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  • Representative II, Customer Service Operations

    Cardinal Health 4.4company rating

    Annapolis, MD jobs

    **_What Customer Service Operations contributes to Cardinal Health_** Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem resolution. Customer Service Operations is responsible for providing outsourced services to customers relating to medical billing, medical reimbursement, and/or other services by acting as a liaison in problem-solving, research and problem/dispute resolution. **_Job Summary_** The Representative II, Customer Service Operations processes orders for distribution centers and other internal customers in accordance to scheduling, demand planning and inventory. The Representative II, Customer Service Operations administers orders in internal systems and responds to customer questions, clearly communicating delays, issues and resolutions. This job also processes non-routine orders, such as product samples, and ensures that special requirements are included in an order. **_Responsibilities_** + Processes routine customer orders according to established demand plans, schedules and lead times using SAP and other internal systems. Enters all necessary order information, reviews order contents, and ensures that orders are closed once completed. + Responds to inquiries from internal customers, such as Distribution Centers, regarding order tracking information as well as on-hold, back order and high priority statuses. + Identifies and communicates resolutions to order delays, missing information, and product availability based on customer profiles. + Uses dashboards and reporting from internal systems to identify causes of order issues, such as lack of inventory or invalid measures or requirements in the order. Creates visuals and conducts analyses as necessary to understand and communicate order data and issues. + Coordinates with a variety of internal stakeholders, including Planners and externally-facing Customer Service Representatives, regarding customer issues. + For international shipping and in cases of special order requirements, coordinates with Quality and Global Trade teams in order to ensure compliance of orders. + Processes orders for product samples and trials, coordinating with Marketing teams as necessary to understand the purpose and requirements of the samples. **_Qualifications_** + High school diploma, GED or equivalent, or equivalent work experience, preferred + 2-4 years' experience in high volume call center preferred where communication and active listening skills have been utilized + Previous experience working in a remote/work from home setting is preferred + Prior experience working with Microsoft Office is preferred + Prior experience working with order placement systems and tools preferred + Customer service experience in prior healthcare industry preferred + Root cause analysis experience preferred + Familiarity with call-center phone systems preferred + Excellent Phone Skills with a focus on quality + Previous experience being able to achieve daily call center metrics including but not limited to average handle time, adherence, average speed to answer, QA **_What is expected of you and others at this level_** + Applies acquired job skills and company policies and procedures to complete standard tasks + Works on routine assignments that require basic problem resolution + Refers to policies and past practices for guidance + Receives general direction on standard work; receives detailed instruction on new assignments + Consults with supervisor or senior peers on complex and unusual problems **Anticipated hourly range:** $15.75 per hour - $18.50 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 03/13/2026 *if interested in opportunity, please submit application as soon as possible. _The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity._ \#LI-DP1 _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************
    $15.8-18.5 hourly 5d ago
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  • Remote VP of Customer Success - Enterprise Health Systems

    Getwellnetwork, Inc. 4.1company rating

    Bethesda, MD jobs

    A leading healthcare solutions provider is seeking a Head of Customer Success to lead its customer success organization. This role requires a results-driven leader with over 10 years of experience in customer success and a proven track record in enterprise settings. Responsibilities include defining customer success strategies, driving customer retention and growth, and collaborating with cross-functional teams to foster exceptional customer experiences. The ideal candidate will thrive in a data-driven environment and possess strong communication skills. #J-18808-Ljbffr
    $119k-178k yearly est. 2d ago
  • Director, Policy and Advocacy

    Cancersupportcommunity 4.0company rating

    Washington, DC jobs

    Full-time (Washington DC Metro Area) The Cancer Support Community (CSC), an international nonprofit organization headquartered in Washington, D.C., isseekingan ambitious and detail-oriented individual who is passionate about making a difference in the lives of peopleimpactedby cancer for our Director, Policy and Advocacy position. JOB SUMMARY The Director, Policy and Advocacy will serve in a leadership position of the Cancer Policy Institute to develop and implement CSC's overall strategy related to regulatory and legislative priorities. The individual selected for this role will be a self-starter, experienced in public policy, and committed to fulfilling the mission of CSC. This role is based in Washington, DC, and the individual will report to the Vice President, Policy and Advocacy of the Cancer Policy Institute. ESSENTIAL FUNCTIONSProgram Management Work to develop and implement the policy and advocacy agenda of the Cancer Policy Institute Serve as a public face of CSC and Cancer Policy Institute at coalition meetings, with policymakers and funders, and at other external convenings with national partners Lead coordination and development of activities around CPI meetings and convenings (e.g. Network Partner quarterly meetings, Utilization Management roundtables) Lead activities around Hill Days, meetings with Congressional staff, and other offerings Lead and manage activities around grassroots communication and advocacy toolkits with Network Partners, patients, and caregivers (e.g. 340B, utilization management, patient engagement, CAR‑T cell therapy) Manage and oversee specific state-based strategies, as assigned (e.g. 340B, CAR‑T cell therapy, Medicaid, telehealth, utilization management) Effectively disseminate methodology and results of CSC projects and services with the goal of influencing state and national policy and practices Steward and develop relationships with funders Advocacy Expert Identify, track, and monitor emerging public policy issues in line with CSC's strategic plan Conduct strategic policy analysis, research issues and draft reports (both informational and instructional) for internal and external distribution Secure and grow relationships with funders, policymakers across multiple sectors, fellow advocates, and other stakeholders Engage and coordinate with CSC's national partners to identify areas of common work and consensus, and to advocate collectively for positive change for people affected by cancer People Leader Coach and mentor staff in the development of capabilities within the department, within CSC and within the support community. Performs other duties as requested by management SKILLS AND ABILITIES Ability to analyze policy, develop recommendations and create position statements Ability to write clearly, persuasively and briefly according to intended audiences Strong project management skills Demonstrated knowledge of the policy and programmatic issues related to cancer and health policy Demonstrated leadership, acute analytical skills, strong public speaking, confidence in communicating with a variety of public figures and partners, including strategic partnerships Highly self-motivated and directed, with attention to detail Support and identify opportunities for innovative partnerships with the public and private sectors, academia and government agencies to advance CSC projects and services Flexible team player who thrives in environments requiring ability to effectively prioritize and juggle multiple concurrent projects Demonstrated experience organizing and coordinating Hill Days and state-based advocacy efforts Experience working with grassroots advocacy software Proven experience working diplomatically and with discretion with diverse policy allies and coalitions Ability to travel up to 25 percent of the time TECHNICAL SKILLS Technical proficiency with Microsoft Office, Teams, and Zoom, and experience with any specific software or technology needed for the job EDUCATION Advanced degree preferred (MPH, MHA, MPP, JD) EXPERIENCE A minimum of 5 years of experience in public policy, public interest law or related field; 3-5 years of experience leading people; oncology experience preferred; experience representing patients, caregivers, and/or healthcare consumers preferred. SALARY AND BENEFITS Dependent on experience. In addition to a competitive base salary, we offer statutory benefits required by law. WORK LOCATION This position is located in Washington, D.C. You may work at CSC's office in Washington, DC on a full-time basis or on a hybrid (in-office/work-from-home) schedule in the Washington, DC area. HOW TO APPLY Please submit an original cover letter and resume to **********************************. In your cover letter, please tell us why you are interested in this opportunity and include your qualifications and potential start date. Applications are accepted and considered on a rolling basis. Applications without a cover letter will not be considered. ABOUT CANCER SUPPORT COMMUNITY The Cancer Support Community is a global nonprofit that uplifts and strengthens people impacted by cancer. We are dedicated to fostering a community where people find connection, compassion, and knowledge. We provide professionally led support and navigation services, along with social connections and award-winning education - when, where and how impacted individuals prefer throughout their cancer experience. These resources are available at over 200 Cancer Support Community, Gilda's Club, and healthcare partner locations as well as online and over the phone - all at no cost. We amplify the voices of those impacted by cancer through research and advocacy and create solutions that break down barriers to care and close the healthcare gap for communities whose members are disproportionately affected by cancer. Cancer Support Community is an Equal Opportunity Employer #J-18808-Ljbffr
    $65k-132k yearly est. 3d ago
  • Hybrid Provider Contracting Lead

