Advanced Urgent Care RN - Per Diem Tacoma Night Shift
Kaiser Permanente job in Tacoma, WA
Description: NIGHT SHIFT Job Summary: Provide nursing care to a defined group of patients, adhering to Kaiser Foundation Health Plan of Washington ambulatory Nursing Care Standards, the Nursing Code of Ethics and Kaiser Foundation Health Plan of Washington policies. Coordinate and facilitate Health Care services for the patient in other segments of the Health Care delivery system. Provide and coordinate nursing care for the patient in collaboration with the Health Care team. The Registered Nurse is an integral member of the Health Care team, overseeing and participating in patient assessment and the formulation and implementation of the care plan.
The Urgent Care RN will provide care in a fast-paced, high-acuity environment that acts similarly to a free-standing emergency department. Patient populations will include all ages, from neonates to geriatrics. Care will also include a large variety of chief complaints ranging from neurological, cardiac, and minor injury or illness. Ability to quickly prioritize and use critical thinking and clinical judgement to provide emergent and urgent care. Ability to work collaboratively with providers and other Urgent Care staff to provide high-quality patient care.
Essential Responsibilities:
Using the nursing process, provides ongoing assessment of the nursing care needs of a defined group of patients. Uses nursing diagnosis to describe this assessment. Develops a written plan of care for patient care needs. Assists patients and families/significant others in developing health care goals which are part of the individualized plan of care. Determines priorities of patient care based on essential patient needs and available resources. Provides nursing interventions safely and competently. Provides the patient and family/significant others with information preceding interventions. Provides telephone consultation to patients and family/significant others Provides ongoing evaluation of the patients response to care. Anticipates and recognizes changes in the patients status and need for nursing care. Modifies the individual plan of care in collaboration with the health care team.
Demonstrates understanding of the physiologic and psychological effects of normal aging by assessing, planning, implementing and evaluating care to meet the needs of those populations served. Demonstrates effective communication skills with those specific age populations served. Identifies own learning needs and participates in educational programs related to those age-specific patient populations served (Neonatal, Pediatric, Adolescent, Geriatric). Collaborates, communicates and coordinates with other health care team members in planning and implementing care. Assesses the needs of designated patients requiring hospitalization; initiates nursing admission database and discharge planning in collaboration with inpatient staff and physician. Cooperates and communicates effectively with other team members in order to accomplish the workload.
Communicates recognition of the patients and family/significant others psychosocial, cultural and emotional needs in each nurse-patient interaction. Orients patients and family/significant others to the role of the professional nurse and other health care team members, the nursing services available, and the means of access to those services. Reinforces orientation to the Consumer Bill of Rights and Responsibilities. Identifies the patients educational needs as part of the nursing assessment. Develops an educational component for each nursing care plan. Provides teaching/counseling congruent with patients and family/significant others learning needs and the medical plan of care. Encourages patient compliance with therapeutic and medical regimens. Teaching is based on scientific and behavioral knowledge.
Assesses patient lifestyle risk factors. Integrates health promotion and preventive aspects of care with the ongoing assessment of nursing care needs. Works with patient to develop a plan to improve general health status. Implements physical and psychological preventive measures. Promotes patient self-care responsibility for meeting their own health needs. Adheres to KFHPW documentation standards. Provides a safe environment for each patient and adheres to KFHPW safety standards. Adheres to KFHPW infection control standards and guidelines, including the guidelines for reporting communicable diseases.
Identifies own learning needs and participates in continued education programs to meet those needs. Participates in staff orientation and student education activities. Collaborates with managers in completing the process for self and colleague/team performance reviews. Assures quality of care through development, implementation and evaluation of professional nursing standards and participation in multidisciplinary quality assurance activities. Participates in professional activities. Participates in nursing research and incorporates research findings into nursing practice. Adheres to KFHPW personnel policies and maintains a high standard of professional work habits. Consistently demonstrates an appearance consistent with current KFHPW dress code policy.
Basic Qualifications: Experience Education
Associates degree in Nursing from an accredited program
License, Certification, Registration
Registered Nurse License (Washington) required at hire OR Compact License: Registered Nurse required at hire
Basic Life Support required at hire
Pediatric Advanced Life Support within 6 months of hire
Advanced Cardiac Life Support required at hire
Additional Requirements:
Communication, problem-solving, leadership and decision-making skills.
Preferred Qualifications:
Ambulatory care nursing experience.
Primary nursing or case-management experience.
Bachelor of science in nursing (BSN).
Emergency department nursing experience.
Pediatric Advanced Life Support at hire.
Auto-ApplyHospice Visiting RN - Redmond/Sammamish
Kaiser Permanente job in Redmond, WA
Provides comprehensive skilled nursing care and services to patients in the home setting. Works on an interdisciplinary team to provide care in the home health, palliative care and hospice programs. Accountable for the assessment, development of plan of care, education and consultation related to pain and symptom management as well as adjustment to changes in health status. Plans for the return of patient care to primary Health Care providers as indicated. Essential Responsibilities:
Communicates and collaborates with other interdisplinary team members and with the patient family in planning and implementing care. Records accurate and pertinent data in the electronic medical record in a timely manner, according to documentation guidelines. Adheres to KFHPW infection control, safety, hazardous waste, universal precautions, and CPR standards.
Provides nursing interventions requiring substantial and specialized nursing skill, and initiates appropriate preventive and rehabilitative nursing procedures. Follows through the plan of care as developed to: provide appropriate instruction to patient/caregiver about health care, disease management and adjustment to illness; direct and supervise the care and services of LPN and HHA in the home setting; perform treatments; instruct patients/families in self care activities and home safety; and competently perform skills/tasks per plan of care. This includes pain and symptom management in the home. Performs skilled procedures to include injections, dressings, catheter insertion and care, colostomy and trachiotomy, central line IVcareand blood draws. Identifies educational needs. Instructs patient according to the plan of care. Provides care and case management with interdisciplinary team.
Identifies own learning needs, including those related to age-specific populations and participates in educational efforts to meet those needs. Participates in the following: staff orientation; self and colleague/team performance reviews; and activities related to quality care and cost saving measures. Adheres to KFHPW personnel policies and maintains a high standard of professional work habits. Demonstrates an appearance consistent with KFHPW dress code policy.
Assesses patient need for care and communicates with other health care providers appropriately and in a timely manner. Collects data relevant to visit throughout the duration of care. Develops and initiates the plan of care based on assessment. Communicates and collaborates with medical doctor(s) to establish plan of care.
Evaluates patient response to care through timely assessment, communication and observation. Modifies plan of care through assessement based upon patient and care systems response.
Basic Qualifications: Experience
Minimum two (2) years of experience as Registered Nurse in medical surgical, home health or hospice.
Per the National Agreement, current KP Coalition employees have this experience requirement waived.
Education
Associates degree in Nursing from an accredited program.
High School Diploma OR General Education Development (GED) required.
License, Certification, Registration
Registered Nurse License (Washington) required at hire OR Compact License: Registered Nurse required at hire
Driver's License (Washington) required at hire
Additional Requirements:
Proof of automobile insurance.
Demonstrated experience providing care planning within a community setting (continuum of care).
