Medical manager jobs near me

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 PAY RANGE: $231,876 - $331,251 Salary EMPLOYEE BENEFITS ****************************************************** 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 #LI-Onsite

*Employment Type:* Full time *Shift:* Day Shift *Description:* The position will oversee the Critical Care units at Mount Carmel St. Ann's as well as the inpatient units for Mount Carmel Dublin * In accordance with the Mission and Guiding Behaviors; the Director, Patient Care Services works collaboratively with all members of the healthcare team to provide administrative support and direction to a group of managers within Patient Care Services. Responsible for quality and standards of patient care, performance improvement, program management, business operations, budget and resource utilization, and management development for designated areas. Functions within the standards, policies, procedures, and guidelines of the Organization. *What You Will Do:* * Leadership Competencies are the required skills, knowledge, and attributes of leaders. They are principles that guide leaders toward the performance and accountabilities expected of them every day. * Managing Performance: Provides coaching, support, guidance, and developmental opportunities for managers in designated areas; evaluates performance in terms of skills, knowledge, ability, and productivity. Develops managers to effectively recruit, develop, counsel, manage and retain staff. Supports fair and consistent Human Resource policy execution. * Collaborates with all disciplines on the healthcare team and within the Organization to develop goals and objectives, performance targets and business and strategic plans as appropriate for designated areas. Develops new programs in response to identified community, organizational and/or patient needs. * Ensures financial performance and profitability of designated areas through the development and monitoring of the operating and capital budgets and department contracts in accordance with the Finance Department's standards. * Oversees and directs quality monitoring for designated areas, focusing on optimal patient outcomes, regulatory, compliance, risk management, and continuous quality and process improvement. *Minimum Qualifications:* * Education: BSN or Master's degree in Healthcare related field or MBA with Health related focus. * Licensure / Certification: Active RN License to practice State of Ohio * Experience: Five years recent healthcare experience, with three years in first line management preferred. * Effective Communication Skills * Evidence of effective leadership and management abilities. * Critical Care experience strongly preferred *Position Highlights and Benefits:* * Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one. * Retirement savings account with employer match starting on day one. * Generous paid time off programs. * Employee recognition programs. * Tuition/professional development reimbursement. * Relocation assistance (geographic and position restrictions apply). * Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing. * Employee Referral Rewards program. * Mount Carmel offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday. You deserve to get paid every day! * Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups. *Ministry/Facility Information:* Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our four hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You! *Our Commitment to Diversity and Inclusion* Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

The Bilingual Lead Care Manager partners with Care Team Operations, Clinical Operations, Compliance, Community Health Workers, Behavioral Health staff, and external providers (medical, housing, and social services) to ensure seamless, culturally responsive, member-centered care coordination. The bilingual LCM additionally supports members with limited English proficiency by facilitating communication, translation, and cultural interpretation as needed. Responsibilities Serve as the primary point of contact for assigned members, building trust and maintaining active engagement through consistent outreach, relationship-based strategies, and a trauma-informed approach. Provide all communication in the member's preferred language. Conduct comprehensive assessments (physical, behavioral, functional, social) and develop person-centered care plans that reflect the member's goals, risks, preferences, cultural needs, and social determinants of health. Implement, monitor, and update care plans following transitions of care, significant changes in condition, or required reassessments; ensure timely and compliant submission of all care plans. Coordinate services across the continuum-including medical, behavioral health, housing, transportation, social services, and community programs-to reduce fragmentation and remove barriers to care. Conduct required in-person home or community visits based on member need and risk stratification and maintain a compliant monthly visit structure. Utilize motivational interviewing, coaching, and health education to promote behavioral change, self-management, and long-term member stability. Identify gaps in care, service delays, lapses in benefits, unmet needs, and environmental risks; collaborate with internal and external partners to resolve issues quickly and effectively. Maintain accurate, timely, audit-ready documentation of all interactions, assessments, and interventions using required HHN platforms, including eClinicalWorks (ECW), Google Suite, RingCentral, PowerBI dashboards, and payer portals. Meet or exceed HHN and payer productivity standards, including encounter metrics, outreach requirements, documentation timelines, and quality measures. Actively participate in multidisciplinary case reviews, team huddles, care conferences, and escalations with nurses, behavioral health staff, CHWs, care operations, and compliance. Coordinate and schedule appointments with primary care, specialists, behavioral health providers, and community partners; manage referrals, transportation, and follow-ups to ensure continuity of care. Support hospital discharge (TOC) planning through follow-up scheduling, care transitions, medication reconciliation support, and education on discharge instructions. Assist members in navigating plan eligibility, redeterminations, documentation, social service applications, housing resources, and crisis interventions. Maintain active and professional communication with members and care partners through HHN-approved channels, including RingCentral, secure messaging, SMS workflows, and phone. Participate in HHN's continuous quality improvement efforts, identifying workflow gaps, documenting barriers, sharing insights, and contributing to best-practice development. Uphold confidentiality and adhere to all HIPAA and payer regulatory requirements across all areas of care delivery. Open to seeing patients in their home or their location of preference. Provide real-time interpretation and translation support (verbal and written) for members and families with limited English proficiency. Help bridge cultural gaps that may impact communication, trust, adherence, or engagement. Skills Required Fluency in English and another language (Spanish preferred); ability to read, write, and speak at a professional level. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Bilingual Communication (interpretation + translation) Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field preferred; equivalent experience considered. Licensure: Not required; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.

Sign-On Bonus Available The following information aims to provide potential candidates with a better understanding of the requirements for this role. Are you looking for a nursing leadership opportunity with a growing organization? The Laurels of West Columbus has an exceptional opportunity for a Director of Nursing (DON) to join our team. We are a small, close knit building with many long term dedicated associates, and great census! 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 Registered Nurses (RN), Licensed Practical Nurses (LPN) and State Tested Nursing Assistants (STNA). Comprehensive health insurance - medical, dental and vision. ~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. ~ 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. RN license in the state. Director of Nursing, management or supervisor experience in long-term care, restorative or geriatric nursing. 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. xevrcyc 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.

