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HCA Healthcare jobs in Riverside, CA

- 285 jobs
  • Hospitalist Physician

    HCA Healthcare 4.5company rating

    HCA Healthcare job in Riverside, CA

    **Specialization:** Internal Medicine Family Medicine without OB **About us:** We pride ourselves on delivering top-tier healthcare services. Our state-of-the-art facilities and collaborative environment make us an ideal place for talented physicians to thrive. **Position Overview** : We are seeking a dedicated and compassionate Academic and Traditional Hospitalist Internal Medicine Doctors to join our team. The ideal candidate will provide high-quality inpatient care, manage complex medical cases, and work collaboratively with a multidisciplinary team to ensure the best outcomes for our patients. **Key Responsibilities:** + Provide comprehensive care to hospitalized patients in the acute care setting. + Collaborate with specialists, nurses, and other healthcare professionals to develop and implement treatment plans. + Participate in daily rounds, patient consultations, and discharge planning. + Ensure accurate and timely documentation in the patient's medical records. + Engage in continuous professional development and education. **Qualified Candidates:** + MD or DO from an accredited medical school. + Board Certification in Internal Medicine or Family Medicine. + Experience in an acute care setting is required. + Strong communication and interpersonal skills. + Ability to work effectively in a team-oriented environment. **Compensation and benefits:** + Competitive salary and comprehensive benefits package. + Supportive and collaborative work environment. + Opportunities for professional growth and development. + Access to cutting-edge medical technology and research. **About Riverside Community Hospital:** Located in the Greater Los Angeles area, Riverside Community Hospital has been a leader in the Inland Empire since 1901. The 542-bed acute care facility specializes in trauma, cancer care, neurosurgery, orthopedics, general surgery, cardiology, stroke intervention and so much more. By combining skilled caregivers with the latest state-of-the-art technology, Riverside Community Hospital delivers world-class healthcare close to home. Riverside Community Hospital is proud to have been named One of the Nation's Top 250 Hospitals three years in a row by Healthgrades. The facility has had multiple expansion projects to be able to continue to provide exceptional care to the community and is one of Riverside County's only STEMI receiving centers. Riverside Community Hospital is a fully accredited Chest Pain Center and DNV Comprehensive Stroke Center, encompassing the full spectrum of stroke care. The hospital is known for providing expert care in the following services: - Level I Trauma Center with helipad, providing access to higher acuity services for the surrounding rural communities up to 200 miles away - Complex and minimally invasive surgical services with robotics including general surgery, orthopedics, neurosurgery, cardiovascular and thoracic, colorectal, gynecology, urology - Comprehensive cardiac services including structural heart, electrophysiology and an advanced cardiogenic program - Extensive women's and children's services; including high-risk OB care and a Level III NICU - Certified joint replacement program and perinatal care program accredited by The Joint Commission - Multi-faceted oncology services with a full care team of specialists - Expert critical care units including surgical, cardiovascular, medical, neonatal and neuro intensive care units for higher level of care - Part of HCA Healthcare, a network of more than 185 hospitals and 2,000 sites of care in 21 states and the United Kingdom - 220 residents in fellows spanning a dozen specialties in HCA Healthcare's largest Graduate Medical Education program - A Top 50 Cardiovascular Hospital by Premier Inc. Riverside, California - located in Southern California and the most populous city in the Inland Empire, Riverside is just 55 miles east of downtown Los Angeles and a 55-minute drive to some of Southern California's most popular beaches. It is known as the birthplace of the California Citrus industry and home to both the famous Mission Inn Hotel and Spa and Mount Rubidoux, a popular attraction providing panoramic views of the city at its summit. Rich in history and outdoor adventures to discover, Riverside allows its residents to take full advantage of all that Southern California has to offer.
    $177k-250k yearly est. 60d+ ago
  • Certified Central Sterile Tech

    HCA Healthcare 4.5company rating

    HCA Healthcare job in Riverside, CA

    Hourly Wage Estimate: $29.58 - $34.84 / hour Learn more about the benefits offered ( ********************************************************************* ) for this job. The estimate displayed represents the typical wage 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** Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Central Sterile Tech Cert today with Riverside Community Hospital. **Benefits** Riverside Community Hospital offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: + 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 wellbeing + 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 child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity and Consumer Discounts + 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._** Come join our team as a Certified Central Sterile Tech. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today! **Job Summary and Qualifications** As a **Certified Sterile Processing Technician** , you will play a critical role in protecting patient safety and supporting life-saving care through precision and attention to detail. In this rewarding role, you will be a vital part of our team - helping surgical staff deliver safe, effective care by ensuring every instrument and supply is clean, prepared, and ready when it is needed most. **Your responsibilities will include:** + Cleaning, inspecting, assembling, and sterilizing surgical instruments and trays to ensure they are sterile, complete, labeled, and ready for use + Managing sterilization equipment and keeping accurate records to support patient safety and infection prevention + Preparing customized surgical sets and case carts based on daily schedules and specific procedure needs + Managing inventory and supplies in OR storage and specialty lockers, working with the surgical team to meet needs and keep operations running smoothly + Responding quickly to instrument requests during surgeries and helping solve urgent equipment needs **What qualifications you will need:** + Experience in processing surgical instruments and operation of sterilizers and instrument washers + (CSPDT) Cert Sterile Processing and Distribution Technician, or (CRCST) Certified Registered Central Service Technician **Required** + Previous SPD/Central Service experience Preferred + Knowledge of aseptic technique and sterile processing desirable Riverside Community Hospital is a large acute care facility with 517 beds, established in 1901. It has the most extensive Emergency Room and Level I Trauma Center in the Inland Empire region and is the primary recipient of STEMI (heart attack) cases in Riverside County. The hospital is accredited as a Chest Pain Center and Comprehensive Stroke Center and has a HeartCare Institute that offers both invasive and non-invasive cardiac procedures. Riverside has a Level III Neonatal Intensive Care Unit, which it is very proud of. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses "The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Central Sterile Tech Cert opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock the possibilities and apply today!** We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
    $29.6-34.8 hourly 60d+ ago
  • Senior Facilitated Enroller (In Field Rochester, NY)

