Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The Director of Claims Audit provides strategic leadership over the internal claims audit function, driving data-informed decision-making and process improvement across the claim's organization. This high-impact role requires deep expertise in claims operations, CMS regulatory requirements, and audit/compliance oversight. The Director will oversee the Claims Audit team, manage key SOX and operational audit deliverables, and serve as the bridge between operations and enterprise leadership, supporting claims transformation efforts and key system initiatives to optimize processes, reduce risk, and enhance efficiency.
Job Duties/Responsibilities:
Lead the design, execution, and continuous improvement of internal claims audit activities, including monitoring, tracking, root cause analysis, and issue resolution.
Ensure compliance with CMS regulations, SOX requirements, and other applicable federal and state mandates; serve as a liaison with Compliance, Legal, and Finance to maintain audit process integrity and readiness.
Oversee preparation and delivery of monthly, quarterly, and ad hoc reporting packages for senior leadership, Audit Committees, and external auditors, including internal audit control reviews and PWC discussions.
Provide data-driven insights by compiling and analyzing claims audit metrics, trends, and variance drivers; develop actionable recommendations to mitigate risks and support operational decision-making.
Partner with Claims Optimization and Operations teams to identify recurring audit issues, performance gaps, or anomalies, and translate findings into sustainable process improvements.
Collaborate cross-functionally to design and implement corrective action plans (CAPs), report cards, and long-term operational solutions that reduce audit findings and enhance efficiency.
Manage weekly audit monitoring reports, engage with BPO partners and internal teams to resolve findings, and track corrective action progress.
Contribute to enterprise-level presentations and initiatives by preparing audit-related insights, analyses, and operational performance updates.
Support other departmental or enterprise priorities as assigned, adapting to evolving business needs.
Job Requirements:
Experience:
Required:
10+ years of experience in health plan operations, claims auditing, compliance, or process optimization.
4+ years in a leadership role, managing cross-functional teams or enterprise-level initiatives.
Demonstrated expertise in CMS regulations, SOX, audit committee reporting, and internal/external audits (e.g., PWC, CMS).
Proven track record of leading initiatives that reduced manual effort, resolved high-volume claim categories, and improved operational efficiency.
Strong understanding of the claims lifecycle, audit principles, and regulatory compliance, with the ability to translate findings into actionable operational improvements.
Strategic thinker with the ability to influence and partner across multiple departments to drive change and optimize processes.
Advanced analytical and reporting skills, including experience with Excel, SQL, and data visualization tools (Power BI, Tableau, or similar).
Excellent communication and presentation skills, capable of engaging executives, auditors, and operational teams.
Demonstrated ability to lead change, prioritize competing initiatives, and operate effectively in a complex, high-visibility environment.
Education:
Bachelor's degree (Healthcare Administration, Business, Healthcare Management, or related field); or equivalent combination of education and experience.
Master's degree (MBA, MHA) preferred.
Training:
• Required: None
Specialized Skills:
Required:
Advanced reporting and data analysis skills (Excel, SQL, Power BI/Tableau preferred).
Strong communication skills, with the ability to present complex data to executives and auditors.
Operational mindset with ability to identify gaps and implement sustainable, efficient solutions.
Proven change leader who can drive adoption across multiple departments.
Comfortable operating with ambiguity, tight timelines, and enterprise-level visibility.
Licensure:
• Required: None
Other:
Required: Intermediate to Advance proficiency in MS Office products - Word, Access, PowerPoint, Visio and Excel
Preferred: Proficiency in data analysis tools such as Excel or SQL; visualization experience a plus
Hands-on experience working with the claims system, Facets claims system a strong plus
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $126,422.00 - $189,634.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.
$50k-89k yearly est. Auto-Apply 60d+ ago
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Hybrid Professional
Adult & Teen Challenge 3.7
Terre Haute, IN jobs
Requirements:
Must have a basic understanding of fundraising and event planning.
Great people skills are a must.
Must excel in computer knowledge and data entry.
Teen Challenge graduate preferred, but not a must.
Must have a current driver's license.
Must be willing to become PSNL certified.
Must be able to teach and be teachable.
Self -starter.
These are a few important basic requirements. However, a phone interview is required to discuss more job details and requirements.
$218k-340k yearly est. 28d ago
Senior Software Development Lead
Alignment Healthcare 4.7
Indiana jobs
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
Alignment is an industry leader in leveraging data and technology to make members healthier, provide cost savings and engage more closely with its providers, members, brokers, customers, and partners. As a part of software engineering team, we're looking for a Software Engineering Technical Lead who is passionate about delivering high quality Data and AI powered technology products and services that will enable next generation care delivery models for seniors. This is a hands-on leadership role requiring strong technical background, solid coding skills and good project management skills.
General Duties/Responsibilities (May include but are not limited to):
Provide thoughtful and impactful technical leadership to a team of engineers to help us deliver products & services to significantly improve healthcare experience and clinical outcomes for seniors.
Define technical roadmap and direction of the project.
Work directly with product management and your team while analyzing and decomposing complex software requirement into simple stories for planning and execution.
Be the technical leader for product features, responsible for ensuring that development activities are coordinated throughout the development cycle.
Own system and feature quality throughout the development, testing, and deployment phases to ensure quality delivery expectations are met.
Actively participate in software development activities: coding, code reviews, testing, and production support.
Drive engineering excellence leveraging software engineering best practices for design, coding standards, performance, security, delivery, and maintainability.
Work closely with business partners to ensure that the right capabilities are delivered.
Minimum Requirements:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
8+ years professional experience in software development with1 year leading a team
5+ years leveraging C#, ASP.NET, MVC and ASP.NET Web API, React
5+ years' experience with HTML, CSS, JavaScript, jQuery
3+ years of experience with Web Services lifecycle (design, build, test, deploy), API versioning and design approaches, tools, inter-operability, and SOA concepts.
Experience working with Microsoft SQL and NoSQ Databases, including database design and access approaches.
Experience in Developing Enterprise level Web Applications using Microsoft technologies
Education/Licensure:
Bachelor's degree in Computer Science, Computer Engineering or Information Technology
Other Relevant Industry certifications such on Microsoft Azure or Amazon Web Services (AWS)
Other:
Demonstrated experience designing, creating, testing, and consuming REST APIs with a focus on security and performance.
Ability to develop unit tests and effectively automate test execution.
Excellent oral and written communication skills.
Hunger to learn and an intense technical curiosity.
Critical thinker and solutions-oriented.
Strong analytical and problem-solving skills.
Desire to learn new technologies.
Preferred:
Hands on experience with Cloud services (AWS, Azure, Google Cloud Platform).
Microsoft Azure Cloud Architecture or Development Certifications.
Hands on experience with Design and Development of Microservices.
Healthcare domain software development experience.
Hands on experience developing, delivering, and supporting publicly facing web applications.
Familiarity with Continuous Integration and Continuous Delivery (CI/CD) best practices.
Experience developing with .NET Core.
Experience with scrum methodology.
Understanding of common design patterns and appropriate usage
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact
******************
.
Pay Range: $130,332.00 - $195,498.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.
$130.3k-195.5k yearly Auto-Apply 18d ago
Medical Records Specialist
Ensemble Health Partners 4.0
Union City, IN jobs
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!
O.N.E Purpose:
Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
The Opportunity:
ENTRY LEVEL CAREER OPPORTUNITY OFFERING:
Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement
This position will pay between $16.00 - $17.05/hr based on experience
We are seeking a Medical Records/Health Information Management Specialist to work on-site at Union Hospital in Terre Haute, IN.
Job Responsibilities:
Completes analysis/reanalysis of all records accurately and timely
Completes accounts from Meditech System Waiting for Documentation and Missing Document work queues when missing documentation is received.
Follow-up with ancillary/nursing departments for missing documentation as outlined.
