Miriam Hospital jobs - 79 jobs

We are seeking a meticulous and proactive individual to join our HR team as an HR Compliance Auditor and Workplace Accommodations Manager. This role will focus on conducting comprehensive audits of HR processes, policies, and records to ensure compliance with legal and regulatory requirements. Additionally, the position will administer workplace accommodations for employees. Position: HR Compliance and Workplace Accommodations Manager Department: Human Resources Schedule: Full Time ESSENTIAL RESPONSIBILITIES / DUTIES: Key Responsibilities: Conduct location audits to assess compliance with HR policies and procedures across all organizational sites. Perform audits of work models to ensure adherence to applicable laws and regulations, including remote work arrangements. Conduct audits based on management levels to ensure consistency and fairness in HR practices and decision-making. Conduct pay audits to ensure compliance with wage and hour laws, including minimum wage and overtime requirements. Conduct personnel file audits to ensure accuracy, completeness, and compliance with record-keeping regulations. Perform audits of all licenses and training records to ensure employees maintain required certifications and qualifications. Conduct audits of policy changes to assess implementation and effectiveness across the organization. Perform documentation audits to ensure compliance with electronic signature policies and procedures. Provide support for vaccine-related initiatives, including tracking vaccination status and compliance. Ensure labor law posters are up-to-date and posted in all organizational locations as required by law. Develop and maintain a record retention policy to ensure compliance with legal requirements for document retention. Oversee the I-9 process, including verification and record-keeping in compliance with immigration laws. Manage the background check process, ensuring compliance with state regulations. Conduct audits of personnel demographics data to ensure accuracy and compliance with reporting requirements. Perform return-to-work audits to ensure compliance with policies and procedures for employees returning from leave. Conduct audits of earned time (e.g., vacation, sick leave) to ensure accuracy and compliance with applicable laws and policies. Perform state registration audits to ensure compliance with registration requirements in all jurisdictions where the organization operates. Serve as the point of contact for onsite or Zoom visits to provide HR documentation for joint commission, DPH, federal, and state agencies. Conduct location audits for HR policy compliance across organizational sites. Collaborate with employees, managers, and HR to assess accommodation needs and determine reasonable accommodations based on individual circumstances and job requirements. Ensure compliance with applicable laws and regulations, including the Americans with Disabilities Act (ADA), by developing, implementing, and enforcing accommodation policies and procedures. Maintain accurate and confidential records of accommodation requests, assessments, approvals, and outcomes in accordance with privacy regulations and organizational policies. Communicate accommodation procedures, rights, and resources to employees, managers, and HR professionals through training sessions, presentations, and written materials. Coordinate with external vendors and service providers to facilitate the procurement of assistive devices, ergonomic equipment, and other accommodations as needed. Oversee the implementation of approved accommodations, including the installation of equipment, modifications to workspaces, and provision of support services. Advocate for accessibility initiatives and promote a culture of inclusivity by raising awareness of disability-related issues and best practices. (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). JOB REQUIREMENTS EDUCATION: Bachelor's Degree required; preferred in Human Resources Management, Business Administration, or a related field CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: EXPERIENCE: Minimum of 5 years of related experience is required. Minimum of 2 years of experience in HR, preferred in compliance auditing, including conducting comprehensive audits of HR processes, policies, and records. Proven track record in managing workplace accommodations, assessing needs, determining reasonable accommodations, and ensuring compliance with disability laws. Experience interpreting and applying federal, state, and local employment laws and regulations, with a focus on wage and hour laws, record-keeping requirements, and anti-discrimination laws. KNOWLEDGE, SKILLS & ABILITIES (KSA): Thorough knowledge of federal, state, and local employment laws, particularly in HR compliance auditing and workplace accommodations. Strong analytical and communication skills, with the ability to interpret complex regulations and effectively communicate compliance requirements. Excellent organizational and time management abilities, capable of managing multiple audits and accommodation requests simultaneously while meeting deadlines. Compensation Range: $72,500.00- $105,000.00 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

About the Job The Senior People Advisor provides guidance and support to leaders and employees to promote a positive workplace environment and working relationships, resolving conflicts, and ensuring compliance with employment laws and regulations. Supports the development of organizational understanding and application of best practice workplace relations processes. Provides subject matter expertise on people policies interpretation, procedures, performance management and federal/state employment laws to guide decision-making. The Senior People Advisor partners closely with other People Services department functions and the People Advisor and People Partner roles to drive consistent, compliant and equitable outcomes. Provides excellent customer service and creates a positive and top-notch experience that strengthens the organization's image as the employer of choice. Responsibilities * Acts as a liaison to other People Services functions when necessary * Investigates and resolves employee complaints and grievances, ensuring fair and impartial handling of cases * Conducts thorough and objective investigations into employee relations (people relations) issues, gathering relevant information and conducting interviews as necessary * Collaborates with supervisors and managers to address performance-related issues and develop appropriate corrective action plans; supports Directors and above as needed and assigned * Mediates and facilitates discussions to resolve conflicts and improve working relationships * Identifies patterns or hotspots and makes proactive recommendations to address root causes * Provides guidance on employee accommodation decisions and transitions * Assists in the development and implementation of employee relations policies, procedures, and practices in alignment with employment laws and organizational values * Stays updated with employment laws and regulations, providing guidance to ensure compliance and mitigate legal risks * Supports the implementation of disciplinary procedures and processes, ensuring consistency and fairness in their application * Escalates systemic concerns, complex cases or repeated behaviors with potential risk implications * Maintains accurate and confidential employee relations documentation and records * Assists in other people-related projects and initiatives as assigned * Supports facilitation of training for leaders * Develops meaningful relationships with key stakeholders across the organization * Monitors compliance with organizational policies and procedures and State and Federal legislative requirements * Enhances positive employee relations by addressing concerns early and timely, and guiding leaders to reduce employee relations risks * May support culture assessments process as needed This is a full-time, day position. This role may be eligible for partial or full remote work, depending on defined business needs, work assignments, system resources, and prior approval. Minimum Qualifications * Bachelor's degree with a focus on human resource management or related field required; Associate's degree and 4 years of related experience may be accepted in lieu of Bachelor's degree * Minimum 2 years' experience with employee relations or as a Human Resources Generalist required * Professional certifications in employee relations or mediation preferred * Demonstrates knowledge of employment laws, regulations, and HR policies and practices * Excellent interpersonal and communication skills to effectively collaborate with employees and leaders * Ability to conduct thorough and objective investigations, maintaining confidentiality and integrity * Strong organizational and time management skills to handle multiple cases and prioritize work effectively * Proficiency in using HRIS systems and other relevant people tools * Ability to work independently and collaboratively in a team environment * Ability to maintain confidentiality and handle sensitive employee information with professionalism About Kootenai Health Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider. As your next employer, we are excited to offer you: * Kootenai Health offers comprehensive medical plan options, including options for fully paid employer premiums for our full-time employees. For part-time employees, we offer the same plan options with affordable part-time premiums. In addition to medical insurance, we offer many voluntary benefits ranging from dental and vision to life and pet insurance. Kootenai Health also offers well-being resources and telemedicine service options to all employees, regardless of benefit eligibility. Benefits begin on the 1st of the month following 30 days of employment. * Kootenai Health's tuition assistance program is available after 90 days. If you want to further your education, we'll help you pay for it * Kootenai Health sponsors retirement plans for employees that enable you to save money on a pre-tax and Roth after tax basis for your retirement. Kootenai Health will match your contributions based on years of service ranging from 3-6 percent. * Competitive salaries with night, weekend, and PRN shift differentials * An award-winning and incentive-driven wellness program. Including a MyHealth corporate team, onsite financial seminars, and coaching * Employees receive discounts at The Wellness Bar, PEAK Fitness, various cell phone carriers, and more * Employee referral program that pays you for helping great people join the team * And much more Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you! Apply today! Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex. #KHHP25