    Molina Healthcare 4.4company rating

    Long Beach, CA job

    The Senior Facilitated Enroller will use a high degree of customer service to successfully work with the team to provide optimal enrollment success. The Senior Facilitated Enroller (SFE) will assist the Facilitated Enrollment Supervisor in meeting and exceeding sites expectations and providing exceptional levels of customer service. The SFE will continue to assist eligible recipients for enrollment by phone or conduct face to face meetings. Assist the Facilitated Enrollment Supervisor in training, assisting with client meetings (webinars and leading meetings) and will be more involved with the Marketing Tracker and Salesforce. The SFE will also work closely with the Facilitated Enroller and will report to the Facilitated Enrollment Supervisor the successes or areas that require improvement and will provide input on strategy as the business needs change within given territory. Knowledge/Skills/Abilities Assists with inbound/outbound calls when necessary to assist FE with achieving monthly, quarterly and annual enrollment goals. The SFE will assist in leading FE and/or projects to help ensure monthly enrollment results. SFE will provide support across projects, including quality checks to Marketing Tracker and Sales Force. Works with Facilitated Enrollment Supervisor to successfully support FEs in enrollment success and to formulate resolutions for struggling FEs. Identifies any challenges and communicates to Facilitated Enrollment Supervisor. Successfully maintains and/or manages monthly FE calendar Excellent time management with the ability to maintain multi-faceted projects, providing both quality and quantity while completing job duties and adhering to various objectives with little to no supervision. Maintains a high level of professionalism to all outgoing emails to clients Shows a comprehensive understanding of processes, best practices, and indications with minor errors Monitors daily operations and identifies need for program tools and works with Facilitated Enroller Supervisor to meet staff needs. Participates in the design and implementation of process improvements within the current facilitated enrollment policies, procedures, services and workflow to improve the customer experience as well as productivity Maintains expert knowledge of current processes, rules and regulations of the MMC, EP, CHP and QHP programs and serves as a resource for implementation, training teams Offers suggestions to Facilitated Enrollment Supervisor regarding corrective action plans and conducts other quality activities to include policy and procedure review and application reviews Performs research assignments as directed by Facilitated Enrollment Supervisor which may include but are not limited to educational resources and best practices. Meets with consumers at various sites throughout the communities Provide education and support to individuals who are navigating a complex system by assisting consumers with application process, explaining requirements and necessary documentation Consistently demonstrates high standards of integrity by supporting Molina Healthcare of NY, Inc mission and values and adhering to the Corporate Code of Conduct Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures Performs other functions as assigned by management. Job Qualifications Required Education: High School Diploma or equivalence Required Experience: Minimum of 3 years of experience working with State and Federal Health Insurance programs and populations Demonstrated organizational skills, time management skills and ability to work independently Previous experience leading projects, processes, or teams Excellent written and oral communication skills; strong presentation skills Basic computer skills including Microsoft Word, Excel, Salesforce and Share Point Strong interpersonal, organizational skills and the ability to work in a team environment. A positive attitude with the ability to be flexible and adapt to change Knowledge of Managed Care insurance plans Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities Required Licensure or Certification: Must have reliable transportation and a valid NYS drivers' license with no restrictions Successful completion of the NYSOH required training, certification 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.
    $92k-124k yearly est. Auto-Apply 4d ago
  • Manager, Growth & Community Engagement (Southern New Mexico)

    Molina Healthcare 4.4company rating

    Long Beach, CA job

    Molina Healthcare is hiring for a Manager of Growth & Community Engagement in southern New Mexico. This position will work alongside leadership and the other Managers to ensure team and department goals are met. They will work closely to lead and execute Molina signature events, manage the day-to-day activities and support the team. They will interact with public officials, external organizations, and internal departments. If you have passion and enthusiasm for building relationships within the community that foster growth all while improving the health and lives of the community, we want to talk with YOU! This position is fast paced and requires someone who is versatile, creative, and can lead by example. They will be a mentor, a leader and need to be hands on. The duties will range from doing ride-a-longs with team members (Community Engagement Reps), leading and facilitating meetings, events, and department activities. This position will interact with other department management and leads. This position is primarily in the Medicaid space, however, will cross over to Marketplace and Medicare. This role will lead by example, working alongside their team. There may be evening and weekend events that the Manager will be needed at. Prior experience working with the community in some capacity is highly desired ***Must live in Southern New Mexico*** ***NM State Driver's License and Reliable Transportation Required** KNOWLEDGE/SKILLS/ABILITIES Responsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages. Works closely with the AVP/Director to develop and execute the enrollment growth strategy for a specific area, while also being accountable to achieve assigned membership growth targets. Accountable for achieving established goals with the primary responsibility for improving the plan's overall “choice” rate. In addition, works collaboratively with other key departments to increase Medicaid assignment percentages for Molina. Responsible for day-to-day operations and management of team members, including hiring, training, developing, coaching and mentoring, etc. Creates and regularly reviews team performance metrics/scorecards to ensure team performance contributes to overall enrollment growth, while providing clear direction and intermittent steps to achieve success. Contributes to the development, implementation, and evaluation of the enrollment growth plan for assigned territory; plans enrollment activities to promote membership growth. Collaborates with other Lines of Business' sales teams to identify growth opportunities focused on key providers and Community Based Organizations. Leads team in the development of relationships with key providers, Community Based Organizations (CBOs), Faith Based Organizations (FBOs), School Based Organizations (SBOs) and Business Based Organizations (BBOs) and how to move them through the enrollment pipeline. Directs the coordination, development and approval of State/Federal guidelines for all marketing and promotional materials for all product lines. Demonstrates thorough understanding of Molina's product lines, Medicaid, CHIP, Medicare SNP, Marketplace, MMP, etc JOB QUALIFICATIONS REQUIRED EDUCATION: Bachelor's Degree or equivalent experience. PREFERRED EDUCATION: Bachelor's degree in marketing or healthcare administration. REQUIRED EXPERIENCE: 5-10 years' experience in business development, community relations or health care related activities. 3 years Managed-Care, Medicaid experience; knowledge of advertising requirements pertaining to the Medicaid and Medicare media campaigns. Prior work experience in a supervisory capacity, demonstrating excellent organizational, prioritizing, and motivational skills. Experience in negotiation, sales or marketing techniques. Must live in San Diego County PREFERRED EXPERIENCE: Previous healthcare enrollment, marketing and/or sales experience. Fluency in a second language is highly desirable. Prior demonstrated work experience in a managerial capacity. REQUIRED LICENSE, CERTIFICATION, ASSOCIATION: Completion of Molina /DHS/MRMIB Marketing Certification Program Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation. PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: Active Life & Health Insurance Marketplace Certified To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #PJHPO Key Words: Medicare, Medicaid, Managed Care, Manager, Leader, Marketing, Duals, Enroll, Enrollees, Coverage, #LI-TR1, NY York State, NY State Department of Health, Star Plus, Reimbursement, community, health coach, community health advisor, nonprofit, non-profit, family advocate, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter and public health aide, NY Care, community lead, HMO, PPO, community advocate, nonprofit, non-profit, social worker, housing counselor, human service worker, Sales, Navigator, Assistor, Connecter, Promotora, Marketing, Growth, Manager, Supervisor, Leader, Management, Medicare Advantage
    $114k-164k yearly est. Auto-Apply 60d+ ago
  • Discharge Coordinator - Case Management