    Health Care Service Corporation 4.1company rating

    Chicago, IL jobs

    A leading health care service organization in Chicago is seeking a Principal Network Management Consultant. The role involves provider recruitment, contracting, and negotiation, ensuring strategic coverage for various lines of business. Requires a Bachelor's or Master's degree combined with extensive experience in provider contracting. This hybrid role allows for 3 days in-office and 2 days remote, offering competitive compensation and a comprehensive benefits package. #J-18808-Ljbffr
    $86k-118k yearly est. 3d ago
  • Senior Counsel, Trademark & Copyright - US Remote

    Amgen 4.8company rating

    Washington, DC jobs

    **Join Amgen's Mission of Serving Patients** At Amgen, if you feel like you're part of something bigger, it's because you are. Our shared mission-to serve patients living with serious illnesses-drives all that we do. Since 1980, we've helped pioneer the world of biotech in our fight against the world's toughest diseases. With our focus on four therapeutic areas -Oncology, Inflammation, General Medicine, and Rare Disease- we reach millions of patients each year. As a member of the Amgen team, you'll help make a lasting impact on the lives of patients as we research, manufacture, and deliver innovative medicines to help people live longer, fuller happier lives. Our award-winning culture is collaborative, innovative, and science based. If you have a passion for challenges and the opportunities that lay within them, you'll thrive as part of the Amgen team. Join us and transform the lives of patients while transforming your career. Senior Counsel, Trademark & Copyright **What you will do** Let's do this. Let's change the world. In this critical role you will be responsible for the day-to-day execution and management of Amgen's global trademark strategy and portfolio for Amgen's therapeutic products and product candidates, copyright, domain names, and social media handles. Your expertise in navigating the growing impact of artificial intelligence on the practice of trademark and copyright law will position you well to advise our scientific and commercial teams executing at the cutting edge of science and technology. You will work individually, in legal teams, and on cross-functional R&D and business teams across various geographies. This Senior Counsel position can be remotely located, or work from one of these Amgen locations: Thousand Oaks, CA; Cambridge, MA; or South San Francisco, CA. **Key Responsibilities** + Manage Amgen's global trademark portfolio, including clearance, prosecution, enforcement, opposition actions, and maintenance. + Perform US and ex-US trademark searches, including online searching; analyze third party goods, services, trademarks and service marks and provide legal advice relating thereto. + Provide legal advice and counsel to cross-functional R&D, marketing, publication, communication teams, and regional legal colleagues on a variety of trademark and copyright-related matters. + Manage naming agencies and vendors, oversee trademark naming process and social media handle registration. + Advise on copyright issues, including licensing, enforcement, and content use. + Provide guidance on the use of AI-generated content. + Manage and engage in online enforcement against unauthorized use of Amgen's trademarks, including working with service providers and online platforms and initiating Uniform Domain Name Dispute Resolution Policy (UDRP) and civil actions as appropriate. + Design, implement and oversee domain name strategy. **What we expect of you** We are all different, yet we all use our unique contributions to serve patients. The professional we seek is an individual with these qualifications. **Basic Qualifications:** + J.D. degree or LL.M. degree from an accredited law school, admission to practice law in a U.S. jurisdiction; and + Four plus (4+) years of experience practicing trademark and copyright law. **Preferred Qualifications:** + Ten (10) or more years of experience practicing trademark and copyright law; + Experience in all aspects of U.S. and foreign trademark prosecution and enforcement in the field of biotechnology at a law firm or biotechnology/pharmaceutical corporation; + Bachelor's degree (or higher) in chemistry, biochemistry, genetics, or a related scientific field; + Experience in all aspects of copyright law, including licensing and AI-generated content issues, and social media asset generation and management; + Excellent analytic, legal drafting and oral and written communication skills; + Strong management and leadership skills as well as a strong client service focus and the ability to work independently and in teams; + Ability to think creatively and devise practical solutions to challenging problems; + Ability to work efficiently, to prioritize workflow, to meet demanding deadlines, and to manage multi-dimensional projects in a fast-paced environment. **What you can expect of us** As we work to develop treatments that take care of others, we also work to care for your professional and personal growth and well-being. From our competitive benefits to our collaborative culture, we'll support your journey every step of the way. The expected annual salary range for this role in the U.S. (excluding Puerto Rico) is posted. Actual salary will vary based on several factors including but not limited to, relevant skills, experience, and qualifications. In addition to the base salary, Amgen offers a Total Rewards Plan, based on eligibility, comprising of health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities that may include: + A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts + A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan + Stock-based long-term incentives + Award-winning time-off plans + Flexible work models where possible. Refer to the Work Location Type in the job posting to see if this applies. **Apply now and make a lasting impact with the Amgen team.** **careers.amgen.com** In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information. **Application deadline** Amgen does not have an application deadline for this position; we will continue accepting applications until we receive a sufficient number or select a candidate for the position. **Sponsorship** Sponsorship for this role is not guaranteed. As an organization dedicated to improving the quality of life for people around the world, Amgen fosters an inclusive environment of diverse, ethical, committed and highly accomplished people who respect each other and live the Amgen values to continue advancing science to serve patients. Together, we compete in the fight against serious disease. Amgen is an Equal Opportunity employer and will consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability status, or any other basis protected by applicable law. We will ensure that individuals with disabilities are provided 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. Please contact us to request accommodation. \#CLOLI
    $127k-161k yearly est. 4d ago
  • Locum Remote Overnight Radiology Coverage needed