Ability to work independently.
Ability to transfer/position patients as needs require.
Basic laptop skills including MS Office Suite.
Customer service skills.
Preferred Qualifications:
Horizon for home care system experience.
Bachelors degree in Nursing or a related health care field.
Auto-ApplyRN Hospital Night Shift Supervisor Per Diem Capitol Hill
Kaiser Permanente job in Seattle, WA
Description:
Variable schedule
ACLS, BLS, and PALS required
Supervises nursing and hospital operations on assigned shift at Central Hospital. Coordinates patient bed placement activities for admissions and internal and external transfers to match patient care need with appropriate nursing unit. Supervises staff placement to meet short term clinical staffing needs. Responsible for activities to maximize patient flow to provide seamless admissions, transfers, and discharges to minimize diversions, delays, or denials of patients. Functions as on-site administrative representative in the absence of regular hospital administration. Supports the mission of the organization.
Essential Responsibilities:
Directs/manages hospital operations on assigned shift to ensure that appropriate safe patient care is provided and patient/family needs are met.
Rounds on all patient units to identify patient placement needs, available beds with assigned staff and staff capacity to safely take additional admissions, at least once every three (3) to four (4) hours. Communicates at Huddles and directly with Charge Nurse to: Review current patients. Identify pending/potential discharges. Determine capacity for and time frame for admissions. Discuss any anticipated internal transfers in department to facilitate patient care needs or room for admission. Support regional utilization strategy.
Works with Unit Managers and their designee, EPro (patient admission transfer center) Surgical Services, Sterile Processing, Inpatient Med/Surg, the Advanced Urgent Care/Emergency Department, Care Coordinators, outside facilities, Physicians/APPs, and KP Clinics, to assure appropriate prioritization and placement of patients, and Food & Nutrition Services Staff.
Coordinates with Managers and/or their designee to ensure appropriate staff is provided on each shift to meet patient needs and maintain cost effectiveness. Collaborates with charge nurses/managers/directors to initiate additional resources for planned or unplanned events.
Ensures compliance with organizational policy and procedures and with regulatory requirements.
Anticipates potential problems and intervenes to minimize adverse impact; manages conflicts that arise. Assists with decedent affairs including organ/tissue procurement procedures.
Acts as a clinical resource for nursing including interpretation of policies and procedures and assisting with clinical practice issues. Supports performance improvement activities.
Assists departmental staff in responding to and resolving patient/family questions, concerns or complaints when management team not available.
Assists with the on-the-job injury management program.
Responds to emergency codes (Rapid Response, Code Blue and other facility/patient emergency calls) to ensure appropriate support is available.
Appropriately communicates and documents administrative, departmental, risk management and member issues to ensure timely follow up and response.
Coordinates with Engineering regarding equipment malfunctions, safety issues and repair needs, and ongoing patient room maintenance.
Initiates Disaster Procedures as necessary and functions as incident commander until relieved.
In absence of Hospital Department Managers, addresses and communicates employee issues that arise after hours. Communicates issue and problem resolution actions to department manager.
Basic Qualifications: Experience
Minimum three (3) years of acute care nursing practice.
Minimum one (1) year of leadership experience to include Charge/Lead RN in health care field.
Education
Bachelors of Nursing (BSN) at hire.
License, Certification, Registration
Registered Nurse License (Washington) required at hire OR Compact License: Registered Nurse required at hire
Pediatric Advanced Life Support within 6 months of hire
Basic Life Support required at hire
Advanced Cardiac Life Support required at hire
Additional Requirements:
Effective communication skills.
Preferred Qualifications:
Seven (7) years of combined acute care clinical experience as RN.
Three (3) years of previous healthcare supervisor or manager experience.
Auto-ApplyRN Educator - Clinical Practice Specialist - Case Management - S. Puget Sound
Kaiser Permanente job in Renton, WA
Description: PRIOR CASE MANAGEMENT WORK EXPERIENCE HIGHLY PREFERRED/NEEDED IN THIS POSITION ONSITE LOCATIONS: KPWA RENTON, ST JOE'S TACOMA, ST PETE'S OLYMPIA, ST MICHAEL OLYMPIA, (SACRED HEART SPOKANE REMOTE) MCG CERTIFICATION A PLUS - RN EDUCATOR WORK EXPERIENCE A PLUS - CCM CERTIFICATION A PLUS ROTATING ON CALL WEEKEND (APPROX. 1X EVERY 8 WEEKS) Job Summary:
At direction of nursing leadership, accountable for education program development and implementation to support nursing skills of nursing staff; develops training to support key initiatives that support quality/redesign/practice improvement. In collaboration with other leaders, accountable for clinical orientation for new nursing staff in ambulatory care. Provides consultation and collaborates with ambulatory care leaders to plan, direct and facilitate clinical practice innovation and best practice changes to achieve cost, quality, safety and service outcomes. In collaboration with team members, acts as an innovator and change agent to foster improved clinical practice and quality care.
Essential Responsibilities:
Identifies, develops and implements strategies to achieve, monitor and evaluate clinical/population/service/safety outcomes within practice teams by interpreting team, facility and division specific data. Provides consultation to team managers to identify practice needs for team/population-based care to achieve quality and safety outcomes. Assists teams to develop and implement individualized educational programs and clinical processes. Consults with team managers in identifying and implementing best practices. Supports the nurse managers ability to achieve desired performance of clinical nursing staff.
Develops, implements and evaluates education programs to support knowledge and skill development of nursing staff. Identifies opportunities to improve clinical practice for nursing staff. Consults with team managers to achieve professional and technical goals/standards including updated performance standards for best practice work.
Develops training to assure key clinical initiatives in quality/redesign/practice improvement are integrated into practice. Collaborates in development and implementation of orientation programs for new nursing staff and works directly with managers to assure development of strategies to integrate new staff members into the health care teams.
Collaborates with other nursing leaders to implement strategies to monitor and evaluate nursing orientation programs, continuing education and skills development programs.
Basic Qualifications: Experience
Minimum three (3) years of recent clinical experience.
Education
Bachelors degree in nursing.
License, Certification, Registration
N/A
Additional Requirements:
Clinical expertise in team and program development.
Verbal and written communication.
Clinical practice in non acute or ambulatory nursing.
Teaching; group facilitation.
Program evaluation.
Individual and group skills assessment.
Adult learning theory and practice.
Computer and technology proficient
Preferred Qualifications:
Clinical nurse specialist experience.
Knowledge and experience in application of quality and process improvement methods and translation into clinical practice.
Public speaking skills and knowledge of Kaiser Foundation Health Plan of Washington or other large health care systems.
Washington State RN license.
Masters degree in nursing or related field (e.g., MPH, MHA).
Auto-ApplyAdjudicator, Provider Claims
Tacoma, WA job
Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. - Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution.
- Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues.
- Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions.
- Assists in reviews of state and federal complaints related to claims.
- Collaborates with other internal departments to determine appropriate resolution of claims issues.
- Researches claims tracers, adjustments, and resubmissions of claims.
- Adjudicates or readjudicates high volumes of claims in a timely manner.
- Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership.
- Meets claims department quality and production standards.
- Supports claims department initiatives to improve overall claims function efficiency.
