Hospital for Special Surgery Remote jobs

Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds - including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service - for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research. The Home Base Veteran Outreach Coordinator is a point of contact for veterans and their families seeking care and/or education regarding Post Traumatic Stress (PTS), Traumatic Brain Injury (TBI) and other combat-related stress. When not assigned to the Intensive Clinical Program, the Veteran Outreach Coordinator role changes to educate and provide outreach to New England-based veterans and their families about Post Traumatic Stress (PTS), Traumatic Brain Injury (TBI), and encourages the community to take advantage of services available through the Home Base Program. The Coordinator is an employee of MGH and works alongside a team of world class medical professionals to help educate veterans, their families, social workers, employers, community service providers, veterans' groups, and others as to how to recognize symptoms of PTS/TBI and the ways in which they or their loved ones can seek help. The Veteran Outreach Coordinator guides veterans through the treatment evaluation process in the Home Base Clinic and works closely with the clinical staff in the Home Base Program around patient case management and ongoing monitoring of patient needs. The Coordinator provides active patient outreach, including phone, email, in-person meetings and text messaging. Job Summary Summary Responsible for community outreach, engagement, and support to enhance access to behavioral health programs. The Outreach Coordinator collaborates with community partners, healthcare professionals, and social service agencies to promote mental health awareness and address the behavioral health needs of individuals. Does this position require Patient Care? Yes Essential Functions * Conduct proactive outreach within the community to identify individuals in need of behavioral health services. * Establish relationships with community organizations, schools, primary care providers, and other relevant stakeholders to enhance outreach efforts. * Conduct initial assessments to identify the behavioral health needs of individuals. * Provide information and referrals to appropriate behavioral health services and resources. * Respond to crisis situations and provide immediate support and intervention. * Collaborate with crisis intervention teams, law enforcement, and emergency services as needed. * Advocate for individuals with behavioral health needs to ensure they receive timely and appropriate care. * Conduct community education and awareness programs on mental health topics. Qualifications Education Bachelor's Degree preferred Experience * minimum of 1-3years of military experience with at least one deployment preferred but not required * must have honorable discharge (proof of DD 214 required). Knowledge, Skills and Abilities * Strong knowledge of behavioral health services, resources, and crisis intervention techniques. * Excellent communication, interpersonal, and organizational skills. * Ability to work independently and collaboratively within a team. * Sensitivity to the understanding of the social determinants of health. * Proficiency in using electronic health records and documentation systems. * Valid driver's license and reliable transportation for community outreach. Additional Job Details (if applicable) Physical RequirementsStanding Frequently (34-66%) Walking Frequently (34-66%) Sitting Occasionally (3-33%) Lifting Frequently (34-66%) 35lbs+ (w/assisted device) Carrying Frequently (34-66%) 20lbs - 35lbs Pushing Occasionally (3-33%) Pulling Occasionally (3-33%) Climbing Rarely (Less than 2%) Balancing Frequently (34-66%) Stooping Occasionally (3-33%) Kneeling Occasionally (3-33%) Crouching Occasionally (3-33%) Crawling Rarely (Less than 2%) Reaching Frequently (34-66%) Gross Manipulation (Handling) Frequently (34-66%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) Remote Type Hybrid Work Location One Constitution Wharf Scheduled Weekly Hours 40 Employee Type Regular Work Shift Rotating (United States of America) Pay Range $20.43 - $29.21/Hourly Grade 4 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: The General Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. This role will be covering oral maxillofacial/ dental. This is a fully remote position. Job Summary Summary: Assists Manager with the Patient Billing Office's client relationship and coordinate the processing, reporting and analysis of key revenue cycle activities. Provides research support to the manager and assigned practices related to accounts receivable management, patient customer service complaints and Third Party Requests for information. Does this position require Patient Care? No Essential Functions: Assists the Manager in completing tasks including, but not limited to, report review and distribution, billing account inquiries, charge reconciliation and research of missing charges, procedure code dictionary maintenance, and other essential Master files. * Analyze information on trends for practice groups; this may involve account research and downloading or inputting information into spreadsheets. * Provides research and follow-up for inquiries from Customer Service. * Pulls monthly rejection details. The role is responsible for pivoting rejections and analyzing rejections prior to RCAM review. * Work EPIC work queues and resolve edits in compliance with GPM Service standards for assigned billing areas. * Review accounts referred for write-off and document collection efforts prior to transferring for write-off approval. * Assist with the orientation and training of new staff. Qualifications Education High School Diploma or Equivalent required Experience Revenue, billing and related experience 2-3 years required Knowledge, Skills and Abilities * Strong knowledge of medical billing and payer requirements. * Excellent leadership and team management skills. * Proficiency in billing software and electronic health records (EHR) systems. * Strong analytical and problem-solving abilities. * Exceptional communication and interpersonal skills. * Ability to handle multiple tasks and work under pressure. * Ability to work with a high degree of accuracy. Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $62,400.00 - $90,750.40/Annual Grade 6 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. Under the direction of the Senior Medical Director, the Medical Director leads as a senior physician at the health plan. This position works closely with the Senior Medical Director in providing medical management leadership for clinical services operations and programs. This role focuses on and has expertise in utilization management, health plan quality and accreditation, care management, and other health plan functions. Qualifications Licensure and Credentials: Must maintain an active full physician license in Massachusetts Experience: * 3-5 years of Health Plan experience * at least 5 years of clinical practice experience Job Duties: Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities * Reviews clinical services and quality incidents when sufficiently serious to merit physician involvement * Coverage of medical necessity determinations to support special investigations/fraud waste and abuse cases * Collaborates on health plan medical policy development * Assesses new, emerging, and existing technologies to determine appropriateness