    All Star Healthcare Solutions 3.8company rating

    Libertyville, IL jobs

    All Star Healthcare Solutions is seeking a Radiologist for Remote Overnight Locum coverage in Illinois. Some details include: Hours are 12a-7a Predominantly CT studies 20 CT's per night on average Occasional US, plain film, or random MR as may be needed Multiple weeks offered each month, ongoing When can you start and what availability can you offer? All Star Healthcare Solutions benefits: Competitive pay; Malpractice coverage; Paid and coordinated travel services; Full-service agency; 24/7 professional and reliable service; Dedicated, specialty-specific consultants; Member of NALTO
    $66k-92k yearly est. 3d ago
  • Senior Systems Engineering Lead - ABMS DI Network (Remote)

    Leidos 4.7company rating

    Bethesda, MD jobs

    A leading technology solutions company is seeking a Systems Engineering Lead to manage the product lifecycle for an agile development program. The role requires a minimum of Top Secret clearance and extensive relevant experience (BS: 12-15 years; MS: 10-13 years). Key responsibilities include work with the Systems Engineering Lifecycle and documentation of requirements. Strong communication skills and the ability to collaborate across various disciplines are essential. This position offers a competitive salary range between $131,300 and $237,350. #J-18808-Ljbffr
    $131.3k-237.4k yearly 2d ago
  • Licensed Clinical Social Worker (LCSW) - Remote

    Brave Health 3.7company rating

    Chicago, IL jobs

    Why We're Here: At Brave Health, we are driven by a deep commitment to transform lives by expanding access to compassionate, high-quality mental health care. By harnessing the power of technology, we break down barriers and bring mental health treatment directly to those who need it most-wherever they are. As a community health-centered organization, we are dedicated to ensuring that no one is left behind. Nearly 1 in 4 people in the U.S. receive healthcare through Medicaid, yet two-thirds of providers don't accept it. Brave Health is stepping up to close this gap by making mental health care accessible, affordable, and life-changing for all. Job description We are looking for full-time Licensed Therapists to join our team and provide outpatient services through our telehealth program! Benefits: Our team works 100% remotely from their own homes! W2, Full-time Compensation package includes base salary plus bonus! Monday - Friday schedule; No weekends! Shift options include 9am-6pm or 10am-7pm CT Comprehensive benefits package including PTO, medical, dental, vision benefits along with liability insurance covered and annual stipend for growth & education opportunities Additional compensation offered to bilingual candidates (Spanish)! We not only partner with commercial health plans, but are also a licensed Medicaid and Medicare provider and see patients across the lifespan Requirements: Master's level degree and licensure Candidates must have unrestricted authorization to work in the United States that does not require employer sponsorship now or in the future. At this time, we are unable to support employment authorization tied to temporary or employer-dependent visa statuses Work from home space must have privacy for patient safety and HIPAA purposes Fluency in English, Spanish preferred; proficiency in other languages a plus Meets background/regulatory requirements Skills: Knowledge of mental health and/or substance abuse diagnosis Treatment planning Comfortable with utilizing technology at all points of the day, including telehealth software, video communication, and internal communication tools Experience working in partnership with clients to achieve goals Ability to utilize comprehensive assessments Ready to apply? Here's what to expect next: It's important to our team that we review your application and get back to you with next steps, fast! To help with that, and be most considerate of your time (which we value and know is limited), you may receive a call from Phoenix - our AI Talent Scout. She'll ask for just 5 minutes of your time to gather some information about you and your job search to get the basics out of the way. If there is a mutual fit we'll match you to the right senior recruiter on our team. Brave Health is very proud of our diverse team who cares for a diverse population of patients. We are an equal opportunity employer and encourage all applicants from every background and life experience to apply.
    $59k-67k yearly est. 7d ago
  • Senior Marketing Strategy Lead (Hybrid)

    Health Care Service Corporation 4.1company rating

    Chicago, IL jobs

    A leading health services organization in Chicago is seeking a Principal Marketing Strategy Consultant to drive strategic alignment and execution within the marketing team. The role involves working closely with various marketing stakeholders to ensure that initiatives are well-defined and aligned. Candidates should have extensive experience in strategy development and project management, alongside strong analytical and communication skills. This position offers competitive compensation and opportunities for professional growth in a fast-paced environment. #J-18808-Ljbffr
    $95k-129k yearly est. 4d ago
  • Infrastructure Operations Lead - Cloud and AI/GenAI Enablement

