to detail. * Good organizational skills. * Ability to follow directions. * Computer literacy. * Working knowledge of clinical research protocols. Additional Job Details (if applicable) Working Conditions: * Duties will be performed remotely Remote Type Remote Work Location 101 Merrimac Street Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $19.76 - $28.44/Hourly Grade 5 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 Incorporated 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 individuals 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. 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.
$19.8-28.4 hourly Auto-Apply 9d ago
Senior Financial Analyst II - Hospital Reimbursement & Reports
Sanford Health 4.2
Michigan jobs
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Senior Financial Analyst II - Hospital Reimbursement & ReportsCost Center:101651010 System Support-FinanceScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; day shifts (United States of America) Job Description: JOB SUMMARY The Senior Financial Analyst II - Hospital Reimbursement & Reports is responsible for analyzing, monitoring and interpreting financial data to estimate cost settlement estimates for multiple hospitals and rural health clinics within the Health System. This individual will assist with Medicare and Medicaid Cost Report coordination, Wage Index, S10, DSH and other governmental audits report preparation and review. The individual will also work under the direction of leadership to develop, prepare, interpret, and monitor trends and other analyses. The Senior Financial Analyst II - Hospital Reimbursement & Reports will stay attuned to changes in reimbursement at both the Federal and State level while having a basic understanding and familiarity with the billing system and reporting. This individual provides financial information, serves as a knowledge resource to operations managers and makes recommendations to senior management. As healthcare reimbursement is an everchanging environment, the individual will also take the initiative to ensure their governmental reimbursement knowledge is up to date by reviewing proposed and final reimbursement rule changes. Location of remote work is a preference to the upper Midwest. JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: Bachelor's degree in finance, business administration, accounting or related field or Associate degree plus eleven years' of experience or Fifteen years' of experience within a healthcare setting in accounting or finance. Preferred/Optional: Master's degree in accounting, finance, business administration. EXPERIENCE Minimum Required: Seven years' experience in accounting and working with hospital cost reports. Demonstrated proficiency with completing independent financial analysis, collaborating with managers and making sound recommendations to managers. Demonstrated proficiency with Excel. Preferred/Optional: Experience within a healthcare setting in accounting and finance. Experience using spreadsheet software, with working knowledge of functions and databases. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: None Preferred/Optional: Certified Public Accountant (CPA) license awarded by the state of Wisconsin or Certified Healthcare Financial Professional (CHEP) certification awarded by the Healthcare Financial Management Association (HFMA). Given employment and/or payroll requirements of individual states, Marshfield Clinic Health System supports remote work in the following states: Alabama Arizona (limitations in some counties) Arkansas Colorado (limitations in some counties) Florida Georgia Idaho Illinois (except Chicago; limitations in other counties) Indiana Iowa Kansas Kentucky (limitations in some counties) Louisiana Maine (limitations in some counties) Michigan Minnesota (limitations in some counties) Mississippi Missouri Montana Nebraska Nevada New Hampshire (limitations in some counties) North Carolina North Dakota Ohio Oklahoma Oregon (limitations in some counties) Pennsylvania (limitations in some counties) South Carolina South Dakota Tennessee Texas (limitations in some counties) Virginia Utah Wisconsin Wyoming Marshfield Clinic Health System will not employ individuals living in states not listed above. Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
$63k-71k yearly est. Auto-Apply 60d+ ago
Remote Psychiatric Nurse Practitioner-1
Sanford Health 4.2
Clay, MN jobs
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: 12 Hours - Day Shifts (United States of America) Scheduled Weekly Hours: 24 Union Position: No Department Details This fully remote position provides real-time behavioral health (BH) assessment support for Sanford's Critical Access Hospitals and two major medical center emergency departments, covering 7 a.m. - 7 p.m. on Saturdays and Sundays. In addition to emergency department assessments, the role includes virtual rounding on BH inpatient units and consultations for behavioral health assessment needs on medical floors as identified. This position offers schedule flexibility, rotating every other weekend with another Psychiatric Nurse Practitioner, and may include opportunities to assist with weekday open shifts. You will work in collaboration with a virtual Psychiatrist during these hours to ensure comprehensive behavioral health coverage. Summary The Psychiatric Nurse Practitioner (PMHNP) provides advanced nursing mental health care to patients of all ages with psychiatric disorders. The NP performs psychiatric assessments, diagnoses, and manages treatment plans including medication management and psychotherapy, in collaboration with psychiatrists and interdisciplinary teams. Conduct thorough psychiatric evaluations, including mental status exams and psychosocial assessments. Diagnose and treat mental health conditions such as depression, anxiety, bipolar disorder, schizophrenia, PTSD, and substance use disorders. Prescribe and manage psychotropic medications, monitoring for efficacy and side effects. Provide individual, group, or family psychotherapy as appropriate. Develop and update individualized treatment plans in collaboration with patients and families. Coordinate care with psychiatrists, therapists, primary care providers, and community resources. Educate patients and families about mental health conditions, medications, and coping