Research Data Associate (Bi-lingual), Infectious Diseases Schedule: 40 hours per week, Hybrid (3-5 days on-site per week) ABOUT BMC: At Boston Medical Center (BMC), our diverse staff works together for one goal - to provide exceptional and equitable care to improve the health of the people of Boston. Our bold vision to transform health care is powered by our respect for our patients and our commitment to ensure everyone who comes through our doors has a positive experience. You'll find a supportive work environment at BMC, with rich opportunities throughout your career for training, development, and growth and where you'll have the tools you need to take charge of your own practice environment. POSITION SUMMARY: The Research Data Associate (RDA) will support research studies and initiatives under the NIH-funded Massachusetts Community Engagement Alliance (MA-CEAL) Program. The RDA will coordinate administrative aspects of the study and will be responsible for coordinating their own travel arrangements to study sites. The RDA aids in analysis of qualitative data and supports the research team with the preparation of data and other reports. The RDA will interact with study subjects, research study coordinators, study investigators, community engagement specialists, work study students/interns and other research staff. The ideal candidate must be bilingual (Spanish/English). JOB RESPONSIBILITIES: * Provides assistance in the development of reports, presentations, and data analysis. Assists in qualitative and quantitative data collection and provides feedback on study's progress. * Recruits subjects to participate in the study by using approved methodologies. Schedules appointments of study participants; conducts reminder phone calls and/or sends mailouts. * Conducts the enrollment of study participants, including explaining research procedures, and obtaining informed consent of subjects and/or their families. * Attends off-site events for purposes of data collection, as needed. Events may be on evenings and/or weekends. Conducts qualitative interviews of study participants, employing best practices for qualitative data collection. * Reviews the data collection forms for each enrollee for completion and quality; aids in data entry, ensuring timely and accurate entry. * Works with translation service vendors to ensure timely and accurate translation of study materials and data, as needed. * Conducts literature searches. Assists Investigators with manuscript and presentation preparation and research. ADMINISTRATIVE: * Responsible for the administrative aspects of the research study, including: managing program records and handling communication needs of the program. * Prepares and maintains Institutional Review Board (IRB) approvals and correspondence, including amendments and renewals as necessary. * Performs office-related duties such as answering phones, picking up and delivering mail, ordering and distributing office supplies, handling faxes, scanning, filing, photocopying, collating materials, maintaining the update of policy manuals, etc. * Obtains and distributes payment vouchers for participant reimbursements/participation and may provide assistance in the development of reports, presentations, and data analysis. (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). JOB REQUIREMENTS EDUCATION: * Bachelor's degree is required. Major in a field related to the research is preferred. EXPERIENCE: * Prior experience in human subjects' research preferred. * Experience in qualitative and quantitative data collection preferred. KNOWLEDGE AND SKILLS: * Excellent English communication skills (oral and written). * Bilingual (Spanish and English). The ideal candidate must be fluent in Spanish * Cultural sensitivity and comfort with a wide range of social, racial and ethnic populations * Organizational ability to perform multiple tasks efficiently and to prioritize duties. * Proficiency with Microsoft Office applications including Word, Excel, and Access, PowerPoint, Outlook, database systems, and web browsers * Ability to perform basic data management tasks (data entry, data cleaning, retrieval). Ability to perform basic data analysis and reporting (in words, numbers and graphics). * Must have a productive and professional location to work remotely. JOB BENEFITS: * Competitive pay * Tuition reimbursement and tuition remission programs * Highly subsidized medical, dental, and vision insurance options * Career Advancement/Professional Development: Access a wealth of ongoing training and development opportunities that will not only enhance your skills but also expand your knowledge base especially for individuals pursuing careers in medicine or biomedical research. * Pioneering Research: Engage in groundbreaking research projects that are driving the forefront of biomedical science. ABOUT THE DEPARTMENT: As the primary teaching hospital for Boston University Chobanian & Avedisian School of Medicine and BU schools of public health and dentistry, intellectual rigor shapes our inquiries. Our research is led by a belief that skin color, zip code, and financial circumstances shouldn't dictate health. Boston Medical Center is an Equal Opportunity/Affirmative Action Employer. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to ************************* or call ************ to let us know the nature of your request. Compensation Range: $43,000.00- $62,000.00 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or "apps" job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

Housing and Community Support Specialist Department: Elders Living at Home Schedule: Full Time Boston Medical Center's Living Well at Home Program (LWAH) provides high-quality housing case management services to support clients in obtaining and maintaining tenancy and living healthy lives in independent housing. Boston Medical Center and its affiliated providers and Community Health Centers serve tens of thousands of patients who face housing issues or are experiencing homelessness. New initiatives across the health system have led to the expansion of LWAH services, including the formation of a new Community Support Program for Homeless Individuals. As part of the LWAH team, the Housing and Community Support (HCS) Specialist will provide case management services to high-risk patients with behavioral health diagnoses who are experiencing long-term homelessness. As a trusted member of the community, the HCS Specialist will help patients access and obtain and stabilizing in independent housing. HCS Specialists are responsible for engaging and enrolling complex patients into services; providing advocacy and case management services; providing specialty services to support a member in becoming “housing-ready” and supporting patients in the process of identifying and obtaining housing opportunities; supporting the development of an interdisciplinary care plan based on identified patient needs; facilitating access to social service resources; monitoring the patient's progress; and problem-solving with patients to both accelerate and enhance access to housing and community-based supports. As part of an interdisciplinary team, the HCS Specialists provides community-based one-on-one support in collaboration with family, social supports, and their health care team, both pre- and post-tenancy. JOB REQUIREMENTS EDUCATION: Bachelor's degree in a behavioral health or related field OR Two years of relevant work experience OR Lived experience of homelessness or behavioral health conditions CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: Driver's license and access to a car preferred. Will be required to complete community visits across Greater Boston region in a timely manner. EXPERIENCE: Minimum of 2 years prior healthcare, public health, or social services work in community-based setting Prior experience working with individuals experiencing homelessness preferred Prior experience working with individuals impacted by mental illness, substance use disorder, and/or chronic health conditions preferred KNOWLEDGE AND SKILLS: Basic knowledge of housing systems, and passion for serving individuals who are unhoused through a non-stigmatizing, patient-centered approach. Knowledge of community resources and healthcare systems commonly used by the patient population. Preference for individual with knowledge of Boston area resources specifically. Understanding of the social determinants of health impacting this patient population and importance in addressing them (housing, food insecurity, transportation, etc.). Outstanding interpersonal skills and ability to communicate in a courteous, pleasant, and professional manner with families and patients, staff, supervisors, and others. Ability to identify, communicate, and problem-solve issues in patient cases to improve overall care in support of patient goals. Ability to work both independently and as part of multi-disciplinary team. Demonstrated prudent judgement and professional presence and demeanor. Ability to adapt to changes in care delivery at local and systems level. Reliability, commitment to setting and meeting goals is a must. Exceptional organizational skills; ability to multi-task and prioritize tasks. Demonstrated oral and written English communication skills. Fluency in Haitian Creole or Spanish preferable. Understanding of how language, culture and socioeconomic circumstances affect health. Desire to work with diverse, multi-cultural and multi-lingual populations. Proficiency with Microsoft Office applications (i.e. MS Word, Excel, Access, Outlook) and web browsers. Proficiency with data entry and data tracking. SPECIAL WORKING CONDITIONS (Responsible for on-call, 24 hr. coverage, etc.): This role requires hybrid working conditions including community based outreach and home visits as well as office based work and some ability to complete work remotely at home. Compensation Range: $20.67- $29.81 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

