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HCA Healthcare jobs in Cincinnati, OH

- 303 jobs
  • Dean - Cincinnati Campus

    HCA Healthcare 4.5company rating

    HCA Healthcare job in Cincinnati, OH

    is incentive eligible. Salary Estimate: $101441.60 - $152172.80 / year Learn more about the benefits offered ( ********************************************************************* ) for this job. The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. **You Can Change the Life of One to Care for the Lives of Many!** At Galen College of Nursing, we educate and empower nurses to change lives. Since 1989, we've dedicated our work to delivering high-quality nursing education with a student-first mindset. As one of the largest private nursing colleges in the country, we combine the support of a close-knit learning environment with the strength of a nationally recognized institution, HCA Healthcare. That same passion for excellence in the classroom extends to our offices. At Galen, you'll find a culture deeply rooted in collaboration, innovation, and a shared commitment to improving the future of healthcare. Your work directly touches the next generation of nurses, and your contributions help our students pursue their dream of a compassionate career. If you're looking for a career where you can make a difference, grow professionally, and be part of a caring team, we'd love for you to apply for the _Dean - Cincinnati Campus_ position today! Click here to learn more about Galen! (******************************* **Position Overview:** As a Dean - Cincinnati Campus at Galen College of Nursing, you will provide accountable leadership for the academic programs, community and hospital partnerships, and serves as an integral member of the College and Campus management team. This position will also ensure teaching excellence, faculty and student engagement, and student success in accordance with established regulations, accreditation standards, and the mission of Galen College of Nursing. **Key Responsibilities:** 1. May be designated as nursing program administrator role for regulatory agencies, state boards of nursing, and programmatic accreditors (see addendum). 2. Directs, leads, and supervises all academic aspects of the campus. 3. Creates and is accountable for the strategic direction and vision for the delivery of quality, responsive curriculum and programs. 4. Develops, maintains, and monitors fiscal resources and secures funding to support educational initiatives. 5. Provides leadership to ensure that the number of full-time faculty is sufficient to ensure that the student learning outcomes and program outcomes are achieved within budgetary guidelines. 6. Ensures the availability of resources required for faculty (full and part-time) to maintain expertise in their areas of responsibility. 7. Provides leadership in the development of policies for students, ensuring that they are congruent with the College, publicly accessible, and non-discriminatory. 8. Ensures the appropriate application of student policies and the correct implementation of related procedures by program directors, faculty, and staff. 9. Provides leadership to ensure that the curriculum is developed by the faculty and regularly reviewed to ensure integrity, rigor, and currency; ensures that accreditation standards and criteria are used as they relate to curriculum. 10. Provides leadership to ensure that fiscal, physical, and learning resources are sustainable and sufficient to ensure the achievement of the student learning outcomes and program outcomes. 11. Other duties as assigned. **Position Requirements:** + Education: Graduate Degree in Nursing required; Doctorate Degree in Nursing or related field preferred. + Experience: Five (5) years of progressive, senior-level experience in higher education preferred; demonstrated excellence in teaching and clinical practice experience in nursing required. . Demonstrated success in development of community relationships; experience in planning and budgeting; excellent communication and interpersonal skills and a record of professional involvement as evidenced in CV. + Special Qualifications: CNE or CNEcl certification preferred. + Licensure: Per State Board of Nursing Requirements + Physical/Mental Demands and Work Environment: Position requires critical thinking, reading, planning, preparing, evaluating, and decision making. Physical demands in classroom and office are minimal and considered sedentary work with occasional lifting and/or carrying such articles as records, files, and books (10 pounds maximum). Operation of standard office equipment such as phone, computer, classroom projector, Scantron, and printer/scanner, occurs on a frequent basis. Physical demands in the clinical area may include lifting, pulling, pushing, kneeling, stooping, crouching and bending or any other related activity. Travel may be required + Degree of Supervision: Minimal. **Benefits** At Galen College of Nursing, we want to ensure your needs are met. We offer a comprehensive package of medical, dental, and vision plans, tuition discounts, along with unique benefits, including: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance, and more. + Free counseling services and resources for emotional, physical, and financial well-being + 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny and adoption assistance. + Referral services for children, elders, and pet care, home and auto repair, event planning, and more. + Consumer discounts through Abenity. + Retirement readiness, rollover assistance services, and preferred banking partnerships. + Education assistance (tuition, student loan, certification support, dependent scholarships). + Colleague recognition program. + Time Away from Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence). + Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits. (*********************************************************************) _Note: Eligibility for benefits may vary by location._ Galen College of Nursing is recognized as a 2023 National League of Nursing (NLN) Center of Excellence (COE). (****************************************************************************************************************** **Galen's Compassionate Care Model Values** + Inclusivity: I foster an environment that provides opportunity for every individual to reach their full potential. + Character: I act with integrity and compassion in all I do. + Accountability: I own my role and accept responsibility for my actions. + Respect: I value every person as an individual with unique contributions worthy of consideration. + Excellence: I commit myself to the highest level of quality in everything I do. Learn more about our vision and mission (*********************************************** . Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. _Submit your application for the opportunity below:_ Dean - Cincinnati Campus Galen College of Nursing
    $101.4k-152.2k yearly 11d ago
  • Full Time Clinical Nursing Faculty