Follow-up with providers regarding missing documentation/dictation preventing the account from being coded.
Completes unbilled spreadsheet with updates regarding the status of missing documentation and sends to management.
Reviews medical record documentation in electronic medical records and, creates appropriate charting deficiencies in the deficiency management system, and assigns those deficiencies to the appropriate provider(s).
Actively manages various analysis-specific work queues, electronic and manual, to ensure timely analysis and chart completion.
Adheres to established company standards/policies and system workflow guidelines to add and re-assign accounts to appropriate work queues for processing.
Identifies systematic problems and routes to the Manager for facility resolution.
Promptly reports issues and trends not complying with facility or corporate policies/standards.
Documents all workflows, including any alterations, modifications, and changes that will occur based on the processes that will be implemented or enhanced.
Other duties as assigned
Experience We Love:
Knowledge of CMS, and Joint Commission regulations preferred
EMR experience preferred
Healthcare Revenue Cycle experience preferred (Acute care facility HIM experience)
Certifications:
CRCR Required within 9 months of hire (company paid)
#LI-JW1
Join an award-winning company
Five-time winner of “Best in KLAS” 2020-2022, 2024-2025
Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
Energage Top Workplaces USA 2022-2024
Fortune Media Best Workplaces in Healthcare 2024
Monster Top Workplace for Remote Work 2024
Great Place to Work certified 2023-2024
Innovation
Work-Life Flexibility
Leadership
Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
Associate Benefits - We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
Our Culture - Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
Growth - We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
Recognition - We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact *****************.
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role's range.
EEOC - Know Your Rights
FMLA Rights - English
La FMLA Español
E-Verify Participating Employer (English and Spanish)
Know your Rights
$16-17.1 hourly Auto-Apply 16d ago
District Manager
Biote Corp 4.4
Indianapolis, IN jobs
Biote Medical is the world leader in hormone optimization and we are adding to our team! We partner with providers to take a complete approach to healthier aging through patient-specific bioidentical hormone replacement therapy and the only nutraceutical line created specifically to support hormone health.
This position will help support our East Indy territory. We're looking for someone with a passion for changing healthcare who wants to be in a hands-on and engaged position working within a dynamic and collaborative sales team.
You must be located in the East Indy area to be considered.
Position and Scope:
We are looking for a driven candidate with the desire to recruit qualified physicians and practitioners into a partnership relationship with Biote; in order to provide cutting edge technology for bioidentical hormone replacement therapy (BHRT) and healthy aging options to their own patients and to the public at large. The ideal candidate is responsible for relationship development, practice development and sales of the Biote Method to practitioners. Sales activity includes prospecting, cold calling, practice development, tradeshows, sales events, and other methods for creating leads and closing sales for Biote within the approved price matrix. In addition, the Liaison provides technical, educational, and Provider Partner support. This is a field-based remote position.
As a District Manager, your daily responsibilities will include:
* Acquiring and retaining extensive knowledge of hormone replacement therapy through materials provided by Biote, as well as outside sources.
* Effectively conducting physician, staff and patient training in the areas of Biote's business protocols; specifically, marketing, financial, therapy, forms, patient seminars, company online resources and other topics that may change from time to time.
* Ability to read and understand medical and scientific studies.
* Researching and evaluating physicians in assigned areas based on Biote's criteria for appropriateness and suitability.
* Effectively presenting Biote's training and business program to physicians, Nurse Practitioners, Physician Assistants, office managers and office staff.
* Recruiting suitable physicians and other practitioners through professional and effective prospecting, appointment setting and presentation skills.
* Cultivating and maintaining mutually productive partnerships with practitioners to grow new and current practices and maintain patient retention levels of 60% or better.
* Effectively conducting physician, staff and patient training in the areas of Biote's business protocols; specifically, marketing, financial, therapy, forms, patient seminars, company online resources and other topics that may change from time to time.
* Securing all required contracts, paperwork and documentation as well as payments and fees as needed for attendees to participate in regular training and certification classes.
* Conducting and facilitating patient educational seminars as needed for trained practitioners on a monthly basis.
* Contributing to the development of the practice by assisting the Office Manager/Marketing position with email marketing, social media, referral cards and website information cards.
* Prospecting for new leads and identifying quality sales prospects from active leads.
* Attending marketing and sales events for prospects and current customers.
* Working with customers for sales referrals with new prospects.
* Updating all relevant sales activities in the Company's CRM system.
* Closing sales accurately and effectively each month to meet or exceed targets.
* Responding to all emails received from the customer and Biote employees and related vendors in a timely manner.
* Performing other related duties as required or requested.
As a District Manager, your background should include:
* Bachelor's degree
* Strong teamwork, communication (written and oral), client management, and interpersonal skills.
* Minimum of 3-5 years of sales experience in a business-to-business model, preferably medical device, diagnostics, and/or biotech.
* Strong work ethic and time management skills
* Ability to make effective and persuasive communications and technical presentations to physicians, management and/or large groups. Ability to thoroughly understand and communicate the attributes and qualities of Company products using professional selling and closing skills.
* Proficient in Microsoft Office suite and customer relationship management software.
* Ability to travel in order to do business, approximately 20% of the month.
* Scheduled hours are 40 to 50 hours per week Monday through Friday but may be extended as required to execute the tasks assigned.
* Valid driver's license issued by the state/province in which the individual resides and a good driving record is required.
* Home office capability is required with reliable high-speed internet access
Company Perks:
* Medical, Dental & Vision Insurance, Virtual Visits/Telemedicine
* Company Paid Life and AD&D Insurance
* 15 days of Paid Time Off and Company Holidays
* 401k with a 3% employer contribution
* Motus mileage program
* Other excellent health and wellness benefits in line with our business
If you're interested in this awesome opportunity, please apply today!
$80k-147k yearly est. Auto-Apply 6d ago
Crisis Counselor - Fully Remote in South Bend, IN
Protocall Services 3.9
South Bend, IN jobs
Benefits Comprehensive medical, dental, and life insurance plans 401(k) retirement plan with company match Short-term and long-term disability (STD/LTD) coverage Employee Assistance Program (EAP) services Accrued Paid Time Off (PTO) package, earning up to 4 weeks of vacation in your first year Company-matched student loan repayment program Opportunities for career growth and advancement Education and Experience Requirements Education Requirement: Bachelor's Degree from an accredited 4 year college or university. Experience Requirement: Minimum of 1 year direct experience in Behavioral Health or Social Services Location Requirement: Fully Remote in Indiana Who We Are: Protocall Services is a national leader in crisis intervention, providing effective solutions and resources 24/7. Recognized nationally, Protocall has consistently received Top Workplace awards over the past five years, establishing itself as one of the top workplaces in the healthcare industry nationwide. We are telephonic first responders for: Community Mental Health Centers, Certified Community Behavioral Health Clinics, Managed Behavioral Healthcare Organizations, college and university counseling centers, and Employee Assistance Programs. Headquartered in Portland, Oregon, Protocall is a remote first organization that serves customers in the U.S and Canada with a team of fully-integrated professionals in select states across the US and Canada.
Who You Are:
You are a compassionate and empathetic professional with exceptional communication skills and the ability to actively listen and connect with others. You are comfortable communicating with individuals in various states of crisis, whether over the phone, via text, or through other methods of interaction, providing support with empathy and professionalism. You thrive in high-pressure, high-stakes environments, remaining calm and focused while employing effective crisis intervention techniques. Your solution-focused mindset, problem-solving abilities, and resilience enable you to navigate complex situations with patience and clarity.
You excel at multitasking, seamlessly managing intense calls while handling multiple tasks and navigating computer systems efficiently. A strong background in psychology, social work, counseling, or a related behavioral healthcare field is essential, and experience in crisis support or similar roles is highly valued.