RIMA, a Radiology Partners practice, is looking for a high quality radiologist to fill a full-time Remote Reader position in our practice. This position will interpret primarily emergency imaging. Candidates must be residency-trained in Diagnostic Radiology and share a vision for an integrative and collaborative care model with a multi-disciplinary team. We have a commitment to quality and ardently promote and invest in the professional development of our radiologists through quality and leadership programs. Candidates must be residency-trained in Diagnostic Radiology and Board-Certified or Board-Eligible in Diagnostic Radiology. Ability to interpret general and advanced emergency radiology studies is required. We offer highly competitive compensation with an opportunity for partnership, as well as competitive salary and benefits including malpractice insurance coverage, 401K, CME discounts, disability coverage and healthcare reimbursement. POSITION DUTIES AND RESPONSIBILITIES * 7 days on and 7 days off (5am EST-2pm EST) "END Time is Negotiable" * Remote reading from home * Interpret emergency (STAT ER, urgent care and inpatient) imaging for several facilities in our practice * Work 26 weeks and enjoy 26 weeks off * Partnership track position DESIRED PROFESSIONAL SKILLS AND EXPERIENCE * Candidates must be a Doctor of Medicine or Osteopathy, Board-certified/Eligible in the practice of Diagnostic Radiology * Current California licensure is preferred, ultimately required for the position * Neuroradiology fellowship preferred * Fellowship trained in Neuro, Emergency Radiology, body, MSK, or Pediatrics is preferred FOR MORE INFORMATION OR TO APPLY For inquiries about this position, please contact Misha Hepner at **************************** or ************. PRACTICE OVERVIEW Radiology Partners, through its affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, we advance our bold mission by innovating across clinical value, technology, service and economics, while elevating the role of radiology and radiologists in healthcare. Using a proven healthcare services model, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve. Radiology Partners is an equal opportunity employer. RP is committed to being an inclusive, safe and welcoming environment where everyone has equal access and equitable resources to reach their full potential. We are united by our Mission to Transform Radiology and in turn have an important impact on the patients we serve and the healthcare system over all. We hold that diversity is a key source of strength from which we will build a practice culture that is inclusive for all. Our goal is to empower and engage the voice of every teammate to promote awareness, compassion and a healthy respect for differences. CCPA Notice: When you submit a job application or resume, you are providing the Practice with the following categories of personal information that the Practice will use for the purpose of evaluating your candidacy for employment: (1) Personal Identifiers; and (2) Education and Employment History. Radiology Partners participates in E-verify. Beware of Fraudulent Messages: Radiology Partners will never request payment, banking, financial or personal information such as a driver's license in exchange for interviews or as part of the hiring process. Additionally, we will not send checks for deposit into your bank account at any stage of recruitment. All communication during the interview and hiring process should come from an email address ending in "@radpartners.com." If you suspect you are receiving a fraudulent job offer or solicitation from Radiology Partners or one of our local practices, please notify our Recruiting Team at **************************.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Inpatient Utilization Management Medical Director works with Senior Medical Officers, Regional Medical Officers, Extensivists, the Healthcare Services Team (Case managers, Social Workers, Utilization Managers) to develop and implement methods to optimize use of Institutional and Outpatient services for all patients while also ensuring the quality of care provided. Through remote access to our web-based Portal, physician advisors will complete clinical reviews for medical necessity, treatment appropriateness and compliance. GENERAL DUTIES/RESPONSIBILITIES: Perform medical necessity utilization reviews primarily for inpatient and post-acute cases with some outpatient / pre-service reviews as needed in accordance with UM guidelines Lead concurrent review activities, including rounds, peer-to-peers, and utilization management strategies to improve clinical and efficiency outcomes Serve as a clinical leader and educator for the nursing / care management team Process claims reviews, appeals, and second-level reviews as needed in compliance with Medicare (NCD, LCD), internal, and third-party guidelines (e.g., MCG) for Inpatient, Outpatient, Skilled Facilities Level of Care and Pharmacy. Acts as a liaison between the medical staff, utilization review team, and 3rd parties to effectively promote clinically necessary and efficient utilization of care Serves as a Physician member of the utilization review team. Work with Interdisciplinary Teams to help manage complex or high risk cases Contributes to development of clinical strategies to improve member outcomes, efficiency metrics, and quality outcomes Duties may include serving on committees as needed, such as quality, utilization management, credentialing, etc Other duties as may be assigned to the medical director. Supervisory Responsibilities: Oversees assigned staff, if any. Responsibilities may include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees. Experience: • Required: Minimum of 3 years of experience in hospital-wide or skilled nursing facility position involving clinical care, quality management, utilization / case management, or medical staff governance required • Preferred: Experience as a Physician Advisor or Medical Director a plus Education: Required: Completion of medical school and specialty residency (preferably in internal medicine). Preferred: Board-certification Specialized Skills: • Required: Ability to build rapport with medical staff and management leadership to obtain necessary approvals of new strategies for utilization management. Knowledge of current medical literature, research methodology, healthcare delivery systems, healthcare financial/reimbursement issues, and medical staff organizations. Dedication to the delivery of high-quality, cost-effective, efficient patient care services Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. Licensure: • Required: Applicants must have current, non-restricted licensure as required for clinical practice in the state of California. Work Environment: This is a remote position. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1 While performing the duties of this job, the employee is regularly required to talk or hear. 2 The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 3 The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.

The Department of Health Economics is seeking a Managing Actuary! This credentialed healthcare actuary would drive high-visibility impactful analysis and would be responsible for developing and driving medical cost improvement strategies for UPMC Health Plan in close collaboration with leaders across the organization. This includes managing an experienced team responsible for analyzing medical cost utilization and unit cost data, developing strategies to improve experience relative to external benchmarks, evaluating and communicating leading indicators of financial performance, identifying top trend drivers and affordability opportunities, and supporting the development of strategies across cross-functional teams. The Managing Actuary will require a diverse set of skills and experience, including data and analytics expertise, a deep understanding of medical and pharmacy claims, broad-based business and health economics acumen, a strategic mindset, and an ability to influence and leverage cross-functional teams in a non-traditional actuarial environment. Strong organizational skills are essential to effectively manage multiple priorities, oversee complex projects, and ensure timely delivery of high-quality analytical outputs. This position will supervise 2-4 supporting staff, including actuarial analysts, in the performance of duties. As a Managing Actuary at UPMC, you will be given support for professional designations through continuing education opportunities. This is a work-from-home position located anywhere within the continental US with the potential for infrequent travel into Pittsburgh (up to 2-3 times a year) for meetings/conferences. Responsibilities: * Partner with Health Plan senior leadership for creative problem-solving and strategic decision-making involving medical cost improvement strategies. * Direct a team to produce detailed actuarial and financial models which communicate drivers of financial performance of all lines of business to facilitate corporate decision-making and the development of strategies and goals. * Forecast and interpret financial results, including variances from budget, to help identify medical cost improvement opportunities and potential risks * Analyze trends in spending and utilization. * Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions. * Bring clarity to complex problems using exceptional communication skills when engaging with senior leadership and technical audiences. * Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations and deliver results to leadership. * Creatively leverage a wide range of datasets to inform key analyses. * Build strong relationships with Actuarial, Analytics, and Finance teams across the enterprise. * Ensure that departmental work products meet the highest standards of quality. * Manage and develop a team of 2-4 supporting staff including actuarial analysts. * Bachelor's degree in mathematics, statistics, actuarial science, economics, or related field required. * ASA or FSA certification by Society of Actuaries required; FSA preferred. * Six and a half (6.5) years of experience in progressively more responsible actuarial work in health insurance/managed care or equivalent training/education. * Management experience preferred. * Experience with commercial and government health programs is preferred. * In-depth understanding of health insurance market dynamics. * Excellent problem-solving and analytical skills. * Excellent oral and written communication skills. * Adaptability and ability to prioritize effectively. * Strong PC skills. * Data retrieval skills and relational database experience. * Data visualization experience is preferred. Licensure, Certifications, and Clearances: * Licensure/Certification: ASA or FSA certification by Society of Actuaries required. * Membership in the American Academy of Actuaries required. UPMC is an Equal Opportunity Employer/Disability/Veteran

