Inland Behavioral & Health Services jobs - 40 jobs

At DAP Health, we are committed to transforming lives and advancing health equity for all. As a leading nonprofit health care provider, we deliver compassionate, high-quality care to the diverse communities of the Coachella Valley and San Diego County. Our comprehensive services range from primary care to mental health, wellness programs, and beyond, with a focus on those who are most vulnerable. Joining our team means becoming part of a passionate, innovative organization dedicated to making a meaningful impact in the lives of those we serve. If you're looking for a dynamic and purpose-driven environment, we invite you to explore the opportunity to contribute to our mission. Job Summary The Patient Connection Agent plays a vital role in ensuring a welcoming, efficient, and compassionate experience for every patient or client contacting DAP Health for medical or social services. This position requires strong communication skills, sound judgment, and the ability to thrive in a fast-paced, service-oriented environment. Agents are expected to meet key performance metrics-including completed call rate, wait time, and call handling time-while consistently delivering high-quality, empathetic customer service. Patience, active listening, and attentiveness to callers' needs are essential to success in this role. Supervisory Responsibilities: None Essential Duties/Responsibilities Maintain patient confidentiality in accordance with HIPAA and all applicable laws and regulations Schedule various types of patient appointments following DAP Health's provider templates and protocols based on patient needs and service requirements Complete mini and full patient registrations to meet Uniform Data System (UDS) standards Verify and update patient demographics when accessing records and scheduling, modifying, or canceling appointments Understand DAP Health's insurance policies and verify patient eligibility using the Electronic Health Record (EHR) system Clearly and effectively explain DAP Health's services to patients, clients, customers, and external agencies Gather and relay accurate patient information to appropriate parties in a timely and professional manner Assist patients with information regarding the Federally Qualified Health Center (FQHC) Sliding Fee and other financial aid programs; schedule application/enrollment appointments as needed Review provider schedules to identify and address missed opportunities, ensuring optimal utilization Serve as a liaison between patients and other departments to facilitate coordinated care Monitor and respond to department voicemails, patient portal messages, and after-hours communications Participate in department workflow improvements by suggesting changes and engaging in team huddles and meetings Distinguish between clinical and non-clinical calls, routing clinical inquiries to nursing staff or on-call providers as appropriate Answer all incoming calls within 20 seconds in a courteous and professional manner, following the DAP Health foundational scripts Deliver consistent, high-quality customer service to all patients and stakeholders Provide in-clinic support at DAP Health locations as needed Support organizational quality initiatives, including completing patient recall and outreach actions Perform other duties as assigned to support departmental and organizational goals Required Skills/Abilities * Bilingual fluency in English and another language may be required depending on patient population needs, with the ability to communicate in culturally sensitive, conversational language. * Demonstrated ability to deliver high-quality, client-centered services in compliance with HIPAA and recognized medical industry standards * Proficiency in Microsoft Office applications and ability to quickly learn and navigate complex software systems * Strong skills in database entry, information retrieval, and electronic records management * Exceptional written, oral, and listening communication skills with an emphasis on clarity, empathy, and professionalism * Proven excellence in customer service, with a focus on responsiveness and patient satisfaction * Preferred experience working with underserved populations, including culturally diverse and underserved communities Education and Experience * Two years of customer service experience using telephone, email, and other communication mediums * Preferred: Experience in medical front office operations, including registration process, use of medical terminology, and medical insurance * Preferred: Previous experience working with an EHR System Working Conditions/Physical Requirements * This position is on-site at the DAP Health Patient Connection Call Center with the possibility of hybrid * Remote/hybrid work option may be available based on sustained high performance and achievement of key performance indicators (KPIs) * Employees who do not maintain these standards may be recalled to the primary work location with a minimum two-week notice * Remote work environments must meet HIPAA compliance standards; noncompliance may result in disciplinary action, up to and including termination * Infrequent travel is essential for off-site training, meetings, and supporting other locations * Operates in an office setting at times and requires frequent times of sitting, standing, repetitive motion and frequent phone calls/conversations * Employees do not perform or help in emergency medical care or first aid * Ability to lift 24 pounds

Additional Information About the Role BJC HealthCare is hiring a Full-time Certified Medical Dosimetrist at our Barnes Jewish Hospital Center for Advanced Medicine located in St. Louis, MO!!! Must reside in MO or IL and able to come onsite if needed * Hybrid * Day Shift, M-F, 40 hours per week (Flexible 5-8's or 4-10's) * No Weekends! No Call! * Active Certified Medical Dosimetrist license, RTT preferred Overview Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center. Staff in the Radiation Oncology Department work with leading experts from the Siteman Cancer Center, the first and only National Cancer Institute designated comprehensive cancer center in the St. Louis region. With a staff of approximately 250 medical and allied health professionals, the department of Radiation Oncology offers its hospital staff the opportunity to work in a cutting-edge environment focused solely on delivering exceptional and uncompromising patient care. Preferred Qualifications Role Purpose Performs treatment planning and dosimetry computations, including CT simulations, encountered in daily clinical physics activities as requested by the Radiation Oncologist. Responsibilities Designs a treatment plan with optimal beam geometry to deliver a prescribed radiation dose and spare critical structures in accordance with the Radiation Oncologist's prescription.Provide assistance and technical support to the Medical Physicist, in radiation safety and protection and quality assurance of treatment plans. Operates and performs quality assurance, under the direction of the Medical Physicist and Radiation oncologists. Adheres to Department Quality Assurance Guidelines.Localizes implant sources and special interest dose points.Communicate with the radiation therapist(s) and assume an advisory role in the implementation of the treatment plan including: the correct use of immobilization devices, compensators, field arrangement, and other treatment or imaging parameters. Minimum Requirements Education Associate's Degree - Physical Sci/Health related Experience Supervisor Experience No Experience Licenses & Certifications Certified Medical Dosimetrist Preferred Requirements Education Bachelor's Degree - Physical/Biological Science Benefits and Legal Statement BJC Total Rewards At BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being. * Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date * Disability insurance* paid for by BJC * Annual 4% BJC Automatic Retirement Contribution * 401(k) plan with BJC match * Tuition Assistance available on first day * BJC Institute for Learning and Development * Health Care and Dependent Care Flexible Spending Accounts * Paid Time Off benefit combines vacation, sick days, holidays and personal time * Adoption assistance To learn more, go to our Benefits Summary. * Not all benefits apply to all jobs The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer

Work From HomeWork From Home Work From Home, Indiana 46544 The Hospital Outpatient Coding Educator is responsible for coordinating and conducting coding training and developing training content and materials for the Franciscan Alliance Corporate Coding Department, hospital outpatient and professional coding staff. This position ensures training practices are standardized and result in consistent coding outcomes, as well as provides input regarding the content of policies and procedures. This position ensures all new and existing staff members are trained and adhere to current coding policies and procedures. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Develops and maintains all corporate outpatient coding education, training policies and procedures, and coding reference materials. Leads training sessions and assess coder comprehension of covered materials. Makes recommendations for the development of coding resources and policy and procedure development. Assists corporate coding leadership with training and/or development of a performance improvement track for coding coworkers in the corrective action process related to quality or productivity performance. Coordinates with Coding Auditors to prepare education material based on audit results. Develops and maintains a consistent coding operations orientation program, and reports the coders' progress to coding leadership throughout the orientation and training processes Assists Coding Manager and Supervisor with review and response to external coding audits. Acts as a nosologist, analyzing and interpreting disease, procedure classifications, and terminologies for the accurate translation of healthcare data. Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability. Ability to analyze information, make decisions and exercise independent judgement. Serves as the subject matter expert with regards to diagnosis and procedure codes, coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payer specific guidelines, public reporting of outcomes, quality of patient care outcome measures, and the interpretation of coded data as it relates to revenue cycle compliance. Participates in problem identification, performs root cause analysis and recommends a solution to Coding Management. Assists with development and maintenance of software system workflow for standardization and maximum efficiency. Oversees system testing with regards to any published software updates or software functionality changes Identifies template variation within the EMR that has a negative impact on coding edits/errors. Escalates trends and makes recommendations for template revisions/standardization to FAIS HIM team and Coding Leadership. Coordinates all testing efforts with coding superusers and FAIS teams. Assists with annual verification of coding staff credentials. Orients new physicians with regards to the coding department's role in the revenue cycle, and prepare training material for coding related to physician education. Assists with identification and implementation of process improvements according to industry best practice standards to make the best use of resources, decrease costs and improve coding services across the specialized service lines. QUALIFICATIONS High School Diploma/GED With 5 years of Franciscan coding experience - Required or Associate's Degree in Health Information Management - Required Bachelor's Degree in Health Information Management - Preferred Surgery Coding Experience - Required 5 Years Franciscan outpatient coding with CCS, CCS-P, CPC - Required or 3 Years Outpatient Coding Experience with RHIT/RHIA - Required 3 Years Coding Manager or Trainer/Auditor - Preferred CCS, Certified Coding Specialist from American Health Information Management Association (AHIMA) - Required or CPC, Certified Professional Coder from the American Academy of Professional Coders (AAPC) - Required or CCS-P, Certified Coding Specialist - Physician from the American Health Information Management Association (AHIMA) - Required RHIT, Registered Health Information Technician from American Health Information Management Association (AHIMA) - Preferred or RHIA, Registered Health Information Administrator from American Health Information Management Association (AHIMA) - Preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Coding Educator - Hospital Outpatient/Professional $51001.60-$75868.00INCENTIVE: EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Hours: Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No Weekends On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $49.700 - $64.130 - $71.820 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. *This is a remote position* What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of law and other misconduct. This role will help promote ethical practices and a commitment to compliance with applicable federal, California, and local laws, rules, regulations, and internal policies and procedures. The position plays a key role in oversight of Sharp HealthCare's (SHC) compliance audit function and maintaining Sharp HealthCare's view of coding, billing and reimbursement compliance audits. Required Qualifications 5 Years experience in acute care inpatient/outpatient coding or professional E/M coding in the following coding systems: ICD-10-CM/PCS, DRG, CPT& HCPCs, and/or E/M CPT. Preferred Qualifications Other : Strong background in in ICD-10-CM/PCS coding, DRG coding and CPT coding classification. Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate -PREFERRED Certified Health Care Compliance (CHC) - Compliance Certification Board -PREFERRED Other Qualification Requirements Bachelor's degree in Business, Healthcare Administration, or related field - required. In lieu of Bachelor's degree, Associate's degree and a minimum of 5 years experience in coding, billing and compliance may be considered. One of the following is required: AHIMA's Certified Coding Specialist (CCS), or Certified Documentation Improvement Practitioner (CDIP), or AAPC Certified Inpatient Hospital/Facility (CIC), or Certified Professional Coder (CPC) certification. Certified Clinical Documentation Improvement Practitioner or Specialist (CDIP or CCDS) is required within 1 year of hire. Department management is responsible for tracking and ensuring employee receive certification within specified timeframe. Essential Functions Coding Compliance Compliance Coding and Billing Audits The Compliance Coding Auditor has the primary responsibility of performing all audits and chart reviews required for inpatient and/or outpatient coding and billing, daily retrospective chart reviews and communication to key stakeholders regarding audit findings and corrective actions, if necessary. Reviews the electronic health record to identify potential coding and billing compliance issues. Prepares written reports of audits, including recommendations to improve compliance. The Auditor will analyze and assess Sharp's potential risks using SHC's billing and coding claims data, risk assessment data, MDAudit risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials, industry experts, etc. Policy and Procedure maintenance Works in collaboration with the Director and Manager of Compliance and System Management (HIM, CDI, Case Management, Quality, etc.) in developing SHC's standardized documentation, medical necessity, coding and billing policies and guidelines in accordance with state and federal laws, regulations and policies. Professional development Maintain current credentials and knowledge of ICD-10-CM/PCS, MS-DRG, CPT and HCPCs coding classification changes, compliance issues and updates regarding changes in federal and state regulations, policies and procedures pertaining to the Compliance Program. Adheres to a personal plan of professional development and growth through professional affiliations, activities and continuing education. Unit support Key Stakeholder/Business Unit Support Responsible for inpatient and/or outpatient coding and billing investigations and inquiries, as well as answering correspondence from key stake holders regarding inpatient and/or outpatient coding and billing matters and other general Compliance reimbursement inquiries. Will continuously evaluate the quality of clinical documentation and monitor the appropriateness of queries with the overall goal of improving physician documentation and achieve accurate coding. Maintain professional relationship with key stakeholders focusing on high level of client satisfaction. Must demonstrate excellent written and oral communication presentation skills in training SHC workforce and physicians. Professional competency Certified Clinical Documentation Improvement Practitioner or Specialist (CDIP or CCDS) is required within 1 year of hire. Department management is responsible for tracking and ensuring employee receive certification within specified timeframe. Knowledge, Skills, and Abilities Ability to perform independent research and factual analysis of coding and billing matters and create proposed solutions to root causes. Computer proficiency with Microsoft office applications is required. Ability to function within a fast-paced, dynamic, and growing environment. Excellent time management and problem solving skills. Must demonstrate analytical ability, motivation, initiative, and resourcefulness. Teamwork and flexibility required. Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