    HCA 4.5company rating

    HCA job in Cincinnati, OH

    Salary Estimate: 56908.80 - 79684.80 / year Learn more about the benefits offered for this job. The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Introduction You Can Change the Life of One to Care for the Lives of Many! At Galen College of Nursing, we educate and empower nurses to change lives. Since 1989, we've dedicated our work to delivering high-quality nursing education with a student-first mindset. As one of the largest private nursing colleges in the country, we combine the support of a close-knit learning environment with the strength of a nationally recognized institution, HCA Healthcare. That same passion for excellence in the classroom extends to our offices. At Galen, you'll find a culture deeply rooted in collaboration, innovation, and a shared commitment to improving the future of healthcare. Your work directly touches the next generation of nurses, and your contributions help our students pursue their dream of a compassionate career. If you're looking for a career where you can make a difference, grow professionally, and be part of a caring team, we'd love for you to apply for a faculty position today! Click here to learn more about the Galen difference Position Overview: Nursing faculty are responsible for engaging in the full scope of the academic nurse educator role. These responsibilities include facilitating learning and learner development; using assessment and evaluation strategies; participating in curriculum development, implementation, and evaluation; evaluating program outcomes; ongoing development of the nurse educator role; engaging in scholarship; developing and functioning as a leader and change agent; and functioning within the educational environment. This role must be fulfilled under the rules and regulations of the state and federal regulatory and accrediting bodies. Key Responsibilities: * Creates an environment that facilitates learning and achieving desired student learning and program outcomes. * Implements various teaching strategies appropriate to learner needs, desired learner outcomes, content, and context. * Helps students develop as nurses and integrate the values and behaviors expected of those who fulfill that role. * Uses a variety of strategies to assess and evaluate student learning in all settings (classroom, lab, or clinical) and all domains (cognitive, psychomotor, and affective) of learning. * Analyzes student assessment and evaluation data to inform decision-making in continuous course improvement. * Implement a curriculum with clearly articulated program student learning outcomes (PSLOs), which are used to organize the curriculum, guide the delivery of instruction, direct learning activities, and evaluate student progress. * Designs and implements program assessments that promote continuous quality improvement of all aspects of the program. * Participates in professional development activities that increase socialization to and effectiveness of the faculty role. * Maintains the professional practice knowledge and expertise in areas of responsibility needed to help students prepare for contemporary nursing practice. * Demonstrates commitment to the College's mission and values of inspiring and fostering excellence, compassion, accountability, and inclusivity. * Other essential responsibilities as outlined by the applicable state board of nursing. Position Requirements * Active, Current, Unencumbered Licensure: Applicable state as a Registered Nurse and per the State Board of Nursing * Education Qualifications: A minimum of a Master of Science in Nursing (MSN) Degree is required. BSN-prepared nurses may be considered depending on the campus' needs. * Experiential Qualifications: Minimum of two (2) years of clinical experience as a Registered Nurse, and per the State Board of Nursing Physical/Mental Demands and Work Environment:If performing nursing duties related to clinical instruction (especially patient contact) hazards may include needle sticks, blood and bodily fluid exposure, or any other hazard a Registered Nurse (RN) might be exposed to in the normal performance of nursing care. Position requires mental activity, reading, planning, preparing, evaluating, and decision making. Physical demands in the classroom and office are minimal and are considered sedentary work with occasional lifting and/or carrying such articles as records, files, and books (10 pounds maximum). Operation of standard office equipment such as phone, computer, classroom projector, Scantron, and printer/scanner occurs on a frequent basis. Physical demands in the clinical area may include lifting, pulling, pushing, kneeling, stooping, crouching, bending, or any other related activity to patient care. Position requires regular attendance, and may require evening or weekend hours, and travel to clinical sites and extended classrooms. Benefits AtGalen College of Nursing, we want to ensure your needs are met. We offer a comprehensive package of medical, dental, and vision plans, tuition discounts, along with unique benefits, including: * Full-time faculty are eligible for a 90% tuition discount for Galen's Academic Leadership MSN and DNP programs. * Certification renewal and exam reimbursement. * Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. * Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance, and more. * Free counseling services and resources for emotional, physical, and financial well-being * 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) * Employee Stock Purchase Plan with 10% off HCA Healthcare stock * Family support through fertility and family building benefits with Progyny and adoption assistance. * Referral services for children, elders, and pet care, home and auto repair, event planning, and more. * Consumer discounts through Abenity. * Retirement readiness, rollover assistance services, and preferred banking partnerships. * Education assistance (tuition, student loan, certification support, dependent scholarships). * Colleague recognition program. * Time Away from Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence). * Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits. Note: Eligibility for benefits may vary by location. Galen College of Nursing is recognized as a 2023 National League of Nursing (NLN) Center of Excellence (COE). Galen's Compassionate Care Model Values Galen's Compassionate Care Model Values * Inclusivity: I foster an environment that provides opportunity for every individual to reach their full potential. * Character: I act with integrity and compassion in all I do. * Accountability: I own my role and accept responsibility for my actions. * Respect: I value every person as an individual with unique contributions worthy of consideration. * Excellence: I commit myself to the highest level of quality in everything I do. * Learn more about our vision and mission. Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized.Submit your application for the opportunity below: Full Time Clinical Nursing Faculty Galen College of Nursing
    $69k-83k yearly est. 4d ago
  • Gastroenterology Opening with Established Practice in Dayton, Ohio

    Tenet Healthcare 4.5company rating

    Dayton, OH job

    OneGI is seeking a BC/ BE Gastroenterologist to join an established practice in Dayton, Ohio. This is a fantastic opportunity to practice high quality clinical care in a large, collegial practice. Highlights: General GI Practice; EUS in OP facilities 1:7 generous call schedule APP support Infusion, Pathology, Fibroscan, Research, Hem Banding, CCM, Anesthesia support services Strong relationship with community Level 1 Trauma Center 3 ASC locations with ownership potential 2-year practice partnership track Benefits: Competitive Base Salary with Competitive Production Earnings Sign On Bonus and Moving Expenses Medical, Dental, Vision, 401k Match Malpractice Insurance At One GI , we provide exceptional gastroenterology care that puts patients at the forefront. Since our inception in 2020, we have grown rapidly while remaining steadfast in our commitment to driving excellence and upholding the highest standards in gastroenterology practice. Our renowned physician leadership, collaborative team culture, state-of-the-art ancillary services, and robust network strength empower our physicians to deliver personalized, compassionate care tailored to each patient's unique needs. One GI is more than just an organization; it's a community of over 1,300 dedicated individuals united by a shared purpose: creating a better healthcare experience for patients, colleagues, and communities. We are a diverse team of professionals who bring our unique perspectives and expertise to the table, fostering an environment of collaboration and continuous improvement. Each One GI practice is the leading provider of gastroenterology care in its respective community, retaining its regional name and unique reputation while leveraging the expansive resources and backing of our national organization. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.
    $29k-33k yearly est. 2d ago
  • Adjudicator, Provider Claims

