Independent Health jobs - 369 jobs

Social Worker - Masters Degree (required) Health Systems Management, Inc. (HSM) is a full-service healthcare management organization providing a full range of development, management, and administrative services for dialysis facilities over the past 35 years in Georgia, South Carolina, and North Carolina. HSM has an outstanding reputation in the renal community for providing high quality patient care and encouraging physician input while maintaining efficient business operations. We are currently seeking compassionate, dedicated, and highly motivated Social Workers to join our dialysis team. Social Worker Responsibilities and Physical Demands: Provides direct and indirect interventions to pre-dialysis and chronic dialysis patients. Provides clinical services in collaboration with the multidisciplinary health care team in order to assist patients in reaching their fullest rehabilitative potential. Communicates with patients and their support system to establish plan of care. Completes comprehensive psychosocial assessment. Assesses family dynamics and need for further interventions. Utilizes appropriate community resources in order to meet patient/family concrete needs. Social Worker Education Requirements and Position Qualifications: Master's degree in Social Work required. Ability to solve practical problems and deal with a number of concrete variables in situations. Must be able to work independently and plan/organize priorities autonomously. Willingness to work a flexible schedule and to fill in when needed. Excellent bedside manner and communication skills. Social Worker Benefits: Extensive Benefits Package to Include: Medical and Prescription Coverage Options Dental Vision Flexible Spending Account Short and Long-Term Disability 401K with Company Match Paid Time Off - start accruing time on your first day with the company Sign on and referral bonuses for qualified positions Employee Assistance Program for: Family Resources, Counseling, Financial, and Legal Guidance Paid on the job training. The training is a combination of classroom setting and direct patient care. Option to work remotely 1 day per week once training is completed. And more... HSM, INC maintains a drug-free workplace in accordance with state and federal laws. Health Systems Management, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, age, marital status, pregnancy, genetic information, or other legally protected status.

Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Job Description HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ************************** How YOU will make a Difference: The Claims Operations Manager will oversee the end-to-end processing of healthcare claims. The manager is responsible for leading the HMA Claims Operations staff and their daily work requirements. Leveraging metrics and forecasts; they prioritize workload and resourcing to maximize operational production in partnership with vendor resources and liaisons. The manager will lead a team responsible for claims intake, pricing, adjudication, coordination of benefits and issue resolution while driving operational excellence What YOU will do: Direct supervisory responsibilities: Manages and coaches individual contributor's performance and quality. Assess and manages claims inventory: Tracks and manages inventory trends and proactively adjusts resource levers as needed to maximize productivity Manage daily operations of claims processing, ensuring accuracy, timeliness, and compliance with healthcare policies and federal guidelines Create daily updates for management team flagging production rates, critical issues and areas of escalation in real time Monitor and resolve pricing discrepancies impacting claims adjudication and provider payments. Lead initiatives to improve pricing workflows, automation, and system performance. Vendor auditing &QA: Leads vendor audits and manages reporting to ensure vendor quality. Apply subject matter expertise to the business of claims processing and operations Manage to vendor agreements, proactively identify and flag issues, escalate appropriately Develop and maintain workflows and documentation specific to claims processing. Train and coach staff and vendors on claims processes as needed Motivate talent: Ability to motivate and lead team members and vendors in accordance with HMA values and objectives Talent planning: Proactively review and assess talent. Continually develop and/or recruit talent to meet objectives Requirements Knowledge, Experience and Attributes: Bachelor's Degree or equivalent work experience Minimum 5 years' of claims operations experience, self-funded health plan experience is a plus Minimum 2 years' of people leading experience Experience with claims platforms such as HealthEdge, Mphasis, or Facets Knowledge of CPT, HCPCS, ICD-10 coding, and reimbursement methodologies. Strong understanding of provider contract terms, fee schedules, and pricing models (e.g., DRG, APC, RBRVS). Proven ability to manage and develop a team of highly skilled staff Proven ability to manage and interact with vendors to support execution of work within the SLA's established Benefits Compensation: The base salary range for this position in the greater Seattle area is $100,000-$123,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ***************** How YOU will make a Difference: As a Claims Specialist, you'll be at the heart of our mission to deliver exceptional service. Working alongside a dedicated team, you'll ensure the accurate and timely processing of medical, dental, vision, and short-term disability claims that HMA administers for our members. Your role goes beyond handling claims, you'll be a key player in shaping a positive healthcare experience for our members. Every claim you interact with helps someone navigate their healthcare journey with confidence, making your work both meaningful and impactful. What YOU will do: Carefully research discrepancies, process returned checks, issue refunds, and manage stop payments with precision. This ensures financial accuracy and builds trust with both clients and members. Manage high-importance claims and vendor billing with urgency and attention to detail. Review and reply to appeals, inquiries, and other communications related to claims. Work with third-party organizations to secure payments on outstanding balances. Process case management and utilization review negotiated claims Spot potential subrogation claims and escalate them appropriately. Actively contribute to team success by assisting colleagues when workloads peak, sharing knowledge, and fostering a collaborative environment. Requirements High school diploma required 3-5+ years of claims processing experience 2+ years of BCBS claims processing experience Strong interpersonal and communication skills Strong attention to detail, with high degree of accuracy and urgency Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving Previous success in a fast-paced environment Benefits Compensation: The base salary range for this position in the greater Seattle area is $28/hr - $32/hr for a level II and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level II, we may consider level III for highly qualified candidates. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit: *****************

The Media Relations Specialist III is responsible for maximizing earned media opportunities in both traditional news and across a variety of platforms, tracking the benefits of these efforts to drive awareness and business goals. Essential Functions: Responsible for identifying new story opportunities to position CareSource with media outlets and build brand awareness with target audiences Develop and manage content for media and external audiences, including news stories, news releases and other communications Manage agencies in markets to support company initiatives Respond to media inquiries in a timely and appropriate manner Provide support during crisis situations with strategic communications Monitor daily local, regional and national news coverage about CareSource, health care and related issues Manage ongoing earned media intelligence platforms and develops quarterly reports Support social media strategy Responsible for promoting CareSource locally in all markets and nationally including developing award entries, coordinating media events and providing support to company spokespeople/ presenters Develop and maintain relationships with key internal stakeholders, including executives, to ensure successful collaboration Responsible for ensuring all external materials are consistent with brand positioning, established guidelines Serve as a liaison with key departments to provide effective communication strategy Maintain a leadership role on project teams Perform any other job duties as requested Education and Experience: Bachelor's degree or equivalent in Communications, Public Relations, Journalism, or related field or equivalent work experience is required Minimum of five (5) years of experience in media relations is required; healthcare communications experience is preferred Previous professional writing experience is preferred as demonstrated by portfolio Competencies, Knowledge and Skills: Intermediate proficiency level with Microsoft Office Intermediate proficiency level with visual software programs, such as PowerPoint or other related software program is required Ability to communicate effectively through oral and written communications Ability to articulate thoughts with all levels of management and in pressure intense situations Ability to handle sensitive and confidential matters with discretion. Effective decision making and problem resolution skills Strong critical listening and thinking skills Advanced writing and editing skills Experienced technical writing skills preferred Ability to work on and meet tight deadlines Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time May require minimal travel Compensation Range: $61,500.00 - $98,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-RW1