Work From HomeWork From Home Work From Home, Indiana 46544 The Lead CDI Specialist assists the CDI Manager by overseeing the day-to-day work functions of the CDI Specialists. In this role, you will assign daily duties, monitor CDI department volumes, and round with employees on a defined basis to solicit feedback. The position is responsible for escalating employee concerns, workflow opportunities, and technology barriers to the Manager/Director of CDI. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Oversee day-to-day CDI functions, including daily assignments and department-wide tasks, and escalates recommendations to the CDI Manager for adjustments to workflow when necessary. Coordinate staff schedules to meet service level expectations. Escalate inconsistencies in CDI operations that do not align with corporate standards. Make recommendations for the development of CDI resources and policy and procedure development based on observations with staff. Participate in problem identification, perform root cause analysis, and recommend a solution to CDI Management. QUALIFICATIIONS Associate's Degree Nursing or Healthcare related field - Required Bachelor's Degree Nursing or Healthcare related field - Preferred 7 years Acute Care Nursing in lieu of Bachelor's Degree - Required 3 years Direct CDI experience - Required 2 years Lead, Supervisory or Management - Preferred 1 year Prior leadership or mentoring experience formally as team lead or informally as a seasoned CDI specialist - Preferred 3 years EPIC/EHR experience - Required Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Integrity Specialists (ACDIS) - Required within 180 days Registered Nurse (RN) - State Licensing Board - Preferred Strong communicator and approachable leader with a positive, servant-leadership style - Required Self-starter who takes initiative, solves problems effectively, and adapts well to change - Required Organized and confident working in dynamic environments - Required TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:CDI Lead Specialist: $75,441.60 - $103,750.40INCENTIVE: EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

About City of Hope, City of Hope's mission is to make hope a reality for all touched by cancer and diabetes. Founded in 1913, City of Hope has grown into one of the largest and most advanced cancer research and treatment organizations in the U.S., and one of the leading research centers for diabetes and other life-threatening illnesses. City of Hope research has been the basis for numerous breakthrough cancer medicines, as well as human synthetic insulin and monoclonal antibodies. With an independent, National Cancer Institute-designated comprehensive cancer center that is ranked top 5 in the nation for cancer care by U.S. News & World Report at its core, City of Hope's uniquely integrated model spans cancer care, research and development, academics and training, and a broad philanthropy program that powers its work. City of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and cancer treatment centers and outpatient facilities in the Atlanta, Chicago and Phoenix areas. The successful candidate: Under the supervision and leadership of the Executive Director of Pharmacy, the Program Director of Clinical Pharmacy Programs is responsible for programmatic and strategic oversight and coordination of all aspects of the Pharmacy Clinical Programs across CAP pharmacy, in conjunction with the counterpart incumbent, to enhance patient outcomes and safety in the most efficient and optimal fashion. The Program Director of Clinical Pharmacy Programs collaborates closely with the Executive Director and other pharmacy leaders to establish the vision for the clinical services provided at City of Hope CAP. Responsibilities include but are not limited to planning and executing new clinical programs, partnering to standardize and optimize medication utilization across the System, leading the regional Formulary/Pharmacy and Therapeutics/other related committees, and developing and implementing policies, guidelines and best practices related to medication therapy. Position is also responsible for management of the CAP pharmacoeconomic program to ensure cost effectiveness of treatments provided. Additionally, the Program Director is responsible for developing strategies to mitigate drug shortage impact to patients treated at all CAP sites. Collaboration is imperative to the success of this position, so routine communication with providers, nurses, pharmacists, and other clinical leaders is essential. This resource will work very closely with clinical pharmacists and pharmacy leadership at each CAP site, helping to guide and lead the development of consistent clinical programs across the System. Essential Functions: Clinical Program Oversight and Compliance: Strategically plan and provide leadership for all aspects of Enterprise Clinical Pharmacy Program across all CAP sites. Developing new programs based on patient needs and optimizing existing programs and practices. Standardizing clinical practices, medication management policies/guidelines, and treatment plans across all CAP sites. Leading the Formulary, Pharmacy and Therapeutics (P&T), and other related committees. Providing drug formulary oversight. Developing and coordinating implementation plans for the use of new products in compliance with institutional policies and regulatory guidelines (e.g. FDA, The Joint Commission) Developing metrics to measure staff productivity and program effectiveness. Liaising between internal affiliated departments and external stakeholders to ensure program integrity. Pharmacoeconomics Program: Leading pharmacoeconomic initiatives to enhance patient care and optimize cost effectiveness of treatments provided. Monitoring the pharmaceutical marketplace for cost saving opportunities. Implementing and tracking therapeutic conversions. Other Responsibilities: Clinical development of pharmacy staff to promote practice at top of their license. Supporting research, publication, and presentation opportunities for the staff at local and national level. Collaborating with schools of pharmacy to oversee pharmacy student training during City of Hope rotations. Representing City of Hope-CAP Pharmacy Department at professional and community organizations at the local, state, and national level. Follows established City of Hope and department policies, procedures, objectives, performance improvement, attendance, safety, environmental, and infection control guidelines, including adherence to the workplace Code of Conduct and Compliance Plan. Practices a high level of integrity and honesty in maintaining confidentiality. Performs other related duties as assigned or requested. The following Pillars in Action are the behaviors that accelerate our impact as we deliver on our Vision and Strategic Priorities: Position Qualifications: Minimum Education: Doctor of Pharmacy Degree (Pharm.D.) Minimum Experience: 6 years of experience planning and executing pharmacy programs with 10 years of experience in a hospital setting Req. Certification/Licensure: Current Pharmacy license Board Certified Oncology Pharmacist (BCOP) Preferred Education: ASHP accredited PGY-1 or PGY-1 and PGY-2 Residencies Preferred Experience: 5 years of experience in Oncology Skills/Abilities: Personal computer approximately 75% of time Working/Environmental Conditions: Work is primarily performed within an office setting. Frequent meetings & walking to meeting sites as required City of Hope is an equal opportunity employer. To learn more about our comprehensive benefits, click here: Benefits Information City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location. This position is eligible for an annual incentive bonus.