    Humana Inc. 4.8company rating

    Washington, DC jobs

    Become a part of our caring community and help us put health first The ideal candidate brings a passion for emerging technologies, a strong foundation in Infrastructure Operations and the curiosity and rigor to build next‑generation capabilities that improve healthcare delivery, reduce risk and optimize operational performance. If you're passionate about innovation and love working in an environment where you can constantly improve and adopt new technologies to drive business results, then Humana's Infrastructure Operations team could be the place for you! Use your skills to make an impact Key Responsibilities Lead and provide direction for our Managed Service Provider (MSP) Lead Managed Service Provider in Operations for Azure, GCP and AWS Cloud environment Drives moderate to complex processing improvements through optimization, enhancements and implementation of new operational features and functions around Cloud compliance, metrics/reporting and cost optimization Provide senior level expertise on decisions and priorities regarding the enterprise's overall Cloud Operations strategy, consumption, and optimization opportunities - understand Cost controls and the various cost optimization techniques Identifies, drives and assists in the implementation of opportunities to standardize Cloud environments Provides Cloud governance, processes and technical advisory support to business units and projects by working cross‑functionally and provides recommendations that support the business needs Participant as required (Level 2/3 escalation point) for Incident Management Participate and develop client relationships within Operations, Business partners, Managed Service Providers and Cloud Providers Work with cross-functional teams to support the engineering and implementation of new Cloud applications or solutions and define the related risks and onboard new capabilities Ability to communicate at all levels within an organization and influence strategic direction Ability to work with minimal supervision, making decisions based upon priorities, schedules and understanding business initiatives This leader will explore and prototype AI‑driven solutions to automate incident response, predict system failures, summarize complex telemetry data, and develop intelligent copilots to support Operations teams Lead research and evaluation of cutting‑edge AI and GenAI tools applicable to Infrastructure Operations (e.g., LLMs, vector databases, predictive analytics) Design and prototype AI‑driven systems for automated incident detection, anomaly classification, infrastructure forecasting/resiliency - leading to lower MttR and manual overhead in mission‑critical environments Develop and lead the strategic roadmap for AI adoption in Infrastructure Operations Collaborate with Infrastructure and Cloud Operations teams to pilot and integrate AI/GenAI features into critical workflows Modernize observability and alerting using AI/ML models for proactive monitoring and self‑healing actions Lead R&D of GenAI solutions for predictive alerting, incident triage and infrastructure automation Build AI copilots and natural language tools for infrastructure operations teams Integrate LLMs into observability platforms for real‑time RCA and log summarization Pilot and productionize GenAI‑based assistants, bots, and copilots to support ticket triage, knowledge management and resolution workflows Identify automation opportunities and implement AI‑enhanced runbooks, workflows and self‑healing mechanisms Contribute to a strategic roadmap for GenAI maturity within Infrastructure & Operations, including tools, governance and organizational readiness Partner with internal data science and clinical innovation teams to create proofs of concept, build ML/GenAI pipelines, and integrate with existing toolchains (e.g., ServiceNow, Splunk, Terraform) Autonomous log summarization, RCA generation and playbook suggestions Natural language interfaces for querying system health or telemetry Act as a GenAI ambassador, helping Infrastructure Operations teams upskill in AI‑augmented technologies and use cases Qualifications Bachelor's in Computer Science, Artificial Intelligence, Healthcare Informatics, or a related field 10+ years in infrastructure operations or engineering, with at least 3+ years of hands‑on involvement in AI/ML or GenAI R&D Deep understanding of large language models (LLMs), vector databases, retrieval‑augmented generation (RAG), and model orchestration (e.g., LangChain, Haystack). Experience integrating AI/GenAI capabilities with infrastructure automation tools (Terraform, Ansible, Python, Bash) Familiarity with healthcare systems and compliance frameworks (HIPAA, HITRUST) Proficiency with observability and telemetry platforms (e.g., Splunk, DynaTrace, SolarWinds) and AI‑driven monitoring Strong problem‑solving and experimentation mindset, with the ability to move from concept to pilot rapidly Experience with Continuous Integration and Deployment Pipelines, i.e. Azure DevOps, Jenkins, Git, Git Hub Has hands‑on scripting experience using one of the following: Terraform, Cloud Formation, PowerShell, Azure CLI, Python, JSON, Perl or Bash Preferred Master's degree Azure, AWS, GCP, ITIL and/or SRE certifications Experience with GenAI platforms (e.g., Azure OpenAI, Google Vertex AI) Experience deploying or evaluating open‑source LLMs or fine‑tuning models for infrastructure use cases Additional Information Work‑At‑Home Requirements WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information#LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $142,300 - $195,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole‑person well‑being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short‑term and long‑term disability, life insurance and many other opportunities. Application Deadline: 01-14-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our *************************************************************************** #J-18808-Ljbffr
    $142.3k-195.7k yearly 2d ago
  • Patient Access Liaison (PAL)- Great Lakes

    Catalyst Pharmaceuticals, Inc. 4.3company rating

    Chicago, IL jobs

    The Patient Access Liaison (PAL) is a regional, field-based position that provides clinical disease state education and product education to patients and their families for our rare disease portfolio of products, oftentimes in the patient's home. This patient facing individual will work closely with patients, families, physicians and other office staff to prevent and address barriers to access and help insure optimal understanding for Catalyst's medicines. The Patient Access Liaison (PAL) will also be responsible for supporting advocacy for patients and providing educational resources and opportunities for patients. The PAL will also interact with our HUB partners at Catalyst Pathways to ensure seamless communication with and to the patients and their families. This is a remote position covering the Great Lakes Geography. Potential candidates should reside in the Great Lakes region and have access to major airports in the preferred states of: Michigan or Illinois. Requirements Responsibilities (included but not limited to): Educate patients and or their families on their disease and Catalyst's FDA approved medication for their disease Provide education to patients and or their families on reimbursement and insurance protocols that affect their ability to access therapy Coordinate communication among key stakeholders to ensure patients have the clinical support required to transition successfully to therapy Advise patients and their families about access and affordability programs that may be available to them Work cross functionally with other commercial personnel to resolve access issues for patients Provide expertise to HCPs on health plan policies and procedures, including guidelines and timelines for Prior Approvals (when appropriate) and Appeals Work cross functionally with Care Coordinators and Reimbursement Specialists at Catalyst Pathways to address any outstanding issues the patient and or family might have and escalate issues when appropriate Conduct Connect Calls to discuss open cases (de-identified) in Catalyst Pathways with sales and market access to address any issues that are actionable and delegate as appropriate Respect and Protect the PHI that is available to the PAL in their work with patients Attend regional and national meetings and come prepared to contribute and participate Document appropriately and accurately all interactions with patients and other stakeholder in the Patient Portal Become an expert on recognizing and reporting AE and product complaints, along with documenting those interactions Maintain ongoing contact with patients and their families to address unmet needs and offer compliant solutions so that patients may adhere to therapy when appropriate Understand and participate in Patient Services Programs developed by agency partners Ability to regularly work extended hours including attendance at business events on evenings and weekends Education/Experience/Skills: Bachelor's degree and 5+ years in the Pharma/Biotech industry in required Prior experience as a Field Reimbursement Manager Experience in the Patient Services Department strongly preferred Be able to work in a team environment that ultimately benefits the patients Ability to work independently with patients for educational purposes and support High comfort level working directly with patients and their families as their main point of contact for access and education Can lead external customers including physicians, nurses and others to assist in achieving access for patients Ability to independently identify access solutions and determine the appropriate plan for resolution Work cross functionally with an external HUB to solve patient issues Ethics above reproach and a strong compliance mindset Must have a high degree of emotional intelligence coupled with empathy and listening skills Technical Experience in at least two of the following areas Rare Disease access or reimbursement Managed Care or public payer reimbursement Nursing Specialty Pharmacy Billing and coding Patient Advocacy Highly recommended Bilingual-fluent in English and Spanish Willingness to travel up to 70% of the time depending on the territory Prefer applicants to live near a commercial airline HUB Catalyst is committed to providing competitive wages and comprehensive benefits including health, dental, and vision insurance, generous paid time off, a retirement savings plan with Company Match, and more. Further details about our benefits package can be found here: **************************************************************************** AsMember=true The base salary for this position will range from $181,000 to $200,000. Candidate experience, professional licensing, and geographic location will be taken into consideration. Employment is contingent upon successful completion of all required screening and verification processes, including for authority to work in the United States. EEO Statement Catalyst Pharmaceuticals is an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status. Recruitment & Staffing Agencies: Catalyst Pharmaceuticals does not accept unsolicited agency resumes. Agency resumes will only be accepted if the agency is formally engaged by Catalyst Human Resources.
    $37k-45k yearly est. 5d ago
  • Actuarial Principal - Strategic FP&A Leader (Remote)