    Tenet Healthcare Corporation 4.5company rating

    Palm Springs, CA job

    Desert Regional Medical Center Hospital is committed to providing exceptional patient care in a supportive and collaborative environment. As a member of our team, you will have the opportunity to work with advanced technology and be part of a healthcare community dedicated to making a positive impact on the lives of our patients. At Desert Regional Medical Center, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include: * Medical, dental, vision, and life insurance * 401(k) retirement savings plan with employer match * Generous paid time off * Career development and continuing education opportunities * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance Note: Eligibility for benefits may vary by location and is determined by employment status Priority 1: Arrange post discharge services at the direction of the case manager or social worker, to include documentation of activities Priority 2: Assist with other clerical duties as assigned, including faxing, phone calls, copying of medical records Priority 3: Maintain effective relationships with case management staff, physicians, nurses, other ancillary staff, payors, post-acute vendors, patients and their families The metrics below provide an indication of the effectiveness of the individual in this role and may be used for evaluative purposes. The list below is not meant to be exhaustive; other relevant metrics may exist. * Avoidable days r/t delay in arranging post discharge services * Disputes related to delays in discharges * IM letter oversight compliance per policy Shift: Rotate Hours: 0800-1630 Job Type: Per Diem. 4 shifts required per month including weekends. Job Summary The individual in this position assists the Case Manager and Social Worker with non-professional tasks. The responsibilities will include, but not be limited to the following activities: a) arrange post-discharge services b) fax, make phone calls c) communicate with patients, families and other members of the care team and d) other duties as assigned. Coordinates Medicare notification letters to comply with regulatory standards. Attends Hospital orientation, workshop led by Director of Case Management or designee that covers the Tenet Case Management Program, focuses on Discharge Planning arrangements and other clerical duties specific to case management. Information used to perform job: patient data, healthcare staff documentation related to patient care, available community resources Software used to perform job: allscripts, Patient Medical Record/HPF, Cerner Required: * One to three years' experience as a discharge planner. * Organized with excellent verbal and written communication skills and computer literacy Preferred: * Medical terminology knowledge * Some college education Physical Requirements: While performing the duties of this job, the employee is regularly required to sit, talk, and hear. The employee is frequently required to use fine motor skill (typing/data entry), and reach with hands and arms. The employee is frequently required to stand; walk; and occasionally stoop, kneel, or crawl. The employee must regularly lift and /or move up to 20 pounds and occasionally lift and/or move up to 50 pounds. Individual works in clinical and office environment. #LI-DH1 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. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $54k-78k yearly est. 10d ago
  • Senior Specialist, Premium Billing (Must Reside in WI)

    Molina Healthcare 4.4company rating

    Long Beach, CA job

    Knowledge/Skills/Abilities • Process daily enrollee's (Individual and family) invoices and premium reconciliation for Marketplace members. • Reconcile premiums received from the individual subscriber or responsible party with the amount due for the healthcare program the member is enrolled. • Guide and support Member Service representatives to help them resolve member inquiries related to healthcare premium. • Assist in resolution for escalated premium issues with Appeals and Grievances team members. • Guide and collaborates with enrollment team to resolve eligibility issues affecting premium billing. • Generate billing data using the QNXT premium billing module to be sent to print and fulfillment vendor. • Reconcile unallocated payments on a daily basis. • Resolve orphan member payments on a daily basis. • Reconcile monies received from the financial institution. • Perform month-end invoicing and accuracy audits. • Comply with all State/Regulatory requirements.Under limited supervision, drives and supports reconciliation of premiums for members enrolled though the Healthcare Marketplace as a part of the Affordable Care Act (ACA). Reconciliation will be performed for more complex premiums received from members, state agencies and CMS. Team member will work closely with enrollment teams and offer guidance where premiums are directly impacted by enrollment discrepancies. Collaborate with and advises call center teams to maintain member satisfaction for this product. Work with financial institutions to ensure timely and accurate processing of payment received.• Marketplace, Commercial, or Medicare healthcare experience with premium billing and reconciliation. • Must have excellent time management and organizational skills. • Strong team-oriented individual. • Excellent communication with all levels of team. • Must have strong knowledge and experience in MS office products, minimally Outlook, Word and Excel. • Access or SQL experience is a plus. • Excellent verbal and written communication skills. • Ability to abide by Molina's policies. • Maintain regular attendance based on agreed-upon schedule. • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.. Job Qualifications Required Education High School diploma required Required Experience 3+ years of Member Billing /R Required License, Certification, Association Marketplace, Commercial or Medicare Industry preferred Required Licensure/Certification: None Preferred Education Associates Degree or higher preferred Preferred Experience Healthcare industry experience, with emphasis on enrollment, member billing, and premium reconciliation preferred. Preferred License, Certification, Association None 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.
    $45k-63k yearly est. Auto-Apply 43d ago
  • QNXT Configuration Analyst