HealthPartners is looking for Medical Director to join our Home-Based Medicine team. This role will be a 1.0 FTE with 0.30 FTE dedicated to the medical director role and 0.70 dedicated to clinical. This is a unique opportunity to make a meaningful impact on the lives of patients with advanced illness by shaping the future of care delivered in the home. The Medical Director of Home-Based Medicine (HBM) will provide clinical and operational leadership across HealthPartners' innovative home-based care programs. You'll help define and guide best practices, scope of care, and clinical quality across multiple care pathways, including Home Based Primary Care, In Home Complex Care and Transitional Visits. This work is being done in close collaboration with the Advance Care Primary Care (ACPC) clinic, as well as many other departments caring for patients with advanced illness in this space. In addition to leadership responsibilities, the Medical Director will dedicate a portion of their time to direct patient care, primarily in the home setting, with a smaller portion of clinical work occurring in the Advanced Care Primary Care (ACPC) Clinic. You will be joining a team that is supportive and respectful of one another and deeply committed to the mission of HealthPartners. Here, you'll become a partner for good, helping to improve the health and well-being of our patients, members and community. Our commitment to excellence, compassion, partnership and integrity is behind everything we do. It's the type of work that makes a difference, the kind of work you can be proud of. We hope you'll join us. QUALIFICATIONS: The position requires board eligibility/board certification, preferably in Hospice and Palliative Care, Internal Medicine, or Family Medicine. Preferred candidates will have a minimum of 2 years leadership/administrative experience and demonstrate ongoing commitment to leadership development. The ideal candidate will have a deep understanding of innovative care models for complex patients within a diverse clinical setting. BENEFITS: HealthPartners benefit offerings (for 0.5 FTE or greater) include medical insurance, dental insurance, 401k with company contribution and match, 457(b) with company contribution, life insurance, AD&D insurance, disability insurance, malpractice insurance for work done on behalf of HealthPartners as well as a CME reimbursement account. Our clinician well-being program provides a wealth of information, tools, and resources tailored to meet the unique needs of our health care professionals, including physicians, advanced practice clinicians (APCs) and dentists. HealthPartners is a qualified non-profit employer under the federal Public Service Loan Forgiveness program. TO APPLY: For more information about the position or to apply, please contact Judy Brown, Sr. Physician and APC Recruiter at *********************************. For immediate consideration, please apply online.

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider-we're your trusted partner in innovation. Position Overview The Medical Review (MR) Manager is responsible for overseeing all medical review activities and quality assurance functions for the CMS Review and Validation Contractor (RVC) program. This role ensures accurate application of Medicare policy, directs daily workflow for medical review staff, and supports the validation of Recovery Audit Contractor (RAC) determinations. The MR Manager must be available Monday-Friday, 8:00 AM to 4:30 PM ET. Key Responsibilities Manage and oversee medical review operations, including accuracy reviews, disputes, RAC topic evaluations, and special studies. Lead and supervise medical review staff to ensure proper application of Medicare policies and procedures. Provide clinical expertise and guidance for complex or questionable claim review situations. Conduct quality assurance (QA) audits to verify compliance with contract and regulatory requirements. Brief, train, and educate review personnel on policy interpretation and validation processes. Stay current on medical practice, technology changes, billing trends, and potential areas of improper payments. Ensure medical review activities align with CMS FFS Recovery Audit Program requirements. Serve as the clinical resource for Medicare coverage, documentation, coding, and regulatory requirements. Maintain timely communication with CMS and internal leadership as required. Ensure that all duties requiring clinical expertise are performed directly by the MR Manager; non-medical staff may not substitute. Required Qualifications Minimum of 5 years of medical review experience. Minimum of 3 years of experience as a Medical Review Manager, including QA oversight. Extensive knowledge of the Medicare program, including coverage, payment, billing, and policy requirements. Working knowledge of the CMS Fee-for-Service (FFS) Recovery Audit Program. Strong analytical and decision-making skills with demonstrated clinical judgment. Education and Licensure Registered Nurse (RN), currently licensed in the United States or U.S. Territory (license verified annually). Bachelor's degree in Nursing (BSN) required. Core Competencies Medical review expertise Clinical judgment and decision-making Medicare coverage and policy knowledge Quality assurance and audit experience Leadership and staff management Policy interpretation and training Strong written and verbal communication Attention to detail and accuracy Work Schedule Monday through Friday 8:00 AM to 4:30 PM ET Availability required during these hours for CMS and operational needs What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and discuss salary requirements. Management will be conducting interviews with the most qualified candidates. We perform a background and drug test prior to the start of every new hires' employment. In addition, some positions may also require fingerprinting. Broadway Ventures is an equal-opportunity employer and a VEVRAA Federal Contractor committed to providing a workplace free from harassment and discrimination. We celebrate the unique differences of our employees because they drive curiosity, innovation, and the success of our business. We do not discriminate based on military status, race, religion, color, national origin, gender, age, marital status, veteran status, disability, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.

Our client, a world leader in diagnostics and life sciences, is looking for a "Medical Affairs Manager I (Remote)”. Job Duration: Long term Contract (Possibility Of Further Extension) Pay Rate: $63/hr on W2 Company Benefits: Medical, Dental, Vision, Paid Sick leave, 401K Supports global launch preparation and clinical adoption of Companion Diagnostics (primarily in Oncology and Pathology) through cross-functional collaboration and both traditional and agile project management. Oversees project timelines, resources, budgets, and deliverables, ensuring efficient execution of Medical Affairs strategies, education programs, clinical readiness initiatives, scientific events, and KOL engagement. Manages medical content dissemination, communication channels, contracts, HCP interactions, KPIs, and vendor relationships, while promoting best practices and continuous improvement. Qualifications: Bachelor's or Master's degree 2-3 years in diagnostics, pharma, or biotech, with project management expertise (PMP preferred) Strong communication and collaboration skills Preferred: experience in Medical Affairs, clinical development, Oncology/Pathology, and agile methodologies If interested, please send us your updated resume at hr@dawarconsulting.com/***************************

DCI Donor Services, Inc. (DCIDS) is looking for a dynamic and enthusiastic team member to join us to save lives!! Our mission at DCIDS is to save lives through organ and tissue donation, and we want professionals on our team that will embrace this important work!! DCI Donor Services is seeking a Donor Eligibility Associate / Medical Record Reviewer to join our team! This position will perform a medical record review and ensure quality assurance for potential tissue donors The Donor Eligibility Associate will work closely with Medical Directors and hospital personnel to receive, compile and prepare written summaries for tissue release. This is a perfect opportunity for someone who has previous experience with medical terminology! COMPANY OVERVIEW AND MISSION For over four decades, DCI Donor Services has been a leader in working to end the transplant waiting list. Our unique approach to service allows for nationwide donation, transplantation, and distribution of organs and tissues while maintaining close ties to our local communities. DCI Donor Services operates three organ procurement/tissue recovery organizations: New Mexico Donor Services, Sierra Donor Services, and Tennessee Donor Services. We also maximize the gift of life through the DCI Donor Services Tissue Bank and Sierra Donor Services Eye Bank. Our performance is measured by the way we serve donor families and recipients. To be successful in this endeavor is our ultimate mission. By mobilizing the power of people and the potential of technology, we are honored to extend the reach of each donor's gift and share the importance of the gift of life. With the help of our employee-led strategy team, we will ensure that all communities feel welcome and safe with us because we are a model for fairness, belonging, and forward thinking. This is a remote position Key responsibilities this position will perform include: Receives, compiles, and prepares the donor record for eligibility review and Medical Director signoff of donor records. Meets with the Medical Director(s) to review and answer questions pertaining to the information and documentation within the donor record. Participates in required quality training and educational growth to ensure staff is competent, compliant, and trained in quality related tasks with all regulatory and accreditation entities and internal DCIDS standards. Enters donor information (e.g. serology results) in computerized record systems. Answers donor recovery screening questions, on an on-call basis, as needed. Enters donor information (i.e. serology results) and utilizes quality management system in electronic system including, but not limited to, Q-Pulse, and PolicyTech. Acts as a role model for DCIDS and the DCIDS Quality Departments by supporting, reinforcing, and exhibiting behaviors consistent with the DCIDS core values; selfless, hardworking, passionate, and dependable. Performs final archive for all donor records. Performs other related duties as assigned. The ideal candidate will have the following attributes: Ability to communicate internally and externally to diverse audiences, with knowledge, tact, courtesy, and superior attention to detail. High School Diploma or Equivalent - Bachelor's Degree preferred. Two (2) years of healthcare experience. We offer a competitive compensation package including: Up to 184 hours of PTO your first year Up to 72 hours of Sick Time your first year Two Medical Plans (your choice of a PPO or HDHP), Dental, and Vision Coverage 403(b) plan with matching contribution Company provided term life, AD&D, and long-term disability insurance Wellness Program Supplemental insurance benefits such as accident coverage and short-term disability Discounts on home/auto/renter/pet insurance Cell phone discounts through Verizon **New employees must have their first dose of the COVID-19 vaccine by their potential start date or be able to supply proof of vaccination.** You will receive a confirmation e-mail upon successful submission of your application. The next step of the selection process will be to complete a video screening. Instructions to complete the video screening will be contained in the confirmation e-mail. Please note - you must complete the video screening within 5 days from submission of your application to be considered for the position. DCIDS is an EOE/AA employer - M/F/Vet/Disability.

