Health Management Associates jobs - 87 jobs

Wakely, an HMA company, is seeking a highly motivated Risk Adjustment Consultant with hands-on experience supporting or leading health plan operations in both ACA and Medicare Advantage (MA). This role will be instrumental in managing client engagements, coordinating internal teams, driving strategic initiatives, and contributing to the continued growth of Wakely's risk adjustment service offerings. The ideal candidate combines operational expertise, strong communication skills, and the ability to translate complex concepts into clear, actionable insights for clients. Key Responsibilities: Client Leadership & Communication: Serve as a primary point of contact for clients, collaborating with actuarial, coding, data, and operational experts to synthesize complex analyses and communicate them clearly. Project & Workflow Management: Develop, manage, and execute project timelines to ensure high-quality, on-time deliverables across multiple engagements. Product & Tool Proficiency: Learn and apply Wakely tools, products, and methodologies to support client needs and internal initiatives. Business Development Support: Assist with new business opportunities including RFP responses, proposal development, and strategic scoping discussions. Risk Adjustment Operations Oversight: Help guide and manage activities across the risk adjustment ecosystem, including coding operations, provider education, and operational assessments. Cross-Functional Collaboration: Partner closely with internal actuarial, coding, operations, and data engineering teams to deliver integrated and comprehensive client solutions. What We're Looking For: Deep experience supporting or leading ACA and MA risk adjustment operations within a health plan or consulting environment. Strong understanding of the full risk adjustment lifecycle, including coding, submissions, analytics, provider engagement, and regulatory requirements. Strategic mindset with the ability to anticipate market or regulatory changes and turn them into actionable client strategies. Ability to build trust, foster strong client relationships, and develop a professional network. Passion for developing team members through mentoring, guidance, and knowledge-sharing. Excellent written and verbal communication skills, with proven success working across cross-functional teams. Job Summary The Consultant I is responsible for providing analytical support and consulting services to clients. This role involves performing data analysis, developing financial models, and assisting in the design and implementation of healthcare strategies. The Consultant I will work closely with senior actuarial staff and clients to deliver actionable insights that support the client's business objectives. Responsibilities Work Performed and Job Requirements Data Analysis and Modeling: Conduct detailed data analysis to support client projects, including claims data, healthcare utilization, and cost projections. Develop and maintain financial models to assess the impact of various healthcare strategies, policies, and programs. Perform risk assessments and support the development of pricing strategies for healthcare products. Client Management: Collaborate with senior consultants and actuarial staff to understand client needs and objectives. Assist in the development of recommendations and solutions that address client-specific challenges. Prepare and present reports, presentations, and other deliverables that effectively communicate findings and recommendations to clients. Project Support: Participate in the design and implementation of client projects, ensuring that all work is completed on time and meets quality standards. Support project management activities, including tracking progress, managing timelines, and coordinating with other team members. Assist in the preparation of proposals, project plans, and other project-related documentation. Healthcare Industry Knowledge: Stay informed about industry trends, regulatory changes, and emerging issues in the healthcare sector. Apply industry knowledge to client projects, ensuring that recommendations are relevant and timely. Support internal knowledge sharing by contributing to team discussions and training sessions. Collaboration and Communication: Work closely with actuarial analysts, senior consultants, and other team members to ensure a collaborative approach to client projects. Communicate effectively with internal and external stakeholders, ensuring that project objectives and deliverables are clearly understood. Contribute to the development of client relationships through professionalism and a strong understanding of client needs. All other duties as assigned. Qualifications Education/Training Minimum of a bachelor's degree in mathematics, statistics, economics, actuarial science, or a related field required. Experience Minimum of 2 years of experience healthcare consulting, actuarial analysis, or a related field required. Knowledge, Skills and Abilities Strong analytical skills, with experience in data analysis, financial modeling, and risk assessment. Proficiency in Excel and experience with actuarial software or data analysis tools (e.g., SAS, R, SQL) is preferred. Solid understanding of healthcare industry trends, regulations, and financial principles. Excellent written and verbal communication skills, with the ability to present complex information clearly and effectively. Strong problem-solving abilities and attention to detail. Ability to work independently and as part of a team in a fast-paced, dynamic environment. EEO Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c) Additional Info #LI-BR1

The Quality Coordinator-Transitions of Care is dedicated to managing quality assurance processes and ensuring compliance with industry standards. This role involves coordinating with various departments to integrate quality systems, facilitating continuous improvement initiatives, and maintaining comprehensive documentation to support assessments and audits. The Quality Coordinator plays a crucial role in fostering a culture of quality and excellence within the organization, driving efforts to meet and exceed quality targets. Essential Functions Implements and monitors quality improvement initiatives to ensure adherence to best practices, policies, and regulatory requirements. Supports teams as a subject matter expert on quality-related workflows, ensuring staff adherence to established procedures. Coordinates and tracks patient outreach efforts to close gaps in care, ensuring timely follow-up on quality attribution reports. Optimizes provider schedules by ensuring appointments address preventive care and chronic disease management gaps. Monitors and analyzes key performance indicators (KPIs) related to quality measures, providing feedback and accountability to stakeholders. Conducts regular rounding with providers and staff to reinforce best practices and identify workflow improvement opportunities. Assists in medical record audits, ensuring compliance with payer requirements and timely submission of quality-related documentation. Facilitates training sessions and provides ongoing support to enhance staff competency in quality care initiatives. Collaborates with data analytics and population health teams to ensure accurate reporting and performance tracking. Maintains compliance with all payer-specific quality programs, ensuring proper documentation and adherence to incentive program requirements. Performs other duties as assigned. Complies with all policies and standards. Qualifications Associate Degree in Healthcare Administration, Nursing, Public Health, or a related field required Bachelor's Degree in Nursing or a related field preferred 2-4 years of experience in quality improvement, population health, or clinical operations within a healthcare setting required Experience in working with payer quality programs and regulatory reporting preferred Knowledge, Skills and Abilities Strong knowledge of quality improvement methodologies and healthcare regulatory requirements. Proficiency in electronic medical records (EMR) systems and quality reporting tools. Excellent communication and interpersonal skills to collaborate effectively with providers, staff, and leadership. Ability to analyze data, identify trends, and develop action plans for performance improvement. Strong organizational skills and attention to detail to ensure compliance with quality initiatives. Ability to adapt to evolving healthcare regulations and payer requirements. Strong problem-solving skills and the ability to drive accountability in a healthcare setting. Licenses and Certifications Certified Medical Assistant (CMA)-AAMA preferred or LPN - Licensed Practical Nurse - State Licensure preferred or RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred CPHQ - Certified Professional in Healthcare Quality preferred