The Managing Actuary provides leadership and direction to ensure team goals and strategies are successfully achieved. Essential Functions: Responsible for pricing, forecasting, reserving or other actuarial processes including development of key assumptions, as well as evaluation of financial experience and trend drivers Develop and communicate actionable and strategic recommendations to leadership in support of company goals Manage the development and maintenance of actuarial models to support key business goals and initiatives, such as actual to expected experience reporting, actuarial reserves and accruals, bid pricing/rate filings, forecasting, and contracting models Own the actuarial processes being managed (i.e., rate/bid filings, pricing, forecasting, reserving) within the company and with external vendors for assigned lines of business Specific function may require performing baseline analysis on expectations of rate changes for future years and work with federal and state agencies to support rate filings and other relevant activities Specific function may require overseeing development and review of Incurred But Not Reported (IBNR) reserve estimates for all CareSource lines of business on a monthly basis Perform any other job related instructions as requested Education and Experience: Bachelor's degree in actuarial science, mathematics, economics or a related field or equivalent years of relevant work experience is required Two to three (2 to 3) years or more of management experience is preferred Two to three (2 to 3) years or more of actuarial experience is preferred Strong database (SQL, SAS or Access) experience is preferred Managed care or healthcare experience is preferred Preferred: Experience leading Medicaid rate advocacy in at least one state Preferred: Understanding of accounting concepts such as accruals Competencies, Knowledge and Skills: Excellent written and verbal communication skills Excellent listening and critical thinking skills Strong interpersonal skills and high level of professionalism Ability to manage, develop, and motivate staff Ability to develop, prioritize and accomplish goals Ability to interact with all levels of management as well as external stakeholders Excellent problem-solving skills with attention to detail Excellent auditing and peer reviewing skills Ability to work independently and within a team Ability to effectively analyze data, develop/maintain appropriate models, draw and report findings and/or conclusions tailored for respective audiences Demonstrate sound business judgment when drawing conclusions and making recommendations Communicate status and results of processes, projects, goals and tasks with leader as needed or requested Expert proficiency level with Microsoft Excel Advanced proficiency with Microsoft Suite to include Word and Power Point Knowledge of SQL, SAS, R, Python or other data manipulation software Licensure and Certification: Associate of the Society of Actuaries (ASA) is required Fellow of the Society of Actuaries (FSA) is preferred Working Conditions: General office environment; may be required to sit or stand for extended periods of time May be required to travel less than 10% of the time Compensation Range: $92,300.00 - $161,600.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-RW1

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ************************** How YOU will make a Difference: The Data Integrations Engineer plays a key role ensuring the smooth transmission and processing of data between internal and external systems. The ideal candidate will have experience in writing complex SQL queries, creating ETL's, and understanding inbound and outbound EDI transactions and protocols. The incumbent will work closely with IT, business partners, and external vendors to implement new systems and update existing systems. Excellent communication skills are a must to ensure the continued smooth operation of the company. What YOU will do: Design, code, test, deploy, maintain, monitor and execute production ETL processes Investigate production ETL issues / problems Work with business users to gather requirements and design, create, and implement database systems & applications. Lead troubleshooting episodes and communicate solutions/resolutions to the team Translate concepts to requirements and technical design Complete projects and development activities timely and accurately while following the System Development Life Cycle (SDLC) Develop, implement, and optimize stored procedures and functions using T-SQL Analyze existing SQL queries for performance improvements. Create and update EDI document mappings Take ownership of SQL development for future products and enhancements of existing products. Must possess analytical and complex problem-solving skills. Performance tuning of database assets and writing queries used for front-end applications (websites, desktop applications, or cloud apps). Evaluating new tools, new technologies to help modernize existing applications. Designing Architecture for ETL/SSIS packages and Designing SSIS packages with different data sources (SQL, Flat files and XMLs etc.) and loaded the data into target source by performing different kinds of transformations. Requirements Knowledge, Experience and Attributes: BA Degree in computer science or related field preferred 3-5+ years of experience in MSSQL T-SQL development 3-5+ years of experience in MSSQL SSIS development 3-5+ years of experience with Data Warehouse - (ETL) Extract, Transform, and Load Skilled at building and optimizing complicated SQL queries and stored procedures Proficiency in programming languages (C# / Python), scripting, and data analysis tools. Bachelor's degree in IT or equivalent experience Excellent communication skills. Benefits Compensation: The base salary range for this position in the greater Seattle area is $117,000-$145,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit **************************

FIND YOUR FUTURE We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. The Red Shirt Promotion Specialist will be responsible for sales acquisition and retention strategies for Medicare. They will be responsible for identifying, contacting, and following up with prospects in the Medicare market. They will staff Independent Health Medicare Information Centers and ensure PHI and security metrics are met. The Specialist will be responsible for compliance/adherence to CMS sales and marketing guidelines. They must demonstrate consultative sales techniques to uncover the prospects' issues and needs and apply comprehensive knowledge of complete line of products and services and CMS guidelines to provide a solution to meet those needs. They will fully utilize systems such as Salesforce.com and IKA to maintain extensive records of prospects and activities. The Red Shirt Promotion Specialist will be responsible for 100% compliance with all CMS corporate requirements. Qualifications * High school diploma or GED required. * One (1) year of customer service and/or sales experience required. Experience working with Medicare preferred. * Current license to sell health insurance in the State of New York required or must obtain that license within ninety (90) days of commencing employment. * The desire and ability to work with the senior population (patience, empathy, kindness). * The ability to understand and communicate Medicare benefits (training provided). * Excellent customer service and interpersonal skills. * Commitment to the fall sales campaign that runs from September through December. * Compliant while interacting with customers. * Ability to work outside of core business hours which may include nights, weekends, and holidays. * Must have a reliable means of transportation. Any Independent Health associate who uses a motor vehicle in the course of their duties representing Independent Health must be compliant with State Motor Vehicle laws and must follow the Policy that pertains to Driver's License Requirements as a condition of employment. * Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable. Essential Accountabilities * Appropriately greet all members, guests, and associates. * Answer inbound member/prospect sales calls. * Make outbound follow up sales calls. * Build new member accounts/opportunities in Salesforce. * Utilize Siebel/Healthrules to look up member accounts and make changes. * Input enrollment/change forms into IKA for prospects/members. * Send daily applications/OTF numbers to manager for reporting purposes. * Complete all training modules prior to answering calls. Immigration or work visa sponsorship will not be provided for this position Hiring Compensation Range: $22.50 - $25.00 hourly Compensation may vary based on factors including but not limited to skills, education, location and experience. In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future. As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information. Current Associates must apply internally via the Job Hub app.

