Center Clinical Director, Associate
Interim Director Job In Virginia Beach, VA
We're unique. You should be, too.
We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.
The Clinical Director will directly supervise and train primary care providers (PCPs) in his/her assigned center. The incumbent in this role is accountable for maximizing overall core model execution, including improving clinical quality, efficiency, outcomes, and clinician/patient satisfaction. In addition to being accountable for the overall clinical outcomes of his/her assigned center, they will have a portion of their time allocated to direct patient care as a PCP and/or other clinical duties (amount dependent on number of direct reports). The remainder of their time is allocated to leadership responsibilities, including PCP performance, engagement, and building a strong clinical-operations synergy and culture. The allocation of time is dependent on several factors, including PCP capacity, market needs, size of centers, patient membership, and Market Clinical Director direction.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
Independently provides care for patients with acute and chronic illnesses encountered in older adult patients.
Takes full accountability for patient care and outcomes and appropriately seeks consultation from specialists when needed, though will still stay involved in, and be responsible for, the detailed care of the patient.
Engages with the hospitalist whenever one of their patients is in the hospital (regardless of whether the hospitalist works for ChenMed or not).
Responsible for assessment, diagnosis, treatment, management, education, health promotion and care coordination and documentation for patients with acute and complex chronic health needs.
Leads their care team consisting of care promoter (medical assistant), care facilitator, and care coordinator for patients able to come to the office.
For patients that are unable to come to the office-in hospital, SNF, LTC or homebound, engages with the transitional care team and others including case managers, acute and transitional-care physicians, and other resources that may be available depending on the market.
Leads Super Huddle (SH) and Transforming Care Meeting (TCM) weekly, as well as supports Center Manager/Center General Manager center clinical leader and/or market clinical leader is not available, based on guidance from Market Chief Medical Officer. Fills in as needed for center clinical leadership needs, including monitoring daily center census as part of joint center accountability for outcomes.
Plays an active role in the management of their center and helps cover for other providers who may be out for various reasons. It is also expected that each Clinical Director will take an active role as needed in recruiting patients for the center and recruiting and interviewing additional providers for the company.
Managing, mentoring and coaching PCPs in his/her assigned center to deliver outstanding clinical outcomes, including sampling other PCP's daily huddles within their center
Leadership rounding with the PCPs (reduced involvement of market clinical leader)
Partnering with Center Operations Director/Market General Manager to drive continued improvement of center financial performance, and helping increase center membership
Performs other duties as assigned and modified at manager's discretion.
KNOWLEDGE, SKILLS AND ABILITIES:
Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other applications used in the company
Ability and willingness to travel locally as needed in their market, if applicable, nationally for initial training (2 weeks) and then occasionally regionally and nationally for recruiting or training purposes
Fluency in English, verbal and written. There may be jobs in some centers that require fluency in other languages, and this will be made known at the time of application.
This job requires use and exercise of independent judgment
EDUCATION AND EXPERIENCE CRITERIA:
MD or DO in Internal Medicine, Family Medicine, Geriatrics, or similar specialty required
Current, active MD licensure in State of employment is required
A minimum of 1-year clinical experience in geriatric, adult or family practice setting preferred, with Lead PCP ideally being a ChenMed PCP Partner
Completion of Chen Medical training, including Masterful Conversations and meeting facilitation, as part of the individual development plan
Board certification in Internal Medicine, Family Medicine, Geriatrics or similar specialty is preferred, Board Eligibility is required
Once Board certified, PCP will maintain board certification in their terminal specialty by doing necessary MOC, CME and/or retaking board exams as required
Must have a current DEA number for schedule II-V controlled substances
Basic Life Support (BLS) certification from the American Heart Association (AMA) or American Red Cross required w/in first 90 days of employment
We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.
Current Employee apply HERE
Current Contingent Worker please see job aid HERE to apply
Associate Director, Clinical Scientist - Hematology/Oncology (Remote)
Remote Interim Director Job
If you are a current Jazz employee please apply via the Internal Career site.
Jazz Pharmaceuticals plc (NASDAQ: JAZZ) is a global biopharmaceutical company whose purpose is to innovate to transform the lives of patients and their families. We are dedicated to developing life-changing medicines for people with serious diseases - often with limited or no therapeutic options. We have a diverse portfolio of marketed medicines and novel product candidates, from early- to late-stage development, in neuroscience and oncology. We actively explore new options for patients including novel compounds, small molecules and biologics, and through cannabinoid science and innovative delivery technologies. Jazz is headquartered in Dublin, Ireland and has employees around the globe, serving patients in nearly 75 countries. For more information, please visit ****************** and follow @JazzPharma on Twitter.
Jazz Pharmaceuticals is seeking a clinical scientist to join the Clinical Development team in hematology/oncology drug development. You will be responsible for supporting senior Clinical Development staff in formulating and executing the Global Development Plan (GDP) for the assigned molecule(s)/indication(s). Responsibilities may include clinical leadership of projects supporting the development program strategy, supporting data management and data cleaning activities of hematology/oncology studies, supporting the medical monitor in routine trial activities and oversight for hematology/oncology studies, supporting regulatory submissions, and/or representing clinical development in multidisciplinary teams within Research and Development (R&D).Essential Functions/Responsibilities:
Participate in the cross-functional team meetings and address study or other program-specific questions
Support execution and implementation of the Global Development Plan by providing strategic clinical science support for assigned studies and programs
Assist in reviewing and authoring study concept documents and clinical study protocols
Read and interpret scientific and medical literature for the use in clinical documents and to assist clinical team decision-making
Contribute to or prepare clinical sections of relevant regulatory filings and meeting packages (INDs, meeting requests, NDAs, etc.)
Help to identify clinical investigators and coordinate activities for the conduct of clinical trials and advisory board meetings
Work closely with other functional areas within R&D (clinical operations, data management, biostatistics, clinical pharmacology, nonclinical) to facilitate the execution of clinical trials and ensure high standards of study conduct are met
Prepare clinical data and clinical program presentations
Review clinical study data; identify and evaluate study data trends, outliers, and protocol deviations; work with data management to issue and resolve queries to ensure data quality
Contribute to clinical study reports, including reviewing and interpreting safety and efficacy data
Write protocol summaries, process documents, investigator brochures, etc., in collaboration with cross-functional groups
Provide input on clinical presentation slides for internal/external meetings and communications (e.g., investigator meetings, pre-study site selection visits, site training, study newsletters, communication to sites, etc.)