strategies. Document assessments, treatment plans, and progress notes accurately and timely. Participate in crisis intervention and emergency psychiatric care as needed. Engage in quality improvement, continuing education, and professional development. Qualifications Master's or Doctorate degree from an accredited Nurse Practitioner program. If APRN was licensed prior to August 1, 1995, master's degree in nursing is preferred. Experience in psychiatric or mental health settings preferred. Current licensure as a Registered Nurse and Nurse Practitioner in each state of practice. Current Drug Enforcement Administration (DEA) permit to prescribe controlled substances in each state of practice. State Controlled Substance License (if required by State) National board certification as a Psych Mental Health. (PMHNP-BC) or (PMHNP-C), Additional certifications require approval from a market executive leader: Family (FNP-BC) or (FNP-C) Obtains and subsequently maintains required specific competencies and certifications as outlined on privilege form. Privileging documents and related credentialing requirements will supersede this job description in defining minimum qualifications, criteria, and scope of practice, if variation between documents exists. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
$109k-160k yearly est. Auto-Apply 10d ago
Authorization Specialist (Remote in Wisconsin/Michigan)
Sanford Health 4.2
Marshfield, WI jobs
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Authorization Specialist (Remote in Wisconsin/Michigan) Cost Center:101651135 Insurance VerificationScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; day shifts (United States of America) Job Description: **Wisconsin and Michigan residents only eligible to apply** JOB SUMMARY The Authorization Specialist is a healthcare professional responsible for reviewing patient medical records to determine if a prescribed treatment, procedure, or medication requires prior authorization from the insurance company, ensuring that the requested care is deemed medically necessary and covered under the patient's benefits before it can be administered; this involves verifying patient eligibility, contacting insurance companies to obtain authorization, and managing the process to minimize delays in patient care. An Authorization Specialist works in a fast-paced environment with high call volumes, requiring strong organizational skills and the ability to manage multiple tasks simultaneously. JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: None Preferred/Optional: Successful completion of post-secondary courses in Medical Terminology and Diagnosis and CPT Coding, and Anatomy & Physiology. Graduate of a Medical Assistant, Health Unit Coordinator or Health Care Business Service program. EXPERIENCE Minimum Required: Two years' experience in a medical business office or healthcare setting involving customer service or patient-facing responsibilities, or equivalent experience. In addition to the following: Medical knowledge: Understanding of basic medical terminology, disease processes, and treatment options to accurately assess medical necessity. Insurance knowledge: Familiarity with different insurance plans, benefit structures, and prior authorization guidelines. Excellent communication skills: Ability to effectively communicate with healthcare providers, insurance companies, and patients to clarify information and address concerns. Attention to detail: High level of accuracy in data entry and review of medical records to ensure correct prior authorization requests. Problem-solving skills: Ability to identify potential issues with prior authorization requests, navigate complex situations, and find solutions to ensure timely patient care. Preferred/Optional: None CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: None Preferred/Optional: None **Wisconsin and Michigan residents only eligible to apply** Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
$31k-34k yearly est. Auto-Apply 48d ago
REMOTE PATIENT MONITORING (RPM)RN
Johns Hopkins Medicine 4.5
Baltimore, MD jobs
Make it happen at Hopkins Provides disease case management oversight of chronic conditions (i.e CHF, COPD, Diabetes, asthma etc.) in adult population using remote patient monitoring as a tool. Responsible for all aspects of remote monitoring including equipment set-up, equipment pick up, patient, physician, and field staff interaction, daily monitoring, response to alerts, inventory and equipment management. Intervenes to ensure patients receive necessary modifications in their care when appropriate. Multitasks and shifts priorities as needed. Tracks, trends and analyzes data relating to the disease management program, utilizes analytical/critical thinking skills with a high level of clinical expertise. Provides clinical instruction to a diverse patient population across many communities. Collaborates with overseeing providers for patient care plans ensuring communication and coordiantion gaps are closed to meet the needs of patients. Escalates issues to the Clincal Operations Manager as appropriate and reports concerns related to patient safety and quality. What Awaits You: * A culture of excellence focused on Patient and Family Focused Care * Electronic medical record that is integrated with the health system to ensure safe transitions of care * An organization that supports, recognizes and invests in their nurses. * Free Parking Who Should Apply: * Associated degree in nursing required, BSN preferred * Active Maryland or Compact RN license is required * BLS CPR certification required * Valid Maryland Drivers License, and current auto insurance * A minimum of two (2) years nursing experience * A minimum of one (1) year experience working with patients with multiple comorbidities (i.e CHF, COPD, Diabetes, asthma etc.) * Excellent Customer Service knowledge and training * Experienced in managing adult patients with chronic conditions * Knowledge of EPIC preferred This is a hybrid position and requires ability to travel to patient homes and or the office as needed Salary Range: Minimum 36.31/hour - Maximum 56.28/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices. Johns Hopkins Health System and its affiliates are drug-free workplace employers.
$71k-106k yearly est. 13d ago

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