The Insurance Verification Representative is responsible for verifying insurance benefits, eligibility, and authorization requirements to ensure accurate billing and reimbursement for procedures and services. This role interacts with physician offices, patients, and internal departments to coordinate insurance approvals, obtain necessary referrals and authorizations, and communicate patient financial responsibilities. The Insurance Verification Representative ensures compliance with payer guidelines and facilitates a smooth scheduling and billing process for patients. This is a REMOTE position Essential Functions Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients to ensure coverage and minimize claim denials. Confirms that the correct insurance package has been loaded into the patient's chart and updates records as needed. Reviews provider schedules in the electronic medical record system to obtain referrals for HMO patients and authorizations for procedures and radiology testing. Works with hospital radiology and scheduling teams to ensure all necessary authorizations are secured for upcoming procedures. Reviews the authorization/referral list in the patient financial system (e.g., Athena) and attaches required authorizations and referrals to pending appointments. Utilizes financial and scheduling systems to generate authorizations, verify patient coverage, and ensure all necessary approvals are documented. Tracks and monitors authorizations and referrals, ensuring compliance with benchmark data and payer requirements. Coordinates with physician offices to resolve issues related to pre-determinations and authorization delays. Contacts patients in advance of procedures to notify them of estimated financial responsibility and available payment options. Assists and provides backup support for other business office positions as needed. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications H.S. Diploma or GED required Associate Degree in Healthcare Administration, Business, or a related field preferred 1-2 years of experience in insurance verification, patient access, medical billing, or healthcare financial services required Experience working with electronic medical records (EMR), patient scheduling systems, and insurance payer portals. preferred Knowledge, Skills and Abilities Strong understanding of insurance verification processes, medical benefit plans, and payer authorization requirements. Knowledge of healthcare reimbursement practices, including prior authorization and referral processes. Proficiency in electronic medical records (EMR), financial systems, and patient scheduling software. Excellent communication and customer service skills to interact professionally with patients, physician offices, and payers. Strong attention to detail to ensure accuracy in insurance verification and documentation. Ability to work independently and prioritize tasks in a fast-paced environment. Knowledge of HIPAA regulations and patient confidentiality requirements.

Wakely is seeking a Consulting Actuary with expertise in ACA risk adjustment in both analytics and operations. This individual will play a key role in leading client engagements, managing internal workflows across various teams, strategic planning with senior leaders, and mentoring the next generation of analysts. Key Responsibilities: Lead and manage client communication, working with multiple experts including non-actuarial staff to piece together and explain complex concepts in a clear and concise manner to clients Manage timeliness of project deliverables by creating, updating, and executing project timelines Delegate and train junior staff on performing actuarial analysis as it relates to risk adjustment operations Learn Wakely Tools and Products Assist with business development opportunities, such as responding to Request-For-Proposals (RFPs) Train analysts on risk adjustment modeling including but not limited to risk adjustment transfer calculations, and review analysts work product Collaborate across internal teams, such as ACA pricing actuaries, to deliver integrated, forward-thinking solutions What We're Looking For: Demonstrated experience with ACA risk adjustment operations and accrual setting Strong technical expertise in claims analysis, risk adjustment, and analytics modeling. Strategic thinker who anticipates market and regulatory changes and translates them into actionable client strategies. Ability and interest to build trust with clients and grow personal network. Passion for mentoring and developing actuarial talent. Excellent communication skills and ability to work effectively across cross-functional teams. Job Summary A Consulting Actuary II is responsible for supporting the Wakely's strategic growth by learning about new business development and product opportunities. In addition, the position will work to effectively apply the principles of project management and client relations. Responsibilities Work Performed and Job Requirements Client Management - Maintain Client Relationships Foster opportunities to promote Wakely tools, services, and products. Implement a strategic plan consistent to client needs. Increase client interaction skills by partnering with client lead on key initiatives. Identify and implement changes to avoid potential compliance risk. Project Management - Manage Project According to Defined Plan Create and communicate a project plan to include scope, goals, timelines, and billed hours. Manage, adjust, and communicate plan internally/externally throughout project. Deliver high quality work (conceptual & technical) within budget and timeline constraints. Organize and set priorities for assigned work. Professional/Industry Development - Gain and Sustain Professional/Industry Knowledge Continue exam progression towards FSA. Seek a deeper knowledge of multiple healthcare concepts and become known for expertise in a particular area. Identify and facilitate learning opportunities for project team and/or individuals. Create core materials, reference items and training programs. New Business Development - Implement New Business Growth Strategies Represent Wakely's brand through involvement in seminars/events and periodicals, etc. Learn and execute on new business and/or product lines. Contribute to new marketing initiatives to generate sales leads. Support and identify value added services to current clients. Internal Operations - Apply Best Business Practices Apply operational improvement initiatives. Incorporate policies and procedures related to cross office collaboration into projects. Recruit top talent and participate in the selection and orientation process. Participate in community and professional volunteer activities/opportunities. Qualifications Education/Training Minimum of an ASA certification and a bachelor's degree in actuarial science, mathematics, or statistics required. Experience Minimum of 4 years of healthcare actuarial experience, including Medicare, commercial ACA, and/or Medicaid lines of business, required. Knowledge, Skills, and Abilities Working knowledge of database/statistical analysis language (SQL/SAS), Microsoft Excel and Access. Initiative - Ability to decide in an independent way what actions should be taken. Effective Communication - Demonstrates the ability to convey thoughts and express ideas effectively, both verbally and written. Team Player - Builds constructive working relationships characterized by a high level of acceptance, cooperation, and mutual respect. Time Management - Makes reasonable estimates of resources needed to achieve goals or complete projects. Uses methods to plan and track work and commitments. Continuous Learning - Displays an ongoing commitment to increasing skills. Leadership - Develops the ability of others to perform and contribute to the organization by providing ongoing feedback and opportunities to learn through formal and informal methods. Emotional Intelligence - Consistently exercises sound judgment. Strategic Thinking - Formulates objectives and priorities and implements plans consistent with the long-term interest of the organization and employees. EEO Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c) Additional Info #LI-BR1