The Healthcare Analyst II is responsible for analyzing healthcare utilization and costs to identify patterns, variation, and outliers. Identify and quantify opportunities to reduce medical costs and understand their related financial outcomes. Essential Functions: Analyze healthcare utilization to identify patterns, variation, and outliers. Identify and quantify opportunities to reduce medical costs within the markets Evaluate the effectiveness of medical cost reduction initiatives. Support tracking and reporting of medical cost reduction initiatives. Work with Actuarial and Market Finance teams to accurately accrue and forecast the savings impacts of medical cost reduction initiatives. Understand the measurement of financial outcomes related to medical cost reduction initiatives. Develop tools to efficiently compare market performance across and within products. Support reporting on realized savings using sound analytical and financial techniques Work collaboratively with cross functional teams, including department leaders and operators, to understand/track operational details of medical cost reduction initiatives. Support the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organization Perform any other job duties as requested Education and Experience: Bachelor's Degree or equivalent years of relevant work experience is required Minimum of two (2) years of experience in healthcare analytics is required Managed care experience is strongly preferred. Experience with financial analysis is required, health plan preferred. Competencies, Knowledge and Skills: Knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferred Proficient in with Excel, Word and PowerPoint Proficient with Transact-SQL or SAS or Microsoft Power BI or Tableau Proficient in Financial reporting concepts Ability to organize data in a way that facilitates inferences, conclusions and decisions Compensation Range: $70,800.00 - $113,200.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-EM1

The Director, Enterprise Value Based Reimbursement (VBR) Strategy serves as the enterprise-wide VBR strategy lead to all markets and lines of business. The Director will lead ongoing engagements with market leadership to build VBR strategy plans, collaborate with state partners around VBR strategy, and coordinate VBR program solutions for markets. Essential Functions: Support the development and execution of both enterprise-level and market-specific value-based reimbursement (VBR) strategies to enhance organizational alignment and effectiveness across various markets and lines of business. Collaborative with market leadership on VBR strategies that address specific requirements for Request for Proposals (RFPs), and continue collaboration post-RFP to build and implement effective VBR program plans. Partner closely with market leadership to ensure compliance with state-level VBR requirements and commitments by leveraging appropriate strategies and programs to meet regulatory expectations. Build strong, influential, and collaborative relationships with key internal stakeholders and external partners to shape and drive VBR program strategy. Lead discussions with healthcare providers and organizations that are instrumental in fostering enterprise-wide VBR partnerships. Continuously evaluate and adjust VBR programs to ensure they remain in alignment with enterprise objectives, enhancing their impact and relevance. Oversee the development and operationalization of policies, standards, benchmarks, performance metrics, and quality control mechanisms to ensure high standards in VBR strategy execution. Maintain up-to-date knowledge of regulatory changes and market-specific performance standards to guarantee compliance and ensure timely execution. Lead negotiations and contract discussions with healthcare providers identified as providing innovative care solutions that support a comprehensive national VBR approach. Provide leadership, mentorship, and professional development opportunities to staff, fostering a supportive environment that encourages growth and excellence in performance. Perform any other job related duties as requested. Education and Experience: Bachelor's degree in management, healthcare management or related field is required Master's degree is preferred Equivalent years of relevant work experience may be accepted in lieu of required education Five (5) years of experience in value-based reimbursement design, methodologies and/or VBR contracting, data analysis, reporting, or data support is required Three (3) years of Provider contracting or Provider relations is required Five (5) years of leadership/management experience is required Competencies, Knowledge and Skills: Proficient in Microsoft Office to include Word, PowerPoint, Access - advanced proficiency in Excel Excellent team facilitation skills High level of analytic skills for solving problems Excellent oral, written, and interpersonal communication skills Strong knowledge of Value Based Contracting methodologies and operations and/or experience in health care quality Knowledge of provider contracting and familiarity with provider network operations Critical listening and thinking skills Problem solving skills Attention to detail and work plan creation, implementation, and evaluation Business acumen and strategic thinking skills, yet able to execute tactically Strong relationship management skills and ability to maintain and build strong working relationships in a matrix environment Licensure and Certification:Working Conditions: General office environment; may be required to sit or stand for extended periods of time Up to 15% (Occasional) travel to attend meetings, trainings, and conferences may be required Compensation Range: $110,800.00 - $193,800.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-SW2

FIND YOUR FUTURE We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. The Supervisor-Rebates Analytics will lead and oversee the day-to-day operations of the Rebates Analytics team, serving as the subject matter expert for rebate administration, analysis, pricing, and process optimization. This role will be responsible for supporting and maximizing the value of PBM rebate proposals, renewals, and pricing strategies through detailed utilization metrics and analytical reporting. Additional responsibilities will include providing decision-support analysis, developing and delivering reports, coordinating cross-functional activities, and supporting manufacturer contract execution and management. The Supervisor will foster a collaborative, high-performing team environment while mentoring and developing direct reports. Qualifications Associates degree required. Bachelor's degree preferred. An additional two (2) years of experience will be considered in lieu of degree. Four (4) years of financial analysis experience required, to include managing or coordinating contract or reporting processes. Healthcare or pharmacy experience preferred. One (1) year of progressive leadership experience/responsibilities required. Strong problem solving, analytical, verbal and written communication skills. Experience with MS Office products, especially Excel and Access. Experience with in Pharmative or Gateway preferred. Ability to work with, manipulate and synthesize large datasets for analysis, performance measuring, key insights, and presentation. Ability to assimilate various market trends, product changes and financial metrics to recommend pricing or pricing strategy. Experience shifting assignments and priorities to meet deadlines. Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring. Essential Accountabilities Coach and mentor staff to achieve departmental and organizational goals and objectives. Conduct regular one-on-one meetings with direct reports to build more effective communications, understand associate needs and provide direction, insight, and feedback. Provide timely feedback to senior management regarding team performance. Manage, support, and optimize analysis, pricing for contracts, RFP's and related processes. Identify opportunities to make recommendations and execute improvements. Lead in auditing and identifying opportunities in various contracting and payment reconciliation. Lead the modeling of RFP's, contracts, and amendments. Analyze contract language and financial parameters to maximize profit and ensure business risk and compliance. Analyze rebate RFPs for new businesses on multiple formularies and formulate strategies and pricing responses that demonstrate the value of our pharmacy products and position in the best competitive light. Develop and update contract and pricing databases for analysis, planning and organization. Oversee the generic pricing program (MAC) and ensure nationally competitive pricing in all channels (retail, mail at retail, mail order and specialty). Work with internal business owners to obtain analytics needed to support network initiatives and requirements. Develop and utilize management reporting mechanism tracking the status of all contracting projects. Manage issue resolution with PBD/IH and pharmacies. Work as a member of a multi-functional team, including actuarial, legal, sales, and marketing, to best position our pharmacy products from both a competitive and margin standpoint, as well as to establish standard pricing methodologies. Evaluate and execute continuous improvement efficiencies in processes, systems and/or projects. Continually monitor departmental SOPs and maintain documents and update when needed. Process and coordinate DIR Reporting to CMS. Assist with value-based contracting to include gathering required data and assessing the contract opportunity. Review and maintain contract and pricing databases for analysis, planning and organization. Create and maintain trending reports for KPIs, customer trends, NDC trends and industry trends. Point person for ad-hoc requests. Immigration or work visa sponsorship will not be provided for this position Hiring Compensation Range: $70,000 - $90,000 annually Compensation may vary based on factors including but not limited to skills, education, location and experience. In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future. As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information. Current Associates must apply internally via the Job Hub app.

