Support Analyst jobs at HCA Healthcare

The Spec, Application Support is tasked with the optimization and management of specified technology. This position will work closely with various vendors, ensuring the most up-to-date information and changes are evaluated for use and effectiveness in the process. Will work with the process team to determine what technology changes and needs are required to drive process improvements. Will own the development and follow through of any service requests or new implementations. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Stays current and has deep, ingrained knowledge of systems, including end user applications, reporting and enhancements. Can demonstrate full understanding of how the technology supports and is used within specific processes and brings technology driven ideas to the process team. * Reviews all ISB's for procedural impact. Edits and works with process leaders and trainers to develop procedural and training documentation. Clarifies system processes and responds to additional requests for information. * Works closely with peers to reduce redundancies and ensure there are no conflicts between multiple technologies within processes. * Ensures that Software Transfer Implementations are completed accurately and develops test plans. Meets user deadlines for system changes and other requested information. * Coordinates with IS to ensure that facility IS departments have the knowledge required to ensure the front-end system is set up appropriately. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. * Understands workflow and technology needs within the business. * Excellent grammar and writing skills * Must have good organizational skills * Able to work independently with little supervision * Able to communicate with all levels of management * Must have general computer skills and be proficient in Word, Excel, and PowerPoint * Excellent working knowledge of Patient Financial Services operations with specific focus on applicable discipline. * Ability to work and coordinate with multiple parties * Ability to manage projects * Knowledge of AR management technology tools being utilized to deliver on key performance * Knowledge of healthcare regulatory rules and how they apply to revenue cycle operations and outsourcing service providers * Excellent verbal and written communication skills EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job. * 4-year college degree in Healthcare Administration, Business or related area or equivalent experience * 2 - 6 years of experience in Healthcare Administration or Business Office * Lean, Six Sigma or other process improvement certification is a plus PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Must be able to work in a sitting position, use computer and answer telephone WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Office Work Environment As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation * Pay: $21.70 - $34.70 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, and life insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * 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, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. #LI-NO3 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. **********

The Specialist, Member & Community Interventions implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid) Executes health plan's member and community quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes. Job Duties Implements evidence-based and data-informed key member intervention strategies, which may include initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state-required quality activities Monitors and ensures that key member intervention activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions Creates, manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables Participates in quality improvement activities, meetings, and discussions with and between other departments within the organization Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations Evaluates project/program activities and results to identify opportunities for improvement Surfaces to the Manager and Director any gaps in processes that may require remediation Demonstrates flexibility when it comes to changes and maintains a positive outlook Other tasks, duties, projects, and programs as assigned This position may require same-day out-of-office travel 0 - 80% of the time, depending upon location This position may require multiple days out-of-town overnight travel on occasion, depending upon location Job Qualifications REQUIRED QUALIFICATIONS: Associate's degree or equivalent combination of education and work experience 1-3 years' experience in healthcare with 1-year experience in health plan quality member interventions, managed care, or equivalent experience Demonstrated solid business writing experience Operational knowledge and experience with Excel and Visio (flow chart equivalent) Excellent problem-solving skills PREFERRED QUALIFICATIONS: Bachelor's Degree in preferred field: Nursing, Social Work, Clinical Quality, Public Health, or Healthcare Administration 1 year of experience in Medicare and in Medicaid managed care Certified Professional in Health Quality (CPHQ) Nursing License (RN may be preferred for specific roles) Certified HEDIS Compliance Auditor (CHCA) 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