Integrity and confidentiality are at the core of your work. You maintain the highest ethical standards and uphold privacy in every interaction. You have a secure, HIPAA-compliant workspace with a locking door which is a non-negotiable to ensure caller confidentiality and privacy. Additionally, you embrace Protocall's fully remote work model, ensuring you have a stable, wired internet connection that directly connects to the work computer provided by Protocall. This setup must meet company standards to maintain the safety and trust of callers.
Primary Responsibilities:
* Maintain a secure, HIPAA-compliant private workspace at home to ensure focus and confidentiality.
* Engage with individuals over the phone, providing support to those experiencing emotional distress or mental health challenges.
* Build rapport and foster client engagement during calls.
* Assess and mitigate risk while maintaining accurate, thorough documentation.
* Provide resources, information, and referrals as needed.
* Assist callers in identifying positive coping strategies and developing safety plans.
* Intervene during emergencies when necessary.
* Stay calm, professional, and focused while multitasking in a fast-paced environment.
* This role is ideal for someone who is dedicated to making a positive impact, capable of navigating high-pressure situations, and committed to providing unwavering support to individuals in need.
What You Can Expect as a New Employee:
As part of Protocall's 24/7/365 crisis call center, you must demonstrate flexibility in your availability, including a regular willingness to work holidays and weekends. This role begins with an intensive, paid six-week virtual cohort training program designed to refine your skills and ensure readiness for the role. During this time, you will develop your skills through various learning modalities, including book learning, group sessions, roleplay, and live call-taking.
This training is an opportunity to enhance your abilities, fill knowledge gaps, and fully prepare you for your role as a telephonic first responder, delivering professional and compassionate support to individuals in crisis. In order to successfully complete this cohort training program, you are expected to develop fluency and demonstrate proficiency in key crisis care skills. Successful completion of this training is necessary for continued employment beyond this 6 week cohort training program.
Six Week Cohort Training Schedule: You will attend a regular Monday through Friday, 8:00 AM to 4:30 PM PST cohort training program for six weeks.
Post Cohort Training: After successfully completing Cohort Training you will begin your regular schedule. This schedule is developed in partnership with Protocall's Scheduling Department, during your Pre-Hire/Onboarding process.
ProtoCall Services Inc. is an Equal Opportunity Employer. We believe deeply in diversity of race, gender, sexual orientation, religion, ethnicity, national origin, and all of the other fascinating characteristics that make us different
$49k-64k yearly est. 31d ago
COMPLIANCE INTERN (50080449)
Health & Hospital Corporation 4.3
Indianapolis, IN jobs
Division:HEALTH AND HOSPITAL CORPORATION Sub-Division: HQ FLS Status: [[JOB_REQUISITION_CUSTOM27]] Marion County Public Health Department is an organization that celebrates diversity, and seeks to employ a diverse workforce. We actively encourage all individuals to apply for employment and to seek advancement opportunities. Marion County Public Health Department also provides reasonable accommodations to qualified individuals with disabilities as required by law. For additional questions please contact us at: *****************.
Job Role Summary
The position offers an intern the opportunity to gain practical experience working within a Compliance Department. They will assist with ensuring the organization adheres to all relevant healthcare laws, regulations, statutes, and ethical standards. The intern will focus on Public and Community Health Programs. Responsibilities include review of programs, workforce, and patient records, analysis of revenue cycle, identifying potential compliance risks, developing educational materials and resources for staff, and special projects ad hoc. The participating intern will be an integral part of the Compliance Department and will obtain hands on valuable experience. Potential projects for 2026 include but are not limited to the risk area of vulnerable adult populations, data integrity, and billing/claims practices. Additional areas of exposure may include The Marion County Public Health Department, Primary Care, Mobile Integrated Health, Mobile Crisis, Residential Care for Sandra Eskenazi Mental Health Center, and the CICI program.
Essential Duties
Intern Job Responsibilities:
Program Review: Program evaluation or evaluation of key aspects of a department or specific program within the organization.
Workforce: Monitoring professional licensures, criminal record position exclusions, Office of Inspector General Sanctions, and background checks; Projects associated with s, and compliance with regulations for emergency management, workplace violence initiatives, complying with position requirements, job descriptions for interns and/or students, vendors, or contractors.
Data Analysis: Patient privacy, reviewing patient records and/or documentation to identify potential discrepancies and errors, billing, coding, and/or reimbursement.
Compliance Audits: Internal audits related to compliance with HIPAA, Stark Law, and Anti-Kickback statutes, as well as Grant Agreements.
Policy or Document Development: Contribute to the development and revision of Compliance policies, procedures, job aids, infographics, or work instructions.
Training or Resource Support: Help create and deliver Compliance training and education materials for healthcare staff.
Incident reporting: Compliance investigations and how to document compliance-related matters.
Research: How to stay current on healthcare compliance laws, statutes, and regulations.
Associated Job Duties
* Other duties as assigned within the scope of training and education.
Key Competencies:
Competencies at the end of the internship will include documentation and a presentation of a program review or audit. The ability to display communication skills, time management, attention to detail and collaboration with internal and external department stakeholders. Demonstration of organizational values and support the mission of caring for vulnerable populations.
Qualifications
Education/Experience:
* Student enrolled in a college or university with an interest in public health, healthcare, human resources, finance, business, corporate compliance, risk management or quality assurance.
Other qualifications:
* Ability to travel as needed to other clinical locations
* Ability to stand or sit for long periods of time
* Maintain protected health information in accordance with HIPAA privacy guidelines and applicable laws/regulations
* Exercise discretion and confidentiality
Knowledge, Skills & Abilities
* Detail oriented
* Ability to listen objectively
* Excellent verbal and written communication skills
* Microsoft Office experience preferred
* Ability to work in a team environment as well as work independently with guidance.
Working Environment
* Primarily in office or remote but occasionally in patient care/clinic areas
* May be required to attend meetings or perform work remote from the hospital campus
* Work hours are flexible but primary during 7:30-4:30 time frame
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
Nearest Major Market: Indianapolis
$30k-40k yearly est. 10d ago
Breast Imaging Radiologist - Indianapolis Based | Partnership Track
Radiology of Indiana P C 3.1
Indianapolis, IN jobs
Radiology of Indiana is seeking an on-site, full-time; ABR fellowship trained Breast Imager to join our expanding private practice group. This is a partnership track position, but other employment opportunities are available, including part-time. One of our largest hospital partners, Community Hospital Network, has a formal affiliation with MD Anderson Cancer Center. Our group has played an integral part in that affiliation, and the breast imagers participate in the multidisciplinary cancer teams and weekly tumor boards at all MDA-affiliated sites. Our breast imagers work closely with our breast surgeons and oncology teams on a daily basis. Workdays consist of breast imaging and breast biopsies, with occasional shifts worked from home doing general radiology. We have also recently acquired the ability to read our breast imaging studies from home and plan with future growth to incorporate a rotating local breast imaging work from home slot.
Candidates can expect:
-Call is shared equally and taken from home. No overnight call requirement.
-12 weeks of vacation, with non-seniority based vacation distribution
-Multiple opportunities for moonlighting with ability to buy and sell shifts.
-Excellent compensation package, with extremely competitive base salary
-Excellent partnership bonus compensation, with quarterly distributions
Practice Highlights:
-Thriving physician-led, professional group
-Group-owned URP (Unified Radiology Platform)-one platform from which all studies are read, no matter the site of origin. Allows flexibility for growth.
-Group-owned IT company- our own IT staff run and maintains our PACS allowing for multiple joint ventures that provide substantial passive revenue streams.
-Robust operational support and resources in a collegial work environment.
-Opportunity for all physicians to participate in growth and leadership roles in the practice.
-24/7 support of Reading Room Coordinator (RRC)-helps facilitate contact with referring clinician on call, need for prior films, etc. Instant message system built-in to the URP makes communication seamless.
