Director of health services jobs near me - 676 jobs

At *Smith Schabo Law*, our philosophy is simple; we put our clients first. We are dedicated to providing the highest caliber of legal representation, treating every client with respect, compassion, and integrity. Our firm is committed to fighting injustice and righting the wrongs suffered by those harmed by individuals, corporations, or public entities. Our personal injury and trial lawyers have a proven track record of results, having successfully recovered millions of dollars for clients through dedicated advocacy and exceptional legal skill. *Position Overview* Smith Schabo Law is seeking an experienced and motivated Personal Injury Attorney / Practice Manager to join our growing legal team. This unique role combines client-facing legal representation with practice management responsibilities, offering the opportunity to both litigate cases and oversee the efficient operations of a dynamic personal injury practice. The ideal candidate will have experience in plaintiff's personal injury law, be bilingual in English and Spanish, and possess strong leadership, organizational, and communication skills. *Responsibilities* *Legal Representation* * Represent clients in personal injury cases, ensuring their rights are protected throughout the legal process * Conduct comprehensive legal research and case analysis using tools such as LexisNexis to support strategy and advocacy * Draft legal documents, including pleadings, motions, and settlement agreements with precision and clarity * Negotiate settlements and manage litigation matters, advocating for clients' best interests in every phase of the case * Maintain accurate case files and documentation to ensure compliance with ethical and legal standards *Practice Management* * Oversee day-to-day operations of the law practice, ensuring efficiency and organization across all active cases * Utilize and maintain the firm's Clio practice management system to track case progress, deadlines, and client communications * Develop and improve operational processes to optimize productivity and client satisfaction * Collaborate with staff to manage scheduling, workflow, and client intake * Assist in business development and client relationship management to help grow the firm's presence in the community *Requirements* * Juris Doctor (JD) degree from an accredited law school * Active license to practice law in Ohio * Minimum 3 years of experience in plaintiff's personal injury law * Demonstrated experience in litigation with strong negotiation skills * Exceptional writing and communication abilities for legal drafting and client interaction * Proven ability to manage multiple priorities, cases, and staff effectively * Proficiency in Clio and Microsoft Office Suite; familiarity with LexisNexis preferred * Strong leadership, organizational, and time management skills with a focus on accuracy and client service *Benefits* * Health insurance * Simple IRA with match * Paid time off * Opportunity for professional growth within a results-driven, client-first law firm *Why Join Smith Schabo Law* At Smith Schabo Law, you'll join a passionate team of professionals committed to seeking justice and delivering meaningful outcome*s* for clients. We value integrity, collaboration, and client care, and we're looking for an attorney who shares our dedication to excellence both in and out of the courtroom. Pay: $80,000.00 - $120,000.00 per year Benefits: * Health insurance * Retirement plan Work Location: In person

Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Job Description Geriatric Care for Seniors in Columbus, Ohio Medical Director Physician Must have leadership experience Including direct physician reports (not mid-levels) Process improvement experience Smaller patient panels Join an expanding state-of-the-art senior care practice Convenient family-friendly locations in Columbus Staff of talented primary and specialty care physicians Collaborative and team-based approach to geriatric care Outpatient only setting with 1:10 or better phone call S

Permanent Associate Medical Director Opportunity Available What we Offer: Schedule: M- F 8am to 5pm, No Weekends Competitive Pay: $250k to $270k. depends on experience Sign On Bonus: $30,000 Full Benefits Package - Medical, dental, vision, disability & life insurance. 401(k). What the Associate Medical Director will Do: 80% Clinical / 20% Administration Supervise and coach fellow providers in how to provide excellent primary care / urgent care and community care Partake in leadership meeting and also act as an ambassador to community based organizations, hospitals, and payers Requirements of the Associate Medical Director: 5+ Years clinical experience / Administrative leadership experience needed Active and unrestricted medical or nursing license in the state required Background in working for a clinic or community based inpatient setting a plus

Medical Director - Medicare Programs Remote | Approx. $300,000 base + significant bonus potential About the Opportunity: A leading national healthcare contractor is seeking a Medical Director to provide clinical leadership and decision-making support for Medicare operations. This position plays a critical role in developing and enforcing coverage determinations, reviewing complex claims, and promoting evidence-based medical policy. The role is ideal for a physician, especially those with a background in Physical Medicine and Rehabilitation (PM&R), who wishes to transition from direct patient care into a leadership position influencing medical necessity and healthcare compliance at scale. Key Responsibilities: Clinical Leadership: Provide medical expertise for claim reviews, appeals, and Medicare policy development. Serve as a subject matter expert across multiple specialties. Policy Development: Collaborate with the Centers for Medicare & Medicaid Services (CMS) and other contractors to create, revise, and maintain Local Coverage Determinations (LCDs) and related guidance. Program Integrity: Identify trends in billing or compliance issues and work with investigative teams to address improper claims. Medical Review & Appeals: Oversee quality assurance in pre- and post-payment medical review determinations and assist with administrative law proceedings when necessary. Provider Education: Lead outreach and training for healthcare providers and professional associations to ensure adherence to Medicare policies and evidence-based practices. Travel is minimal (approximately 3-4 weeks per year), and the position is fully remote with occasional in-person meetings or conferences. Required Qualifications: MD or DO from an accredited institution. Active, unrestricted medical license in at least one U.S. state (must be eligible for additional licensure where required). Board Certification in a specialty recognized by the American Board of Medical Specialties (minimum three years). At least three years of experience as an attending physician. Prior experience within the Medicare, health insurance, or utilization review environment. Strong understanding of clinical evidence evaluation and medical necessity determination within fee-for-service structures. Excellent communication and collaboration skills across technical, regulatory, and clinical teams. Computer proficiency (MS Office, data analysis tools, virtual collaboration platforms). Preferred Qualifications: Background in PM&R, Internal Medicine, Oncology, Radiology, Ophthalmology, or Infectious Disease. Five or more years of clinical practice experience. Prior experience as a Medical Director in a Medicare or commercial payer organization. Familiarity with HCPCS, CPT, and ICD-10 coding standards. Advanced degree or coursework in healthcare administration or systems management (MBA, MHA, MS). Experience performing systematic literature reviews or using GRADE methodology. Compensation & Benefits: Base salary: Approximately $300,000, flexible depending on experience. Bonus structure: Significant performance-based bonuses. Benefits: Comprehensive health coverage, generous retirement contributions, paid time off, and strong professional development support. Schedule: Full-time, remote position with flexible hours. Why Join: This is an opportunity to move beyond clinical work while continuing to make a direct impact on patient access and policy integrity at a national level. Join a mission-driven organization that values medical expertise, promotes collaboration, and advances fairness and compliance within the U.S. healthcare system.