The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ensure compliance with utilization management policies. This role conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital utilization review plans and works to optimize hospital resource utilization, reduce readmissions, and maintain compliance with payer requirements. Essential Functions Performs admission and continued stay reviews using evidence-based criteria, clinical expertise, and regulatory guidelines to ensure appropriate utilization of hospital services. Collaborates with physicians and clinical teams to obtain necessary documentation for medical necessity, discharge planning, and payer requirements. Documents all utilization review activities in the hospital's case management software, including clinical reviews, escalations, avoidable days, payer communications, and authorization details. Works with insurance companies to secure coverage approvals and mitigate concurrent denials by submitting reconsiderations or coordinating peer-to-peer reviews. Communicates effectively with utilization review coordinators, case managers, and discharge planners to ensure a collaborative approach to patient care. Analyzes trends in hospital admissions and extended stays, identifying opportunities for process improvements to enhance utilization management. Serves as a key contact for facility staff and insurance representatives regarding utilization review concerns. Supports training initiatives within the department and escalates complex issues to management as needed. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications Associate Degree in Nursing required Bachelor's Degree in Nursing preferred 2-4 years of clinical experience in utilization review, case management, or acute care nursing required 1-3 years work experience in care management preferred 1-2 years of experience in utilization management, payer relations, or hospital revenue cycle preferred Knowledge, Skills and Abilities Strong knowledge of utilization management principles, payer guidelines, and regulatory requirements. Proficiency in case management software and electronic health records (EHR). Excellent communication and collaboration skills to work effectively with interdisciplinary teams and external payers. Strong analytical and problem-solving skills to assess utilization trends and optimize hospital resource use. Ability to work in a fast-paced environment while maintaining attention to detail and accuracy. Knowledge of HIPAA regulations and patient confidentiality standards. Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure required CCM - Certified Case Manager preferred or Accredited Case Manager (ACM) preferred

Shift: 7:00PM-7:00AM The Phlebotomist is responsible for the proper collection of blood specimens to support accurate laboratory testing for the diagnosis and treatment of diseases. This role ensures positive patient identification, timely specimen collection, and adherence to safety and regulatory standards. The Phlebotomist provides exceptional patient care by maintaining professionalism and demonstrating effective communication during interactions with patients, staff, and visitors. Essential Functions Performs venipuncture and capillary blood collection following laboratory policies and procedures to ensure accurate and timely specimen collection. Ensures positive patient identification by using two patient identifiers and labeling specimens at the patient's bedside to prevent errors. Prepares, packages, and transports specimens to the laboratory while maintaining sample integrity and adhering to safety protocols. Explains procedures to patients, providing reassurance and addressing concerns to ensure a positive patient experience. Cleans, sterilizes, and maintains phlebotomy equipment and workspace in compliance with safety and infection control standards. Accurately documents patient and specimen information in the laboratory system, ensuring compliance with regulatory requirements. Collects timed specimens as ordered, prioritizing and efficiently completing phlebotomy tasks to meet clinical needs. Identifies and resolves specimen issues, including addressing rejections and recollecting samples when necessary. Collaborates with healthcare team members to clarify orders, resolve collection challenges, and communicate specimen status. Adheres to all laboratory and hospital safety requirements and follows Laboratory procedures to ensure compliance with accreditation and regulatory standards. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications 0-2 years of phlebotomy experience required Phlebotomy Certification Required BLS Certification Required Knowledge, Skills and Abilities Knowledge of safety guidelines, sanitation, and infection control protocols. Ability to perform blood collection techniques successfully across all age groups (neonates to geriatrics). Understanding of standards for patient identification, specimen handling, and lab testing requirements. Strong communication skills, both written and verbal, with the ability to interact professionally with patients, staff, and physicians. Ability to multitask, remain calm in stressful situations, and adapt to a dynamic environment. Proficiency in distinguishing sample types and understanding order-of-draw requirements for lab testing. Demonstrates a high level of attention to detail and accuracy in specimen collection and documentation.

As an Accounts Payable Manager at Community Health Systems (CHS) - Shared Business Operations, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including: 120 hours of PTO 9 paid holidays Group Medical, Dental, & Vision Flexible Benefits Plan 401(k) Plan Life Insurance/Accidental Death and Dismemberment Long-Term Disability Job Summary The Accounts Payable Manager is responsible for overseeing a large and diverse accounts payable function, including managing a team of accounts payable professionals. This role encompasses the comprehensive management of invoice processing, payments, travel card administration, PCARD administration, auditing expense reports, sales and use tax compliance, and automation of uploads in Excel. The Manager will ensure seamless integration with Oracle Cloud ERP, drive process improvements, and maintain high standards of financial accuracy and compliance. Essential Functions Lead, mentor, and develop a team of accounts payable professionals, including assigning responsibilities, setting performance goals, and conducting performance evaluations. Oversee recruitment, onboarding, and training of new team members. Foster a collaborative and high-performance work environment, ensuring team members are well-trained and motivated. Supervise the end-to-end accounts payable process, including invoice receipt, validation, approval, and payment execution. Ensure timely and accurate processing of invoices and payments, adhering to company policies and vendor agreements. Implement and monitor controls to prevent errors and fraud in the accounts payable function. Oversee the administration of corporate travel cards and PCARDS, including issuance, management, and reconciliation. Address and resolve issues related to travel card and PCARD usage, including discrepancies and unauthorized charges. Supervise the auditing of employee expense reports to ensure compliance with company policies and accuracy in expense reporting. Implement and maintain procedures for reviewing and approving expense reports, including travel, entertainment, and other business expenses. Manage the resolution of issues related to expense report discrepancies and policy violations. Oversee sales and use tax compliance within the accounts payable function, including accurate calculation, reporting, and payment. Support the preparation and filing of sales and use tax returns and resolve any related issues. Manage the automation of accounts payable processes, including the execution of Excel upload templates and procedures for integration with Oracle Cloud ERP. Identify opportunities for process improvements and automation to enhance operational efficiency. Collaborate with IT and ERP specialists to address system issues, implement updates, and optimize ERP integration. Ensure compliance with internal controls, company policies, and regulatory requirements related to accounts payable. Support internal and external audits by providing accurate documentation and explanations related to accounts payable processes and transactions. Identify and implement process improvements to streamline accounts payable operations and reduce processing times. Develop and review reports on accounts payable performance, including key metrics such as invoice processing times, payment accuracy, and outstanding liabilities. Maintain effective relationships with vendors, addressing and resolving issues related to payments, invoices, and contract terms. Track team KPI's and SLA's and communicate results throughout organization. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. This is a remote position. Qualifications Associate Degree required Bachelor's Degree in Accounting, Finance, Business Administration, or a related field preferred Minimum of 4-6 years of experience in accounts payable required 2-4 years in a management or leadership role preferred 1-3 years Advanced proficiency in Microsoft Excel, including experience with complex formulas, pivot tables, and data manipulation required 1-3 years Experience with automation tools and techniques for data integration and process optimization required 1-3 years Experience with Oracle Cloud ERP preferred Healthcare industry experience preferred Knowledge, Skills and Abilities Proficiency in Oracle Cloud ERP or similar enterprise resource planning systems. Analytical and problem-solving abilities. Effective communication and interpersonal skills. Ability to manage multiple priorities and work independently in a fast-paced environment. Strong leadership and management abilities, with experience in team development and performance management. Excellent problem-solving and analytical skills, with the ability to manage complex issues and make data-driven decisions. Effective communication and interpersonal skills, with the ability to collaborate with various stakeholders and build strong relationships. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Shared Business Operation (SBO) for CHS offers a wide range of career opportunities, including many fully remote positions. Come be a part of the future of healthcare by joining an organization dedicated to a service-oriented modernized approach to providing the operational support to our facilities, ultimately, our patients. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

