Memorial Hospital Remote jobs - 21 jobs

Required Qualifications: Education: Bachelor's degree or equivalent experience may be accepted in lieu of degree. Licensure: None Experience: Two (2) years of experience (with bachelor's degree), five (5) years of experience (with Associates) or seven (7) years of experience (with no degree) supporting Revenue Cycle software applications. Knowledge, Skills, Abilities: Knowledge of current patient accounting systems. Preferred Qualifications: Experience: Three (3) years of experience with billing and/or follow up as well as a working knowledge of hospital reimbursement and managed care contracts Job Summary: Responsible for supporting and maintaining applicable Revenue Cycle applications. Provides assistance, problem solving and functional support to staff. Coordinates with software support services to maintain updates to software and contracts. Supports charge master build process and maintains appropriate tables and databases to meet regulatory claims processing and charge rules.

UPMC is looking for Help Desk Associates to join their team. These positions are fully remote and will consist of four 10 hour shifts with the following schedules. Wed-Sat 6a-4p Sun-Wed 7a-5p Wed-Sat 7a-5p Must be open to all shifts. Description Under the direction of management and more senior members of the team, the Help Desk Support Analyst - Associate will provide day to day support remotely by telephone and chat, for the UPMC end user. The work shifts are based on a 7/24/365 schedule. Responsibilities: + Communication: Responsible for demonstrating appropriate, clear, concise, and effective written and oral communications in all interactions to build relationships and accomplish day to day work and projects. + Securing UPMC Data/Information: Protect the integrity and confidentiality of all data and information through physical and electronic measures. + Call/Chat Quality Evaluation Acknowledgement/Feedback Application: Consistently acknowledge call/chat quality evaluations in quality evaluation software and consistently apply feedback. + Troubleshooting: Has a fundamental understanding of UPMC System support/Knowledge repository and ability to navigate to resolve common customer issues. Consistently document troubleshooting in the ticket. + System Interruption Response and Handling: Follow the System Interruption Handling process consistently. Communicate with other staff for possible system wide interruption. + Meeting Participation: Attend meetings on time, ask questions and apply feedback + Time Management: Responsible for accurate timecard entry in Kronos and PPM systems. Proper use of phone and chat auxiliary codes within defined parameters. + Scorecard Expectations: Typically achieves expected baseline scores. + Disaster Recovery Adherence: Understand the basics of Disaster Recovery processes. Has UPMC equipment on standby. + Answering Support Calls/Answer Support ChatsProvide customer service support to any or all customers via calls/chats. + Ticket Quality: Document and manage end user requests in the Incident Tracking System. Basic understanding of what demographic information, details related to technical issues to capture to properly route to appropriate team. + Technical Skills/Problem Solving: Understand the basics of UPMC technologies. Apply basic problem solving skills to achieve resolution. + Self/Team Development: Successfully completes projects, tasks, and initiatives by embracing a team-first approach. Works in collaboration with team and offers feedback, where appropriate, to complete individual and group efforts. Shows the ability to adjust and be flexible to change by adapting approach when necessary. Responsible for continuous self-study, trainings, partnering with more senior members of team, and/or seeking out opportunities to broaden scope to stay up to date with industry and organizational trends. Seeks feedback from senior team members for development and effectively incorporates feedback into work and behaviors. Qualifications + Familiarity with modern technology and best support practices through education or practical experience. + Prior customer service experience required. + Excellent interpersonal, written and communication skills required. + Ability to work in a fast-paced environment. Licensure, Certifications, and Clearances: A+, N+, Security+, HDI, ITIL, or other technical certifications preferred. Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

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

UPMC is hiring a full-time Sr. Diabetes Educator, CDCES to join their Maternal Fetal Medicine office at Magee Women's Hospital! This is an American Diabetes Association, Education Recognition Program with our hospital outpatient maternal fetal medicine diabetes center that specializes in blood sugar management for pregnant patients with diabetes. The Sr. Diabetes Educator provides diabetes education in outpatient setting and manages diabetes care according to standards and in consultation with the physician (when needed). Hours for this position will start with Monday through Friday, daylight hours, with the option to transition to 4 10-hour shifts after orientation and training. This position will also allow for some work from home flexibility after completion of orientation. No evenings, weekends, or holidays! Previous Dietitian experience is preferred but not required. Responsibilities: + Provides education according to the National Standards for Diabetes Self-Management Education in association with all aspects of health care for the person with diabetes. + Demonstrates a service-oriented approach to her/his position by conveying courtesy, respect, enthusiasm and a positive attitude. + Instructs patients and family members/significant others in the implementation of Healthy lifestyles, Blood glucose testing, Medication management, Risk reduction, Insulin administration, Insulin pumps + Accurately documents all patient interactions and ensures appropriate and complete billing for diabetes education services + Educators are expected to provide training and updates on diabetes education to staff. + Manages on-going care for patients (consulting with physician as appropriate) by answering questions, reviewing home glucose monitoring results, reviewing diabetes medications accordingly and monitoring glycemic control + Provides support services for diabetes care/education when applicable. + Act as a resource/advisor for new Diabetes Educators + Assesses diabetes patients' educational needs and create a care plan in outpatient, inpatient or community setting + Participates in achieving/maintaining American Diabetes Association Recognition of Health System's educational programs in outpatient, inpatient or community setting + Adjusts medication/insulin doses according to established protocols. + Bachelor's Degree in Nursing or related health care field required + Minimum of 3 years of clinical experience Experience in diabetes education strongly recommended Must obtain a Solid/Strong/Good or higher on a Performance Evaluation to be promoted to this level. Must maintain a Solid/Strong/Good or higher on annual performance evaluation to maintain status. Annual completion of a VP approved professional contribution selected from one of the corporate goals. Must have VP approval for promotion. Licensure, Certifications, and Clearances: BLS or CPR required based on AHA standards that include both a didactic and skills demonstration component within 30 days of hire + ACSM Certified Exercise Physiologist (ASCM-CEP) OR Doctor of Medicine (MD) OR Doctor of Osteopathic Medicine (DO) OR Doctor of Podiatric Medicine OR Licensed Master Social Work (LMSW) OR Master Certified Health Education Specialist (MCHES) OR Occupational Therapist (OT) OR Optometrist OR Pharmacist OR Physical Therapist (PT) OR Physician Assistant Certified (NCCPA) OR Psychologist OR Registered Dietitian (RD) OR Registered Dietitian Nutritionist (RDN) OR Registered Nurse (RN) + Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Certified Diabetes Care and Education Specialist (CDCES) *Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state. UPMC is an Equal Opportunity Employer/Disability/Veteran