Medical Director (Utilization Management) The Medical Director plays a key role in ensuring coverage and payment determinations are clinically appropriate, compliant, and aligned with plan benefits and contractual agreements with participating provider networks. This position requires sound clinical judgment, collaborative leadership, and a strong understanding of healthcare delivery, population health, and payer operations. Key Responsibilities Provide physician leadership and clinical guidance to Utilization Management and Care Management functions Render coverage and payment determinations in accordance with health plan benefits, medical policies, and provider contracts Apply evidence-based clinical guidelines and best practices to support consistent, high-quality decision-making Exercise informed medical judgment grounded in clinical medicine, patient safety, quality management, and population health principles Collaborate effectively with clinical teams, operational leaders, senior management, and external partners Promote efficient, cost-effective care delivery across all lines of business Support organizational initiatives related to quality improvement, compliance, and healthcare outcomes Required Qualifications & Experience Medical Doctor (MD) or Doctor of Osteopathy (DO) from an accredited medical or osteopathic medical school recognized by AAMC, AOA, or WHO Unrestricted and active Pennsylvania medical or osteopathic license Current board certification through ABMS or AOBMS (Family Medicine or Internal Medicine preferred) Ability to successfully complete organizational credentialing requirements Strong knowledge of Utilization Management, healthcare delivery systems, and payer-based medical decision-making Work Location Fully Remote: This position is designated as fully remote Work must be performed within the Tri-State Area (Pennsylvania, New Jersey, or Delaware)

Reports Jointly To: Chief Executive Officer and Chief Medical Officer Clinical Specialty: MD, Board Certified in Sports Medicine (primary board specialty flexible) ViewFi is a nationwide virtual musculoskeletal (MSK) practice bringing high-quality orthopedic, sports-medicine, and physical-therapy care directly to patients in both traditional and non-traditional markets. We serve a diverse set of partners including personal injury/med-legal groups, self-insured employers, risk-based payers, and digital health collaborators in the sports and fitness markets through technology enabled, evidence-based clinical care. We are redefining what excellent MSK care looks like in a virtual environment. Position Summary The Medical Director will serve as the clinical leader of ViewFi's physician team and a core partner to our physical therapy, product, operations, and business teams. This role requires a practicing, board-certified Sports Medicine physician who can balance patient care with 30-40% administrative/leadership responsibilities. The Medical Director will ensure clinical excellence, maintain high-quality and consistent clinical pathways, represent ViewFi as the medical voice of the organization, and advance the science and evidence behind virtual MSK care. Key Responsibilities Clinical Leadership & Oversight Lead, oversee, and support the national team of physicians delivering virtual MSK care. Maintain and update clinical pathways, treatment standards, and practice guidelines across all ViewFi service lines. Partner closely with the Physical Therapy leadership team to ensure integrated, cohesive care between MDs and PTs. Ensure consistent, high-quality clinical documentation, coding accuracy, and compliance across markets. Oversee peer review, quality assurance activities, and clinical performance metrics. Participate in recruitment, onboarding, and ongoing development of new clinicians. Patient Care (70-80%) Actively see patients in a virtual setting, providing MSK consults and follow-ups. Model best-in-class virtual care workflows and contribute to continuous improvement of the patient experience. Support escalated or complex cases requiring senior clinical judgment. Strategic & Administrative Leadership (20-30%) Serve as the medical voice of ViewFi at conferences, webinars, panels, and partner meetings. Collaborate with executive leadership on product development, new service lines, geographic expansion and clinical innovation initiatives. Guide medical input for payers, partners, self-insured employers, and med-legal groups. Participate in strategic planning related to national expansion, licensure strategy, and resource allocation. Work cross-functionally with operations and technology teams to enhance clinical workflows. Provide medical insight and feedback on ViewFi's technology roadmap, including clinical decision support, AI integration, and general telehealth tools. Research, Publishing & Thought Leadership Lead or collaborate on clinical research demonstrating the efficacy of virtual MSK care, including both MSK MD consults and virtual PT. Publish and present outcomes, case series, and efficacy studies at relevant medical and industry conferences. Help build ViewFi's reputation as the leader in evidence-based virtual MSK care. Quality, Compliance & Risk Management Ensure the practice meets state and federal clinical guidelines, telehealth regulations, and licensure requirements. Maintain oversight of clinical incident review processes, risk-mitigation protocols, and outcome tracking. Drive continuous improvement in clinical quality, patient safety, and service reliability. Qualifications MD with Board Certification in Sports Medicine (primary board: FM, IM, EM, PM&R, etc. is flexible). Multi-state licensure required; willingness to pursue additional licensure required. Minimum 10 years of clinical experience; virtual care experience strongly preferred. Demonstrated leadership experience in a clinical or medical director role. Strong collaboration skills with PTs, operational teams, and cross-functional partners. Excellent communication and presentation skills; comfortable representing ViewFi publicly. Passion for virtual care, musculoskeletal medicine, and innovative delivery models. What We Offer Opportunity to lead a national MSK practice at the forefront of technology enabled virtual healthcare Collaborative environment with clinical and operational teams aligned around quality care and aggressive growth Competitive compensation with protected administrative time Support for conference travel, research, publishing, and clinical innovation Commitment to clinical excellence, patient outcomes, and provider support

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally.

This role works closely with Care Team Operations, Clinical Operations, Behavioral Health clinicians (LMFT/LCSW/LPCC), Community Health Workers (CHWs), Compliance, Finance (for authorizations), Care Operations Associates, and external partners including hospitals, primary care providers, behavioral health agencies, housing providers, and community-based organizations. Responsibilities Serve as the primary point of contact for assigned members with behavioral health and psychosocial complexity, building trust through consistent, trauma-informed engagement. Conduct comprehensive, holistic assessments addressing behavioral health, substance use, functional status, social determinants of health, safety risks, and care gaps. Develop, implement, and maintain person-centered care plans that integrate behavioral, medical, and social goals; update plans following transitions of care or changes in condition. Coordinate services across the continuum of care, including behavioral health providers, primary care, hospitals, housing supports, transportation, social services, and community-based organizations. Conduct required in-person home or community visits based on acuity, risk stratification, and payer requirements. Support Transitions of Care (TOCs) by completing timely follow-up, coordinating post-discharge services, and reinforcing discharge instructions and medication understanding. Utilize motivational interviewing, behavioral coaching, and health education to promote engagement, adherence, self-management, and long-term member stability. Identify, escalate, and address behavioral health risks, safety concerns, service delays, benefit lapses, and environmental barriers using HHN escalation protocols. Coordinate and track referrals, appointments, transportation, and follow-ups to ensure continuity and timeliness of care. Maintain accurate, timely, and audit-ready documentation of all assessments, encounters, and interventions in eClinicalWorks (ECW) and other HHN systems. Meet or exceed HHN and health plan productivity standards, including outreach cadence, encounter requirements, documentation timeliness, TOC completion, and quality measures. Actively participate in multidisciplinary case reviews, care conferences, team huddles, and escalations with nurses, behavioral health clinicians, CHWs, care operations, and compliance. Assist members with plan navigation, eligibility redeterminations, social service applications, housing resources, and crisis intervention support. Communicate professionally with members and care partners using HHN-approved channels, including phone, RingCentral, secure messaging, and SMS workflows. Contribute to continuous quality improvement efforts by identifying workflow gaps, documenting barriers, and sharing insights to improve care delivery. Uphold confidentiality and comply with all HIPAA, Medi-Cal, ECM, and payer regulatory requirements. Remain flexible and responsive to member needs, including field-based work and engagement in community settings. Skills Required Bilingual (English/Spanish) proficiency required to support member engagement and care coordination. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field. Licensure: Licensed LMFT, LCSW, LPCC.; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.