    Molina Healthcare 4.4company rating

    Long Beach, CA job

    Responsible for providing business process redesign, communication and change management for operations. Backend operationalization of policies, standardization of system set-up and a resource for all departments and health plans company-wide. Knowledge/Skills/Abilities Conduct interviews with staff and management to assess internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures and other internal guidelines. Review, research, analyze and evaluate information to assess compliancy between a process or function and the corresponding written documentation. Use analytical skills to identify variances. Use problem solving skills and business knowledge to make recommendations for process remediation or improvement. Summarize and document assessment outcomes and recommendations. Ensure that they are appropriately communicated (written and verbal) to process owners and management. Collaborate with process owners to maintain and/or create business process documentation and workflows related to Core Operations functions. Serve as liaison between Core Operations and internal and external auditors for all formal Core Operations audits that are not compliance related. Coordinate, facilitate and document audit walkthroughs. Research, collect or generate requested documentation. Provide timely and accurate responses, both written and verbal. Research and respond to clarifying questions submitted by internal and external auditors. Work in partnership with other functional areas as needed.. Ability to write SQL queries Experience with QNXT configuration Experience with troubleshooting and analyzing issues. Experience working in a Medicare environment is highly preferred. Claims adjudication experience is highly preferred. Job Qualifications Required Education Associate's Degree or two years of equivalent experience Required Experience • Four years proven analytical experience within an operations or process-focused environment. Additional required experience for Corporate Operations: • Analytical experience within managed care operations. • Knowledge of managed care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. Preferred Education Bachelor's Degree Preferred Experience • Six years proven analytical experience within an operations or process-focused environment. • Previous audit and/or oversight 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.
    $112k-147k yearly est. Auto-Apply 20d ago
  • Associate Specialist, Provider Contracts HP

    Molina Healthcare 4.4company rating

    Long Beach, CA 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.
    $32k-62k yearly est. Auto-Apply 8d ago
  • Supervisor of Diagnostic Imaging

    HCA 4.5company rating

    HCA job in Riverside, CA

    Salary Estimate: 98966.40 - 148449.60 / 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 Managers thrive with us! HCA Healthcare is one of the nation's leading providers of healthcare services, comprising of over 180 hospitals and about 2,000 sites of care in 21 states and the United Kingdom. We are looking for a Supervisor of Diagnostic Imaging for our Riverside Community Hospital team where excellence creates excellence. Benefits Riverside Community Hospital offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: * 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 wellbeing * 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 child, elder and pet care, home and auto repair, event planning and more * Consumer discounts through Abenity and Consumer Discounts * 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. HCA Healthcare has expanded our influence across the healthcare industry by investing 3.5 billion in capital improvements in recent years. Do you want to be an influencer in healthcare? Apply for our Supervisor of Diagnostic Imaging role today! Job Summary and Qualifications The Supervisor of Diagnostic Imaging assists the radiologists and the Department Director in establishing department policies and procedures. The incumbent will report all problems relevant to staffing, morale, work methods, procedures, transfers and recommends action in other personal matters. The incumbent will supervise technologists and ancillary personnel to ensure quality control and is responsible to ensure safety regulations, both state and federal, are adhered to. This position requires initiative and independent judgment in supervision of technologists. * You will assign tasks and responsibilities to front line personnel and ensures tasks are completed accurately and in a timely manner. * You will assist in promoting an environment in which teamwork is facilitated and patient care objectives are obtained. * You will establish and maintain mechanism to ensure, assess, and evaluate staff qualifications and competency upon employment and upon regular ongoing basis through written orientation plans, skills validation, competency assessment and secured education in response to needs assessment, and verification of required licensure and certifications. * You will encourage and consistently reinforce staff compliance with organizational policies, safety regulations, infection control procedures, ethics and compliance, risk management activities, standard precautions and proper body mechanics. * You will work with or function as clinical instructor / preceptor for students and plan and participate in unit staff development activities. What qualifications you will need: * Graduate of an approved program of Medical Imaging - REQUIRED * ARRT in CT/X-Ray/MRI/NM or ARDMS or NMTCB - REQUIRED * CDPH RHB licensure - Diagnostic Radiologic Technology (if applicable) * Current Basic Cardiac Life Support certification - REQUIRED * Minimum of five (5) year experience preferred. * Minimum of (1) year supervisory experience preferred Riverside Community Hospital is a large acute care facility with 517 beds, established in 1901. It has the most extensive Emergency Room and Level I Trauma Center in the Inland Empire region and is the primary recipient of STEMI (heart attack) cases in Riverside County. The hospital is accredited as a Chest Pain Center and Comprehensive Stroke Center and has a HeartCare Institute that offers both invasive and non-invasive cardiac procedures. Riverside has a Level III Neonatal Intensive Care Unit, which it is very proud of. HCA Healthcare has been recognized as one of the Worlds Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses "Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If youre looking for a leadership opportunity that provides both personal satisfaction and professional growth, apply to join HCA Healthcare as a(an) Supervisor of Diagnostic Imaging.Unlock your leadership potential with HCA Healthcare. We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
    $58k-82k yearly est. 42d ago
  • Adjudicator, Provider Claims