of health plan coverage * Partners with clinical leaders to ensure medical service expenditures remain within budget * Collaborates with business development, quality, finance and medical management teams to promote improvements in the quality and cost efficiency of care throughout the MGB Health Plan provider network * Delivers consultation to network management staff and deployment of education programs for network clinicians * Develops and delivers presentations for clinical staff on current topics relevant to MGB Health Plan members and network * May represent MGB Health Plan at a variety of external forums and committees * Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees * Monitors performance metrics and audits to identify areas for continuous improvement and ensure compliance * Anticipates and meets or exceeds internal and/or external customer expectations and requirements; establishes and maintains positive relationships with customers and gains their trust and respect * Build strong relationships and infrastructure that designate MGB Health Plan as a people-first organization * Ensure diversity, equity and inclusion are integrated as a guiding principle * Other duties as assigned with or without accommodation Additional Job Details (if applicable) Primarily remote position, exempt * In person meetings as requested for business needs * Participates in after hours and weekend call rotation as assigned Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) EEO Statement: Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

The Lead Agent for the Access Center is a senior level individual, responsible for scheduling appointments, consults and follow-up appointments for patients, and who takes a lead role among this group, mentoring and managing all training for new and less experienced staff. This individual assists the Supervisor in oversight of front desk and office activity, or functions as point of contact in the Supervisors absence. **Qualifications** + High School diploma/GED + 3+ years of secretarial/clerical experience, preferably with some directly related experience, in a medical practice environment **Responsibilities** 1. Schedules patient FPA appointments and updates practice management system. 2. Collects patient demographics and insurance information and enters into practice management system. 3. Verifies patient insurance coverage prior to appointment and advises patient of any insurance referrals or authorizations needed. 4. May schedule patients appointments for tests or consults. 5. May initiate reminder calls for next days appointments. 6. Manages training and mentors less experienced Scheduling Coordinator and administrative staff, and discusses issues of concern with Supervisor. 7. May perform duty as liaison between Scheduling Coordinator staff and Administrative Assistants in addressing patient concerns. 8. Participates in customer service initiatives, patient satisfaction surveys, ACD and appointment reporting. 9. May participate and offer input into the Performance Appraisal process with the Supervisor. 10. Point of contact in the Supervisors absence. 11. Performs other related duties. **About Us** **Strength through Unity and Inclusion** The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai's unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual. At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history. **About the Mount Sinai Health System:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report's "Best Children's Hospitals" ranks Mount Sinai Kravis Children's Hospital among the country's best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's Best Smart Hospitals" ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. **Equal Opportunity Employer** The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. **Compensation Statement** Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $21 - $34 Hourly. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

At Virtua Health, we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between - we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics. Location: 100% RemoteCurrently Virtua welcomes candidates for 100% remote positions from: AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV only. Remote Type: 100% Remote Employment Type: Employee Employment Classification: Regular Time Type: Part time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 17 Additional Locations: Job Information: Please note all candidates must complete onsite testing in Marlton, NJ. Summary: Codes and abstracts hospital medical records (including Inpatients, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department) for diagnostic and procedural coding. Utilizes federal, state procedures/guidelines to assure accuracy of coding and abstracting and productivity standards. Collaborates with medical staff and clinical documentation improvement (CDI) staff to clarify documentation. Maintains performance in accordance with corporate compliance requirements as it pertains to the coding and abstracting of medical records, as well as Diagnosis Related Group (DRG) assignment. Position Responsibilities: Accurately reviews each record and knowledgeably utilizes ICD-10-CM, ICD-10-PCS, CPT-4, and encoder to accurately code all significant diagnoses and procedures according to American Hospital Association (AHA), American Health Information Management Association (AHIMA), Uniform Hospital Discharge Data Set (UHDDS) hospital specific guidelines and rules/conventions. Records coded include Inpatient, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department. Sequences principal (or first-listed) diagnosis and principal procedures according to documentation found in the medical records and UHDDS definitions. Utilizes ongoing knowledge and reference material regarding DRGs to validate DRG assignments. Accurately utilizes written federal and state regulations and written guidelines regarding definitions and prioritizing of abstract data elements to assure uniformity of database. Records abstracted include Inpatient, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department. Verifies and/or abstracts required data into computer system according to procedure. Utilizes equipment and processes appropriately, to ensure efficient coding and abstracting; utilizes the established downtime procedures as needed. Participates in maintaining DNB and accounts receivable goal. Maintains department level competencies. Participates in performance improvement activities. Position Qualifications Required / Experience Required: Minimum of two years inpatient records coding experience Ability to perform functions in a Microsoft Windows environment Ability to be detailed oriented and perform tasks at a high level of accuracy Ability to make sound decisions Demonstrate good communication and teamwork skills Previous experience with an electronic legal health record system Required Education: High School Diploma or GED required Knowledge of Anatomy & Physiology/ Medical terminology required Coding education Training/Certifications/Licensure: AHIMA Certification: Certified Coding Specialist (CCS) required for all employees hired after 10/1/2025. Non-CCS-Certified Hourly Rate: $26.22 - $40.65 Hourly Rate: $27.80 - $43.12 The actual salary/rate will vary based on applicant's experience as well as internal equity and alignment with market data.Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies. For more benefits information click here.