The Regional Medical Affairs Director (RMAD) is a member of a field-based team which is an extension of the US Regional Medical Affairs organization and is responsible for developing and enhancing professional relationships with specified key thought-leaders (KTLs), institutions, and organizations in their assigned geographical region. A RMAD focuses on medical & scientific engagement with identified healthcare and decision maker stakeholders by providing medical and scientific support via scientific exchange, addressing customers medical and scientific informational needs, and collaborating in mutually identified areas of medical, education, clinical research, and real-world experience/evidence. RMADs are recognized as an internal subject matter expert and provide appropriate medical and scientific support for internal teams as identified. Candidate to reside in Denver, CO or St. Louis, MO or Minneapolis, MN Territory covers: WY, CO, NM, ND, SD, NE, KS, MN, IA, MO, IL, IN Responsibilities Fostering mutually collaborative relationships with institutions, Centers of Excellence, thought leaders (TLs) and key decision makers across the healthcare ecosystem in the areas of medical, education, clinical research, and real world experience. Provide medical information through scientific exchange in a fair-balanced manner and clinical/scientific support as identified or requested in addressing the informational needs of the healthcare community, as well as responding to unsolicited requests for pipeline or off-label information. Delivering medical presentations to diverse healthcare professional (HCP) audiences including healthcare decision makers, professional medical societies, and identified advocacy groups. Providing scientific and liaison support related to Xeris clinical research activity, including thought leader and investigator engagement and follow-up, and facilitation of unsolicited requests for interactions related to Investigator Initiated Studies (IISs). Maintaining cross-functional collaboration with internal & external field teams to provide scientific expertise and medical support within Medical Affairs, Clinical Development, Commercial, and other internal stakeholders, etc. Obtaining, assimilating, organizing, and reporting appropriate competitive and scientific intelligence in a concise, clear manner, compliant with all applicable Xeris policies, procedures, and processes Attending & participating in medical/scientific meetings and conferences for the purpose of gaining scientific insights, collecting emerging scientific data, identifying healthcare trends, and supporting the scientific exchange and communication related to Xeris therapeutic areas of interest and research & development As identified, contribute to internal training for headquarter- and field-based teams and supporting speaker training initiatives. Assisting with the implementation and engagement of TL participation in advisory boards, consultant meetings and other scientific meetings consistent with all Xeris policies, procedures, and processes. Maintain clinical/scientific expertise and providing strategic insights into emerging scientific data and healthcare trends. Collaborating with TLs and Xeris Medical Communications to support the development of appropriate publications and related medical communications. Participate in assigned Medical Affairs projects, initiatives, and activities as identified and requested. Performing and completing administrative responsibilities, including reporting requirements in a timely fashion Qualifications Advanced degree (MD, PhD, PharmD, DNP) in a related discipline strongly preferred Less than 2 years of experience [Entry level as Associate Director]; 2+ years of experience [Entry Level as Director] of previous Field Medical or Medical Affairs pharmaceutical industry [post-doctoral pharmaceutical industry training via residency or fellowship also welcomed] Active clinical care, clinical research, or academia experience preferred Clear understanding of regional medical practice, clinical decision-making and healthcare systems affecting patient care. Demonstrated strong understanding of clinical research trial and/or related laboratory research design and execution Extensive knowledge of Endocrinology, including Cushing's Disease and field medical affairs is strongly preferred. Competencies: Customer Service focus, Teamwork & Collaboration, Written and Verbal Communication skills, Presentation skills, Time Management skills, Self-Starter. Working Conditions: Position may require periodic evening and weekend work, as necessary to fulfill obligations. Periodic overnight travel. Approximately 60% overnight travel The level of the position will be determined based on the selected candidate's qualifications and experience. #LI-REMOTE As an equal employment opportunity and affirmative action employer, Xeris Pharmaceuticals, Inc. does not discriminate on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, veteran status, genetics or any other characteristic protected by law. It is our intention that all qualified applications are given equal opportunity and that selection decisions be based on job-related factors. The anticipated base salary range for this position is $170,000 to $225,000. Final determination of base salary offered will depend on several factors relevant to the position, including but not limited to candidate skills, experience, education, market location, and business need. This role will include eligibility for bonus and equity. The total compensation package will also include additional elements such as multiple paid time off benefits, various health insurance options, retirement benefits and more. Details about these and other offerings will be provided at the time a conditional offer of employment is made. Candidates are always welcome to inquire about our compensation and benefits package during the interview process. NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization.