    Humana Inc. 4.8company rating

    Annapolis, MD jobs

    A leading healthcare company seeks an Actuarial Analytics/Forecasting Principal in Annapolis, Maryland. This role involves analyzing financial data and collaborating with senior leadership to support business decisions. The ideal candidate has over a decade of technical experience, strong leadership abilities, and ideally, expertise in Medicare Advantage pricing. Humana offers competitive compensation, including a salary range of $156,600 to $215,400 per year along with comprehensive benefits. #J-18808-Ljbffr
    $156.6k-215.4k yearly 3d ago
  • Senior Security Engineer II (IAM)

    Aledade, Inc. 4.1company rating

    Bethesda, MD jobs

    As a Senior Security Engineer II for Identity and Access Management (IAM) at Aledade, you will play a central role in enhancing the security posture of our enterprise, cloud‑native environments, and applications. We are seeking a dedicated professional with in‑depth knowledge of IAM principles, standards, and best practices to help safeguard our systems and support our security compliance initiatives. In this role, you will work to design, implement, and maintain robust IAM solutions, managing authentication, authorization, and provisioning across diverse platforms. You will also collaborate closely with various teams to ensure alignment between IAM solutions and organizational security requirements, enabling secure and seamless access across the enterprise and cloud services. Your ability to partner cross‑functionally will be key to driving impactful outcomes and further strengthening our digital landscape. Primary Duties Working cross functionally to design, build, and operate solutions that continuously improve and automate our security capabilities Leveraging data to understand trends, metrics, and opportunities to improve our security posture and then helping execute on those opportunities with stakeholders Leading and enhancing incident response efforts, spearheading analysis, containment, and mitigation strategies in a cross‑functional environment to ensure effective resolution and remediation of security incidents Helping craft and refine security documentation pertinent to our Security Program, such as policies, standards, baselines, and standard operating procedures Mentoring and coaching more junior engineers or analysts Minimum Qualifications BS / BTech (or higher) in Computer Science, Information Technology, Cybersecurity or a related field, 8 years security domain experience without degree 6+ years of experience in software or security engineering within Cloud Native environments 4+ years of experience working with large datasets to identify opportunities for security posture improvements or to detect, investigate and respond to threats 4+ years of experience acting as a trusted advisor in a team setting, solving for short‑term and long‑term business value 4+ years of experience coaching other engineers or analysts Preferred KSA's Identity & Access Management Experience with Identity & Access Management (IaM) systems and practices In‑depth knowledge of authentication protocols, authorization mechanisms, and directory services Strong proficiency implementing IAM solutions within very complex environments Familiarity with regulatory compliance and security standards Experience generating automated metrics to measure service and program effectiveness and consistency Strong communication skills, both written and verbal, with the capability to articulate complex security issues to a diverse audience Automation skills: Powershell, Python, Terraform Expertise on Okta products - Directory, SSO, MFA, Workflows, ISPM and IGA Experience with tools in the security stack strongly preferred: Auth0/Entra ID/Ping Identity, Cloud Platforms - AWS/Azure/GCP Physical Requirements Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required. Who We Are Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value‑based care. Additionally, by creating value‐based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee‑for‑service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive, and remote‑first culture - you've come to the right place. What Does This Mean for You? At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open‑mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission. Benefits Flexible work schedules and the ability to work remotely are available for many roles Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners Robust time‑off plan (21 days of PTO in your first year) Two paid volunteer days and 11 paid holidays 12 weeks paid parental leave for all new parents Six weeks paid sabbatical after six years of service Educational Assistant Program and Clinical Employee Reimbursement Program 401(k) with up to 4% match Stock options And much more! Equal Employment Opportunity Statement At Aledade, we don't just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation. Privacy Policy By applying for this job, you agree to Aledade's Applicant Privacy Policy available at ************************************************* #J-18808-Ljbffr
    $102k-141k yearly est. 5d ago
  • Senior Development Strategist & Fundraising Lead (Remote)

    Stryker Corporation 4.7company rating

    Chicago, IL jobs

    A nonprofit fundraising firm is seeking a Lead Consultant and Director of Development. This role demands a senior fundraising strategist to manage individual giving and annual fund campaigns while ensuring client engagement through effective communication. Applicants should possess extensive nonprofit experience. The position allows for remote work but requires occasional in-person meetings in Chicago. Successful candidates will demonstrate strong leadership and organizational skills. #J-18808-Ljbffr
    $94k-122k yearly est. 1d ago
  • Nutritionist - HYBRID

    Unity Health Care 4.5company rating

    Washington, DC jobs

    Job Description INTRODUCTION Unity Health Care has launched a Food Pharmacy Program, a collaborative effort with Capitol Area Food Bank, to combat food insecurity for senior patients aged 65 years of age and older. The Food Pharmacy will target seniors who have hypertension, diabetes and/or obesity at Unity's East of the River health center site. Under the supervision of the Medical Director, the Nutritionist will provide patient nutrition education and consultation. Also, the nutritionist will determine and prioritize the nutritional risks of clients based on established priority factors. MAJOR DUTIES Provides nutritional instructions to patients 65+ living with hypertension, diabetes and/or obesity. Disseminates Unity-CAFB designed toolkit that promotes health education around healthy foods etc., Provides nutrition-based patient health education on tailored food prescription to address the patient's medical and nutritional needs, taking into consideration food preferences and cultural background. Develops nutritional care plans for designated high-risk individuals and provides follow-up instructions, as required, to assure that the health and nutritional needs of the clients are adequately addressed. Coordinates nutritional care with other health care members in order to ensure comprehensive medical and social services for clients, including referrals for related services, such as Food Stamps, Medicaid benefits, as required. Keeps abreast of current research findings in nutrition health education and related nutritional needs to assure that appropriate and up to date intervention strategies are provided to participants. Reviews patient's medical records for medical history, laboratory results in order to provide nutritional instructions and develop an appropriate and feasible meal plan. Participates in Food Pharmacy related meetings to provide ongoing patient progress/overall updates. Assures that nutrition education, patient engagement and counseling services are documented, as appropriate in the medical record. Performs other duties as assigned. QUALIFICATIONS Bachelor's of Science degree in Food and Nutrition required. Master's of Science in Food and Nutrition or related area preferred. Current Registered Dietitian DC License. Current Registered Dietician License preferred. Registered Dietitian with the American Dietetic Association. KNOWLEDGE & EXPERIENCE REQUIRED BY THE POSITION Bachelor's-level candidate must have minimum of two years of clinical experience. Master's candidate must have a minimum of one year of clinical experience, preferably in the area of infectious diseases. SUPERVISORY CONTROLS This position reports directly to the Medical Director, East of the River GUIDELINES This position abides by all rules and regulations set forth by applicable licensing and regulatory bodies, as well as UHC policies and Procedures. PERSONAL CONTACTS: This position has primary contact with the clients and employees of Unity Health Care. PHYSICAL DEMANDS Refer to attached ADA requirements. WORK ENVIRONMENT Refer to attached ADA requirements. OTHER SIGNIFICANT FACTS The incumbent must be able to balance the needs of diverse constituencies on a daily basis. RISKS The position involves everyday risk and discomfort, which require normal safety precautions typical of such places as offices, meetings, training rooms, and other UHC health Care Sites. The work area is adequately lit, heated, and ventilated. The position requires contact with staff at all levels throughout the organization. There are also external organizational relationships that may be a part of the work of this individual. All medical services shall be provided according to medically accepted community standards of care. The employee shall provide evidence of a recent (within the past twelve (12) months) health assessment that includes a PPD and/or chest x-ray results. The statements contained herein describe the scope of the responsibility and essential functions of this position but should not be considered to be an all-inclusive listing of work requirements. Individuals may perform other duties as assigned including work in other areas to cover absences or relief to equalize peak work periods or otherwise balance the workload.
    $50k-65k yearly est. 7d ago
  • Medical Central Scheduling Specialist - Remote