(These statements are intended to describe the essential functions and related requirements of persons assigned to this job. They are not intended as an exhaustive list of all job duties, responsibilities and requirements.) Under the supervision of the Physical Therapist, provides treatment within the established plan of care to accomplish the established goals. Exercises the skills, safeguards and professional conduct of a Physical Therapist Assistant. Completes documentation of patient accurate FIM scores, treatment, progress and response to treatment as well as thorough weekly progress notes and discharge summaries within the designated time frames Reports patient progress and changes in patient condition to the Physical Therapist in a timely manner to ensure high quality and safe outcomes. Assists in discharge planning with other staff team members on the rehabilitation unit. Maintains effective and timely communication with team staff members and physician on the rehabilitation unit ensuring high quality and safe outcomes. Contributes to a high performance work environment by seeking educational resources that enhance and maintain current knowledge and skills. Participate and completes other duties and special projects/ committees as assigned. Secondary Job Duties That May be Reassigned: Assist in orienting staff members. Supervise PTA clinical students, teen volunteers and shadow students. Assist with departmental Performance Improvement Program and designated committees. Maintain adequate supplies, assist in keeping department clean and ready for patient treatment. Attend appropriate patient care conferences or meetings. Assist in transportation of patients and preparation for treatment. Provide staff inservices as requested. Job Specifications: Education: Graduate from an accredited physical therapy assistant program. State licensure. Experience: Clinical experience from physical therapist assistant program.

Purpose: Do you have experience with medical insurance and codes? Do you have a high attention to detail? UPMC is hiring a full-time Data Quality Monitor to support the Patient Advocacy department. This position would work alternating shifts Monday through Friday between 8:00am and 7:00pm. The position is eligible to work from home, with travel on-site as needed. The Data Quality Monitor maintains data quality in the Enterprise Master Patient Index for the UPMC Health System. They act as a resource person for all implementation phases of the EMPI project as well as post implementation. They interact closely with IS, Medical Records and Patient Access employees and Managers, including working with local Medical Records offices to obtain, verify and finalize data. The Data Quality Monitor also troubleshoots and provides assistance for all levels of responsibility within UPMC as requested, as well as follows Confidential Policy guidelines to avoid legal complications and breach of confidentially. If you have a high attention to detail, enjoy monitoring data for accuracy, and have experience with medical insurance and coding, apply today! Responsibilities: + Keep management informed of work area status, plans, goals, problems and resolutions. + Responsible for full scope of entry and maintenance of the EMPI for UPMC Health System. + Responsible for verification of data integrity within the Enterprise-wide MPI as well as some legacy systems. + Participate in required educational activities and confronts all work with a positive attitude. + Acts as a resource to monitor data elements in the EMPI, rules and matching algorithms. + Review EMPI reports and take action accordingly to maintain data quality in the EMPI. + Participate in training activities for the Enterprise Master Patient Index for the UPMC Health System. + Support and contribute to UPMC Health System (UPMCHS) service excellence mission and abides by all UPMCHS departmental policies, procedures and goals in the process of performing all job responsibilities. + Coordinate and perform merging and unmerging of patient information in the Enterprise Master Patient Index. + High school education required. + Associate degree in Computer Science or related area preferred. + 3-5 years in a HIM (Health Information Management) or computer environment position, access management required. + Communication and interpersonal skills. + Good assessment and problem-solving skills.Licensure, Certifications, and Clearances: + Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

