Charge Nurse Acute Care
HCA Florida Northside Hospital job in Saint Petersburg, FL
**Sign-on bonus available**
Introduction
Are you looking for a place to deliver excellent care patients deserve? At HCA Florida Northside Hospital we support our colleagues in their positions. Join our Team as a(an) Charge Nurse Med Surg and access programs to assist with every stage of your career.
Benefits
HCA Florida Northside 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.
Are you a continuous learner? With more than 94,000 nurses throughout HCA Healthcare, we are one of the largest employers of nurses in the United States. Education is key to excellence! As a majority owner of Galen College of Nursing, which joins Research College of Nursing and Mercy School of Nursing as educational facilities within the HCA Healthcare family, we make it easier and more affordable to gain certifications and job skills. Apply today for our Charge Nurse Med Surg opening and continue to learn!
Job Summary and Qualifications
The Clinical Nurse Coordinator (CNC) ensures and delivers high quality, patient-centered care and coordination of all functions in the unit/department during the designated shift. In collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization's vision/mission/values to support an unparalleled patient experience and clinical outcomes that contribute to overall departmental performance.
What you will do in this role:
Assists with admission and discharge processes to ensure efficient throughput and high quality, patient-centered care.
Participates in the ongoing assessment of the quality of patient care services provided in the unit, in collaboration with other members of the management team.
Collaborates with subject matter experts and other managers to create an environment of teamwork that supports improved outcomes and service.
Supports a patient-first philosophy and engages in service recovery when necessary.
Supports the efforts of the facility to improve engagement by operationalizing current nursing strategies, including employee rounding, hourly rounds, and other initiatives.
Provides recommendations related to interviewing, selecting, and training new staff. Recommends and implements courses of action, including training and development, conflict resolution, personnel policy compliance, completion of performance evaluations, and/or disciplinary actions to ensure a competitively better organization.
Assists with staff scheduling. Manages all practical aspects of staff labor in accordance with patient care needs and established productivity guidelines.
Supports proper inventory control and assists with managing supplies and equipment.
What qualifications you will need:
Advanced Cardiac Life Spt must be obtained within 30 days of employment start date
Basic Cardiac Life Support must be obtained within 30 days of employment start date
Registered Nurse
Bachelors Degree, or Associate Degree
Northside Hospital is a 280+ bed facility offering state-of-the-art treatment. We are located in the heart of South Pinellas County. We're minutes from the pristine Gulf Coast beaches and downtown St. Petersburg, FL. Our facility offers a full range of services. These include interventional stroke care, and spine care. These also include orthopedics, 24-hour emergency services, cardiac care and general surgery. We are the first nationally recognized Comprehensive Stroke Center in Pinellas County. Northside Hospital is proud of our recognition as an Accredited Chest Pain Center with PCI. We are an American College of Radiology Accredited facility. We are a Top Performer on Key Quality Measures. The Tampa Bay Heart Institute at Northside Hospital is a comprehensive cardiac care center. Our heart program is widely known for introducing new procedures. The team at Northside Hospital continues to expand its services. We strive to give the St. Petersburg community a healthier tomorrow.
HCA Healthcare has been named one of the World's Most Ethical Companies by Ethisphere Institute for ten consecutive years (2010-2019). In 2019, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If growth and continued learning is important to you, we encourage you to apply for our Charge Nurse Med Surg opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. Unlock the possibilities 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.
Clinical Support Resource RN
HCA Florida St. Petersburg Hospital job in Saint Petersburg, FL
Introduction
Do you have the career opportunities as a Clinical Nurse Coordinator RN you want in your current role? We invest in what matters most to nurses like you - at home, at work, and at every stage in your career. We have an exciting opportunity for you to join HCA Florida St. Petersburg Hospital which is a part of the nation's leading provider of healthcare services, HCA Healthcare.
Do you want to work where you have a voice? Nurses are at the forefront of our commitment to the care and improvement of human life. At HCA Healthcare, there are many ways for nurses to have a voice through professional practice councils, advisory councils, vital voices surveys, and units of distinction. We learn from our multi-generational nursing family. We partner with our Nurses at HCA Florida St. Petersburg Hospital!
Job Summary and Qualifications
We are seeking Medical Surgical Resource Nurse to support high-quality, patient-centered care by offering feedback, guidance, and mentoring to new graduate nurses and/or nurses who are transitioning to a new specialty. The Resource Nurse will support multiple units. You will provide guidance and education on the hospital's standard of nursing practice, policies, and procedures to ensure compliance with all accrediting and regulatory agency requirements.