The Remote Medical Billing Specialist is responsible for processing, auditing, and submitting primary and secondary insurance claims, ensuring accuracy, compliance, and timely reimbursement. This role utilizes electronic claims management systems to review, correct, and resolve billing errors, denials, and rejections. The Billing Specialist I collaborates with internal teams, facility liaisons, and payers to ensure clean claim submission and adherence to federal, state, and payer-specific regulations. As a Billing Specialist at Community Health Systems (CHS) - Shared Services Center, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental, and vision insurance, paid time off (PTO), 401(k) with company match, tuition reimbursement, and more Essential Functions Processes and submits primary and secondary insurance claims accurately and in a timely manner, ensuring compliance with payer guidelines and regulatory requirements. Reviews and resolves claim errors, rejections, and denials, making necessary corrections and resubmitting claims as needed. Demonstrates working knowledge of billing forms, including UB-04, CMS-1500, or state-specific billing forms, ensuring claims are submitted with the appropriate documentation. Audits claims for accuracy, checking for duplicate charges, overlapped accounts, and missing information before submission. Investigates and processes rebill requests, verifying claim accuracy and making necessary updates per facility or coding liaison direction. Maintains knowledge of billing regulations, payer policies, and electronic submission guidelines, staying up to date with federal, state, and local billing requirements. Utilizes electronic billing systems to analyze, research, and transmit claims, ensuring proper documentation of actions taken in the collection system. Monitors and reports charging or edit trends, collaborating with internal teams (such as coding, patient access, and ancillary departments) to improve billing accuracy. Performs daily balancing tasks using SSI and other billing systems, escalating unresolved issues or billing delays to the Billing Services Manager. Communicates professionally with payers, facility representatives, and internal teams, ensuring efficient issue resolution and proper follow-up on outstanding claims. Performs other duties as assigned. Complies with all policies and standards. This is a fully remote opportunity. Qualifications H.S. Diploma or GED required Associate Degree in Business, Healthcare Administration, Medical Billing, or a related field preferred 0-1 years of experience in medical billing, insurance claims processing, or revenue cycle operations required 1-3 years of billing experience in a medical facility, ambulatory surgery facility, or acute-care preferred Experience with hospital or physician billing, including knowledge of payer policies and electronic claims systems preferred Knowledge, Skills and Abilities Basic understanding of insurance claim processing, medical billing, and reimbursement guidelines. Familiarity with billing software, electronic claims management systems (e.g., SSI, Pulse/DAR), and eligibility tools. Knowledge of CMS, Medicaid, Medicare, and commercial insurance billing regulations. Ability to analyze and resolve claim errors, denials, and rejections efficiently. Strong attention to detail, organizational skills, and ability to meet deadlines. Proficiency in Microsoft Office Suite (Excel, Outlook, Word) and electronic health record (EHR) systems. Excellent communication and problem-solving skills, with the ability to interact professionally with internal teams and external payers. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer.

Community Health Systems is seeking an Application Systems Programming Specialist to join its Integration Services team. This advanced technical role is responsible for leading the analysis, design, development, and support of complex system interfaces within a healthcare environment. The specialist will demonstrate expertise in industry trends, best practices, and interface programming using tools such as Mirth, Intersystems, and Rhapsody. Key responsibilities include ensuring seamless data integration, maintaining comprehensive documentation, and providing proactive solutions to optimize system performance. This role requires collaboration with internal and external stakeholders to achieve business objectives and the ability to manage complex technical projects in dynamic environments. Essential Functions Mirth Connect (Primary Focus) Develop, maintain, and monitor HL7/FHIR interfaces using Mirth Connect. Manage channels, transformations, filters, and communication protocols (TCP, SFTP, REST, etc.). Handle Mirth upgrades, performance tuning, and participate in Disaster Recovery/High Availability (DR/HA) documentation and validation. Collaborate with platform specialists to ensure high availability and platform integrity. Troubleshoot production issues and lead root cause analysis across a diverse ecosystem of clinical systems and vendors. Coordinate with offshore/onshore teams for 24x7 support coverage. InterSystems HealthShare (Strategic Focus) Participate in the pilot deployment of HealthShare Health Connect. Build and configure message routes, transformations, and business processes using HealthShare components (IRIS, Ensemble). Support platform consolidation planning across fragmented integration engines. Assist in evaluating cloud-hosted options (e.g., Google Cloud Platform) for future-state deployment. Interoperability & Standards Work closely with the Technical Integration Manager and enterprise architecture team. Implement and support workflows involving HL7 v2/v3, FHIR R4, X12, Continuity of Care Document (CCD), and Clinical Document Architecture (CDA). Contribute to roadmap planning for advanced Health Information Exchange (HIE) participation, API adoption, and care coordination use cases. Documentation & Communication Develop and maintain documentation including design specifications, test cases, support runbooks, and DR plans. Communicate effectively with hospital IT teams, vendors (Cerner, Medhost, Athena), and state agencies. Qualifications Bachelor's degree in Computer Science or Information Technology. 8+ years of hands-on integration engine experience in a healthcare integration environment. 5+ years of hands-on Mirth Connect experience in a healthcare integration environment. Strong working knowledge of HL7 v2.x, FHIR, CCD/CDA, and interfacing protocols. At least 2 years of experience with InterSystems HealthShare (Health Connect or Ensemble). Experience supporting production interfaces in mission-critical hospital or HIE environments. Familiarity with EMRs such as Cerner, Athena, Medhost, or Epic. Basic scripting experience (JavaScript, XSLT, or Python preferred). Ability to contribute to a 24x7 on-call rotation. Preferred Qualifications: Experience with cloud-based integration (Google Cloud Platform preferred). Familiarity with Carequality/CommonWell networks, immunization registries, and HIE frameworks. Understanding of HIPAA, HITECH, and healthcare compliance.