Job Posting We are dedicated to providing exceptional care to every patient, every time. * Sign On Bonus Available * St. Luke's Hospital is a value-driven award-winning health system that has been nationally recognized for its unmatched service and quality of patient care. Using talents and resources responsibly, we provide high quality, safe care with compassion, professional excellence, and respect for each other and those we serve. Committed to values of human dignity, compassion, justice, excellence, and stewardship St. Luke's Hospital for over a decade has been recognized for “Outstanding Patient Experience” by HealthGrades. Position Summary: Performs data quality reviews on patient records to validate coding appropriateness, missed secondary diagnoses and procedures, and ensures compliance with all coding related regulatory mandates and reporting requirements. Monitors Medicare and other payer bulletins and manuals and reviews the current OIG Work Plans for coding risk areas. Responsible for promoting teamwork with all members of the healthcare team. Performs all duties in a manner consistent with St. Luke's mission and values. This position is 40hrs/week and 100% remote. Education, Experience, & Licensing Requirements: Education: Associate degree in Health Services Experience: 5 years of production coding experience or 5 years coding auditing experience. ICD-10-CM (including coding conventions and guidelines), CPT-4 (including coding conventions and guidelines), HCPCS, NCCI edits, and APC experience. Cerner and 3M/Solventum experience. Licensure: RHIA, RHIT, or CCS certification Benefits for a Better You: Day one benefits package Pension Plan & 401K Competitive compensation FSA & HSA options PTO programs available Education Assistance Why You Belong Here: You matter. We could not achieve our mission daily without the hands of our team. Our culture and compassion for our patients and team is a distinct reflection of our dynamic workforce. Each team member is focused on being part of something much bigger than themselves. Join our St. Luke's family to be a part of making life better for our patients, their families, and one another.

Bonus Opportunity - Eligible for up to $2,000 HIRE Incentive The Certified Medical Assistant (CMA) will facilitate patient care during each scheduled office visit. In addition, the CMA will assist the provider with any patient care issues including but limited to follow up, prescription refills, prior authorizations, vital signs, scheduling, referrals, etc. The CMA will contribute to a positive patient experience. The CMA will be an active participant in the organization to maintain a positive, healthy work environment. Certified Medical Assistants must not refer to themselves or allow patients to refer to them as nurses or licensed personnel. Essential Job Duties: Performs triage activities and prepares patient for physical examination. Updates and revises all patient medical history as it pertains to each specific visit. Explains treatment procedures to patients, if applicable. Assists provider during patient examination as requested by provider. Administers ordered medications. Assists with minor surgical procedures, if needed. Assists patient with follow up activities including coordination of scheduling of ancillary services, diagnostic tests, and surgical procedures if applicable. Attends to phone calls from hospitals, nursing homes, patients, etc. required for continuity of patient care. Comply with HIPAA, CLIA, OSHA, and office policies and procedures Maintain supplies in and keep exam rooms and back office neat and clean. Secondary Job Duties That May be Reassigned: Performs other duties as assigned or requested Job Specifications: Education -- Required: graduate from an accredited Medical Assistant program. Certification through an accrediting organization for Medical Assistants. The medical assistant shall perform duties and procedures as directed and educated by a physician. The medical assistant will demonstrate annual competencies with verification of a physician. Experience -- Preferred minimum of 2 years of experience as a Certified Medical Assistant in an office/clinic setting. Required completion of a Clinical Skills Assessment prior to working independently in an office or clinic.

Join our Medical Oncology team as a Financial Counselor in Erie, PA! Are you a skilled medical office professional looking to broaden your horizons? We have an exciting opportunity for a Financial Counselor who will not only work in the front office but also play a crucial role in ensuring patients receive the care they need. If you're passionate about healthcare, finance, and teamwork, read on! As a Financial Counselor, you'll be at the forefront of patient care, ensuring that insurance benefits are verified, authorizations are obtained, and financial assistance is explored. Your expertise will contribute to a seamless patient experience, and your ability to collaborate with various departments will make a significant impact. _Why Join Our Team?_ + Teamwork: At our oncology office in Erie, teamwork is at the heart of what we do. Collaborating with colleagues and providers is essential for success. + Work-Life Balance: This full-time position offers regular hours-Monday through Friday, daylight hours. No evenings, holidays, or weekends! + Work from home flexibility will be available once training is completed. + Impact: Your work directly impacts patients' lives. You'll be part of a compassionate team dedicated to making a difference. Ready for the challenge? Apply online today and be part of our mission to provide exceptional care at Hillman Cancer Center! Responsibilities: + Obtain initial and subsequent prior authorization/referrals as required by specific payers. + Secure verification of insurance benefits prior to office visits and required treatments. + Initiate Financial Assessment Application for those patients who do not have adequate insurance coverage. + Work in collaboration with billing department to resolve open insurance claims as presented by walk-in patients. + Assists with other office functions as required. + Ability to work in a team environment. + Evaluate all self pay patients, as well as those patients who are being prescribed drugs that are not reimbursable, to determine eligibility for financial assistance through drug reimbursement programs, off label drug policy, medical assistance and/or all other applicable programs as made available. + Demonstrate the ability to solve problems through effective communication. + Demonstrate an understanding of patient confidentiality with regards to HIPAA Regulations in order to protect both the patient and the UPMC Cancer Centers. + Complete the financial counseling process for all patients prior to treatment, including evaluation of patient financial obligations. + Meet with patients and designated family members to discuss billing issues. + Utilize the Summary of Patient Reimbursement and Liability Form and obtain appropriate approvals, as required, prior to services being rendered. + Completion of High school diploma or GED + 3 years work experience, preferably in a medical office setting + Prefer knowledge of medical terminology; third party payer rules and regulations; and credit and collections laws + Word processing and computer experience required preferably including EPIC experience. + Experience working with health insurance and authorizations is preferred.Licensure, Certifications, and Clearances: + Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