- Completes basic claims projects as assigned.
**Required Qualifications**
- At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience.
- Research and data analysis skills.
- Organizational skills and attention to detail.
-Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
- Customer service experience.
- Effective verbal and written communication skills.
- Microsoft Office suite and applicable software programs proficiency.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $21.16 - $38.37 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Director, Clinical Data Acquisition
Tacoma, WA job
The Director, Clinical Data Acquisition for Risk Adjustment, is responsible for the implementation, monitoring, and oversight of all chart collection for Risk Adjustment, RADV, or Risk Adjustment-like projects, and other state specific audit projects and deliverables related to accurate billing and coding. This role also works with the Health Plan Risk/Quality leaders to strategically plan for supplemental data source (SDS) acquisition from providers as well as Electronic Medical Record (EMR) access. This position oversees management of training for all CDA team members as well as company Risk Adjustment retrieval and data completeness training, onboarding for CDA team members, vendor management for chart collection vendors, Supplemental data, and chart collection research.
**Job Duties**
+ Plans and/or implements operational processes for Risk Adjustment operations that meet state and federal reporting requirements/rules and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans.
+ Develops and implements targeted collection of clinical data acquisition related to performance reporting and improvement, including member and provider outreach.
+ Serves as operations subject matter expert and lead for Molina Risk Adjustment, using a defined roadmap, timeline and key performance indicators.
+ Collaborates with the national intervention collaborative analytics and strategic teams to deliver value for both prospective and retrospective risk programs.
+ Communicates with the Molina Plan Senior Leadership Team, including the Plan President, Chief Medical Officer, national Risk Adjustment teams and strategic teams about key deliverables, timelines, barriers and escalated issues that need immediate attention.
+ Presents concise summaries, key takeaways and action steps about Molina Risk Adjustment processes, strategy and progress to national, regional and plan meetings.
+ Demonstrates ability to lead and influence cross-functional teams that oversee implementation of Risk Adjustment projects.
+ Possesses a strong knowledge in Risk Adjustment and RADV to implement effective operations that drive change.
+ Functions as key lead for clinical chart review/abstraction and team management. This includes qualitative analysis, reporting and development of program materials, templates or policies. Maintains productivity reporting, management and coaching.
+ Maintains advanced ability to collaborate and Manage production vendor relationships, including oversight, data driven KPI measurement and performance mitigation strategies.
**Job Qualifications**
**REQUIRED EDUCATION:**
Bachelor's Degree in a clinical field, Public Health, Healthcare, or equivalent.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:**
- 8+ years' experience in managed healthcare, including at least 4 years in health plan Risk Adjustment or clinical data acquisition/chart retrieval roles
- Operational knowledge and experience with Excel and Visio (flow chart equivalent).
**PREFERRED EXPERIENCE:**
- 10+ years' experience with member/ provider (Risk Adjustment) outreach and/or clinical intervention or improvement studies (development, implementation, evaluation)
- 3-5 years Supervisory experience.
- Project management and team building experience.
- Experience developing performance measures that support business objectives.
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:**
- Certified Professional in Health Quality (CPHQ)
- Nursing License (RN may be preferred for specific roles)
- Certified Risk Adjustment Coder (CRC)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $107,028 - $250,446 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Supervisor, Healthcare Services Operations Support
Tacoma, WA job
JOB DESCRIPTION Job SummaryLeads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc.
- Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes.
- Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance.
- Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement.
- Assists in the development and implementation of internal desktop processes and procedures.
- Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers.
Required Qualifications- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience.
- Strong analytic and problem-solving abilities.
- Strong organizational and time-management skills.
- Ability to multi-task and meet project deadlines.
- Attention to detail.
- Ability to build relationships and collaborate cross-functionally.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
- Supervisory/leadership experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Associate Specialist, Provider Contracts HP
Tacoma, WA job
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when available, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**Job Duties**
This role supports negotiations with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures.
- Sends out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members.
- Receives calls from prospective providers and answers questions regarding contracting process, policies and procedures.
- Forwards requested information/documentation to prospective providers in a timely manner.
- Maintains database of all contracts and specific applications sent to prospective new providers.
- Completes and updates Provider Information Forms for each new contract.
- Ensures accuracy and completeness of provider demographic information and coordinates communication of such information to Provider Configuration team.
- Sends out new provider welcome packets to providers who have contracted with the plan.
- Utilizes Plan's system to track and follow up with Providers who have not responded to Contracts and/or Applications sent as directed by management.
- Formats and distributes Provider network resources (e.g. electronic specialist directory).
**Job Qualifications**
**REQUIRED EDUCATION** :
High School Diploma or equivalent GED
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
1 year customer service, provider service, contracting or claims experience in the healthcare industry.
**PREFERRED EDUCATION** :
Associate's Degree or Bachelor's Degree in a related field or an equivalent combination of education and experience
**PREFERRED EXPERIENCE** :
Managed Care experience
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Strategy Advancement Advisor
Olympia, WA job
**Become a part of our caring community and help us put health first** Humana is a publicly traded, Fortune 100 health benefits company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the 60's, to the largest US hospital corporation in the 80's, to a leading health benefits company beginning in the 90's. Today, Humana is a leader in consumer-focused health solutions and is one of the largest health benefits organizations in the country.
Consumer Segment Team
Identifying and delivering new avenues of growth is a critical company priority. The Consumer Segment team is an entrepreneurial, multi-functional team within Humana's Medicare and Medicaid business unit. The team is focused on driving industry leading membership growth, retention and health outcomes by identifying new consumer insights, developing growth strategies, and activating them across the enterprise to serve the unique needs of prioritized segments.
Humana is seeking an experienced team member with meaningful strategy consulting or healthcare strategy experience to join this team. As Strategy Advancement Advisor, you will support development and implementation of consumer segment strategies that drive growth and retention while optimizing member experience and outcomes. You'll collaborate with teammates and cross-functional partners to frame up business questions, conduct analyses, and recommend solutions. You will help answer key strategic business questions that arise during the annual product/sales cycle across multiple domains, including product design, plan footprint, marketing and sales performance, membership analytics, customer/provider satisfaction and more. You will proactively identify new consumer insights and create business cases to support new pilots and initiatives to address critical unmet consumer needs.