Indianapolis is a major Midwestern city with a vibrant downtown and attractive suburbs. It is host to two professional sports teams (Colts and Pacers) and is conveniently located near two Big Ten universities. Carmel, Fishers, Noblesville and Westfield are a few of the suburban towns with exceptional school systems.
If interested, please submit your CV and cover letter.
Requirements
Board Certified or Board Eligible
Indiana License
$195k-346k yearly est. 60d+ ago
Fraud and Waste Investigator
Humana 4.8
Indianapolis, IN jobs
**Become a part of our caring community and help us put health first** Humana is looking for an experienced Healthcare Investigator to join its industry leading Special Investigations Unit. Do you enjoy speaking with members, providers, and other industry colleagues? Do you thrive on solving problems and thinking outside the box? Are you self-driven and enjoy being proactive? But, most of all do you have a passion for combating Fraud, Waste, and Abuse in the Health Care Industry? If this resonates with you, then you should strongly consider this amazing opportunity to join Humana's SIU.
The Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Fraud and Waste Investigator collaborates in investigations with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares investigative and audit reports. Begins to influence department's strategy. Makes decisions on issues regarding technical approach for project components. Exercises good judgment with considerable latitude in determining objectives and approaches to assignments.
In order to thrive in this role, the following attributes and experience would be helpful:
o Self-starter and organized
o Interview skills and able to conduct a thorough investigation to maintain compliance with Humana and governmental requirements
o Able to collaborate with internal and external partners (Law Enforcement, Legal, Compliance).
o Comfort with data analysis (Excel, Access, PowerBI), report writing, and creating/presenting via PPT or other platform
o Performing Investigative research and medical record reviews
o CPT code experience
o Experience with testifying in Court
This role will regularly engage with all of the following:
o Local, State and Federal Law Enforcement
o Humana Legal and Outside Counsel
o Internal Compliance
o Market Areas
o Clinical Teams
o Business areas for all product lines (Medicare, Medicaid, Commercial)
o Industry Trend areas
**Use your skills to make an impact**
**WORK STYLE:** Work at Home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**WORK HOURS:** Typical work hours are Monday-Friday, 8 hours/day, 5 days/week. EST/CST time zones
**Required Qualifications**
- Bachelor's degree
- 2 years of healthcare fraud investigations and auditing experience
- Knowledge of healthcare payment methodologies, claims, submissions, and payments
- Strong organizational, interpersonal, and communication skills
- Inquisitive nature with ability to analyze data to metrics
- Proficiency with MS Word, Excel, Access
- Strong personal and professional ethics
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
- Graduate degree and/or certifications (MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI)
- Experience testifying in court
- Understanding of healthcare industry, claims processing, and investigative process development
- Experience in a corporate environment and understanding of business operations
**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
**How We Value You**
- Benefits starting day 1 of employment
- Competitive 401k match
- Generous Paid Time Off accrual
- Tuition Reimbursement
- Parent Leave
- Go365 perks for well-being
**Interview Format**
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
\#ThriveTogether #WorkAtHome
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.
$65,000 - $88,600 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: 01-15-2026
**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 ***************************************************************************
$65k-88.6k yearly 8d ago
Principal Project Manager
Alignment Healthcare 4.7
Indiana jobs
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The Principal Project Management is a key driver of process optimization and project success across our organization. This is a highly strategic and hands-on role where you will be responsible for both defining the "what" and optimizing the "how." You will lead the development and implementation of a unified project management framework while simultaneously analyzing, designing, and improving our core business processes. The ideal candidate is a seasoned expert who can think at a strategic level, mentor and lead teams, and get into the weeds to solve complex operational challenges.
Job Duties/Responsibilities:
Strategic Project Management Framework: Design, implement, and govern a standardized, scalable project management methodology (e.g., Agile, Waterfall, Hybrid) that is tailored to our organization's needs and ensures consistency, predictability, and quality in project delivery.
Process Optimization Leadership: Act as the lead subject matter expert in process improvement. Conduct comprehensive analysis of current business processes to identify inefficiencies, bottlenecks, and opportunities for automation and optimization.
Capacity and Demand Management: Develop, implement, maintain and report on the capacity of the IT organization to intake work, prioritize it, and report on demand for those resources. This will support work execution and resource planning.
Change Management: Lead the change management initiatives to ensure the successful adoption of new project management methodologies and optimized business processes across all departments. This includes developing training materials, conducting workshops, and providing ongoing support.
Enterprise Project Management: Lead multiple complex, enterprise-wide initiatives with significant financial and operational impact.
Mentorship and Coaching: Serve as a senior-level mentor and coach to project managers and operational teams. Provide expert guidance on best practices in project planning, execution, risk management, and stakeholder communication, as well as process analysis and continuous improvement techniques.
Performance Metrics and Reporting: Define and track key performance indicators (KPIs) for both project health and process efficiency. Develop and maintain dashboards and reports that provide executive leadership with a clear, data-driven view of our project portfolio and operational performance.
Tooling and Technology: Evaluate, select, and optimize project management and business process management (BPM) software and tools to support our methodologies and improve overall efficiency.
Cross-Functional Collaboration: Partner with senior leaders and stakeholders across the organization to align project and process optimization initiatives with strategic business goals. Facilitate cross-functional teams to drive and implement complex improvements.
Risk Mitigation: Proactively identify and address risks related to project execution and process failures. Develop and implement strategies to mitigate these risks and ensure business continuity.
Continuous Improvement Culture: Foster a culture of continuous improvement by promoting lean principles, data-driven decision-making, and a proactive approach to identifying and solving problems.
Required Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Experience: 10+ years of progressive experience in a combination of project management, process improvement, information technology, and business analysis roles, with a minimum of 5 years in a principal or leadership capacity.
Certifications: PMP (Project Management Professional) and/or other relevant certifications (e.g., Lean Six Sigma Black Belt, Agile, Scrum Master) are .
Education: Bachelor's degree in Business Administration, Operations Management, Engineering, or a related field.
Technical & Analytical Skills: Deep expertise in process mapping, data analysis, and the use of process improvement methodologies (e.g., Lean, Six Sigma, Kaizen).
Leadership & Influence: Exceptional leadership, communication, and interpersonal skills with a proven ability to influence and drive organizational change without direct authority.
Strategic Thinking: Proven ability to develop and execute a strategic vision for project and process management that aligns with and supports business growth.
Problem-Solving: Strong analytical and problem-solving skills with a meticulous attention to detail.
Tool Proficiency: Advanced proficiency with project management software (e.g., Jira, Asana, Microsoft Project) and process mapping tools (e.g., Visio, Lucidchart).
Preferred Qualifications:
Education/Licensure:
Master's degree preferred.
Experience with FreshService or ServiceNow
Physical Requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $130,332.00 - $195,498.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.
$59k-75k yearly est. Auto-Apply 60d+ ago
Chief Data Scientist (Remote)
Trimedx 4.6
Indianapolis, IN jobs
If you are wondering what makes TRIMEDX different, it's that all of our associates share in a common purpose of serving clients, patients, communities, and each other with equal measures of care and performance.
Everyone is focused on serving the customer and we do that by collaborating and supporting each other
Associates look forward to coming to work each day
Every associate matters and makes a difference
It is truly a culture like no other - We hope you will join our team! Find out more about our company and culture here.
TRIMEDX is an industry-leading, independent clinical asset management company delivering comprehensive clinical engineering services, clinical asset informatics, and medical device cybersecurity solutions to many of the largest health systems in the US. We help healthcare providers transform their clinical assets into strategic tools, driving reductions in operational expenses, optimizing clinical asset capital purchasing decisions and usage, improving caregiver satisfaction and productivity, maximizing resources for patient care, and delivering improved patient safety & protection.