UPMC is hiring a Senior Systems Analyst to join their ISD Revenue Cycles team. This opportunity offers opportunity for additional training and for career advancement within the department. If you have experience supporting the OnBase application and HL7, APPLY NOW!!! Fully Remote Opportunity: Must be able to work eastern standard time. Purpose: Under the general direction of the management team and senior staff, the Systems Analyst - Senior requires a proficient level of experienced analytical services, defining requirements, developing and/or maintaining computer applications/systems, and providing services to meet client IT and business needs. Responsibilities: + Supporting the new deployment of Hyland OnBase in an Epic hospital environment. + Documentation: Complete detail-oriented documentation for new and moderately complex processes. Responsible for the quality and validity of produced documents. Extract and document customer/business requirements and needs for use by enterprise architecture and engineering teams (network, system, and software). + Second and Third Level Support (Including Maintenance Activities): Independently triage and resolve Level 2 and Level 3 support issues. Act as a mentor to less experienced staff in resolution of Level 2 and Level 3 issues. Ability to handle problem management as appropriate. + Project Management: Take ownership of a project and have the ability to distribute tasks to team members and meet milestone completion. Update all project management and time tracking tools accordingly. + SDLC (System Development Life Cycle): Have a proficient understanding of multiple system/application development life cycles. + Data Confidentiality/Security: Maintain confidentiality of sensitive information at all times. + Data Quality: Maintain data quality at all times. + Vendor Relationships: Interact with vendors (technical issues, project initiatives) independently, as necessary. Ability to act as the point person for issue escalation. + Report Writing/Analysis: Write and analyze complex reports. Make modifications to complex reports. Mentor less experienced team members. Communicate with the business/act as business analyst. + End User Training: Ability to create training content. Facilitate more detailed user training sessions. Ability to train peers. + Process Improvement: Ability to manage process improvement efforts. Create and update processes, as necessary. Ability to independently recognize opportunity for process improvements. + Application Upgrades and Implementation: Identify new functionality and/or hardware requirements related to application upgrades and implementations. Creates test plans. Responsible for review and validation of functionality. Report back any problems. Create and/or manage cutover plans including downtime, etc. Responsible for evaluating impact and coordinating efforts across multiple platforms as necessary. + Communication: Responsible for demonstrating appropriate, clear, concise, and effective written and oral communications in all interactions to build relationships and accomplish day to day work and projects. + Interactions with Others: Successfully completes projects, tasks, and initiatives by embracing a team-first approach. Works in collaboration with team and offers feedback, where appropriate, to complete individual and group efforts. Shows the ability to adjust and be flexible to change by adapting approach when necessary. Mentors less experienced staff. + Self-Development: Responsible for continuous self-study, trainings, partnering with more senior members of team, and/or seeking out opportunities to broaden scope to stay up to date with industry and organizational trends. Seeks feedback from senior team members for development and effectively incorporates feedback into work and behaviors. + System Integration: May be responsible for coordination of tasks and resources related to system integration, validation of testing and implementation. + *Performs in accordance with system-wide competencies/behaviors. + *Performs other duties as assigned. + Typically has 5+ years' experience with modern technology and application support through education or practical experience. + Highly driven and self-motivated to exceed expectations. + Ability to work independently and in a team-based environment. + Demonstrates thorough understanding of information technology fundamental tools and concepts (SDLC) of one of the information technology professional disciplines and applies that understanding to make independent practical contributions to IT work within a UPMC department or function. + Completes on-going training on-the-job, through courses, self-study, certifications and/or advanced degrees to maintain and enhance technical and business capabilities. + Additionally, this position may be required to maintain a standby status as part of a rotation within the team. + This requires 24 hours per day, 7 days per week availability during the standby period. The frequency varies based upon the number of colleagues in the rotation. Top 3 Skills: + OnBase certified supporting the OnBase application + Technical skills including: HL7 integration knowledge, SQL query development solutions. + Knowledge of Microsoft IIS configuration for OnBase infrastructure. Preferred: + Someone who already has the experience with the suite of applications required to support the Hyland OnBase project long-term. + Experience leading and supporting Hyland OnBase projects in a hospital environment. + Knowledge and experience managing document conversions from clinical systems to OnBase + Current or Past UPMC employee or contractor Licensure, Certifications, and Clearances:Preferred Licensure:ACBT - Avaya CBTCXADMIN - AVST Cert CX AdminITIL - IT Infrastructure LibraryUPMC is an Equal Opportunity Employer/Disability/Veteran