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Reporting to the Revenue Integrity Manager, the Revenue Integrity Analyst II plays an important role in a high-profile group tasked with improving revenue results by taking a global view of clinical and financial processes, functions and interdependencies from the provision of patient care to final bill generation. Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, well-developed analytic and organizational skills, and the ability to meet deadlines while influencing, but not directly managing the work of others. PRINCIPAL DUTIES AND RESPONSIBILITIES * Provide support for assigned service lines and in collaboration with team, performs reviews related to Charge Description Master (CDM) integrity. * Evaluates current charging, coding structures and processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payor requirements. * Assesses the accuracy and build of all charging workflows in EPIC, including documentation, dictionaries, preference lists and other interface or third-party charging systems. * Provides MGB Enterprise guidance, communication and education on correct charge capture, coding and billing processes. * Leads and participates in moderately complex projects related to revenue cycle initiatives. * Collaborates with Digital Health eCare (DHeC), Revenue Cycle Operations staff, Compliance, Budget Office, MGB Coding, Internal Audit and other Revenue and Finance departments on revenue management initiatives. * Analyzes Epic work/error que data and performs root cause analysis. Executes on work plans to correct identified deficiencies. Formally prepares and presents findings in standard presentation for other committees, including leadership. * Analyzes changes to coding and billing rules and regulations by utilizing appropriate reference materials, internet sources, seminars and publications. Executes on work plans to adapt systems and processes to accommodate changes. * Attend seminars/webinars on payor regulations and annual code set changes. * Professional development to include training and support of coding certifications. * Provide support to junior analysts by assisting with day-to-day questions and assisting with training. Qualifications Education Bachelor's degree in finance or science or equivalent combination of education and experience preferred Role accept experience in lieu of a degree? Yes Licenses and Credentials Applicable clinical or professional certifications/licenses such as COC, CPC or AHIMA-CCS are highly desirable Experience Three to five years of experience in a hospital setting or within the healthcare industry preferred Knowledge, Skills and Abilities * Ability to review, analyze and interpret payor payment policies, billing guidelines, and state and federal regulations. * Financial analysis application skills, including database development and report generation. * Advanced Excel and Access skills required. * Strong customer service skills * Well-developed, formal presentation skills. * Comfort in presenting to and interacting with senior levels of hospital management and with physician leaders. * Excellent organizational and project management skills. * Capacity to manage time effectively, attention to detail, and follow through. * Well-developed research skills. * Strategic thinker with business acumen. * Advanced level root cause analysis Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $62,400.00 - $90,750.40/Annual Grade 6 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. LCSW: starting pay rate $68,224 LICSW: starting pay rate $92,227 SIGN ON BONUS AVAILABLE for eligible Non-MGB employees: $3,000 FOR LCSW, $10,000 FOR LICSW/LMHC, Please ask about the details! Job Summary Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds - including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service - for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research. The Massachusetts General Hospital seeks a dynamic Licensed Clinical Social Worker (LCSW)/Licensed Independent Clinical Social Worker (LICSW) to serve on the Special Operations Team. In this role, the LCSW/LICSW will provide and oversee the provision of psychiatric, psychosocial, and overall mental health services and referrals for military Special Operators into the Home Base program. They will also be dedicated to supporting the Special Operations Forces (SOF) program and will provide coverage to other clinical operations as needed. The LCSW/LICSW may help cover approximately 2-3 weekend shifts per year. Summary This position will collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs as part of the interdisciplinary team. They work collaboratively with all healthcare team members to develop and implement treatment plans that support patient-centered plans of care for both individual patients and the medical community. Does this position require Patient Care? Yes Essential Functions * Provides psychosocial assessments of patients and families with social, emotional, interpersonal, and/or environmental issues. Formulates biopsychosocial assessment, disposition, and treatment plans. * Collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs as part of the interdisciplinary team. * Monitor, evaluate, and record client progress according to measurable goals described in the treatment and care plan. * Coordinate care for Special Operations Forces (SOF) veterans and military-connected family members seeking care at Home Base with the appropriate internal or external clinicians in a multi-disciplinary team, coordinated care model. * Serve as a contact point for accepting and triaging SOF referrals from internal clinicians, outside clinicians and self-referred patients. * Serve as primary case manager for patients in SOF admissions process in collaboration with Admissions Coordinator, including, but not limited to, the following responsibilities: conduct pre-screening to assess treatment and evaluation needs for SOF patients referred; coordinate signing of Release of Information forms, acquire relevant medical records, and coordinate with SOCOM where applicable; serve as point of contact for ongoing questions from the patient as they arise. * Monitor patient's status in admissions process using appropriate documentation. * May be asked to collaborate with SOF/ComBHaT team, patients, clinical team, and Resource Specialist to identify clinical and psychosocial needs in patients' home communities and identify appropriate resources. * May provide direct clinical services to Veterans and/or family members, which may include group or individual therapy. * May provide psychoeducation regarding PTSD, TBI, and related conditions to Veteran patients and family members as clinically appropriate within the context of the Intake and triage duties. * Collaborate with an inter-disciplinary team of clinical staff (social workers, psychologists, nurses, psychiatrists, physiatrists, physical therapists, etc.) to coordinate patient care and plan for discharge/aftercare when needed. * Consult with team to facilitate mandated assessments when abuse is suspected (child, disabled adult, elder), and safety assessment when violence is reported. Collaborates with MGH resources (HAVEN and Child Protection Team). * May assist with crisis intervention and management. * Documents timely and relevant information in patient electronic medical record and Home Base database. * Provide