Division Practice Manager - Insights & Data Location: Sogeti North East Division (Connecticut, D.C., Maryland, Massachusetts, New Jersey, New York, Pennsylvania and Virginia) As a Division Practice Manager for Insights & Data (I&D), you will drive presales efforts for large-scale Data and AI programs, lead a high-performing team of data and analytics professionals, drive client engagements, and ensure delivery excellence across the I&D portfolio. This role requires strong thought leadership, strategic vision, and the ability to deliver innovative data-driven solutions that create measurable business value for our clients. What you will do at Sogeti: Presales Leadership: Drive presales efforts for large-scale Data and AI programs, including solutioning and proposal development. Team Management: Lead and mentor a team of data engineers, BI specialists, automation experts, and data scientists. Oversee engagements, talent acquisition, and professional development. Engagement Delivery: Manage complex, large-scale data and analytics programs, including strategy, implementation, and operational run phases. Client Partnership: Serve as a trusted advisor to clients, ensuring exceptional service delivery, managing expectations, and presenting insights effectively. Solution Ownership: Own end-to-end solutioning, client management, and delivery of data and analytics projects. Business Growth: Collaborate with account teams on pre-sales activities, research, and solutioning. Partner with alliances for joint go-to-market opportunities. Capability Development: Drive continuous improvement of data and analytics capabilities, develop new assets, and contribute to go-to-market strategies. What you will bring: Proven experience in presales, with a track record of selling Data and AI programs valued at $10M+. 10+ years of experience delivering large-scale data and analytics engagements. Expertise across the full data lifecycle: integration, management, architecture, governance, quality, automation, and data science. Ability to define business cases, measure outcomes, and communicate insights through compelling storytelling. Strong client-facing skills, capable of engaging at all levels from executives to engineers. Hands-on technical proficiency and ability to coach teams when needed. Deep knowledge of data and analytics ecosystems across Azure (required), AWS, and Google Cloud, including tools such as SQL, Azure Data Lake, Synapse, Azure ML, and Purview. Must be located in the Columbus or Cincinnati Ohio. Personal Attributes Strategic thinker and thought leader with strong executive presence. Thrives in a fast-paced, agile environment. Highly motivated, self-driven, and accountable for delivering exceptional client outcomes. Able to work independently with minimal supervision. Education Bachelor's or Master's degree in Computer Science, Software Engineering, Information Systems, Business Administration, or a related field. Life at Sogeti - Sogeti supports all aspects of your well-being throughout the changing stages of your life and career. For eligible employees, we offer: Flexible work options 401(k) with 150% match up to 6% Employee Share Ownership Plan Medical, Prescription, Dental & Vision Insurance Life Insurance 100% Company-Paid Mobile Phone Plan 3 Weeks PTO + 7 Paid Holidays Paid Parental Leave Adoption, Surrogacy & Cryopreservation Assistance Subsidized Back-up Child/Elder Care & Tutoring Career Planning & Coaching $5,250 Tuition Reimbursement & 20,000+ Online Courses Employee Resource Groups Counseling & Support for Physical, Financial, Emotional & Spiritual Well-being Disaster Relief Programs About Sogeti Part of the Capgemini Group, Sogeti makes business value through technology for organizations that need to implement innovation at speed and want a local partner with global scale. With a hands-on culture and close proximity to its clients, Sogeti implements solutions that will help organizations work faster, better, and smarter. By combining its agility and speed of implementation through a DevOps approach, Sogeti delivers innovative solutions in quality engineering, cloud and application development, all driven by AI, data and automation. Become Your Best | ************* Disclaimer Capgemini is an Equal Opportunity Employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, national origin, gender identity/expression, age, religion, disability, sexual orientation, genetics, veteran status, marital status or any other characteristic protected by law. This is a general description of the Duties, Responsibilities and Qualifications required for this position. Physical, mental, sensory or environmental demands may be referenced in an attempt to communicate the manner in which this position traditionally is performed. Whenever necessary to provide individuals with disabilities an equal employment opportunity, Capgemini will consider reasonable accommodations that might involve varying job requirements and/or changing the way this job is performed, provided that such accommodations do not pose an undue hardship. Capgemini is committed to providing reasonable accommodation during our recruitment process. If you need assistance or accommodation, please reach out to your recruiting contact. Please be aware that Capgemini may capture your image (video or screenshot) during the interview process and that image may be used for verification, including during the hiring and onboarding process. Click the following link for more information on your rights as an Applicant ************************************************************************** Applicants for employment in the US must have valid work authorization that does not now and/or will not in the future require sponsorship of a visa for employment authorization in the US by Capgemini. Capgemini discloses salary range information in compliance with state and local pay transparency obligations. The disclosed range represents the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting, although we may ultimately pay more or less than the disclosed range, and the range may be modified in the future. The disclosed range takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, geographic location, relevant education, qualifications, certifications, experience, skills, seniority, performance, sales or revenue-based metrics, and business or organizational needs. At Capgemini, it is not typical for an individual to be hired at or near the top of the range for their role. The base salary range for the tagged location is $190,000 - $210,000. This role may be eligible for other compensation including variable compensation, bonus, or commission. Full time regular employees are eligible for paid time off, medical/dental/vision insurance, 401(k), and any other benefits to eligible employees. Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Job Title: Respiratory Therapist Team Lead Job Category: Rehabilitation Services Schedule: Nights Work Type: Full time Department: GWV/GSWB Respiratory Services Division Job SummaryCoordinates and supervises the provision of respiratory care and activities of The Respiratory Care Services Department and clinical area(s) of designated responsibility. Assures compliance with the directives, policies, and applicable laws and regulations. Job Duties Supervises assigned personnel, assists with orientation and integration of new employees. Assists with addressing performance problems initiating the disciplinary process as appropriate. Supports Operations Manager in administrative responsibilities for the unit as delegated (i.e. performance appraisals, monitoring absenteeism, ordering supplies, scheduling 4 hour staffing, recruitment, and the hiring of potential candidates). Communicates pertinent information regarding patient care activities and operations to appropriate personnel. Participates in the formulation of Respiratory Care policies and goals as well as policies affecting other departments. Assures effective, efficient and cost-effective use of physical, financial and human resources. Monitors financial and statistical reports. Assists the in addressing system issues. Develops and maintains an effective liaison with physicians, patients, employees, other departmental managers and administrators. Provides feedback to staff or managers for professional practice issues, promoting evidence-based practices and research activities. Assists leadership team and operations manager with patient rounding. Follows up on incidents (patient, procedural and medication) occurring on assigned units. Assures proper documentation and follow through. Assists with resolution of patient and family concerns. Assumes responsibility for identifying processes or systems that could potentially lead to errors and adverse events and participates in problem resolution of those issues. Coordinates the education, implementation, and ongoing management of the department electronic communication systems including the billing, documentation, and electronic medical record systems. Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position. Position Details Hours: 7p-7a OR 11p-7a; 40 weekly hours; Every other weekend and holiday requirements Minimum Qualifications: 3 Years of Experience, Registered Certification, Bachelors in Respiratory Therapy EducationBachelor's Degree-Respiratory Therapy (Required) ExperienceMinimum of 3 years-Related work experience (Required) Certification(s) and License(s) Basic Life Support Certification - Default Issuing Body; Pediatric Advanced Life Support Certification - American Heart Association (AHA); Neonatal Resuscitation Program Certification - Neonatal Resuscitation Program; Registered Respiratory Therapist - National Board for Respiratory Care (NBRC); Advanced Cardiac Life Support Certification - American Heart Association (AHA) Our Purpose & ValuesOUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