Participate and develop communication strategies for existing and concluded studies through KOL interactions, advisory boards, scientific and industry conferences and meetings, and publications
Required Knowledge, Skills, and Abilities:
Excellent oral and written communication skills
Proven ability to work independently and as part of a multidisciplinary team
Collaborative and flexible in personal interactions with high emotional intelligence
2+ years of clinical/scientific research experience required, with hematology/oncology expertise preferred
2+ years of experience working in a pharma/biotech company or postdoctoral or principle investigator experience within an academic or government setting
Willing to travel (variable, up to 20%)
Required/Preferred Education and Licenses:
PhD, MD, DO, PharmD, or other advanced scientific or clinical degree
Jazz Pharmaceuticals is an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any characteristic protected by law.
FOR US BASED CANDIDATES ONLY
Jazz Pharmaceuticals, Inc. is committed to fair and equitable compensation practices and we strive to provide employees with total compensation packages that are market competitive. For this role, the full and complete base pay range is: $160,000.00 - $240,000.00
Individual compensation paid within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, and other pertinent factors. The goal is to ensure fair and competitive compensation aligned with the candidate's expertise and contributions, within the established pay framework and our Total Compensation philosophy. Internal equity considerations will also influence individual base pay decisions. This range will be reviewed on a regular basis.
At Jazz, your base pay is only one part of your total compensation package. The successful candidate may also be eligible for a discretionary annual cash bonus or incentive compensation (depending on the role), in accordance with the terms of the Company's Global Cash Bonus Plan or Incentive Compensation Plan, as well as discretionary equity grants in accordance with Jazz's Long Term Equity Incentive Plan.
The successful candidate will also be eligible to participate in various benefits offerings, including, but not limited to, medical, dental and vision insurance, 401k retirement savings plan, and flexible paid vacation. For more information on our Benefits offerings please click here: *********************************************
Medical Director - Remote
Remote Interim Director Job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
This Medical Director role in the Clinical & Coding Advisory Team (CCAT) is a rare opportunity to work directly within Optum Payer Operations. As a member of CCAT, you will play a vital role in helping stop fraud, waste, abuse, and error and help healthcare work better every day.
The purpose of this job is to help people live their lives to the fullest by providing clinical leadership and expertise for the clinical investigation teams, including involvement in clinical reviews, provider education, high level appeals, development of clinical resources, and operations improvements.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Provide expert clinical and strategic leadership for operational teams
Collaborate with clinical operations teams on complex or difficult cases
Apply clinical knowledge in the interpretation of medical policy, clinical resources, and benefit document language in the review of professional and facility pre-pay and post-pay clinical reviews
Collaborate with and educate network and non-network providers on cases and clinical coding situations in pursuit of accurate billing practices
Actively participate in regular meetings and projects focused on clinical decision-making, clinical resources, analytics, savings, and staff training
Participate in development of medical policy, clinical resources, and guidelines utilized in the review of professional and facility pre-pay and post-pay clinical reviews
Other duties and goals assigned by the Sr. Medical Director
Critical Success Factors:
Ability to effective lead, manage and deliver in a fast pace, ever changing environment
Solid understanding of Fraud, Waste, Abuse, and Error methodology
Ability to foster communications, robust collaboration, and solid partnerships among providers, clients, leaders, and clinical teams
Solid problem-solving, negotiation and persuasion skills
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Current, active, and fully non-restricted licensed Medical Doctor
5+ years of clinical practice experience
2+ years of experience in leading clinical operations within a health plan/or managed care environment to include client facing experience
CPT/HCPCS/ICD-9/ICD-10 coding experience with a thorough knowledge of health insurance business, including knowledge of industry terminology and regulatory guidelines
Familiarity with current medical issues and practices
Preferred Qualifications:
Coding Certification thru AHIMA (CCS, CDIS, RHIA, RHIT) or AAPC (CIC)
3+ years in facility (DRG and Clinical Validation Audit) Reviews
Experience in claims handling related to Fraud, Waste, Abuse and Error
Experience with Encoder and Grouper Software (3M)
Knowledge of federal (e.g., CMS) and state laws and regulations
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $286,104 to $397,743 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Appeals and Grievances Medical Director - Cardiology Specialty Required - Virtual
Remote Interim Director Job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
Work at home!
The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies
Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses
Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations
Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues
Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results
Provide clinical and strategic input when participating in organizational committees, projects, and task forces
What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
MD or DO with an active, unrestricted license
Board Certified Cardiologist in an ABMS or AOBMS specialty
5+ years clinical practice experience
2+ years Quality Management experience
Intermediate or higher level of proficiency with managed care
Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills
Proven excellent telephonic communication skills; excellent interpersonal communication skills
Proven excellent project management skills
Proven data analysis and interpretation skills
Proven excellent presentation skills for both clinical and nonclinical audiences. Familiarity with current medical issues and practices
Proven creative problem-solving skills
Proven solid team player and team building skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $286,104 to $397,743 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Inpatient Care Management Medical Director - Remote
Remote Interim Director Job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
We are currently seeking an Inpatient Care Management Medical Director to join our Optum team. This team is responsible for conducting acute level of care and length of stay reviews for medical necessity for our members being managed within the continuum of care. Our clients include local and national commercial employer, Medicare, and state Medicaid plans. The Medical Directors work with groups of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expenses
Responsible to collaborate with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations
Is grounded in the use and application of evidence-based medicine (EBM) such as InterQual care guidelines and criteria review
Occasionally, may participate in periodic market oversight meetings with the outward facing Chief Medical Officers, network contractors, nurse management and other internal managers
Maintain proficiency in all required software and platforms
Although the United Health Services ICM Medical Director's work is typically concentrated in a region, they are part of a national organization and team, and collaborate with peers, nurse managers, and non-clinical employees from across the country. In response to customer needs and expectations, Optum is continuously modifying its programs and approaches. Although not a primary job function, Medical Directors with the interest in doing so often can be involved with change design and management.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
MD or DO with an active, unrestricted medical license
Current Board Certification in an ABMS or AOBMS specialty
3+ years of clinical practice experience post residency
Private home office and access to high-speed Internet
Technical proficiency in computer software and systems
Preferred Qualifications:
Licensure in either HI, AK, OR, ID, WA, UT a plus
2+ years of managed care, Quality Management experience and/or administrative leadership experience
Prior UM experience
Clinical experience within the past 2 years
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Director of Nursing (DON)
Interim Director Job In Richmond, VA
Are you looking for a nursing leadership opportunity with a growing organization? The Laurels of Bon Air has an exceptional opportunity for a Director of Nursing (DON) to join our team. As the Director of Nursing (DON), you will plan, coordinate and manage the nursing department. You will be responsible for the overall direction and evaluation of nursing care and services provided to the residents. You will supervise nursing care provided by RNs, LPNs and CNAs.
Benefits:
Comprehensive health insurance - medical, dental and vision.
401K with matching funds.
DailyPay, a voluntary benefit that allows associates at our facilities the ability to access their pay when they need it.
Paid time off (beginning after six months of employment) and paid holidays.