Under the guidance of the SIU Management, this position is responsible for the accurate and thorough clinical investigation of potential fraud, waste and abuse (FWA) for all lines of business. The scope of accountability includes investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical reviews of medical records to ensure correct billing of services and appropriateness of care, interviewing potential witnesses, developing corrective action plans, developing correspondence to impacted parties, managing disputes, and collaborating with law enforcement and regulatory agencies. Essential Accountabilities: Level I Functions as a clinical reviewer of medical records, researching and investigating complex medical cases. Interprets a variety of documents including, but not limited to provider contracts, group benefit structures, Corporate Medical Policies, the AMA CPT Coding Guidelines, HCPCS coding, inter-plan regulations, government policies, as well as diverse regulatory and legal requirements. Thoroughly researches allegations or issues and develops sources of information to create a plan of action, accumulates sufficient detailed evidence including statements, documents, records and exhibits. Evaluates situations accurately and interacts with management, medical directors and legal, where appropriate, to ensure complex issues are addressed appropriately. Prepares comprehensive summary reports and assures accuracy of information provided to providers, regulators, law enforcement, Legal, Compliance and outside counsel. Prepares cases for prosecution, civil settlement, or overpayment recoupment by documenting findings in a clear and concise manner. Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. Manages cases as assigned, prioritizing case load as appropriate. Maintains case logs, prepares records and regular status reports. Interacts with health care providers, often under adverse conditions due to discovery of potential FWA. Discusses sensitive material in a professional, fair and accurate manner. Recommends providers for referrals to the New York State Office of Professional Medical Conduct Office of Professional Medical Conduct/NYS Education Department, Office of Professional Discipline and/or internal referral for quality review by the applicable business area. Acts as primary point of contact with law enforcement for assigned cases and may be required to prepare files and testify in court, as needed, in matters regarding litigation related to their reviews. Prepares recommendations on preventive/corrective measures for the deterrent of future fraud. Supports other SIU investigators and analysts with their cases by providing clinical information/expertise and as necessary, performs clinical reviews of medical records. Consults with external practitioners, medical professional groups and agencies, professional medical associations, the BlueCross BlueShield Association, the Food and Drug Administration (FDA), and Centers for Medicare and Medicaid Services (CMS). Provides routine interaction and coordination with the BCBS Association National Anti-Fraud office, BC/BS Plan SIUs, FEP, CMS, DOH, OMIG, MFCU, local, state and federal law enforcement and prosecutorial agencies and medical licensing boards. Maintains accurate and up-to-date knowledge of all Government Programs regulations (Medicaid, Medicare, Federal Employee Program, New York State Department of Financial Services, etc.). Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Regular and reliable attendance is expected and required. Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) Performs more complex investigations with less direct supervision. Performs compliance and/or governance on more complex special projects and audits. Offers process improvement suggestions and participates in the solution of more complex issues/activities. Provides and supports training or reference materials for internal team members as appropriate. Consistently provides accurate, organized and well written audit results with minimal assistance from management. Oversees and coordinates the daily activities of the non-clinical SIU staff medical record reviews. Keeps abreast of new developments in the field of medical technology through medical literature research, participation in seminars, monitoring professional society websites, etc. Mentors new/junior staff and assists with coaching, whenever necessary. Participates on committees. Level III (in addition to Level II Accountabilities) Manages the highest level of complex investigations, compliance and regulatory issues and exercises decision-making in project work groups. Assesses potential non-compliance vulnerabilities, identifies root causes of issues and provides practical business recommendations for corrections. Works with business area staff, Compliance, and other internal departments as necessary to develop recommendations and reach meaningful and appropriate resolutions. Serves as a subject matter expert and liaison for interdepartmental projects and represents non-clinical staff in discussions with Medical Directors and/or clinical consultants. Serves as an internal auditor/peer reviewer for new clinical staff, as needed. Mentors (to others in the department), provides coaching, guidance and leadership for daily activities of the SIU clinical staff. Acts as a resource to staff members. Provides back-up for Supervisor/Manager, whenever necessary. Minimum Qualifications: NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities. All Levels Must meet the NYS DFS's and the NYS OMIG's minimum investigator requirements as follows: Persons employed by the SIU as investigators shall be qualified by education or experience, which shall include: A minimum of five years in the healthcare field working in FWA investigations and audits; or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies; or seven years of professional investigation experience involving economic or insurance related matters; or an associate's or bachelor's degree in criminal justice or related field; or employment as an investigator in the SIU on or before December 28, 2022. Current NYS R.N. license with a minimum of three years clinical experience; medical/surgical background preferred. Current CPC designation or must obtain CPC designation within one year of hire date. Knowledge of medical record coding conventions (e.g. CPT, DRG, HCPCS, ICD10, etc.). A general understanding of contract benefits, electronic data processing systems, and organizational policies and procedures. Demonstrates excellent oral communication skills and proficient writing skills for the creation of comprehensive professional documents. Demonstrates proficient computer skills in Word, Excel, Internet, and email. Ability to multi-task and balance priorities. Excellent interpersonal skills. Level II (in addition to Level I Qualifications) Two or more years of experience in the Medical Investigator role. Expertise in the technology of the job. Excellent understanding of contract benefits, electronic data processing systems, and corporate policies and procedures. Excellent ability to determine State and Federal fraudulent activity and compile necessary documentation for prosecution presentation. Ability to explain and interpret these findings to law enforcement authorities in a comprehensive manner. Excellent dispute resolution and negotiation skills in order to interface appropriately with many different provider types, attorneys, other Blue Plans and external agencies and business partners. Demonstrated superior oral communication skills, strong presentation skills, and strong writing skills for the creation of comprehensive professional documents. Proficient with health systems operations including an understanding of reimbursement methodologies and coding conventions for governmental and commercial products (e.g., Medicare, Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). Extensive experience with claims processing systems, claims flow, adjudication process, system edits and display screens. Level III (in addition to Level II Qualifications) Five or more years in a Medical Investigator role. Subject matter expert in health systems operations including an understanding of reimbursement methodologies and coding conventions for governmental and commercial products (e.g., Medicare, Medicaid, CPT, HCPCS, ICD10, DRG, APC, RBRVS, etc.). Comprehensive understanding of multiple functional areas (i.e., SIU, Legal, Regulatory, Operations) and supporting systems. (BREADTH). Expertise in complex clinical coding/reviewing assignments, difficult investigations and highly visible issues. (DEPTH). Lead the training of new staff and provide feedback to management for evaluation. Displays leadership abilities and serves as a positive role model to others in the department. Demonstrates superior oral communication skills, excellent presentation skills and excellent writing skills for the creation of comprehensive professional documents. Physical Requirements: Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer. Ability to travel across the Health Plan service region for meetings and/or trainings as needed. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Level I (E2): Minimum: $60,410 - Maximum: $96,081 Level II (E4): Minimum: $65,346 - Maximum: $117,622 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Available for any of Partners locations; Remote Option Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Provider Engagement & Outreach Specialist serves as a liaison between Partners Health Management and healthcare/physical health providers to drive quality improvement, practice transformation, and provider engagement. This role supports physical health providers in implementing evidence-based workflows, optimizing care delivery models, and aligning with value-based care initiatives. The Specialist also leads outreach efforts to foster collaborative relationships, deliver educational resources, and support providers in meeting performance and compliance benchmarks. Roles and Responsibilities: Support medical providers in transforming care delivery through implementation of patient-centered medical home (PCMH), value-based care models, and quality improvement initiatives. Engage directly with providers and healthcare teams across North Carolina to build strong partnerships, understand their unique challenges, and provide tailored assistance Conduct on-site and virtual practice visits to assess workflows, identify improvement opportunities, and provide technical assistance and resources. Analyze and utilize performance data (e.g., HEDIS, Medicaid measures) to collaborate with providers to design targeted interventions that improve care quality and patient outcomes. Assist practices with change management strategies to enhance patient outcomes and operational efficiency Act as a liaison in supporting providers in adopting value-based care practices, that enhance clinical efficiency and patient outcomes Develop and disseminate outreach materials, toolkits, and communication strategies to strengthen provider relationships. Stay abreast of emerging best practices, payer requirements, and regulatory changes affecting provider performance and transformation. Deliver training and coaching on practice transformation topics, data use, and workflow redesign Track provider progress, document interactions, and report outcomes and barriers to leadership for continuous program improvement. Work directly with physicians, clinical teams, and administrative staff to improve care delivery, enhance patient outcomes, and increase performance. Collaborate with internal stakeholders to align resources and interventions Support practice transformation initiatives that drive sustained improvements in care quality and operational efficiency Work with providers to encourage preventive service utilization and effective chronic condition management among their patient populations Assist clinicians achieve measurable improvements in health outcomes and patient satisfaction by fostering patient engagement and adherence to recommended care plans Knowledge, Skills and Abilities: • Deep understanding of value-based care models, and healthcare quality programs. • Experience in healthcare practice transformation, care delivery redesign or clinical operations • Experience engaging and coaching clinical teams (physicians, nurses, and practice managers) • Familiarity with health equity initiatives and strategies to address social drivers of health. • Experience in Project Management and familiarity in process mapping and workflow analysis tools. • Knowledge of and ability to explain and apply the provisions of contractual practices adopted by Partners Health Management and required by NC Division of Health Benefits. • Demonstrate working knowledge of HEDIS quality measures and reporting requirements to support accurate provider education and engagement • Collaborate with providers and internal teams to close care gaps and ensure compliance with HEDIS and other quality initiatives. • Experience working with large multi-site practices. • Ability to analyze clinical and operational data to drive improvement initiatives. • Excellent facilitation and project management skills and familiarity in process mapping and workflow analysis tools. • Strong problem solving, decision-making and negotiating skills. • Exceptional interpersonal skills and strong written and verbal communication skills. • Excellent organizational skills. • Ability to multi-task and meet deadlines. • Considerable knowledge of the laws, regulations and policies that govern the program, which includes and is not limited to contractual requirements adopted by NC Division of Health Benefits and other governmental oversight agencies. • Strong problem solving, negotiation, arbitration, and conflict resolution skills. • Excellent computer skills and proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint. • Demonstrated ability to verify documents for accuracy and completeness; to understand and apply laws, rules and regulations to various situations; to apply regulations and policies for maintenance of consumer medical records, personnel records, and facility licensure requirements. • Ability to make prompt independent decisions based upon relevant facts. • Ability to establish rapport and maintain effective working relationships. • Ability to act with tact and diplomacy in all situations. • Ability to maintain strict confidentiality in all areas of work. • Experience with Electronic Health Records (HER) for clinical processes Education and Experience Required: Bachelor's degree and a minimum of four years of experience in managed care or a related field with a healthcare provider or insurer/payer. Relevant areas may include provider relations, network development or design, provider engagement services, contract management, or patient financial services. Experience in auditing, accounting, or finance is also applicable. A combination of relevant education and experience may be considered in lieu of a Bachelor's degree. Must be able to travel as required. 4 years of significant and relevant work experience in medical practice management in lieu of educational requirements may be accepted, particularly with significant administrative experience in a clinic setting. Must have the ability to travel as indicated. Other requirements: Must reside in North Carolina or within 40 miles of the NC border. Education and Experience Preferred: Bachelor's degree in Nursing, Public Health, Healthcare Administration, or a related field (Master's degree preferred). Deep understanding of value-based care models, healthcare quality programs, and population health initiatives. Demonstrated experience in practice transformation roles and practice support. Licensure/Certification Requirements: None