Acts as a positive interface with all customers and in a manner consistent with world class service. Demonstrates the ability to competently perform those duties within the scope of practice for Sonographers as outlined by the American Society of Radiologic Technologists. Adheres to and practices in accordance with the American Society of Radiologic Technologists Clinical, Quality, and Professional Performance Standards for Sonographers related to assessment, analysis/determination, patient education, performance, evaluation, implementation, outcomes measurement, documentation, quality self-assessment, education, collaboration/collegiality, and ethics. Ensures services are delivered with the highest possible quality, safety and outcomes within a model plan of care consistent with world class care. Secondary Job Duties That May be Reassigned: May assume responsibility as Charge Technologist according to assigned work shift requirements, or as needed/delegated. Rotate regular work schedule to accommodate vacations, illnesses, and weather conditions. Transport patients and assist others with patient transportation relative to patient acuity level. Provide fixed and mobile ultrasound services at outlying centers, facilities, and/or physician offices. Perform various tasks to assist Department in maintaining cohesive, efficient operation. Perform other responsibilities and duties as assigned. Job Specifications: Education: Satisfactory completion of a Program in Diagnostic Medical Sonography Accredited by one of the following: Joint Review Committee on Education in Diagnostic Medical Sonography; Commission on Accreditation of Allied Health Education Programs; Council for Higher Education Accreditation; or United States Department of Education. Licensure: Current Registry and Certification by the American Registry of Radiologic Technologists (ARRT) in Sonography (S) or the American Registry of Diagnostic Medical Sonography (RDMS). Current Certification in Basic Life Support for Healthcare Providers. Experience: Previous experience as a Ultrasound Technologist preferred but not required.

UPMC Health Plan is hiring a licensed individual to function as a Health Plan Specialist to work onsite at UPMC Presbyterian. This role will work standard daylight hours, Monday through Friday. The Health Plan Specialist will act as a connector, building a bridge for UPMC Health Plan members between hospital services and Health Plan and community resources. They will support the Discharge Plan Managers, identifying members who might have higher needs and benefit from Health Plan resources. Additionally, they will help to link Your Care Program eligible members to a Your Care representative for enrollment. Individuals hired into this role will be hired into the appropriate title as either a Mobile Professional Care Manager, Sr Mobile Care Manager, or Clinical Care Manager based on experience and qualifications. Responsibilities: + Demonstrates role model behavior for the team. + Conducts member assessments, identifying behavioral, clinical, social, and environmental concerns and needs, and provides unique expertise as the UPMC Health Plan liaison. + Coordinates care and services across the continuum of care with case management, physicians, pharmacy, behavioral health, and other providers or health plan departments as appropriate. + Provides leadership and expertise regarding the resources available to UPMC Health Plan members through community and government agencies. + Makes member referrals and is the UPMC Health Plan liaison to other UPMC Health Plan medical case managers and team members. + Facilitates the comprehensive integration of behavioral health services with existing physical health services for members with significant co-morbidity. Independently identifies and analyzes barriers to care; develops specific integrated plan of care in collaboration with the member, family, providers, and UPMC Health Plan staff. + Assesses members' knowledge of their clinical conditions and the need for further education; independently provides education concerning complex physical health and behavioral health conditions. + Ensures that cases are managed and documentation is within established timeframes in accordance with departmental standards. + Participates and facilities professional development project and activities as assigned in senior role. + Participates in case conferences, interagency and provider treatment planning and departmental meetings. + Conducts face-to-face member assessments by visiting the member in the member's community, place of residence, or facility. + Conducts on-site hospital or facility coordination for discharge planning with facility staff if needed. + Acts as a UPMC Health Plan liaison for members with facility admissions; actively networks with UPMC Health Plan high-risk and acute care managers. + Coordinates with members' providers and Practice-Based Care Managers to ensure follow-up and coordination of care. + Performs duties and responsibilities in accordance with the philosophy and standards of the UPMC Health Plan, including conveying courtesy, respect, enthusiasm, integrity, innovation, and a positive attitude through contacts with staff, health plan members, peers, and external contacts. + For Sr Mobile Care Manager + Master's degree in social work/human service field OR licensed RN (BSN preferred) OR Paramedic/EMT with 8-10 year of experience + 6 years of experience in medical social work, home care, discharge planning, and case management required. + For Mobile Care Manager + Pennsylvania Licensure in health or human services field and master's degree OR licensed RN (BSN preferred) OR Paramedic/EMT with 6-8 year of experience. + 3 years of experience in behavioral, clinical, utilization management, home care, discharge planning, and/or case management required + For Clinical Care Manager + Minimum of 2 years of experience in a clinical setting and case management nursing required. + Minimum 1 year of health insurance experience required. + Case management certification or approved clinical certification required (or must be obtained within 2 years of hire to remain in role) + Registered Nurse (RN) Licensure, Certifications, and Clearances: + LSW, CSW, LCSW LPC, Licensed Marriage Family Therapist, Paramedic, EMT, RN or Psychologist required + Valid driver's license required + Proof of current automobile insurance + Valid CPR certification required + Current Act 33/34 + Clearance required + Current Act 73 FBI required. UPMC is an Equal Opportunity Employer/Disability/Veteran

Provides professional nursing care to an assigned patient population. Provides nursing leadership for coordination of care given with interdisciplinary team members to facilitate the patient along the continuum. Required Qualifications: Education: Graduation from an accredited, state-approved, school of nursing. Licensure: Current MS RN license or temporary permit for same (valid for 90 days only). Experience: N/A Skills, Knowledge, Abilities: Ability to use Microsoft: Word, Access, Excel, Windows, and Outlook. Preferred Qualifications: Experience: One (1) year as a staff RN. Skills, Knowledge, Abilities: Standard nursing principles, practices, and procedures. Ability to interpret physicians' instructions. Use and operation of equipment and instruments used in patient care.