**Key Responsibilities Include** :
+ Managing analysis and/or work streams within high-profile, high-impact strategy projects
+ Conducting industry, market, competitor, and financial analysis and deliverables that clearly frame objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations
+ Conducting interviews, working sessions, and report-outs with associates and leaders across the company
+ Own development and presentation of key deliverables for leadership and cross-functional partners
+ Innovate new pilots and member experiences to drive growth and improved retention
+ Support business case development for key initiatives
**Use your skills to make an impact**
**Required Qualifications**
+ 7+ years of full-time relevant strategic work experience, ideally post-MBA
+ Strategy management consulting experience
+ Experience leading broad initiatives with cross-functional collaboration
+ Strong problem-solving skills and the ability to perform complex qualitative and quantitative analysis
+ Experience leveraging consumer insights to design and implement new products/services/solutions
+ Proficiency in verbal/written communication to senior and executive leadership
+ Proficient in delivering engaging and informative presentations to diverse audiences
**Preferred Qualifications**
+ MBA, MPH, PhD, or graduate degree in a management field
+ Prior healthcare industry experience, preferably in the managed care or provider sector
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$115,200 - $158,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-18-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Director, Supply Chain
Kaiser Permanente job in Renton, WA
Oversees department(s) applying best standards and practices in Supply Chain and Logistics and advocates and proactively monitors departmental compliance of relevant guidelines. Monitors the resolution of inventory, asset, and vendor/suppliers deficiencies. Monitors the implementation of recommendations suggested to streamline current systems to optimize, maintain, and transform current processes, and approves and makes future-oriented decisions to move forward with research plans to develop innovative strategies to streamline new/existing business operating models according to supply chain future state. Partners with senior leaders and approves next steps based on results from the audits of suppliers, conducts corrective actions based on interpreting needs identified from audits, and facilitates business reviews. Directs the implementation and development of strategic future-oriented plans based on results on utilization, quality, inventory levels, and courier routes for projects, while assessing customer satisfaction levels.
Essential Responsibilities:
+ Prepares individuals for growth opportunities and advancement; builds internal collaborative networks for self and others. Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Demonstrates continuous learning; oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs. Stays up to date with organizational best practices, processes, benchmarks, and industry trends; shares best practices within and across teams. Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning resource plans with business objectives. Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact.
+ Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion; translates business strategy into actionable business requirements; ensures products and/or services meet member requirements and expectations while aligning with organizational strategies. Gains cross-functional support for business plans and priorities; assumes responsibility for decision making; sets standards, measures progress, and fosters resolution of escalated issues. Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; prioritizes and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; ensures teams accomplish business objectives.
+ Ensures long-term asset accounting by: guiding and providing support, when needed, for the asset approval (e.g., vehicles, medical equipment), transfer, and disposal processes; guiding the development of strategies to improve the maintenance of records of dispositions in the accounting system; developing innovative strategies to implement policies and compliance procedures, by proposing strategies for cost reductions that achieves accountability for the misuse of assets; and establishing innovative strategies to identify, evaluate, and implement cost restructuring and cost reductions.
+ Ensures ongoing quality customer services by: developing innovative strategies to improve the resolution of customer issues; determining innovative strategies to improve the resolution of backorder problems, delivery delays, repairs, and returns; and establishing innovative strategies to improve the efficiency of product returns and limit and address recalls.
+ Ensures adequate levels of inventory are maintained by: developing advanced strategies to resolve major disruptions in inventory, and guiding the development of strategies for administering of transactions and requests for supplies, equipment, and services; developing inventory management strategies to meet future inventory demand to minimize obsolescence or expiration; developing advanced strategies for maintaining automated inventory and ordering systems to support inventory reconciliation and engaging others on the team to implement; engaging others on the team to implement strategies to confirm highly complex and long-term reorder levels are updated, maintained, and adhered to so that proper product rotation remains valid, and inventory levels are accurate; and working collaboratively as an expert internal consultant and external spokesperson to maintain the inventory control system for broad initiatives (e.g., ensure accuracy of product line, proper level of stock, rotation of product, cleanliness of product/carts), and engaging others on the team to implement.
+ Maintains and improves supply chain and operations by: leading complex and long-term activities (i.e., shipping logistics, carrier, and inventory system evaluation) to optimize, maintain, and transform current processes for increased efficiency; developing and leading research plans to identify new/existing business operating models according to supply chain future state functional and technical design, and engaging others on the team to implement; and, as an expert internal consultant and external spokesperson, directing and leading processes on initiatives to determine end-to-end sourcing, procurement, and logistics.
+ Ensures purchasing strategy is consistent with the overall national sourcing strategy by: developing advanced strategies for improving the processing of purchase requests; forming strategies for purchase standardization, quality, amounts, or equivalency across a range of product categories; building advanced strategies to resolve future purchase-related problems and defining advanced long-term cost savings strategies; creating advanced strategies that establish order quantities, and developing innovative long-term strategies for improving product evaluations and trials; and establishing advanced processes to drive novel strategies for selection of new products and equipment.
+ Ensures ongoing compliance with state and federal regulations, and company policy/procedures pertaining to purchasing, inventory management, and distribution by: developing innovative strategies for applying best standards and practices; developing innovative strategies for managing quotations for new stock and non-standard items, fulfilling contracts, monitoring the external environment, and internal trends, ensure compliance; establishing policies and procedures for compliance monitoring (e.g., Joint commission, Sarbanes-Oxley [SOX]) and performance management audits to ensure staff performance is consistent with established standards; building advanced strategies for improving the implementation of corrective action and the resolution of deficiencies as necessary on a timely basis and in accordance with company policy; and developing advanced strategies for improving the educational and training programs for managers/product users.
+ Ensures suppliers/vendors performance and relationships by: developing long-term strategies to evaluate suppliers/vendor compliance with policies and regulations; directing, designing, and integrating components of relevant programs while also supporting the onboarding new suppliers/vendors, guiding contract negotiation, and serving as an external spokesperson regarding broad suppliers/vendor-related organizational initiatives to ensure their continued ability to support KP; promoting innovative strategies for corrective actions at scale; developing innovative strategies for managing the resolution of suppliers/vendor issues; and establishing strategies to broadly improve strategies for meeting operational and cost targets across suppliers/vendors.
+ Provides technical analysis and reporting services for others by: driving analyses and integrating results on utilization, quality, inventory levels, and courier routes for highly complex and long-term projects; forming innovative strategies to continually expand customer services and improve member satisfaction, and forming advanced strategies for the implementation of proven quality improvement procedures; defining tools, techniques, and assumptions to ensure highly complex analyses are appropriate to support operational and business decisions; and distributing reports in response to business needs for broad initiatives documenting complex analytical results.
Minimum Qualifications:
+ Minimum four (4) years of experience with databases and spreadsheets.
+ Minimum three (3) years of experience in a leadership role with direct reports.
+ Minimum six (6) years of experience managing operational or project budgets.
+ Bachelors degree in Mathematics, Statistics, Engineering, Social/Physical/Life Science, Business, or related field AND minimum nine (9) years of experience in purchasing, contracting, negotiations, material management, logistics, finance, or directly related field OR Minimum twelve (12) years of experience in Materials and Inventory Control/Management, Logistics, Finance, Distribution, or a directly related field.
Additional Requirements:
Preferred Qualifications:
+ Four (4) years of experience in healthcare experience or another heavily regulated industry (e.g., Banking, Manufacturing).
+ Five (5) years of experience working cross-functionally across departments, functions, or business lines.
COMPANY: KAISER
TITLE: Director, Supply Chain
LOCATION: Renton, Washington
REQNUMBER: 1391311
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
Clinical Documentation Specialist, Clinician
Olympia, WA job
We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Conducts concurrent and retrospective reviews of patient medical records to evaluate the accuracy and completeness of clinical documentation, ensuring notes reflect the severity of patient's illness and quality of care. Interacts thoughtfully and effectively with physicians, patient care team, and ancillary departments to gather and clarify medical record documentation. Identifies opportunities for improvement to ensure understanding of documentation requirements, optimize reimbursement for the level of service rendered, and enhance the measurement and reporting of outcomes.