FIND YOUR FUTURE We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. The Pharmacy Systems Coordinator is responsible for maintaining all pharmacy systems to allow Pharmacy Benefit Dimensions (PBD) to accurately adjudicate prescription claims against the pharmacy benefits of its members and provide accurate pharmacy information to all stakeholders. Responsibilities include, but are not limited to, benefit designs, claims payment, eligibility issues, researching and resolving inquiries, assist with training associates, and updating documentation for all lines of business. Occasional evenings, weekends, holidays and overtime are a requirement of the position. Qualifications High School diploma or GED required. Three (3) years of pharmacy experience required. One (1) year of experience as a PBD Pharmacy Systems Assistant may be considered in lieu of three (3) years pharmacy experience requirement. Significant and detailed knowledge and experience with RxClaim™ and associated systems is preferred. Strong interpersonal, written and verbal communication skills. Strong Microsoft Office skills required. Experience with Microsoft Office applications, and demonstrated ability to learn new software application. Experience in report production, and the ability to maximize use of system capabilities to lead the organization in outcome improvement. Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring. Essential Accountabilities System Administration and Maintenance: Assist with maintenance of RxClaim functionality as it pertains to all lines of business. Attend assigned MOD review meetings, test and/or review SR's assigned for MOD implementation and assist with installation tasks on MOD night. Communicate problem defects to Pharmacy Systems Specialist along with detailed documentation and associated testing scenarios. Ensure reliable interfacing with the HealthRules system, and other support systems. Responsible for maintenance of the RxAuth application. Benefit and Formulary Administration: Build benefit plans in the RxClaim system to ensure pharmacy claims process according to the design of the product. Responsible for assigned primary or secondary testing for all plan builds or updates, including tests to confirm administration accuracy and consistency. Maintain and follow the documented drug change process for formulary updates within set time frames and with accuracy within the policy. This includes reporting issues or questions to the Pharmacy Systems Specialist. Responsible for the maintenance of all eligibility files for all lines of business, including but not limited to updating person codes, dual eligible members, UOI updates, staging/loading files, and updating monthly eligibility logs. Provide support and assist with process improvements. Participate in any ad-hoc projects as needed. Claims Management and Payment: Responsible for daily review of the payment process in RxClaim, including but not limited to reviewing reports and resolving any associated issues. Monitor and validate claims for processing accuracy. Participate as the Detective of the Day to handle help desk issues. Escalate all unresolved issues to the Pharmacy Systems Specialist. Also responsible for build and testing of new pharmacies, pharmacy pricing and QA-ing client pricing. Complete processing of file loads needed for claims management. Assist with any ad-hoc projects as needed. Training and Documentation: Assist with the creation or revision of all training documentation, policies and procedures. Ensure that documentation accurately reflects system functionality, industry best practices, and are appropriate, current, and well organized. Also accountable for the training and mentoring of associates. Immigration or work visa sponsorship will not be provided for this position Hiring Compensation Range: $22.00 - $25.00 hourly Compensation may vary based on factors including but not limited to skills, education, location and experience. In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future. As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information. Current Associates must apply internally via the Job Hub app.