    Molina Healthcare 4.4company rating

    Long Beach, CA 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
    $41k-53k yearly est. Auto-Apply 13d ago
  • Supervisor, Healthcare Services Operations Support

    Molina Healthcare 4.4company rating

    Long Beach, CA 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
    $57k-96k yearly est. Auto-Apply 38d ago
  • Certified Medical Dosimetrist Per Diem Days

    Tenet Healthcare Corporation 4.5company rating

    Palm Springs, CA job

    Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others. Our Impact Today Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions. Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions. Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day. Desert Regional Medical Center is a 385-bed acute-care hospital classified as a stroke receiving center and Level I Trauma Center with an innovative, patient centered and evidence-based Rehabilitation Services Department. Our compassionate team provides a wide range of inpatient and outpatient services, including acute care rehabilitation, joint replacement & spinal surgery, neurosurgery, ICU, Telemetry, step-down care, skilled nursing, as well as outpatient therapy, hand and lymphedema clinics. Summary: Perform Radiation Oncology Treatment planning. Knowledge of SBRT, VMAT, IMRT, and 3D treatment planning required. Work with Varian equipment - Eclipse, Aria, and 2 Varian accelerators, and use Radformation's ClearCheck and ClearCalc for plan documentation and checks. AlignRT is used for patient setup/monitoring, and for gated abdominal treatments and DIBH breast. Work with Sunrise Ambulatory Care and Cerner electronic medical records. Perform other duties as assigned. Shift: days Hours: Qualifications: * 3+ years of clinical treatment planning experience * Associate or Bachelors degree in Radiation Therapy or equivalent degree in Medical Dosimetry * Registration as a CMD (Certified Medical Dosimetrist) by the MDCB * Familiar with operation of linear accelerators, HDR afterloader, and CT-Simulator * Broad experience within an Eclipse/Aria environment * Experience in treatment planning across all treatment sites * Familiarity with deformable image registration, RapidArc and SBRT planning in Eclipse, and use of Radformation's suite of software is a plus * Experience in creating gated lung SBRT and DIBH breast treatment plans * Knowledge and understanding of current practices in radiation therapy, planning, and administration * Accurately document patient plans and associated tasks in accordance with institutional and departmental guidelines. * Ability to work independently, with strong attention to detail and problem solving * Strong interpersonal and communication skills #LI-TM2 Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law. 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. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $135k-193k yearly est. 26d ago
  • Social Worker II - Case Management

    Tenet Healthcare Corporation 4.5company rating

    Palm Springs, CA job

    Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others. Our Impact Today Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions. Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions. Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day. Desert Regional Medical Center is a 385 bed acute-care hospital classified as a stroke receiving center and level 2 trauma facility with an innovative , patient centered and evidence-based Rehabilitation Services Department. Our compassionate team provides a wide range of inpatient and outpatient services, including acute care rehabilitation, joint replacement & spinal surgery, neurosurgery, ICU, Telemetry, step-down care, skilled nursing, as well as outpatient therapy, hand and lymphedema clinics. Summary * The Social Worker is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to self-determination. * The individual in this position has overall responsibility for to assess the patient for transition needs including identifying and assessing patients at risk for readmission. * Conducts complex psycho-social assessment and intervention to promote timely throughput, safe discharge and prevent avoidable readmissions. * This position integrates national standards for case management scope of services including: * Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction * Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care * Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy * Education provided to physicians, patients, families and caregivers •Leads a population of patients by service line and/or leads the team by being a resource to Tenet performance standards. Responsibilities This individual's responsibility will include the following activities: * Complex psycho-social transition planning assessment and reassessment and intervention, * Assistance with adoptions, abuse and neglect cases, including assessment, intervention and referral as appropriate to local, state and /or federal agencies, * Care coordination, d) implementation or oversight of implementation of the transition plan, * Leading and/or facilitating multi-disciplinary patient care conferences including Complex Case Review, * Making appropriate referrals to other departments, g ) communicating with patients and families about the plan of care, * Collaborating with physicians, office staff and ancillary departments, I) assuring patient education is completed to support post-acute needs , * Timely complete and concise documentation in Case Management system, k ) maintenance of accurate patient demographic and insurance information, * Precepts new staff members and acts as a resource to all staff, * Facilitates TEMPO as needed, * Participates in department quality improvement initiatives, and * Other duties as assigned. Qualifications Experience Preferred: Two (2) years acute hospital experience. Certifications * Required: LCSW based on license requirements of the state in which the Tenet Hospital operates. * Preferred: Accredited Case Manager (ACM). Sign On Bonus: Up to $25,000 Hours: 1200pm - 12:30am Schedule: Fridays through Sunday #LI-DH1 Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law. 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. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $63k-79k yearly est. 4d ago
  • TRA All Travel and Local Contracts Application

    Tenet Healthcare Corporation 4.5company rating

    Palm Springs, CA job

    Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others. Our Impact Today Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions. Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions. Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day. This role provides direct clinical patient care. The role will assume responsibility for assessing, planning, implementing direct clinical care to assigned patients on a per shift basis, and unit level. The role is responsible for supervision of staff to which appropriate care is delegated. The role is accountable to support CNO to ensure high quality, safe and appropriate nursing care, competency of clinical staff, and appropriate resource management related to patient care in the following areas: All Critical Care CCU/ICU, ER, NICU, CVICU PICU, MICU, Radiology, Dialysis, PACU, CVOR, Labor and Delivery, OR, Cardiac Cath Lab, and GI/Endo. This position will be required to travel overnight or temporarily relocate to support a facility or facilities in a market as needed. This role will be required to be assigned to various hospitals or markets as needed. 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. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $96k-118k yearly est. 26d ago
  • Behavioral Health Coordinator