coverage for social work responsibilities in Outpatient Clinic as needed. * For LICSWs: provide clinical supervision to LC-level and/or MSW students as needed. * Additional responsibilities as assigned. Qualifications Education Master's Degree Social Work required or Master's Degree Mental Health & Behavioral Medicine required Can this role accept experience in lieu of a degree? No Licenses and Credentials Current professional licensure in Massachusetts (LCSW required, LICSW preferred). Experience Clinical Social Worker I Clinical Experience in a medical setting 0-1 years required Clinical Social Worker II Clinical Experience in a medical setting 2-3 years required Knowledge, Skills and Abilities * Excellent organizational and time management skills. * Excellent crisis intervention skills. * Good problem solving and conflict resolution skills. * Ability to work well collaboratively and independently. * Strong written and verbal communication skills. * Knowledge of community resources and the aging process. * Demonstrates basic foundational skills, showing fundamental knowledge and a commitment to the application of professional values and ethics. * Demonstrates fundamental skills in formulation, assessment of risks, crisis intervention completion of psychosocial treatment plans, and appropriate documentation. * May need assistance and guidance in ensuring the patient's needs, safety measures, and concerns are brought forward. Emerging knowledge of internal and external resources. * Developing and demonstrating interpersonal collaboration in a medical setting- inpatient or outpatient. * May need coaching/guidance in this area. * May provide some assistance and support with onboarding for new team members. * Aware of opportunities in department/service initiatives; participates in initiatives at an entity level. Uses data to measure progress. * Demonstrate fundamental skills under supervision. May need assistance in promoting collaboration among healthcare team members, other colleagues, and the organization to support and enhance patient care. Additional Job Details (if applicable) Physical Requirements * Standing Frequently (34-66%) * Walking Frequently (34-66%) * Sitting Occasionally (3-33%) * Lifting Frequently (34-66%) 35lbs+ (w/assisted device) * Carrying Frequently (34-66%) 20lbs - 35lbs * Pushing Occasionally (3-33%) * Pulling Occasionally (3-33%) * Climbing Rarely (Less than 2%) * Balancing Frequently (34-66%) * Stooping Occasionally (3-33%) * Kneeling Occasionally (3-33%) * Crouching Occasionally (3-33%) * Crawling Rarely (Less than 2%) * Reaching Frequently (34-66%) * Gross Manipulation (Handling) Frequently (34-66%) * Fine Manipulation (Fingering) Frequently (34-66%) * Feeling Constantly (67-100%) * Foot Use Rarely (Less than 2%) * Vision - Far Constantly (67-100%) * Vision - Near Constantly (67-100%) * Talking Constantly (67-100%) * Hearing Constantly (67-100%) Remote Type Hybrid Work Location One Constitution Wharf Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $56,992.00 - $82,992.00/Annual Grade 6 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: The General Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: Scheduled Weekly Hours: 40Salary Range: 19.00 - 30.50 Union Position: No Department Details Summary Responsible for conducting internal audits and monitors to ensure that the organization's processes and operations are in compliance with laws, corporate guidelines, best practices, and contractual agreements. Job Description Knowledgeable of general audit concepts and techniques, including the type of audits, the approaches and processes, and the subsequent activities, as they relate to internal audits. Demonstrates the ability to interpret Federal rules and regulations. Demonstrates the ability to research regulation from various data sources. Demonstrates an advanced knowledge and skill in analyzing patient records to identify non-conformances in Current Procedural Terminology (CPT), International Classification of Diseases, Tenth Edition (ICD-10), and Healthcare Common Procedure Coding System (HCPCS) code assignment. Demonstrates both knowledge and application of Sanford Health Systems, policies, procedures, and guidelines. Demonstrates commitment to continuous learning for themselves and performs as a role model to other coding staff. Qualifications High school diploma or equivalent preferred. Advanced diploma or degree in Health Information Management or healthcare related field is preferred. Prior relevant compliance work experience is preferable. Two years' experience is required. Certification in one of the following is required: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC) or an equivalent. Certified Healthcare Auditor (CHA) certification to be completed within one year of employment is preferred. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.

is Onsite/Hybrid - currently 1 day a week onsite** **Location: 150 E 42nd Street location. Prefer candidates that reside in tri-state area NY, NJ, CT or a commutable distance to meet onsite/hybrid requirements for this position.** The Product Manager - AI is a key leadership role responsible for defining, prioritizing, and delivering AI-driven solutions to optimize clinical effectiveness and improve patient safety across hospitals and diverse care settings. This role will lead the deployment and operationalization of AI products in collaboration with cross-functional stakeholders, including clinicians, operational leaders, data scientists, engineers, and compliance teams. The Product Manager will ensure these products deliver measurable impact, meet regulatory and ethical standards, and integrate seamlessly into clinical workflows. **Qualifications** **Minimum Education** Bachelor's degree; Master's in Healthcare, Data Science, or related field preferred **Minimum Related Experience** + Four or more years of related experience + Background in analytical and strategic roles + Familiarity with EHR systems, healthcare interoperability, and clinical workflows. + Technical, design, and data fluency preferred + Understanding of healthcare preferred **Desired Qualities:** + **High-agency** : Strong sense of ownership, accountability, and urgency in delivering AI products that make a real-world clinical impact. + **Healthcare AI expertise** : Understanding of machine learning/AI development, deployment, and monitoring in clinical settings. + **Results-oriented** : Committed to measurable improvements in patient safety, care quality, and operational efficiency. + **Effective communicator** : Able to explain complex AI concepts and clinical workflows to diverse audiences, including executives and frontline clinicians. + **Advanced social-emotional skills** : Relationship-driven, collaborative, humble, and patient + **Quality decision maker** : Curious, analytical, and critical thinker with top-tier acumen. Strong product, design, and business instincts + **Collaborative leader** : Skilled at aligning data science, engineering, and clinical teams toward shared goals. 