    Molina Healthcare Inc. 4.4company rating

    Covington, KY job

    Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. * Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. * Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. * Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. * Assists in reviews of state and federal complaints related to claims. * Collaborates with other internal departments to determine appropriate resolution of claims issues. * Researches claims tracers, adjustments, and resubmissions of claims. * Adjudicates or readjudicates high volumes of claims in a timely manner. * Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. * Meets claims department quality and production standards. * Supports claims department initiatives to improve overall claims function efficiency. * Completes basic claims projects as assigned. Required Qualifications * At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. * Research and data analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Customer service experience. * Effective verbal and written communication skills. * Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-38.4 hourly 13d ago
  • Supervisor, Healthcare Services Operations Support

    Molina Healthcare Inc. 4.4company rating

    Covington, KY job

    JOB DESCRIPTION Job SummaryLeads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc. * Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes. * Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance. * Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement. * Assists in the development and implementation of internal desktop processes and procedures. * Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers. Required Qualifications• At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience. * Strong analytic and problem-solving abilities. * Strong organizational and time-management skills. * Ability to multi-task and meet project deadlines. * Attention to detail. * Ability to build relationships and collaborate cross-functionally. * Excellent verbal and written communication skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Supervisory/leadership experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $77,969 - $106,214 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $78k-106.2k yearly 24d ago
  • Medical Director, Behavioral Health

    Molina Healthcare 4.4company rating

    Cincinnati, OH job

    JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. • Facilitates behavioral health-related regional medical necessity reviews and cross coverage. • Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. • Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. • Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. • Provides second level behavioral health clinical reviews, peer reviews and appeals. • Supports behavioral health committees for quality compliance. • Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. • Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). • Assists with the recruitment and orientation of new psychiatric medical directors. • Ensures all behavioral health programs and policies are in line with industry standards and best practices. • Assists with new program implementation and supports for health plan in-source behavioral health services. Required Qualifications • At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. • Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice. • Board Certification in Psychiatry. • Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. • Ability to work cross-collaboratively within a highly matrixed organization. • Strong organizational and time-management skills. • Ability to multi-task and meet deadlines. • Attention to detail. • Critical-thinking and active listening skills. • Decision-making and problem-solving skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications • Experience with utilization/quality program management. • Managed care experience. • Peer review experience. • Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. #PJHS #LI-AC1 #HTF To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $186,201.39 - $363,092.71 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $186.2k-363.1k yearly 1d ago
  • Lead Business Analyst - Managed Care Operations

    Molina Healthcare Inc. 4.4company rating

    Cincinnati, OH job

    Provides lead level support for accurate and timely intake and interpretation of regulatory and/or functional requirements related but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance for system changes. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. This role will work directly with Ohio Healthplan leadership including the Plan President, CFO, and other department heads to improve performance according to our Key Performance Indicators. Candidate will utilize SQL and Azure Databricks to query and analyze data however this is not just a technical role. They must be able to understand the business need, propose solutions, and meet KPIs. JOB DUTIES * Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to regulatory baseline requirements and any health plan/product team developed requirements. * Monitors regulatory sources to ensure all updates are aligned. Uses comprehensive background to navigate analytical problems, including: clearly defining and documenting their unique specifications. Leads coordinated development and ongoing management / interpretation review process, committee structure and timing with key partner organizations. * Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements. * Provides status and updates to health plan/product team partners, senior management and stakeholders. * Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. * Where applicable, codifies the requirements for system configuration alignment and interpretation. * Provides support and/or requirement interpretation inconsistencies and complaints. * Assists with the development of requirement solution standards and best practices while suggesting improvement processes to consistently apply requirements across states and products where possible. * Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials. * Conducts industry research and engagement to evaluate, provide insights, and best practices as applicable. * Coordinates with relevant teams for analysis, impact and implementation of changes that impact the product. * Engages with operations leadership and Plan Support functions to review compliance-based issues for benefit planning purposes. * Mentors and trains new staff as well as provide ongoing support, leadership, and training new/integrating health plans and corporate teams. KNOWLEDGE/SKILLS/ABILITIES * Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation is agreed on and clear for solutioning. * Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. * Ability to lead complex projects across organizational boundaries with little direct instruction. * Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. * Ability to concisely synthesize large and complex requirements. * Ability to organize and maintain regulatory data including real-time policy changes. * Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. * Ability to work independently in a remote environment. * Ability to work with those in other time zones than your own. * Create reporting tools to enhance communication on updates and initiatives. JOB QUALIFICATIONS Required Qualifications * At least 6 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience. * Policy/government legislative review knowledge. * Strong analytical and problem-solving skills. * Familiarity with administration systems. * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. Preferred Qualifications * Project implementation experience * Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $66,456 - $129,590 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $66.5k-129.6k yearly 26d ago
  • Associate Specialist, Provider Contracts HP