    Community Health Systems 4.5company rating

    Fallbrook, CA job

    The Care Coordinator is responsible for attending to patients on the phone and in person. The incumbent will coordinate and organize appointments and documentation to facilitate the smooth running of the healthcare environment and support the delivery of quality patient care to the population we serve. ESSENTIAL DUTIES AND RESPONSIBILITIES: * Upholds and supports the mission, philosophy, objectives, policies and ethics of CHSI.Protects organization's value by keeping information confidential and complying with HIPAA regulations. * Translate for patients and Providers as necessary. * Per Providers order and/or under "standing orders" with the supervision of the RN, MA will perform clinical procedures within the California MA scope of practice. * Returns calls to patients and documents all communications in EHR; follows all guidelines of CHSI patient communication protocol. * Handle emergencies appropriately and seek qualified help when required per CHSI policy and protocols. * Ensures patient readiness prior to Provider entering the exam room. * Will chaperone/assist the patient with the Provider as required by policy. * Complete all required charting. Review Providers orders and ensures they are followed/completed. * Obtain patient's signature on all forms where it is required. * Maintains timeliness of specimens through the use of the laboratory report. * Will scan patients' paperwork in EHR as required. * Responsible for completing electronic health record (EHR) tasks per CHSI policy and processing all referrals; (i.e. referrals to any and all outside organizations, and following any and all specific guidelines required by these organizations). * Notifies patient of scheduled appointment date/location and instructions for type of referral, when applicable. * Responsible for processing all stat, urgent, and routine referrals per CHSI policy. * Utilize the referral report daily for timeliness and accuracy. * Refer pending referrals to Site Manager (SM) when timeliness exceeds policy and sends a weekly report on open/pending/closed referrals to the SM. * Follow the required guidelines determined by each individual insurance plan/program.(i.e. PACT (Family planning program), (PE) presumed eligibility, sliding fee discount program, state health plans, Managed Care, etc.) * Coordinates and schedules referral initial appointments and follow-up appointments as designated. * Interact with patients', physicians and other staff both within the Clinic and at outside facilities providing accurate, timely and responsive information. * Coordinate, processes, and routes all paperwork as required to meet physician and CHSI requirements. * Demonstrate courtesy and helpfulness toward patients and their families. * Responsible for participating in quality improvement projects/activities and accountable for quality and PCMH. * Perform all other duties as directed either formally or informally, verbally or in writing. SUPERVISORY RESPONSIBILITIES: There are no current supervisory duties required. KNOWLEDGE, SKILLS AND ABILITIES: * Bilingual (English/Spanish) required. Knowledge of medical terminology, procedures and diagnosis strongly preferred. * Must possess good customer service including verbal and written communication. * A high standard of professionalism and professional ethics and conduct is expected in speech, manner, attitude and appearance at all times. * Possess strong interpersonal skills and ability to work well with others. * Ability to deal effectively with changing situations and stressful environment. * Experience working with an electronic health records (EHR) system desirable. * Ability to perform tasks related to physical activity to complete the responsibilities of the position. EXPERIENCE AND EDUCATION: * High School graduate or equivalent (Back Office) * Medical Assistant Certificate required from an accredited school * Current American Heart Association (AHA) BLS Certificate required and must be maintained * Venipuncture, Injection and Phlebotomy Certifications required * One year or more of MA experience preferred Electronic Health Record (EHR) experience preferred
    $27k-43k yearly est. 37d ago
  • Lead Business Analyst - Managed Care Operations

    Molina Healthcare 4.4company rating

    Long Beach, CA 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.
    $102k-128k yearly est. Auto-Apply 32d ago
  • Healthcare Services Intern (Ohio Health Plan)

    Molina Healthcare 4.4company rating

    Long Beach, CA job

    The Molina Healthcare Internship Program shares an objective to create a stepping stone for students who aim to be professionals and future leaders in the healthcare business profession. Interns are assigned special projects and various other duties that are intended to provide them with valuable professional work experience and industry insight. The purpose of an internship is to develop talent by providing students with experiential learning, formal training and opportunities to interact with healthcare professionals and community leaders. Interns will perform meaningful work alongside talented professionals, gaining insight to Molina's culture, Mission and Values. KNOWLEDGE/SKILLS/ABILITIES Healthcare Services (HCS) - Ohio Medicaid Learn Molina HCS Medicaid business and the customers we serve in Ohio Learn our HCS platforms, SharePoint, and the corresponding business processes the platform supports Work closely with a team of Care Coordination, Population Health and Utilization management SMEs and leaders Assist with SharePoint review, editing, organizing, and page development Assist with review and updating of training materials, research new topics - all HCS areas Support and assist with cost-of-care initiatives Preferred Experience Must possess clear and professional written, verbal and interpersonal communication skills Strong work ethic, self-motivated and ability to develop relationships Good time management, organizational and interpersonal skills required Computer experience including MS Word, Excel, Outlook and PowerPoint and experience with internet research. Excellent critical thinking/problem solving skills Ability to handle confidential information Ability to maintain confidentiality and to comply with Health Insurance Portability and Accountability Act (HIPAA) JOB QUALIFICATIONS REQUIRED EDUCATION: Must be currently enrolled in an undergraduate program as a freshman, sophomore, or junior Minimum GPA of 3.0 or higher Pursuing a degree in Healthcare Administration, Public Health, or a related field Must have unrestricted authorization to work in the United States Able to commit to the full-time, 10-week internship program from June 1st - August 7, 2026 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.
    $35k-43k yearly est. Auto-Apply 60d+ ago
  • Infection Prevention Manager Full Time Days