271 - DTP Clinical Data Science - MSH, Mount Sinai Hospital **Responsibilities** + **Identify AI Product Opportunities** o Conduct workflow analysis, stakeholder interviews, and data reviews to define and prioritize opportunitieso Translate clinical requirements into AI product specifications and success metrics + **Oversee AI Product Lifecycle** o Lead product vision, strategy, and roadmap for AI solutions from concept to implementationo Collaborate with data science and engineering teams to develop and validate models, ensuring compliance with institutional policies and regulatory requirementso Partner with clinical and operational leaders to ensure seamless integration into hospital and care setting workflows + **Launch and Operationalize AI Products** o Develop adoption and change management plans to support clinician engagement and sustained useo Ensure deployment aligns with clinical workflows, DTP infrastructure, and patient safety protocols + **Demonstrate Impact** o Define KPIs for safety, quality, efficiency, and adoption; measure ROIo Prepare business cases and assurance reports for leadership and governance committees.o Drive ongoing stakeholder engagement to sustain product effectiveness. + **Manage Stakeholders and Governance** o Serve as the primary point of contact for AI product governance, including compliance, risk, and assurance activities.o Build cross-functional coalitions, seek feedback, and drive decision-making.o Participate in institutional AI governance committees and working groups. + **Other responsibilities:** This role involves ambiguous, complex problem solving and will require flexibility in the scope of responsibilities. Other responsibilities include, but are not limited to, becoming a subject matter expert on various product, operational, and technical domains, participating in governance committees and working groups, and executing diverse initiatives **About Us** **Strength through Unity and Inclusion** The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai's unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual. At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history. **About the Mount Sinai Health System:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report's "Best Children's Hospitals" ranks Mount Sinai Kravis Children's Hospital among the country's best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's Best Smart Hospitals" ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. **Equal Opportunity Employer** The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. **Compensation Statement** Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $120000 - $180060 Annually. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

It's more than a career, it's a calling. MO-REMOTE Worker Type: Regular Performs as a vital member of the interdisciplinary care team member, an auditor, and an educator ensuring medical records are complete and clinical documentation comprehensively represents the current health status of network patients against ever-changing risk adjusted models. Responsible for achieving improved documentation results and risk adjusted scores for the organization, along with documentation and electronic health record charts that accurately capture the clinical picture. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Reviews clinical records of both clinical documentation integrity and mortality scoring. Collaborates with others regarding clinical documentation improvement (CDI) and risk adjustment (mortality) findings. Maintains knowledge of Centers for Medicare and Medicaid Services (CMS) requirements related to clinical documentation and provides feedback to clinical staff regarding these requirements during the concurrent record review process. Maintains knowledge of mortality models, observed rate/expected rate (O/E ratios), industry trends, variable and diagnosis review group (DRG) frequency. Serves as a liaison between coding staff and physicians as appropriate. Identifies and initiates opportunities for new program development or program extensions, as well as opportunities based on outcomes analysis for program process improvements. Works with other team members regarding opportunities for improvement in standard work. Maintains documentation, logs adjusted risk and CDI opportunities. Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient's age-specific needs and clinical needs as described in the department's scope of service. Works in a constant state of alertness and safe manner. Performs other duties as assigned. EDUCATION Graduate of accredited school of nursing, PA, NP, or medical school, or Associate's degree and Certified Clinical Documentation Specialist (CCDS) certification from the Association of Clinical Documentation Improvement Specialist (ACDIS) EXPERIENCE Two years in an acute care setting with two years experience in clinical documentation or 4 years experience in clinical documentation with a Certified Clinical Documentation Specialist (CCDS) certification PHYSICAL REQUIREMENTS Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc. Frequent keyboard use/data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Rare climbing. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Physician Assistant in Medicine, Licensed - Illinois Department of Financial and Professional Regulation (IDFPR) Or Physician - Regional MSO Credentialing Or Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Or Advanced Practice Nurse (APN) - Illinois Department of Financial and Professional Regulation (IDFPR) Or APN Controlled Substance - Illinois Department of Financial and Professional Regulation (IDFPR) Or Full Practice Authority APRN Control Substance - Illinois Department of Financial and Professional Regulation (IDFPR) Or Full Practice Authority APRN - Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Physician Assistant - Missouri Division of Professional Registration Or Physician - Regional MSO Credentialing Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Missouri Division of Professional Registration Or Nurse Practitioner - Missouri Division of Professional Registration State of Work Location: Oklahoma Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Acknowledgement of Receipt of Application for Physician Assistant - Oklahoma Medical Board Or Physician Assistant - Oklahoma Medical Board Or Physician - Regional MSO Credentialing Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Oklahoma Board of Nursing (OBN) Or Advanced Practice Registered Nurse (APRN) - Oklahoma Board of Nursing (OBN) Or Certified Family Nurse Practitioner (FNP-C) - American Academy of Nurse Practitioners (AANP) State of Work Location: Wisconsin Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS) Or Physician Assistant - Wisconsin Department of Safety and Professional Services Or Physician - Regional MSO Credentialing Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services Or Advanced Practice Nurse Prescriber (APNP) - Wisconsin Department of Safety and Professional Services Work Shift: Day Shift (United States of America) Job Type: Employee Department: ********** Sys Clinical Documentation Improvement Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Visas Accepted N/A Specialty Practice Details Sanford Virtual Care Center is seeking a BE/BC General Radiologists and fellowship trained Radiologists to join the practice. • All shifts will be CST • Schedule is flexible: rotate between days, nights and weekends • Compensation plan: virtual radiologists are on a shift based plan • Hourly rate = $380.00 • Includes a retention incentive for qualified candidates • Candidates interested in general and neuro for emergent and inpatient studies are desired, all others are encouraged to apply • Provide