Job Description:
EDUCATION:
* Graduate of an accredited school of nursing OR Foreign trained physician
CERTIFICATION & LICENSURE:
* RN-Registered Nurse of California OR Foreign trained physician
* CCDS or CDIP certification
TYPICAL EXPERIENCE:
* 5 years recent relevant experience.
SKILLS AND KNOWLEDGE:
* Clinical knowledge of diagnoses, severity of illness, risk of mortality, co-morbidities and complications.
* Knowledge of age-specific needs and the elements of disease processes and related procedures.
* Knowledge of current coding classification and reimbursement guidelines and regulations.
* Critical thinking with the ability to analyze and interpret medical record/clinical documentation and formulate appropriate physician queries.
* Ability to define issues, collect data, establish facts and draw valid conclusions.
* Demonstrates a proactive approach in identifying and addressing issues and concerns.
* Collaboration skills to facilitate open sharing of information and cooperation with various stakeholders to problem solve and achieve desired results/outcome.
* Displays a customer service focus in all decisions and actions.
* Ability to communicate through verbal and written means, and to present information to a variety of audiences.
* Ability to create and translate data into reports and presentations for appropriate audience.
* Organization skills to effectively manage and/or re-prioritize activities and projects to meet deadlines while maintaining a high degree of responsiveness.
* Ability to interact and maintain effective working relationships with those contacted in the performance of required duties.
* Demonstrates respect for cultural and linguistic differences and promotes an inclusive work environment.
* Demonstrates initiative in providing feedback/input to improve workflow/processes.
* Ability to work effectively in a dynamic and fast-paced environment with changing business priorities.
* Ability to maintain and work discreetly with confidential information.
* Ability to use essential applications and/or databases associated with the role's duties and responsibilities.
Job Shift:
Days
Schedule:
Full Time
Shift Hours:
8
Days of the Week:
Variable
Weekend Requirements:
None
Benefits:
Yes
Unions:
No
Position Status:
Non-Exempt
Weekly Hours:
40
Employee Status:
Regular
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
Pay Range is $82.86 to $108.54 / hour. New Jersey, Washington, California Pay Range is $82.85 to $108.54 / hour. Colorado, Florida, Georgia, Illinois, Michigan, Minnesota, Nevada, North Carolina, Ohio, Oregon, Pennsylvania, Texas, Virginia Pay Range is $42.95 to $56.26 / hour. Arizona, Arkansas, Idaho, Louisiana, Missouri, Montana, South Carolina, Tennessee, Utah Pay Range is $39.05 to $51.15 / hour.
The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.
Associate Analyst, Clinical Informatics (Bilingual in Spanish Required) - Monday - Friday 7AM - 4PM PST (REMOTE)
Bellevue, WA job
Provides entry level analyst support for clinical information systems activities. Responsible for provision of application technical support and design for clinical information systems - ensuring creation of workflows and enhancements that support process improvement and change management initiatives. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Assists in the development and support of clinical, practice management and operational workflows.
- Assists in the design of workflow analysis, device integration, planning and implementation of clinical systems.
- Participates in the system implementation life cycle including: planning, implementation, training, and post-implementation support.
- Assists in issue resolution related to the clinical information system.
Required Qualifications
- At least 1 year of system implementation experience, or equivalent combination of relevant education and experience.
- Knowledge of systems design methods and techniques.
- Knowledge base in health care informatics.
- Ability to work independently, within a team and collaboratively across teams.
- Analysis, synthesis and problem-solving skills.
- Attention to detail and accuracy.
- Multi-tasking, planning, and workload prioritization skills.
- Verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Patient Service Specialist
Kent, WA job
At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.We all have the power to help, heal and change lives - beginning with our own. That's the power of the Cleveland Clinic Health System team, and The Power of Every One.Job TitlePatient Service SpecialistLocationHudsonFacilityCleveland Clinic Hudson ExpressDepartmentKent Express Care-Regional OperationsJob CodeB15028ShiftDay/Evening/Night/WeekendSchedule4:00pm-7:30pm/8:00am-3:30pmJob SummaryJob Details
Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world.
Cleveland Clinic is the first hospital in the nation to make great customer service a cornerstone of our mission. As a Patient Service Specialist, your responsibility is to deliver an exceptional experience to patients, families and visitors, from the moment they enter to the time they return home. You will assist them with everything from scheduling and pre-registration to MyChart enrollment and visit preparations. This role is a great steppingstone to others within Customer Service and various departments within Cleveland Clinic.
This is a part-time position. Caregivers in this role will support our Kent Express Care facility, averaging approximately 20 hours per week between 8:00am and 8:00pm including some evening and weekend requirements. The training phase will require caregivers to average approximately 40 hours per week, Monday through Friday from 8:00am to 4:30pm. This will include training with EPIC and peer coaching.
A caregiver who excels in this role will:
Provide a comprehensive, proactive and “Patients First” experience for patients and visitors.
Investigate, triage and resolve patient issues using the established HEART model.
Create a welcome and professional environment, interact with patients and ensure stellar patient experiences.
Perform patient registration, visit preparation, telephone triage, insurance verification, co-pay collection, patient and record tracking, scheduling, arrival and/or departure desk activities and screening and scheduling of interpreter services.
Enter and maintain confidential patient information.
Recruit, enroll and educate patients on MyChart and Appointment Pass.
Minimum qualifications for the ideal future caregiver include:
High School Diploma/GED and two years of experience in patient registration, appointment scheduling, insurance processing or customer service OR Associate's Degree and one year of experience OR Bachelor's Degree
Preferred qualifications for the ideal future caregiver include:
Knowledge of medical terminology
Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we're dedicated to providing what matters most to you: ********************************************
Physical Requirements:
Dexterity sufficient to operate a PC and other office equipment.
Requires extended periods of standing, walking or sitting.
Good visual acuity through normal or corrected vision.
Must be able to navigate various locations and function in a fast-paced, hectic environment.
Ability to lift and transport up to 25 pounds.
Personal Protective Equipment:
Follows standard precautions using personal protective equipment as required.
Keywords: Patient Services, Customer Service, CSR, PSS, Part Time, Express Care, Patient Access
The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All offers of employment are follwed by testing for controlled substances and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.
Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.
Please review the Equal Employment Opportunity poster.
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities
Auto-ApplyOperations Director, Ambulatory - Tacoma District Director
Kaiser Permanente job in Tacoma, WA
Directs ambulatory operations to optimize patient care and support organizational goals. Develops and/or directs strategy with stakeholders to identify factors contributing to business value. Assumes accountability for department performance targets. Aligns human resource management programs with KPs mission and values.. Directs survey readiness activities to maintain compliance with regulatory standards and prepares audit documentation. Oversees budget, expenditures and ensures overall financial performance meets expectations. Ensures standardized care delivery by partnering with physicians and other clinical leaders to align key care delivery initiatives across KP. Oversees the development and implementation of long-term plans, policies, and processes for data gathering and analysis. Aligns resources to ensure efficient assignment and utilization. Directs multidisciplinary clinical teams and designs comprehensive emergency preparedness programs. Directs improvements in operations and technology processes, defining standards for clinical teams to identify and address root causes, and implement solutions. Consults with senior and executive management to identify relevant performance metrics to monitor success of strategic improvement projects.