**City/State:** Saint Louis, Missouri **Categories:** Health Information Management **Job Status:** Full-Time **Req ID** : 102294 **Pay Range:** $23.10 - $38.36 / hour (Salary or hourly rate is based on job qualifications and relevant work experience) **Additional Information About the Role** Barnes Jewish Hospital is seeking an experienced Trauma Registrar III! Our department is growing and we are looking to add to our current team! Schedule: M-F, days, 8 hour shifts (may start as early as 4:00 a.m.) Remote position **Overview** **_Barnes-Jewish Hospital_** at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center. At Barnes-Jewish Hospital, the Trauma team members (RN, data analysts, care coordinators, educators) find the kind of fast-paced environment that will test their professional judgment and critical thinking skills, and encourage tremendous growth. It's an exhilarating place to build a nursing career. Here, you'll work with world-renowned surgeons and anesthesiologists, assist on unique and complex procedures, work with the latest technologies and treatments and play a vital role in developing new procedures and treatment protocols. In fact, people from all over the nation and the world come to Barnes-Jewish for our surgical specialties. **Preferred Qualifications** **Role Purpose** The position is responsible for data entry into the Emergency General Surgery Registry and/or Trauma Registries to include: injury, procedural and ICD-10 Coding in the Emergency General Surgery and/or Trauma Registries. This position will also assist with IRR reporting on other team members and data dictionary review and upkeep. This position requires the ATS Registry certification, AAAIM coding certification and the CSTR certification or CAISS certification. This position is responsible for maintaining concurrency to meet the required standards as set forth by the accrediting bodies. This position requires a CSTR and/or CAISS Certification. **Responsibilities** + Includes all responsibilities of lower level Trauma/Emergency General Surgery Registrars. + Application of trauma flag in patient's EPIC chart. + Assist with Admit process for Trauma/Emergency General Surgery patients. + Completion and distribution of scheduled registry reports. + Serve on planning committee for Trends in Trauma conference. **Minimum Requirements** **Education** + High School Diploma or GED **Experience** + 2-5 years **Licenses & Certifications** + ATS Registry Course Cert **Preferred Requirements** **Education** + Associate or Trade School Equi - Healthcare related field **Experience** + 5-10 years **Supervisor Experience** + No Experience **Licenses & Certifications** + AAAIM Coding Course Cert + RHIA/RHIT **Benefits and Legal Statement** **BJC Total Rewards** At BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being. + Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date + Disability insurance* paid for by BJC + Annual 4% BJC Automatic Retirement Contribution + 401(k) plan with BJC match + Tuition Assistance available on first day + BJC Institute for Learning and Development + Health Care and Dependent Care Flexible Spending Accounts + Paid Time Off benefit combines vacation, sick days, holidays and personal time + Adoption assistance **To learn more, go to our** **Benefits Summary** **.** *Not all benefits apply to all jobs The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer

Work From HomeWork From Home Work From Home, Indiana 46544 The PACE Claims Specialist II is responsible for performing day-to-day claims processing and adjudication tasks while providing support to vendors and internal teams. Serving as a team lead for the claims processing team, this role has additional responsibilities in workflow development, process improvement, and advanced technical knowledge to support complex claims scenarios. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. The PACE program's vision statement is to provide unmatched, individualized, and joyful care through teamwork that is worthy of praise so that seniors experience the best quality-of-life in their communities. PACE offers seniors and their families the care, nutrition, rehabilitation, transportation, and supportive services they need to remain healthy so that they can live in their own home. Franciscan is known for our mission of caring. WHAT YOU CAN EXPECT Practice Hours: Monday - Friday, 8:00 a.m. - 5:00 p.m. No Weekends, Evenings, or Holidays Performs duties related to the timely and accurate adjudication of PACE participant medical claims while maintaining advanced knowledge of coding and billing rules. This includes data entry, processing manual and electronic claims, verifying authorizations, issuing claim payments and remittance advice, and processing claim denials. Responsible for working complex or high-priority claims, ensuring accuracy and compliance. Reviews escalated claim issues and delivers resolutions in alignment with CMS requirements. Ensures claims adhere to CMS rules, Medicare guidelines, and PACE-specific policies. Collaborates with the interdisciplinary team (IDT) to resolve discrepancies in authorizations or documentation. Conducts any necessary follow up with internal and external stakeholders. Supports the PACE Claims Specialist I in providing industry leading customer service to PACE vendors. Performs customer service activities including, but not limited to, support and education to vendors during onboarding phase of partnership, communicating claim statuses to vendors, investigating vendor inquiries, and gathering information related to vendor claim appeals. Assists with maintaining the vendor and provider network within the claims adjudication software. Builds and modifies vendor profiles as program's vendor network changes. Ensures accuracy of vendor profiles in relation to reimbursement structure in vendor contracts, provider lists, W-9s, etc. Verifies updates to Medicare and Medicaid rates and codes are accurately reflected in claim adjudication software. Performs monthly EDPS reporting and error clearance. This includes, but is not limited to, reporting to regulatory agencies, clearing errors for resubmission of codes, and monthly auditing of EDPS return/output data. Generates detailed claim performance reports, identifying trends and potential areas for improvement. Collaborates with PACE intake and eligibility team members to maintain accurate participant eligibility record in claim adjudication software, driving accurate and compliant claim payments. Supports the PACE Claims Operations Manager in tracking vendor 1099s and gathering claims data for reinsurance reporting. Works closely with finance to aid in the facilitation of timely and accurate claim payments to vendors. Monitors aging reports to escalate and expedite necessary claim payments. Assists with monthly financial reporting to ensure accurate recordation of financial data. Works closely with internal stakeholders, including finance, compliance, and clinical teams, to facilitate claims processing workflows. Partners with external stakeholders, such as CMS or third-party vendors, to ensure seamless claims operations. Trains and mentors PACE Claims Specialist I team members to enhance their understanding of claims adjudication and regulatory requirements. Acts as a resource for troubleshooting technical or procedural issues. Develops and refines workflows to improve the efficiency of the claims processing team. Assists in the implementation of technology solutions to enhance claims processing reporting capabilities. Innovates workflows to drive automation in claim processing. Monitors claims workflows for bottlenecks and provides recommendations for improvements to PACE Claims Operations Manager. Assists with the development, implementation, and maintenance of policies and procedures in accordance with best practices for claims adjudication. QUALIFICATIONS Associate's Degree- Finance, Business or Healthcare Administration- Required In lieu of degree- 5 years of medical claims processing experience- Required In lieu of degree- 3 years of PACE medical claims processing experience- Required Bachelor's Degree- Preferred Certified Medical Reimbursement Specialist- American Medical Billing Association- Preferred 3 Years- Medical Claim Adjudication/Processing Experience- Required 1 Year- PACE Specific Medical Claim Processing Experience- Preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:PACE Claims Specialist II $54,350.40-$74,733.32INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Work From HomeWork From Home Work From Home, Indiana 46544 The Certified Coding Specialist upholds the critical responsibilities of reviewing electronic medical record (EMR) documentation, and applying ICD and CPT codes, per official coding guidelines, with a specific focus on professional primary care and urgent care visits. The position services as a subject matter expert to providers and staff for questions and updates related to coding. WHO WE ARE Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Review and audit EMR content, charts, CPT procedure codes, ICD diagnosis codes, and documentation to ensure accuracy and standard; provide corrective action if needed. Review MWV, TCM and CCM visits to ensure billing follows Medicare and coding guidelines. Verify insurance eligibility and update electronic medical record registration as appropriate. Demonstrates a thorough knowledge of coding guidelines, medical terminology, and anatomy/physiology, and payer specific coding guidelines. Communicate electronically with the provider and/or staff for documentation or clarification to support codes, and communicate concerns to the manager. QUALIFICATIONS High School Diploma/GED - Required Associate's Degree Health Information Management - Preferred 1 year of hands-on ICD-10 coding experience in a professional healthcare setting (not solely coursework or software training) - Preferred Highly detail-oriented with a commitment to accuracy - Required CPC, CCS, or CCA coding certification - Required TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Certified Coding Specialist $20.06-$26.81INCENTIVE: EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