Based on the book of business associated with this opening, candidates must reside in the Rochester region. The Account Service Consultant ensures prompt, accurate, and efficient servicing of all Broker, Member, and Employer Group Administrator inquiries. Inquiries may be via telephone, email, written inquiries, and lobby walk-in's or through on-site visits with an employer group and/or broker. This role provides service for customers and business partners while responding in a professional, efficient, and timely manner to resolve issues and enhance Group & Broker satisfaction/retention. The Account Service Consultant maintains constant communication with the Sales staff and other Business Partners throughout the organization. Essential Accountabilities: Level I • Responsible for the implementation of new groups, renewals, and conversion of groups to new product lines. • Researches, interprets, and responds to inquiries from internal and external customers, business partners, brokers, consultants, and groups concerning our products, services, and policies in accordance with MTM, Corporate Service strategy, NCQA, and legislative requirements. • Responsible for custom, complicated employer group servicing. Partners with Sales to create and deliver presentations to external customers. • Manages any de-implementations associated with a complex group that terminates from our portfolio when applicable. • Reviews all group-facing documents and validates for accuracy. This can include, but is not limited to, benefit summaries, summary plan descriptions, Member Contracts, Group Agreements, etc. • Partners with Project Management team to support vendor relationships and conversations related to electronic enrollment methods for assigned book of business. • Acts as a liaison between the group/broker and internal departments when it comes to new group implementations and renewals. • Identifies and responds to issues brought forward either internally or externally and ensures all inquiries will be responded to within 24-48 hours - same business day preferred where possible. Interacts with Operations, Enrollment and Billing, Customer Care, Claims, Advocacy, Clinical Operations, Medical Affairs and Finance/Underwriting Departments to resolve identified issues. • Assures that all account data is maintained on a timely and accurate basis such as initial account setup, benefit books, summaries, contracts, etc. • Utilizes both standard and custom products in a manual workflow to meet the needs of clients. • Validates all group set up and renewal completions. • Completes and successfully passes training(s) to support job role/function. • Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. • Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. • Regular and reliable attendance is expected and required. • Performs other functions as assigned by management. • Demonstrates willingness to adapt and be flexible to changes and business needs while taking ownership and accountability for issue identification and resolution. Level II (in addition to Level I Accountabilities) • Assists with on-the-job training of other Account Service and Sales Account Managers as requested. Support Level I team members with more complex issues. • Ongoing participation in meetings, training, and skill development to support career path and individual development plans. • Identifies issues, patterns and/or trends generated by external and internal action affecting customer satisfaction and consistently and independently recommends and initiates changes and improvement for process review. • Attends meetings and/or trainings as a representative of the Account Service Team and shares the information learned with the Account Service Staff within a reasonable timeframe • Handles HIPAA (Health Information Portability and Accountability Act) issues as requested by members through Group Administrators. Specifically, handles all Designated Record Set (DRS) requests and may serve as a point person for the Account Service team when difficulties arise in obtaining information through normal channels. Level III (in addition to Level II Accountabilities) • Assists with tasks assigned by management that require advanced problem-solving skills. • Partners with Sales to create and deliver presentations to external customers. • Mentors and trains more junior Account Service team members to initiate resolution to all outstanding and/or difficult issues. • Acts as a back up to Account Manager when individual is out of the office. Minimum Qualifications: NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities. All Levels • In lieu of degree, 2 years of experience in service or healthcare industries. High School diploma or equivalent required. Associates Degree in related field preferred. • Valid NYS Accident and Health license within six months of employment required. • Familiarity with NYS and Federal regulations and underwriting policies and all process flows. • Strong oral/written communication and customer service skills. • Strong organizational skills and ability to prioritize, multitask, and work in fast paced environment and remain professional and focused under multiple pressures and demands. • Ability to complete required internal Medicare Training per Center for Medicare Services within one year of start date. • PC skills essential: spreadsheet and word processing applications, database functions and sales force automation software applications. Level II (in addition to Level I Qualifications) • Two or more years of experience in a sales operation's environment. • Valid NYS Accident and Health license. • Knowledge of NYS and Federal regulations and underwriting policies and all process flows. • Demonstrated relationship building skills. Level III (in addition to Level II Qualifications) • Five or more years of experience in a sales operations environment. • Valid NYS Accident and Health license. • Proficient with NYS and Federal regulations and underwriting policies and all process flows. • Experience creating and delivering client presentations. • Excellent analytical/problem-solving skills. Physical Requirements: • Ability to travel within the Health Plan service region as necessary to offer support for on-site visits to groups/brokers, open enrollments, training, and/or off-site meetings. • Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Level I (N7) Minimum: $23.56/hr - Maximum: $37.70/hr Level II (N8 Minimum: $26.89/hr - Maximum: $43.03/hr Level III (N9) Minimum: $29.57/hr - Maximum: $47.32/hr The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone support to Sutter Health patients, other callers, in-basket and other remote support for physicians, and limited in-clinic support. Uses the nursing process, input from physicians, and Sutter Health's approved telephone nursing guidelines and protocols to maintain highly efficient operations, to provide quality care, and to ensure positive patient outcomes. Assesses patients' needs, appropriately dispositions cases, collaborates with the clinic and hospital-based providers to renew electronic prescriptions, identifies hospital and community resources, consultations and referrals, and preforms nursing follow-up activities. Clinical support includes assisting physician partners with message management and other communications within the electronic medical record (EMR) system, as well as limited patient care in an outpatient setting. Job Description: DISCLAIMER Applicants must be a resident of one of the following states to be eligible for consideration for this position: Utah, Idaho, Arizona, Arkansas, Louisiana, Tennessee, Missouri, Montana, or South Carolina. DISCLAIMER 2 This is a Work from Home position, therefore internet minimum speeds of 15 mbps download and 5 mbps upload are required. EDUCATION Graduate of an accredited school of nursing CERTIFICATION & LICENSURE RN-Registered Nurse of California (You can submit application without the CA RN license, but must acquire it prior to your start date if selected). RN-Registered Nurse in State of Residence PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN: 2 years' experience of practical nursing in a hospital, clinic, urgent care, or emergency room/department 2 years' experience with several specialties and subspecialties. OB/GYN experience helpful SKILLS AND KNOWLEDGE Professional knowledge of clinical nursing protocols, regulations and institutional standards of care and risk management with an emphasis in the areas of disease processes, emergencies, health sciences and pharmacology. Advanced clinical knowledge of medical diagnoses, procedures, protocols, treatments, and terminology, including a working knowledge of state and federal regulations and guidelines. Solid analytical and project management skills, including the ability to analyze problems, situations, practices, and procedures, reach practical conclusions, recognize alternatives, provide solutions, and institute effective changes. Communication, interpersonal, and interviewing skills, including the ability to build rapport and explain medical lab results or sensitive information clearly and professionally to diverse audiences (patients). Proficient computer skills, including Microsoft Office Suite and experience working electronic medical/health records. Work independently, as well as part of a multidisciplinary team, while demonstrating exceptional attention to detail and organizational skills. Manage multiple priorities/projects simultaneously, sometimes with rapidly changing priorities, while maintaining event/project schedules. Recognize unsafe or emergency situations and respond appropriately and professionally. Ensure the privacy of each patient's protected health information (phi). Analyze possible solutions using precedents, existing departmental guidelines and policies, experience and good judgment to identify and solve standard problems. Build collaborative relationships with peers, physicians, nurses, administrators, and public to provide the highest quality of patient care. Pay Range: Starting wage is $37.19 hourly Job Shift: Varied Schedule: Part Time Shift Hours: 8/10 Blended Days of the Week: Variable Weekend Requirements: Rotating Weekends Benefits: Yes Unions: No Position Status: Non-Exempt Weekly Hours: 32 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $0.00 to $0.00 / hour The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