The Manager, Medical Core Content is a team-level operational role responsible for the development, maintenance, and day-to-day quality assurance of all core scientific and medical content for the relevant therapeutic area. This role focuses on the execution and production of scientific assets, ensuring they accurately reflect clinical data, adhere to the core scientific narrative, and are compliant with all internal and external regulations. This position reports directly to the Associate Director, CNS Scientific Communications. **** **Key Responsibilities Include:** **Core Content Development** + Under the guidance of the Associate Director, Medical Communications, draft and maintain high-priority, foundational scientific communication core materials, including: + Core Disease State Decks + Core Field Materials + Medical Publications + New Data Reporting + Medical Information Content Generation **Scientific Accuracy and Consistency** + Ensure all content adheres to the approved core scientific narrative and lexicon, accurately reflects clinical trial data, and maintains consistency across global materials + Maintain content repositories and ensure version control and accessibility for global teams + Utilize platforms like Veeva Vault, to manage content lifecycle and Medical Review submissions. + Track and report content usage and effectiveness, providing insights for optimization **Data Integration** + Collaborate with Clinical Development and Research teams to integrate new data from clinical study reports or publications into existing core content **Cross-Functional Collaboration** + Act as key support resource for the Field Medical Affairs team, managing the content repository and version control for field-facing materials + Partner with external medical writing agencies, providing operational input and feedback, reviewing drafts for scientific accuracy, and ensuring deliverables align with project timelines + Ensure all content creation and review processes adhere to internal Standard Operating Procedures (SOPs), Good Publication Practices (GPP), and global regulatory guidelines **Medical Information Content Generation** + Develop, review, and maintain high-quality, scientifically accurate medical information content for relevant therapeutic area products, including standard response letters, FAQs, and global core content. + Ensure all content complies with regulatory, legal, and medical standards, and is aligned with product strategy and scientific messaging. + Collaborate cross-functionally with Medical Affairs, Regulatory, Legal, and Commercial teams to ensure consistency and accuracy of medical communications. + Support the global-to-local adaptation of core content for use by regional and affiliate medical teams. + Serve as a champion for Medical Review / Promotional review processes for materials + Manage content lifecycle processes, including version control, periodic review, and archiving in content management systems (e.g., Veeva Vault). + Partner with external vendors and internal stakeholders to ensure timely and efficient content development and approval. + Monitor scientific literature and product data to ensure content reflects the most current evidence and clinical guidance. + Contribute to the development and implementation of content governance frameworks and best practices. + Provide training and guidance to internal stakeholders on the appropriate use of medical information content. + Consider technology and AI to support workflow improvement **Qualifications** **Education and Experience:** + Advanced scientific degree is strongly preferred (PharmD, MD, PhD, or equivalent) with expertise in Neuroscience or a related field + Minimum of 4+ years of applied experience in Medical Affairs, Scientific Communications, Medical Writing, and/or medical information within the pharmaceutical or biotechnology industry + Proven experience in the development and writing of core medical affairs content (e.g., scientific decks, disease state materials) + Experience working with medical writing agencies and managing content projects against strict timelines **Skills and Competencies:** + Ability to interpret complex scientific data and translate it into clear, concise, and scientifically accurate communication materials for a professional medical audience + Strong focus on accuracy, consistency, and quality assurance in content creation and version control + Demonstrated ability to manage multiple content projects and deadlines independently within defined scope and guidance + Strong verbal and written communication skills to collaborate effectively with internal cross-functional partners and external vendors + Foundational understanding of the principles governing scientific and medical communications, including GPP and regulatory compliance requirements **Competencies** **Accountability for Results -** Stay focused on key strategic objectives, be accountable for high standards of performance, and take an active role in leading change. **Strategic Thinking & Problem Solving -** Make decisions considering the long-term impact to customers, patients, employees, and the business. **Patient & Customer Centricity -** Maintain an ongoing focus on the needs of our customers and/or key stakeholders. **Impactful Communication -** Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka. **Respectful Collaboration -** Seek and value others' perspectives and strive for diverse partnerships to enhance work toward common goals. **Empowered Development -** Play an active role in professional development as a business imperative. Minimum $117,027.00 - Maximum $175,030.00, plus incentive opportunity: The range shown represents a typical pay range or starting pay for individuals who are hired in the role to perform in the United States. Other elements may be used to determine actual pay such as the candidate's job experience, specific skills, and comparison to internal incumbents currently in role. Typically, actual pay will be positioned within the established range, rather than at its minimum or maximum. This information is provided to applicants in accordance with states and local laws. **Application Deadline** : This will be posted for a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental, vision, prescription drug coverage, company provided basic life, accidental death & dismemberment, short-term and long-term disability insurance, tuition reimbursement, student loan assistance, a generous 401(k) match, flexible time off, paid holidays, and paid leave programs as well as other company provided benefits. Come discover more about Otsuka and our benefit offerings; ********************************************* . **Disclaimer:** This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position. It is not intended to include every job duty and responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary. Otsuka is an equal opportunity employer. All qualified applicants are encouraged to apply and will be given consideration for employment without regard to race, color, sex, gender identity or gender expression, sexual orientation, age, disability, religion, national origin, veteran status, marital status, or any other legally protected characteristic. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation, if you are unable or limited in your ability to apply to this job opening as a result of your disability. You can request reasonable accommodations by contacting Accommodation Request (EEAccommodations@otsuka-us.com) . **Statement Regarding Job Recruiting Fraud Scams** At Otsuka we take security and protection of your personal information very seriously. Please be aware individuals may approach you and falsely present themselves as our employees or representatives. They may use this false pretense to try to gain access to your personal information or acquire money from you by offering fictitious employment opportunities purportedly on our behalf. Please understand, Otsuka will **never** ask for financial information of any kind or for payment of money during the job application process. We do not require any financial, credit card or bank account information and/or any payment of any kind to be considered for employment. We will also not offer you money to buy equipment, software, or for any other purpose during the job application process. If you are being asked to pay or offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive such an offer of employment. Otsuka will also never ask you to download a third-party application in order to communicate about a legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo, Gmail, Hotmail, etc, and not from an official Otsuka email address. Please take extra caution while examining such an email address, as the scammers may misspell an official Otsuka email address and use a slightly modified version duplicating letters. To ensure that you are communicating about a legitimate job opportunity at Otsuka, please only deal directly with Otsuka through its official Otsuka Career website ******************************************************* . Otsuka will not be held liable or responsible for any claims, losses, damages or expenses resulting from job recruiting scams. If you suspect a position is fraudulent, please contact Otsuka's call center at: ************. If you believe you are the victim of fraud resulting from a job recruiting scam, please contact the FBI through the Internet Crime Complaint Center at: ******************* , or your local authorities. Otsuka America Pharmaceutical Inc., Otsuka Pharmaceutical Development & Commercialization, Inc., and Otsuka Precision Health, Inc. ("Otsuka") does not accept unsolicited assistance from search firms for employment opportunities. All CVs/resumes submitted by search firms to any Otsuka employee directly or through Otsuka's application portal without a valid written search agreement in place for the position will be considered Otsuka's sole property. No fee will be paid if a candidate is hired by Otsuka as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

**_What Finance Operations contributes to Cardinal Health_** Finance oversees the accounting, tax, financial plans and policies of the organization, establishes and maintains fiscal controls, prepares and interprets financial reports, oversees financial systems and safeguards the organization's assets. Finance Operations is responsible for core financial operation processes. This can include customer and vendor contract administration; customer and vendor pricing, rebates, billing vendor chargeback research and reconciliation; processing vendor invoices and employee expense reports for payment; fixed asset accounting for book and tax records; cash application; and journal entries. + Demonstrates knowledge of financial processes, accounting policies, systems, controls, and work streams + Demonstrates experience working in a transnational finance environment coupled with strong internal controls + Possesses understanding of service level goals and objectives when providing customer support + Works collaboratively to respond to non-standard requests + Possesses strong organizational skills and prioritizes getting the right things done **_Responsibilities_** + Manage a team of Cardinal Health and Genpact individuals who oversee the entirety of the GPO Admin Fees and Rebates set up and report creation functions, including P&L accruals, rebate setups within SAP Vistex and ad hoc reporting for key internal and external stakeholders + Ensure GPO Admin Fees and Rebates are properly accounted for + Own first level review/approval responsibilities for non-standard rebate structures to ensure proper audit documentation is maintained and proper approvals are received + Oversee key rebate accuracy and timeliness CSLs and KPIs + Partner with cross-functional teams to research and resolve root cause issues impacting rebate accuracy or ability to set up Rebates and GPO Admin Fees timely; apply big picture knowledge to assess and interpret financial impact of process changes and resulting driver outcomes of GPO Admin Fee/Rebate set up changes + Foster a strong SOX internal control structure and seek opportunities for improvements, including build out of SOP processes and project development + Transform current payout and reporting process into Vistex implementation and go-forward build/upkeep + Develop plans for future systematic enhancements + Assist team with more complicated customer and transaction activities; oversee escalations to ensure closure in a timely manner + Partner with and be a thought-provoking leader to business partners across the organization to properly account for transactions, including but not limited to Sales, Legal, Finance, Pricing, Accounting and Contracting + Actively collaborate and support cross-functional team initiatives to improve customer experience, both internally and externally + Establish team and individual-oriented goals for growth and development **_Qualifications_** + Bachelor's Degree in Accounting, Finance or Business Management, preferred + 8+ years of professional experience in related field preferred, including but not limited to Accounting, Finance, or Audit + Accounting and Finance acumen + Ability to lead a new team and influence others + Knowledge with SAP and legal contracts (revenue recognition standards is a plus) + Data mining experience (relevant application tool experience is a plus) + Strong written and verbal communication skills + Process improvement oriented + Strong SOX/internal control understanding **_What is expected of you and others at this level_** + Applies comprehensive knowledge and a thorough understanding of concepts, principles, and technical capabilities to manage varied tasks and projects + Manages department operations, supervises professional employees, and ensures employees operate within guidelines + Develop team and individual development plan goals for direct reports + Participates in the development of policies and procedures to achieve specific goals + Recommends new practices, processes, metrics, or models + Works on or may lead complex projects of large scope, including leading offshore teams and working in conjunction with other CAH teams + Develops technical solutions to a wide range of difficult problems; solutions are innovative and consistent with organization objectives + Receives guidance on overall project objectives + Independently determines method for completion of new projects + Gains consensus from various parties involved + Acts as a mentor to less experienced colleagues **Anticipated salary range:** $105,100 - $135,090 **Bonus eligible:** Yes **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 12/28/2025 *if interested in opportunity, please submit application as soon as possible. The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************