**Facility:** Corporate Offices **City** San Diego **Department** **Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse (RN) - CA Board of Registered Nursing; Bachelor's Degree **Hours** **:** **Shift Start Time:** 8 AM **Shift End Time:** 5 PM **AWS Hours Requirement:** 8/40 - 8 Hour Shift **Additional Shift Information:** **Weekend Requirements:** As Needed **On-Call Required:** No **Hourly Pay Range (Minimum - Midpoint - Maximum):** $72.290 - $93.280 - $104.470 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. **What You Will Do** Supervise the effective implementation of the Ambulatory Case Management (ACM) programs that includes the management of patients in the different areas of the care management spectrum. Responsible for operational planning consistent with existing policies and procedures. Responsible for supervision of ACM activities to include tracking, trending, and analyzing data, streamlining and improvement of programs, facilitation of provider education, supporting the Medical Directors, and collaborating on interdepartmental activities. Develop and implement new programs under the direction of the Manager of Integrated Care Management and Director of Health Services. Participates in the development of the annual ACM plans and implementation of corrective action plans related to health plan audits and requirements of National Committee on Quality Assurance (NCQA) and other governing regulatory bodies. Collaborates with the Quality, Compliance, and Training Department to effectively integrate and implement processes consistent with health plan, NCQA, DMHC, and CMS requirements. Participates in the development and implementation of new programs under the direction of the Manager of Integrated Care Management. **Required Qualifications** + Bachelor's Degree nursing or health care related field. + 3 Years experience in the acute patient care setting, including ICU or intermediate care units, Medical-Surgical Nursing, and/or Home Health. + 3 Years in medical management experience, preferably in managed care. + California Registered Nurse (RN) - CA Board of Registered Nursing -REQUIRED **Preferred Qualifications** + 2 Years leadership experience, preferably in a managed care setting. **Other Qualification Requirements** + Utilization, Case Management, or Quality Management certification preferred. **Essential Functions** + Ambulatory Case Management OperationsSupervise Ambulatory Case Management staff and operational processes in accordance with NCQA, DMHC, CMS and health plan requirements.Oversee the ACM and UM processes of the assigned teams, ensuring staff access to needed information and tools.Ensure that tools utilized by ACM teams are up to date and in alignment with regulatory requirements and internal processes.Establish and maintain appropriate policies and procedures and training plans to include enforcement of standards for all ACM team activities.Coordinate with the Health Services Quality and Compliance department to ensure timely and relevant implementation of training and verify adherence with quality and compliance parameters.Implement and maintain the reporting systems for operational and utilization outcome indicators as it relates to the daily ACM operations. Implement and maintain regular reporting systems for operation and ambulatory care management outcome indicators.Participate in groups in developing and implementing strategic plan to implement organization vision and/or service-culture initiatives.Establish specific quality goals, connecting the vision to the necessary actions and long-term strategies.Recognize physician needs and concerns and act on opportunities for improvement in conjunction with leadership. Collaborate with physicians to address operational issues.Promotes positive outcomes in a managed healthcare setting in support of program initiatives.Lead team members to facilitate and coordinate quality healthcare services and delivery of goods and services to meet a member's specific healthcare needs in a timely, efficient, and cost effective manner utilizing strong communication, problem solving, and critical thinking skills.Direct and collaborate with peers and assists in the case management process as necessary.Assists leadership in promoting team performance goals and in monitoring team progress toward accomplishment of departmental goals and initiatives.Assists in the ongoing education of providers, physicians and their office staff.Implements action plan to improve referral processing under ACM management direction.Enforce policies and procedures for all Case Management activities.Maintains ongoing analysis of program performance and monitors trends and opportunities for enhancement or expansion of the ACM processes and operations Document ACM processes according to SCMG policies and procedures.Collaborate with other disciplines/departments to resolve identified issues with demonstrated improvement in operational flow.Facilitate ACM staff and provider collaboration.Operationalize and establish efficient ambulatory case management and referral management work flows to ensure timely patient care.Bring to attention of the ACM Manager, areas of non-compliance and provide input on actions for improvement.Establish and maintain operational documents such as policies and procedures, desktop procedures as well as all other tools that ACM staff utilize to complete case management activities.Collaborate with vendors to provide in services as appropriate to provide staff with available services. + Human Resource Management All 90 day and annual performance reviews are completed per Sharp guidelines. Provides feedback toward employee performance. Facilitates staff's progress toward agreed upon annual performance goals. Assure employee files are current and complete, including annual TB testing, Safety Testing, Compliance Training, and annual HIPAA test, etc.Manage and assist staff to resolve identified attendance, performance, learning and behavior issues through feedback, counseling, corrective action and goal-setting.Hire staffing for the department per department plan. Orient/mentor staff into new role resulting in achieved competencies. Ensure accuracy with new employee onboarding as it relates to granting systems access, e.g., EPIC, OnBase, health plan websites, EHR, etc.Increases retention rate (or reduces turnover) of select group of staff.Leads initiative that results in improved teamwork and/or building more effective relationships.Decreases occurrences of unsafe work practices and/or worker's injuries.Arranges team coverage for ACM teams in the event of staff absence by demonstrating willingness, flexibility, and competence to assign coverage and/or serve as 'float' as needed with thorough understanding of program differences.Supports ergonomic improvement initiatives, teaching, and assists with enforcing compliance with measures designed to reduce employee injury.Provides training and assistance to staff. Mentors others in developing new skills and assuming new responsibilities.Staffing schedules are coordinated to assure adequate department coverage.Special projects as assigned by Manager, and/or Director. + LeadershipLead groups in developing and implementing strategic plan to implement organization vision and/or service culture initiatives.Establish specific quality goals, connecting the vision to the necessary actions and long-term strategies.Recognize physician needs and concerns and initiate opportunities for improvement.Recognize patient needs and concerns and initiate opportunities for improvement.Collaborate with other disciplines/departments to resolve daily operational issues when supervising unit.Facilitate staff in prioritizing and problem solving daily operational issues.Demonstrate resolution of operational issues with targeted outcomes as negotiated with manager.Utilize team-building skills to provide direction, goal setting, and attainment of goals.Conduct team meetings to include documentation of agendas and minutes on a consistent schedule. + Quality and Productivity PerformanceMonitor and manage staff deviations from team quality and productivity goals.Conduct and report quarterly performance audits and results.Establish and maintain staff meetings quarterly to review progress towards meeting quality and productivity goals. + System Configuration and TestingPlan and develop of operating systems to manage specific SCMG operational and business objectives through the set-up of ACM queues and workflows.Participate in the development and implementation of software functionality, upgrades, and system integration.Coordinate testing efforts of new and current software functionalities and applications.Oversight the process of identifying, reporting, trouble-shooting, and resolving system problems.Analyze the impact of software changes on accuracy and productivity.Oversee the ACM ambulatory CM and UM process workflows from an application perspective and staff adherence. + Professional Development Maintains competence in all standards of ambulatory case management, referral management and care coordination. Keeps current knowledge and understanding of applicable accreditation and regulatory statutes related to health care, managed care, case management practice.Serves as a resource and mentor to Health Services teams.Attends and actively participates in department/team process/quality improvement activities. + Program Improvement Maintains ongoing analysis of program performance and monitors trends and opportunities for enhancement or expansion of the program.Provides expertise/consultation in developing services/programs, marketing strategies, and business planning.Consults/liaisons with other programs and agencies, and consultants as appropriate Collaborates with other disciplines/departments to resolve identified issues. **Knowledge, Skills, and Abilities** + Effective interpersonal skills: strong verbal, written and presentation skills. + Ability to work well with staff for various educational and professional skills backgrounds to achieve common goals. + Accepts accountability for performance and decisions. + Thorough computer knowledge, including on-line database and personal computer skills. + Knowledge of wide variety of local and national resources for use in Care Management process. + Strong organizational skills with ability to work well under pressure with conflicting priorities. + Ability to read, speak and hear English clearly. + Occasional travel between Sharp HealthCare facilities and provider offices; must provide own transportation. + Demonstrated leadership skills. Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

**City/State:** Saint Louis, Missouri **Categories:** Information Services **Job Status:** Full-Time **Req ID** : 101019 **Pay Range:** $69,326.40 - $112,860.80 / year (Salary or hourly rate is based on job qualifications and relevant work experience) **Additional Information About the Role** BJC is hiring for an EHR Application II Analyst. This role will be focused on charge workflows (hospital and professional) within the labs (clinical and anatomic). Looking for a lab billing expert. This is a remote position. **Overview** **BJC HealthCare** is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development. BJC's patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children's Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country. **Preferred Qualifications** **Role Purpose** Under moderate direction, the EHR Application Analyst II is responsible for configuring, modifying, testing, and maintaining Epic & other Clinical applications. Builds collaborative relationships with hospital leadership, clinical department users, technology and other corporate departments to facilitate usage and acceptance of the system. May be assigned to more complex build and configuration tasks and resolve advance issues. Provides second-tier support to end users to ensure reliable application system availability and performance. May be responsible for system integrity. Provides solutions or resolves end-user system issues. Epic or applicable certifications will be required within 6 months of hire. **Responsibilities** + Designs, verifies, documents, amends and refactors complex software configurations for deployment. Contributes to the selection of the software configuration methods, tools and techniques. Applies agreed standards and tools, to achieve well-engineered outcomes. Participates in reviews of own work and leads reviews of colleagues' work. + Investigates and resolves issues relating to applications. Follows agreed procedures to identify and resolve issues with applications. Uses application management software and tools to collect agreed performance statistics. Carries out agreed applications maintenance tasks. + Develops and executes test plans and test cases. Collaborates across parties involved in product, systems or service design and development to enable comprehensive test coverage. Analyses and reports on test activities, results, issues and risks, including the work of others. + Evaluates design options and prototypes to obtain user feedback on requirements of developing systems, products, services or devices. Selects appropriate tools and techniques to evaluate user experiences of systems, products, services or devices. + Ensures that incidents are handled according to agreed procedures.Prioritizes and diagnoses incidents. Investigates causes of incidents and seeks resolution. Escalates unresolved incidents.Documents and closes resolved incidents.Contributes to testing and improving incident management procedures. + May be part of an after-hours on-call rotation. **Minimum Requirements** **Education** + High School Diploma or GED **Experience** + 2-5 years **Supervisor Experience** + No Experience **Preferred Requirements** **Education** + Bachelor's Degree **Experience** + 5-10 years **Benefits and Legal Statement** **BJC Total Rewards** At BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being. + Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date + Disability insurance* paid for by BJC + Annual 4% BJC Automatic Retirement Contribution + 401(k) plan with BJC match + Tuition Assistance available on first day + BJC Institute for Learning and Development + Health Care and Dependent Care Flexible Spending Accounts + Paid Time Off benefit combines vacation, sick days, holidays and personal time + Adoption assistance **To learn more, go to our Benefits Summary (******************************************* *Not all benefits apply to all jobs The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer

Sierra Drive Campus1040 Sierra Dr Greenwood, Indiana 46143 Medical record documentation has become an industry all its own. An industry that has strict coding requirements and compliance standards. Our Ambulatory Coding Analyst must be current on all federal and state requirements and procedures. Our physicians and healthcare providers depend on it. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Hybrid Position - Part-time onsite and part-time remote work Approximately 40% Travel Assist the department director and lead analyst in the development of an annual work plan for the review of each provider assigned to them. Select a provider from the established work plan and use software, to compare the average of CPT codes utilized by the provider as compared to their peers. Obtain and review the respective progress note for the provider they are reviewing for each date of service involved in the review. Use auditing software to assess each progress note for key components, CPT compliance, and level of service. Review pertinent records, compile the applicable regulations, summarize the review and findings, and create a report using the established template. Review findings from audits with each provider. Audit physicians whose report indicated billing activity falls significantly below the benchmark. Provide orientation on coding and other billing compliance issues, and answer pertinent questions from the provider. QUALIFICATIONS High School Diploma/GED - Required Bachelor's Degree - Preferred 3 years Coding Experience - Required Certified Coding Specialist (CCS) - Required or Certified Professional Coder (CPC) -- Required RHIT - Preferred Detail-oriented and highly organized, with the ability to accurately manage coding tasks and documentation - Required TRAVEL IS REQUIRED: Up to 50%JOB RANGE:INCENTIVE: EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Work From HomeWork From Home Work From Home, Indiana 46544 The Clinical Pharmacy Specialist provides comprehensive pharmacotherapy services for patient populations, responds to complex drug therapy issues, and provides leadership to improve medication use. The Specialist leads education efforts for Clinical Staff Pharmacists, Pharmacy Students, Pharmacy Residents, and other healthcare professionals. This position collaborates with other Franciscan Alliance medical staff and facilities to achieve best practices and optimal outcomes for all patients. BOTH INDIANA AND ILLINOIS PHARMACIST LICENSE REQUIRED. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Collaborate with allied health disciplines to provide quality patient care. Consult with and advise other Healthcare professionals and patients on matters pertaining to selection, procurement, distribution, and safe and appropriate use of medications. Coordinate and deliver ongoing staff education for clinical staff pharmacist. Direct and precept students and/or residents. Lead cost effective formulary management initiatives. Review adverse events related to the medication use process, recommend improvements to the medication use process, as needed, and ensure improvements are implemented. Review literature and publications in area of specialization, and recommend improvements to the medication use process. Review prescriptions and medication orders, check for appropriateness, and provide information needed to properly and safely administer the medication. Attend and participate in local and system-wide committees to improve the medication use process. Draft, review, and revise medication related policies, procedures, guidelines and protocols. Provide clinical pharmacy services as outlined in approved hospital policies, including but not limited to: pharmacokinetic consults, renal dosing, parenteral nutrition management, anticoagulation management, neonatal/pediatric/geriatric dosing management, route optimization, antimicrobial stewardship, and reviewing medications at transitions of care. QUALIFICATIONS Required Bachelor's Degree Pharmacy Preferred Doctorate Pharmacy 1 year PGY1 Pharmacy Residency Required 3 years In area of specialization Required 1 year PGY-2 Pharmacy residency Preferred Registered Pharmacist (RPh) - State Licensing Board Board Certified in applicable area of specialty or pharmacotherapy (if specialty area not available) - . Required within 24 months Basic Life Support Program (BLS) - American Heart Association As required by unit TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Clinical Pharmacy Specialist $128960.00-$153140.00INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Work From HomeWork From Home Work From Home, Indiana 46544 The Corporate Coding Manager develops and implements coding strategies and provides operational leadership to manage and maintain efficient coding processes. This position supervises staff, prepares and forecasts budgets and strategic plans oversees quality assurance programs, and ensures regulatory compliance. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Provides oversight and leadership to the Coding Supervisors within the department, and manages the performance of coworkers through ongoing coaching, feedback, and development to motivate, engage and drive a high performing team. Oversees the auditing and education program to ensure accurate and compliant coding and billing practices. Makes decisions regarding changes to coding staff day-to-day functions; aligns all aspects of coding operations to align acute and ambulatory corporate initiatives, including standardized corporate coding policy and procedure development and enforcement. Participates in problem identification, performs root cause analysis, and develops a solution that produces expected outcomes and intended results. Assists with the development of the organizational wide standardization and implementation of a corporate coding compliance plan to include compliance with external regulatory and accreditation requirements. Creates an environment that coworkers want to work in and maintain a high level of coworker satisfaction. Serves as department liaison for regional meetings and projects and to other teams that interact with the coding team; assists with items specific to coding needs for planning of new department builds and department revisions. Assists the Coding Manager with inquiries/audits and denials from third party agencies related to coding. Function Purpose Orientation to coding fundamental support role in business operations in supporting the revenue cycle and how coding influences. (ex. Physicians, Clinical Operations teams, BPCI, quality measures Acts as a nosologist, analyzing and interpreting disease and procedure classifications and terminologies for the accurate translation of healthcare data; applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability. Serves as the subject matter expert with regards to diagnosis and procedure codes, coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payer specific guidelines, public reporting of outcomes, quality of patient care outcome measures, and the interpretation of coded data as it relates to revenue cycle compliance. Maintains expert knowledge of Franciscan Alliance coding software tools; assists with development and maintenance of software system workflow for standardization and maximum efficiency. Assists with identification and implementation of process improvements, according to industry best practice standards, to make the best use of resources, decrease costs and improve coding services across the specialized service lines. Director with development and manages departmental budgets, including making budget allocations, approving expenditures and ensuring expenses are within budget. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders, and adheres to official coding guidelines. QUALIFICATIONS Associate's Degree Health Information Management - Required Bachelor's Degree Health Information Management - Preferred 4 years Coding Manager - Required 4 years Franciscan Coding Supervisor - Required 3 years Coding Experience - Required Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) - Required - OR - Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) - Required TRAVEL IS REQUIRED: Up to 20%JOB RANGE:Coding Manager $77,750.40 - $121,492.80INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Work From HomeWork From Home Work From Home, Indiana 46544 We are seeking a Site Reliability & DevOps Systems Engineer to design, automate, and maintain the infrastructure supporting our enterprise data and analytics platforms, including Power BI, Tableau, Databricks, and Epic Cogito. This role bridges systems engineering, DevOps development, and data operations - ensuring our analytics ecosystems are resilient, automated, secure, and high-performing. You will manage Azure DevOps and GitHub environments for CI/CD, infrastructure-as-code (IaC), and environment deployments, while collaborating with BI, data engineering, and cloud teams to standardize and optimize platform operations. Data Systems Engineer III (DSE) is responsible for making intuitive, high-level decisions in designing data analytics infrastructure to extract and organize data for authorized individuals to access. Responsibilities include identifying a company's internal and external data sources, collaborating with department heads to determine their data needs and using the information to create and maintain data analytics infrastructure for company employees. Is responsible for software design and implementation for the development team. The Architect will design and develop a unified vision for software characteristics and functions, with the goal of providing a framework for the development of software or systems that result in high-quality IT solutions. DSE III takes direction and guidance from lead data systems architect and department leadership to work towards enhancement of self and the team's capabilities around data and analytic competencies. Mentors junior architects and guides users across the organization to promote data education and a data-driven culture in all aspects of clinical and business operation. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Facilitate the establishment and execution of the roadmap and vision for information delivery and management; including the modernizing the data platforms, on-prim and cloud data, BI & analytics, content management and data management Work with stakeholders to understand their vision, challenges, and pain points. Work with data and analytics experts to strive for greater functionality in our data systems; consults with data systems management teams to get a big-picture idea of the data needs. Conduct detailed assessments of the data landscape including data platforms, technology architecture, data flows, data consumption, data integration and documentation Identifying installation solutions for new databases; determining the requirements for a new database. Develop future state architecture and process/data flows to realize the modern data strategy Design modern data supply chain, and evaluate and recommend new tools and technologies Guide the decision making of selecting cloud vs on-premise environments and assist with cloud service provider selection Document and present data strategies to stakeholders, gain buy in, and grow strategic relationships Assist in the development of capability roadmaps Identifying areas for improvement in current systems; participate in setting objectives and scope, and developing a roadmap for the data initiatives that support the client leadership in meeting their objectives Auditing database regularly to maintain quality; creating systems to keep data secure Own the technical relationship with the client, be a technical subject matter expert and principal data evangelist across the planning efforts that intersect the data discipline. Educate clients and internal constituents on the available technologies and general best practices. Mentor others as they build complex strategy and solutions Provide specialized expertise, cross-industry perspective, and thought leadership in big data, cloud, enterprise information management, and other next generation technology offerings Provides maintenance and support; performs other duties, as assigned. Qualifications Required Bachelor's Degree Business, Computer Science, Engineering, Information Systems, Public Health, or related field Preferred Master's Degree Computer Science, Business, Healthcare Management, Information Systems, or related field 6 years Systems, Application, and/or Database platforms administration experience with platforms such as Epic, SQL Server, Tableau, SAS, BusinessObjects etc. Experience architecting data management, analytics, business intelligence and application integration solutions. Required TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Data Systems Engineer III $82,931.74 - $114,031.14INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Work From HomeWork From Home Work From Home, Indiana 46544 The Prior Authorization Specialist is responsible for obtaining prior authorization for provider practices which may include outpatient services, specialty care and other ancillary services. The Prior Authorization Specialist verifies insurance coverage and gathers clinical information to ensure that all reimbursement requirements are met. The ability to Compassionately engage in conversation with patients on their responsibilities for Copayment, Prepayment and Outstanding Balances. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Follows payer processes (website, fax, contact number) to submit appropriate clinical documentation; remains current on updates from payers to ensure appropriate reimbursement from payers. Serves as primary resource to ambulatory clinics regarding the prior authorization process and requirements. Collects clinical information regarding services to be rendered for prior authorizations. Contacts payers to obtain prior authorizations; enters standardized documentation within electronic medical record, to identify prior authorization and the criteria surrounding each authorization. Educates providers and their clinical staff regarding the prior authorization process; advises providers and their clinical staff when issues arise relating to obtaining prior authorization. Primary resource to patients regarding prior authorization process. Verifies that all insurance requirements have been met. QUALIFICATIONS Required High School Diploma/GED 1 year Prior Authorizations and Revenue Cycle Required TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Prior Authorization Specialist $18.55-$24.12INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Work From HomeWork From Home Work From Home, Indiana 46544 The ACO Care Manager III is critical for working with assigned beneficiaries, assessing, facilitating, planning, and advocating health needs on an individual basis. In this role you will assist with the coordination of delivery of cost-effective Healthcare services and establish a transition plan for post-acute care. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Weekend Position- Saturday & Sunday- 10-hour days Works collaboratively with other members of the Healthcare team in coordination of the patient's care. Meets patient and family to complete psychosocial history and assess family dynamics. Reviews computer record and chart and becomes familiar with the patient's history and current circumstances. Assesses the Plan of Care to meet patient needs. Connects patients to relevant community resources as required, with the goal to increase satisfaction, patient health, and well-being and reduce Healthcare costs. Guides the delegation of responsibilities to the appropriate staff member to meet the needs of the patient. Ensures services are in compliance with professional standards, state and federal regulatory requirements. Implements discharge plans as agreed upon by patient, family, and physician. Provides education for families, patients and other members of the healthcare team. Acts as a liaison between patients, consulting physician, referring physician or outside agencies to coordinate patient appointments, admission, or surgery. Coordinates the exchange of information either written or verbal before and after patients are seen. Maintains patient accounts by obtaining, recording, and updating personal and financial information. Assists patients, family members or other client support members with concern and empathy. QUALIFICATIONS Associate's Degree- Nursing/Patient Care- Required Bachelor's Degree- Nursing/Patient Care- Preferred Registered Nurse (RN)- State Licensing Board- Indiana- Required Registered Nurse (RN)- State License Board- Illinois- Required within 180 days of hire Certified Case Manager (CCM)- Commission for Case Manager Certification- Preferred Basic Life Support (BLS) American Heart Association- Required 5 Years Nursing/Patient Care Experience- Required 1 Year Case Management Experience- Preferred TRAVEL IS REQUIRED: Up to 20%JOB RANGE:ACO CMIII $73,278.40 -$100,776.00INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

**Facility:** Health Plan **City** San Diego **Department** **Job Status** Per Diem **Shift** Day **FTE** 0 **Shift Start Time** **Shift End Time** California Physicians and Surgeons License - Medical Board of CA; Doctor of Osteopathic Medicine (DO); Doctor of Medicine (MD) **Hours** **:** **Shift Start Time:** Not Specified **Shift End Time:** Not Specified **AWS Hours Requirement:** 8/40 - 8 Hour Shift **Additional Shift Information:** **Weekend Requirements:** No Weekends **On-Call Required:** No **Hourly Pay Range (Minimum - Midpoint - Maximum):** $99.560 - $128.460 - $143.880 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. **Please Note:** As part of our recruitment process, you may receive communication from Dawn, our virtual recruiting assistant. Dawn helps coordinate scheduling for screening calls and interviews to ensure a smooth and timely experience. Rest assured, all candidate evaluations and hiring decisions are made by our recruitment and hiring teams. **What You Will Do** The position is responsible for the medical direction of Authorization Review for Sharp Health Plan (SHP). The Physician Reviewer will perform all reasonably necessary functions to ensure quality of care and appropriate utilization in the most cost-effective, appropriate and professional manner, which meets the expressed needs of patients and professional colleagues. **Required Qualifications** + Doctor of Medicine (MD) or + Doctor of Osteopathic Medicine (DO) + 5 years' experience as a practicing primary care physician with knowledge of managed care and the process for prior authorization review. + California Physicians and Surgeons License - Medical Board of CA - REQUIRED **Other Qualification Requirements** + Board Certification in Internal Medicine or Family Medicine preferred. **Essential Functions** + Customer service Provides prompt, accurate, and excellent services to internal and external customers.Develops solid professional working relationships with various internal departments and units and, as required, vendors and providers. + General support Participates in special projects and other duties as assigned. These may include, but are not limited to, work groups, audits and back-up medical management support for the Chief Medical Officer. + Professional competency Maintain current knowledge of the service denial process and pertinent health plan authorization criteria and regulations.Keeps abreast of advances in medical care methodologies that may contribute to enhanced quality of services and effective utilization of services. + Provider interaction Periodically presents information regarding authorization services at various SHP meetings on an as needed basis.Provides educational support for PCPs both on a "program" basis and one-on-one basis as needed in regard to proper utilization authorization.Provides strong leadership and direction for appropriate and efficient prior authorization services. + TrainingParticipate in Milliman and Hayes Technology Assessments training or have plans to do so (whether independently or through SHP). **Knowledge, Skills, and Abilities** + Knowledge of physician social and political behavior and managed care philosophy. + Demonstrate effective communication skills, ability to work collaboratively with medical leadership and administration of SHP, medical staff, nurses, and Sharp Hospital administration. + Position is expected to be on-call based on hours that are mutually agreed upon. Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

Work From HomeWork From Home Work From Home, Indiana 46544 At Franciscan, our IS Enterprise Digital Solutions Architect ("Architect") is a strategic and hands-on technical leader responsible for designing and delivering enterprise-grade digital solutions across data analytics, automation, interfaces, and AI domains. In this role you will be accountable for creating a cohesive architectural strategy that unifies the organization's technology stack to solve complex business challenges and advance digital transformation. You will play a key role in shaping the technical direction for developing integrated business and enterprise data product solutions, providing technical expertise to project teams, and ensuring that new and existing software solutions are strategically aligned and effectively developed. WHO WE ARE Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Working in close partnership with other IS architects and colleagues, lead the architectural vision, reference models, and standards for several domains including data, AI, and automation, ensuring alignment with enterprise goals and IT strategies. Serve as the Product Owner for prioritized digital, AI, and solutions dev initiatives, working across clinical, operational, and administrative teams. Increase the analytics, AI, and solutions development maturity for the organization. Drive best practices and continuous improvement in domains including business applications, open API-based architecture, data lifecycle management, interoperability, information delivery, closed loop analytics, and vendor/partner integration. Effectively lead, in partnership with other FA colleagues, to promote, deliver, and adopt mature and robust solutions and capabilities for data segmentation, data security, privacy, compliance, monitoring, and auditing. Define, articulate, and update the guiding principles that drive the technical standards for the organization across assigned areas. Endorse technical standards and ensure that they are aligned with technical vision, architecture, and roadmap. Prescribe and optimize the use of modern platforms and capabilities, effectively integrating cloud-native and third-party systems, services, and technologies into FA tech stack. Drive reuse of components, modular architecture, and standardized practices across business units and solution teams through technical leadership in designing integrated data pipelines, orchestration workflows, model deployments, and automation frameworks. QUALIFICATIONS Required Bachelor's Degree Computer Science, Informatics, Computer Programming, Engineering (Computer, Mechanical, Network, or Electrical), Information Security Preferred Master's Degree Computer Science, Informatics, Computer Programming, Engineering (Computer, Mechanical, Network, or Electrical), Information Security 10+ years Hands-on solutions development and architecture across cloud and on-prem environments Required 8 years Custom development experience with deep understanding of IT systems, applications, data structures, and infrastructure, including end-to-end system mapping across data, digital, or business solutions areas. Required 8 years Software development/engineering and programming with one or more industry standard languages such as SQL, Python, Java, C++ etc. Required 7 years Progressive experience in enterprise architecture or IT strategy roles through technical leadership at an architect or solutions lead level Required 5 years Experience with cloud-native tool and technologies on Microsoft Azure platform with solid technical knowledge of relevant data architecture, metadata management, AL/ML and automation frameworks. Required 5 years Experience with healthcare enterprise platforms such as Epic, Workday, ServiceNow etc. Preferred 5 years Healthcare technology experience, particularly within hospital systems or integrated delivery networks Preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:IS Enterprise Digital Solutions Architect $117,340 - $161,343.63INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.