    Qualderm Partners 3.9company rating

    Lombard, IL jobs

    Job Description Candidates must reside within a reasonable driving distance of Lombard, IL. Hours Scheduled: Mon-Thurs 9:30am-6pm/Fridays 8am-5pm QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S., with over 150 locations across 17 states. Our commitment is to educate, protect, and care for your skin while delivering the highest quality dermatological services. We strive to make skin health accessible to all while fostering a rewarding work environment for both our patients and employees. Position Summary: The Remote Central Scheduling Specialist will be responsible for managing and coordinating the scheduling of patient appointments across our various practice locations. This role requires exceptional customer service skills and the ability to handle a high volume of calls while ensuring that each patient feels valued and supported throughout their scheduling experience. Requirements High School Diploma required; Associate's Degree preferred. Minimum of 1 year customer service experience in a healthcare setting preferred. Strong communication and interpersonal skills. Ability to manage multiple tasks efficiently in a fast-paced environment. Proficiency in scheduling software and Microsoft Office applications. Understanding of HIPAA regulations is a plus. Benefits Competitive Pay Medical, dental, and vision 401(k) - The company match is 100% of the first 3%; and 50% of the next 2%; immediately vested Paid Time Off - accrual starts upon hire, plus 6 Paid Holidays and 2 floating days Company paid life insurance and additional coverage available Short-term and long-term disability, accident and critical illness, and identity theft protection plans Employee Assistance Program (EAP) Employee Discounts Employee Referral Bonus Program QualDerm Partners, LLC is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Compensation Range: $17.00 - 19.50 per hour. Final offer will be based on a combination of skills, experience, location, and internal equity.
    $17-19.5 hourly 28d ago
  • Emergency Radiologists - Clinical Associates

    AMN Healthcare 4.5company rating

    Chicago, IL jobs

    Job Description & Requirements Emergency Radiologists - Clinical Associates Emergency Radiologists - Clinical Associates Salary Range: $430,000 - $480,000 per year as well as an anticipated annual incentive payment between $30,000 to $75,000 based on work schedule The University of Chicago s Department of Radiology seeks Clinical Associates at 100% effort for renewable terms of up to three years. Appointees will have responsibilities that include interpretation of all aspects of emergency radiology diagnostic examinations and will be joining our team of six emergency radiologists, extending an existing evening shift. Work shifts will be primarily nights and weekends; arrangements are flexible and may be fully remote. The anticipated clinical schedule is 7 days on clinical service and 14 days off clinical service. These positions do not require teaching or scholarly activity. Compensation (including a generous package of fringe benefits) depends on qualifications. For information on benefits, please consult the University of Chicago Benefits Guide: . Prior to the start of employment, qualified applicants must: 1) have a medical doctorate or equivalent, 2) hold or be eligible for medical licensure in the State of Illinois and the State of Indiana, and 3) be American Board of Radiology certified or eligible. We especially welcome applicants with emergency radiology fellowship training or equivalent experience. Basic pediatric ER radiology skills are also sought. The University of Chicago has retained AMN Healthcare to support this recruitment. CJ Stanford, Senior Search Consultant and Nicole Sturznickel, Senior Search Consultant with AMN Healthcare is leading the search. Inquiries, applications, and nominations must be sent by email to CJ Stanford and Nicole Sturznickel at and . Please note all job seekers wishing to be considered for the position must also submit their materials through The University of Chicago s Academic Recruitment job board, which uses Interfolio to accept applications: . Applicants must upload a CV including bibliography and cover letter. Review of applications ends when the positions are filled. For instructions on the Interfolio application process, please visit . Equal Employment Opportunity Statement The University of Chicago is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender, gender identity or expression, national or ethnic origin, shared ancestry, age, status as an individual with a disability, military or veteran status, genetic information, or other protected classes under the law. For additional information please see the University's Notice of Nondiscrimination . Job seekers in need of a reasonable accommodation to complete the application process should call or email with their request. Facility Location Situated on the banks of Lake Michigan, this Midwestern metropolis combines global high-style with a friendly, down-home soul. Along with its superb medical facilities, visitors to Chicago relish the city s 29-mile long lakefront park, fabulous shopping districts, multicultural neighborhoods and world-class arts and entertainment. Job Benefits About the Company At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable. Radiology Physician, Radiologist, Radiology Doctor, Radiology Specialist, Imaging Radiologist, Diagnostic Radiologist, radiology radiology, radiologist AMN Healthcare is a digitally enabled workforce solutions partner focused on solving the biggest challenges affecting healthcare organizations today. We offer a single-partner approach to optimize labor sources, increase operating margins, and provide technologies to expand the reach of care.
    $36k-44k yearly est. 19d ago
  • Clinical Quality Documentation Specialist, Full-time, Days, Hybrid (Sign-on bonus eligible)