TRIMEDX was built by providers, for providers, and leverages a history of expert clinical engineering with data on 90-95% of in-use medical equipment in the United States and an industry-leading data set of more than 6 million medical device records. A recent study by Fortune states that global healthcare asset management market is estimated to be $215B by 2032 with a CAGR of 25.3%. The United States is the largest single market for medical devices and accounts for about 40 percent of worldwide sales (BMI Research 2015).
We are looking for the Chief Data Scientist who can accelerate our growth as a thought leader in Data Science, Research, and application of models to solve complex business problems. This person will lead the Company's efforts to create a data science practice dedicated to harnessing this proprietary data set to support commercialization of novel new market solutions to enable providers to make informed decisions regarding their clinical asset investments and utilization. This role will be one of the most prominent voices in the global medical device industry. As the Chief Data Scientist, you will be responsible for leading TRIMEDX data and AI architecture and design to help our customers increase their clinical asset utilization and reduce cost to operate. You will design our enterprise-wide AI and Machine Learning initiatives.
This new role will be instrumental in shaping and implementing our AI roadmap, driving innovation through advanced data modeling, and applying automation to optimize operations across diverse data ecosystems. It involves orchestrating Agentic AI across multiple SaaS infrastructures, including, but not limited to, Snowflake, Azure, ServiceNow, and Looker. In this role, you will work with senior executives and customers to arrive at solutions that significantly lift their business and accelerate the growth.
Key Responsibilities
You are a strategic leader that has defined enterprise AI/ML platforms with a strong focus on LLMs, generative AI, and predictive modeling. You will implement model-driven features from initial concept to production, covering all stages including model creation, evaluation, performance metrics, A/B testing, drift monitoring and self-correction with feedback loops. You will coach and train talented engineers in their career growth and set an example for data and AI organization. Your experience is building pricing models, forecasting, smart work assignment are preferred. You stay at the forefront of AI/ML research and emerging technologies; evaluate and integrate cutting-edge tools and frameworks. You will foster a culture of experimentation and continuous learning within the data science team. You will create high levels of engagement across teams in partnership with other key leaders within broader teams.
Skills and Experience
• Minimum of 12 years of experience in computer science, data science, Statistics or related field. Experience preference in machine learning, data analytics or related disciplines with a focus on algorithmic product development.
• Deep expertise in statistics, econometrics, predictive analytics, and related disciplines.
• Working experience with modeling tools and languages such as Python, PyTorch, JAX, Tensorflow, SQL, and experience deploying production models on clouds platforms (AWS, Azure, GCP).
• Must have demonstrated experience leading data driven initiatives. Experience leading people is preferred.
• Demonstrated experience with multi-modal LLMs. Experience with A/B testing and cocreate MLOps practice for systemic application and maintenance of the models.
• Hands on experience deploying high impact, high Throughput, highly scalable, multi-modal ML models in Azure.
• Experience in data analysis using different types of datasets with statistics and predictive modeling foundations, including PC and foundation models.
• Experience creating patents and publications and / or speaking at top conferences such as CVPR (Computer Vision and Pattern Recognition Conference), IEEE (The Institute of Electrical and Electronics Engineers), SIGKDD (Special Interest Group on Knowledge Discovery and Data Mining), AAAI (Association for the Advancement of Artificial Intelligence), NeurIPS.
• Successful and proven experience to collaborate and deliver results in a fast paced, multifaceted, matrix environment.
• Proven success at working with abstract ideas and solving complex problems while driving collaboration across various teams.
• Ability to be hands-on when necessary as well as strategic is required.
• Excellent public speaking and presentation skills; strong written and verbal communication skills.
• Ability to travel up to 50%.
Education and Qualifications
Bachelor's degree in Statistics, Economics or related field is required, or equivalent experience.
Master's degree or Ph.D. in Statistics or Economics is highly preferred.
#LI-Remote
At TRIMEDX, we are committed to cultivating a workplace culture where every associate feels valued, supported, and empowered to thrive. This culture reflects our belief that our people are our foundation, their well-being is essential, and shared success is built through meaningful work, recognition, and opportunities for growth.
We embrace people's differences which include age, race, color, ethnicity, gender, gender identity, sexual orientation, national origin, education, genetics, veteran status, disability, religion, beliefs, opinions and life experiences.
Visit our website to view our Workplace Culture Commitment , along with our social channels to see what our team is up to: Facebook, LinkedIn, Twitter.
TRIMEDX is an Equal Opportunity Employer. Drug-Free Workplace.
Because we are committed to providing a safe and productive work environment, TRIMEDX is a drug-free workplace. Accordingly, Associates are prohibited from engaging in the unlawful manufacture, sale, distribution, dispensation, possession, or use of any controlled substance or marijuana, or otherwise being under the influence thereof, on all TRIMEDX and Customer property or during working/on-call hours.
$64k-86k yearly est. Auto-Apply 60d+ ago
Billing Analyst
Press Ganey Associates 4.7
South Bend, IN jobs
PG Forsta is the leading experience measurement, data analytics, and insights provider for complex industries-a status we earned over decades of deep partnership with clients to help them understand and meet the needs of their key stakeholders. Our earliest roots are in U.S. healthcare -perhaps the most complex of all industries. Today we serve clients around the globe in every industry to help them improve the Human Experiences at the heart of their business. We serve our clients through an unparalleled offering that combines technology, data, and expertise to enable them to pinpoint and prioritize opportunities, accelerate improvement efforts and build lifetime loyalty among their customers and employees.
Like all great companies, our success is a function of our people and our culture. Our employees have world-class talent, a collaborative work ethic, and a passion for the work that have earned us trusted advisor status among the world's most recognized brands. As a member of the team, you will help us create value for our clients, you will make us better through your contribution to the work and your voice in the process. Ours is a path of learning and continuous improvement; team efforts chart the course for corporate success.
Our Mission:
We empower organizations to deliver the best experiences. With industry expertise and technology, we turn data into insights that drive innovation and action.
Our Values:
To put Human Experience at the heart of organizations so every person can be seen and understood.
Energize the customer relationship: Our clients are our partners. We make their goals our own, working side by side to turn challenges into solutions.
Success starts with me: Personal ownership fuels collective success. We each play our part and empower our teammates to do the same.
Commit to learning: Every win is a springboard. Every hurdle is a lesson. We use each experience as an opportunity to grow.
Dare to innovate: We challenge the status quo with creativity and innovation as our true north.
Better together: We check our egos at the door. We work together, so we win together.
This position has a hybrid schedule which will require to go to the South Bend's office Tuesday through Thursday and working from home Monday and Friday.
Job Overview
This position will be responsible for processing new contracts and amendments and setting them up for accurate invoicing and revenue recognition. They will manage a client load and be available to answer questions directly from clients as well as from other internal departments regarding the contracts and invoices for their assigned client.
Duties and Responsibilities
Assist with the monthly invoice process including posting and review of client invoicing.
Review and process contracts to ensure accurate invoicing and revenue recognition.
Process monthly cancellations and issue necessary credits.
Perform maintenance on client accounts to realign services, change billing cycles and adjust current or future pricing.
Maintain a strong working relationship with clients both external and internal to ensure the accuracy of invoices and to serve as a resource when questions arise.
Qualifications
A high level of attention to detail to prevent and/or resolve existing billing issues timely and accurately.
Excellent phone and written communication skills
Ability to work independently, prioritize their work load, meet deadlines, and work in a team environment.
Knowledge of the Microsoft Suite of products, especially Excel, is preferred.
Education
Bachelor's degree in Accounting, Finance, Business or related area is required with 1-3 years of relevant experience preferred.
Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At PG Forsta we are dedicated to building a diverse, inclusive and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.