Our Benefits: As an Oracle EPM Functional Analyst at Community Health Systems (CHS) - Shared Business Operations, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including: • Competitive compensation • Paid time off for vacations, holidays, and illness • Comprehensive health insurance (medical, dental, vision, prescription) • 401(k) retirement savings plan • Education support and student loan assistance • Life and disability insurance • Flexible spending account Job Summary The Oracle EPM Functional Analyst leads the design, development, testing, deployment, and support of complex application systems. This role serves as a technical expert, providing strategic insights into system enhancements and database management. The Senior Analyst collaborates with cross-functional teams to optimize system performance, mentor junior analysts, and drive continuous improvement initiatives across the organization. In addition, the Oracle EPM Functional Analyst is responsible for implementing, configuring, and supporting Oracle EPM solutions including FCCS, ARCS, EPBCS, EDMCS, Automate Server, Essbase, and OIC. This role bridges the gap between business needs and technical teams, ensuring efficient and effective financial operations within the Oracle EPM environment. Essential Functions Leads the development and maintenance of advanced programs, ensuring efficient and effective application performance. Analyzes and translates complex business requirements into robust technical solutions, aligning with organizational objectives. Oversees the planning, testing, implementation, and optimization of database systems, including performance tuning and capacity analysis. Develops and reviews database interface programs, advanced SQL queries, and other database objects to ensure efficient data management and retrieval. Provides technical leadership in database design, data modeling, and the creation of relational database structures, supporting corporate and client information systems. Manages database security protocols, auditing procedures, and disaster recovery planning to maintain data integrity and availability. Conducts comprehensive troubleshooting and resolves critical system and database issues, minimizing downtime and ensuring continuity. Mentors and provides guidance to junior analysts, fostering skill development and knowledge sharing within the team. Collaborates with stakeholders across departments to identify improvement opportunities and implement innovative solutions. Stays abreast of emerging technologies and industry best practices, applying this knowledge to enhance system capabilities. Performs other duties as assigned. Complies with all policies and standards. Position-Specific Responsibilities Conducts requirements gathering workshops and interviews with stakeholders to understand business needs and identify gaps between current and future processes. Designs and configures Oracle EPM modules (FCCS, ARCS, EPBCS, EDMCS) to meet business requirements, translating needs into techno-functional specifications. Leads or participates in functional, system integration, and user acceptance testing for Oracle EPM solutions. Develops training materials and delivers training to end-users on effective use of Oracle EPM modules. Provides production support, troubleshooting issues, and resolving service requests for Oracle EPM modules via ticketing and email systems. Builds custom reports within EPM Suite/SmartView, manages data reconciliation between Fusion GL and EPM modules, and develops automations using batch scripts or Python. Supports quarterly upgrades and change management efforts, ensuring system stability and audit compliance. Stays updated on industry trends and Oracle EPM enhancements, proposing continuous improvement initiatives to optimize financial processes. Qualifications B 2-4 years of experience with SQL databases and enterprise-level application systems preferred. Position-Specific Qualifications 5 or more years of proven experience as a Techno-Functional Analyst or similar role with Oracle EPM modules (FCCS, ARCS, EPBCS, EDMCS, Essbase, OIC) required. Experience with Oracle Fusion integration, requirements gathering, solution design, configuration, testing, and documentation required. Knowledge, Skills and Abilities Strong ability to analyze complex business problems and develop effective solutions in Oracle EPM modules - FCCS, ARCS, EPBCS, EDMCS, Automate Server, Essbase, OIC. Project management skills to handle multiple initiatives simultaneously, meet deadlines, and deliver high-quality results. Expert knowledge of application systems, software development life cycle (SDLC), and database management. Advanced proficiency in Oracle EPM modules, SQL, data modeling, and database performance tuning. Strong leadership, mentorship, and collaboration skills, with the ability to manage complex projects and drive strategic initiatives. Excellent analytical and problem-solving abilities with a focus on continuous improvement and data-driven decision-making. Effective communication and presentation skills, capable of articulating complex technical concepts to diverse audiences. In-depth understanding of database security, compliance requirements, and disaster recovery planning. Licenses and Certifications Oracle EPM Implementer certifications (FCCS, ARCS, EPBCS, Fusion GL/FIN/PPM subledgers) preferred OTBI and BIP reporting certifications preferred This is a fully remote opportunity This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

Count sponges, rags, needles, and instruments before, during, and after procedures. Ensure proper operation of equipment, such as lights and suction machines. Assist the surgical team with scrubbing in and putting on gloves and masks. Wash and sterilize all medical instruments and equipment following surgeries. Clean, organize and restock the operating room after surgical procedures.

HMA is excited to enter 2026 with renewed energy and a mindset for growth. As part of these efforts, we are recruiting for a physician principal role to support two of our growing service lines, Behavioral Health (inclusive of Substance Use Disorders) and Justice Involved Services. We recently engaged in a firm-wide realignment that promises to position us for great success in this new year and for years to come. We have identified the need to recruit a dynamic, national leader to join our team of existing physician principals and the two identified service lines. The psychiatrist who is successful in this role will work nationally support projects across several states, both large and small. They will be able to collaborate with existing experts and contribute new expertise and knowledge, act as a thought leader in the field, increase HMA's visibility across the country and also contribute to business development and growth. Job Summary The Physician Principal is responsible for providing expertise and advice to help organizations improve their business performance in terms of operations, profitability, management, structure, and strategy; develops and maintains client relationships; and is responsible for achieving firm expectations for effective client services (i.e., project direction, project management, and work product quality). The Physician Principal also mentors junior staff, contributes to HMA's strategic objectives, meets internal administrative expectations, accepts accountability, and contributes to HMA's culture. Responsibilities Work Performed and Job Requirements Business development Performs business development activities to expand funded work from existing clients or new Develops and maintains a pipeline of future work that demonstrates a likelihood of achieving business development requirements in future Both lead and participate in proposal development and Client management Meets with client to understand Gathers and organizes information about the issue to be solved or the procedure to be Analyzes data to identify and understand issues to be Presents findings to Provides advice, implementation plans, and/or suggestions for improvement according to project Evaluates the client's needs as warranted and adjusts as Ensures that all deliverables are high-quality. Project management Serves as subject matter expert on Undertakes internal and external short-term or long-term projects to address identified issues and Develop and document tools, analysis, frameworks, tracking tools, road maps, dashboards, and other approaches to manage a variety of large and small projects Leadership Leads and manages teams, provides feedback and development, and advances internal Serves as a mentor for other staff members, as requested. Performance metrics Ensures performance meets or exceeds HMA expectations in the following areas: Business development Billable hour target attainment Manages to budget/project caps established at the outset or assists in negotiating additional fees Meets quality and operational standards Completes and submits timesheets, expense reports, revenue forecasts, and other internal reports when due Participates in and completes all HMA training and development requirements in a timely manner Participates in internal activities related to business strategies, forecasts, adoption of new technologies/platforms/approaches, and other process All other duties as Qualifications Education/Training Minimum of a medical degree (MD or DO), as well as a current active license is required. A master's degree in a related discipline is strongly preferred. Experience Minimum of 15 years of progressively increasing prior leadership or management experience in work involving publicly funded healthcare including, but not limited to policy, administration, operations, compliance, research, consulting, and/or evaluation. Knowledge, Skills, and Abilities Strong project management Solid time management Excellent internal and excellent professional networking Excellent attention to Excellent critical thinking Exceptional oral and written communication Superior interpersonal skills, including leadership, contribution to culture, and acceptance of accountability Ability to multi-task and adhere to strict Capable of handling confidential information in a discrete Ability to work extended hours when deadlines are Demonstrated thought leadership and deep expertise in more than one critical healthcare Maintains approach to stay current in trends in areas of subject matter EEO Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