    Northwestern Memorial Healthcare 4.3company rating

    Palos Heights, IL jobs

    At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better? Job Description The Clinical Quality Documentation Specialist I reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Clinical Quality Documentation Specialist I position facilitates improvement in the overall completeness and accuracy of quality data and outcomes through extensive interaction with physicians, nursing staff, interdisciplinary quality committees, multidisciplinary teams and clinical coders. The Clinical Quality Documentation Specialist I applies clinical expertise, knowledge of the national Quality agenda, professional nursing standards, current research, best practices, and interdisciplinary collaboration to advance problem analysis and creative process redesign for clinical documentation. The Clinical Quality Documentation Specialist I acts as a change agent to systematically drive and implement change as prioritized by Clinical Documentation Leadership and Senior Clinical and Senior Quality leadership and/or through the quality and safety committees. Participates in performance improvement initiatives, receives and monitors control plans and data trends under the purview of the Clinical Documentation and Clinical Quality Programs and in collaboration with clinical interdisciplinary quality committees and physician practices. Key to this role is the ability to compel changes in documentation through in-person interaction to facilitate accurate representations of patient characteristics within the medical record so that process and outcome measures based on documentation reflect performance accurately. Responsibilities: In partnership with Clinical Documentation Leadership and the Medical Directors of Clinical Documentation, maintains integrated relationships with business unit and system physician and administrative leaders to advance quality metrics through front-line documentation efforts. Rounds daily with physician and advanced practice providers (APPs) in assigned service line(s) or business units to ensure appropriate and accurate documentation in the medical record. Ensures the level of services and acuity of care will accurately be reflected in quality outcomes. Partners with operational and medical leadership in a given service line or business unit to identify, develop and implement successful communication and education, to engage physicians and improve processes and outcomes. Performs daily medical record reviews in assigned service line(s). Performs data collection activities to identify documentation issues, quality issues, and opportunities for improvement in patient care and services. Basic understanding of clinical documentation through the lens of local and national quality and ranking methodologies, including but not limited to, U.S. News and World Report, Vizient, Leapfrog, the CMS Star Rating, and payer contracts and assists the Managers of Clinical Documentation in execution of and maintenance of key strategies to effect change. Understands the basics of leveraging their NM network to initiate conversations, identify root causes and resolution, and align resources. Analyzes quality and patient safety data to identify patterns in the management of patient care and services using reported 1.) Hospital acquired conditions, 2) Patient safety indicators, 3) Case Mix index, and 4) Expected mortality. Collaborates with the Clinical Quality Team to model, teach and improve upon the culture of safety with shared improvement in all venues. Presents updates to operational and medical leadership, attending and resident physicians and interdisciplinary quality committees. Communicates effectively and collaborates with colleagues and the Clinical Coding Team. Fosters an environment to execute a shared vision in creating a model of best practice in the accurate reporting of patient diagnoses, comorbid conditions and treatment rendered. Professional Development and Education: Masters evidence and literature in relevant clinical area, discipline, and improvement science, including clinical quality improvement, patient safety, human factors, failure modes, root cause analysis, and related performance and safety resources. Applies knowledge of professional nursing standards, best practices, and interdisciplinary collaboration to advance problem analysis and resolution and creative process redesign. Other: Participates in a minimum of one NM Clinical Documentation committee as approved by Manager, Clinical Documentation Participates on departmental and hospital committees and task-forces as assigned. Participates in concurrent performance improvement activities and on-going review activities. Performs other job-related duties as requested, including special projects. Complies with Northwestern Memorial Hospital policies on patient confidentiality including HIPPA requirements and Personal Rules of Conduct. Qualifications Required: Registered Nurse in the State of Illinois Bachelor's or Master's degree in nursing Minimum 2 years of experience of bedside nursing care and participation in clinical quality, patient safety, or related initiatives with evidence of effective change management skills. Must possess and consistently demonstrate: Strong interpersonal, communication, conflict management, diplomacy and negotiation skills. Proven leadership to affect positive clinical quality outcomes. Analytical skills necessary to independently collect analyze and interpret clinical data. Basic computer skills and willingness to learn computer applications relative to this position Preferred: Master's Degree Five years' experience in medical/ surgical, critical care, intensive care or emergency care preferred Additional Information Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status. Background Check Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act. Artificial Intelligence Disclosure Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person. Benefits We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more. Sign-on Bonus Eligibility: Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family.
    $35k-56k yearly est. 14d ago
  • Billing Coordinator - CTI Pulmonology and Thoracic Surgery (hybrid)