Description Tumor Registrar Position Code: RegTumor-6175 Department: Cancer Center Safety Sensitive: YES Reports to: Director/Supervisor Exempt Status: NO - Available ONLY to Arizona Residents - Must be an Arizona Resident Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision of providing the region's best clinical care and patient service through an environment that fosters respect for others and pride in performance. Maintains a data system on patients diagnosed with malignancies. Retrieves, analyzes, and disseminates registry data in accordance with professional ethics. Key Responsibilities [List of material responsibilities and essentials duties which must be completed in achieving the objectives of the position] Level One: Non-Certified Tumor Registrar · Identifies and reports all cases of malignant disease gleaned from various resources within the medical facility where patients are diagnosed and treated. · Acts as a monitor for all cases of previously reported malignancies that are currently receiving cancer-related treatments within the medical facility. · Abstracts core information from patient's medical records including demographic characteristics of diagnosis, extent of disease and treatment within 6 months of diagnosis. · A resource of accurate data for cancer programs, administration and multiple research investigations. · Serves as a resource for department staff regarding questions, situations and/or problem solving. · Provides technical skills and is a resource for those individuals documenting cancer-related information. · Follows all living patients to obtain end-results information on the quality of life and length of survival per the American College of Surgeon's standards. · Produce disease index; identify, abstract and report all cases of malignant disease diagnosed within the facility according to the schedule set by ACR. · Follow-up included in abstract 5th day of odd months. 98% of the time based on supervisory observation. · Maintain registry statistics, annual reports, collection, preparation and reporting in a manner consistent with medical administrative, ethical, legal, and regulatory requirements. · Completes daily and weekly back-ups. · Demonstrates dependability and teamwork skills by following time clock procedures. · Completing assigned duties in a safe, cost-effective manner. · Controlling interpersonal differences; promoting cooperation with fellow employees. · Maintains confidential information. · Input from 2 to 4 Medical Records staff may be collected for review. · Utilizes time in between regular duties to assist others 80-95% of the time. · Attendance at mandatory department meetings and mandatory hospital meetings 85-90% of the time. · Prepares charts for physician review at tumor board. Assist physicians during review. · Attends tumor board meetings. · Completes all elements of the Commission on Cancer accreditation requirements associated with tumor registry under the direct supervision of a certified tumor registrar. Level Two: Certified Tumor Registrar · Meets all of the Level One requirements. · Provides direct supervision over non-certified tumor registrars. · Completes all elements of the Commission on Cancer accreditation requirements required to be completed by a certified tumor registrar. Qualifications [Statements regarding minimum educational and experience qualifications, required proficiencies with specialized knowledge, computer proficiencies, military service, required certifications, etc.] · Requires knowledge of medical terminology, anatomy, tumor nomenclature, classification systems, as well as cancer treatment modalities. · Must have awareness of ACOS and State requirements for an approved cancer program. · Must possess good organizational skills, attention to detail, and the ability to accurately decipher questionable handwriting through analysis and deduction. · Effective human relation skills are required for interfacing with all levels of contact. · Must have adequately developed interpersonal skills; work independently; demonstrate behaviors consistent with those identified as confidential and core behaviors set forth by this medical facility. Required Education: High school diploma or GED equivalent or college level education Required Experience: Level One : Minimum of 2 years' experience, or equivalent, in any medical related field Level Two : Minimum of 3 years' experience, or equivalent, in cancer registry field Certification: Level Two : Certified Tumor Registrar (CTR) Preferences [Preferred attributes for the position which are not absolutely required in the minimum qualifications (i.e., multi-lingual, master's degree)] Special Position Requirements [Optional section: any travel, security, risk, hazard or related special conditions which apply to the position] Exposure Categories: · Category II: Expected duties have possible, but not routine, potential for exposure to blood, body fluids or tissues · Other Potential Hazard(s): Possible exposure to hostile individuals Work Requirements [Optional section: work requirements for physical or other important issues which relate to the job] · Must be able to speak, read and write English. · Perform basic mathematical calculations. · Meet deadline requirements of projects assigned. · Work is performed in an office environment and/or remotely. · Ability to accurately interpret medical terminology and statistical data. · Ability to interact efficiently with physicians and multidisciplinary team members utilizing effective verbal and communication skills. · Basic knowledge of computer, printer, photocopier, fax machine, calculator, telephone and answering machine. · Position requires sedentary work, occasionally lifting 10 lbs. and carrying small objects short distances. · Ability to site at a computer terminal 6 to 8 hours a day. · Regularly needs to bend, stoop and reach to file charts.

UPMC Health Plan has an exciting opportunity for a Clinical Auditor/Analyst Intermediate! The Clinical Auditor/Analyst Intermediate is an integral part of the Special Investigations Unit (SIU) and is responsible for conducting clinical audits and reviews regarding the analysis of care and services related to clinical guidelines, coding requirements, regulatory requirements, and resource utilization. This role also acts as a SME for the department in representing management in meetings, training new staff and auditing peers. Collects program data to monitor/ensure compliance requirements and establishes and revises better best practice within the department. The Clinical Auditor/Analyst Intermediate creates, maintains and analyzes auditing reports related to their assigned work plan and communicates the results with management. Other responsibilities include but are not limited to analysis of controlled substance prescribing and utilization to identify potential clinical care issues; prepayment review of claims, and prepayment review of unlisted codes. Claims analysis and the use of fraud and abuse detection software tools will be an integral part of the function of this position. Responsibilities will involve working in collaboration with appropriate Health Plan departments including Quality Improvement, Legal, and Medical Management to facilitate the resolution of issue or cases. Responsibilities may involve multiple line of business focused reviews, or ad hoc reviews as needed; analysis of billing by providers/physicians, and providing trending, analysis and reporting of auditing data. The Clinical Auditor/Analyst Intermediate will routinely interact with providers, law enforcement and/or regulatory entities in the course of their duties. Responsibilities: + Respond to fraud, waste, and abuse referrals and/or complete data analysis and related audits as assigned. + Utilize fraud detection software to assess and monitor for potential FWA. + Review and analyze claims, medical records and associated processes related to the appropriateness of coding, clinical care, documentation, and health plan business rules. + Provide a clinical opinion for special projects or various issues including appropriate utilization of controlled substances, prescribing of controlled substances, or medically appropriate services. + Query medical and/or pharmacy claims and conduct a risk assessment by performing data analysis and applying applicable coding guidelines, Health Plan policies and any applicable National Coverage Determination (NCD) or Local Coverage Determination (LCD). + Evaluate referrals from Pharmacy Benefit Manager (PBM) by analyzing medical and pharmacy claims and associated clinical documentation in HealthPlaNET, Mars, Epic and/or Cerner. + Complete audits by utilizing standard coding guidelines and principles and coding clinics to verify that the appropriate CPT codes/DRGs were assigned and supported in the medical record documentation. + Attend in person or virtual recipient restriction hearings. + Review Medical Pended Queue claims to understand and resolve claim referral issues through research and interaction with other Health Plan Departments including Medical Management, Medical Directors, various committees, and other appropriate Health Plan departments. + As necessary, assist in the development of new policies concerning future Health Plan payment of identified issue. + Assess, investigate and resolve complex issues. + Write concise written reports including statistical data for communication to other areas of UPMC Health Plan and to communicate with department heads for identification of various problem issues, how they affect the Health Plan, and to make recommendations for resolution of the issue. + Identify error trends to determine appropriate training needs and suggest modifications to company policies and procedures. + Conduct provider education, as necessary, regarding audit results. Communicate effectively with Medical Directors and ancillary departments as necessary to address issues and concerns. + Participate as needed in special projects and other auditing activities. Provide assistance to other departments as requested. + Understand customers including internal Health Plan Departments (i.e. Claims staff, Customer Service, Marketing, etc.) and external customers (i.e. Health System Internal Audit, Client Audit teams) to understand issues, identify solutions and facilitate resolution. + Serve as an SIU representative at internal and external meetings, document and present findings to SIU Staff and document as appropriate in the SIU FWA Case Management Database. + Assist in the development and revision of SIU policies and procedures. Identify trends for improvements internally, such as claims payment, to determine appropriate training needs and suggest modification to company policies and procedures. + Perform audit peer reviews for Clinical Auditor/Analysts. + Provide new-hire training to Clinical Auditor/Analysts. Performing administrative appeals/preparing medical necessity appeals for Medical Directors for second level appeals. Participate in training programs to develop a thorough understanding of the materials presented. + Obtain CPE or CEUs to maintain nursing license, and/or professional designations. + Design and maintain reports, auditing tools and related documentation. Maintain or exceed designated quality and production goals. Maintain employee/insured confidentiality. Registered Nurse (RN). Bachelor of Science in Nursing (BSN) or the equivalent combination of education, professional training and work experience. Five years of clinical experience. Three years of fraud & abuse, auditing, case management, quality review or chart auditing experience required. Ability to analyze data, maintain designated production standards, and organize multiple projects and tasks. In-depth knowledge of medical terminology, ICD-10 and CPT-4 coding. Knowledge of health insurance products and various lines of business. Detail-oriented individual with excellent organizational skills. Keyboard dexterity and accuracy. High level of oral and written communication skills. Proficiency with Microsoft Office products (Excel, Access, OneDrive, OneNote and Word). Licensure, Certifications, and Clearances: AAPC or AHIMA Certified (CPC, CPMA, CIC, CCA, CCS, CCS-P) or AHFI designation required. + Registered Nurse (RN) + Act 33 with renewal + Act 34 with renewal + Act 73 FBI Clearance with renewal *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