About Us: JUDI Health is a health technology company offering a wide range of benefits administration solutions for employers and health plans. This includes Capital Rx, a public benefit corporation that provides full-service pharmacy benefit management (PBM) solutions to self-insured employers; JUDI Health™, which offers comprehensive health benefit management solutions for employers, TPAs, and health plans; and JUDI , the industry's leading proprietary Enterprise Health Platform. To learn more, visit **************** Position Summary: We are seeking a visionary and results-driven Director to lead and oversee Prior Authorization Operations, with responsibility for all lines of business (LOBs), including Commercial and Medicare, as well as the Clinical Call Center. This role will manage the end-to-end operations of Prior Authorization processes and ensure optimal efficiency, compliance, and performance across the department. Reporting to the Chief Clinical Officer, the Director will set the strategic direction for the PA and Clinical care teams, drive cross-functional collaboration, and optimize operations to align with the organization's broader business goals. Position Responsibilities: Define and execute the strategic vision for Prior Authorization and Clinical Care Operations teams across all lines of business (Commercial, Medicare, Exchange, Medicaid, etc.) in alignment with overall company objectives. Lead the development and implementation of long-term goals to improve workflow and efficiency while maintaining high-quality standards. Lead and develop a large team of pharmacists, technicians, and support staff to deliver efficient and accurate Prior Authorization and Clinical Care operations. Champion the adaption of advanced automations to improve accuracy, efficiency, and decision making. Lead and manage client needs, requests, and meetings as it pertains to the Prior Authorization and Clinical Care functions including leading and actively participating in calls with clients, consultants, and other external stakeholders. Serve as a liaison with internal stakeholders, including other departments in Clinical Operations, to ensure transparency, collaboration, and effective communication regarding Prior authorization and Clinical Care operations and requirements. Ensure that Prior Authorization and Clinical Care processes comply with regulatory standards, including URAC, NCQA, and federal and state guidelines, managing risks associated with compliance, regulatory audits, and industry certifications. Support the development of Capital Rx's formulary management platform Provide strategic direction and mentorship to PA leadership to foster a culture of collaboration, professional growth, accountability, and team success. Drive the development of KPIs and performance metrics for the PA department, ensuring that progress is measured against both departmental and organizational goals. Prepare and present executive-level reports, highlighting key performance trends, challenges, and recommendations for improvement. Key stakeholder and SME for Prior Authorization to the development team to implement advanced solutions that increase operational agility. Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance. Required Qualifications: Active, unrestricted pharmacist license required Doctor of Pharmacy degree required 8+ years of experience in Prior Authorization or Utilization Management at a PBM, health plan, or healthcare provider organization 5+ years of leadership experience, including direct supervision in a complex, multi-functional environment Proven track record of leading large teams and managing complex prior authorization and clinical care operations Strong knowledge of pharmacy regulations, accreditation standards, and compliance requirements Client facing experience required Experience in overseeing multiple lines of business including Commercial, Exchange, and Medicare Experience in managing Clinical Call Center operations and integrating customer service teams. Proven ability to define and execute strategic operational plans for large-scale operations at a senior leadership level, translating organizational strategy into actionable department-level initiatives Strong financial acumen including the ability to manage unit cost Innovative problem-solver with a continuous improvement mindset Strong proficiency in data analysis and performance reporting, with the ability to leverage insights for decision-making Excellent communication skills, both written and verbal, with significant experience in presenting to executive leadership Proficiency in Microsoft Office Suite and familiarity with other advanced data and reporting tools (e.g., Tableau, Power BI, etc.) In-depth understanding of regulatory compliance and industry standards such as URAC, NCQA, and federal/state requirements Ability to work effectively in a fast-paced, evolving environment and manage complex, cross-functional teams #LI-BC1 Salary Range$170,000-$185,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. JUDIHealth values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************