We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply now.
What you will do in this role:
Perform rounds on each nursing unit, by continuously observing, assessing the quality of patient care, and identifying nursing educational needs. Escalates concerns about nursing skills, patient care, policies, processes, and equipment as appropriate.
Utilizes skills of observation. Provides feedback on nursing assessments, nursing diagnosis, planning, intervention, and evaluation of patient care.
Provides feedback and mentoring on patient assessments and care planning.
Assists with performing or troubleshooting specific skills.
Maintains IMobile phone for easy contact by new graduates or nurses within the scope of support.
Tracks request to identify the most commonly requested skills for purposes or enhancing orientation and education.
Fosters teamwork and contributes to the achievement of team goals.
Attends Rapid Response and codes as needed, to observe, provide feedback and debrief, and facilitate education, direction, and coaching before, during, and after the Rapid Response or code as indicated.
Shares knowledge/expertise and assists coworkers.
Requirements:
Must be licensed as a Florida Registered Nurse by state regulations or appropriate compact licensure. If a compact license is held, an active FL RN license is required within 60 days of hire.
Nursing Diploma or ASN required; BSN preferred.
More than two years as an RN is required.
More than one year as a Preceptor is preferred.
More than one year in a leadership role is preferred.
Previous experience in an acute care setting is strongly preferred.
Current American Heart Association BLS (Basic Life Support) certification is required.
American Heart Association ACLS (Advanced Cardiac Life Support) certification is required.
American Heart Association PALS (Pediatric Advanced Life Support) and/or ENPC (Emergency Nurse Pediatric Course) certifications is required.
Current NIHSS (National Institute of Health Stroke Scale) certification is required.
Critical thinking, service excellence and good interpersonal communication skills, ability to read/comprehend written instructions, ability to follow verbal instructions, PC skills.
Benefits
HCA Florida St. Petersburg Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
Wellbeing support, including free counseling and referral services
Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
"Nurses play a pivotal role and are the backbone of healthcare delivery. At HCA Healthcare, we are dedicated to ensuring nurses have necessary tools and resources to provide world-class patient care, advocating for the profession and helping to shape the future of nursing."
Sammie Mosier, DHA, MA, BSN, NE-BC
Senior Vice President and Chief Nursing Executive, HCA Healthcare
HCA Florida St. Petersburg Hospital is a 215 bed acute care hospital. We are Joint Commission accredited. We provide emergency, diagnostic, medical and surgical services. We have women's services that include labor and delivery, post-partum and nursery. We are an accredited advanced primary stroke center and chest pain center. We are a certified atrial fibrillation center and an accredited community cancer center. We are the women's choice award for best emergency care for the 4th year in a row. We are a blue distinction center+ for maternity care and are accredited as a breast center with digital imaging and computer aided detection. We are a GYN robotic surgery training epicenter. We have a pelvic pain and incontinence center and an orthopedic center for join replacement and spine surgery. We are located in Pinellas County. St. Petersburg is growing and offers nightlife and outdoor activities. Our hospital has ranked as a top work place by the Tampa Bay Times. We hope you'll consider our careers at HCA Florida St. Petersburg Hospital.
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.
If this opportunity is your next step in your career path, we encourage you to apply for our Clinical Nurse Coordinator RN opening. We review all applications. Qualified candidates will be contacted by a member of our team.
We are interviewing 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.
Registered Nurse RN OR First Assist
HCA Florida Northside Hospital job in Saint Petersburg, FL
Introduction
Do you currently have an opportunity to make a real impact with your work? With over 2,000 sites of care and serving over 31.2 million patient interactions every year, nurses at HCA Florida Northside Hospital have the opportunity to make a real impact. As a(an) Registered Nurse RN OR First Assist you can be a part of change.
Benefits
HCA Florida Northside 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.
It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential and see how rewarding it can be to reach your personal and professional goals. Help to advance the practice of nursing and improve positive outcomes for your patients as a (an) Registered Nurse RN OR First Assist. We want your knowledge and expertise!
Job Summary and Qualifications
We are seeking an Operating Room First Assistant Registered Nurse. You will provide clinical expertise to ensure all patients receive high quality, efficient care in a surgical environment. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply now.
What you will do in this role:
You will assess, plan, intervene and evaluate the care of intra-operative patients.
You will assist surgeons in operative procedures patients.