Additional Information for US based jobs:
Press Ganey Associates LLC is an Equal Employment Opportunity/Affirmative Action employer and well committed to a diverse workforce. We do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, veteran status, and basis of disability or any other federal, state, or local protected class.
Pay Transparency Non-Discrimination Notice - Press Ganey will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
The expected base salary for this position ranges from $44,000 - $55,000 (annually). It is not typical for offers to be made at or near the top of the range. Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where applicable, licensure or certifications obtained. Market and organizational factors are also considered. In addition to base salary we offer a competitive benefits package
All your information will be kept confidential according to EEO guidelines.
Our privacy policy can be found here: *****************************************
$44k-55k yearly Auto-Apply 14d ago
Claims Auditor- Remote
American Health Partners 4.0
Indianapolis, IN jobs
American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. For more information, visit AmHealthPlans.com.
If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application!
Benefits and Perks include:
* Affordable Medical/Dental/Vision insurance options
* Generous paid time-off program and paid holidays for full time staff
* TeleMedicine 24/7/365 access to doctors
* Optional short- and long-term disability plans
* Employee Assistance Plan (EAP)
* 401K retirement accounts
* Employee Referral Bonus Program
ESSENTIAL JOB DUTIES:
To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.
* Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials
* Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards
* Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment
* Work assigned claim projects to completion
* Provide a high level of customer service to internal and external customers; achieve quality and productivity goals
* Escalate appropriate claims/audit issues to management as required; follow departmental/organizational policies and procedures
* Maintain production and quality standards as established by management
* Participate in and support ad-hoc audits as needed
* Other duties as assigned
JOB REQUIREMENTS:
* Proficient in processing/auditing claims for Medicare and Medicaid plans
* Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other complex claim processing rules and regulations
* Current experience with both Institutional and Professional claim payments
* Knowledge of automated claims processing systems
* Hybrid role that may require 2-3 days per week onsite at the Franklin, TN office.
REQUIRED QUALIFICATIONS:
* Experience:
* Two (2) years' experience with complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system
* Two (2) years' experience in managed healthcare environment related to claims processing/audit
* Two (2) years' experience with standard coding and reference materials used in a claim setting, such as CPT4, ICD10 and HCPCS
* Two (2) years' experience with CMS requirements regarding claims processing; especially Skilled Nursing Facility and other complex claim processing rules and regulations
* Two (2) years' experience processing/auditing claims for Medicare and Medicaid plans
* License/Certification(s):
* Coding certification preferred
EQUAL OPPORTUNITY EMPLOYER
Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.
This employer participates in E-Verify.
$44k-55k yearly est. 22d ago
Clinical Pharmacist
Alignment Healthcare 4.7
Indiana jobs
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The Clinical Pharmacist at Alignment health Plan is involved in a wide range of projects throughout the year. Projects include, performs Part D coverage determination and appeal, responds to internal pharmacy questions, assists audits, reviews member materials, tests, and builds benefits among others.
GENERAL DUTIES/RESPONSIBILITIES:
1. Reviews Part D coverage determination and appeal requests and make clinical decisions in accordance with formulary benefits, guidelines, and CMS requirements
2. Researches and responds to Part D grievances and inquiries, conducting outreach to prescribers, pharmacies, and members as needed
3. Monitors and oversees activities of Pharmacy Benefit Manager (i.e. benefit administration, clinical decision making, quality of customer service, compliance, etc.)
4. Supports annual pharmacy benefit build activities and development of member materials
5. Manages Part D formulary and related activities
6. Develops formulary recommendations by assessing drug utilization trends, clinical guidelines, and drug spend
7. Conducts therapeutic class reviews and analyze pharmacy cost and utilization management trends
8. Performs Medication Therapy Management over the phone
9. Attends interdisciplinary clinical rounds to provide pharmacy recommendations and improve patient health outcomes
10. Participates in plan and regulatory reporting and audits
11. Supports various Pharmacy Department operations, programs, and initiatives as needed
12. Performs other related duties and projects assigned
Minimum Requirements:
Standard work schedule: Monday through Friday, 8 AM - 5 PM PST, with availability for rotational weekend shifts as needed.
Occasional onsite travel to the corporate office in Orange, CA may be required. Candidates should be prepared to travel up to 10% of the time to meet business needs
Experience:
• Required: Minimum of three years of experience at a health plan and/or PBM. Three years of work experience with Medicare Part D. Three years' experience in CDAG (coverage determinations, appeals, and grievances)
• Preferred: Previous work experience in Part D formulary management. Previous work experience in Medication Therapy Management.
Education:
• Required: Bachelors Degree, Masters Degree or PhD in Pharmacy.
• Preferred: Pharm. D.
Specialized Skills Required:
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly
Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
Report Analysis Skills: Comprehend and analyze statistical reports.
Licensure:
• Required: Active pharmacist license in good standing
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1 While performing the duties of this job, the employee is regularly required to talk or hear.
2 The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
3 The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $126,422.00 - $189,634.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.
$41k-80k yearly est. Auto-Apply 6d ago
Vice President-Federal Communications and Marketing (Hybrid Remote - McLean, VA / DC Area)
Maximus 4.3
Indianapolis, IN jobs
Description & Requirements Maximus is seeking a dynamic and experienced Vice President-Federal Communications and Marketing to join our innovative team. The ideal candidate will bridge the gap between technology, business process services and marketing in the Federal Government sector. In this role, you will be responsible for Team Leadership and Change Management in a large organization. The VP-Federal Communications and Marketing will collaborate with cross-functional teams to drive Federal solutions and offerings. If you are a strategic thinker with a passion for technology services and marketing, and if you thrive in a dynamic and collaborative environment, we invite you to apply to the position at Maximus.
This is a hybrid position with the need to go into the office a minimum of 3 days per week and occasionally attend meetings and/or events in the Tyson Corners, VA/ Washington, DC area. This position requires some travel. The selected candidate must live in this geographical area.
Key Areas of Responsibility
- Identify, plan, develop, and oversee differentiated and impactful marketing strategies/materials.
- Developing new programs for customer engagement including integrated marketing programs from concept to execution
- Drive Maximus Federal solutions and offerings.
- Manage digital and social media strategies across the federal market
- Build, manage, and coach a high-performing marketing team.
- Direct and support market research collection, analysis, interpretation of market data for short- and long- term market forecasts and reports.
- Work closely with the growth leaders to align sales and marketing strategies
- Maintain brand standards and ensure compliance across all marketing and communications channels.
- Build long-term relationships with employees, clients, government officials, and stakeholders.
- Serve as a collaborative and senior leader on the Maximus Communication & Marketing Team, helping to align strategy and outcomes across the company.
- Drive the implementation of marketing campaigns that meet business objectives and drive customer engagement.
- Develop relationships with associations, academia and industry partners to drive thought leadership and brand elevation.
This role will develop and oversee the Maximus Federal segment marketing strategy. Responsibilities include building brand visibility in the Federal marketplace, driving customer and partner engagement to support growth goals. This position will be responsible for developing annual marketing plans building strategy, managing the cross functional team and budget and, leveraging partner relationships, driving go-to-market solutions.
Qualifications:
-15+ years of experience in a Federal Marketing and Industry Analysis position including 7+ years managing a team.
-Previous experience at a corporation focused on the Federal sector.
-Bachelor's degree in Marketing, Business, or a related field; technical background and digital marketing are a plus. Additional experience in lieu of degree will be considered.
-MA degree in Marketing, Communication, or similar relevant field, preferred.
-Outstanding communication, presentation, and leadership skills.
-In-depth knowledge of the Federal sector.
-Critical thinker with problem-solving skills.
-Strong interpersonal and communication skills.
Key Competencies include the following: Marketing and Communication Strategies, Team Leadership, Technical Expertise, Cross-Functional Collaboration, Content Development, Sales Enablement, Product and Solutions Positioning and Change Management
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************.