The Medical Director is responsible for supporting staff by providing training, clinical consultation, and clinical case review for members. Essential Functions: Provide prior authorization medical reviews, consultation and clinical review services Participate in peer-to-peer discussions Provide provider education, training, data sharing, performance evaluations and orientation to the plan Conduct clinical reviews for designated CareSource members as requested Provide physician review for clinical appeals cases Participate in the evaluation and investigations of cases suspected of fraud, abuse, and quality of care concerns Participate in development of policies and procedures Participates in quality improvement initiatives, case management activities and member safety activities (i.e. incident management Provide cross-coverage for other Medical Directors and/or markets, as needed Oversight and quality improvement activities associated with case management activities Assist in the review of utilization data to identify variances in patterns, and provide feedback and education to MCP staff and providers as appropriate Participate in the development, implementation and revision of the clinical care standards and practice guidelines ensuring compliance with nationally accepted quality standards Participate in the development, implementation and revision of the Quality Improvement Plan and corporate level quality initiatives Collaborate with market/product leaders to help define market strategy Community collaborative participation Support of regulatory and accreditation functions (eg. CMS, State, NCQA and URAC) and compliance for all programs Perform any other job related instructions, as requested Education and Experience: Completion of an accredited Medical Degree program as a medical doctor (MD) or Doctor of Osteopathic (DO) medicine is required Successful completion of a residency training program, preferably in primary care is required Minimum of five (5) years of clinical practice experience is required Managed care medical review/medical director experience is preferred Bachelor's or Master's degree in Business Administration, Operational Excellence, Healthcare Administration or Medical Management is preferred Competencies, Knowledge and Skills: Basic Microsoft Word skills Excellent communication skills, both written and oral Ability to work well independently and within a team environment Ability to create strong relationships with Providers and Members High ethical standards Attention to detail Critical listening and systematic thinking skills Ability to maintain confidentiality and act in the company's best interest Ability to act with diplomacy and sensitivity to cultural diversity Decision making/problem solving skills Conflict resolution skills Strong sense of mission and commitment of time, effort and resources to the betterment of the communities served Licensure and Certification: Current, unrestricted license to practice medicine in state of practice as necessary to meet regulatory requirements is required Board Certification, preferably in primary care specialty is required Re-certification, as required by specialty board, must be maintained (exceptions may be granted by Chief Medical Officer) MCG Certification is required or must be obtained within six (6) months of hire Working Conditions: General office environment; may be required to sit or stand for extended periods of time May be required to work evenings/weekends May be required to travel to fulfill duties of position Compensation Range: $191,400.00 - $334,900.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-SW2

We are seeking a Medical Director in Neurology to join our dynamic team in Cincinnati, Ohio. The Medical Director has overall responsibility for providing medical, scientific, and strategic leadership for the successful planning, execution, and reporting of clinical trials. Additionally, this role acts as the Medpace internal medical expert and will serve as a medical resource for the review, presentation, and interpretation of results in the Clinical Study Report. The Medical Director will also be involved in the development of new clinical projects, including study design, protocol, and project plans as required. We are currently seeking Medical Directors in all Therapeutic Areas. * All Medical Directors receive hybrid, work from-home flexibility. This role also has the ability to be fully remote-based with the right experience. Responsibilities * Provide medical management and expertise for clinical trials; * Contribute medical expertise to study reports, regulatory documents, and manuscripts; * Manage safety issues in clinical trials and work closely with associates in evaluation and assessment of the trials; * Participate in new business development through involvement in proposal and sponsor meetings as requested; * Coordinate with other departments in all phases of the studies and trials including feasibility assessments, design processes, educational efforts, management of medical information, and reviewing and editing of medical documents; * Follow specific research related protocol and lead others in strict adherence to the policies. Qualifications * Must have an M.D., specialization in Neurology * Must be eligible to obtain a medical license * Board certification preferred * Prior clinical trial research experience preferred * Previous experience in pharmaceutical-related clinical research is preferred Travel: up to 20% at times Medpace Overview Medpace is a full-service clinical contract research organization (CRO). We provide Phase I-IV clinical development services to the biotechnology, pharmaceutical and medical device industries. Our mission is to accelerate the global development of safe and effective medical therapeutics through its scientific and disciplined approach. We leverage local regulatory and therapeutic expertise across all major areas including oncology, cardiology, metabolic disease, endocrinology, central nervous system, anti-viral and anti-infective. Headquartered in Cincinnati, Ohio, employing more than 5,000 people across 40+ countries. Why Medpace? People. Purpose. Passion. Make a Difference Tomorrow. Join Us Today. The work we've done over the past 30+ years has positively impacted the lives of countless patients and families who face hundreds of diseases across all key therapeutic areas. The work we do today will improve the lives of people living with illness and disease in the future. Cincinnati Perks * Cincinnati Campus Overview * Flexible work environment * Competitive PTO packages, starting at 20+ days * Competitive compensation and benefits package * Company-sponsored employee appreciation events * Employee health and wellness initiatives * Community involvement with local nonprofit organizations * Discounts on local sports games, fitness gyms and attractions * Modern, ecofriendly campus with an on-site fitness center * Structured career paths with opportunities for professional growth * Discounted tuition for UC online programs Awards * Named a Top Workplace in 2024 by The Cincinnati Enquirer * Recognized by Forbes as one of America's Most Successful Midsize Companies in 2021, 2022, 2023 and 2024 * Continually recognized with CRO Leadership Awards from Life Science Leader magazine based on expertise, quality, capabilities, reliability, and compatibility What to Expect Next A Medpace team member will review your qualifications and, if interested, you will be contacted with details for next steps.