**All candidates must be flexible to work Sunday through Saturday, 8am to 8pm, local time, including holidays. (assigned one day off during the week and one day off during the weekend)** Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** - Responsible for owning, handling and resolving complex issues. Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. - Work with coworkers, management, and other departments to help coordinate problem solving in an effective and timely manner. - Provide technical expertise to co-workers and handles elevated escalations. Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. - Provide exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public - Assists agents with questions and escalated contact center communication channels and across multiple states and/or products. Recognizes trends and patterns in call types and engages leadership with suggested solutions. - Accurately documents all contact center communication channels. - Achieves individual performance goals as it relates to call center objectives. - Assists with training needs of employees as needed. - Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE:** 5-7 years **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 7-9 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**All candidates must be flexible to work Sunday through Saturday, 8am to 8pm, local time, including holidays. (assigned one day off during the week and one day off during the weekend)** Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** - Responsible for owning, handling and resolving complex issues. Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. - Work with coworkers, management, and other departments to help coordinate problem solving in an effective and timely manner. - Provide technical expertise to co-workers and handles elevated escalations. Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. - Provide exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public - Assists agents with questions and escalated contact center communication channels and across multiple states and/or products. Recognizes trends and patterns in call types and engages leadership with suggested solutions. - Accurately documents all contact center communication channels. - Achieves individual performance goals as it relates to call center objectives. - Assists with training needs of employees as needed. - Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE:** 5-7 years **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 7-9 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**All candidates must be flexible to work Sunday through Saturday, 8am to 8pm, local time, including holidays. (assigned one day off during the week and one day off during the weekend)** Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** - Responsible for owning, handling and resolving complex issues. Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. - Work with coworkers, management, and other departments to help coordinate problem solving in an effective and timely manner. - Provide technical expertise to co-workers and handles elevated escalations. Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. - Provide exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public - Assists agents with questions and escalated contact center communication channels and across multiple states and/or products. Recognizes trends and patterns in call types and engages leadership with suggested solutions. - Accurately documents all contact center communication channels. - Achieves individual performance goals as it relates to call center objectives. - Assists with training needs of employees as needed. - Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE:** 5-7 years **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 7-9 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**All candidates must be flexible to work Sunday through Saturday, 8am to 8pm, local time, including holidays. (assigned one day off during the week and one day off during the weekend)** Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** - Responsible for owning, handling and resolving complex issues. Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. - Work with coworkers, management, and other departments to help coordinate problem solving in an effective and timely manner. - Provide technical expertise to co-workers and handles elevated escalations. Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. - Provide exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public - Assists agents with questions and escalated contact center communication channels and across multiple states and/or products. Recognizes trends and patterns in call types and engages leadership with suggested solutions. - Accurately documents all contact center communication channels. - Achieves individual performance goals as it relates to call center objectives. - Assists with training needs of employees as needed. - Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE:** 5-7 years **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 7-9 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

The Specialist, Member & Community Interventions implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid) Executes health plan's member and community quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes. **Job Duties** + Implements evidence-based and data-informed key member intervention strategies, which may include initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state-required quality activities + Monitors and ensures that key member intervention activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed + Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions + Creates, manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables + Participates in quality improvement activities, meetings, and discussions with and between other departments within the organization + Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations + Evaluates project/program activities and results to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation + Demonstrates flexibility when it comes to changes and maintains a positive outlook + Other tasks, duties, projects, and programs as assigned + This position may require same-day out-of-office travel 0 - 80% of the time, depending upon location + This position may require multiple days out-of-town overnight travel on occasion, depending upon location **Job Qualifications** **REQUIRED QUALIFICATIONS:** + Associate's degree or equivalent combination of education and work experience + 1-3 years' experience in healthcare with 1-year experience in health plan quality member interventions, managed care, or equivalent experience + Demonstrated solid business writing experience + Operational knowledge and experience with Excel and Visio (flow chart equivalent) + Excellent problem-solving skills **PREFERRED QUALIFICATIONS:** + Bachelor's Degree in preferred field: Nursing, Social Work, Clinical Quality, Public Health, or Healthcare Administration + 1 year of experience in Medicare and in Medicaid managed care + Certified Professional in Health Quality (CPHQ) + Nursing License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) 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: $49,930 - $97,363 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**All candidates must be flexible to work Sunday through Saturday, 8am to 8pm, local time, including holidays. (assigned one day off during the week and one day off during the weekend)** Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** - Responsible for owning, handling and resolving complex issues. Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. - Work with coworkers, management, and other departments to help coordinate problem solving in an effective and timely manner. - Provide technical expertise to co-workers and handles elevated escalations. Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. - Provide exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public - Assists agents with questions and escalated contact center communication channels and across multiple states and/or products. Recognizes trends and patterns in call types and engages leadership with suggested solutions. - Accurately documents all contact center communication channels. - Achieves individual performance goals as it relates to call center objectives. - Assists with training needs of employees as needed. - Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE:** 5-7 years **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 7-9 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**All candidates must be flexible to work Sunday through Saturday, 8am to 8pm, local time, including holidays. (assigned one day off during the week and one day off during the weekend)** Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information, and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** - Responsible for owning, handling and resolving complex issues. Effectively manage escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. - Work with coworkers, management, and other departments to help coordinate problem solving in an effective and timely manner. - Provide technical expertise to co-workers and handles elevated escalations. Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work supporting our Medicaid, Medicare and/or Marketplace business. - Provide exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public - Assists agents with questions and escalated contact center communication channels and across multiple states and/or products. Recognizes trends and patterns in call types and engages leadership with suggested solutions. - Accurately documents all contact center communication channels. - Achieves individual performance goals as it relates to call center objectives. - Assists with training needs of employees as needed. - Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience **REQUIRED EXPERIENCE:** 5-7 years **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 7-9 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Responsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical consultations or account referrals when necessary, * Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations. * Follow specific payer guidelines for appeals submission * Escalate exhausted appeal efforts for resolution * Work payer projects as directed * Research contract terms/interpretation and compile necessary supporting documentation for appeals, Terms & Conditions for Internet enabled Managed Care System (IMaCS) adjudication issues, and referral to refund unit on overpayments. * Perform research and makes determination of corrective actions and takes appropriate steps to code the DCM system and route account appropriately. * Escalate denial or payment variance trends to NIC leadership team for payor escalation. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Intermediate understanding of Explanation of Benefits form (EOB), Managed Care Contracts, Contract Language and Federal and State Requirements * Intermediate knowledge of hospital billing form requirements (UB-04) * Intermediate understanding of ICD-9, HCPCS/CPT coding and medical terminology * Intermediate Microsoft Office (Word, Excel) skills * Advanced business letter writing skills to include correct use of grammar and punctuation. Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. * High School Diploma or equivalent, some college coursework preferred * 3 - 5 years experience in a hospital business environment performing billing and/or collections PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to sit and work at a computer terminal for extended periods of time WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Call Center environment with multiple workstations in close proximity As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $18.60 - $28.00 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status. * Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, and life insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * 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, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. 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. **********

Responsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical consultations or account referrals when necessary, * Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations. * Follow specific payer guidelines for appeals submission * Escalate exhausted appeal efforts for resolution * Work payer projects as directed * Research contract terms/interpretation and compile necessary supporting documentation for appeals, Terms & Conditions for Internet enabled Managed Care System (IMaCS) adjudication issues, and referral to refund unit on overpayments. * Perform research and makes determination of corrective actions and takes appropriate steps to code the DCM system and route account appropriately. * Escalate denial or payment variance trends to NIC leadership team for payor escalation. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Intermediate understanding of Explanation of Benefits form (EOB), Managed Care Contracts, Contract Language and Federal and State Requirements * Intermediate knowledge of hospital billing form requirements (UB-04) * Intermediate understanding of ICD-9, HCPCS/CPT coding and medical terminology * Intermediate Microsoft Office (Word, Excel) skills * Advanced business letter writing skills to include correct use of grammar and punctuation. Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. * High School Diploma or equivalent, some college coursework preferred * 3 - 5 years experience in a hospital business environment performing billing and/or collections PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to sit and work at a computer terminal for extended periods of time WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Call Center environment with multiple workstations in close proximity As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $18.60 - $28.00 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status. * Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, and life insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * 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, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. 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. **********

Responsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical consultations or account referrals when necessary, * Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations. * Follow specific payer guidelines for appeals submission * Escalate exhausted appeal efforts for resolution * Work payer projects as directed * Research contract terms/interpretation and compile necessary supporting documentation for appeals, Terms & Conditions for Internet enabled Managed Care System (IMaCS) adjudication issues, and referral to refund unit on overpayments. * Perform research and makes determination of corrective actions and takes appropriate steps to code the DCM system and route account appropriately. * Escalate denial or payment variance trends to NIC leadership team for payor escalation. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Intermediate understanding of Explanation of Benefits form (EOB), Managed Care Contracts, Contract Language and Federal and State Requirements * Intermediate knowledge of hospital billing form requirements (UB-04) * Intermediate understanding of ICD-9, HCPCS/CPT coding and medical terminology * Intermediate Microsoft Office (Word, Excel) skills * Advanced business letter writing skills to include correct use of grammar and punctuation. Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. * High School Diploma or equivalent, some college coursework preferred * 3 - 5 years experience in a hospital business environment performing billing and/or collections PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to sit and work at a computer terminal for extended periods of time WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Call Center environment with multiple workstations in close proximity As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $18.60 - $28.00 per hour. Compensation depends on location, qualifications, and experience. * Position may be eligible for a signing bonus for qualified new hires, subject to employment status. * Conifer observed holidays receive time and a half. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, and life insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * 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, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. 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. **********