The Pharmacy Patient Liaison is a unique role that provides integrated support to patients and pharmacists by providing a 'hands-on' approach to total quality patient care. This position is considered essential to the growth and maintenance of the specialty pharmacy business line and is considered at the core of supporting health system operating margin. This hybridized role is a unique combination of patient service delivery and business performance. The Pharmacy Patient Liaison works closely with patients to deliver a full continuum of medication adherence support by utilizing BMC's various tools and applications. The Pharmacy Patient Liaison is responsible for providing technician pharmacy services with an emphasis on performing assigned tasks that require working independently with assigned tasks and increased competency skills relating to patient medication therapy. Position: Pharmacy Patient Liaison Department: Pharmacy-Amb Care Specialist Schedule: Full Time ESSENTIAL RESPONSIBILITIES / DUTIES: Care Center Operations Make outbound calls to patients for medication confirmation and address verification. Answer inbound calls in a timely and friendly manner. Evaluate problems and complaints of the callers and provide proper solutions to them. Respond to the needs of customers and provide personalized service. Provide information on the company's services and generate interest if appropriate. Research needed information using available resources Process orders, forms, and applications such as initiating prior authorizations, copay assistance or connecting patient with financial services Route calls to other team members whenever appropriate Make relevant notes from customer interactions. Identifying any pharmacy related issues that customers might be struggling with or need guidance for. Report on customer feedback Follow-up on customer calls and voicemail Boost customer loyalty by offering exceptional care and a positive experience over the phone Under the direct supervision of leadership, supports the department in the ethical practice of pharmacy on a daily basis by providing effective, appropriate, and safe pharmacy services. Exemplifies the creation and maintenance of a healthy work environment. A healthy work environment is one where each member of the team feels supported and held accountable for their actions based on clearly defined standards and expectations. Conducts interpersonal communications and assistance with patients, visitors, physicians, and fellow team members in a courteous and friendly manner. Refers patients and visitors to pharmacist or manager on matters requiring their attention. Greets customers and provide a positive customer service experience and service recovery conflict resolution when appropriate; assist customers with their questions, problems and complaints in person and via the phone in professional manner; obtains information for new prescriptions, while maintaining customer / patient confidentiality. For prescriptions related inquiries offer a pharmacist consult. Refer all clinician and customer clinical questions to a pharmacist as appropriate. Communicates to pharmacists and/or pharmacy manager on the maintenance and malfunctioning of equipment and unsafe working conditions. Performs the packaging and shipping preparation steps of mailing prescriptions to patients with accuracy. High level functioning individual with an ability to perform assigned and responsible tasks independently. Patient Relationship Development- Responsible for managing and growing ambulatory pharmacy services driven through BMC Health System Patient Retention Retention of patient business is essential for growth and thus is measured as closely as the sales and recruitment functions of patient liaisons Build relationships with patients by providing friendly, courteous and efficient service Provide outbound therapy/medication adherence check-ups by process refills to ensure no gaps in refills/treatment Work closely with patients to deliver a full continuum of medication adherence support by utilizing our various tools and applications Encourages patients of clinics to utilize BMC pharmacy to fully benefit from its superior patient care services Personnel Responsibilities - Responsible for building and maintaining relationships with provider, care teams, and ancillary support necessary to sustain sales and recruitment functions Internal Relationships Developing and growing trusting relationships with providers and hospital staff to provide highest level of care for a complex patient panel Maintaining and supporting pharmacy interdepartmental relationships and management to ensure seamless transition of patient care from clinic to pharmacy External Relationships Developing and growing trusting relationships with patients to provide highest level of care Operational Responsibilities - Technical savvy, communicating at all levels of the hospital organization and problem solving are required Navigate patient Electronic Medical Record (EMR) to effectively answer questions and/or provide documentation as needed for prior authorizations Communicate with providers (Doctors, Nurses, Clinical Pharmacists) in person, over the phone, and through written transmission via EMR in a timely and professional manner Communicate with Specialty Pharmacy Management, Medical Directors, and Practice Managers to provide support for new and ongoing hospital initiatives Resolve high level patient care issues and situational awareness around when to involve managers and/ or clinicians Demonstrate resourcefulness in the face of challenges and providing workable solutions to complex problems Capacity to work independently by managing workload and meeting established goals in a fast paced environment Train and support new staff in understanding and learning the expectations for day-to-day operations in a specific role OTHER DUTIES: Possess competency to train/mentor other technician team members and become involved in staff development. Possess competency and a willingness to participate in special projects and tasks as assigned/appropriate by management. Must adhere to all of BMC's RESPECT behavioral standards. (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). JOB REQUIREMENTS EDUCATION: Requires a high school diploma (or state accepted equivalency). AA or BA preferred CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: Must be currently registered as a Pharmacy Technician with the Board of Pharmacy in Massachusetts. Pharmacy Technicians must have current active National Certification verified by PTCB EXPERIENCE: Must have 4-5 years' of pharmacy experience KNOWLEDGE AND SKILLS: Excellent English oral and written communication skills required; as well as ability to communicate professionally over the phone. Excellent interpersonal skills to provide superb personalized customer service and to instill confidence and to advocate for patients; ability to explain required information to customers in a comprehensible manner. Other professional skills and qualities: organized, strong attention to detail, ability to self-direct through multitasking and prioritizing, dependable, empathetic, focused on quality service, goal oriented. Cultural sensitivity, understanding, and comfort with a wide range of social, racial and ethnic populations. Must practice discretion and confidentiality as position deals with highly sensitive and private data. Ability to understand, explain, and actively promote the hospital's objectives through direct coordination and commitment to the program's goals. Flexibility to adapt to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc. Highly proficient in Microsoft Office particularly Excel, Word, and Outlook. Ability to quickly learn other relevant applications that support management of patient care and assigned responsibilities; and ability to extract necessary information. Additional preferred qualifications: Knowledge of weight loss medication therapies preferred. Bilingual or multi-lingual skills (beyond that of English) appropriate to the patient population served is a plus. Experience with submission of prior authorization requests to third party payors Familiarity with 340B drug program and ACO hospital models. Knowledge of QS1/NRx, EPIC, Salesforce, Navinet As part of the employment screening process employees hired into this role must pass a drug screen. Compensation Range: $22.36- $31.25 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