You will maintain and review patients' records including posting tests and examination results.
You will administer medications in accordance with physician orders.
Requirements:
Must be licensed as a Florida Registered Nurse or ARNP in accordance with state regulations or appropriate compact licensure. If compact license held, active FL RN license required within 60 days of hire.
Graduate of an accredited by CAAHEP (Commission on Accreditation of Allied Health Education Programs) and the State of Florida Surgical Assistant Program, or Medical School Graduate, or Allied Health professional having completed 2250 hours surgical rotation.
Current Certified First Assistant (CFA) having completed 350 cases. Two years of experience within the last four years.
Current American Heart Association BLS (Basic Life Support) certification required.
Current Certification as First Assistant (CFA) required.
Critical thinking, service excellence and good interpersonal communication skills, ability to read/comprehend written instructions, ability to follow verbal instructions, PC skills
Northside Hospital is a 280+ bed facility offering state-of-the-art treatment. We are located in the heart of South Pinellas County. We're minutes from the pristine Gulf Coast beaches and downtown St. Petersburg, FL. Our facility offers a full range of services. These include interventional stroke care, and spine care. These also include orthopedics, 24-hour emergency services, cardiac care and general surgery. We are the first nationally recognized Comprehensive Stroke Center in Pinellas County. Northside Hospital is proud of our recognition as an Accredited Chest Pain Center with PCI. We are an American College of Radiology Accredited facility. We are a Top Performer on Key Quality Measures. The Tampa Bay Heart Institute at Northside Hospital is a comprehensive cardiac care center. Our heart program is widely known for introducing new procedures. The team at Northside Hospital continues to expand its services. We strive to give the St. Petersburg community a healthier tomorrow.
HCA Healthcare has been named one of the World's Most Ethical Companies by Ethisphere Institute for ten consecutive years (2010-2019). In 2019, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
Be a part of an organization that leverages our size to make a real impact in our industry! Our Talent Acquisition team is reviewing applications for our Registered Nurse RN OR First Assist opening. Submit your application today and help advance the practice of nursing.
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.
Care Manager - Multiple Openings in FL (RN, LBSW, LLMSW, LMSW)
Saint Petersburg, FL job
Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments.
• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• Collaborates with licensed care managers/leadership as needed or required.
• 25- 40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
Preferred Qualifications
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
#PJHS
#HTF
Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Adjudicator, Provider Claims
Saint Petersburg, FL 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.
Supervisor, Healthcare Services Operations Support
Saint Petersburg, FL 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.
Associate Specialist, Provider Contracts HP
Saint Petersburg, FL 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.
Care Review Clinician (RN)
Saint Petersburg, FL job
Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - 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
• Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
• Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
• Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
• Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
• Processes requests within required timelines.
• Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
• Requests additional information from members or providers as needed.
• Makes appropriate referrals to other clinical programs.
• Collaborates with multidisciplinary teams to promote the Molina care model.
• Adheres to utilization management (UM) policies and procedures.
Required Qualifications
• At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Ability to prioritize and manage multiple deadlines.
• Excellent organizational, problem-solving and critical-thinking skills.
• Strong written and verbal communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Certified Professional in Healthcare Management (CPHM).
• Recent hospital experience in an intensive care unit (ICU) or emergency room.
Preferred Experience
Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
MULTI STATE / COMPACT LICENSURE
Individual state licensures which are not part of the compact states are required for: CA, NV, IL, NY and MI
WORK SCHEDULE: Tues - Sat shift will rotate with some holidays.
Training will be held Mon - Fri
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
QNXT Configuration Analyst
Saint Petersburg, FL 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.
Pay Range: $77,969 - $116,835 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Associate Analyst, Clinical Informatics (Bilingual in Spanish Required) - Monday - Friday 7AM - 4PM PST (REMOTE)
Saint Petersburg, FL job
Provides entry level analyst support for clinical information systems activities. Responsible for provision of application technical support and design for clinical information systems - ensuring creation of workflows and enhancements that support process improvement and change management initiatives. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Assists in the development and support of clinical, practice management and operational workflows.
- Assists in the design of workflow analysis, device integration, planning and implementation of clinical systems.
- Participates in the system implementation life cycle including: planning, implementation, training, and post-implementation support.
- Assists in issue resolution related to the clinical information system.
Required Qualifications
- At least 1 year of system implementation experience, or equivalent combination of relevant education and experience.
- Knowledge of systems design methods and techniques.
- Knowledge base in health care informatics.