The Specialist, Member & Community Interventions implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid) Executes health plan's member and community quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes. **Job Duties** + Implements evidence-based and data-informed key member intervention strategies, which may include initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state-required quality activities + Monitors and ensures that key member intervention activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed + Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions + Creates, manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables + Participates in quality improvement activities, meetings, and discussions with and between other departments within the organization + Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations + Evaluates project/program activities and results to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation + Demonstrates flexibility when it comes to changes and maintains a positive outlook + Other tasks, duties, projects, and programs as assigned + This position may require same-day out-of-office travel 0 - 80% of the time, depending upon location + This position may require multiple days out-of-town overnight travel on occasion, depending upon location **Job Qualifications** **REQUIRED QUALIFICATIONS:** + Associate's degree or equivalent combination of education and work experience + 1-3 years' experience in healthcare with 1-year experience in health plan quality member interventions, managed care, or equivalent experience + Demonstrated solid business writing experience + Operational knowledge and experience with Excel and Visio (flow chart equivalent) + Excellent problem-solving skills **PREFERRED QUALIFICATIONS:** + Bachelor's Degree in preferred field: Nursing, Social Work, Clinical Quality, Public Health, or Healthcare Administration + 1 year of experience in Medicare and in Medicaid managed care + Certified Professional in Health Quality (CPHQ) + Nursing License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) 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: $49,930 - $97,363 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

CHSPSC, LLC seeks an IT Application Portfolio Management analyst to assist with governing application submissions into ServiceNow, developing data stewards, and contributing to application decision management. The role will be engaged with various governance teams, building process documents, communicating across the organization, and reporting various outcomes. Key responsibilities include: Manage the structure, attributes, taxonomies and nomenclature of service line elements and categories within the repository toolset (ServiceNow) to ensure completeness and accuracy of the list of enterprise IT business applications Govern submitted application requests into ServiceNow Develop data steward processes to maintain application portfolio Assist in developing data governance processes with application records Educate peers and business partners on department methodologies and drive adoption of standard process via a developed process guide Develop certification processes for the application records Provide expertise on decisions and priorities regarding the overall enterprise application portfolio Develop reports showcasing status, decisions, and plans Participate in various governance meetings Support executive leadership application updates Support strategic analysis of the enterprise application portfolio including lifecycle management, application rationalization, consolidation and standardization to achieve the department objectives of the organization including reducing variation of redundant or unused applications Understand the data driven decisions pertaining to IT project investments Collaborate with business partners, technology leaders and department directors to identify and promote adoption of enterprise standards and rationalization of application systems to achieve economic and patient experience improvement goals Participate in application rationalization feasibility analysis and proposals for management and business partners which support the organization's clinical and economic objectives Review and support applications' advantages, risks, costs, benefits and impact on the enterprise business process and goals Collaborate with Audit teams to respond to and mitigate audit findings and manage audit controls related to application systems registered in ServiceNow Support and evaluate portfolio risks and recommend mitigation plans Support business impact analysis and application criticality assessments Communicate timely and accurate status to appropriate levels and stakeholders including the development and delivery of status reports and presentations Required: ServiceNow Enterprise Architecture/Application Portfolio Management knowledge ServiceNow CMDB and CSDM components within the ServiceNow platform Lifecycle management understanding Results oriented mentality to drive accurate deliverables with appropriate time to market while taking responsibility for the outcomes Customer focused to align services with customer needs Creativity in developing and executing innovative strategies to meet unique customer needs Excellent verbal and written communication, presentation and customer service skills Ability to handle pressure to meet business requirement demands and deadlines Expertise in analyzing and presenting large volumes of data to senior leadership Critical thinking in developing proposals with sound analysis and achievable outcomes Ability to prioritize tasks and quickly adjust in a rapidly changing environment Exceptional analytic problem solving skills Ability to work independently and in a team environment Organizational awareness and the ability to understand relationships to get things accomplished more effectively Preferred: Application product ownership experience Strong relationship management experience Project management experience/certification 2 or more years in an application portfolio/services management role Lean / Six Sigma Green Belt Qualifications and Education Requirements: Bachelor's degree in Clinical Informatics, Health Science, Information Systems, Computer Science or a related discipline, or 2 years of relevant experience ServiceNow certifications ITIL certifications

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.

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.

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.

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.

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.