Flexible scheduling.
Tuition reimbursement and student loan forgiveness.
Zero cost uniforms.
Responsibilities:
Schedule and perform resident rounds to monitor and evaluate the quality and appropriateness of nursing care.
Insure proper charting and documentation of care and of medications and treatments.
Recommend to the administrator the number and levels of nursing personnel to be employed.
Participate in the budget process of the facility and maintains the nursing supply, equipment and nurse staffing budgets.
Maintain current knowledge of applicable managed care, Medicare and state Medicaid regulations, reimbursement systems and methodology.
Participate in the Quality Assurance Performance Improvement program, making necessary improvement to processes based on quality assurance data.
Qualifications:
RN license in the state.
Director of Nursing, management or supervisor experience in long-term care, restorative or geriatric nursing.
Maintains current CPR certification.
Additional certification in nursing specialty desired.
Ciena Healthcare:
We are a national organization of skilled nursing, subacute, rehabilitative, and assisted living providers dedicated to achieving the highest standards of care in five states including Michigan, Ohio, Virginia, North Carolina, and Indiana.
We serve our residents with compassion, concern, and excellence, believing that every one of them is a unique person who deserves our best each day that we care for them. If you have a passion for improving the lives of those around you and working with others who feel the same way.
IND123
Nursing Director
Interim Director Job In Richmond, VA
Sunrise Senior Living was again certified as a Great Place to Work by Activated Insights. This is the 7th time Sunrise has received this top culture and workplace designation, highlighting the special place Sunrise is to be a part of. COMMUNITY NAME The Colonnades
Job ID
2024-221578
JOB OVERVIEW
*Relocation Assistance to Charlottesville, VA*
The Resident Care Director (RCD) serves as the nursing clinical leader for the community and is responsible to lead and manage the health and wellness along with coordination of care and services to residents within the community. Responsible for oversight and implementation of all Care programs, regulatory compliance, recruiting, and performance management.
RESPONSIBILITIES & QUALIFICATIONS
Responsibilities:
As a part of the Sunrise team, supporting our Mission, Principles of Service and Core Values is a fundamental part of this job. Our foundational belief is the sacred value of human life. The unique responsibilities for this role include but are not limited to the essential functions listed as follows:
Managing Health and Wellness:
Provides strategic leadership for resident care in the community by managing, directing, and monitoring the nursing team as applicable by State/Provincial law, to promote the health and wellness of the resident population.
Provides clinical care through the direct application of the nursing process; performs and documents resident assessments and progress notes, evaluates changes in care needs, completes Individualized Service Plans (ISP)/Individualized Care Plan (ICP), provides or delegates hands-on clinical care as indicated by the plan of care, and evaluates resident outcomes.
Collaborates with physicians, pharmacists, and other clinical providers to coordinate care and services for the residents.
Serves as the CLIA Director as applicable for the community and according to the federal and state/provincial requirements.
Partners with Neighborhood Coordinators to promote an integrated and collaborative approach to wellness operations and resident care.
Collaborates with Sales partners to determine community capability and assess potential residents' appropriateness for move-in.
Seeks direction from a Registered Nurse as needed in accordance with state/provincial regulations and nurse practice acts.
Medication Management:
Provides strategic leadership for resident care in the community by managing, directing, and monitoring the medication care managers, as applicable by State/Provincial law, to promote the health and wellness of the resident population.
Provides oversight of the community medication management program to promote resident safety in the medication use process including onboarding, training, and performance reviews.
Provides clinical training and education, as needed, to nurses, medication care managers, care managers, and others who provide resident care. Performs skill evaluation to assure clinical capability of care team members.
Quality Assurance and Regulatory Compliance:
Tracks, trends, and reports clinical quality data to identify risk.
Participates actively as a member of the community Quality Assurance and Performance Improvement committee.
Leads clinical quality and process improvement initiatives within the community to mitigate risk and improve resident care outcomes.
Recruits, hires, and trains clinical team members and is responsible for performance management, evaluations, and engagement.
Completes direct report team member staffing and scheduling according to operational and budgetary guidelines.
Partners with the community leadership team to promote resident safety and compliance with Risk Management and OSHA/British Columbia Workers Compensation Act and Occupational Health and Safety Regulation requirements.
Serves as the ICC and CLIA Director as applicable for the community.
Responsible for infection control programming, including delegation of infection control preventionist, as per state/provincial requirements.
Assures compliance with all Federal, State/Provincial, board of nursing, and other applicable regulations.
Financial Management:
Manages the department budget to include labor/labour and other expenses and understands it's impact on the community's bottom line.
Processes and submits monthly expenses and budget data in a timely manner, per Sunrise policies and internal business controls.
Understands the internal costs associated with all Sunrise resident care programs.
Training, Leadership and Team Member Development:
Partners with the Regional Director of Resident Care and/or Executive Director in the delivery and participation in Sunrise University training and self-study programs.
On-boards new RCD leaders and other department coordinators as needed.
Develops a working knowledge of state/provincial regulations and ensures compliance through supervising and coaching team members.
Completes clinical team member staffing and scheduling according to operational and budgetary guidelines when assigned to a community.
Holds clinical team accountable, corrects actions when necessary, and documents.
Attends regular meetings; Stand Up, Cross Over, Department Head, Town Hall, QAPI, and others as directed by the Executive Director.
Keeps abreast of professional developments in the field by reading and attending conferences and training sessions.
Maintains compliance in assigned required training and all training required by state/province or other regulating authorities as applicable to this role to ensure that Sunrise standards are always met.
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed throughout this job description are representative of the knowledge, skills, and abilities required.
Graduate of an accredited college or school of nursing with a current state/provincial license as a professional Registered Nurse (RN).
Minimum two (2) years RN experience with at least one (1) year experience in home health, assisted living, or long-term care environment preferred.
Minimum of one (1) year nursing management experience, including hiring, coaching, performance management, scheduling, and daily operations supervision.
Certified in CPR and First Aid.
Demonstrated knowledge of applied nursing practices, techniques, and methods in accordance with federal, state/provincial and board of nursing requirements.
Knowledge of infection control practices and prevention of disease transmission.
Ability to delegate assignments to the appropriate individuals based on their demonstrated skill capability and in compliance with all regulations.
Experience in tracking, trending, and analysis of clinical performance data preferred.
Experience in quality and clinical process improvement and risk assessment preferred.
Experience in staff development, training, and/or clinical education preferred.
Proven ability to handle multiple priorities, organize efficiently, and manage time effectively.
Demonstrated critical thinking, clinical judgment, and decision-making skills.
Computer proficiency with electronic medical records, the Microsoft Office suite, and the ability to learn new applications.
Ability to work weekends, evenings and flexible hours as needed for resident care/services, including 24/7 on call responsibility.