The UPMC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director, Utilization Management role. The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. They will be responsible for assuring physician commitment and delivery of comprehensive high quality health care to UPMC Health Plan members. They will oversee adherence to quality and utilization standards through committee delegations and further establish an effective working relationship between UPMC Health Plan's Network and its physicians, hospitals and other providers. UPMC offers a premier benefits package, designed to care for your total well-being - physically, emotionally, and financially - paired with endless opportunities for career advancement and growth. Discover the culture, the teams, and the passions that drive us to make Life Changing Medicine happen. _This is a full-time and full remote role._ Responsibilities: + Provide leadership direction for provider credentialing processes. + Physicians must devote sufficient time to the CHC-MCO to provide timely medical decisions, including after-hours consultation, as needed + Provide leadership and direction in meeting Quality Improvement and Care Management goals directed at improvements in member health status outcomes and established business strategies. + Provide expedited review and determination of medically pressing issues in accordance with the established policies of the Health Plan. + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and retrospective reviews, member grievances, provider appeals, and potential quality of care concerns. + Keep current with accepted standards and professional developments in the areas of quality improvement and utilization management. + Communicate and educate network providers regarding clinical guidelines, pathways, protocols, and standards related to quality and utilization processes. + Responsible for reporting the communication of reportable communicable diseases in accordance with statute. + Interacts with physicians regarding opportunities to improve member satisfaction and compliance with Utilization Management and Quality Improvement policies and procedures. + Work with the DOH State and District Office Epidemiologists in partnership with the designated county/municipal health department staff to appropriately report reportable conditions in accordance with 28 Pa. Code 27.1 et seq. + Daily interventions support implementation of the Health Plan's Quality Improvement and Care Management Programs. + Represent the Health Plan in external accreditation and certification activities. + Act as first level physician reviewer for all cases referred by the Quality Improvement and Care Management Departments. + Daily activities support adherence to quality and utilization standards, and establish an effective working relationship between UPMC Health Plan's Network and its physicians, hospitals and other providers. + This position requires a Doctor of Medicine or Doctor of Osteopathy from an accredited school + PA Medical license Required + The ideal candidate will have 5-10 years of clinical experience, as well as managed care experience + Internal Medicine, Family Medicine, or Emergency Medicine highly preferred Licensure, Certifications, and Clearances:Doctor of Medicine (MD) OR Doctor of Osteopathic Medicine (DO) UPMC is an Equal Opportunity Employer/Disability/Veteran

Under the supervision of the Outpatient Pharmacy Manager and according to department policies, procedures, and guidelines, the outpatient/retail Technician III is responsible pharmacist/technician training as applicable; return to stock (RTS) and refill calls process maintenance; maintaining, accessing, improving, and control the efficiency of pharmacy automation devices; and other related duties for the purpose of providing high quality patient focused pharmacy services. Position: MMH Technician III Department: Pharmacy HUB Services Schedule: Full Time, No weekends ESSENTIAL RESPONSIBILITIES / DUTIES: Assists the pharmacist in providing effective, appropriate, and safe pharmacy services: Maintains appropriate records and documentation. Maintains all work environments in a clean and orderly fashion. Maintains good telephone communication skills. Ensures all work is checked by a pharmacist. Attends and participates in all appropriate department programs and committees. Remains informed by reading all department communications which includes maintaining a working knowledge of pharmacy protocol, policies and updated procedures. Reports to the pharmacist or their supervisor the finding of malfunctioning equipment, and unsafe working conditions. Maintains a high level of proficiency on systems/applications as related to the outpatient/retail operations; Script-Pro, Innovation-RobotX, RxSafe, PickPoint, QS/1-NRx, and RxASP/Dispill. Also, has above basic proficiency in Microsoft Excel, Power Point, Access, Word, etc. Performs all department required quality assurance responsibilities as assigned. Maintains own professional and specialized competency through continuing education. Ability to work independently. Conforms to hospital standards of conduct so that the best possible customer service and patient care may be provided: Maintains confidentiality at all times. Supports the service needs of the pharmacist relative to pharmacy services and maximized patient care outcomes. Provides performance improvement documentation, charts, etc. to support progress and efficiency relating to training programs, automation, systems, etc. Utilizes hospital's Values as the basis for decision making and to facilitate the division's hospital mission. Follows established hospital infection control and safety procedures. Reports to the pharmacist or his/her supervisor the finding of malfunctioning equipment. Must demonstrate annual proficiency to perform tasks relating to the systems and applications within the outpatient pharmacy department. Provides orientation and training for pharmacists, technicians, and students as assigned. As assigned will provide training to Pharmacy Technicians I and II. May be responsible for managing and growing employee prescription capture to meet monthly goals, annual growth and annual targets for the retail and specialty pharmacy population. Performs other duties and projects as needed such as lead QA projects, scheduling and others established by the department director as needed. JOB REQUIREMENTS EDUCATION: Requires a high school diploma or equivalent. Associate's Degree or Bachelor's Degree preferred. CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: Must be registered as a Pharmacy Technician with the Massachusetts Board of Pharmacy or have a Massachusetts Pharmacy Intern License. Certified Pharmacy Technician (CPhT) required from Pharmacy Tech Certification Board (PTCB) or Exam of Certified Pharmacy Techs (ex CPT). EXPERIENCE: Requires minimum of four years of related experience. KNOWLEDGE AND SKILLS: Requires excellent interpersonal skills, telephone communications skills and pharmaceutical calculation skills. Must be able perform at a high level in all aspects of outpatient pharmacy operations and must maintain competency in all areas of outpatient pharmacy. Compensation Range: $24.28- $35.10 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

UPMC Health Plan has an exciting opportunity for a Compliance Specialist position in the CHC Compliance department. This is a full time position working Monday through Friday daylight hours and will be a hybrid shift consisting of working from home and in office. The UPMC Insurance Services Divisions (ISD) Corporate Compliance and Ethics Program serves to promote the highest degree of ethical and lawful conduct throughout the organization by examining, evaluating, and coordinating processes that demonstrate compliance with applicable federal, state and local laws, rules regulations. The position incumbent will work alongside UPMC's Compliance Officer and the Compliance Committee to ensure that our organization's insurance practices meet applicable regulatory requirements and assist mitigating risks within our health insurance operations. The ideal candidate must be self-motivated, comfortable working independently, and eager to take initiative. Responsibilities: The Compliance Specialist, reports to management within the Department. This position strategically works to ensure compliance with all relevant and applicable federal, state and contractual requirements and standards in a manner that continually supports the business and operational areas. + Assist in the development of clear, effective and timely reports and updates for senior management and/or the Board regarding Compliance Program effectiveness, initiatives and issues, including all relevant metrics, dashboards, and information. Work with Program Leadership to complete regular gap analyses, risk assessments and program effectiveness assessments for the Compliance Program. In a timely manner, develop, assess and adapt clear and effective Compliance policies, procedures, training, communications, controls and initiatives to promote clear and consistent understanding and practice throughout internal operations. Participate in Policy and Procedure reviews by verifying for accuracy and making edits as appropriate. + Develop, assess and adapt clear and effective remediation and corrective action initiatives, protocol and control to ensure proper and timely compliance. Support UPMC Insurance Services Division (as applicable), updating audit documents, and reviewing materials prior to submission. + Ensure strategic and operational partnership and collaboration with the business, operational and additional compliance areas to leverage cross-departmental synergies and efficiencies. + Keep abreast of changing industry requirements and regulations, including all relevant laws, industry standards, and company practices and initiatives. Provide to the business teams applicable compliance analysis and work products associated with regulatory product filings, proposal development, statutory reporting and service area expansions. Responsible for the accurate communication of contractual requirements and guidance throughout the health plan, as well as the internal coordination of compliance activities. This includes disseminating requirements and regulations to the appropriate UPMC Insurance Services Division staff and research any inquiries received in a timely manner. Coordinate participation of various health plan subject matter experts in periodic meetings impacting the health plan's ability to comply with the contract and program requirements. + Represent UPMC Insurance Services Division with all relevant regulatory agencies and Compliance reviews, investigations or requests for information. Work with Program Leadership to conduct annual and ongoing compliance training to UPMC Insurance Services Division staff and applicable parties. + Effectively lives, models, communicates and supports the values of UPMC and UPMC Health Plan. + Performs in accordance with UPMC System-wide competencies and behaviors. + Bachelor's degree required. + Relevant graduate degree (e.g. Master's degree in a related field or Juris Doctor) is a bonus. + Five years of compliance experience, compliance experience, and/or legal experience, preferably on the insurance (payer) side preferred. + Pennsylvania-specific compliance experience preferred.Licensure, Certifications, and Clearances: + Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