Immunovant, Inc. is a clinical-stage immunology company dedicated to enabling normal lives for people with autoimmune diseases. As trailblazer in anti-FcRn technology, the Company is developing innovative, targeted therapies to meet the complex and variable needs of people with autoimmune diseases. The Role: The Senior Director, Clinical Operations leads and drives program oversight in conjunction with Clinical Development and Project Management (PM) for an indication's life cycle for a single asset. This role also partners with Clinical Development and PM to define overall strategy toward achieving/exceeding program specific corporate targets, identifying and mitigating potential issues, and ensuring budget and timeline compliance. Additionally, the role serves as an escalation point and resolution resource for operational issues and decision gates. Lastly, the role will involve direct supervision and mentoring of clinical operations team members. Key Responsibilities: Contributes to program strategy, resourcing, budgeting, project plans, and oversight for clinical studies to achieve clinical program goals Guides and supports trial management activities including budget management, study management, CRO/Service Provider oversight, risk mitigation and Good Clinical Practices Leads the CRO/vendor selection strategy to support assigned studies, oversee the documentation for contracting process (SOWs, MSAs, etc.), ensure sponsor oversight, and leverage positive working relationships to enable robust sourcing strategies for future studies Supervise and direct clinical trial activities to ensure adherence to internal SOPs, as well as adherence to regulatory requirements (ICH, FDA, EMA, etc.) and GCP guidelines through establishment and reporting of clinical performance indicators KPIs/KQIs, and through innovative and agile methodology to improve processes Contribute to the design, preparation, and finalization of clinical protocols, study manuals, study reports, and other key operational/regulatory documents. Ensure adherence to regulatory requirements (ICH, FDA, EMA, etc.) and GCP guidelines through establishment and reporting of clinical performance indicators KPIs/KQIs, and through innovative and agile methodology to improve processes Provide input to the drafting of governance documents, SOPs, work instructions, and other resources Leads and/or participates in initiatives for process, technology or other continuous improvement to achieve cost-reduction, time-savings, efficiency, quality or other business objectives Build collaborative relationships with key internal stakeholders to facilitate the planning and execution of clinical trials, operational strategy, risk management and mitigation and oversees appropriate progress and timely completion of trials and deliverables according to established milestones and goals Collaborate cross-functionally to oversee the clinical operations aspects of work processes involving site management, medical writing, legal, finance, quality assurance, pharmacovigilance, biometrics, program management, regulatory, pharmaceutical sciences, IT, medical affairs, translational science and clinical science Provide input to the drafting of governance documents, SOPs, work instructions, and other Manage clinical operations manager/assistants, including effective performance reviews, feedback, mentoring, coaching and development of staff Requirements: Bachelors in Life Sciences with an advanced degree preferred At least 15 years of experience in the pharmaceutical industry, with at least 10 years in a clinical leadership role on a cross-functional drug development project team. Experience working at a CRO, small pharma or biotech company is a plus. PMP is a strong plus. Experience executing complex global development programs across all phases of clinical research (Phases 1-4) Experience leading a cross functional team is a strong plus Strong knowledge of ICH/GCP guidelines and multinational clinical trial regulations is required Experience selecting and oversight of CROs/vendors required Experience in rare disease therapeutic areas and patient engagement strategies preferred Ability to function in a fast pace, dynamic environment Ability to deal with ambiguity Ability to clearly develop action plans to ensure delivery on company strategy and goals as well as clinical development plans Strong interpersonal and negotiation skills Proven complex problem solving and decision-making skills Must be a demonstrated self-starter and team player with strong interpersonal and communication skills Excellent written and verbal skills Must display strong analytical and problem-solving skills Direct supervisory experience Unrelenting dedication to delivering quality results Integrity, in word and action Willingness to roll up your sleeves to get the job done Work Environment: • Remote-based; Immunovant's headquarters is in NYC • Dynamic, interactive, fast-paced, and entrepreneurial environment • Domestic or international travel is required (20%) Salary range for posting$275,000-$285,000 USD Compensation is based on a number of factors, including market location, and may vary depending on job-related knowledge, skills, and experience. Equity and other forms of compensation may be provided as part of a total compensation package, in addition to a full range of medical, dental, vision, 401k, and other benefits, including unlimited paid time off and parental leave.

The Clover Care Services organization delivers proactive support and care to our members through our clinical Clover Home Care teams, and quality improvement services to our aligned providers through our practice engagement team. Clover has built one of the most proactive, data-driven health care services platforms and is excited about how technology impacts our ability to bring transformative results to both patients and providers. The Director, Clinical Business Operations is a strategic and analytical leader responsible for the financial and operational infrastructure that supports Clover Care Services clinical programs. This role oversees business operations across CCS - ensuring that Clover's care delivery model operates efficiently, effectively, and in alignment with budget and growth goals. The Director, Clinical Business Operations will partner closely with Clinical Operations, Clinical leadership, and Finance to develop and manage budgets, forecast volume and staffing needs, oversee vendor and cost-center performance, and implement scalable operational processes that drive both clinical and financial outcomes. This role combines operational acumen, financial discipline, and a process-improvement mindset - someone who thrives at the intersection of data, execution, and strategy. As Director of Clinical Business Operations, you will: Lead financial and operational planning for Clover Care Services, including cost center oversight, budgeting, forecasting, and alignment of spend with visit volumes and growth goals. In partnership with the Chief Operating Officer, manage vendor relationships and contracting, ensuring efficiency, compliance, and alignment with operational and financial objectives. Oversee call center and scheduling operations performance for CCV operations (staffing levels, capacity, reach rates, scheduling utilization, productivity metrics) to optimize patient access and team efficiency. Drive productivity and logistics management for clinical and administrative support functions, including visit volume tracking, staffing models, and capacity planning. Support revenue cycle management by ensuring accurate and timely billing, claims processing, denial management, and issue resolution in partnership with Finance and Compliance. Lead EHR systems oversight, including provider education, configuration management, and issue escalation to ensure seamless operational workflows. Develop and implement standardized workflows and procedures that promote consistency, scalability, and operational excellence across care delivery support teams. Partner in modeling and forecasting, developing data-driven projections for visits, enrollment, and staffing to guide strategic decision-making. Collaborate cross-functionally with clinical and business leaders to align operational performance with quality, cost, and patient/member experience goals. Monitor operational performance metrics and lead continuous improvement initiatives to increase efficiency and reduce cost per visit. Ensure financial stewardship, including invoice review, spend tracking, and cost management for all CCS vendors and contractors. Support OKR development and management, ensuring key performance indicators are aligned with organizational strategy and regularly reported. Success in this role looks like: Financial and operational alignment: Budgets, forecasts, and cost centers are well-managed, with spending consistently aligned to visit volumes and growth targets. Operational excellence: Standardized workflows and processes drive measurable improvements in efficiency, quality, and team productivity. Data-driven decision-making: Key metrics and dashboards are actively used to identify opportunities, inform planning, and guide strategic priorities. Cross-functional collaboration: Clinical, financial, and technical teams operate in sync, achieving shared goals and improving member and provider experiences. Continuous improvement: Processes evolve through iteration and innovation, resulting in streamlined operations, reduced waste, and sustained performance gains. You should get in touch if: You have 7+ years of experience in healthcare operations, finance, or business management, with at least 3+ years in a leadership role. You have demonstrated success managing budgets, forecasting, and P&L elements in a healthcare or value-based care environment. You bring deep operational experience in scheduling, logistics, revenue cycle, or care delivery support services. You excel in data-driven decision-making and have advanced analytical and problem-solving skills. You thrive in a matrixed, collaborative environment and can build relationships across clinical, financial, and technical teams. You are passionate about creating systems and processes that make care delivery more efficient, accessible, and patient-centered. About Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most. We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare. From Clover's inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one's identity. All of our employee's points of view are key to our success, and inclusion is everyone's responsibility. Benefits Overview: Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions. Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare. Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location. Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews. Additional Perks: Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities Reimbursement for office setup expenses Monthly cell phone & internet stipend Remote-first culture, enabling collaboration with global teams Paid parental leave for all new parents And much more! #LI-Remote Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company. A reasonable estimate of the base salary range for this role is $170,000 to $210,000. Final pay is based on several factors including but not limited to internal equity, market data, and the applicant's education, work experience, certifications, etc.