timely reads for emergent (including adult and pediatric trauma), urgent, and routine imaging studies • Interpret a wide range of imaging studies, including: • X-rays • CT scans • MRI • Ultrasound • Well-trained Radiographic Technologists and support staff in the various clinical environments • State of the art technology including dual energy CT and 3T MRI Community Description Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. Headquartered in Sioux Falls, South Dakota, the organization has 53,000 employees and serves over 2 million patients and nearly 425,000 health plan members across the upper Midwest including South Dakota, North Dakota, Minnesota, Wyoming, Iowa, Wisconsin and the Upper Peninsula of Michigan. The integrated nonprofit health system includes a network of 56 hospitals, 288 clinic locations, 147 senior care communities, 4,000 physicians and advanced practice providers and nearly 1,500 active clinical trials and studies. Sanford Health Virtual Care Initiative The organization's transformational virtual care initiative brings care close to home. At Sanford Health, through our transformational virtual care initiative, we are reimaging how care is delivered to our rural communities by expanding our virtual care options and bringing care close to home. • Commitment to providing the right care at the right time in the right place • Improve access to care by creating a reliable, easy to use connection for patients, families and clinicians • Elevate the human experience to engage patients and families in whole-person care • Ensure continuity of care across all health care settings • Offer best-in-class education and training curriculum to clinicians, patients, families and communities • Use and develop next generation tools and technology to provide high-quality, safe care with an emphasis on convenience and affordability • A team focused on research and development that creates and tests next-generation care solutions Job Description Radiology Core Privileges include the ability to perform history and physical examination, consult, evaluate, diagnose, and provide treatment plans for patients of all ages. Qualifications M.D. or D.O. degree. Experience can be demonstrated in one of the following ways: An applicant who has just completed a residency shall provide his/her residency. OR An applicant who is not applying directly out of a residency shall provide a quality profile from hospital(s) where he/she currently has privileges showing his/her clinical activity for the past 24 months, including numbers of procedures performed morbidity, mortality, infection rates, and other complications. The applicant must be able to demonstrate active involvement of at least 200 Radiology examinations in the last 24 months. OR If a quality profile is not available from the hospital(s) where the applicant currently has privileges, documentation of the applicant's clinical activity for the past 24 months will be accepted. The applicant must be able to demonstrate active involvement of at least 200 Radiology examinations in the last 24 months. More education and experience may be required the more advanced the practice becomes. Successful completion of a hospital affiliated Radiology residency program accredited by the ACGME, the American Osteopathic Association (AOA) or the Royal College of Physician and Surgeons of Canada. The Credentials Committee; Physician Executive or Medical Affairs Committee; and the Board of Directors or the Board of Governors may consider training at residency program accredited by organizations other than the above. Certification by the appropriate specialty board of the American Board of Medical Specialties (ABMS), the American Osteopathic Association (AOA), or the Royal College of Physicians and Surgeons of Canada, as applicable. Those applicants who are not board certified at the time of application but who have completed their residency training within the last five years shall be eligible, however must achieve board certification within five years from the date of completion of their residency training unless the appropriate governing Board waives such requirement. (Refer to each entities policy for grandfather exceptions) Compensation Sanford Health offers a nationally competitive shift based compensation plan with an additional physician benefits package including health, dental and vision insurance, 401K plan, short-term and long-term disability, life insurance, CME dollars, malpractice insurance and tail coverage Recruiter Information Jessilyn Barker, Lead Physician RecruiterPhone: ***************** Or ********************************* Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Authorization Specialist (Remote in Wisconsin/Michigan) Cost Center:101651135 Insurance VerificationScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; day shifts (United States of America) Job Description: **Wisconsin and Michigan residents only eligible to apply** JOB SUMMARY The Authorization Specialist is a healthcare professional responsible for reviewing patient medical records to determine if a prescribed treatment, procedure, or medication requires prior authorization from the insurance company, ensuring that the requested care is deemed medically necessary and covered under the patient's benefits before it can be administered; this involves verifying patient eligibility, contacting insurance companies to obtain authorization, and managing the process to minimize delays in patient care. An Authorization Specialist works in a fast-paced environment with high call volumes, requiring strong organizational skills and the ability to manage multiple tasks simultaneously. JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: None Preferred/Optional: Successful completion of post-secondary courses in Medical Terminology and Diagnosis and CPT Coding, and Anatomy & Physiology. Graduate of a Medical Assistant, Health Unit Coordinator or Health Care Business Service program. EXPERIENCE Minimum Required: Two years' experience in a medical business office or healthcare setting involving customer service or patient-facing responsibilities, or equivalent experience. In addition to the following: Medical knowledge: Understanding of basic medical terminology, disease processes, and treatment options to accurately assess medical necessity. Insurance knowledge: Familiarity with different insurance plans, benefit structures, and prior authorization guidelines. Excellent communication skills: Ability to effectively communicate with healthcare providers, insurance companies, and patients to clarify information and address concerns. Attention to detail: High level of accuracy in data entry and review of medical records to ensure correct prior authorization requests. Problem-solving skills: Ability to identify potential issues with prior authorization requests, navigate complex situations, and find solutions to ensure timely patient care. Preferred/Optional: None CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: None Preferred/Optional: None **Wisconsin and Michigan residents only eligible to apply** Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: Day (United States of America) Scheduled Weekly Hours: 0Starting Rate: $16.50 Union Position: No Department Details Summary Contribute to Sanford Health Talent Acquisition by engaging in recruitment and brand awareness efforts that spread the mission, vision, and values of the organization on their college campus. Job Description Campus Ambassadors are college students that will work remotely from the college campuses they currently attend to promote the mission of Sanford Health and Good Samaritan Society through various recruitment and brand awareness efforts. Ambassadors will be responsible for building and maintaining candidate pipelines to support the workforce needs of Sanford Health and Good Samaritan Society in collaboration with talent acquisition professionals, academic leaders, and business leaders. Qualifications Current enrollment in an Associate or Bachelor's degree program from an accredited college or university. Working knowledge of Microsoft Office products. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary General Summary/Overview Statement: The Clinical Research Regulatory Coordinator I (CRRCI) works under general supervision to ensure the regulatory requirements for clinical trials are met. This position involves working with clinical teams, Institutional Review Boards (IRB), clinical trial sponsors and federal regulatory agencies. The CRRCI will be trained on the institutional and federal regulations governing clinical research. This position does not involve patient contact. Principal Duties and Responsibilities: The following regulatory duties will be performed under general supervision by the Clinical Research Manager: * Maintain and organize study specific regulatory binders * Prepare and submit protocol amendments, continuing reviews, and safety reports to the IRB * Revise informed consent documents to include new risk information and/or updated protocol requirements through the course of the study * Manage adverse event and deviation/violation/exception documentation for all enrolled patients and report to the sponsor and IRB as required * Submit Data and Safety Monitoring Reports * Maintain source documentation of correspondence with the IRB, investigators, and sponsors throughout the clinical trial process * Collect, complete, and submit essential regulatory documents to various regulatory entities * Participate in monitoring visits and file all monitoring visit correspondence * Ensure appropriate documentation of delegation and training for all study staff members * Maintain screening and enrollment logs Skills/Abilities/Competencies Required * Careful attention to detail * Good organizational skills * Ability to follow directions * Good communication skills * Computer literacy * Working knowledge of clinical research protocols Qualifications Education: Bachelor's Degree Related Field of Study required Can this role accept experience in lieu of a degree? Yes Licenses and Credentials: n/a Experience: Knowledge, Skills and Abilities: * Careful attention to detail. * Good organizational skills. * Ability to follow directions. * Computer literacy. * Working knowledge of clinical research protocols. Additional Job Details (if applicable) Working Conditions: * Duties will be performed remotely Remote Type Remote Work Location 101 Merrimac Street Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $19.76 - $28.44/Hourly Grade 5 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

**Why BayCare?** At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers, and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy built on trust, dignity, respect, responsibility, and clinical excellence. BayCare Health System is currently in search of our newest **Respiratory Therapist** who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Our team members focus on tomorrow by achieving personal and professional success today. **Position Details** + **Facility:** BayCare Health System - Respiratory Service Care Float-HSS + **Location:** BayCare System Office West + **Status:** Full Time, Exempt: No + **Shift Hours:** 6:30 PM - 7:00 AM + **Shift:** Nights (Shift 3) + **Weekend Work:** Every Other + **On Call:** No + **Remote Work:** Never **Job Summary** Provides advanced respiratory care in high-acuity settings including hospital-based and free-standing emergency/trauma centers, as well as neonatal, pediatric, and adult intensive care units. Demonstrates proficiency in complex respiratory interventions and serves as a lead therapist, preceptor, mentor, and role model within the department. Supports clinical excellence by guiding peers, promoting best practices, and ensuring high standards of patient care. **Responsibilities** + Deliver advanced respiratory care services under physician orders and hospital protocols. + Perform complex interventions validated through competency assessments. + Serve as a resource and mentor for team members. + Provide coverage across multiple care settings as needed. **Certification and Licensure Required** + **Adult Critical Care:** RRT + ACCS (RRT-ACCS) + Mixed Care (Adult + Neonatal/Pediatric): RRT + ACCS or RRT + NPS + Neonatal/Pediatric ICU & Transport: RRT + NPS + **Pulmonary Function Lab:** RRT + RPFT + **Pulmonary Rehabilitation:** RRT + Pulmonary Rehab Certificate or RPFT + Blood Gas & CAPs: RRT + BS Degree meeting CAPs requirement + **Additional Certifications:** + BLS (Basic Life Support) + ACLS (within 30 days) + PALS (within 6 months if pediatric) + NRP (within 6 months if neonatal) **Education Required** + Technical Respiratory Therapy Program Completion + **Preferred:** Associate Degree in Respiratory Therapy **Specific Skills Required** + Advanced respiratory assessment and evaluation + Clinical judgment in high-acuity settings + Ability to mentor and collaborate within a team + Critical thinking and problem-solving Equal Opportunity Employer Veterans/Disabled **Position** Respiratory Therapy Specialist Float **Location** Clearwater:BayCare Sys Office West | Clinical | Full Time **Req ID** 119236

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Patient Assistance Counselor - Local Wisconsin Remote PotentialCost Center:101651100 Financial CounselingScheduled Weekly Hours:40Employee Type:RegularWork Shift:40 Normal (United States of America) Job Description: JOB SUMMARY The Patient Assistance Counselor is responsible for interviewing, verifying insurance benefits, and following up with uninsured and underinsured patient referrals to assess and assist with their medical, social and financial needs. The individual reviews financial assistance and medication assistance applications to ensure program and financial requirements are met. The individual may calculate income and assets totals and determine level of financial assistance award, and medication assistance eligibility, according to protocol. The Patient Assistance Counselor maintains a thorough knowledge of health care coverage opportunities available through local, state or federal and pharmaceutical programs and Foundation grants, and assists with outreach and enrollment to bridge patients with these resources. Candidate selected for this role will need to be located, or willing to relocate to Wisconsin, Marshfield Clinic regional footprint. JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: None Preferred/Optional: Successful completion of a diagnosis, current procedural terminology (CPT) and medical terminology courses at time of hire. EXPERIENCE Minimum Required: Two years' experience in medical business office, health care setting or comparable experience required. Preferred/Optional: None CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: None Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: Day (United States of America) Scheduled Weekly Hours: 40Salary Range: $15.00 - $20.00 Union Position: No Department Details WFH Day 1 Summary The Associate Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement; primarily but not limited to prebilled accounts. Job Description Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Processes daily workflow changes that depending on department may include, eligibility verification, verification of information, payment postings, initiating refunds, processing month end, resolving and troubleshooting incidents, reporting, initial billings and re-billings of claims, scanning and indexing of documents, and be the point of contact to provide assistance as needed. Responsible for assuring accounts are set up correctly with the information available is completed timely and accurately. Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials that are technical in nature (i.e.: records required denials). Performs miscellaneous job related duties as requested. Qualifications High school diploma or equivalent preferred. Previous billing experience preferred. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Physician - Remote Emergency RadiologistCost Center:201641261 System Radiology-ProfScheduled Weekly Hours:40Time Type:Full time Job Description: Marshfield Medical Center is looking for a BC/BE Radiologist to join our ED section in Wisconsin. Fellowship training in Body, Neuro, ED or MSK is required. Must be comfortable with all emergent diagnostic imaging modalities including Neuro CTA/perfusion, trauma (including MRI), Ultrasound (including OB), pediatrics and occasional musculoskeletal MRI/CT. No CVIR, nuclear medicine or mammography. Choose to work remote as a Non-Associate on a casual contract or may have the option to work locally at one of our centers as an Associate physician with additional salary and benefits. If working onsite, you will need to be comfortable with and will be responsible to occasionally perform some local minor procedures. Service coverage includes a level 2 soon to be level 1 trauma center and stroke center as well as additional regional hospitals and urgent care centers. Coverage needed for afternoons and evenings. No midnight shifts required. Yearly work requirement is 182 shifts a year - typically 7 on/7 off schedule/26 weeks per year Compensation/Benefits: Competitive Salary Flexible shift based model Health, Dental, Life, and Occurrence Based Malpractice insurance Relocation support available if working onsite Marshfield Clinic Health System is a non-profit 501(c)(3) organization. This may qualify you for additional state and/or federal education loan forgiveness programs. MCHS strongly encourages our physicians to be involved in medical education and research to continue building our strong foundation of patient care, research, and education for years to come. Marshfield Clinic Research Institute: ********************************** Marshfield Clinic Division of Education: ****************************************** Marshfield, Wisconsin Nestled in the heart of Wisconsin, Marshfield is a safe, clean community with a population of about 20,000 people. The region boasts a solid economy and a low cost of living, which includes below national average costs for housing and transportation. Community pride is evident in the private and city funds invested in making Marshfield a great place to live. Located one mile outside of town, you will have access to 6,500 acres for hiking, biking, hunting, canoeing, cross-country skiing, berry picking, and wildlife or bird watching or simply enjoying the fresh air. With excellent schools and high school graduation rates high above the national average, Marshfield is committed to offering and preparing students for top-notch educational opportunities. Those of us that have chosen to call Marshfield home have come to enjoy the benefits of short commutes, safe and friendly neighborhoods, fresh air and water, bountiful nature, and so much more. Come and see for yourself. Fun Fact: Marshfield is known as the HEART of Wisconsin! Marshfield Clinic Health System physicians and staff are motivated by our mission to enrich lives. We serve more than 350,000 unique patients each year through accessible, high quality health care, research and education. With more than 1,600 providers in 170 medical specialties and subspecialties as well as over 13,000 employees in 65 clinical locations in 45 communities serving Wisconsin and Michigan's Upper Peninsula, Marshfield Clinic Health System is nationally recognized for innovative practices and quality care. The Marshfield Promise Motivated by our mission to enrich lives, we use common values to ensure those we serve feel supported in their healthcare journey and staff and providers are actively engaged with one another. Together through our actions, we promise to deliver compassionate, safe and expert care to everyone. The Marshfield Promise is centered around 5 core values; Patient-Centered, Trust, Teamwork, Excellence and Affordability. For more information, please contact: Lindsay Becker, Physician and Advanced Practice Clinician Recruiter Phone: ************ *********************************** Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Risk Adjustment Revenue Manager (Remote) Cost Center:682891390 SHP-Strategic FinanceScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; 8:00 am - 5:00 pm (United States of America) Job Description: The Risk Adjustment Revenue Manager is responsible for risk adjustment strategy and related revenue management for Security Health Plan's Medicare, Affordable Care Act and Medicaid business. This individual provides development and implementation of programs and initiatives to improve the accuracy of the coding, including education; retrospective and prospective review processes; and vendor contract management; accountability for preparation for and management of the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Services (DHS) auditing processes; management of encounter data processes; and management of applicable state and federal guidance. The Risk Adjustment Revenue Manager works collaboratively with Security Health Plan executives and leadership as well as Marshfield Clinic Health System (MCHS) executives and leadership to lead risk adjustment strategy and process. JOB QUALIFICATIONS EDUCATION Minimum Required: Bachelor's Degree in Business Administration, Finance, Health Care Administration, Management or related field required. Preferred/Optional: Post graduate degree(s) desirable. EXPERIENCE Minimum Required: Five years of experience in risk adjustment or related area. Three years of experience in a management or leadership role and experience in the healthcare industry. Demonstrate a broad understanding of healthcare and health insurance. Demonstrate proficiency with verbal and written communication, strategic planning and business acumen. Preferred/Optional: Working knowledge of CMS and/or Medicaid risk adjustment methodologies. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: Certifications in professional coding and risk adjustment coding from American Academy of Professional Coders. State of Wisconsin driver's license with an acceptable driving record. Preferred/Optional: None Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.