Minimum Salary
$
216,155.00
Maximum Salary
$
292,455.00
$106k-200k yearly est. Easy Apply 7d ago
ClinDoc- Clinical Application Analyst III - Digital Technology Services
Deaconess Health System 4.8
Evansville, IN jobs
Clinical Application Analyst, HIM (Health Identity Management) Join Our Team We are looking for a skilled and detail-oriented Clinical Application Analyst to join our Clinical Informatics and Data Analytics Team (CIDA). This position focuses on optimizing workflows related to Epic Identity, Cosmos, and Care Everywhere applications and plays a key role in enhancing patient identity management, medical records, and hospital coding processes. Additionally, you will support the growth of Deaconess Health System by assisting in the build-out of new facilities and hospital structures.
Benefits
We pride ourselves in retaining our top talent by offering work environments that support professional development and personal success. In addition to our robust healthcare and retirement plans, we offer:
* Onsite children's care centers (Infant through Pre-K)
* Tuition reimbursement
* Free access to fitness centers, where health coaches are available to help with workout plans
* Career advancement opportunities
* Competitive pay, yearly opportunities for pay increases and bonuses
Job Overview
* Hybrid or remote position depending on location of employee
* Responsible for configuration, build, testing, go-live, and ongoing support of Epic Identity, Cosmos, and Care Everywhere applications
* Coordinate system upgrades, updates, and optimization processes
* Work closely with end users to troubleshoot application-related issues and provide effective resolutions
* Solve complex technical and workflow problems with attention to detail
* Manage and oversee medium to large projects related to application optimization and development
What You Will Need
* Bachelor's degree in healthcare, IT, or a related field, or equivalent work experience
* 5+ years of experience in healthcare IT, clinical applications, or health information management, with a focus on Epic Identity, Cosmos, and/or Care Everywhere applications
* Epic Certification in Identity, Cosmos, or Care Everywhere preferred or required (depending on position level)
* Proven expertise in clinical workflows within an application setting, particularly related to patient identity management, medical records, and hospital coding
* Experience in the configuration, testing, implementation, and support of Epic applications
* Strong knowledge of clinical data standards, HL7 messaging, data integration, and interface management
* Experience with system upgrades, troubleshooting, and workflow optimization in a healthcare IT environment
* Familiarity with healthcare industry compliance standards (e.g., HIPAA, HL7, ICD-10, etc.)
* Advanced proficiency in Microsoft Office Suite, including Excel (pivot tables, VLOOKUPs, etc.) for data analysis and reporting
Other Keywords: Clinical Application Analyst, HIM, Epic Identity, Cosmos, Care Everywhere, Patient Identity Management, Medical Records, Hospital Coding, Healthcare IT, Project Management, Workflow Optimization, Hybrid Position, Remote Position, Competitive Salary, IT, Epic Systems Analyst, Electronic Health Record (EHR) Support, Master Patient Index (MPI), Data Governance, Duplicate Record Resolution, Patient Data Integrity, Enterprise Health Information Systems, EHR Workflow Optimization, Health Information Exchange (HIE), Clinical Data Management, Information Governance, Clinical Systems Integration, Application Configuration Analyst, Health Informatics, Interface Engine, Identity Management Analyst, Healthcare Data Quality, Application Lifecycle Management (ALM), Data Reconciliation, Interoperability, Patient Safety, Information Services (IS), Clinical Data Standards, Technical Troubleshooting, Epic User Provisioning, Epic Security and Access, Epic Chronicles, Support Analyst - Epic EHR, Clinical Documentation Improvement (CDI)
$71k-91k yearly est. 60d+ ago
Virtual Care Summer Non-Clinical Intern
Dekalb Health 4.4
Fort Wayne, IN jobs
Virtual Care is part of the larger Nursing Informatics team - reporting to Michelle Charles, SVP. Informatics focuses on the use of technology in the care of patients, as well as data analysis. The Virtual Care team is seeking an intern who will work in a hybrid of remote (local to Fort Wayne only) and on-site at the hospitals and the Business & Technology Center. Remote work will involve the use of a Parkview provided laptop to assist with data gathering, validation, and analysis. The various project work experienced as an intern provides a great opportunity to learn about healthcare and will prepare them for future roles.
The intern will receive training on the technology used in the hospital and department which the Virtual Care team supports, such as iPhones, iPads, video equipment, etc. Once trained, the intern may go to the hospital units helping to support the use of these devices or other technologies (working alongside other Virtual Care team members). The intern may be involved in observing and assisting with the implementation of new processes. For remote work, the intern may complete chart audits, gather data, create reports, and assist the teams with other similar tasks. Actual duties will depend upon the project work at that time.
Students will need to have knowledge of Microsoft Office tools, specifically Excel. Background in data analysis and data visualization is a plus. Students should be willing and able to assist the Virtual Care team in providing technical and workflow support in the hospital/department setting following training. Students will need good communication skills, as they may be interacting with Nurses and Patient Care Techs in the hospital.
Work Schedule
Monday-Friday, typically 8:00 a.m.-5:00 p.m. (day shift).
Some flexibility may be available. An internship is structured for 24-40 hours per week.
The preferred areas of study are students studying Nursing, Health Informatics, or similar fields with an interest in healthcare technology are encouraged to apply. All years of study are welcome.
Additional Notes:
Applicants must have their own transportation for local travel between hospitals and the Business & Technology Center.
Must be current undergraduate college student or graduate college student. Specific educational focus or degree may be preferred, depending on the internship hosting department. A specific license and/or certification may be preferred, depending on the hosting department of the internship. GPA of 3.0 or above Submission of Cover Letter Resume and Letter of Recommendation. Other qualifications may vary by department of internship.
$24k-28k yearly est. 60d+ ago
Sr. Knowledge Analyst - Contact Center Content Specialist (Remote)
Maximus 4.3
Indianapolis, IN jobs
Description & Requirements Maximus is looking for a dynamic Senior Knowledge Analyst to serve as the dedicated Contact Center Content Specialist (CCCS). In this pivotal role, you'll collaborate closely with government and internal teams to identify content gaps, drive improvements, and ensure that agents are equipped with clear, effective, and bilingual resources.
*Position is contingent upon contract award*
This is a fully remote role.
Must have the ability to pass a federal background check.
Remote Position Requirements:
- Hardwired internet (ethernet) connection
- Internet download speed of 25mbps and 5mbps (10 preferred) upload or higher required (you can test this by going to ******************
- Private work area and adequate power source
Essential Duties and Responsibilities:
- Build and maintain knowledge base in SharePoint.
- Build document management processes and procedures.
- Assess knowledge base needs, inaccuracies, gaps; work quickly to resolve and make content current.
- Work cross-functionally with internal teams for maximum efficiency and accuracy in documentation content.
- Create hierarchy and ownership structure to sustain knowledge management.
- Empower contributions from key stakeholders to improve the knowledge base.
- Design and implement work flows to manage documentation process.
- Establish standard templates for all documentation for the teams to utilize in document creation.
- Collaborate with and support the Implementation Team to tune and evolve our Knowledge Base.
- Create, promote and apply best practices for writing, style and content in Microsoft style.
- Create training material in support of the Knowledge management process.
- Improve search results by honing and maintaining the knowledge base taxonomy, labels list and ensuring symptoms and subject terms are present in each article.
- Utilize SharePoint knowledge for site management, list creation, workflow creation/modification and document management within SharePoint.
• Coordinate with client content teams, and the Senior Training Manager to identify and address content gaps specific to contact center operations.
• Serve as a bilingual subject matter expert (English and Spanish) for contact center content development.
• Support the creation and refinement of training materials for contact center agents.
• Draft monthly action and improvement reports with recommendations on knowledge content, quality, customer satisfaction, and training materials.