The Manager of Utilization Review oversees a team of utilization review nurses and coordinators, ensuring compliance with clinical regulatory standards, and enhancing the overall utilization review process to optimize patient care and manage resources effectively. The manager supports and coordinates the various aspects of the hospital's utilization management program, denials and appeals activities. Works with UR Director, UR Senior Director, and Payor Relations Manager to facilitate coordination of services related to utilization review. Collaborates with the multidisciplinary team, lending professional clinical expertise to ensure quality, timely, and cost effective utilization management to achieve optimal outcomes. The manager will be responsible for implementing process improvement plans and projects to maximize desired outcomes. Essential Functions Serves as escalation point and oversight of daily functions for UR Clinical Specialists and Coordinators for questions or concerns regarding appropriateness and medical necessity of admission and continued hospital stay. Coordinates with Regional Case Management Directors to address identified issues and trends or escalated challenges. Communicates Utilization Review information with facility Case Manager Directors, proactively sharing KPI (Key Performance indicator) data and trends with facility leadership. Collaborates with the UR Senior Director, Director and Payor Relations Manager to support dashboard/reporting, solution, and training needs based on trends and common issues. Efficiently refers cases to the Physician Advisor or representative of the UR committee when cases are not meeting criteria. Distinctively establishes and maintains criteria or identifies resolutions of problems associated with Utilization Review functions for committee. Completes employee evaluations in a timely manner and assesses staff competencies on an ongoing basis. Collaborates with Training & Education Specialist(s) and Coordinators to address educational needs for staff. Tasked with problem analysis and resolution as it pertains to the areas of job responsibility. Maintains performance metrics in line with Utilization Review Service Line KPIs. May serve as a key contact for facility and insurance contacts. Ensures staff compliance with regulatory requirements including but not limited to Condition Code 44, 2 midnight IP cert audits, physician orders for correct status level, etc. Ensures the operation of the Utilization Review department in their area is in compliance with established UR policies, procedures and guidance documents. Performs responsibilities that contribute towards meeting or exceeding team goals. Promptly escalate appropriate issues to Director and/or Senior Director. Provide suggestions and/or recommendations for changes to applicable processes or tools as recognized from functioning in the role on a daily basis. Provide oversight of department staff to ensure adherence to above duties. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications Associates or Bachelor's Degree in Nursing required Bachelor's or Master's Degree in Nursing preferred 3-5 years work experience in healthcare as a nurse required 1-3 years work experience in Care Management or Utilization Review required 1-2 years work experience as a healthcare manager preferred Knowledge, Skills and Abilities Strong analytical skills for reviewing medical records and treatment plans. In-depth knowledge of healthcare policies and regulations. Strong communication, organizational and customer service skills required. Proven ability to work successfully in a fast-paced environment while maintaining good relationships with co-workers and supervisors. Demonstrated proficiency in computer and web-based applications. Licenses and Certifications CN-RN - General Nursing Practice RN license required Active compact state license or active license in the states of support and review required

CHSPSC, LLC seeks an IT Specialty Services Support & Process Analyst to assist with leading escalated support activities and provide process improvement initiatives. The department handles services lines such as Surgery, Anesthesia, OB/Perinatal, and others. The role will be involved with the facilitation of application services management processes pertaining to analyzing value, evaluating risk, prioritizing projects and onboarding new technology requests to ensure alignment with organizational strategies for the service lines. Key responsibilities include: Alignment with the service lines to address escalated support issues Review transition materials from the Project Management Office for application product ownership Develop and maintain application support plans Document current state and contribute to the direction of the application lifecycle management (LCM) roadmap to reduce costs, mitigate risks, and drive growth and revenue Participate in related efforts such as Disaster Recovery exercises, Cyber Table Top exercises, etc. Present to executive leadership on support-related issues Understand current processes and propose more efficient methods 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 definition, implementation and support of portfolio management standards, policies and processes Understand the data driven decisions pertaining to IT project investments Participate in 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 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 Provide expertise on decisions and priorities regarding the overall enterprise application portfolio Track application and vendor trends and maintain knowledge of new technologies to support the organization's current and future needs Maintain an awareness of industry standard best practices and apply relevant methodologies for process improvement 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 Develop and maintain productive relationships of trust both within and outside CHS and embrace the authoritative role in respect to maintaining enterprise standards and align others to the strategic direction Collaborate with Audit teams to respond to and mitigate audit findings and manage audit controls related to application systems and LCM Educate peers and business partners on department methodologies and drive adoption of standard process Support and evaluate portfolio risks and recommend mitigation plans Support business impact analysis and application criticality assessments Partner with key business and delivery stakeholders to conduct application and service line reviews including scope, metrics, expenses and net promoter scores to determine the disposition of existing and proposed solutions Communicate timely and accurate status to appropriate levels and stakeholders including the development and delivery of status reports and presentations Required: 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: Experience with APM, CMDB and CSDM components within the ServiceNow platform 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 ITIL certifications 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