    Molina Healthcare Inc. 4.4company rating

    Cincinnati, OH job

    Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when available, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. Job Duties This role supports negotiations with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. * Sends out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members. * Receives calls from prospective providers and answers questions regarding contracting process, policies and procedures. * Forwards requested information/documentation to prospective providers in a timely manner. * Maintains database of all contracts and specific applications sent to prospective new providers. * Completes and updates Provider Information Forms for each new contract. * Ensures accuracy and completeness of provider demographic information and coordinates communication of such information to Provider Configuration team. * Sends out new provider welcome packets to providers who have contracted with the plan. * Utilizes Plan's system to track and follow up with Providers who have not responded to Contracts and/or Applications sent as directed by management. * Formats and distributes Provider network resources (e.g. electronic specialist directory). Job Qualifications REQUIRED EDUCATION: High School Diploma or equivalent GED REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 1 year customer service, provider service, contracting or claims experience in the healthcare industry. PREFERRED EDUCATION: Associate's Degree or Bachelor's Degree in a related field or an equivalent combination of education and experience PREFERRED EXPERIENCE: Managed Care experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $42.2 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-42.2 hourly 7d ago
  • Corporate Development Manager

    Molina Healthcare Inc. 4.4company rating

    Covington, KY job

    This position will be responsible for supporting the execution of merger and acquisition transactions and will actively contribute in advancing Molina Healthcare's overall growth strategy. The role entails working closely with the senior members of the Corporate Development team and will actively interact with the business leaders and senior management team at Molina. The ideal candidate will have at least two years of experience as an analyst at an investment bank or similar firm. Knowledge/Skills/Abilities * Develop financial models and perform analyses to assess potential acquisition, joint venture and other business development opportunities (i.e., discounted cash flow, internal rate of return and accretion/dilution) * Prepare ad-hoc analyses and presentations to help facilitate various discussions * Research and analyze industry trends, competitive landscape and potential target companies * Coordinate deal activities among internal cross-functional teams and external parties * Coordinate due diligence and closing-related activities * Actively participate in reviewing and negotiating transaction agreements * Prepare board and senior management presentations Job Qualifications REQUIRED EDUCATION: Bachelor's degree in Accounting or Finance or related fields REQUIRED EXPERIENCE: * Minimum 5 years' experience in financial modeling and analysis * Ability to synthesize complex ideas and translate into actionable information * Strong analytical and modeling skills * Excellent verbal and written communication skills * Highly collaborative and team-oriented with a positive, can-do attitude * Ability to multi-task, set priorities and adhere to deadlines in a high-paced organization PREFERRED EXPERIENCE: * Prior analyst experience in investment banking strongly preferred * Healthcare industry experience preferred PHYSICAL DEMANDS: Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #PJCorp #LI-AC1 Pay Range: $80,412 - $156,803 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $80.4k-156.8k yearly 23d ago
  • Adjunct Clinical Nursing Faculty

    HCA 4.5company rating

    HCA job in Cincinnati, OH

    Salary Estimate: 62400.00 - 83200.00 / year Learn more about the benefits offered for this job. The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. You Can Change the Life of One to Care for the Lives of Many! At Galen College of Nursing, we educate and empower nurses to change lives. Since 1989, we've dedicated our work to delivering high-quality nursing education with a student-first mindset. As one of the largest private nursing colleges in the country, we combine the support of a close-knit learning environment with the strength of a nationally recognized institution, HCA Healthcare. That same passion for excellence in the classroom extends to our offices. At Galen, you'll find a culture deeply rooted in collaboration, innovation, and a shared commitment to improving the future of healthcare. Your work directly touches the next generation of nurses, and your contributions help our students pursue their dream of a compassionate career. If you're looking for a PRN nursing position where you can make a difference while also working in your bedside nursing position, growing professionally, and being part of a caring team, we'd love for you to apply for an Adjunct Faculty position today! Click here to learn more about the Galen difference! Position Overview: Adjunct Nursing faculty are responsible for facilitating learning and learner development, using assessment and evaluation strategies, participating in curriculum development, implementation, and evaluation, evaluating student learning and program outcomes, and functioning within the educational environment. This role must be fulfilled in accordance with the rules and regulations of the state and federal regulatory and accrediting bodies. Key Responsibilities: * Creates an environment that facilitates learning and achieving desired student learning and program outcomes. * Implements various teaching strategies appropriate to learner needs, desired learner outcomes, content, and context. * Helps students develop as nurses and integrate the values and behaviors expected of those who fulfill that role. * Uses a variety of strategies to assess and evaluate student learning in all settings (classroom, lab, or clinical) and all domains (cognitive, psychomotor, and affective) of learning. * Analyzes student assessment and evaluation data to inform decision-making in continuous course improvement. * Implement a curriculum with clearly articulated program student learning outcomes (PSLOs), which organize the curriculum, guide the delivery of instruction, direct learning activities, and evaluate student progress. * Designs and implements program assessments that promote continuous quality improvement of all aspects of the program. * Participates in professional development activities that increase socialization to and effectiveness of the faculty role. * Maintains the professional practice knowledge and expertise in areas of responsibility needed to help students prepare for contemporary nursing practice. * Demonstrates commitment to the College's mission and values of inspiring and fostering excellence, compassion, accountability, and inclusivity. * Other essential responsibilities as outlined by the applicable state board of nursing. Position Requirements * Active, Current, Unencumbered Licensure: Applicable state as a Registered Nurse and per the State Board of Nursing * Education Qualifications: A minimum of a Master of Science in Nursing (MSN) Degree is required. BSN-prepared nurses may be considered depending on the campus's needs. * Experiential Qualifications: Minimum of two (2) years of clinical experience as a Registered Nurse, and per the State Board of Nursing Physical/Mental Demands and Work Environment: If performing nursing duties related to clinical instruction (especially patient contact) hazards may include needle sticks, blood and bodily fluid exposure, or any other hazard a Registered Nurse (RN) might be exposed to in the normal performance of nursing care. Position requires mental activity, reading, planning, preparing, evaluating, and decision making. Physical demands in the classroom and office are minimal and are considered sedentary work with occasional lifting and/or carrying such articles as records, files, and books (10 pounds maximum). Operation of standard office equipment such as phone, computer, classroom projector, Scantron, and printer/scanner occurs on a frequent basis. Physical demands in the clinical area may include lifting, pulling, pushing, kneeling, stooping, crouching, bending, or any other related activity to patient care. Position requires regular attendance, and may require evening or weekend hours, and travel to clinical sites and extended classrooms. Benefits At Galen College of Nursing, we want to ensure your needs are met. We offer a comprehensive package of unique benefits to our Adjunct faculty, including: * Adjunct faculty are eligible for a 75% tuition discount for Galen's Academic Leadership MSN program and a 50% discount on tuition for our Academic Leadership DNP Program. * Certification renewal and exam reimbursement (after 12 months of employment) * Free counseling services and resources for emotional, physical, and financial well-being. * 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) * Employee Stock Purchase Plan * Consumer discounts * Colleague recognition program * Disaster Relief Support Learn more about Employee Benefits. Note: Eligibility for benefits may vary by location. Galen College of Nursing is recognized as a 2023 National League of Nursing (NLN) Center of Excellence (COE). Galen's Compassionate Care Model Values * Inclusivity: I foster an environment that provides opportunity for every individual to reach their full potential. * Character: I act with integrity and compassion in all I do. * Accountability: I own my role and accept responsibility for my actions. * Respect: I value every person as an individual with unique contributions worthy of consideration. * Excellence: I commit myself to the highest level of quality in everything I do. Learn more about our vision and mission. Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Adjunct Clinical Nursing Faculty Galen College of Nursing
    $68k-81k yearly est. 4d ago
  • Supervisor, Healthcare Services (Behavioral Health/LSW/LISW