UPMC is looking for a Network Convergence Engineer -Intermediate to join their team. This position will be primarily ON-SITE, you will work 4 days a week ON-SITE and get 1 day a week to work remote/from home. We are targeting local candidates in and around the PA area. Description The Converged Network Engineer - Intermediate works closely with all UPMC departments and business units, ISD departments and/or groups, as required, to meet business objectives, resolve problems, provide technical assistance in accordance with assigned responsibilities, and when necessary, coordinates with other telecommunications resources in carrying out the assigned responsibilities. This position also interacts with vendors and suppliers. Responsibilities: + Functions in an upper level position, with responsibility for timely service delivery as well as project management. + Work on medium to large-scale projects in addition to providing services, as determined by the management team. + Possesses advanced knowledge of the PBX system, voice mail and wiring support design and function. Provides technical assistance to departmental personnel, clients, vendors, and other parties as assigned. + Interfaces with others on system infrastructure problems and advises management on technical problems, priorities, and methods. + Contributes to systems infrastructure plans based on an understanding of the customer's organizational direction, technical context and business needs. + Participates in day-to-day orders, Special Projects, and trouble tickets to include Move, Add, and Change requests for the data and/or voice network. + Contributes to the creation of new policies and procedures for Maintenance Plan and Continuity of Operations Plan. + Provides network performance statistics and reports and recommends technical enhancements to the network. + The Converged Engineer - Intermediate is responsible for handling and working in all aspects of the UPMC Enterprise Communications Group. This includes responsibilities on the telephony systems, PBXs, data networks, wireless networks, and data network infrastructure. Converged Network Engineers are responsible for using Nokia, Cisco, Alcatel-Lucent, and Avaya products, as well as a working knowledge of encryption solutions, private branch exchanges (PBX), and local and wide area networks and wireless networks (LAN/WAN/WLAN). + Reviews, organizes, communicates and records all requests for voice services. + Responsible for creating, managing, tracking, and reporting the status of assigned projects, using the specified project management software. Coordinates, with other Engineers in the delivery to telecommunications and networking services. + Reviewing, organizing, communicating and recording requests for Telecommunications systems, including adds, moves and changes on PBX, Voice Mail, Networking, wiring support, and maintenance of all voice related databases at UPMC and affiliated business units. + Constructs, tests and implements integrated network, hardware and software solutions, distributed computing solutions, and/or physical and logical communications networks for the customer. + Researches, evaluates and stays current on emerging tools, techniques and technologies. + Responsible for the day to day maintenance and support of the data communications equipment and systems within UPMC and affiliated business units for connectivity requests and/or reported problems. + Ensures customer satisfaction with the resolution or circumvention of hardware, software, and/or circuit problems including the assessment of bandwidth requirements based upon empirical data. + Configuration of data communications devices, design and implementation of local and wide area networking, problem determination knowledge in these areas. Qualifications * Typically has 2+ years of converged communications infrastructure design and support experience. * Required Experience/Skills/Attributes: o Experience conducting site surveys and organizing the documentation into an Engineering Plan. o Up-to-date Avaya voice product experience. o Up-to-date PBX experience. * Hands-on skills to include: o Aura Communication Manager, ACD call center, CMS, unified messaging, SIP/H.323 trunking, SIP services, G430/450, S8800. o Intermediate to expert level skills required in networking to support converged applications including voice/video/WLAN Strong interpersonal, written and oral skills. o From time to time, candidates may be asked to present project outline to customers. o Ability to conduct research on products with various vendors to accommodate changing customer requirements. o Ability to work in a team-oriented collaborative environment while being highly motivated to take the lead on projects. * Desired Experience/Skills/Attributes: o Experience with Microsoft products including Windows 2000 Server, Active Directory, and Exchange Unified Messaging would be a plus. o Experience with Cisco Enterprise solution products. o Understanding of Cisco router, switch, and ASA products. o Ability to troubleshoot access-lists, IPv4 and IPv6 issues across varying protocols such as OSPF, BGP, and Static Routing. o Hands-on administration experience with Linux/Solaris Licensure, Certifications, and Clearances: Act 34 Preferred Licensure: CCNA - Cisco Cert Networking Assoc NRS1 - Nokia Ntwrk Routing Spec I ACIS - Avaya Cert Integration Spec ACCA - Avaya Call Center Admin CXTECH - AVST Certified CX Tech SBCADMIN - Avaya SBC Admin ITIL - IT Infrastructure Library UPMC is an Equal Opportunity Employer/Disability/Veteran