ABOUT SUNRISE
Sunrise Senior Living has championed quality of life in senior care for more than 30 years. We believe team members are our greatest resource and are looking for people who share our commitment to provide quality care for seniors and their families. It's no surprise that many of the world's leading experts in Senior Living entrust their career to Sunrise.
At Sunrise, you will...
Make a Difference Every Day
We are passionate about our mission - to champion quality of life for all seniors. We deliver high-quality care with a personal touch and encourage our residents to enjoy life to the fullest.
Be Part of a Uniquely Supportive Community
The care-focused environment we create for residents extends to our team members. We offer programs, rewards, and benefits to help you live your best.
I gnite Your Potential
We believe potential has no limits. We offer best-in-class leadership development programs designed to grow our leaders. We are committed to helping our team members achieve their career goals.
We also offer benefits and other compensation that include:
Medical, Dental, Vision, Life, and Disability Plans
Retirement Savings Plans
Employee Assistant Program / Discount Program
Paid time off (PTO), sick time, and holiday pay
Daily Pay offered to get paid within hours of a shift (offered in the U.S. only)
Tuition Reimbursemen t
In addition to base compensation, Sunrise may offer discretionary and/or non-discretionary bonuses. The eligibility to receive such a bonus will depend on the employee's position, plan/program offered by Sunrise at the time, and required performance pursuant to the plan/program.
Some benefits have eligibility requirements
Apply today to learn why Sunrise Senior Living is a certified Great Place to Work
PRE-EMPLOYMENT REQUIREMENTS
Sunrise considers the health and safety of its residents, family members, and team members to be one of its highest priorities. Employment with Sunrise is conditioned on completing and passing a drug test (which does not include marijuana), participating in testing requirements (e.g. Tuberculosis Test, Physical Evaluation). Covid-19 and Influenza vaccination is only required to the extent mandated by applicable federal, state, and local laws and authorities.
COMPENSATION DISCLAIMER
Selected candidates will be offered competitive compensation based on geographic location of community/office, skills, experience, qualifications, and certifications/licenses (where applicable).
Director of Preconstruction
Interim Director Job In Ashburn, VA
JOB TITLE: Director, Preconstruction
Aligned Data Centers is seeking a dynamic and experienced Director of Preconstruction to join our team. The ideal candidate will have a strong background in construction estimating, preconstruction management, progressive contract delivery approaches, and a strong understanding of construction execution and delivery. This candidate must have a proven track record of leadership and technical success in the data center or mission-critical facility sector.
DUTIES AND RESPONSIBILITIES (to include, but not limited to):
Lead the preconstruction efforts of the platform delivery team including schematic level budgeting, cost estimating, integration of contractor budgeting into the design process, constructability reviews, and scope alignment processes.
Develop accurate and detailed cost estimates based on conceptual designs, schematic drawings, and specifications to support sales efforts.
Collaborate with internal teams, external consultants, and trade partners to ensure that project estimates are comprehensive and competitive.
Analyze project documents to identify potential risks, opportunities, and cost-saving measures.
Reduce the need for value engineering exercises by actively engaging in the design process to ensure contractor cost data is utilized in the design decision making process.
Prepare and present cost estimates, proposals, and scope alignment recommendations to clients and stakeholders.
Lead NRC/MRC cost breakouts and tracking efforts to assist in project underwriting and sales efforts. Engage with customers in support of the project team as necessary to develop confidence in NRC costs and fit-out costs as may be required.
Participate in project meetings and provide ongoing support to project teams throughout the preconstruction phase.
Maintain up-to-date knowledge of industry trends, construction costs, market conditions, and commodity indices.
Assist in the development and implementation of preconstruction best practices, procedures, and tools.
Develop and lead a team as necessary to support scaling of the business.
Qualifications:
Bachelor's degree in construction management, Engineering, or related field (or equivalent work experience).
Minimum of 7-10 years of experience in construction estimating, with a focus on data centers or mission-critical facilities.
Proficiency in construction cost estimating software (e.g., RSMeans, Timberline, WinEst) and Microsoft Office Suite.
Strong analytical, problem-solving, and decision-making skills.
Excellent communication and interpersonal skills, with the ability to interact effectively with clients, consultants, and team members.
Ability to manage multiple projects and priorities simultaneously.
Knowledge of sustainable construction practices and LEED accreditation is a plus.
Experience in alternative contracting methodologies such as Lean IPD and incentive based pricing structures.
The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or physical requirements. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Aligned Data Centers is an equal opportunity employer that embraces diversity and is committed to building a team that represents a variety of backgrounds, perspectives, and skills. Equal employment opportunities are available to all applicants and teammates without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information, military and veteran status, and any other characteristic protected by applicable law. All aspects of employment including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business
needs.
Spectrum Policy Director
Interim Director Job In Arlington, VA
Freedom Technologies Inc., an Arlington (Rosslyn), VA-based technology policy consulting firm, is seeking candidates with educational and professional backgrounds in technology, public policy, government affairs, or law for a full-time position as part of a senior team of dedicated professionals. We provide strategic policy analysis and cutting-edge research to both government and private-sector clients. Our portfolio includes domestic and international issues in wireless radio spectrum, space and satellite regulations, legislation, and related national security policy matters. Our client base includes senior-level officials who influence and shape national policy in these areas.
An ideal applicant brings intellectual curiosity, issue management expertise and excellent communications skills, with 8-12 years of relevant work experience in wireless spectrum policy/engineering. Candidates should have a demonstrated experience in technology policy, communications regulations, and/or national security, and familiar with the National Spectrum Strategy and Implementation Plan and other national level spectrum directives. The firm is seeking a candidate who is detail-oriented, well-organized, enthusiastic, and can meet deadlines working on individual or team projects as part of a collaborative environment.
This role is well suited for a MA or JD graduate, or other mid-career professional with experience in these areas.
Essential responsibilities:
Provide in-depth strategic support to clients on a wide range of technology matters relevant to client business or government mission objectives.
Deliver a range of written materials that summarize domestic and international policy, technology, business, and regulatory occurrences and developments on a daily, weekly, and monthly basis.
Assess complex regulatory and legislative developments as well as technology trends that affect policy.
Support strategic communications efforts such as drafting speech content, developing content for slide decks, and supporting policy symposia for critical government missions and private sector client interests.
Engage collaboratively with client and team members to meet deadline-driven materials.
Manage client relations and take responsibility as needed for project management.
Qualifications:
Knowledge of federal government agencies with spectrum-based missions, particularly with regard to military and space interests. Relevant regulatory and policy stakeholders include the Department of Commerce, the Department of State, the Department of Defense, the FCC, NASA, and Congress.
Demonstrated interest in technology/communications and public policy, both domestically and internationally, including both satellite and terrestrial communications.