    Molina Healthcare Inc. 4.4company rating

    Dayton, OH job

    JOB DESCRIPTION Job SummaryLeads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care. Preferred licensure: Licensed Social Worker (LSW/LISW) or Licensed Professional Counselor (LPC/LPCC) Essential Job Duties * Assists in implementing health management, care management, utilization management, behavioral health and other program activities in accordance with regulatory, contract standards and accreditation compliance. * Functions as a "hands-on" supervisor, assisting with assessing and evaluation of systems, day-to-day operations and efficiency of operations/services. * Assists in the coordination of orienting and training staff to ensure maximum efficiency and productivity, program implementation, and service excellence. * Trains and supports team members to ensure high-risk, complex members are adequately supported. * Assists with staff performance appraisals, ongoing monitoring of performance, and application of protocols and guidelines. * Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources, system and program needs. * Assists with coordination and reporting of department statistics and ongoing client reports, as assigned. * Local travel may be required (based upon state/contractual requirements). Required Qualifications• At least 5 years health care experience, and at least 2 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. r equivalent combination of relevant education and experience. * Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. * Ability to manage conflict and lead through change. * Operational and process improvement experience. * Strong written and verbal communication skills. * Working knowledge of Microsoft Office suite. * Ability to prioritize and manage multiple deadlines. * Excellent organizational, problem-solving and critical-thinking skills. Preferred Qualifications * Licensed Social Worker (LSW/LISW) or Licensed Professional Counselor (LPC/LPCC). License must be active and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. * Medicaid/Medicare population experience. * Clinical experience. * Supervisory/leadership experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $66,456 - $129,590 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $66.5k-129.6k yearly 24d ago
  • Adjudicator, Provider Claims-Ohio-On the Phone

    Molina Healthcare Inc. 4.4company rating

    Covington, KY job

    The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems. Knowledge/Skills/Abilities * Facilitates the resolution of claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. * This role is involved in member enrollment, provider information management, benefits configuration and/or claims processing. * Responds to incoming calls from providers regarding claims inquiries and provides excellent customer service; documents calls and interactions. * Assists in the reviews of state or federal complaints related to claims. * Supports the other team members with several internal departments to determine appropriate resolution of issues. * Researches tracers, adjustments, and re-submissions of claims. * Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards. * Manages defect reduction by supporting the identifying and communicating error issues and potential solutions to management. * Handles special projects as assigned. * Other duties as assigned. Knowledgeable in systems utilized: * QNXT * Pega * Verint * Kronos * Microsoft Teams * Video Conferencing * Others as required by line of business or state Job Function Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating Molina values in their actions. Responsible for effectively managing and documenting calls and responding to providers regarding issues with claims and inquiries. Handles escalated inquiries, complex provider claims payments, records, and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent combination of education and experience; REQUIRED EXPERIENCE: 2-3 years customer service, claims, provider and investigation/research experience. Outcome focused and knowledge of multiple systems. 1+ years of claims research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry PREFERRED EDUCATION: Bachelor's Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: 4 years PHYSICAL DEMANDS: Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-38.4 hourly 12d ago
  • Associate Specialist, Provider Contracts HP

    Molina Healthcare 4.4company rating

    Covington, KY job

    Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when available, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** This role supports negotiations with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. - Sends out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members. - Receives calls from prospective providers and answers questions regarding contracting process, policies and procedures. - Forwards requested information/documentation to prospective providers in a timely manner. - Maintains database of all contracts and specific applications sent to prospective new providers. - Completes and updates Provider Information Forms for each new contract. - Ensures accuracy and completeness of provider demographic information and coordinates communication of such information to Provider Configuration team. - Sends out new provider welcome packets to providers who have contracted with the plan. - Utilizes Plan's system to track and follow up with Providers who have not responded to Contracts and/or Applications sent as directed by management. - Formats and distributes Provider network resources (e.g. electronic specialist directory). **Job Qualifications** **REQUIRED EDUCATION** : High School Diploma or equivalent GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 1 year customer service, provider service, contracting or claims experience in the healthcare industry. **PREFERRED EDUCATION** : Associate's Degree or Bachelor's Degree in a related field or an equivalent combination of education and experience **PREFERRED EXPERIENCE** : Managed Care experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $42.2 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-42.2 hourly 6d ago
  • Medical Director, Behavioral Health