Essential Responsibilities:
+ Prepares individuals for growth opportunities and advancement; builds internal collaborative networks for self and others. Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Demonstrates continuous learning; oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs. Stays up to date with organizational best practices, processes, benchmarks, and industry trends; shares best practices within and across teams. Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning resource plans with business objectives. Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact.
+ Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion; translates business strategy into actionable business requirements; ensures products and/or services meet member requirements and expectations while aligning with organizational strategies. Gains cross-functional support for business plans and priorities; assumes responsibility for decision making; sets standards, measures progress, and fosters resolution of escalated issues. Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; prioritizes and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; ensures teams accomplish business objectives.
+ Directs ambulatory operations to support patient care by: approving timelines and developing and/or directing strategy with stakeholders to identify factors contributing to business value; assuming accountability for department performance targets and aligning with market strategies;championing short- and long-term operational initiatives and directing program, services, and/or systems development; aligning human resource management programs (e.g., performance measurement and employee management) with KPs mission and values; directing continuous survey and compliance readiness activities, including mock rounds and mitigating issues, to maintain compliance and regulatory standards and reviewing prepared audit documentation, information, and reports; and leading the development of budgets for assigned areas (e.g., branch office, staffing, business services departments) and ensuring overall financial performance meets expectations.
+ Ensures standardized care delivery by: partnering with physicians and other clinical leaders to align key care delivery initiatives across KP, providing oversight of all workstreams; assuming accountability for short- and long-term results and performance while ensuring guideline and regulation alignment for service lines or programs; driving cross-functional patient management resolution with internal and external leaders; anticipating and aligning resources in clinical areas to ensure appropriate assignment and utilization for service lines or programs; directing multidisciplinary ambulatory team(s) and holding team(s) accountable for performance; planning long-term strategic goals and designing emergency preparedness programs and ensuring the departments emergency preparedness and recovery plans are current and that managers and staff are trained and know what is expected during and after an emergency; and providing strategic direction to project teams leading initiatives and ensuring implementation, equitable distribution of resources, and delivery on objectives.
+ Directs improvements to patient-centered operations and technology processes by: driving KP-wide internal and external strategic projects designed to remediate issues for impacted groups and improve quality, service, affordability, and/or operating efficiency; ensuring clinical teams use standardized tools to identify root causes for escalations, making recommendations, and implementing solutions to improve the performance of operations system processes; and consulting with senior and executive management to identify relevant performance metrics to monitor the success of strategic improvement projects.
Minimum Qualifications:
+ Minimum two (2) years of experience managing operational or project budgets.
+ Minimum two (2) years of experience in a leadership role with direct reports.
+ Minimum five (5) years of customer or member/patient service experience.
+ Bachelors degree in a business, nursing, health care, or directly related field AND minimum seven (7) years of experience in business operations, clinical health care, or a directly related field OR Minimum ten (10) years of experience in business operations, clinical health care, or a directly related field.
Additional Requirements:
+ Knowledge, Skills, and Abilities (KSAs): Change Management; Business Process Improvement; Compliance Management; Confidentiality; Health Care Compliance; Maintain Files and Records; Financial Acumen; Human Resources Systems; Workforce Planning; Conflict Resolution; Stakeholder Management; Legal And Regulatory Requirements; Calendar Management; Microsoft Office; Health Care Quality Standards; Information Systems; Union Work Environment; Training
Preferred Qualifications:
+ Basic Life Support (BLS) Certification.
+ Five (5) years of project/program management and/or implementation-related experience.
COMPANY: KAISER
TITLE: Operations Director, Ambulatory - Tacoma District Director
LOCATION: Tacoma, Washington
REQNUMBER: 1381747
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
Care Review Clinician (RN)
Seattle, WA job
Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
• Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
• Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
• Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
• Processes requests within required timelines.
• Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
• Requests additional information from members or providers as needed.
• Makes appropriate referrals to other clinical programs.
• Collaborates with multidisciplinary teams to promote the Molina care model.
• Adheres to utilization management (UM) policies and procedures.
Required Qualifications
• At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Ability to prioritize and manage multiple deadlines.
• Excellent organizational, problem-solving and critical-thinking skills.
• Strong written and verbal communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Certified Professional in Healthcare Management (CPHM).
• Recent hospital experience in an intensive care unit (ICU) or emergency room.
Preferred Experience
Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
MULTI STATE / COMPACT LICENSURE
Individual state licensures which are not part of the compact states are required for: CA, NV, IL, NY and MI
WORK SCHEDULE: Tues - Sat shift will rotate with some holidays.
Training will be held Mon - Fri
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $26.41 - $61.79 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Advanced Urgent Care RN - Per Diem Bellevue - Night shift
Kaiser Permanente job in Bellevue, WA
Provide nursing care to a defined group of patients, adhering to Kaiser Foundation Health Plan of Washington ambulatory Nursing Care Standards, the Nursing Code of Ethics and Kaiser Foundation Health Plan of Washington policies. Coordinate and facilitate Health Care services for the patient in other segments of the Health Care delivery system. Provide and coordinate nursing care for the patient in collaboration with the Health Care team. The Registered Nurse is an integral member of the Health Care team, overseeing and participating in patient assessment and the formulation and implementation of the care plan. Essential Responsibilities:
Using the nursing process, provides ongoing assessment of the nursing care needs of a defined group of patients. Uses nursing diagnosis to describe this assessment. Develops a written plan of care for patient care needs. Assists patients and families/significant others in developing health care goals which are part of the individualized plan of care. Determines priorities of patient care based on essential patient needs and available resources. Provides nursing interventions safely and competently. Provides the patient and family/significant others with information preceding interventions. Provides telephone consultation to patients and family/significant others Provides ongoing evaluation of the patients response to care. Anticipates and recognizes changes in the patients status and need for nursing care. Modifies the individual plan of care in collaboration with the health care team.
Demonstrates understanding of the physiologic and psychological effects of normal aging by assessing, planning, implementing and evaluating care to meet the needs of those populations served. Demonstrates effective communication skills with those specific age populations served. Identifies own learning needs and participates in educational programs related to those age-specific patient populations served (Neonatal, Pediatric, Adolescent, Geriatric). Collaborates, communicates and coordinates with other health care team members in planning and implementing care. Assesses the needs of designated patients requiring hospitalization; initiates nursing admission database and discharge planning in collaboration with inpatient staff and physician. Cooperates and communicates effectively with other team members in order to accomplish the workload.
Communicates recognition of the patients and family/significant others psychosocial, cultural and emotional needs in each nurse-patient interaction. Orients patients and family/significant others to the role of the professional nurse and other health care team members, the nursing services available, and the means of access to those services. Reinforces orientation to the Consumer Bill of Rights and Responsibilities. Identifies the patients educational needs as part of the nursing assessment. Develops an educational component for each nursing care plan. Provides teaching/counseling congruent with patients and family/significant others learning needs and the medical plan of care. Encourages patient compliance with therapeutic and medical regimens. Teaching is based on scientific and behavioral knowledge.