    Northwestern Memorial Healthcare 4.3company rating

    Chicago, IL jobs

    Company DescriptionAt Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better? Job Description Performs charge capture for all procedures completed in the Bronchoscopy suite. This includes: Audit of CPT codes associated with each procedure Confirmation of supplies used and verification of alignment with operative notes Assists patients with billing and insurance related matters including communicating with patients regarding balances owed and other financial issues and facilitating collection of balances owed. Educates patients about financial assistance opportunities, insurance coverage, treatment costs, and clinic billing policies and procedures. Collaborates closely with physicians and technicians to understand treatment plans and determine costs associated with these plans; Works closely with the staff on managed care and referral related issues; communicates findings to patients. Coordinates the pre-certification process with the clinical staff as it relates to procedures in the Bronchoscopy Suite and Operating Rooms Handles billing inquiries received via telephone or via written correspondence. Responsible for thoroughly investigating and understanding financial resources or programs that may be available to patients and educating staff and patients about these programs. Conducts precertification for appropriate tests or procedures and facilitates the process with managed care and the clinical team. Documents all information and authorization numbers in Epic and acts as a liaison for follow-up related to precertification. Performs activities and responds to patient inquiries related to billing follow-up. Requests necessary charge corrections. Identifies patterns of billing errors and works collaboratively with department manager and outside entity to improve processes as needed. Provides guidance regarding clinical documentation to optimize charges and RVUs Confirms coding accuracy based on clinical documentation and reviews common errors or misses with physicians and leadership. The Billing Coordinator reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Billing Coordinator is responsible for processing charges, payments and/or adjustments for all services rendered at all NM Corporate Health Clinics. Researches and follows- up on all outstanding accounts. Answers all calls regarding charges and claims, providing exceptional customer service to all callers. Possesses extensive knowledge of coding, billing, insurance and collections procedures and coordinates the accounts receivable functions. Performs weekly claims, monthly late bills and patient statement runs and reviews accounts to be placed with an outside collection agency. RESPONSIBILITIES: Department Operations Ensures patient demographic and billing/insurance information is kept current in the computer application. Documents all patient and company contacts. Reviews daily clinic schedules and tracks receipt of documentation to assure completeness of charge capture. Ensures notes are is placed in systems, clearly identifying steps taken, according to established procedures. Works with patients/clients to establish payment plans according to predetermined procedures. Handles all incoming customer service calls in a professional and efficient manner. Provides exceptional service to all customers, guarantors, patients, internal and external contacts. Prepares itemized bill upon request; explains charges, payments and adjustments. Produces a clear and understandable statement to individuals on any outstanding account balance. Responsible for timely submission of accurate bills and invoices to clients, patients and insurance companies. Ensures timely posting of all charges, payments, denials and write-offs to the appropriate account, maintaining the highest level of quality for each transaction processed within 48 hours of receipt. Responsible for balancing each payment and adjustment batch with reconciliation report and bank account deposits after completion. Ensures compliant follow up procedures are followed, to third party payers regarding outstanding accounts receivables. Run outstanding A/R reports, follow-up on unpaid claims or balances with insurance companies, patients, and collection agency, as defined by department. Perform daily systematic review of accounts receivable to ensure all accounts ready to be worked are completed. Recommend accounts for contractual or administrative write-off and provide appropriate justification and documentation. Denials and appeals follow-up including root cause analysis to reduce/prevent future denials. Reviews, prepares and sends pre-collection letters as defined by department procedures. Identifies and sends accounts to outside collection agency. Prepares and distributes reports that are required by finance, accounting, and operations. Handles all work in an accurate and timely manner, consistently meets or exceeds productivity standards, quality standards, department goals and deadlines established by the team. Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices. Identify opportunities for process improvement and submit to management. Demonstrate proficient use of systems and execution of processes in all areas of responsibilities. Communication and Teamwork Fosters and maintains positive relationships with the Corporate Health team, Human Resources, NM employees and physicians. Provides courteous and prompt customer service. Answers the telephone in a courteous professional manner, directs calls and takes messages as appropriate. Checks for messages and returns calls. Demonstrates teamwork by helping co-workers within and across departments. Communicates effectively with others, respects diverse opinions and styles, and acknowledges the assistance and contributions of others. Communicates appropriately and clearly to physicians, manager, nursing staff, front office staff, and employees. Maintains a good working relationship within the department. Organizes time and department schedule well. Demonstrates a positive attitude. Service Excellence Displays a friendly, approachable, professional demeanor and appearance. Partners collaboratively with the functional areas across Northwestern Medicine in support of organizational and team objectives. Fosters the development and maintenance of a cohesive, high-energy, collaborative, and quality-focused team. Supports a “Safety Always” culture. Maintaining confidentiality of employee and/or patient information. Sensitive to time and budget constraints. Other duties as assigned. Qualifications Required: High school graduate or equivalent. Strong Computer knowledge, data entry skills in Microsoft Excel and Word. Thorough understanding of insurance billing procedures, ICD-10, and CPT coding. 3 years of physician office/medical billing experience. Ability to communicate clearly and effectively, both orally and in writing, at all levels within and outside the organization. Ability to work independently. Preferred: 3 years of physician office/medical billing experience in Corporate Health/Occupational Health a plus. CPC (Certified Professional Coder) or R (Registered Medical Coder) Certificate a plus. Additional Information Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status. Background Check Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act. Artificial Intelligence Disclosure Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person. Benefits We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more. Sign-on Bonus Eligibility: Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family.
    $45k-58k yearly est. 32d ago
  • Director, Next Best Action (NBA) Platform

    Humana Inc. 4.8company rating

    Washington, DC jobs

    Become a part of our caring community and help us put health first The Director, Next Best Action (NBA) Platform, is accountable for architecting and expanding an enterprise-level, real-time decisioning platform that enables personalized, compliant, and measurable interactions across digital, call‑center, and marketing channels. This position provides both technical and delivery leadership in the areas of decisioning, state management, business rules, machine learning integration, and channel activation, ensuring that all decisions are rapid, transparent, governed, and continuously optimized. Primary Responsibilities Platform & Architecture Leadership Oversee the comprehensive architecture of real-time decisioning, including: Decision orchestration services State management and lifecycle tracking Eligibility and policy evaluation Action and offer metadata management Integration of ML scoring and ranking Define clear boundaries between decisioning, state management, rules, models, data platforms, and channel systems. Ensure the platform operates with low latency, is highly scalable, fault‑tolerant, and fully auditable. Engineering & Delivery Leadership Guide multiple cross‑functional engineering teams responsible for: Decision APIs and orchestration services State machines and transactional outbox implementations Action/offer catalog services Rules and policy evaluation services Integration of machine learning inference Establish engineering best practices related to: API contracts Idempotency and exactly‑once processing Observability, logging, and tracing Reliability and performance SLAs Drive predictable, agile delivery while maintaining architectural integrity. Decision Intelligence & Machine Learning Integration Collaborate with Data Science and ML teams to: Deploy propensity, uplift, and engagement models into production Maintain separation between offline modeling and online inference Implement safe rollout, monitoring, and fallback strategies Ensure explainability and governance of model outputs, particularly in regulated contexts Experience & Activation Enablement Partner with channel and experience teams to ensure decision outputs are: Channel‑agnostic Rendered consistently Enhanced post‑decision without adding latency Reusable across web, mobile, call‑center, and marketing platforms Governance, Compliance & Trust Guarantee all decision outputs are: Traceable (including rationale and input data) Reproducible Aligned with regulatory and compliance obligations Work with compliance, legal, and audit teams to establish guardrails and controls Promote a culture of “decision trust” throughout the organization People & Leadership Build, mentor, and retain senior engineering and architecture talent Define clear ownership models and accountability across teams Foster an engineering culture centered on clarity, accountability, and results Serve as the primary accountable leader for the NBA platform's technical delivery Use your skills to make an impact Required Qualifications Minimum 12 years' experience in software engineering, platform engineering, or distributed systems At least 5 years managing large, multi‑team engineering organizations Deep expertise in: Real‑time APIs and microservices Distributed state management Event‑driven architectures Transactional consistency (e.g., outbox, idempotency) Experience with: Rules/policy engines Machine learning inference in production Demonstrated capability to operate in regulated industries (healthcare, finance, insurance, etc.) Preferred Qualifications Experience with personalization, recommendation, or decisioning platforms Familiarity with marketing, care navigation, or customer engagement systems Experience with enterprise data platforms and feature stores Excellent executive communication skills, with the ability to clearly explain complex systems Success Criteria Decisions are made rapidly, consistently, and transparently across all channels Engineering teams deliver reliably and maintain architectural discipline Business stakeholders trust and rely on platform outputs The organization can confidently answer “why was this recommended?” The platform is continuously refined based on feedback and learning Additional Information SSN Alert Statement Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self‑provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi‑weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $189,400 - $260,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole‑person well‑being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short‑term and long‑term disability, life insurance and many other opportunities. Application Deadline: 03-19-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our *************************************************************************** #J-18808-Ljbffr
    $189.4k-260.5k yearly 2d ago

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