Job DescriptionMEDICAL DIRECTOR - REMOTE ARC Group has an immediate opportunity for a Medical Director! This position is 100% remote working eastern time zone business hours. This is a direct hire FTE position and a fantastic opportunity to join a well-respected organization and have a positive impact on the lives of millions of people. At ARC Group, we are committed to fostering a diverse and inclusive workplace where everyone feels valued and respected. We believe that diverse perspectives lead to better innovation and problem-solving. As an organization, we embrace diversity in all its forms and encourage individuals from underrepresented groups to apply. 100% REMOTE! Candidates must currently have PERMANENT US work authorization. Sorry, but we are not considering any candidates from outside companies for this position (no C2C, 3rd party / brokering). SUMMARY STATEMENT The Medicare Contractor Medical Director (CMD) provides medical leadership and decision making for an organization that serves as a Medicare Administrative Contractor (MAC). This role serves as a liaison between the Centers for Medicare and Medicaid Services (CMS) and stakeholders. CMDs play a vital role in developing Local Coverage Determinations (LCDs) and ensuring compliance with Medicare policies, reviewing medical claims, and promoting evidence-based healthcare. ESSENTIAL DUTIES & RESPONSIBILITIES Clinical Expertise and Consultation 30% Provide leadership in clinical program outreach to the practitioner/provider/supplier/beneficiary community. Provide direction and assistance to clinical staff in conducting provider education, as well as assist in the development of clinical guidelines as needed. Keep clinical knowledge up to date and abreast of medical practice and technology changes. Serve as a subject matter expert in medical and clinical areas relevant to the Medicare program. Provide clinical consultation to internal teams (e.g., medical review staff, appeals teams) and external stakeholders. Provide the clinical expertise, scientific literature analysis, claims data analytics to effectively focus medical polical policy and reviews on identified problem areas. Collaboration and Leadership 30% Collaborate with CMS and other Medicare Contractors (e.g., A/B or DME MACs and others) to develop and update medical policies and articles based on clinical evidence and regulatory requirements. Work with multidisciplinary teams within the MAC to improve processes and ensure compliance with CMS directives. Liaise with CMS staff, medical societies, and other stakeholders to align goals and address emerging issues. Represent the MAC at CMS meetings and industry conferences. Strengthen the quality improvement procedures with emphasis on decision consistency and clinical education of clinical staff through various mechanisms including but not limited to overseeing Inter-Reviewer Reliability (IRR) reviews. Program Integrity 20% Support program integrity initiatives, including identifying trends in inappropriate billing practices or noncompliance. Ensure the proper application of Medicare regulations, national and local coverage determinations (NCDs and LCDs), and clinical guidelines. Participate in all phases of LCD development by leading the Local Coverage Determination (LCD) process to include development, revision, retirement, education, and decision making. Collaborate with investigative teams and law enforcement when required. Medical Review (MR) and Appeals 10% Oversee medical review activities to ensure appropriate and consistent decisions on claim determinations including pre- and post-payment determinations. Provide leadership in developing and implementing MR Quality Assurance Programs. Provide leadership in effectively focusing MR and developing internal MR guidelines. Review complex or high-level appeals and provide guidance on the application of Medicare policies. Provide support to the claim appeal process including assistance in the development of position papers and participation in the administrative process when needed such as Administrative Law Judge (ALJ) hearings. Provider Education and Communication 10% Provide leadership in the provider community (including interacting with hospital/specialty associations). Educate providers, individually or as a group, regarding identified problems or medical policy. Maintain Professional and Organization Relationships Performs other duties as the supervisor may, from time to time, deem necessary. Travel within and outside the assignedjurisdictions, as needed. Expected to be no more than 3-4 weeks/year but could vary based on business needs. REQUIRED QUALIFICATIONS MD or DO degree from accredited Medical School Minimum of three years clinical practice experience as an attending physician Extensive knowledge of the Medicare program, particularly the coverage and payment rules Work experience in the health insurance industry, a utilization review firm, or another health care claims processing organization in a role that involved developing coverage or medical necessity policies and guidelines. Knowledge, skill, and experience to evaluate clinical evidence, and to develop evidence-based medical necessity standards within the Medicare fee-for-service benefit structure Ability to develop strategies and processes to ensure evidence-based decision-making for policy in the Medicare population Basic understanding of medical coding conventions Ability to effectively communicate, collaborate with, and provide education on health care policy issues to both internal team members and external entities Ability to work collaboratively with internal staff to evaluate aberrancies, determine appropriate billing, coding, pricing, and utilization of services Proficiency with effective public speaking and ability educate providers Ability to work collaboratively with clinical and non-clinical team members Ability and desire to educate team members and external entities (i.e., CMS, providers, other federal agencies, law enforcement, etc.) Computer literacy, including proficiency using word processing, spreadsheets, presentation, and virtual meeting applications Ability to complete independent or computer-based training and education Certifications, Licenses, Registration: Current, active, valid, unrestricted license to practice medicine in at least one state or territory within the United States, never suspended or revoked in any state or territory of the United States Eligible for licensure within jurisdiction of enterpriseoperations Board Certified Doctor of Medicine or a Doctor of Osteopathy in a specialty recognized by the American Board of Medical Specialties for at least three years PREFERRED QUALIFICATIONS Experienced Physical Medicine and Rehabilitation (PM&R), Oncology, Radiology, Ophthalmology or Infectious Diseases professionals with five years of clinical practice MBA, MHA, MS in Management, or formal accredited coursework in medical systems management Demonstrated successful working experience in organized medicine group(s) (e.g., AMA, specialty society, state health department) as a committee chairperson or other leadership Medical Director experience in Medicare-related or commercial healthcare organization Coding and billing experience utilizing HCPCs, CPT, and ICD-10 codes Experience using GRADE methodology for literature analysis and performing systematic reviews Experience working with physician groups, beneficiary organizations, and/or congressional offices Would you like to know more about our new opportunity? For immediate consideration, please send your resume directly to John Burke at ******************** or apply online while viewing all of our open positions at ******************* ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed. At ARC Group, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know. Position is offered with no fee to candidate.