Assesses patient lifestyle risk factors. Integrates health promotion and preventive aspects of care with the ongoing assessment of nursing care needs. Works with patient to develop a plan to improve general health status. Implements physical and psychological preventive measures. Promotes patient self-care responsibility for meeting their own health needs. Adheres to KFHPW documentation standards. Provides a safe environment for each patient and adheres to KFHPW safety standards. Adheres to KFHPW infection control standards and guidelines, including the guidelines for reporting communicable diseases.
Identifies own learning needs and participates in continued education programs to meet those needs. Participates in staff orientation and student education activities. Collaborates with managers in completing the process for self and colleague/team performance reviews. Assures quality of care through development, implementation and evaluation of professional nursing standards and participation in multidisciplinary quality assurance activities. Participates in professional activities. Participates in nursing research and incorporates research findings into nursing practice. Adheres to KFHPW personnel policies and maintains a high standard of professional work habits. Consistently demonstrates an appearance consistent with current KFHPW dress code policy.
Basic Qualifications: Experience Education
Associates degree in Nursing from an accredited program
License, Certification, Registration
Registered Nurse License (Washington) required at hire OR Compact License: Registered Nurse required at hire
Basic Life Support required at hire
Additional Requirements:
Communication, problem-solving, leadership and decision-making skills.
Preferred Qualifications:
Ambulatory care nursing experience.
Primary nursing or case-management experience.
Bachelor of science in nursing (BSN).
Auto-ApplyLaboratory Technical Assistant, Renton (40 hrs)
Kaiser Permanente job in Renton, WA
The Technical Assistant performs the pre-analytic phases of laboratory testing procedures and may also perform the analytic and post analytic phases of waived testing procedures, loading of specimen and quality control material for testing on instruments, loading of reagents and appropriate documentation, and routine instrument maintenance. Other duties include: responsibility for documentation of all activities, monitoring supplies; compliance with all regulatory and accreditation requirements related to safety and laboratory testing; face to face and telephone customer service; computer data entry and retrieval; workplace cleanliness and maintenance, training, and point-of-care testing.
Essential Responsibilities:
+ Technologist Assistance: Loads specimen and quality control material for testing on instruments, records the receipt of reagent and supply shipments, loads reagents and appropriate documentation, and performs routine instrument maintenance, specimen banking/storage and disposal.
+ Technical Resource: Helps resolve problems and answer pre-analytical procedural questions. Serves as a resource to laboratory customers.
+ Computer Data Entry & Retrieval: Accessions specimens, enters results, retrieves information, enters results.
+ Specimen Collection and Processing: Collects specimens for lab testing. Has knowledge of special specimen collection and handling requirements for specific populations, e.g. infants, pediatric and geriatric patients. Processes specimens for lab testing according to laboratory procedures.
+ Other duties: Participates in Performance Improvement activities. Performs maintenance. Performs waived testing and EKG testing. Trains phlebotomy students and employees.
Basic Qualifications:
Experience
+ Minimum one (1) year of recent clinical laboratory experience.
Education
+ High School Diploma OR General Education Development (GED) required.
License, Certification, Registration
+ Medical Assistant Phlebotomist Certificate (Washington)
Additional Requirements:
+ Basic computer skills.
+ Good verbal and written communication skills.
+ Customer service and problem-solving skills.
Preferred Qualifications:
+ Five (5) years of clinical laboratory experience.
+ Bachelors degree in a science related field.
+ Background studies in science-related classes.
COMPANY: KAISER
TITLE: Laboratory Technical Assistant, Renton (40 hrs)
LOCATION: Renton, Washington
REQNUMBER: 1393226
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
Imaging Manager (Radiology Supervisor)-Bellevue
Kaiser Permanente job in Bellevue, WA
$10,000 Sign on Bonus Eligible The Imaging Manager is leadership for a large multidisciplinary department (typically CT, MRI, Nuclear Medicine, Ultrasound, Mammography, X-ray; often Dexa or Fluoroscopy; potentially Interventional and other applicable imaging modalities) with > 35 headcount in a Level III Medical Office Building. The Imaging Manager is responsible for all operations. Greater than 60% of employees will report to the Imaging Manager.
Essential Responsibilities:
+ Manages operations: Responsible for FTE and NPE Budgets, responsible for approving PTO through TORT, responsible for securing backfill through Stafferlink, responsible for approving and/or entering supply orders in OneLink, manages unsigned studies report, manages PACS exceptions, manages unended exams, conducts monthly staff meetings. Cascades regional and departmental messages to employees. Responsible for researching and resolving member concerns. Partners with internal customers (Ambulatory, Pediatrics, ACC, Specialties, Pain Clinic, Orthopedics) to improve workflows/resolve issues.
+ Manages employees: Responsible for 60-75% of departments employees, responsible for total performance reviews.
+ Manages performance in partnership. Responsible for development of employees. Responsible for submitting FMLA for impacted employees. Partners with IDM for impacted employees
+ Manages equipment: Oversees equipment failures. Messages leadership/call center of equipment failures impacting patient care. Manages appropriate documentation of equipment failures.
+ Manages resources/access: Identifies trends in exam/patient needs by monitoring volumes and access reports. Drafts and submits business cases to Director and drafts and submits capital cases.
Basic Qualifications:
Experience
+ Minimum five (5) years of experience as a radiologic technologist, sonographer/ultrasound technologist, mammographer, or nuclear medicine technologist.
+ Minimum three (3) years of experience as a radiology supervisor (having had direct reports, responsible for annual reviews, responsible for hiring and terminating employees).
Education
+ Graduate of an accredited diagnostic imaging program or Bachelors Degree or four (4) years of experience in a directly related field.
+ High School Diploma or General Education Development (GED) required.
License, Certification, Registration
+ Nuclear Medicine Technologist Certificate (Washington) OR Registered Diagnostic Medical Sonographer Certificate OR Radiologic Technologist Certification OR Nuclear Medicine Technologist Certificate from Nuclear Medicine Technology Certification Board
Additional Requirements:
+ Work experience demonstrating knowledge of hospital regulatory requirements, hospital accreditation and imaging accreditations, managed care and health care delivery systems.
+ Demonstrated ability to recruit, mentor, develop and engage staff, monitor performance standards, deliver results, and hold staff accountable.
+ Demonstrated ability to manage multiple tasks simultaneously.
+ Able to prioritize and effectively anticipate and respond to issues as they arise.
+ Effective communication, collaboration and change management skills.
+ Financial management skills.
Preferred Qualifications:
+ Medical Office Buildings may be open 24 hours a day and/or 7 days per week.
+ Employees call in to their manager 2 hours before the beginning of shift requiring managers to be available by phone currently as early as 5a.m. Evening shift & overnight shift can call into on call supervisor/manager beginning at 5p.m.
+ Managers are required to participate in on call rotation. The frequency is determined by the number of managers in therotation. The rotation requires 24 hrs/7 days per week regionwide support.
+ Computer Skills; Microsoft Office.
+ Registration in multiple disciplines.
+ Masters Degree or six (6) years of experience in a directly related field.