The Internal Auditor II works in a self-directed team environment to execute internal audits as defined by management and the Audit Committee with progressive latitude for team goal setting, initiative and independent judgement on collective work products. The auditor works to identify and evaluate organizational risk, recommends and monitors mitigation action and supports the development of the annual audit plan. Essential Functions: Conduct operational, performance, financial and/or compliance audit project work including, business process survey, project planning, risk determination, test work, recommendation development and monitoring and validation of remediation Work within a self-directed team environment with limited direct supervision, employing significant creativity in determining efficient and effective ways to achieve audit objectives Actively participate in the development and implementation of a flexible risk-based, flexible annual audit plan considering control concerns identified by senior management Coordinate and collaborate on internal audit projects including assessing the adequacy of the control environment to achieve defined objectives in accordance with the approved audit program and professional standards Facilitate communication of organizational risks and audit results to business owners through written reports and oral presentations and provide support and guidance to organizational leadership on effective internal control design and risk mitigation Coordinate, monitor, and complete team tasks within agreed upon timeframes and meet individual and team project timelines, which may be aggressive at times. Influences team prioritization and scheduling of work, problem solving, assignment of tasks, and takes initiative when problems arise. Provides cross-training of team members Support management in onboarding new team members through mentorship, shadowing, and training of all required functions and processes and influence standards for expected team behaviors Assist in the coordination of external audits of CareSource by government agencies, accounting firms, etc. Develop and maintain productive professional relationships with CareSource staff and management by developing trust and credibility Significant interaction with others in the Department of differing skillsets (clinical, IT, etc.), organizational management and staff throughout CareSource, including interaction with the senior most levels Coordinate audit projects as necessary with other CareSource functions, including CareSource Assurance teams Generally conform to IIA standards and maintain all organizational and professional ethical standards, even in difficult or challenging situations Willing to accept feedback, coaching and criticism from others, including peers and management both in Internal Audit or outside of Internal Audit, reflect on the information, and adapt when appropriate Perform any other job duties as requested Education and Experience: Bachelor's degree in finance, business management, healthcare administration, accounting or related field or equivalent years of relevant work experience is required Master of Business Administration (MBA), or other graduate degree is preferred A minimum of three (3) years of finance, business management, healthcare administration, accounting or related field is required; experience in internal auditing or public accounting is preferred Knowledge of audit principles and IIA Standards and Code of Ethics required Experience in risk and control assessments is preferred Experience in thoroughly documenting process flows and controls in financial, and/or business operations cycles preferred Experience with Sarbanes Oxley 404 or Model Audit Rule preferred Experience in health care or insurance fields is preferred Competencies, Knowledge and Skills: Strong communication skills, including proper writing skills adaptable for the audience and purpose, presentation skills for internal or external audiences and senior management, and interpersonal skills sufficient to develop strong professional relationships with CareSource management and staff Solid critical thinking skills including professional skepticism and problem resolution Data analysis and trending skills and ability to compose and present reports using audit data Ability to work in a matrix environment with responsibility for multiple deliverables for multiple functional areas within CareSource Team and customer service oriented Collaborative mindset and ability to operate in a self-directed team environment with collective accountability Strong ability to adapt to changing environment Strong self-leadership, organizational and time management skills Driven to proactively seek relevant development, education and training opportunities Strong sense of integrity and ethics in performance of all duties Takes initiative to identify and influence innovative process improvement Self-driven to work independently within a team environment Success in working in a self-directed matrixed environment Advanced level experience in Microsoft products Licensure and Certification: CIA, CISA, CPA, CMA, CRMA or other appropriate finance, IT or internal audit licensure or certification is preferred Working Conditions: Most work will be performed in an office or virtual setting; however, performing onsite audits may also be necessary depending on assignments May be required to sit or stand for extended periods Compensation Range: $61,500.00 - $98,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-RW1