University of Pittsburgh Physicians is hiring a Full-Time Medical Education Program Academic Manager to help support the Internal Medicine Residency, Department of General Internal Medicine. Hours: Monday-Friday, 8:30 am - 4:30 pm. No evenings or weekends. Location: UPMC Presbyterian Hospital, typically one day WFH per week. Department Details: Working in a Graduate Medical Education department offers a unique opportunity for personal and professional growth in a collaborative working environment working closely with physician teaching faculty, residents/fellows and other departments. Graduate Medical Education career path can lead to career growth and leadership roles within various academic settings. Flexible and remote work options available dependent on academic calendar. Responsibilities: + Utilize Residency Management system (MedHub) to complete various tasks. Tasks may include entering rotation schedules, documenting PTO, LOAs, etc. in lieu of Kronos, monitoring work hour submissions by residents/fellows, uploading required program documentation and policies, maintaining trainee specific credentialing documentation, etc. + Prepare and maintain documentation related to program accreditation requirements (e.g., ACGME, ASHP, CODA or CPME) as well as specialty board requirements. Monitor completion of annual update submissions (e.g., WebADS Annual Update, ACGME milestones, ACGME Resident/Fellow and Faculty Surveys, AMA FREIDA). + Coordinate and maintain documentation pertaining to the UPMC Medical Education Annual Program Oversight Review (APOR) and anticipated required documents that will be requested during accrediting body Site Visits. + Monitor the management of trainee, rotation, faculty, and program evaluations. o Ensure trainees receive documented evaluations at the end of each rotation. If rotations are longer than three (3) month periods, a trainee must have documented evaluations at a minimum of every ninety (90) days. + Coordinate Program Evaluation Committee (PEC) and Clinical Competency Committee (CCC) meetings including scheduling, preparing agenda, meeting materials, program/trainee evaluation analytics, and meeting minutes. + Develop and maintain program recruitment resources such as brochures, PowerPoint presentations, websites, and other social media outlets as necessary. Maintain skills and knowledge needed to remain competitive and support recruitment efforts in a primarily virtual landscape. + Construct productive working relationships and act as a liaison between trainees, program directors, hospital administration, UPMC ME central team, additional internal departments, staff, and other hospitals, as necessary. + Regularly attend UPMC ME sponsored meetings and retain knowledge of information presented for updates to process change and adjustments in work requirements. + Manage the planning and execution of live/virtual meetings, conference, lectures, and other events including recruitment, orientation, and program celebrations. Organize, prepare, and distribute materials as needed. + Provide UPMC ME with information on incoming trainees required in the credentialing process, for issuance of a new hire contract and paperwork (including but not limited to items such as licensing, visas, and clearances). Communicate with incoming residents/fellows to ensure timely submission of documentation for hire. Complete all program specific tasks associated with hire (e.g., computer access requests, parking applications, office/phone assignments) and partner with program leadership to provide program specific new hire orientation. + Submit confirmation of trainee termination (including program completion) to UPMC ME including processing requests for completion certificates, collection of UPMC property (e.g., identification badges, laptops, pagers). + Process expense submissions for the trainees and department and track utilization of program specific funds. Submit documentation for supplemental pay processing as necessary for Clinical Skills Enhancement (CSE) Activities. + Serve as supervisor for UPMC compliance oversight for trainee employment including but not limited to mandatory module complete, employee health reporting requirements, expense approvals, etc. + This position involves high level administration in Department of Medicine academic affairs. + Responsible for management of General Internal Medicine residency and fellowship training programs. + Ensures and oversees GIM Training programs maintaining compliance with residency and fellowship program accreditation policies and annual training requirements and that are consistent and compatible with those adopted by the University of Pittsburgh Medical Center, University of Pittsburgh Medical Center Medical Education Program, University of Pittsburgh Physicians, UPMC Hospital and other accreditation organizations. + Responsible for all aspects of the residency and fellowship applicant interview process with file management via the Electronic Residency Application Service, including process improvement. + Oversight and audit appropriate data systems for residency and fellowship program assessment, accreditation, and reporting, including trainee entry in the Accreditation Council for Graduate Medical Educations OP Log (procedure reporting), online evaluation system, resident work hour entry into the UPMC Graduate Medical Education ROCS system, and others. Facilitate submission of all documents for and monitors maintenance of appropriate licensure, visas and certification of residents/fellows. + Maintain budgets and tracking related to trainee stipends and expenditures. + Serve as liaison with program directors, trainees, and GME leadership. + High School or equivalent and 4 years of Medical Education experience + OR a Bachelor's Degree and 2 years of experience in Medical Education required Licensure, Certifications, and Clearances: + Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

UPMC Community Care Behavioral Health is seeking a full-time Community Health Worker to support the Allegheny County Care Management Department as part of the Community Based Care Management Team! The Community Health Worker will work daylight hours, Monday through Friday, in a hybrid work structure! This role will primarily be out in Allegheny County and surrounding areas, visiting members at community organizations, provider locations, shelters, private residences, and so on to support member needs. This role will also be able to work remotely when not out in the community, with limited office time at the US Steel Tower for occasional meetings, as well as only limited evening and weekend event opportunities. Work arrangements are subject to change at any time. The Community Health Care Worker (CHW) will work directly with individuals receiving services, family members, providers and other stakeholders, at the direction of a supervisor. This position requires the candidate have close understanding of the community they serve. This trusting relationship enables CHWs to serve as a liaison link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. We recognize CHWs build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, social supports and advocacy. To fill this position we will recruit a seasoned person who has expertise in issues such as housing, transportation, peer support, informal counseling, career training, and social supports. The CHWs will provide care coordination services to address health needs of individuals enrolled in the program. This position will include telephonic and face to face contact with individuals receiving services, family members, and other stakeholders to engage in problem solving and referral strategies; community based services; resources for housing and resources available to members to promote recovery. The CHW also represents the organization to the general public, individuals in, and seeking, recovery, family members, and to stakeholder groups. Title and salary will be determined based upon education and Community Health Worker experience for Sr. Community Health Worker within Community Care Behavioral Health. Responsibilities: + Flexibility in schedule to meet members' need + Provides telephonic assistance to members and family members concerning recovery tools and resources + Engage the community to improve underlying social and economic conditions that impact health + Assist in scheduling appointments as needed + Identifying challenges a member faces in the Eight Stages of Wellness and Recovery + Connect the member to community-based treatment and recovery supports. + Travel throughout the region + Mobilize the community level to enhance provider understanding of community needs and preferences + Advocate for the members' community needs, medical and behavioral health needs + Empower the member to self-advocate and follow through with treatment (making and attending scheduled appointments, setting goals, and community networking) + Represents Community Care's and UPMC Health Plan recovery and transformation at all levels + Utilize motivational interviewing to effectively identify the member's strengths, needs, motivation, triggers, and goals in managing life circumstances. + Collaborate with Community Care and UPMC Health Plan Care Management staff, as needed, for interventions + Promotes principles of recovery with members, providers, and stakeholders + Bridge the gap between the physical health care and behavioral health treatment + Work in the community setting at least 80% of the time, to have direct contact with members, support teams, treatment providers and recovery supports + Assist members with specific non-medical needs that affect health and access to care + Proof of high school graduation or GED + 1 year providing customer service, clinical, social service or case management experience in the community required + Behavioral health experience highly preferred. + Has own vehicle + A person in the community who has expertise in issues such as housing, transportation, peer support, career training and community education. This person will also be working with members that have concurrent medical difficulties. + Ability to develop rapport and demonstrate good interpersonal skills + Knowledge of basic mental health systems and co-occurring substance use issues, substance use recovery issues and services, education, social services, medical systems, etc preferred + Personal or family experience in the health care system preferred + Knowledge of key concepts and principles (recovery, resiliency, and wellness) + Demonstrate ability to work with other people through a cooperative effort + Ability to utilize motivational interviewing Ability to model and share the recovery principles: Hope, Personal Responsibility-Empowerment Skills, Self-Advocacy, Educational Opportunities, and use of Community supports + Basic computer skills and familiarity with Microsoft products + Good verbal and written communication skills + Willingness to travel throughout our service area + Solid organization skills and ability to set priorities and schedule time efficiently + Self-directed and flexible to meet the needs of our members + Value for and ability to deliver excellent customer service Licensure, Certifications, and Clearances:UPMC is an Equal Opportunity Employer/Disability/Veteran

Schedule: No Call Elective Only - Primarily OR with some Clinic days Hiring Incentive: $50,000 Starting Bonus • No Call. This is a strict elective program • Some days in the clinic and most days in the OR • We have 3 APPs that support surgeons • Program will expand next year as we open a new Specialty Hospital • $71/per RVU incentive - RVUs above threshold paid as a quarterly bonus • Some of the follow-up will be done by Ortho Surgicalists or Ortho on Call for the hospital • Dedicated OR blocks • Use of Robot available when needed About Kingman Regional Medical Center Located in the high desert of Northwestern Arizona along Historic Route 66, Kingman is about 90 minutes south of Las Vegas and two hours north of Phoenix. Kingman Regional Medical Center (KRMC) is the largest healthcare provider and the only remaining non-profit hospital in Mohave County, Arizona. As a 235-bed multi-campus healthcare system, our medical center has almost 2,000 employees, over 300 physicians/allied health professionals, and 150 volunteers. Recognized as an innovator in rural healthcare, KRMC is Arizona's first rural teaching hospital, and provides a full continuum of highly technical and specialized medical services to meet the healthcare needs of our growing community. Benefits Medical, Dental, Vision, and Paid Time Off 403b and 457b with matching contributions Hospital provided liability insurance coverage Reimbursed expenses for professional licenses, memberships and CMEs + additional paid time off for CMEs Free membership at our on-site Wellness Center with fitness classes, personal training, indoor pool, racquetball and basketball courts On-site Learning/Child Care Center exclusive to the children of KRMC employees Recognized as a Health Professional Shortage Area (HPSA) which benefits some Physicians and Advanced Practitioners with federal and state funded student loan forgiveness programs. For more information please go to: *************************************************************************** And many other great benefits available to you at Kingman Regional Medical Center! Qualifications Doctor of Medicine or Osteopathy degree from an accredited medical school Successful completion of residency program in area of specialty BC / BE Must possess a current license to practice medicine in the state of Arizona Fellowship trained in trauma, joints, or sports medicine is preferred