US Citizen. Secret security clearance is a requirement. Candidates can be clearance eligible.
8-12 years of relevant work experience in wireless spectrum policy/engineering.
Strong interpersonal communication skills, both oral and written.
Excellent research, analytical, and organizational skills.
Proactive and flexible, with an ability to work on multiple projects.
Work experience in engineering, IT/high-tech, or communications is highly desirable.
Political Director
Interim Director Job In Falls Church, VA
ACMER is seeking a dynamic and proactive applicant for the Political Director (PD) position. The primary goal of the PD is to build political power for ACMER by building relationships with key political stakeholders. The position reports to the Executive Director and will be a DC-based position with anticipated grassroots organizing work in the Washington DC, Chicago, Detroit, Dallas, New Jersey, New York, and Virginia areas. The Political Director must possess exceptional managerial and interpersonal skills and demonstrate the ability to adapt and effectively accomplish a variety of tasks as needed.
Responsibilities:
Develop and implement long-term political strategies to advance ACMER's strategic plans by building influence and advocating for the organization's policy positions among DC political leadership
Provide strategic guidance to the ED and other departments
Collaborate with departments to execute grassroots advocacy and electoral strategies, including developing goals, design, and infrastructure for candidate support efforts
Direct strategic priorities for candidates' endorsement program
Collaborate with various departments to execute grassroots advocacy and electoral strategies, including setting goals, designing infrastructure, and supporting candidate efforts
Lead efforts to educate members of Congress on issues related to human rights, developing and executing comprehensive strategies for engagement
Plan and execute grassroots events, conferences, workshops, public panels, and other organizational activities
Write and compile press clips, proposals, and grantor update reports to communicate ACMER's achievements and ongoing initiatives
Initiate, plan, organize, execute, and support ACMER's conferences, workshops, public panels, and other events
Organize, schedule, record notes for board meetings, and follow up on action items
Maintain and improve internal database systems for tracking reports and develop an efficient, flexible internal process for organizational operations
Track political developments in the region and assist with related research to inform strategic decision-making
Help coordinate collaborative initiatives that promote the mission of the organization
Maintain strict confidentiality in all aspects of work, including phone calls, emails, memos, and financial statements
Track political developments in the region
Assist research as needed
Coordinate with grassroots, collaborating organizations
Assessment of management and administrative problem and issues that surface
Assist with special projects as needed
Qualifications:
Master's degree required in International Relations, Political Science, or related field;
10+ years leadership/management experience in political campaigns, electoral management, or organizing;
Background in international affairs and/or the Middle East and experience with political and economic issues highly desired;
Adept at consulting, advising, and training others to increase grassroots activities and strategies;
A proactive self-starter capable of thriving in a startup environment;
Excellent interpersonal, coordination, and communication skills;
Superb writing, research, copy-editing, and analytical abilities;
Ability to handle multiple detail-oriented tasks and prioritize effectively;
Strong computer skills, proficiency in Microsoft programs
Demonstrated strong critical thinking and analytical skills
Ability to work in a diverse team environment;
Ability to take the initiative to manage multiple, detail-oriented tasks simultaneously with limited supervision;
Travel:
Occasional travel may be required.
Benefits:
ACMER offers a salary and benefits competitive with other international non-governmental organizations. Professional development is a foundational aspect as a member of ACMER's team. Applicants must be legally able to work in the United States. ACMER is unable to sponsor employees for work visas.
Other Information:
This job description in no way states or implies that these are the only duties to be performed by the employee incumbent in this position. The employee will be required to follow any other job-related instructions and to perform any other job-related duties. Open communication and feedback with the ED is encouraged, especially as the job evolves.
A review of this position has excluded the marginal functions of the position that are incidental to the performance of fundamental job duties. All duties and responsibilities listed above are essential job functions and requirements and are subject to possible modification to accommodate individuals with disabilities reasonably. To perform this job successfully, the incumbent will possess the skills, aptitudes, and abilities to perform each duty proficiently. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities.
Equal Opportunity Employer:
ACMER is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. ACMER does not discriminate in employment based on race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factors.
Center Clinical Director, Associate
Interim Director Job In Richmond, VA
We're unique. You should be, too.
We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.
The Clinical Director will directly supervise and train primary care providers (PCPs) in his/her assigned center. The incumbent in this role is accountable for maximizing overall core model execution, including improving clinical quality, efficiency, outcomes, and clinician/patient satisfaction. In addition to being accountable for the overall clinical outcomes of his/her assigned center, they will have a portion of their time allocated to direct patient care as a PCP and/or other clinical duties (amount dependent on number of direct reports). The remainder of their time is allocated to leadership responsibilities, including PCP performance, engagement, and building a strong clinical-operations synergy and culture. The allocation of time is dependent on several factors, including PCP capacity, market needs, size of centers, patient membership, and Market Clinical Director direction.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
Independently provides care for patients with acute and chronic illnesses encountered in older adult patients.
Takes full accountability for patient care and outcomes and appropriately seeks consultation from specialists when needed, though will still stay involved in, and be responsible for, the detailed care of the patient.
Engages with the hospitalist whenever one of their patients is in the hospital (regardless of whether the hospitalist works for ChenMed or not).
Responsible for assessment, diagnosis, treatment, management, education, health promotion and care coordination and documentation for patients with acute and complex chronic health needs.
Leads their care team consisting of care promoter (medical assistant), care facilitator, and care coordinator for patients able to come to the office.
For patients that are unable to come to the office-in hospital, SNF, LTC or homebound, engages with the transitional care team and others including case managers, acute and transitional-care physicians, and other resources that may be available depending on the market.
Leads Super Huddle (SH) and Transforming Care Meeting (TCM) weekly, as well as supports Center Manager/Center General Manager center clinical leader and/or market clinical leader is not available, based on guidance from Market Chief Medical Officer. Fills in as needed for center clinical leadership needs, including monitoring daily center census as part of joint center accountability for outcomes.
Plays an active role in the management of their center and helps cover for other providers who may be out for various reasons. It is also expected that each Clinical Director will take an active role as needed in recruiting patients for the center and recruiting and interviewing additional providers for the company.
Managing, mentoring and coaching PCPs in his/her assigned center to deliver outstanding clinical outcomes, including sampling other PCP's daily huddles within their center
Leadership rounding with the PCPs (reduced involvement of market clinical leader)
Partnering with Center Operations Director/Market General Manager to drive continued improvement of center financial performance, and helping increase center membership
Performs other duties as assigned and modified at manager's discretion.
KNOWLEDGE, SKILLS AND ABILITIES:
Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other applications used in the company
Ability and willingness to travel locally as needed in their market, if applicable, nationally for initial training (2 weeks) and then occasionally regionally and nationally for recruiting or training purposes
Fluency in English, verbal and written. There may be jobs in some centers that require fluency in other languages, and this will be made known at the time of application.