Our Benefits: As a Project Management Analyst at Community Health Systems (CHS) - Shared Business Operations, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including: Competitive compensation Paid time off for vacations, holidays, and illness Comprehensive health insurance (medical, dental, vision, prescription) 401(k) retirement savings plan Education support and student loan assistance Life and disability insurance Flexible spending account Job Summary The Project Manager independently manages multiple projects involving Oracle Health EHR, information systems, and database management. This role requires experience with multi-facility design, planning, execution, and oversight of complex initiatives. The Project Manager will be responsible for the technical components of project management, coordinating with departmental and cross-functional teams to deliver expert-level customer support. They must possess comprehensive knowledge of all phases of the EHR system, deployments, and ongoing support. The ideal candidate is confident in leading projects, managing vendor resources, and ensuring delivery on time and within budget. Strong communication skills and adherence to corporate and departmental policies are essential. Essential Functions This role requires a strong team leader capable of coordinating efforts across multiple stakeholders. Successful implementation involves managing hospital executives and physician expectations, collaborating with local medical staff (nurses and technicians), engaging local technical resources (systems analysts and programmers), and working closely with vendor support teams. Ensures projects are executed with precision by applying strong organizational skills, attention to detail, and consistent follow-through to drive tasks, deliverables, and milestones to completion. Develops and maintains project management tools and documentation to ensure comprehensive planning, execution, and tracking of all project activities, from business requirements through project completion. Develop, implement, and maintain project plans, including schedules, milestones, and deliverables. Document and manage business requirements, ensuring alignment with stakeholder expectations. Facilitate definition success metrics to measure project performance and outcomes. Supports stakeholder engagement by ensuring consistent communication, timely updates, and the coordination of resources across departments. Monitor and manage resources, including allocation, utilization, and capacity planning. Maintain scope documentation and ensure scope changes are evaluated, approved, and communicated. Use project management tools to centralize and organize project information for team access and reporting. Skilled in partnering with stakeholders to streamline processes and promote continuous improvement. Develops and delivers clear, concise, and professional communications-including presentations, written reports, and executive summaries-to engage stakeholders, convey project status, highlight key decisions and risks, and support informed decision-making. Tailors content to the audience, facilitates discussions, and maintains credibility while ensuring clarity and alignment. Demonstrates adaptability by remaining effective and solution-focused in ambiguous situations, and confidently navigates complex, evolving environments to drive projects forward. Applies CHS project management methodology and standards to ensure consistent, disciplined, and successful project execution, including adherence to established processes, documentation requirements, and governance practices. Responsible for proactively identifying, assessing, and managing project risks and issues to minimize impact on scope, schedule, and budget. Ensures that risks and issues are documented, mitigated, and communicated to stakeholders in a timely and effective manner. Coordinates and maintains all project documentation and communications, ensuring information is accurate, accessible, and escalated appropriately when issues or decisions require attention. Serves as a trusted escalation point for project issues and incidents, providing guidance, support, and resolution to ensure project continuity and team confidence. Foster trust and credibility with project team members to encourage open communication and timely reporting of issues. Promote a proactive culture of problem-solving and accountability within the project team. Facilitates effective team and stakeholder meetings, ensuring clear communication, productive collaboration, and the establishment of credibility and trust with all participants. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications Bachelor's Degree or equivalent professional experience required Minimum of 5 years of experience with EHR Implementation required Experience working with cross-functional teams and using project management methodologies preferred Knowledge, Skills and Abilities Knowledge of project management principles, including scope, schedule, cost, risk, and stakeholder management. Proficient in Microsoft Office Suite and project tracking tools (e.g., Smartsheet, Microsoft Project, Asana). Strong organizational and time management skills with the ability to manage multiple priorities simultaneously. Effective written and verbal communication skills, including status reporting and stakeholder updates. Analytical thinking and problem-solving abilities. Ability to work both independently and collaboratively in a fast-paced environment. Detail-oriented with a commitment to quality and accuracy. Licenses and Certifications PMP Certification from the Project Management Institute (PMI) preferred This is a fully remote opportunity This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

Drive Growth and Innovation in the Provider Market with HMA Are you ready to lead transformative strategies for hospitals, health systems, and physician groups? As Sector Lead - Providers, you'll define and execute HMA's growth strategy in the provider space-partnering with C-suite leaders and industry influencers to deliver solutions that address today's most pressing challenges in care delivery, financial performance, and operational excellence. This high-impact role combines strategic business development with internal collaboration, aligning marketing, sales, and delivery teams to expand market share and reinforce HMA's reputation as a trusted advisor to healthcare providers. You'll shape the firm's presence in the provider community through thought leadership, executive engagement, and innovative approaches that drive measurable results. If you thrive on building relationships, influencing decision-makers, and leading growth in a dynamic healthcare landscape, this is your opportunity to make a lasting impact. The ideal candidate will have at least 10 years of experience shaping and executing growth strategies within the healthcare provider sector. This leader will be part of our Growth Office and should have significant experience partnering with practices and services lines to identify opportunities for consulting and advisory services. Specific expectations and responsibilities are outlined below. Job Summary The Sector Lead is responsible for driving HMA's business growth, visibility and market leadership within an assigned sector. This individual will develop and execute the sector business plan, align enterprise resources to support market pursuits, and lead direct client engagement and business development efforts. The Sector Lead serves as a strategic and business development leader, ensuring HMA's offerings, thought leadership, and brand prominence are effectively represented with the industry. Responsibilities Work Performed and Job Requirements Strategic Planning and Market Leadership Develop and implement the sector business plan and corresponding execution and marketing strategies aligned with HMA's overall growth objectives. Monitor market trends, client needs, and competitive positioning to inform business priorities and opportunities. Maintain HMA's thought leadership and market prominence with the assigned sector through publications, speaking engagements, and active participation in professional associations. Market Development and Pursuit Coordination Coordinate market pursuits across the enterprise, ensuring collaboration among business units, practice leaders, and sellers to maximize client opportunities. Ensure sales teams have the tools, materials, and support needed to successfully position and sell HMA's services within the sector. Lead development of sector-focused marketing collateral, case studies, and client presentations. Client Engagement and Sales Execution Maintain personal visibility and credibility within the sector, leveraging deep subject matter expertise to build client trust and advance relationships. Lead direct selling efforts to key clients and prospects, achieving or exceeding sales goals. Represent HMA at industry conferences, trade shows, and networking events to promote capabilities and expand market presence. Partner with internal teams to ensure client satisfaction and high-quality delivery of services. Leadership and Collaboration Serve as a sector ambassador within HMA, fostering collaboration, knowledge sharing, and alignment across practices. Provide coaching and mentoring to pursuit teams and emerging business developers within the sector. Collaborate with marketing, communications, and service delivery leaders to align business develop efforts with client solutions and HMA strategy. All other duties as assigned. Qualifications Education/Training Minimum of a bachelor's degree in business, life sciences, public health, or a related field; however, we welcome candidates with significant, directly relevant work experience in place of a formal degree. Experience Minimum of 10+ years of experience in business development, client relationship management, or sector leadership within a professional services or consulting environment. Proven track record of developing and executing business plans and achieving measurable sales growth. Strong subject matter expertise and credibility within the assigned sector. Excellent communication, presentation, and leadership skills along with demonstrated ability to lead cross-functional teams and influence without direct authority. Knowledge, Skills and Abilities Deep knowledge of the assigned industry sector, market dynamics, and competitive landscape. Strong understanding of business planning, market strategy, and go-to-market execution. Strong understanding of at least one of HMA's functional areas of expertise (actuarial services, healthcare policy and regulatory strategy, healthcare delivery and operations) Proven business development and relationship management skills Excellent strategic thinking, communication, and presentation abilities Demonstrated leadership and collaboration skills to drive cross-functional initiatives. Ability to analyze market data and translate insights into actional business plans. Ability to adapt strategies and priorities in response to changing market conditions. Core Competencies Strategic Execution - Drives strategic priorities through cross-functional leadership and accountability Resource Allocation - Anticipates long-term resource needs and aligns allocation with business growth Results Orientation - Leads teams to exceed performance expectations through continuous improvement and accountability Opportunity Development: Builds and advances new client opportunities by identifying needs, designing solutions, and supporting pursuit efforts. Develops professional networks and leverages relationships for new leads. Anticipates client challenges and translates them into consulting solutions. Leads pursuit activities, proposal sections, and pricing strategies. Strategic Positioning: Aligns expertise and market knowledge to strengthen the firm's relevance and differentiation within the sector. Analyzes trends and policy shifts to identify growth potential. Partners with Marketing, Strategy, and Thought Leadership to develop sector insights. Contributes to thought leadership, panels, or publications. Pursuit Leadership: Leads proposals and pursuit efforts that align with client goals and firm capabilities. Shapes pursuit strategy, proposal content, and pricing approaches. Coordinates contributions across internal teams and SMEs. Delivers compelling presentations and follow-up communications. EEO Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c) #LI-DM Additional Info The Sector Lead - Providers is responsible for defining and executing the firm's business growth strategy within the healthcare provider sector, including hospitals, health systems, physician groups, integrated delivery networks, and other providers. This leader leverages deep knowledge of provider sector to drive provider revenue growth across the breadth of HMA's services. The Sector Lead- Providers partners across practices to align business development, marketing, and delivery teams in pursuit of high-impact opportunities. They maintain a strong market presence, build executive relationships, and ensure the firm's brand and expertise remain visible and respected across the provider community. Specific Responsibilities Business Development (50%) Develop and execute the Provider sector business plan, targeting health systems, hospitals, physician enterprises, and other providers. Engage directly with C-suite and senior leaders (e.g., CEOs, CFOs, COOs, CMOs, CHROs, CIOs) to identify opportunities and address client challenges. Build trusted relationships with key provider organizations, associations, and alliances to expand the firm's reach and reputation. Coordinate firmwide provider outreach on priority business development initiatives. Support pursuit efforts, advise on proposals, and conduct personal outreach to strategic accounts. Drive the firm's brand recognition and visibility through speaking engagements, thought leadership, and participation in healthcare industry forums (e.g., AHA, HFMA, SHSMD, ACHE). Partner with internal business developers to connect consultants and practice leaders to client opportunities aligned with strategic priorities. Internal Seller Coordination Across the Firm (25%) Educate internal teams on the Provider sector strategy, trends, and market priorities, ensuring alignment across business units. Coordinate enterprise-wide pursuits, connecting resources and subject matter experts to strengthen proposals and client solutions. Ensure sellers and consultants have up-to-date sector collateral, pitch decks, and case studies relevant to provider clients. Identify service or capability gaps and assist with the development of strategic initiatives to address them. Foster collaboration across practices (e.g., Actuarial, Policy & Strategy, and Delivery & Operations) to deliver integrated client value. Marketing Plan Execution (15%) Lead execution of the Provider sector marketing and engagement plan, aligning efforts with the firm's overall healthcare growth strategy. Guide the development of client-facing collateral, thought leadership, and industry insights highlighting the firm's value to provider clients. Partner with marketing and communications teams to elevate the firm's presence through speaking engagements, industry publications, and digital campaigns. Promote internal visibility of market trends and successes to encourage firmwide engagement and knowledge sharing. Management Reporting and Business Plan Development (10%) Develop and update the annual Provider sector business plan, including revenue targets, key accounts, and strategic initiatives. Track performance metrics, sales progress, and pipeline development; provide updates to leadership and practice heads. Monitor industry developments, regulatory changes, and competitive movements affecting the provider landscape. Provide data-driven insights and recommendations to guide strategic decision-making and future growth. Preferred Expertise and Knowledge Extensive experience in the healthcare provider sector, including hospitals, health systems, or physician groups. Proven success in business development or client leadership roles within healthcare consulting, advisory, or vendor organizations. Deep understanding of provider operations, financial performance, and care delivery models, including value-based care and clinical transformation. Familiarity with provider market trends and the policy environment. Established relationships with health system executives and industry associations (e.g., AHA, HFMA, ACHE). Demonstrated ability to translate complex challenges into actionable solutions that align with client and firm priorities. Recognized as a thought leader or subject matter expert within the healthcare provider community. Performance Emphasis Success in the Provider area is measured through: Pipeline growth Sales and revenue growth Margin expansion Positive client feedback scores