    Molina Healthcare 4.4company rating

    Covington, KY job

    JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. • Facilitates behavioral health-related regional medical necessity reviews and cross coverage. • Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. • Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. • Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. • Provides second level behavioral health clinical reviews, peer reviews and appeals. • Supports behavioral health committees for quality compliance. • Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. • Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). • Assists with the recruitment and orientation of new psychiatric medical directors. • Ensures all behavioral health programs and policies are in line with industry standards and best practices. • Assists with new program implementation and supports for health plan in-source behavioral health services. Required Qualifications • At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. • Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice. • Board Certification in Psychiatry. • Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. • Ability to work cross-collaboratively within a highly matrixed organization. • Strong organizational and time-management skills. • Ability to multi-task and meet deadlines. • Attention to detail. • Critical-thinking and active listening skills. • Decision-making and problem-solving skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications • Experience with utilization/quality program management. • Managed care experience. • Peer review experience. • Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. #PJHS #LI-AC1 #HTF To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $186,201.39 - $363,092.71 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $186.2k-363.1k yearly 1d ago
  • Lead Business Analyst - Managed Care Operations

    Molina Healthcare Inc. 4.4company rating

    Dayton, OH job

    Provides lead level support for accurate and timely intake and interpretation of regulatory and/or functional requirements related but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance for system changes. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. This role will work directly with Ohio Healthplan leadership including the Plan President, CFO, and other department heads to improve performance according to our Key Performance Indicators. Candidate will utilize SQL and Azure Databricks to query and analyze data however this is not just a technical role. They must be able to understand the business need, propose solutions, and meet KPIs. JOB DUTIES * Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to regulatory baseline requirements and any health plan/product team developed requirements. * Monitors regulatory sources to ensure all updates are aligned. Uses comprehensive background to navigate analytical problems, including: clearly defining and documenting their unique specifications. Leads coordinated development and ongoing management / interpretation review process, committee structure and timing with key partner organizations. * Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements. * Provides status and updates to health plan/product team partners, senior management and stakeholders. * Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. * Where applicable, codifies the requirements for system configuration alignment and interpretation. * Provides support and/or requirement interpretation inconsistencies and complaints. * Assists with the development of requirement solution standards and best practices while suggesting improvement processes to consistently apply requirements across states and products where possible. * Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials. * Conducts industry research and engagement to evaluate, provide insights, and best practices as applicable. * Coordinates with relevant teams for analysis, impact and implementation of changes that impact the product. * Engages with operations leadership and Plan Support functions to review compliance-based issues for benefit planning purposes. * Mentors and trains new staff as well as provide ongoing support, leadership, and training new/integrating health plans and corporate teams. KNOWLEDGE/SKILLS/ABILITIES * Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation is agreed on and clear for solutioning. * Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. * Ability to lead complex projects across organizational boundaries with little direct instruction. * Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. * Ability to concisely synthesize large and complex requirements. * Ability to organize and maintain regulatory data including real-time policy changes. * Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. * Ability to work independently in a remote environment. * Ability to work with those in other time zones than your own. * Create reporting tools to enhance communication on updates and initiatives. JOB QUALIFICATIONS Required Qualifications * At least 6 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience. * Policy/government legislative review knowledge. * Strong analytical and problem-solving skills. * Familiarity with administration systems. * Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. * Previous success in a dynamic and autonomous work environment. Preferred Qualifications * Project implementation experience * Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). * Medical Coding certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $66,456 - $129,590 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $66.5k-129.6k yearly 31d ago
  • Corporate Development Manager

    Molina Healthcare 4.4company rating

    Covington, KY job

    This position will be responsible for supporting the execution of merger and acquisition transactions and will actively contribute in advancing Molina Healthcare's overall growth strategy. The role entails working closely with the senior members of the Corporate Development team and will actively interact with the business leaders and senior management team at Molina. The ideal candidate will have at least two years of experience as an analyst at an investment bank or similar firm. **Knowledge/Skills/Abilities** - Develop financial models and perform analyses to assess potential acquisition, joint venture and other business development opportunities (i.e., discounted cash flow, internal rate of return and accretion/dilution) - Prepare ad-hoc analyses and presentations to help facilitate various discussions - Research and analyze industry trends, competitive landscape and potential target companies - Coordinate deal activities among internal cross-functional teams and external parties - Coordinate due diligence and closing-related activities - Actively participate in reviewing and negotiating transaction agreements - Prepare board and senior management presentations **Job Qualifications** **REQUIRED EDUCATION:** Bachelor's degree in Accounting or Finance or related fields **REQUIRED EXPERIENCE:** + Minimum 5 years' experience in financial modeling and analysis + Ability to synthesize complex ideas and translate into actionable information + Strong analytical and modeling skills + Excellent verbal and written communication skills + Highly collaborative and team-oriented with a positive, can-do attitude + Ability to multi-task, set priorities and adhere to deadlines in a high-paced organization **PREFERRED EXPERIENCE:** + Prior analyst experience in investment banking strongly preferred + Healthcare industry experience preferred **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. \#PJCorp \#LI-AC1 Pay Range: $80,412 - $156,803 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $80.4k-156.8k yearly 60d+ ago
  • Dean - Cincinnati Campus