This job requires use and exercise of independent judgment
EDUCATION AND EXPERIENCE CRITERIA:
MD or DO in Internal Medicine, Family Medicine, Geriatrics, or similar specialty required
Current, active MD licensure in State of employment is required
A minimum of 1-year clinical experience in geriatric, adult or family practice setting preferred, with Lead PCP ideally being a ChenMed PCP Partner
Completion of Chen Medical training, including Masterful Conversations and meeting facilitation, as part of the individual development plan
Board certification in Internal Medicine, Family Medicine, Geriatrics or similar specialty is preferred, Board Eligibility is required
Once Board certified, PCP will maintain board certification in their terminal specialty by doing necessary MOC, CME and/or retaking board exams as required
Must have a current DEA number for schedule II-V controlled substances
Basic Life Support (BLS) certification from the American Heart Association (AMA) or American Red Cross required w/in first 90 days of employment
We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.
Current Employee apply HERE
Current Contingent Worker please see job aid HERE to apply
Medical Director - Post-Acute Care Management - Care Transitions - Remote
Remote Interim Director Job
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere.
As a team member of our navi Health product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home.
We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.
Why navi Health?
At navi Health, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. navi Health is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company's technical vision and strategy
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. We are currently looking for Medical Directors that can work daytime in any of the continental time zones in the US.
Primary Responsibilities:
Provide daily utilization oversight and external communication with network physicians and hospitals
Daily UM reviews - authorizations and denial reviews
Conduct peer to peer conversations for the clinical case reviews, as needed
Conduct provider telephonic review and discussion and share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care
Communicate effectively with network and non-network providers to ensure the successful administering of Care Transitions' services
Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers
Represent Care Transitions on appropriate external levels identifying, engaging and establishing/maintaining relationships with other thought leaders
Collaborate with Client Services Team to ensure a coordinated approach to delivery system providers
Contribute to the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals
Interact, communicate, and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees
Provide leadership and guidance to maximize cost management through close coordination with all network and provider contracting
Regularly meet with Care Transitions' leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues
Provide input on local needs for Analytics Team and Client Services Team to better enhance Care Transitions' products and services
Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME
Participate on the Medical Advisory Board
Providing intermittent, scheduled weekend and evening coverage
Perform other duties and responsibilities as required, assigned, or requested
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Board certification as an MD, DO, MBBS with a current unrestricted license to practice and maintain necessary credentials to retain the position
Current, unrestricted medical license and the ability to obtain licensure in multiple states
3+ years of post-residency patient care, preferably in inpatient or post-acute setting
Preferred Qualifications:
Licensure in multiple states
Willing to obtain additional state licenses, with Optum's support
Understanding of population-based medicine, preferably with knowledge of CMS criteria for post-acute care
Demonstrated ability to work within a team environment while completing multiple tasks simultaneously
Demonstrated ability to complete assignments with reasonable oversight, direction, and supervision
Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals
Demonstrated competence in use of electronic health records as well as associated technology and applications
Proven excellent organizational, analytical, verbal and written communication skills
Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues
Proven highest level of ethics and integrity
Proven highly motivated, flexible and adaptable to working in a fast-paced, dynamic environment
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $286,104 to $397,743 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Appeals and Grievances Medical Director - Cardiology Specialty Required - Virtual
Remote Interim Director Job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
Work at home!
The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies
Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses
Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations
Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues
Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results
Provide clinical and strategic input when participating in organizational committees, projects, and task forces
What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
MD or DO with an active, unrestricted license
Board Certified Cardiologist in an ABMS or AOBMS specialty
5+ years clinical practice experience
2+ years Quality Management experience
Intermediate or higher level of proficiency with managed care
Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills
Proven excellent telephonic communication skills; excellent interpersonal communication skills
Proven excellent project management skills
Proven data analysis and interpretation skills
Proven excellent presentation skills for both clinical and nonclinical audiences. Familiarity with current medical issues and practices
Proven creative problem-solving skills
Proven solid team player and team building skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $286,104 to $397,743 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Medical Director Cardiology or Cardiothoracic Surgery - Remote
Remote Interim Director Job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.
The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.
The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
Engage with requesting providers as needed in peer-to-peer discussions
Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
Participate in daily clinical rounds as requested
Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
Communicate and collaborate with other internal partners
Participate in call coverage and holiday rotation
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
M.D or D.O.
Board certification in Cardiology or Cardiothoracic Surgery
Active unrestricted license to practice medicine
5+ years of clinical practice experience after completing residency training
Sound understanding of Evidence Based Medicine (EBM)
Solid PC skills, specifically using MS Word, Outlook, and Excel
Participate in rotational holiday and call coverage
Preferred Qualifications:
Proven excellent oral, written, and interpersonal communication skills, facilitation skills
Proven data analysis and interpretation aptitude
Proven innovative problem-solving skills
Proven excellent presentation skills for both clinical and non-clinical audiences
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
The salary range for this role is $285,500 to $325,500 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Director of Nursing
Interim Director Job In Fairfax, VA
Sunrise Senior Living was again certified as a Great Place to Work by Activated Insights. This is the 7th time Sunrise has received this top culture and workplace designation, highlighting the special place Sunrise is to be a part of. COMMUNITY NAME Northern Virginia Metro Area - Fairfax
Job ID
2023-187381
JOB OVERVIEW
Calling all sales, operational, LPN and RN candidates: Sunrise Senior Living at Silas Burke House, Burke, VA is conducting an exclusive RelationSIPs hiring event in Fairfax, VA!
Info below:
WE CONTINUE TO SHINE WITH
• New flexible shifts
• Paid vacation, sick, holiday and bereavement leave
• Retirement savings plan, health and dependent day care and flexible spending accounts
• Tuition reimbursement program and discounts at higher education institutions
• Higher wage rates
• Fun work environment
• Improved benefits starting January 2023
RESPONSIBILITIES & QUALIFICATIONS
Sunrise Senior Living at Silas Burke House, Burke, VA invites you to attend our exclusive RelationSIPs hiring event at a popular brewery in Fairfax, VA!
Enjoy complimentary cocktails and food, network, and learn about our awesome development and career growth opportunities for our sales, operational, LPN and RN positions.
Thursday, March 16th 2023 from 5:00-8:00pm
Caboose Commons
2918 Eskridge Rd
Fairfax, VA 22031
RSVP by applying to this event or email Allison Moore at *************************************
Currently hiring for:
Executive Director
Director of Sales
Resident Care Director/Director of Nursing
Business Office Coordinator
We look forward to having you!
ABOUT SUNRISE
Sunrise Senior Living has championed quality of life in senior care for more than 30 years. We believe team members are our greatest resource and are looking for people who share our commitment to provide quality care for seniors and their families. It's no surprise that many of the world's leading experts in Senior Living entrust their career to Sunrise.