COMPANY: KAISER
TITLE: Imaging Manager (Radiology Supervisor)-Bellevue
LOCATION: Bellevue, Washington
REQNUMBER: 1376900
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
Hospice Chaplain/Spiritual Counselor - King & Snohomish County (Per Diem)
Kaiser Permanente job in Seattle, WA
BLS REQUIRED AT TIME OF HIRE Provide spiritual and emotional care to patients and families in the home or inpatient facility. Provide spiritual and emotional care to patients, families and staff members of the Hospice Program through direct request or in coordination with community clergy.
Essential Responsibilities:
+ Assess the spiritual needs and resources of the hospice patient and significant other and/or family and other care givers. Provide care directly and/or make referrals to appropriate community spiritual providers.
+ Provide spiritual and emotional counseling and support to Hospice patients, families, Hospice team members and other health care providers working with Hospice patients.
+ Facilitate the planning of appropriate rituals and services with patients, family and friends.
+ Participates in weekly interdisciplinary team meetings by sharing pertinent, non-confidential patient/family information and assures the incorporation of the patient/family spiritual plan into the overall plan for care.
+ Participates in the spiritual community at large to identify and develop specific resources for spiritual, religious support among all denominations. Provides education and consultation to the public and professional community in the area of spiritual care for the dying
+ Provides training and consultation to the Hospice Program and Bereavement Volunteers.
Basic Qualifications:
Experience
+ Minimum one (1) year of recent clinical pastoral experience.
Education
+ Masters degree in theology with clinical pastoral education from an accredited school In addition, ordination or commissioning to function in a ministry of pastoral care and ecclesiastical endorsement by a faith group.
License, Certification, Registration
+ Ordainment/Endorsement of a recognized religious/spiritual body. within 36 months of hire OR Board Certified Chaplain Certification within 36 months of hire
Additional Requirements:
+ Ability to be open, flexible and ecumenical in ministry.
+ Excellent interpersonal, communication, group process and development skills.
Preferred Qualifications:
+ N/A
COMPANY: KAISER
TITLE: Hospice Chaplain/Spiritual Counselor - King & Snohomish County (Per Diem)
LOCATION: Seattle, Washington
REQNUMBER: 1365258
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
Regional Sterile Processing Specialist-Renton
Kaiser Permanente job in Renton, WA
Serves as a liaison across teams and departments to ensure cleaning and processing standards are met, providing recommendations for optimization and standardization. Provides expert consultation on regional guidelines, drafting and creating policies, procedures, and workflows for sterile processing activities. Advises the development and refinement of regional sterile processing policies and procedures and independently conducts and refines audits of sterile processing performance. Directs education across the region on optimizing sterile processing tools, leading strategic efforts across the region on waste prevention and cost efficiencies. Identifies training needs, develops and implements education programs, and evaluates efficacy of training and education programs across the region related to sterile processing. Assists leadership with analyzing and defining priorities for sterile processing services, coordinating across service areas to develop and implement a standardized delivery plan for sterile processing services. Serves as a regional expert on compliance with applicable regulations and requirements, contributing to and overseeing regular audits across the region for compliance with relevant regulations and policies and providing expert consultation on corrective action plans. Serves as an expert resource on developments in regulations/policies and best practices.
Essential Responsibilities:
+ Promotes learning in others by communicating information and providing advice to drive projects forward; builds collaborative, cross-functional relationships. Solicits and acts on performance feedback; provides actionable feedback to others, including upward feedback to leadership; influences, mentors, and coaches team members. Practices self-leadership; creates, evaluates, and responds to the strengths and weaknesses of self and unit or team members. Leads the adaptation to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Fosters open dialogue amongst team members.
+ Drives the execution of multiple work streams by identifying member and operational needs; translates business strategy into actionable business requirements; develops and updates new procedures and policies. Gains cross-functional support for objectives and priorities; determines and carries out processes and methodologies; solves highly complex issues; escalates and resolves issues as appropriate; sets standards and measures progress. Develops work plans to meet business priorities and deadlines; coordinates, obtains and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; influences the completion of project tasks by others.
+ Evaluates and promotes sterile processing knowledge across the region by: identifying training needs and developing and implementing education programs to improve sterile processing services and meet organizational needs; evaluating the efficacy of training and education programs across the region on sterile processing activities; and representing the region on regional and national sterile processing committees to influence national strategy, link national changes to local markets, and sponsor national initiatives.
+ Leads improvements in managing and implementing equipment inventory by: directing education across the region on optimizing sterile processing tools, supporting managers in developing standardized processes for implementing tools; leading strategic efforts across the region on waste prevention and cost efficiencies; and identifying and recommending innovative products/technology to improve quality, efficiency, and cost savings.
+ Drives the sterilization and processing of equipment by: serving as a liaison across teams and departments to ensure cleaning and processing standards are met, providing recommendations for optimization and standardization; providing expert consultation on regional guidelines, giving directional guidance, and drafting and creating policies, procedures, and workflows for sterile processing activities; serving as a subject matter expert to advise the development and refinement of regional policies and procedures to meet evidence-based clinical or technological changes; and independently conducting and refining audits to identify gaps between sterile processing performance standards and actual performance and driving corrective action plans based on audit results to improve processes.
+ Leads regulatory compliance by: serving as a regional expert for standards of practice and regulatory compliance based on industry standards and relevant requirements and policies; contributing to and overseeing regular audits across the region for compliance with relevant regulations and policies; providing expert consultation to managers and directors on the development and implementation of corrective action plans for compliance concerns; and serving as an expert resource for the region on developments in regulations/policies and best practices.
Minimum Qualifications:
+ Minimum five (5) years of experience in a leadership role with or without direct reports.
+ Minimum five (5) years of experience in sterile processing and/or processing reusable medical/surgical equipment/instruments.
+ Bachelors degree in Health Care Administration, Public Health, Health Sciences, Business, or related field AND minimum nine (9) years of experience in sterile processing, health care operations, health care administration, materials management, supply distribution, inventory control, or a directly related field OR Minimum twelve (12) years of experience in sterile processing, health care operations, health care administration, materials management, supply distribution, inventory control, or a directly related field.
+ Sterile Processing Distribution Technician Certificate required at hire OR Registered Central Service Technician Certificate required at hire
Additional Requirements:
+ Knowledge, Skills, and Abilities (KSAs): Systems Thinking; Business Acumen; Business Operations; Cost Optimization; Operational Excellence; Audits; Compliance Management; Maintain Files and Records; Company Representation; Consulting; Vendor Management; Quality Assurance Process; Safety Management; Cleaning Policies and Procedures; Medical Waste Management; Medical Sanitation and Infection Control; Safety and Environmental Health Knowledge; Hazardous Materials and Chemicals; Internal Audit Processes; Bloodborne Pathogen Knowledge; Instrumentation; Infection Control; Sterile Processing; Facilities Management/Operations; Delegation; Mentoring and Coaching; Medical Equipment
Preferred Qualifications:
+ Certified Flexible Endoscope Reprocessor (CFER) OR Certified Endoscope Reprocessor (CER).
+ Certified Healthcare Leader (CHL) OR Management in Sterile Processing (CSPM).
COMPANY: KAISER
TITLE: Regional Sterile Processing Specialist-Renton
LOCATION: Renton, Washington
REQNUMBER: 1392915
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.