• Represent the contact center perspective in content-related discussions and decisions.
• Work extensively with business partners and SMEs to perform knowledge needs analysis, develop and update training and knowledge resources that meet staff and stakeholder needs and organizational quality standards.
• Manage and develop knowledge articles, chat quick text scripts and email templates.
• Conduct audits of knowledge articles and procedures to ensure accuracy and relevance.
• Identify emerging contact center trends and coordinate content updates to address urgent needs.
• Collaborate with client content teams to create, update, and review contact center-specific content.
• Serve as a subject matter expert for assigned customer agencies.
• Salesforce and SharePoint experience preferred.
• Call center knowledge and experience preferred.
Minimum Requirements
- Bachelor's degree with 5+ years of experience.
- Advanced degree or professional designation preferred.
- Develops solutions to a variety of complex problems.
- Work requires considerable judgment and initiative.
- Exerts some influence on the overall objectives and long-range goals of the organization.
• Developing website content experience
• Self-motivated and able to work independently
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************.
Minimum Salary
$
65,000.00
Maximum Salary
$
85,200.00
$55k-65k yearly est. Easy Apply 6d ago
Sr Coordinator, Individualized Care (Reimbursement Coordinator)
Cardinal Health 4.4
Indianapolis, IN jobs
Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products.
**_Responsibilities_**
+ Investigate and resolve patient/physician inquiries and concerns in a timely manner
+ Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
+ Proactive follow-up with various contacts to ensure patient access to therapy
+ Demonstrate superior customer support talents
+ Prioritize multiple, concurrent assignments and work with a sense of urgency
+ Must communicate clearly and effectively in both a written and verbal format
+ Must demonstrate a superior willingness to help external and internal customers
+ Working alongside teammates to best support the needs of the patient population or will transfer caller to appropriate team member (when applicable)
+ Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry
+ Must self-audit intake activities to ensure accuracy and efficiency for the program
+ Make outbound calls to patient and/or provider to discuss any missing information as applicable
+ Assess patient's financial ability to afford therapy and provide hand on guidance to appropriate financial assistance
+ Documentation must be clear and accurate and stored in the appropriate sections of the database
+ Must track any payer/plan issues and report any changes, updates, or trends to management
+ Handle escalations and ensure proper communication of the resolution within required timeframe agreed upon by the client
+ Ability to effectively mediate situations in which parties are in disagreement to facilitate a positive outcome
+ Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties
+ Support team with call overflow and intake when needed
+ Proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner.
**_Qualifications_**
+ 3-6 years of experience, preferred
+ High School Diploma, GED or technical certification in related field or equivalent experience preferred
**_What is expected of you and others at this level_**
+ Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
+ In-depth knowledge in technical or specialty area
+ Applies advanced skills to resolve complex problems independently
+ May modify process to resolve situations
+ Works independently within established procedures; may receive general guidance on new assignments
+ May provide general guidance or technical assistance to less experienced team members
**TRAINING AND WORK SCHEDULES:** Your new hire training will take place 8:00am-5:00pm CT, mandatory attendance is required.
This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CT.
**REMOTE DETAILS:** You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:
Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. **Dial-up, satellite, WIFI, Cellular connections are NOT acceptable** . Download speed of 15Mbps (megabyte per second)
+ Upload speed of 5Mbps (megabyte per second)
+ Ping Rate Maximum of 30ms (milliseconds)
+ Hardwired to the router
+ Surge protector with Network Line Protection for CAH issued equipment
**Anticipated hourly range:** $21.50 per hour - $30.70 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:** 2/11/2026 *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.
_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 (***************************************************************************************************************************
$21.5-30.7 hourly 19d ago
Director, Information Security and Risk (Identity & Access Management)
Cardinal Health 4.4
Indianapolis, IN jobs
**_What Information Security and Risk contributes to Cardinal Health_** Information Security and Risk develops, implements, and enforces security controls to protect the organization's technology assets from intentional or inadvertent modification, disclosure or destruction. This job family develops system back-up and disaster recovery plans. Information Technology also conducts incident response, threat management, vulnerability scanning, virus management and intrusion detection and completes risk assessments.
The _Director, Information Security and Risk (Identity & Access Management)_ is responsible for leading the organization's Identity & Access Management (IAM) strategy, governance, and operations to ensure secure, efficient, and compliant access to technology resources. This role requires a leader with proven ability to execute large-scale enterprise IAM programs that directly impact how employees, contractors, and customers interact with Cardinal Health technology. Success in this role demands a balance between delivering a frictionless, user-friendly experience and maintaining the highest standards of security. The Director must also excel at building partnerships across the organization and collaborating on program delivery, while driving operational excellence and anticipating business risks associated with IAM changes.
**Location** - Ideally targeting individuals local to Central Ohio, but open to candidates located nationwide (fully remote). If living within commutable distance of our corporate HQ in Dublin, OH - the expectation would be to come in-office two or three days a month for team meetings.
**Responsibilities**
+ Act as a visionary in designing and executing multi-year IAM strategy that aligns with business goals and customer needs
+ Develop and oversee enterprise IAM policies, standards, and procedures, ensuring consistent enforcement across the organization.
+ Lead IAM initiatives including identity lifecycle management (provisioning, de-provisioning, role-based access, entitlement reviews).
+ Direct privileged access management (PAM) programs to safeguard critical systems and sensitive data.
+ Ensure compliance with internal policies and external regulatory requirements (e.g., SOX, HIPAA, GDPR, PCI-DSS) through strong access controls.
+ Execute enterprise IAM programs with significant business impact, ensuring seamless access for employees, contractors, and customers.
+ Balance user experience with security by designing IAM solutions that are simple, intuitive, and resilient.
+ Drive operational excellence by establishing repeatable processes, KPIs, and service delivery models for IAM functions.
+ Build strong partnerships across IT, Security, HR, and business units to align IAM delivery with organizational priorities.
+ Establish metrics and reporting mechanisms to monitor IAM effectiveness, operational performance, and program maturity for executive leadership.
+ Lead training and awareness programs related to IAM policies, secure access practices, and identity governance.
**Qualifications**
+ Bachelor's degree in Information Technology, Computer Science, Cybersecurity, or a related field preferred.
+ Ideally targeting individuals with 12+ years of IT/security experience with at least 5 years in IAM leadership roles preferred.
+ Proven track record of executing enterprise IAM programs with measurable business impact.
+ Prior people leadership experience and demonstrated ability to manage operational IAM teams, highly preferred.
+ Expertise with IAM tools and platforms (e.g., Okta, SailPoint, CyberArk, Azure AD).
+ Strong understanding of relevant Regulatory and Compliance requirements (HIPAA, SOX, HITRUST CSF, etc.).
+ Strong understanding of authentication protocols (SAML, OAuth, OpenID Connect, Kerberos) and cloud IAM (AWS IAM, Azure RBAC, GCP IAM).
+ Certifications such as CISSP, CIAM, or CISM preferred.
+ Strong analytical, relationship management, and communication skills (both written and verbal).
+ Ability to collaborate across functions and influence stakeholders to achieve IAM program success.
**What is expected of you and others at this level**
+ Provides leadership to managers and experienced professional staff; may also manage front line supervisors
+ Manages an organizational budget
+ Develops and implements policies and procedures to achieve organizational goals
+ Assists in the development of functional strategy
+ Decisions have an extended impact on work processes, outcomes, and customers
+ Interacts with internal and/or external leaders, including senior management
+ Persuades others into agreement in sensitive situations while maintaining positive relationships
_\#LI-LP_
_\#LI-Remote_
**Anticipated salary range:** $135,400 - $228,910
**Bonus eligible:** Yes
**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:** 12/25/2025 *if interested in opportunity, please submit application as soon as possible.
The salary 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.
_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 (***************************************************************************************************************************