UPMC Corporate Payor Contracts is hiring a Financial Analyst, Senior to join our team! We are seeking an individual with healthcare knowledge and strong data analytic skills in the population health space. The ideal candidate will perform data analysis of value-based healthcare programs and be responsible for tracking potential reimbursement, collating and sharing that information across UPMC and the clinically integrated network. This individual will be responsible for creating dashboards and budgets that display revenue opportunity and monitor program(s) performance. This individual will disseminate information for population health-based opportunities derived from data driven insights. Strong Excel skills required. This role will be a hyrbid model with work from home as well as being on site in Harrisburg. The position will work Monday through Friday during daylight hours. Look no further and apply today! Responsibilities + Interpret value based programs and transactions for users who must make economic or business decisions. + Review costs and perform cost benefit analysis related to projects and/or programs. + Analyze financial data and extract payor data and define relevant information; interpret data for the purpose of determining past financial performance and/or to project a financial probability. + Perform moderately complex statistical, cost, and financial analysis of data reported in the various financial systems. + Develop quality, utilization, and financial reports for forecasting, trending, and results analysis. + Record, classify, and summarize financial transactions and events in accordance with generally accepted accounting principles. + Collect and study data to determine costs of business activities. Recommend budget adjustments, and other cost improvement measures + Bachelor's degree in finance or related business field required. + Minimum of one year of related work experience required. + OR High School Diploma/GED and three years of related work experience. + Microsoft Office spreadsheet application required, and PeopleSoft General Ledger proficiency preferred. + Power BI experience preferred. + Population health and payer relations experience preferred. + Epic, electronic health record experience preferred. Licensure, Certifications, and Clearances: + Act 33 with renewal + Act 34 with renewal + Act 73 FBI Clearance with renewal UPMC is an Equal Opportunity Employer/Disability/Veteran + Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

Purpose: The Senior AI Architect position requires a high degree of technical expertise in at least 2 relevant domains such as AI solution development, data science, security, cloud, integrations, Healthcare IT or similar. As a Senior AI Architect, you will be challenged with aligning the AI strategy with the business strategy of multiple projects and/or department initiatives. You will lead the creation of best practices, policies, procedures, and other applicable AI documentation. You will collaborate with data scientists and other AI professionals to augment digital transformation efforts by identifying and piloting use cases. You will align technical implementation with existing and future requirements by gathering inputs from multiple stakeholders - business users, data scientists, security professionals, data engineers and analysts, and those in IT operations. Fully Remote Opportunity! Must be able to work eastern standard time. Responsibilities: The AI architect role spans the life cycle of AI solution development. The following paragraphs summarize the key responsibilities at each AI development stage. + Develop Business Case - The AI architect works with business stakeholders and business owners to develop the architecture needed and clearly define the outcomes and success metrics. + Data Discovery - The AI architect must work with information/data architects, analytics team members and data scientists to identify and make available the data required. In addition, the AI architect must be sensitive to the data's privacy, security and compliance issues. + Model Selection- Depending on the business outcome sought, the AI solution development team will need to select the right foundation model to deliver the services needed. The AI architect will support the identification of the foundation model and ensure that it can address the needs of the business architecture. + Model Training and Testing-The AI architect must work with stakeholders from across the IT organization to ensure that the right environment and computing resources are available for training and testing. This extends to ensuring that the data needed for testing and training is made available to the development team. The AI architect also supports the development of a training and testing plan, as well as the analysis of results and opportunities for improvement. + Model Deployment- The AI architect will work with business and IT stakeholders to develop a roll-out plan for the AI solution. + Continuous Monitoring- The AI architect will support the development of the monitoring plan and participate in the governance model if needed. + Bachelor's Degree in a related field with 10 years of relevant work experience OR 14 years total relevant work experience. + Holds deep technical mastery and business knowledge across multiple technology domains. + Strategic thinking and analytical skills with demonstrated ability to combine broad technical, business, clinical and political factors. + Has a broad background implementing different architectures to meet differing needs. + Strong written and verbal communication skills and possesses good presentation skills. + Demonstrated ability to direct the implementation of diverse technologies in a complex organization. + Diplomacy and interpersonal skills to lead others to provide inputs for the purpose of sharing with customers, partners, and higher management on vision and need for key technologies. + Demonstrated experiences innovating beyond the state of the art. + Maximizing technical efficiency and setting technical direction. MUST HAVES: + Understand the workflow and pipeline architectures of ML and deep learning workloads. An in-depth knowledge of components and architectural trade-offs involved in data management, governance, model building, deployment and production workflows of AI. + Demonstrates a good understanding of product management, agile principles and development methodologies + Translates business and technical requirements into an architectural blueprint to achieve business objectives; documents all AI solution architecture design and analysis work + Supports the development and delivery of data strategy for AI solution training, testing and deployment + Creates architectural designs to guide and contextualize AI solution development across products, services, projects and systems, including applications, technologies, processes and information + Leads evaluation, design and analysis for the implementation of an AI solutions architecture across a group of specific business applications or technologies, based on enterprise business strategies, business capabilities, value streams, business requirements and enterprise standards. + Develops data management strategies for AI model development, training and deployment + Articulates the business impact of AI solutions that translate technical performance into business success metrics + Deliver presentation skills to relevant stakeholders and technical audiences + Demonstrates a broad background implementing different architectures to meet differing needs. + Experience in software development and coding in various languages (C#, .NET, Java etc.) PREFERRED: + Healthcare IT experience preferred. + Has a Healthcare Payers knowledge of business and processes + Deliver presentations to senior-level executives + Experience with such AI techniques as natural-language processing (NLP); computer vision; deep learning tools, such as PyTorch, TensorFlow and AI/ML; libraries, such as GitHub and Hugging Face **Licensure, Certifications, and Clearances:** N/A **UPMC is an Equal Opportunity Employer/Disability/Veteran**