Who We Are BioMarin is a global biotechnology company that relentlessly pursues bold science to translate genetic discoveries into new medicines that advance the future of human health. Since our founding in 1997, we have applied our scientific expertise in understanding the underlying causes of genetic conditions to create transformative medicines, using a number of treatment modalities. Using our unparalleled expertise in genetics and molecular biology, we develop medicines for patients with significant unmet medical need. We enlist the best of the best - people with the right technical expertise and a relentless drive to solve real problems - and create an environment that empowers our teams to pursue bold, innovative science. With this distinctive approach to drug discovery, we've produced a diverse pipeline of commercial, clinical and preclinical candidates that have well-understood biology and provide an opportunity to be first-to-market or offer a substantial benefit over existing therapeutic options. About Worldwide Research and Development From research and discovery to post-market clinical development, our WWRD engine involves all bench and clinical research and the associated groups that support those endeavors. Our teams work on developing first-in-class and best-in-class therapeutics that provide meaningful advances to patients who live with genetic diseases. BioMarin Clinical Science (CLS) is responsible for overseeing clinical programs across various phases, from proof-of concept to Phase 3 and BLA/NDA/MAA filing. The Clinical Science team provides leadership for clinical strategy and oversight to ensure excellence in clinical trial conduct, data analysis and interpretation, publication preparation, and safety monitoring BioMarin Clinical Science (CLS) is responsible for overseeing clinical programs across various phases, from proof-of concept to Phase 3 and BLA/NDA/MAA filing. The Clinical Science team provides leadership for clinical strategy and oversight to ensure excellence in clinical trial conduct, data analysis and interpretation, publication preparation, and safety monitoring. Summary Description: Fully remote role - US based candidates The Medical Director has a key scientific and analytical leadership role in the development of CLS core deliverables across study planning, design and execution, results analysis and regulatory filings. Key focus areas include: acting as a study Medical Monitor and providing the scientific input into the creation and review of all CLS study deliverables and monitoring subject eligibility, study data and contributing critically to the scientific interpretation and integration of clinical study results.The Medical Director will also contribute to the scientific strategy and plan as outlined in the Clinical Development Plan (CDP). The Medical Director is also responsible for providing medical input into the creation and review of all CLS study deliverables to support clinical decision making, problem solving, and safety surveillance, as well as collaboration with external physician stakeholders. Key Responsibilities: Scientific Leadership Support the definition of the core clinical and scientific strategy that serves as the basis for the CDP and provide CLS expertise in the design and execution of clinical studies under the purview of the CDP Participate (as assigned) in the development of CLS-assigned sections of regulatory filings and in drafting regulatory responses in collaboration with Medical Writing Establish relationships with investigators and KOLs as appropriate in support of the CDP Stay up to date with advances in literature in therapeutic/disease area including mechanism of action, diagnostic tests, treatment, drug development trends, and regulatory requirements Develop therapy-specific publication plans and work with internal and external colleagues to prepare study results for timely publication Attend and contribute to relevant scientific conferences, seminars or presentations Clinical Study Planning and Monitoring Act as the scientific subject matter expert, and primary contact, for assigned clinical study; take a proactive approach to identifying issues and mitigating risk Initiate and provide the medical and scientific content and insight for development and review of: protocols, protocol amendments; ICFs; CRFs; statistical tables and listings including accurate AE (MedDRA) and concomitant medications (WHODrug) coding; audit reports; clinical study reports; inspection readiness activities, regulatory submissions and other key study deliverables Provide clinical input to statistical analysis plan to ensure alignment with Regulatory and business interests Facilitate the review and approval of all study related CLS deliverables and content Act as study scientific subject matter expert and main point of contact for Principal Investigators (PIs) and sites to assess subject eligibility, provide scientific rational and manage ongoing protocol issues Provide leadership to sites by developing or participating in training, answering investigator/site questions about the protocol Respond to site and Health Authority questions about the protocol Conduct periodic review of protocol deviations in collaboration with Clinical Operations Study Lead or designee (per protocol specific Protocol Deviation Plan) Attend and present at Investigator Meetings, as needed Conduct data review, assessment and interpretation of clinical data to ensure that the data are correct and presented with the appropriate interpretation including thorough review of SAEs and other important AEs (per the study specific Medical Monitoring Plan) Review and analyze SAEs, safety and efficacy trends on an ongoing basis Work closely with the Pharmacovigilance representatives providing medical input into safety reports including, SAE narratives and analysis of similar events, Development Safety Update Reports (DSURs) and Suspected Unexpected Serious Adverse Reactions (SUSARs) reports, Company Core Safety Information (CCSI), Investigator Brochure (IB), Risk Management Plans, Integrated Summaries of Safety and Efficacy, Clinical Study Reports and preparation of labels Participate in and provide scientific advice, as appropriate, during key Database Lock (DBL) activities (final listing review, review of blinded tables, listings and figures (TLFs), etc.) and actively participate in all data snapshots taken (not limited to final DBL) Collaborate with Biometrics to identify key issues, prepare content and facilitate discussions at study Data Review Board (internal) or Data Monitoring Committee (DMC) Lead the selection of and interactions with independent Data Monitoring Committees (DMC) The Medical Director will also act as the medical subject matter expert for review of clinical and safety data to ensure data are correct and presented with the appropriate medical interpretation and for discussing safety concerns with sites Governance and Communication Provide timely and high-quality functional deliverables and contributions to Study Execution Team (SET) Act as primary point of contact between SET and BCLS to ensure appropriate dissemination of information and communication (including functional managers and other relevant individuals) Provide agenda topics to be discussed during SET meetings Act as the medical and scientific subject matter expert (SME) to the SET with the ability to make decisions and recommendations on behalf of BCLS Proactively identify and communicate potential risks and mitigations relevant to the BCLS deliverables Contribute to the development and maintenance of study- specific plans; manage the development of study-specific plans that are the responsibility of BCLS Collaborate with BCLS Therapeutic Area Lead, CDTL and CSL on all study related decisions, as appropriate Escalate issues affecting BCLS function deliverable quality, timelines, resources or budget, as appropriate Competencies The Medical Director is expected to exhibit mastery-level understanding of multiple technical competencies, including scientific knowledge, data analysis, and scientific writing. S/he should also have advanced-level competence in several areas, including strategic thinking and problem solving. The Medical Director should: Identify scientific and medical knowledge gaps in therapeutic area and target populations to drive research and publication strategies Assess the clinical and medical impact of clinical and external research findings and data on overall therapeutic area and clinical development strategies Conduct comprehensive document evaluations including evaluation of statistical presentations, research methods, quality and completeness of content Identify internal and external best practices, trends, developments or alternative approaches that can be leveraged for strategy development Demonstrate ability to look beyond the obvious toward innovative approaches, avoiding biases and historical crutches The Medical Director will also demonstrate mastery of relevant clinical and therapeutic area knowledge to support clinical decision making, problem solving, safety surveillance, and as well as collaboration with external physician stakeholders. Education and Experience: MD, MD/PhD (or equivalent) Advanced degree in life or health sciences (e.g. PhD/PharmD/RN) 5 or more years of relevant experience in Clinical Development, with experience in genetic diseases, specialty care, and/or rare diseases desired; Clinical experience preferred Note: This description is not intended to be all-inclusive, or a limitation of the duties of the position. It is intended to describe the general nature of the job that may include other duties as assumed or assigned. Equal Opportunity Employer/Veterans/Disabled An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Mass General Brigham Health Plan Medical Director Qualifications Education: MD or DO required Licenses and Credentials: * Physician - Massachusetts active full license required Experience: * 3-5 years of Health Plan experience * at least 5 years of clinical practice experience Knowledge, Skills and Abilities: * Utilization Management experience * Excellent written and oral communications skills * Proficient in basic computer skills, use of EHR's, digital tools * Multitasking abilities * Adaptable to change due to business growth Job Description: * Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities * Reviews clinical services and quality incidents when sufficiently serious to merit physician involvement * Coverage of medical necessity determinations to support special investigations/fraud waste and abuse cases * Collaborates on health plan medical policy development * Assesses new, emerging, and existing technologies to determine appropriateness of health plan coverage * Partners with clinical leaders to ensure medical service expenditures remain within budget * Collaborates with business development, quality, finance and medical management teams to promote improvements in the quality and cost efficiency of care throughout the MGB Health Plan provider network * Delivers consultation to network management staff and deployment of education programs for network clinicians * Develops and delivers presentations for clinical staff on current topics relevant to MGB Health Plan members and network * May represent MGB Health Plan at a variety of external forums and committees * Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees * Monitors performance metrics and audits to identify areas for continuous improvement and ensure compliance * Anticipates and meets or exceeds internal and/or external customer expectations and requirements; establishes and maintains positive relationships with customers and gains their trust and respect * Build strong relationships and infrastructure that designate MGB Health Plan as a people-first organization * Ensure diversity, equity and inclusion are integrated as a guiding principle * Other duties as assigned with or without accommodation Additional Job Details (if applicable) * Primarily remote position, exempt * In person meetings as requested for business needs * M-F 830-5pm EST; Participates in after hours and weekend call rotation as assigned * Ensures that all assigned work is completed within regulatory timelines * Checks and addresses assigned work queues, email, Teams messages during assigned work hours Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) EEO Statement: Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.