At Sunrise, you will...
Make a Difference Every Day
We are passionate about our mission - to champion quality of life for all seniors. We deliver high-quality care with a personal touch and encourage our residents to enjoy life to the fullest.
Be Part of a Uniquely Supportive Community
The care-focused environment we create for residents extends to our team members. We offer programs, rewards, and benefits to help you live your best.
I gnite Your Potential
We believe potential has no limits. We offer best-in-class leadership development programs designed to grow our leaders. We are committed to helping our team members achieve their career goals.
We also offer benefits and other compensation that include:
Medical, Dental, Vision, Life, and Disability Plans
Retirement Savings Plans
Employee Assistant Program / Discount Program
Paid time off (PTO), sick time, and holiday pay
Daily Pay offered to get paid within hours of a shift (offered in the U.S. only)
Tuition Reimbursemen t
In addition to base compensation, Sunrise may offer discretionary and/or non-discretionary bonuses. The eligibility to receive such a bonus will depend on the employee's position, plan/program offered by Sunrise at the time, and required performance pursuant to the plan/program.
Some benefits have eligibility requirements
Apply today to learn why Sunrise Senior Living is a certified Great Place to Work
PRE-EMPLOYMENT REQUIREMENTS
Sunrise considers the health and safety of its residents, family members, and team members to be one of its highest priorities. Employment with Sunrise is conditioned on completing and passing a drug test (which does not include marijuana), participating in testing requirements (e.g. Tuberculosis Test, Physical Evaluation). Covid-19 and Influenza vaccination is only required to the extent mandated by applicable federal, state, and local laws and authorities.
COMPENSATION DISCLAIMER
Selected candidates will be offered competitive compensation based on geographic location of community/office, skills, experience, qualifications, and certifications/licenses (where applicable).
Assistant Director of Nursing (ADON)
Interim Director Job In Richmond, VA
$10,000 Sign-On Bonus!
Are you a Registered Nurse (RN) looking for a leadership opportunity with a growing organization? We have an exceptional opportunity for an Assistant Director of Nursing (ADON) to join our team at The Laurels of Bon Air.
As Assistant Director of Nursing (ADON), you will assist the Director of Nursing (DON) and help plan, coordinate and manage the nursing department. You may provide infection prevention management as well.
If you are committed to providing the highest level of care and service to our guests and community, you will love this position with The Laurels of Bon Air.
Benefits:
Comprehensive health insurance - medical, dental and vision.
401K with matching funds.
DailyPay, a voluntary benefit that allows associates at our facilities the ability to access their pay when they need it.
Paid time off (beginning after six months of employment) and paid holidays.
Flexible scheduling.
Tuition reimbursement and student loan forgiveness.
Zero cost uniforms.
When you work with Laurel Health Care Company, you will join an experienced, hard-working team that values communication and collaboration.
Why just work when you can help shape a legacy?
Responsibilities:
Assure that adequate strategies are in place to verify the current licensure and credentials of nursing employees.
Aid with scheduling and performing guest rounds to monitor and evaluate the quality and suitability of nursing care.
Maintain proper charting and documentation of care and of medications and treatments.
Helps develop and implement the written staffing plan and nursing schedule that reflects the needs of the guest and guest population.
Participates in the budget process of the facility and helps maintain the nursing supply, equipment and nurse staffing budgets.
Maintains current knowledge of applicable managed care, Medicare and state Medicaid regulations, reimbursement systems and methodology.
Aids in assigning responsibilities to associates, taking into consideration guest safety and that duties are commensurate with the educational preparation, experience, knowledge and ability of the persons to whom the duties are assigned.
Qualifications:
Registered Nurse, RN with management or supervisor experience in long-term care or geriatric nursing.
Maintains current CPR certification.
Laurel Health Care Company is a national provider of skilled nursing, subacute, rehabilitative, and assisted living services dedicated to achieving the highest standards of care.
We are a national organization of skilled nursing, subacute, rehabilitative, and assisted living providers dedicated to achieving the highest standards of care in five states including Michigan, Ohio, Virginia, North Carolina, and Indiana.
We serve our residents with compassion, concern, and excellence, believing that every one of them is a unique person who deserves our best each day that we care for them. If you have a passion for improving the lives of those around you and working with others who feel the same way.
#IND123
Center Clinical Director, Associate
Interim Director Job In Newport News, VA
We're unique. You should be, too.
We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.
The Clinical Director will directly supervise and train primary care providers (PCPs) in his/her assigned center. The incumbent in this role is accountable for maximizing overall core model execution, including improving clinical quality, efficiency, outcomes, and clinician/patient satisfaction. In addition to being accountable for the overall clinical outcomes of his/her assigned center, they will have a portion of their time allocated to direct patient care as a PCP and/or other clinical duties (amount dependent on number of direct reports). The remainder of their time is allocated to leadership responsibilities, including PCP performance, engagement, and building a strong clinical-operations synergy and culture. The allocation of time is dependent on several factors, including PCP capacity, market needs, size of centers, patient membership, and Market Clinical Director direction.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
Independently provides care for patients with acute and chronic illnesses encountered in older adult patients.
Takes full accountability for patient care and outcomes and appropriately seeks consultation from specialists when needed, though will still stay involved in, and be responsible for, the detailed care of the patient.
Engages with the hospitalist whenever one of their patients is in the hospital (regardless of whether the hospitalist works for ChenMed or not).
Responsible for assessment, diagnosis, treatment, management, education, health promotion and care coordination and documentation for patients with acute and complex chronic health needs.
Leads their care team consisting of care promoter (medical assistant), care facilitator, and care coordinator for patients able to come to the office.
For patients that are unable to come to the office-in hospital, SNF, LTC or homebound, engages with the transitional care team and others including case managers, acute and transitional-care physicians, and other resources that may be available depending on the market.
Leads Super Huddle (SH) and Transforming Care Meeting (TCM) weekly, as well as supports Center Manager/Center General Manager center clinical leader and/or market clinical leader is not available, based on guidance from Market Chief Medical Officer. Fills in as needed for center clinical leadership needs, including monitoring daily center census as part of joint center accountability for outcomes.
Plays an active role in the management of their center and helps cover for other providers who may be out for various reasons. It is also expected that each Clinical Director will take an active role as needed in recruiting patients for the center and recruiting and interviewing additional providers for the company.
Managing, mentoring and coaching PCPs in his/her assigned center to deliver outstanding clinical outcomes, including sampling other PCP's daily huddles within their center
Leadership rounding with the PCPs (reduced involvement of market clinical leader)
Partnering with Center Operations Director/Market General Manager to drive continued improvement of center financial performance, and helping increase center membership
Performs other duties as assigned and modified at manager's discretion.