UPMC is currently hiring multiple Certified Coding Specialists to join the Physician Revenue Cycle Enhancement team. This position offers the flexibility to work remotely. In this role, you will be responsible for reviewing medical charts to identify opportunities for process improvement. You will conduct audits to ensure accuracy in code and charge selection, support internal and external audit reviews-including RAC-related audits-and approve account adjustments as appropriate. We're seeking candidates who are passionate about driving process enhancements and comfortable collaborating directly with physicians across the UPMC system. The final candidate will be selected for a job title within the career ladder that reflects the level of education, experience, and manager discretion at the time of offer. Responsibilities: + Adhere to internal system-wide policies, competencies, behaviors and procedures to ensure efficient work processes. Actively participate in periodic coding meetings and shares ideas and suggestions for operational improvements. + Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with third party payer requirements. + Code all diagnoses and procedures by assigning and verifying the proper ICD and CPT codes. Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding. + Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to accurately complete the coding process. + Investigate and resolve reimbursement issues, including denials, in a timely manner and demonstrate proficiency on billing system. + Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling. + Prepare periodic reports for clinical staff identifying unbilled charges due to inadequate documentation. + Advise and instruct coders/providers regarding billing and documentation policies, procedures, and regulations; interacts with providers regarding conflicting, ambiguous, or non-specific medical documentation, to obtain clarification. + Refer problem accounts to appropriate coding or management personnel for resolution. + Work with department management on coding interface, development, enhancements and changes, as well as implementation of those functions. Certified Coding Specialist I Qualifications: + High school graduate or equivalent. + Graduate of an approved certified coding program preferred. + Proficient computer skills with MS excel knowledge preferred. + 5 years surgical coding experience (includes anesthesia coding) OR advanced E/M coding experience. + Professional coding experience is preferred Certified Coding Specialist II Qualifications: + High school graduate or equivalent. + Graduate of an approved certified coding program preferred. + Proficient computer skills with MS excel knowledge preferred. + 5 years surgical coding experience (includes anesthesia coding) or advanced E/M coding experience. + 2 years training or supervisory experience required. + 7-10 years of professional coding is preferred Licensure, Certifications, and Clearances: + CPC or Certified Coding Specialist (CCS) specialty certification required + Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT) UPMC is an Equal Opportunity Employer/Disability/Veteran

(These statements are intended to describe the essential functions and related requirements of persons assigned to this job. They are not intended as an exhaustive list of all job duties, responsibilities and requirements.) Performs patient evaluations to determine patient deficits and need for therapy. Develops an individualized patient plan of care, physical therapy interventions and expected outcomes based on the evaluation and documents findings. Implements or supervises the patient treatment within the established plan of care. Evaluates or reassesses patient progress towards established goals. Supervises Physical Therapist Assistants and Techs on rotation. Assists in discharge planning including communication to the patient, family and other health care professionals. Exercises the skills, safeguards and professional conduct of a Physical Therapist. Completes other duties and special projects as assigned. Participates and reports in weekly patient conference with current patient progress and discharge planning with team staff members. Performs home assessments as coordinated and assigned by the therapy supervisor. Secondary Job Duties That May be Reassigned: Responsible for reporting breakdown of necessary support services to supervisor. Assist in orienting staff members. Supervise PT /PTA clinical students, teen volunteers and shadow students. Assist with departmental Performance Improvement Program and maintain FIM certification. Maintain adequate supplies, assist in keeping department clean and ready for patient treatment. Job Specifications: Education: Graduate of an accredited physical therapy program. Attend appropriate continuing education courses. State licensure. Experience: Clinical experience from a school of physical therapy.