    HCA 4.5company rating

    HCA job in Cincinnati, OH

    is incentive eligible. Salary Estimate: 101441.60 - 152172.80 / year Learn more about the benefits offered for this job. The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. You Can Change the Life of One to Care for the Lives of Many! At Galen College of Nursing, we educate and empower nurses to change lives. Since 1989, we've dedicated our work to delivering high-quality nursing education with a student-first mindset. As one of the largest private nursing colleges in the country, we combine the support of a close-knit learning environment with the strength of a nationally recognized institution, HCA Healthcare. That same passion for excellence in the classroom extends to our offices. At Galen, you'll find a culture deeply rooted in collaboration, innovation, and a shared commitment to improving the future of healthcare. Your work directly touches the next generation of nurses, and your contributions help our students pursue their dream of a compassionate career. If you're looking for a career where you can make a difference, grow professionally, and be part of a caring team, we'd love for you to apply for the Dean - Cincinnati Campus position today! Click here to learn more about Galen! Position Overview: As a Dean - Cincinnati Campus at Galen College of Nursing, you will provide accountable leadership for the academic programs, community and hospital partnerships, and serves as an integral member of the College and Campus management team. This position will also ensure teaching excellence, faculty and student engagement, and student success in accordance with established regulations, accreditation standards, and the mission of Galen College of Nursing. Key Responsibilities: * May be designated as nursing program administrator role for regulatory agencies, state boards of nursing, and programmatic accreditors (see addendum). * Directs, leads, and supervises all academic aspects of the campus. * Creates and is accountable for the strategic direction and vision for the delivery of quality, responsive curriculum and programs. * Develops, maintains, and monitors fiscal resources and secures funding to support educational initiatives. * Provides leadership to ensure that the number of full-time faculty is sufficient to ensure that the student learning outcomes and program outcomes are achieved within budgetary guidelines. * Ensures the availability of resources required for faculty (full and part-time) to maintain expertise in their areas of responsibility. * Provides leadership in the development of policies for students, ensuring that they are congruent with the College, publicly accessible, and non-discriminatory. * Ensures the appropriate application of student policies and the correct implementation of related procedures by program directors, faculty, and staff. * Provides leadership to ensure that the curriculum is developed by the faculty and regularly reviewed to ensure integrity, rigor, and currency; ensures that accreditation standards and criteria are used as they relate to curriculum. * Provides leadership to ensure that fiscal, physical, and learning resources are sustainable and sufficient to ensure the achievement of the student learning outcomes and program outcomes. * Other duties as assigned. Position Requirements: * Education: Graduate Degree in Nursing required; Doctorate Degree in Nursing or related field preferred. * Experience: Five (5) years of progressive, senior-level experience in higher education preferred; demonstrated excellence in teaching and clinical practice experience in nursing required. . Demonstrated success in development of community relationships; experience in planning and budgeting; excellent communication and interpersonal skills and a record of professional involvement as evidenced in CV. * Special Qualifications: CNE or CNEcl certification preferred. * Licensure: Per State Board of Nursing Requirements * Physical/Mental Demands and Work Environment: Position requires critical thinking, reading, planning, preparing, evaluating, and decision making. Physical demands in classroom and office are minimal and considered sedentary work with occasional lifting and/or carrying such articles as records, files, and books (10 pounds maximum). Operation of standard office equipment such as phone, computer, classroom projector, Scantron, and printer/scanner, occurs on a frequent basis. Physical demands in the clinical area may include lifting, pulling, pushing, kneeling, stooping, crouching and bending or any other related activity. Travel may be required * Degree of Supervision: Minimal. Benefits At Galen College of Nursing, we want to ensure your needs are met. We offer a comprehensive package of medical, dental, and vision plans, tuition discounts, along with unique benefits, including: * Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. * Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance, and more. * Free counseling services and resources for emotional, physical, and financial well-being * 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) * Employee Stock Purchase Plan with 10% off HCA Healthcare stock * Family support through fertility and family building benefits with Progyny and adoption assistance. * Referral services for children, elders, and pet care, home and auto repair, event planning, and more. * Consumer discounts through Abenity. * Retirement readiness, rollover assistance services, and preferred banking partnerships. * Education assistance (tuition, student loan, certification support, dependent scholarships). * Colleague recognition program. * Time Away from Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence). * Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits. Note: Eligibility for benefits may vary by location. Galen College of Nursing is recognized as a 2023 National League of Nursing (NLN) Center of Excellence (COE). Galen's Compassionate Care Model Values * Inclusivity: I foster an environment that provides opportunity for every individual to reach their full potential. * Character: I act with integrity and compassion in all I do. * Accountability: I own my role and accept responsibility for my actions. * Respect: I value every person as an individual with unique contributions worthy of consideration. * Excellence: I commit myself to the highest level of quality in everything I do. Learn more about our vision and mission. Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Dean - Cincinnati Campus Galen College of Nursing
    $81k-103k yearly est. 11d ago
  • Supervisor, Healthcare Services Operations Support

    Molina Healthcare 4.4company rating

    Covington, KY job

    JOB DESCRIPTION Job SummaryLeads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc. - Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes. - Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance. - Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement. - Assists in the development and implementation of internal desktop processes and procedures. - Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers. Required Qualifications- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience. - Strong analytic and problem-solving abilities. - Strong organizational and time-management skills. - Ability to multi-task and meet project deadlines. - Attention to detail. - Ability to build relationships and collaborate cross-functionally. - Excellent verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Supervisory/leadership experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $77,969 - $106,214 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $78k-106.2k yearly 37d ago
  • Full Time Clinical Nursing Faculty