    Tenet Healthcare Corporation 4.5company rating

    Palm Springs, CA job

    Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others. Our Impact Today Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions. Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions. Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day. Department Specific Duties: Sign on 25K for Qualified applicants * Creates and implements in-service programs with respect to infection prevention and control * Prepares and presents Annual Infection Control Evaluation and Plan * Coordinates Infection Control Committee meeting, prepares agenda and is responsible for meeting minute's content as well as meeting all regulatory standards as it pertains to Infection Control * Infection Control Champion for the Joint Commission and responsible for implementing house wide initiatives to ensure uninterrupted compliance * Prepares and maintains Infection Control Manual consistent with federal regulations and Joint Commission standards. Ensures any updates are distributed to appropriate departments. * Ensures Committee actions are communicated and action plans are completed * Responsible for development and implementation of actions for identified infection control issues utilizing surveillance data * Identifies areas of improvement and serves as educator for house-wide infection control program and serves as educator for all new employees, New Grads, volunteers, medical residents, and medical/nursing students. Jointly provides education to Medical Staff in collaboration with Infection Prevention Medical Director * Has direct supervision of Infection Control Practitioners. Responsible for training and mentoring * Consults with Occupational Health Services regarding Employee Health Program as it relates to infectious diseases and infection control * Identifies documents and reports hospital acquired infections according to the Infection Control Plan. * Ensures Corporate Score Card Infection Control initiatives are reported on time and with-in established benchmarks. * Demonstrates team approach to projects. * Takes initiative to keep Chief Quality Officer fully informed on work related issues * Reports to work station on a regular basis for scheduled day and time * Answers the phones and responds to our customer needs professionally and without complaints. Desert Regional Medical Center is a 385-bed acute-care hospital classified as a stroke receiving center and Level I Trauma Center with an innovative, patient centered and evidence-based Rehabilitation Services Department. Our compassionate team provides a wide range of inpatient and outpatient services, including acute care rehabilitation, joint replacement & spinal surgery, neurosurgery, ICU, Telemetry, step-down care, skilled nursing, as well as outpatient therapy, hand and lymphedema clinics. General Duties: The Infection Prevention Manager directs and coordinates the infection control program in the hospital. The designated person will be given the authority to implement and enforce the Surveillance, Prevention and Control Program policies, coordinate all infection prevention and control within the hospital and facilitate ongoing monitoring of the effectiveness of prevention and/or control activities and interventions. The Infection Prevention Manager (IPM) will work directly with Infection Prevention Medical Director and coordinates activities to ensure adherence to regulatory and state requirements. The IPM is responsible for training and direct oversight of Infection Control Practitioners to ensure consistency in infection prevention practices throughout the hospital. Position Summary: * Manages the Infection Prevention (IP) department and staff; has the ability to hire, fire and discipline; may be responsible for surveillance activities; evaluates the effectiveness of the program; provides education to staff, patients and families and implements all facets of the IP program * Implements and designs programs for staff education on infection control and prevention principals * Assists Hospital Administration and Patient Safety with maintaining regulatory Infection Control Standards to protect all hospital patients and visitors (with emphasis on populations at high risk for infections) * Acts as hospital liaison for corporate quality Infection Control Issues * Partners with the Hospital Leadership on Environment of Care Issues involving Infection Prevention and Control * Partners with the Employee Occupational Health Department to assure Infection Prevention and Control principals are maintained * Coordinates the activities of the Infection Control Committee with the Infection Prevention Medical Director Surveillance * Develops and maintains an effective system for the surveillance of specific hospital associated infections as designated by the Infection Control Committee, Tenet Corporate Quality Program and the Public Health Department * Ensures that data is effectively evaluated and analyzed using sound epidemiological principals as recommended by APIC, CDC, SHEA. Responsible for data uploads to NHSN * Coordinates and communicates surveillance data to the Infection Control Committee. Ensures that surveillance information and action items achieved in committee are submitted to Quality Council, MEC and Governing Board * Monitors and reports all Department of Public Health required communicable diseases. Serves as a hospital resource to nursing, and medical staff regarding communication Shift: Days Hours: Required Education/ Training/ Experience: Sign on 25K for Qualified applicants * Baccalaureate degree required in nursing, lab, or other healthcare related field * Minimum 5 years of experience in infection prevention or other related roles including, health care management or quality or patient safety role. * 4 years experience in Infection Prevention with previous experience in health care * CIC required within 2 year of job Preferred: * CA RN License or Degree in Epidemiology #LI-JS4 Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law. 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. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $60k-80k yearly est. 26d ago
  • Community Health Worker