- Ability to work independently, within a team and collaboratively across teams.
- Analysis, synthesis and problem-solving skills.
- Attention to detail and accuracy.
- Multi-tasking, planning, and workload prioritization skills.
- Verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) 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 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Corporate Development Manager
Tampa, FL 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.
Per Diem / PRN Ultrasound Technologist - $51 per hour
Bradenton, FL job
HealthTrust Workforce Solutions Local is seeking a per diem / prn Ultrasound Technologist for a per diem / prn job in West Bradenton, Florida. Job Description & Requirements Specialty: Ultrasound Technologist Discipline: Allied Health Professional Duration:
Ongoing
Employment Type:
Per Diem
Posted rates reflects the maximum rate, including night and weekend shift differentials
Entrust Your Career to HealthTrust!
At HealthTrust, we believe that healthcare is not defined by the four walls in which it is practiced; it's defined by its people. We pride ourselves on crafting opportunities that expand skill sets, broaden career horizons, provide economic stability, and cultivate personal growth.
HealthTrust Offers:
Getting to know HCA facilities within 50mi of home zip code
Self scheduling through our Mobile GO HWS App
Minimum of just three shifts a month, however, you can work more!
401K Matching
Weekly pay every Friday
Not required to work weekends
Not Required to work holidays
To get started, you will need:
RN's a minimum of 1 year in specialty
Allied 6 months of experience
An adventurous spirit and fierce dedication
Degree in corresponding specialty as required
Appropriate certifications for the specific position
HealthTrust Benefits:
Opportunities for a lifetime: When you become a part of the HCA family, you will have exclusive access to more opportunities than any other healthcare system in the nation. At HWS, we help open the door to a lifetime of lasting career opportunities.
A culture of care: Our clinicians have made HWS an industry leader for over 25 years. We are passionate about our mission that, above all else, we are committed to the care and improvement of human life.
Career Development: As a wholly owned subsidiary of HCA Healthcare, HWS is a preferred partner to thousands of top-performing hospitals. We provide our healthcare professionals with first-priority access to more than 200,000 jobs nationwide. We are uniquely positioned to offer you exclusive and direct access to HCA Healthcare's vast network of facilities. Let us open the door to nationwide opportunities that fit your lifestyle!
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Job Requirements
Certifications
ARDMS (Required)
BLS (Required)
HealthTrust Workforce Solutions Per Diem Job ID #784937. Posted job title: Per Diem Ultrasound Technologist - Cardio Sonographer (General)
Medical Director, Behavioral Health
Tampa, FL 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.
Rad Tech - Interventional Radiology
Bradenton, FL job
Job Title:Rad Tech,BACKFILL TRAVEL- IR TECH (727) - 8A-4:30, City: Bradenton, State: Florida, Estimated Start Date:07/29/2025, Shift:5 x 8 Hour Day Shift, 07:00:00-15:00:00, 8.00-5, Length of Contract (Days) : 91, Estimated Gross Pay: 0.00
Convergence Medical Staffing is known for transparent communication, quick response, and personable service that helps travelers meet their professional and personal goals - contract after contract. The Convergence Medical Staffing Mobile App enables our travelers to search for jobs as well as upload and manage needed information quickly and simply, thus allowing for speedy submittal to facilities. Travelers find our online credentialing straightforward and easy to navigate. We offer Major Medical Insurance on day one of an assignment and supplemental dental, vision, short and long-term disability, and life insurance. Travelers are paid accurately through weekly direct deposit. We also offer a lucrative Referral Bonus Program and other bonus opportunities. For more details on this position or to inquire about additional jobs email **************** or call ************. You can download the Convergence Medical Staffing Mobile App for free.
RN Same Day Surgery Phase II Recovery
HCA Florida Northside Hospital job in Saint Petersburg, FL
Introduction
Do you want to be appreciated daily? Our nurses are celebrated for being on the front line, empathetic for patients. At HCA Florida Northside Hospital our nurses set us apart from any other healthcare provider. We are seeking a(an) RN Same Day Surgery Phase II Recovery to join our healthcare family.
Benefits
HCA Florida Northside 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.
At HCA Florida Northside Hospital, our nurses play a vital part. We know that every nurse's path and purpose is unique. Do you want to create your own personal career path in nursing? HCA Healthcare is your career destination! Our scale makes it possible for nurses to create the career path that fits their life - for life - and empowers their passion for patient care. Apply today for our RN Same Day Surgery Phase II Recovery opportunity.