KNOWLEDGE, SKILLS AND ABILITIES:
Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other applications used in the company
Ability and willingness to travel locally as needed in their market, if applicable, nationally for initial training (2 weeks) and then occasionally regionally and nationally for recruiting or training purposes
Fluency in English, verbal and written. There may be jobs in some centers that require fluency in other languages, and this will be made known at the time of application.
This job requires use and exercise of independent judgment
EDUCATION AND EXPERIENCE CRITERIA:
MD or DO in Internal Medicine, Family Medicine, Geriatrics, or similar specialty required
Current, active MD licensure in State of employment is required
A minimum of 1-year clinical experience in geriatric, adult or family practice setting preferred, with Lead PCP ideally being a ChenMed PCP Partner
Completion of Chen Medical training, including Masterful Conversations and meeting facilitation, as part of the individual development plan
Board certification in Internal Medicine, Family Medicine, Geriatrics or similar specialty is preferred, Board Eligibility is required
Once Board certified, PCP will maintain board certification in their terminal specialty by doing necessary MOC, CME and/or retaking board exams as required
Must have a current DEA number for schedule II-V controlled substances
Basic Life Support (BLS) certification from the American Heart Association (AMA) or American Red Cross required w/in first 90 days of employment
We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.
Current Employee apply HERE
Current Contingent Worker please see job aid HERE to apply
Appeals and Grievances Medical Director - Cardiology Specialty Required - Virtual
Remote Interim Director Job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
Work at home!
The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies
Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses
Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations
Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues
Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results
Provide clinical and strategic input when participating in organizational committees, projects, and task forces
What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
MD or DO with an active, unrestricted license
Board Certified Cardiologist in an ABMS or AOBMS specialty
5+ years clinical practice experience
2+ years Quality Management experience
Intermediate or higher level of proficiency with managed care
Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills
Proven excellent telephonic communication skills; excellent interpersonal communication skills
Proven excellent project management skills
Proven data analysis and interpretation skills
Proven excellent presentation skills for both clinical and nonclinical audiences. Familiarity with current medical issues and practices
Proven creative problem-solving skills
Proven solid team player and team building skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $286,104 to $397,743 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Associate Director, HEOR - Value-Based Contracting
Remote Interim Director Job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Optum Health Economics and Outcomes Research (HEOR) is a leading provider of health economics and outcomes research and consulting to help customers realize the full potential of their brands. As an international organization that counts among its customers most of the top 20 biopharmaceutical companies in the world, Optum HEOR has a world-class reputation in consulting, econometrics, and outcomes research. We are seeking high-energy, driven scientists who thrive in a fast-paced environment and who have a talent for communicating complex concepts to diverse audiences. We offer access to some of the largest secondary data assets available for outcomes research and the resources of our parent company to drive unique data and research opportunities.
We are seeking a highly skilled Associate Director, VBC and HEOR to join our team and lead value-based contracting analysis to support PBM contracts and lead HEOR research studies. This role will employ health economics and outcomes research to support value-based contracts in the pharmaceutical and device manufacturer space, as well lead HEOR researcher studies with pharmaceutical customers.
The Associate Director, VBC and HEOR will be responsible for overseeing and conducting multiple health Value Based Contracting (VBC) and HEOR projects. Additionally, this role will provide leadership in developing new service offerings and mentoring junior researchers. This role involves leading project teams, analyzing data, developing economic models, and providing strategic insights to optimize PBM contracts and improve patient outcomes. The ideal candidate will be highly collaborative and skilled at building relationships across business silos to ensure alignment and integration of research objectives with broader business goals.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Provide scientific leadership and project management on multiple outcomes research and health economic studies simultaneously
Lead HEOR studies in designated therapeutic area and VBC consulting to provide sound research design and high-quality analysis
Collaborate with cross-functional teams, including PBM, GPO and health plan to help design and implement value-based contracts
Lead and manage HEOR studies from conception through publication, ensuring high-quality and timely delivery of research outputs.
Analyze healthcare data, including claims data, clinical trial data, and real-world evidence, to generate insights.
Prepare and present research findings to internal and external customers and stakeholders.
Monitor and stay updated on industry trends, regulatory changes, and advancements in health economics and outcomes research.
Develop and implement economic models to demonstrate the value of pharmaceutical products and services.
Contribute substantially to HEOR and VBC business development
Successfully manage internal study teams and keep studies on timeline and within budget
Provide consistent superior consultative customer service by focusing on their high-level and immediate business needs
Mentor junior researchers in methodology and customer interaction
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Before applying, please ensure each of these experiences are stated clearly on your resume under each applicable employer entry."
3+ years of research experience in the pharmaceutical industry, health economics or health outcomes research OR minimum 5 years data driven research experience in another field
3+ years of project management experience and demonstrated ability to manage all aspects of a research study from design development to completion
Understanding of drug reimbursement processes in the US healthcare system
Experience analyzing secondary data assets, administrative claims databases or electronic medical record data and communicating results
Experience authoring research protocols or analysis plans and working with a technical team to operationalize
Proven track record of publication in peer-reviewed literature and/or clinical conference abstracts
Proven ability to navigate complex enterprise environments and build relationships with internal and external stakeholders
2 - 3 trips to customers and/or conferences annually - domestically within the United States
Preferred Qualifications:
Experience with innovative or value-based contracting and PBM contracts
Proven ability to work independently and collaboratively in a fast-paced, dynamic environment
Proven solid attention to detail and commitment to producing high-quality research
Proven passion, dedication and energy, commitment to high standards and core values, and an entrepreneurial spirit
Proven curious mind and be internally motivated to achieve excellence. We are seeking smart people who thrive on helping customers solve complex challenges
Proven excellent communication and presentation skills, with the ability to convey complex information to diverse audiences
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Medical Director Cardiology or Cardiothoracic Surgery - Remote
Remote Interim Director Job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.
The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.
The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
Engage with requesting providers as needed in peer-to-peer discussions
Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
Participate in daily clinical rounds as requested
Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
Communicate and collaborate with other internal partners
Participate in call coverage and holiday rotation
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
M.D or D.O.
Board certification in Cardiology or Cardiothoracic Surgery
Active unrestricted license to practice medicine
5+ years of clinical practice experience after completing residency training
Sound understanding of Evidence Based Medicine (EBM)
Solid PC skills, specifically using MS Word, Outlook, and Excel
Participate in rotational holiday and call coverage
Preferred Qualifications:
Proven excellent oral, written, and interpersonal communication skills, facilitation skills
Proven data analysis and interpretation aptitude
Proven innovative problem-solving skills
Proven excellent presentation skills for both clinical and non-clinical audiences
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
The salary range for this role is $285,500 to $325,500 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.