    HCA Healthcare 4.5company rating

    HCA Healthcare job in Cincinnati, OH

    Salary Estimate: $56908.80 - $79684.80 / year Learn more about the benefits offered ( ********************************************************************* ) for this job. The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Introduction You Can Change the Life of One to Care for the Lives of Many! At Galen College of Nursing, we educate and empower nurses to change lives. Since 1989, we've dedicated our work to delivering high-quality nursing education with a student-first mindset. As one of the largest private nursing colleges in the country, we combine the support of a close-knit learning environment with the strength of a nationally recognized institution, HCA Healthcare. That same passion for excellence in the classroom extends to our offices. At Galen, you'll find a culture deeply rooted in collaboration, innovation, and a shared commitment to improving the future of healthcare. Your work directly touches the next generation of nurses, and your contributions help our students pursue their dream of a compassionate career. If you're looking for a career where you can make a difference, grow professionally, and be part of a caring team, we'd love for you to apply for a faculty position today! Click here to learn more about the Galen difference (************************************************ Position Overview: Nursing faculty are responsible for engaging in the full scope of the academic nurse educator role. These responsibilities include facilitating learning and learner development; using assessment and evaluation strategies; participating in curriculum development, implementation, and evaluation; evaluating program outcomes; ongoing development of the nurse educator role; engaging in scholarship; developing and functioning as a leader and change agent; and functioning within the educational environment. This role must be fulfilled under the rules and regulations of the state and federal regulatory and accrediting bodies. Key Responsibilities: + Creates an environment that facilitates learning and achieving desired student learning and program outcomes. + Implements various teaching strategies appropriate to learner needs, desired learner outcomes, content, and context. + Helps students develop as nurses and integrate the values and behaviors expected of those who fulfill that role. + Uses a variety of strategies to assess and evaluate student learning in all settings (classroom, lab, or clinical) and all domains (cognitive, psychomotor, and affective) of learning. + Analyzes student assessment and evaluation data to inform decision-making in continuous course improvement. + Implement a curriculum with clearly articulated program student learning outcomes (PSLOs), which are used to organize the curriculum, guide the delivery of instruction, direct learning activities, and evaluate student progress. + Designs and implements program assessments that promote continuous quality improvement of all aspects of the program. + Participates in professional development activities that increase socialization to and effectiveness of the faculty role. + Maintains the professional practice knowledge and expertise in areas of responsibility needed to help students prepare for contemporary nursing practice. + Demonstrates commitment to the College's mission and values of inspiring and fostering excellence, compassion, accountability, and inclusivity. + Other essential responsibilities as outlined by the applicable state board of nursing. Position Requirements + Active, Current, Unencumbered Licensure: Applicable state as a Registered Nurse and per the State Board of Nursing + Education Qualifications: A minimum of a Master of Science in Nursing (MSN) Degree is required. BSN-prepared nurses may be considered depending on the campus' needs. + Experiential Qualifications: Minimum of two (2) years of clinical experience as a Registered Nurse, and per the State Board of Nursing Physical/Mental Demands and Work Environment:If performing nursing duties related to clinical instruction (especially patient contact) hazards may include needle sticks, blood and bodily fluid exposure, or any other hazard a Registered Nurse (RN) might be exposed to in the normal performance of nursing care. Position requires mental activity, reading, planning, preparing, evaluating, and decision making. Physical demands in the classroom and office are minimal and are considered sedentary work with occasional lifting and/or carrying such articles as records, files, and books (10 pounds maximum). Operation of standard office equipment such as phone, computer, classroom projector, Scantron, and printer/scanner occurs on a frequent basis. Physical demands in the clinical area may include lifting, pulling, pushing, kneeling, stooping, crouching, bending, or any other related activity to patient care. Position requires regular attendance, and may require evening or weekend hours, and travel to clinical sites and extended classrooms. Benefits At _Galen College of Nursing_ , we want to ensure your needs are met. We offer a comprehensive package of medical, dental, and vision plans, tuition discounts, along with unique benefits, including: + Full-time faculty are eligible for a 90% tuition discount for Galen's Academic Leadership MSN and DNP programs. + Certification renewal and exam reimbursement. + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance, and more. + Free counseling services and resources for emotional, physical, and financial well-being + 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny and adoption assistance. + Referral services for children, elders, and pet care, home and auto repair, event planning, and more. + Consumer discounts through Abenity. + Retirement readiness, rollover assistance services, and preferred banking partnerships. + Education assistance (tuition, student loan, certification support, dependent scholarships). + Colleague recognition program. + Time Away from Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence). + Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits. (*********************************************************************) _Note: Eligibility for benefits may vary by location._ Galen College of Nursing is recognized as a 2023 National League of Nursing (NLN) Center of Excellence (COE). Galen's Compassionate Care Model Values (****************************************************************************************************************** Galen's Compassionate Care Model Values + Inclusivity: I foster an environment that provides opportunity for every individual to reach their full potential. + Character: I act with integrity and compassion in all I do. + Accountability: I own my role and accept responsibility for my actions. + Respect: I value every person as an individual with unique contributions worthy of consideration. + Excellence: I commit myself to the highest level of quality in everything I do. + Learn more about our vision and mission (*********************************************** . Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. _Submit your application for the opportunity below:_ Full Time Clinical Nursing Faculty Galen College of Nursing
    $56.9k-79.7k yearly 3d ago
  • Associate Specialist, Provider Contracts HP

    Molina Healthcare Inc. 4.4company rating

    Covington, KY job

    Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when available, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. Job Duties This role supports negotiations with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. * Sends out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members. * Receives calls from prospective providers and answers questions regarding contracting process, policies and procedures. * Forwards requested information/documentation to prospective providers in a timely manner. * Maintains database of all contracts and specific applications sent to prospective new providers. * Completes and updates Provider Information Forms for each new contract. * Ensures accuracy and completeness of provider demographic information and coordinates communication of such information to Provider Configuration team. * Sends out new provider welcome packets to providers who have contracted with the plan. * Utilizes Plan's system to track and follow up with Providers who have not responded to Contracts and/or Applications sent as directed by management. * Formats and distributes Provider network resources (e.g. electronic specialist directory). Job Qualifications REQUIRED EDUCATION: High School Diploma or equivalent GED REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 1 year customer service, provider service, contracting or claims experience in the healthcare industry. PREFERRED EDUCATION: Associate's Degree or Bachelor's Degree in a related field or an equivalent combination of education and experience PREFERRED EXPERIENCE: Managed Care experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $42.2 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-42.2 hourly 7d ago

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