    Community Health Systems 4.5company rating

    Moreno Valley, CA job

    Under the direction of the Site Manager, the Community Health Worker (CHW) will be responsible for supporting complex Members in achieving "whole health" by fulfilling the roles and using the skills below. The CHW will be proactive and responsive to Members' needs in a friendly and professional manner. The CHW is a member of the Integrated Complex Care Team (ICC). ESSENTIAL DUTIES AND RESPONSIBILITIES: * Plan and provide the care for and the management of stabilized chronic conditions, asymptomatic and well patients of all ages and socioeconomic cultures. * Assist in developing and implementing procedures and protocols to facilitate the delivery of comprehensive health services. * Assists in maintaining and implementing protocols for Quality Assurance on a routine basis. * Will serve, as needed, as preceptor for students at all levels, i.e., Medical Assistant, Registered Nurse, Certified Nurse Practitioner, Medical Student, or Resident Physician, as requested. * Provides services in the clinic, the home (when medically indicated) or community setting, including schools when requested. * Initiate referrals to medical specialties as needed. * May be required to work weekends or evenings as designated. * Responsible for coordinating admission to hospital or extended care facilities. * In absence of our Community Health Systems, Inc.'s Physician in Charge is delegated as our Director of Operations in Charge. * Physician in Charge has overall responsibility for quality of care at the clinic. * He or she is the advocate for patients in that clinic. * Assist in implementing and maintaining procedures and protocols for quality assurance on regular basis. * Assist and educate other Providers in complying with Policy and Procedures of our clinic. * Maintain dialogue with Site Supervisor and Nursing Supervisor to assure smooth operation of clinic. * Every attempt should be made to solve all problems at clinic level. * Ensures departmental Site Review Sheet is signed by the Director of Operations in Charge and the Site Manager; then faxed to the Chief Medical Director every month. * Will report direct patient care issues to the Chief Medical Director and any other issue(s) (i.e. administrative) to the Site Manager. * Responsible for participating in quality improvement projects/activities and accountable for quality and PCMH. * Perform all other duties as directed either formally or informally, verbally or in writing. KNOWLEDGE, SKILLS AND ABILITIES: * Bilingual (English/Spanish) preferred. * A high standard of professionalism and professional ethics and conduct is expected in speech, manner, attitude and appearance at all times. * Possess strong interpersonal skills and ability to work well with others. * Well-developed verbal and written communication skills and the ability to work cooperatively with divergent groups * Must possess excellent customer service including verbal and written communication. * Ability to deal effectively with changing situations and stressful environment. * Ability to perform tasks related to physical activity to complete the responsibilities of the position. EXPERIENCE AND EDUCATION: * Possession of a high school diploma or equivalent is required * Two years' work experience in at least one (1) of the following: CHW experience, Community Outreach, Behavioral Health or Substance use Disorder Programs, Community Event Participation, Customer Service, Health Care Coordination, Delivering presentations/trainings to varied audiences or has worked at a health plan organization.
    $28k-41k yearly est. 33d ago
  • Family Practice Physician

    HCA Healthcare 4.5company rating

    HCA Healthcare job in Riverside, CA

    For over 50 years, our team has been dedicated to serving our community with top-quality healthcare. Our team of Doctors, Nurse Practitioners, and Physician Assistants provides comprehensive primary and urgent care services with a strong focus on compassion, excellence, and innovation. We are committed to delivering the highest quality of care in the community, guided by state-of-the-art, evidence-based practices. Our focus on overall wellness and efficient care ensures that our patients receive the best possible outcomes. Compassionate service and accessibility are at the heart of what we do, leading to high patient satisfaction across all our locations. Our dedication extends beyond the clinic. We actively engage with our community through education, charitable efforts, and professional training, ensuring that our impact is felt both inside and outside our doors. Innovation is key to our success, and we continuously embrace new technologies to enhance the care we provide. Integrity, respect, and fairness are the principles that guide our interactions with patients and colleagues alike. We believe in proactive participation in organizational changes, working together towards shared goals with a strong sense of accountability to ourselves and each other. **Qualified Candidates:** As we continue to grow, our team is actively recruiting physicians to join our expanding team. This is your chance to be part of a dynamic, compassionate, and innovative healthcare community that is dedicated to making a difference. **Incentive/Benefits Package:** + Hybrid Scheduling: Includes telemedicine options + Shareholder Opportunities + Flexible Scheduling: Option for weekend hours (not mandated but available for those who prefer alternative working times) + **Full Benefits Package:** + Medical + Dental + Vision + Short-Term Disability (STD) + Long-Term Disability (LTD) + 401(k) Plan with Matching **About Riverside Community Hospital:** Located in the Greater Los Angeles area, Riverside Community Hospital has been a leader in the Inland Empire since 1901. The 542-bed acute care facility specializes in trauma, cancer care, neurosurgery, orthopedics, general surgery, cardiology, stroke intervention and so much more. By combining skilled caregivers with the latest state-of-the-art technology, Riverside Community Hospital delivers world-class healthcare close to home. Riverside Community Hospital is proud to have been named One of the Nation's Top 250 Hospitals three years in a row by Healthgrades. The facility has had multiple expansion projects to be able to continue to provide exceptional care to the community and is one of Riverside County's only STEMI receiving centers. Riverside Community Hospital is a fully accredited Chest Pain Center and DNV Comprehensive Stroke Center, encompassing the full spectrum of stroke care. The hospital is known for providing expert care in the following services: - Level I Trauma Center with helipad, providing access to higher acuity services for the surrounding rural communities up to 200 miles away - Complex and minimally invasive surgical services with robotics including general surgery, orthopedics, neurosurgery, cardiovascular and thoracic, colorectal, gynecology, urology - Comprehensive cardiac services including structural heart, electrophysiology and an advanced cardiogenic program - Extensive women's and children's services; including high-risk OB care and a Level III NICU - Certified joint replacement program and perinatal care program accredited by The Joint Commission - Multi-faceted oncology services with a full care team of specialists - Expert critical care units including surgical, cardiovascular, medical, neonatal and neuro intensive care units for higher level of care - Part of HCA Healthcare, a network of more than 185 hospitals and 2,000 sites of care in 21 states and the United Kingdom - 220 residents in fellows spanning a dozen specialties in HCA Healthcare's largest Graduate Medical Education program - A Top 50 Cardiovascular Hospital by Premier Inc. Riverside, California - located in Southern California and the most populous city in the Inland Empire, Riverside is just 55 miles east of downtown Los Angeles and a 55-minute drive to some of Southern California's most popular beaches. It is known as the birthplace of the California Citrus industry and home to both the famous Mission Inn Hotel and Spa and Mount Rubidoux, a popular attraction providing panoramic views of the city at its summit. Rich in history and outdoor adventures to discover, Riverside allows its residents to take full advantage of all that Southern California has to offer.
    $154k-215k yearly est. 60d+ ago

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