Who We Are Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs. We deliver 24/7 virtual first and in home medical, behavioral, and social care, working alongside families, providers, and health plans to break down barriers to quality care. We do not replace existing care teams; we enhance them, providing an extra layer of support with compassion, creativity, and an unwavering commitment to children with medical complexity. The primary location for this role is remote, travel is expected to be up to 10%, and the expected schedule is Monday - Friday 8:00am - 05:00pm central. Independently licensed in TX, MO, or LA (LCSW, LPC, LMHC, or LMFT) required. What You'll Do As the Manager, Behavioral Health Longitudinal at Imagine Pediatrics you will manage a team of supervisors overseeing three roles: Behavioral Health Therapists, Behavioral Health Care Managers, and Care Team Assistants who work as an interdisciplinary team to serve a patient population experiencing severe mental illness (SMI). This role oversees a regional behavioral health care team and is responsible for team metrics and program outcomes. 90% of Manager, Behavioral Health, longitudinal role will be administrative inclusive of the following: Manage a team of regional cross functional care team members with the support of supervisors. Provide oversight to a team of supervisors including 1:1 support, quarterly feedback, and typical functions of people management Provide guidance to supervisors regarding performance management of indirect reports. Uphold team members responsible to Imagine specific policies, clinical programming requirements, and utilization targets. Partner with talent acquisition to carry out hiring plans, interviews, and onboard new team members. Assist with strategic planning for expansion into new markets for company growth. Analyze programmatic metrics and individual metrics in order to utilize staff appropriately. Hold the team accountable for working at the top of their license and utilizing team functions as efficiently as possible Identify areas for improvement within team processes, clinical care, and action on projects to make them more efficient. Serve as the Behavioral Health Longitudinal representative in leadership meetings to provide feedback, improve patient experience, and support the development of new programs and services. Acts as the liaison for behavioral health services to all stakeholders taking a lead role in process and performance improvement and the delivery of high-quality services Collaborate with clinical education team for implementation of new trainings in alignment with care team and organizational needs. Create a positive and inclusive culture of teamwork and accountability Assist behavioral health team with navigating new processes, policies, and procedures. 10% of Manager, Behavioral Health - longitudinal role will be clinical and include but are not limited to the following responsibilities. Consult with market leaders on behavioral health cases. Manage patient escalations as needed. Support service recovery calls. What You Bring & How You Qualify First and foremost, you're passionate and committed to creating the world our sickest children deserve. You want an active role in building a diverse and values-driven culture. Things change quickly in a startup environment; you accept that and are willing to pivot quickly on priorities. A qualified candidate will be empathetic, caring, organized, and has strong relationship-building skills. In this role, you will need: Master's degree in social work, Marriage and Family Therapy, Counseling, or related area Must be licensed to independently practice in TX, MO, or LA (LCSW, LPC, LMHC, LMFT), openness to cross-state licensure. 5 years of experience post independent licensure in a behavioral health setting. 3 years of experience in management/supervision of mental health providers (experience in remote/start-ups environments preferred). Experience working with children, adolescents, and their caregivers inclusive of external systems involved in a minor's care. Experience with chart auditing and training to improvement-oriented outcomes. Certification/Training in evidence-based modalities including but not limited to cognitive behavioral therapy and dialectical behavioral therapy preferred Experience working with high-risk behavioral health populations including but not limited to suicidal ideation, homicidal ideation, severe persistent mental illness (SPMI), children in the foster care system. Strong preference and comfortability conducting triage assessments and crisis interventions. Diligent regarding documentation standards and accustomed to using electronic medical records. Experience working with a diverse population or demographics. Telehealth experience Familiarity with technology, Microsoft suites, and documenting in electronic health records. Fully remote with 10% travel for training/education What We Offer (Benefits + Perks) The role offers a base salary range of $88,000 - $107,000 in addition to annual bonus incentive, competitive company benefits package and eligibility to participate in an employee equity purchase program (as applicable). When determining compensation, we analyze and carefully consider several factors including job-related knowledge, skills and experience. These considerations may cause your compensation to vary. We provide these additional benefits and perks: Competitive medical, dental, and vision insurance Healthcare and Dependent Care FSA; Company-funded HSA 401(k) with 4% match, vested 100% from day one Employer-paid short and long-term disability Life insurance at 1x annual salary 20 days PTO + 10 Company Holidays & 2 Floating Holidays Paid new parent leave Additional benefits to be detailed in offer What We Live By We're guided by our five core values: Our Values: Children First. We put the best interests of children above all. We know that the right decision is always the one that creates more safe days at home for the children we serve today and in the future. Earn Trust. We listen first, speak second. We build lasting relationships by creating shared understanding and consistently following through on our commitments. Innovate Today. We believe that small improvements lead to big impact. We stay curious by asking questions and leveraging new ideas to learn and scale. Embrace Humanity. We lead with empathy and authenticity, presuming competence and good intentions. When we stumble, we use the opportunity to grow and understand how we can improve. One Team, Diverse Perspectives. We actively seek a range of viewpoints to achieve better outcomes. Even when we see things differently, we stay aligned on our shared mission and support one another to move forward - together. We Value Diversity, Equity, Inclusion and Belonging We believe that creating a world where every child with complex medical conditions gets the care and support, they deserve requires a diverse team with diverse perspectives. We're proud to be an equal opportunity employer. People seeking employment at Imagine Pediatrics are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information, or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