Job Summary and Qualifications
We are seeking a Same Day Surgery Registered Nurse to join our Surgical Services Department. You will provide clinical expertise to ensure all patients receive high quality, efficient care in a surgical environment. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply now.
What you will do in this role:
You will assess, plan, intervene and evaluate the care of intra-operative patients.
You will assist surgeons in operative procedures patients.
You will maintain and review patients' records including posting tests and examination results.
You will administer medications in accordance with physician orders.
Requirements:
Must be licensed as a Florida Registered Nurse in accordance with state regulations or appropriate compact licensure. If compact license held, active FL RN license required within 60 days of hire.
Nursing Diploma or ASN required; BSN preferred.
Previous experience in an acute care setting strongly preferred.
Current American Heart Association BLS (Basic Life Support) certification required.
Critical thinking, service excellence and good interpersonal communication skills, ability to read/comprehend written instructions, ability to follow verbal instructions, PC skills
Northside Hospital is a 280+ bed facility offering state-of-the-art treatment. We are located in the heart of South Pinellas County. We're minutes from the pristine Gulf Coast beaches and downtown St. Petersburg, FL. Our facility offers a full range of services. These include interventional stroke care, and spine care. These also include orthopedics, 24-hour emergency services, cardiac care and general surgery. We are the first nationally recognized Comprehensive Stroke Center in Pinellas County. Northside Hospital is proud of our recognition as an Accredited Chest Pain Center with PCI. We are an American College of Radiology Accredited facility. We are a Top Performer on Key Quality Measures. The Tampa Bay Heart Institute at Northside Hospital is a comprehensive cardiac care center. Our heart program is widely known for introducing new procedures. The team at Northside Hospital continues to expand its services. We strive to give the St. Petersburg community a healthier tomorrow.
HCA Healthcare has been named one of the World's Most Ethical Companies by Ethisphere Institute for ten consecutive years (2010-2019). In 2019, 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
Join a family that cares about every stage in your career! We are interviewing candidates for our RN Same Day Surgery Phase II Recovery opening. Apply today and a member of our Talent Acquisition team will reach out.
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.
Supervisor, Healthcare Services Operations Support
Saint Petersburg, FL 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.
QNXT Configuration Analyst
Tampa, FL 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.
Pay Range: $77,969 - $116,835 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Associate Specialist, Provider Contracts HP
Tampa, FL 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.
ECHO Tech - Echocardiology
Bradenton, FL job
Job Title:ECHO Tech,TRAVEL ECHO TECH CARDIOLOGY (750) - 7A-5:30P, City: Bradenton, State: Florida, Estimated Start Date:11/25/2025, Shift:4 x 10 Hour Day Shift, 07:00:00-17:00:00, 10.00-4, Length of Contract (Days) : 91, Estimated Gross Pay: 0.00
Convergence Medical Staffing is known for transparent communication, quick response, and personable service that helps travelers meet their professional and personal goals - contract after contract. The Convergence Medical Staffing Mobile App enables our travelers to search for jobs as well as upload and manage needed information quickly and simply, thus allowing for speedy submittal to facilities. Travelers find our online credentialing straightforward and easy to navigate. We offer Major Medical Insurance on day one of an assignment and supplemental dental, vision, short and long-term disability, and life insurance. Travelers are paid accurately through weekly direct deposit. We also offer a lucrative Referral Bonus Program and other bonus opportunities. For more details on this position or to inquire about additional jobs email **************** or call ************. You can download the Convergence Medical Staffing Mobile App for free.
Care Review Clinician (RN)
Tampa, FL job
Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - 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
• Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
• Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
• Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
• Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
• Processes requests within required timelines.
• Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
• Requests additional information from members or providers as needed.
• Makes appropriate referrals to other clinical programs.
• Collaborates with multidisciplinary teams to promote the Molina care model.
• Adheres to utilization management (UM) policies and procedures.
Required Qualifications
• At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Ability to prioritize and manage multiple deadlines.
• Excellent organizational, problem-solving and critical-thinking skills.
• Strong written and verbal communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Certified Professional in Healthcare Management (CPHM).
• Recent hospital experience in an intensive care unit (ICU) or emergency room.
Preferred Experience
Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
MULTI STATE / COMPACT LICENSURE
Individual state licensures which are not part of the compact states are required for: CA, NV, IL, NY and MI
WORK SCHEDULE: Tues - Sat shift will rotate with some holidays.
Training will be held Mon - Fri
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: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.