Join our Medical Oncology team as a Financial Counselor in Monroeville, PA! Are you a skilled medical office professional looking to broaden your horizons? We have an exciting opportunity for a Financial Counselor who will not only work in the front office but also play a crucial role in ensuring patients receive the care they need. If you're passionate about healthcare, finance, and teamwork, read on! As a Financial Counselor, you'll be at the forefront of patient care, ensuring that insurance benefits are verified, authorizations are obtained, and financial assistance is explored. Your expertise will contribute to a seamless patient experience, and your ability to collaborate with various departments will make a significant impact. _Why Join Our Team?_ + Teamwork: At our oncology office in Monroeville, teamwork is at the heart of what we do. Collaborating with colleagues and providers is essential for success. + Work-Life Balance: This full-time position offers regular hours-Monday through Friday, 8:00 am to 4:30 pm. No evenings, holidays, or weekends! + Work from home flexibility will be available once training is completed. + Impact: Your work directly impacts patients' lives. You'll be part of a compassionate team dedicated to making a difference. Ready for the challenge? Apply online today and be part of our mission to provide exceptional care at Hillman Cancer Center! Responsibilities: + Obtain initial and subsequent prior authorization/referrals as required by specific payers. + Secure verification of insurance benefits prior to office visits and required treatments. + Initiate Financial Assessment Application for those patients who do not have adequate insurance coverage. + Work in collaboration with billing department to resolve open insurance claims as presented by walk-in patients. + Assists with other office functions as required. + Ability to work in a team environment. + Evaluate all self pay patients, as well as those patients who are being prescribed drugs that are not reimbursable, to determine eligibility for financial assistance through drug reimbursement programs, off label drug policy, medical assistance and/or all other applicable programs as made available. + Demonstrate the ability to solve problems through effective communication. + Demonstrate an understanding of patient confidentiality with regards to HIPAA Regulations in order to protect both the patient and the UPMC Cancer Centers. + Complete the financial counseling process for all patients prior to treatment, including evaluation of patient financial obligations. + Meet with patients and designated family members to discuss billing issues. + Utilize the Summary of Patient Reimbursement and Liability Form and obtain appropriate approvals, as required, prior to services being rendered. + Completion of High school diploma or GED + 3 years work experience, preferably in a medical office setting + Prefer knowledge of medical terminology; third party payer rules and regulations; and credit and collections laws + Word processing and computer experience required preferably including EPIC experience.Licensure, Certifications, and Clearances: + Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

The University of Pittsburgh Medical Center (UPMC) in Altoona, PA is seeking a General Radiologist to join our world class health system. Option for tele-radiology or on-site as well as full-time or part-time positions. Candidate must be residency trained in general radiology. About the Position + Flexible Scheduling + Full or part time + Join a group of 19 Radiologists including, 6 Neuroradiology/MSK/Body Imaging, 2 Mammographers (one part time), 2 Interventional Radiologists, 2 Nuclear Medicine/PET Radiologists, Physician extenders and several nurses + Option for an academic appointment if desired + Live in a great community while having the support of UPMC through teleradiology. The UPMC Department of Radiology is one of the largest academic departments in the country with over 184 Radiologists, 31 research faculty, 67 residents and fellows. + Visa sponsorship + Phillips iSite and Powerscibe which will convert to Phillips Vue PACS. Cerner is used as the inpatient EMR and EPIC as the outpatient. Will be all EPIC fall 2025. What we Offer + Earning potential $700K plus + Sign-on bonus + Competitive base salary commensurate with experience plus lucrative incentive plan + Relocation expenses + Outstanding benefit package including health, dental, vision and pension + Option to earn significant additional income + CME allowance + Work at a busy community hospital + Employed by UPMC Altoona Regional Health System About UPMC Altoona and UPMC + Part of the University of Pittsburgh Medical Center's 40+ hospital network + 400-bed regional tertiary health care system for residents in central Pennsylvania + Joint Commission certified thrombectomy capable stroke center with 24/7 care and a renowned interventional neurology program + Other signature services include Level lll Trauma Center, UPMC Hillman Cancer Center, UPMC Heart & Vascular Institute, UPMC Magee Womens + 400 primary care and specialty credentialed physicians on medical staff + 'A' patient safety grade in Leapfrog's most recent hospital safety survey + 4-star quality hospital, as rated by Centers for Medicare and Medicaid services (CMS). + HeartCARE Center National Distinction of Excellence award recipient by the American College of Cardiology. + UPMC is a $23 billion world-renowned health care provider and insurer + 92,000 employees, including 4,900 physicians + Over 40 academic, community and specialty hospitals + Over 800 doctors' offices and outpatient sites + UPMC is inventing new models of accountable, cost-effective, patient-centered care + Closely affiliated with the University of Pittsburgh About the Community + Choose to live in the Altoona/Hollidaysburg area or State College (hometown of Penn State University's main campus). Both communities offer safe and enriching environments to enjoy work/life balance + Located in the Altoona/Blair County/Central Pennsylvania region + Very reasonable cost of living + Excellent school systems + Abundant cultural amenities including theatre, symphony, minor league baseball, transportation history, festivals, Big10 sports and national touring performing artists + Centrally located with easy access to larger, neighboring cities. Between 40 minutes to 4.5 hours to major cities including Pittsburgh, State College, Philadelphia, DC, and NYC. + Mountains to climb and ski, rivers and lakes to paddle and fish, trails and roadways to bike, numerous golf courses, tennis and pickle ball courts - right here! + Everything you need within a 15-minute drive - no rush hour traffic, no parking fees Must have an MD or equivalent, be BC or BE in Radiology with the ability to obtain an unrestricted PA license.