which will work primarily out in the assigned communities.** Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Location: Available for Gaston, Cleveland, Rutherford NC locations; Mobile/Remote position Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Intellectual and Developmental Disabilities (I/DD) Care Manager is responsible for providing Tailored Care Management and/or care coordination to members/recipients with I/DD to help secure and coordinate a variety of physical health, developmental disability, behavioral health and long-term services and support (LTSS) services. The I/DD Care Manager actively engages with members/ recipients through comprehensive assessment, care planning, health promotion, and comprehensive transitional care. Tailored Care Management is comprehensive and longitudinal for members with Medicaid coverage. Recipients with no Medicaid receive Tailored Care Management based on specified triggers and for a duration not to exceed ninety (90) days. Travel is an essential function of this position. Role and Responsibilities: Duties of the I/DD Care Manager include, but are not limited to, the following: Comprehensive Care Management Provide assessment and care management services aimed at the integration of primary, behavioral and specialty health care and community support services, using a comprehensive person-centered care plan which addresses all clinical and non-clinical needs and promotes wellness and management of chronic conditions in pursuit of optimal health outcomes Complete a care management comprehensive assessment within required timelines and update as needed Develop a comprehensive Individual Support Plan and update as needed Provide diversion activities to support community tenure Care Coordination Facilitate access to and the monitoring of services identified in the Individual Support Plan to manage chronic conditions for optimal health outcomes and to promote wellness. Facilitate communication and regularly scheduled interdisciplinary team meetings to review care plans and assess progress. Monitors services for compliance with state standards and Medicaid regulations, including home and community-based standards for 1915i services Verify that services are delivered as outlined in ISP and addresses any deviations in services Individual and Family Supports Provide education and guidance on self-management and self-advocacy Provide information about rights, protections, and responsibilities, including the right to change providers, the grievance and complaint resolution process, and fair hearing processes Educate members and recipients about the Registry of Unmet Needs, with referral as indicated Utilize person centered planning methods/strategies to gather information and to get to know the members supported Ensure that members/legally responsible persons are informed of services available, service options available, processes (e.g. requirements for specific service), etc. Promote prevention and health through education on the member's chronic conditions and/or disabilities for the member, family members, and their caregivers/support members Promote culturally competent services and supports. Health Promotion Educate and engage the member/recipient and caregivers in making decisions that promote his/her maximum independent living skills, good health, pro-active management of chronic conditions, early identification of risk factors, and appropriate screening for emerging health problems Closely coordinate care with the member's I/DD, behavioral health, and physical health providers, including in person visits to Emergency Departments and Skilled Nursing Facilities Support medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment Transitional Care Management Proactive and intentional care management when the member/recipient is experiencing care transitions (including, but not limited to transitions related to hospitalization, nursing facility, rehabilitation facility, community-based group home, etc.), significant life changes including, but not limited to loss of primary caregiver, transition from school services, etc.) or when a member/recipient is transitioning between health plans. Create and implement a 90-day transition plan as an amendment to the ISP that outlines how services will be maintained or accessed and includes a process to transition to the new care setting and integrate into his or her community. Referral to Community/Social Supports Provide information and assistance in referring members/recipients to community-based resources and social support services, regardless of funding source, which can meet identified needs Provide comprehensive assistance securing health-related services, including assistance with initial application and renewal with filling out and submitting applications and gathering and submitting required documentation, including in-person assistance when it is the most efficient and effective approach. Time-Limited Care Coordination for Member Excluded from Receiving Tailored Care Management Assist member who are receiving care management from other entities (e.g., CCNC, CAP/C, CAP/DA) with referral/linkage to I/DD services available through the Tailored Plan or Medicaid Direct contract Provide transitional care management Participate in weekly conference with CCNC, as needed, to share information on high-risk members, including members with a behavioral health transitional care need and members with special health care needs, who are receiving care coordination and care management from both entities or require referrals Coordinate with each member's care manager to the extent the member is engaged in care management through another entity (e.g. PCCM Vendor, Skilled Nursing Facility, CAP/C or CAP/DA, etc.) Share the results of the any assessments completed, the member's person-centered plan, and the member's Care Plan (to the extent one exists) with entity providing care management Notify the member's care manager that the member is undergoing a transition and engage the member's assigned care manager to assist with transitioning the member into the community, including in the development of the ninety (90) day post-discharge transition plan to the extent there are items within the care manager's scope. With the assistance of the care management entity, encouraging, supporting, and facilitating communication between primary care providers and the Partners network providers regarding medication management, shared roles in care transitions and ongoing care, the exchange of clinically relevant information, annual exams, coordination of services, case consultation, and problem-solving as well as identification of a medical home for persons determined to have need. Other: Assist state-funded recipients apply for Medicaid Coordinate Medicaid deductibles, as applicable, with the member/legally responsible person and provider(s) Proactively monitor documentation/billing to ensure that issues/errors are resolved as quickly as possible Ensure all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency and Medicaid requirements Maintain medical record compliance/quality, as demonstrated by ≥90% compliance on Qualitative Record Reviews Recognizes and reports critical incidents Promotes member satisfaction through ongoing communication and timely follow-up on any concerns/issues Collaborates with providers to ensure accurate/timely submission of authorization requests for all Tailor Plan-funded services/supports Document within the grievance system any expression of dissatisfaction/concern expressed by member/recipient supported or others on behalf of the member/recipient supported Ensure strong leadership to care team for each member/recipient, including effectively communicating with and providing direction to Care Management extenders Knowledge, Skills, and Abilities: Demonstrated knowledge of the assessment and treatment of I/DD needs, with or without co-occurring physical health, mental health or substance use disorder needs Ability to develop strong, person-centered plans Exceptional interpersonal skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts and established processes Demonstrated ability to collaborate and communicate effectively in team environment Ability to maintain effective and professional relationships with member/recipients, family members and other members of the care team Problem solving, negotiation and conflict resolution skills Excellent computer skills including proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) Detail oriented Ability to learn and understand legal, waiver and program practices/requirements and apply this knowledge in problem-solving and responding to questions/inquiries Ability to independently organize multiple tasks and priorities and to effectively complete duties within assigned timeframes Ability to manage and uphold integrity and confidentiality of sensitive data Sensitivity and knowledge of different cultures, ethnicities, spiritual beliefs and sexual orientation. Education/Experience Required: Bachelor's degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area and two (2) years of full-time experience with I/DD population OR Bachelor's degree in a field other than human services and four (4) years of full-time experience with I/DD population OR Master's degree in human services and one (1) year of full-time experience with I/DD population OR Licensure as a registered nurse (RN) and four (4) years of full-time accumulated experience with I/DD AND Two (2) years of prior Long-Term Services and Supports (LTSS)and/or Home and Community Based Services (HCBS) coordination, care delivery monitoring and care management experience. This experience may be concurrent with the two years of experience working with I/DD population described above AND Must reside in North Carolina Must have ability to travel regularly as needed to perform job duties Education/Experience Preferred: Experience working with member/recipients with co-occurring physical health and/or behavioral health needs preferred. Licensure/Certification Requirements: If a Registered Nurse (RN), must be licensed in North Carolina.

FIND YOUR FUTURE We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. The Financial Systems Analyst will be responsible for the development, maintenance and administration of finance systems related to new product initiatives, upgrades, and enhanced system functionality. This role will also support reporting and analysis, including process improvement. The analyst will research and analyze system and business issues to identify root causes thereby developing subject matter expertise on both process and system, supporting the organization as a liaison between finance, IT technical staff and other organizational departments. They will also support finance leadership with internal and external audits and compliance requests. Qualifications Bachelor's degree required. An additional four (4) years of experience will be considered in lieu of degree. Three (3) years of multi-dimensional financial operations/systems experience required including experience implementing, developing, enhancing, and supporting packaged financial application systems. Ability to work independently with minimal supervision. Excellent verbal and written communication skills. Proven ability to identify problems and recommend appropriate resolutions. Exceptional organizational and time management skills. Knowledge and experience in the development of departmental policies as well as process/procedural SOP. Ability to utilize, maintain and enhance financial reporting systems and recommend reporting and process efficiencies. Proven problem-solving track record with high level attention to detail with demonstrated ability to meet project deadlines. Experience with web-based applications (Workday, etc.) Advanced PC and systems aptitude required, proficiency in MS Office environment. Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative, and Accountable. Essential Accountabilities Proactively research Finance technology functionality for operational efficiencies. Lead project prioritization and Finance technology system upgrades. Remain proficient in our financial software package and reporting tools and assist in its administration. Assist in the development and updating of processes and procedures relative to the accurate reporting of financial information and intercompany charges. Support internal and external audit requests. Support Financial Operations daily operations as needed. Monitor system controls and processes to ensure continuous smooth operations; coordinate with business and technical areas to resolve issues. Provide support by answering questions on system transaction processing and assist with system problem resolution. Immigration or work visa sponsorship will not be provided for this position Hiring Compensation Range: $65,000 - $70,000 annually Compensation may vary based on factors including but not limited to skills, education, location and experience. In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future. As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information. Current Associates must apply internally via the Job Hub app.