JR167272 Manager Behavioral Health Services Responsible for overseeing Behavioral Health Utilization Management (BH UM), this position supports the Medicaid line of business. Location: Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. How will you make an impact: * Serves as a resource for medical management programs. Identifies and recommends revisions to policies/procedures. * Ensures staff adheres to accreditation guidelines. * Supports quality improvement activities. * May assist with implementation of cost of care initiatives. * May attend meetings to review UM and/or CM process and discusses facility issues. * Hires, trains, coaches, counsels, and evaluates performance of direct reports. * Responsibilities for BH UM may include: Manages a team of licensed clinicians and non-clinical support staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of BH services through level of care determination, accurate interpretation/application of benefits, corporate medical policy and cost efficient, high quality care; manages consultation with facilities and providers to discuss plan benefits and alternative services; manages case consultation and education to customers and internal staff for efficient utilization of BH services; leads development and maintenance of positive relationship with providers and works to ensure quality outcomes and cost effective care; assists in developing clinical guidelines and medical policies used in performing medical necessity reviews; provides leadership in the development of new pilots and initiatives to improve care or lower cost of care. Minimum requirements: LICENSURE REQUIREMENTS FOR ALL FUNCTIONS: * Requires current, active, unrestricted license such as LCSW (as applicable by state law and scope of practice), LMHC, LPC, LMSW (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States. * For Government business only: LAPC, and LAMFT are also acceptable if allowed by applicable state laws and any other state or federal requirements that may apply; provided that the manager's director has one of the types of licensures specified in the preceding sentence. * Licensure is a requirement for this position. EDUCATION/EXPERIENCE REQUIREMENTS: * Prior experience in Managed Care setting required. * Additional requirements for BH UM: MS in social work, counseling, psychology or related behavioral health field or a degree in nursing and minimum of 5 years of clinical experience with facility-based and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of education and experience, which would provide an equivalent background. * Experience applying clinical and policy knowledge on the continuum of Behavioral Health treatment strongly preferred. Preferred Skills, Capabilities, and Experiences: * Leadership and prior management experience. * Experience in managed care. * Candidates from all states are welcome, but they must reside within commuting distance of a Pulse Point office location where we have an office to be considered. * Proficiency in MS Office and data reporting. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

At Author Health, we're revolutionizing how mental health care is delivered, and we want you to be part of it! Our mission is to bring compassionate, high-quality care to people with serious mental illness, substance use disorders, and dementia, including older adults. We don't just treat symptoms. We treat people - fully, holistically, and with heart! Through our virtual-first, innovative care model, we deliver community-based wrap-around outpatient mental health care inclusive of psychiatric, psychotherapeutic and care management services. We partner with primary care providers, hospitals, families, and caregivers to keep patients out of the hospital and empower them to live healthier, more connected lives. At Author, inclusivity isn't a checkbox. It's how we build trust and drive better outcomes! We honor the unique cultures, identities, and stories that shape every patient's experience, and we're creating a workplace where team members can show up as their full selves, too. If you're driven by purpose, ready to shake up the status quo, and eager to make a real impact in people's lives, we'd love to meet you. Let's build the future of mental health care together! We are seeking a dynamic and experienced Clinical Manager of Care Management Services to oversee,coordinate, and deliver comprehensive care management services across both behavioral health and medical care settings. This clinical leadership role is critical in ensuring the seamless delivery of integrated care, optimizing patient outcomes, and promoting the efficient and effective utilization of resources within our organization. This Clinical Manager is expected to split his or her time between administrative / managerial responsibilities (typically ~60% of the time) and time serving patients directly (typically ~40% of the time). WHAT IS YOUR SUPERPOWER? Administrative & Managerial Responsibilities * Develop, implement, and oversee care management policies, procedures, and protocols for behavioral health and medical care. * Lead and supervise a multidisciplinary Care Management team organized in a "pod" model where: * Care Managers (Registered Nurses and Behavioral Health Care Managers) are responsible for comprehensive care planning and clinical coordination, * Licensed Practical Nurses (LPNs) focus on post-discharge outreach, coordination, and Transitional Care Management (TCM), while * Patient Resource Specialists (PRSs) support our patients by addressing health-related social needs and social determinants of health. * Manage care coordination processes across multiple payor environments, ensuring consistent standards of care, regulatory alignment, and effective operational workflows. * Ensure compliance with regulatory requirements related to care management and patient care. * Support the design and implementation of strategic initiatives that enable Author Health to innovate by piloting modifications or new builds in our care delivery model. * Participate in interdisciplinary meetings and committees to enhance coordination and communication across departments. * Coach members of the Care Management team to enhance performance on both clinical quality and overall efficiency - do so while using a data-driven approach, and by regularly shadowing and auditing individual team members (e.g., auditing calls and documentation). * Monitor and analyze data related to care management outcomes, utilization, and quality improvement initiatives. * Promote a culture of excellence, professionalism, and continuous improvement within the Care Management team. * Perform other duties as assigned to support departmental and organizational needs. Patient Care Delivery Responsibilities * Conduct regular assessments of patient needs, develop individualized care plans, and monitor progress towards goals. * Coordinate transitions of care and ensure continuity across different levels of care and health care settings. * Collaborate closely with interdisciplinary teams of health care providers both within and outside of Author Health, including physicians, nurses, therapists, and social workers, to ensure integrated care planning and delivery. * Serve as a resource for staff, patients, and families regarding care management services, resources, and community referrals. WHAT WE ARE SEEKING: * Bachelor's degree in Nursing; Master's degree preferred. * Experience building and leading teams * Minimum of 5 years of Nursing experience in care management, preferably in behavioral health or medical care settings. * Proven leadership and supervisory experience with strong team-building skills. * Excellent interpersonal and communication skills, with the ability to collaborate effectively with diverse stakeholders. * Solid understanding of health care regulations, policies, and reimbursement practices. * Strong analytical skills and the ability to use data for decision-making and quality improvement. * Certification in Case Management (CCM, ACM, or similar) preferred WHAT WE OFFER: * Retirement savings plan (401k) Plan up to 3.5% company match * Low cost benefits package for employee and dependents ( medical/ dental/ vision/ STD/ Life Insurance) * Paid vacation * Paid sick leave * 9 paid holidays throughout the year with (2) additional flex holidays .. 11 in total! * Performance-based bonuses * and more! NEXT STEPS: * Submit an application * Upload an updated resume * Share LinkedIn profile and/or cover letter Author Health is committed to a diverse and inclusive workplace. It is the company's policy to comply with all applicable equal employment opportunity laws by making all employment decisions without unlawful regard or consideration of any individual's race, religion, ethnicity, color, sex, sexual orientation, gender identity or expressions, transgender status, sexual and other reproductive health decisions, marital status, age, national origin, genetic information, ancestry, citizenship, physical or mental disability, veteran or family status or any other basis protected by applicable national, federal, state, provincial or local law. The company's policy prohibits unlawful discrimination based on any of these impermissible bases, as well as any bases or grounds protected by applicable law in each jurisdiction. We are committed to providing an inclusive and accessible experience for all applicants. If you require any accommodations at any stage of the process, please let us know. The company is pleased to provide such assistance and no applicant will be penalized as a result of such a request. In accordance with applicable legal requirements such as the San Francisco Fair Chance Ordinance Author Health will consider for employment qualified applicants with arrest and conviction records. Monday through Friday, 8am-5pm EST