Job Title:Physical Therapist,OH - Pediatric Physical Therapist (Outpatient) - ARMC 10.101.73700, City: Chillicothe, State: Ohio, Estimated Start Date:01/26/2026, Shift:3 x 12 Hour Day Shift, 07:00:00-19:00:00, 12.00-3, 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.

The Collections Specialist II is responsible for managing outstanding patient accounts, ensuring accurate and timely collections from insurance companies, third-party payers, and self-pay patients. This role requires strong knowledge of insurance processes, medical billing, and collection regulations to maximize reimbursement and minimize bad debt. The Collections Specialist II works independently to research accounts, resolve payment discrepancies, and negotiate payment arrangements while maintaining compliance with federal, state, and organizational guidelines. **This position is REMOTE** **Essential Functions** + Manages assigned inventory of outstanding patient accounts, following up on insurance, third-party, and self-pay balances to ensure timely payment collection. + Reviews and analyzes patient accounts, identifying alternative payment options, including insurance coverage, financial assistance programs, or legal action when necessary. + Communicates with patients, guarantors, and insurance representatives via phone, email, and written correspondence to secure outstanding balances. + Understands and explains the litigation process and its requirements, providing guidance on legal collections procedures when applicable. + Resolves claim denials and payment discrepancies, working with payers and internal revenue cycle teams to ensure accurate reimbursement. + Demonstrates knowledge of third-party collections regulations, utilizing automated resources and payer collection guidelines. + Handles inbound and outbound collection calls professionally, ensuring courteous and compliant communication with all stakeholders. + Accurately updates and maintains patient account records, documenting all actions taken in the system for compliance and audit purposes. + Abides by all local, state, and federal collection laws, including HIPAA, FDCPA, TCPA, and CFPB regulations. + Performs other duties as assigned. + Maintains regular and reliable attendance. + Complies with all policies and standards. **Qualifications** + H.S. Diploma or GED required + 2-4 years of experience in medical billing, collections, accounts receivable, or insurance follow-up required + Experience in hospital revenue cycle, third-party collections, or litigation-related collections preferred **Knowledge, Skills and Abilities** + Strong knowledge of insurance billing, reimbursement processes, and collection regulations. + Familiarity with third-party payer requirements, claim denial management, and payment posting procedures. + Ability to interpret and explain patient financial responsibilities, payment options, and litigation processes. + Strong communication and negotiation skills, ensuring positive patient interactions and effective payer negotiations. + Proficiency in healthcare billing software, electronic health records (EHR), and collections management systems. + Knowledge of federal, state, and industry regulations related to collections, including HIPAA, FDCPA, and consumer protection laws. + Strong problem-solving skills, with the ability to analyze account details, resolve billing disputes, and secure payments. Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to ************************************************* to obtain the main telephone number of the facility and ask for Human Resources.

Job Title:Certified Surgical Tech,Ohio - Surg Tech - General/Vascular OR - Zanesville (replacing Richard M.), City: Zanesville, State: Ohio, Estimated Start Date:02/09/2026, Shift:DAYS, 07:00:00-07:00:00, 36.00-1, 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.