Job Address: 10270 Blacklick - Eastern Road NW Pickerington, OH 43147 Role: Director of Clinical Services Job Post Title: Director of Clinical Services Solero Behavioral Transitions We provide a safe and supportive environment for individuals struggling with severe mental illness. Our program offers comprehensive care, including individual and group therapy sessions, case management services and life skills training. A mental health residential facility is a place where people receive intensive, specialized care for mental health and or substance abuse issues in a non-hospital setting. Residents receive 24-hour supervision, treatment, and support from mental health experts. The environment is homelike and supportive, and residents participate in therapeutic activities. Shift: M-F, with a weekend rotation Hours: 8-4:30 Perks at Work Healthcare: Medical Packages with Rx - 3 Choices Flexible Spending Accounts (FSA) Dependent Day Care Spending Accounts Health Spending Accounts (HSA) with a company match Dental Care Program - 2 choices Vision Plan Life Insurance Options Accidental Insurances Paid Time Off + Paid Holidays Employee Assistance Programs 401k with a Company Match Education + Leadership Development Up to $15,000 in Tuition Reimbursements Student Loan Forgiveness Programs Approved HRSA Site Approved STAR-LRP Site The Role Itself License/Education/Certification: Formal education program or training in Quality Improvement/Risk Management/Compliance for inpatient or behavioral health settings. Familiarity with healthcare laws, regulations, accreditation standards, state licensure or certification and Best Practices in healthcare compliance program implementation Knowledge of the principals of The Joint Commission and must be well versed in CMS guidelines Knowledge and understanding of the Regulatory Compliance Ohio Department of Mental Health and Addictions Serves as resource for faculty regarding medical record content and regulatory requirements Ability to adapt to change and work under stressful situation Education: Masters degree in social work with LSW and documented experience in group therapy setting. Counselor Degree Must be 21 yrs or older Top of Form License: LSW, LISW, LPC, LPCC, MFT, LMFT Current unencumbered clinical license per state of practice guidelines. Levels of Care Residential Mental Health Services A service activity which uses clinical and medical interventions, including the administration of physician prescribed medications and clinical monitoring, to help stabilize mental health symptoms to for individuals requiring a more structured and supervised environment. Partial Hospitalization Program Comprehensive Mental Health program with intensive treatment services to help individuals prepare for re-entry into all aspects of their lives including home, work, school and relationships. Program Purpose: We are committed to producing the highest level of clinical outcomes for clients and their families. Solero Behavioral Transitions is a trauma-informed, non-coercive treatment program designed to treat individuals struggling with Mental Health symptoms. The Solero's focused mental health rehabilitation includes; Building Resiliency Optimistic outlook Locus of control Sense of self Ability to bounce back Change management Practical Life Skills Problem-solving Money management Time management Personal change Self-awareness Communication Skills Active listening Nonverbal communication Communication skills Social Radar Negotiation skills These are the core concepts that extend into many areas of a client's life and help develop the foundations for recovery and recovery sustainability.

The Clinic Manager II assumes primary responsibility for overseeing clinical and administrative functions of capital and operating budgets, patient registration, billing, clinical information systems, management of clinical and administrative staff and clinic marketing and planning. This position is responsible for managing performance for Caregiver Engagement, Service Excellence, Quality & Safety and Stewardship. Responsible for multiple small practices or a large complex practice with a score between 7 and 12 on the Manger Trigger Tool (see below). This position ensures compliance with all regulatory and accreditation standards, financial performance and clinic policies. Decisions are made independently or in collaboration with others. This position has patient contact, has access to confidential information and functions under the direct supervision of a Director. Minimum Qualifications: Required Educational Degree: Bachelor's Degree Major/Area of Concentration: Any Effective 01/01/2021 for all current Managers and New Hires Bachelor's degree required within 5 yrs (3 yrs if you already posses an Associate's degree) Preferred Education: Bachelor's Degree in Business Administration or related field preferred Required Certifications, Credentials and Licenses: De-escalation training within 6 months. Required Experience: 2 - 4 years of practice management experience with progressive responsibility Job Specific Essential Functions: Provide operational leadership and oversight of one or more high-volume or multi-specialty clinics. Participate in recruitment, hiring, onboarding, training, and professional development of staff. Direct, supervise, and evaluate performance of clinical and administrative staff. Partners with hospital leaders to oversee outpatient ancillary operations, when applicable. Engage physicians and staff through communication of priorities, delegation of clinic tasks, and accountability to the achievement of goals. Utilize huddles and rounding to facilitate problem solving, communication from AHS system meetings, and identification of clinic concerns/issues. Manage processes in the clinic through implementation of SOP's, auditing, correction and suggestions for continuous quality improvement. Develop plans for improved provider productivity by working with providers on waste elimination, template redesign, optimization of outrotations, improving fill rate, and marketing / sales interfaces where appropriate. Responsible for metric tracking, root cause analysis, and improvement to meet or exceed budgeted quality, service, volumes and expenses. Ensure all provider encounters are captured, documented, locked in a timely manner and coded for comprehensive revenue cycle process. Responsible for completion of cash posting, financial deposits, A/R tracking and improvement toward MGMA service specific days in A/R and reporting of variances Act as liaison for providers to answer questions, communicate concerns to system, and solve day to day issues. Holds clinic team accountable for adherence to leadership and provider compact expectations of communication / behavior in delivery of care for optimal service to patients. Adhere to AHS, local, state and national legal and regulatory compliance requirements through ongoing clinic audit reviews and corrective action Benefits for Eligible Caregivers: Paid Time Off Retirement Plan Medical Insurance Tuition Reimbursement Work-Life Balance About Adena Heart and Vascular: The Adena Heart and Vascular Institute provides advanced, comprehensive care for heart, vascular, and thoracic conditions through cutting-edge technology and a skilled team of specialists. The institute emphasizes personalized treatment plans, collaboration among experts, and a focus on both immediate and long-term health. A key feature is our new hybrid operating room, which integrates advanced imaging and surgical capabilities to perform complex, minimally invasive cardiovascular procedures-such as TEVAR and EVAR-with a multidisciplinary team. This approach reduces complications and recovery times, allowing patients to receive high-quality, innovative care close to home. About Adena Health: Adena Health is an independent, not-for-profit and locally governed health organization that has been “called to serve our communities” for more than 125 years. With hospitals in Chillicothe, Greenfield, Washington Court House, and Waverly, Adena serves more than 400,000 residents in south central and southern Ohio through its network of more than 40 locations, composed of 4,500 employees - including more than 200 physician partners and 150 advanced practice provider partners - regional health centers, emergency and urgent care, and primary and specialty care practices. A regional economic catalyst, Adena's specialty services include orthopedics and sports medicine, heart and vascular care, pediatric and women's health, oncology services, and various other specialties. Adena Health is made up of 341 beds, including 266-bed Adena Regional Medical Center in Chillicothe and three 25-bed critical access hospitals-Adena Fayette Medical Center in Washington Court House; Adena Greenfield Medical Center in Greenfield; and Adena Pike Medical Center in Waverly.