While this position will collaborate closely with UPMC, it will be a contract role employed by Strategic Consulting Partners (SCP). The Care Manager Associate (CMA) position will be part of the UPMC Health Plan's Community Services Community Paramedic Team. The team expands paramedic roles from emergency care to a focus on non-emergent and preventative health services tailored to individuals' needs and goals. The CMA will begin their journey in mobile care management while helping resolve members' SDOH issues, develop a community resource knowledge-based understanding while collaborating with multidisciplinary resources and providers, and manage referrals using administrative skills for the Health Plan's one of a kind's homebound vaccination program. All this significantly positively impacts members' health and well-being. The CMA works business hours in a hybrid work structure, with minimum weekend, after hours, or holiday coverage as needed by the department. This is a flexible community-based position that requires travel to hospitals, provider sites, and member residences within Allegheny County. After the successful completion of orientation and training, this role works remotely when not out in the community! In collaboration with the Community Paramedic team the CMA coordinates the appropriate support services and resources throughout the Community Services Team at UPMC Health Plan to facilitate effective care plans that achieve optimal satisfaction, and clinical, and financial outcomes along the defined continuum of care. Through the CMA's collaborations, practical comprehension and hands-on experience in clinical care/utilization management will result by collecting and assisting with face-to-face documentation for complex care management assignments. This opportunity will also build on communication and administrative skills during vaccination season by supporting the homebound vaccination processes. The Health Plan Community Services Team is a multidisciplinary team providing mobile face-to-face interactions in the community to address any physical or behavioral health conditions and/or social determinants of health needs that might be negatively impacting the health and well-being of their members. The Community Services team is composed of several smaller specialized teams that provide intense case management and mobile interventions to best serve the communities in which they live and work. Strategic Consulting Partners (SCP) is an award-winning, woman-owned, minority, small business. As a member of the SCP organization you will work as a contractor for UPMC to improve the health and well-being of the UPMC Health Plan members in our communities. Benefits Available through SCP include: + Medical insurance + Vision insurance + Dental insurance + Disability insurance + 401(k) + Paid Time Away from Work: 11 Paid Holidays and 2 weeks PTO your first year Responsibilities + Review Health Plan data for services the member has received and identify gaps in care based on clinical standards of care. + Assist clinical team with scheduling transportation, scheduling appointments, and tracking utilization. + Refer members to appropriate case management, health management, or lifestyle programs based on assessment data. + Assist members with non-medical needs that affect health and access to care. + Successfully engage member in developing an individualized plan of care in collaboration with the member's care team. + Document all activities in the Health Plan's care management tracking system following Health Plan standards based on information obtained from interaction with members and providers. + Recognize and demonstrate shared accountability in development of a care plan with the member/caregiver as well as the team members to ensure optimal outcomes. + Advocate on behalf of patient/family/caregivers for services access and for the protection of the patient's health, wellbeing, safety and rights. + Maintain an understanding of all health benefits and remains current on covered or in-plan services, benefit limitations, exclusions, and health management policies and procedures. + Interfaces with and refers members to community-based resources and other supportive services as appropriate. + Performs in accordance with system-wide competencies/behaviors. + Performs other duties as assigned. + Bachelor's degree in social work or associate degree in another health or human services field that promotes the physical, and psychosocial well-being of those being served. No license is required. + Managed care experience preferred. + Ability to interact with other health care professionals in a professional manner required. + Computer efficiency is preferred. Excellent verbal and written communication and interpersonal skills are required. Knowledge of community resources is preferred. + Value for and ability to deliver excellent customer service. **Licensure, Certifications, and Clearances:** + Act 34 + Act 33 + Act 73 + CPR Certification preferred **UPMC is an Equal Opportunity Employer/Disability/Veteran**

At UPMC, we're all here for the same reason - to make Life Changing Medicine happen. Join our team and you will play a unique and important role in our mission to change healthcare for the better. Why Join UPMC? We don't just take care of patients - we take care of our team, too. And we have the data to prove it. In addition to the benefits you'd expect from an industry leader you can expect: * AWARD-WINNING WORKPLACE: Ranked #1 for Best Places to Work for Women & Diverse Managers by Diversity MBA * A recent study showed that UPMC benefits are 20% higher in value than other healthcare providers in our market. * Competitive pay * Tuition reimbursement * Opportunities to grow in your career at UPMC UPMC is looking for a full-time Senior Strategic Sourcing Lead. This position works Monday- Friday, generally 8:00a-4:00p. There is a hybrid schedule with remote work flexibility. Occasional daytime travel required. Purpose: The Senior Strategic Sourcing Lead reflects the mission, vision, and values of UPMC, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Senior Strategic Sourcing Lead (SSL) helps to manage the medical / surgical product portfolio, drive cost reduction initiatives throughout UPMC and act as a consultant to and supporting resource for the clinical and non-clinical areas of UPMC. The SSL drives organization-wide product change, and serves as an internal advocate of UPMC product standardization/utilization initiatives. This individual coordinates new product introduction, product trials and overall product change initiatives on behalf of end users. As a senior member of the team, the Senior Strategic Sourcing Lead serves as a mentor for Strategic Sourcing Leads and Analysts. The Senior Strategic Sourcing Lead is responsible for more complex categories and strategies within Sourcing. The Sourcing to Pay Departmental mission is to ensure the preservation and improvement of the quality of patient care while reducing or maintaining costs and risks related to the procurement and the use of products and services at all UPMC business units and facilities through collaborative efforts and effective communication by a mode of service line steering teams and specialty sub-committees. Responsibilities: + Consulting/Utilization Analysis + Acts as a lead consultant, working with end users throughout UPMC in identifying, analyzing and facilitating implementation of expense reduction initiatives tied to medical and surgical products, equipment and services. Includes communications with vendors, end users, physicians, management and third-party partners. + Facilitates the procurement of medical/surgical products, equipment and services for UPMC in collaboration with end users, UPMC Contracting Services, UPMC Purchasing Services, Inventory and Logistics and third-party vendors. + Coordinates and conducts complex Competitive Market Assessment (CMA), Request for Proposal (RFP) and financial negotiations with vendors per UPMC policies and procedures. + Responsible for negotiation of key business terms related to complex savings and contracting initiatives, ongoing portfolio maintenance, contract arrangements, and monitoring of vendor contract compliance. + Supports complex clinical specialty committees focused on product introductions, value analysis and utilization review consistent with UPMC policies and procedures. + Manages the overall medical / surgical product and services portfolios for various clinical and non-clinical disciplines across UPMC, including regular utilization review, spend analysis, product introductions and trials. + Facilitates the use of clinical outcome data to support the selection and ongoing use of selected products. + Develops complex qualitative/quantitative analyses, methodologies and reporting platforms for product utilization and cost reduction efforts. + Tracks identified and implemented cost savings and audits projected utilization and actual spend. + Leads in developing new programs, training efforts, product trials, departmental or organization goals and projects, etc. + Identifies and supports product standardization initiatives across UPMC that aligns with quality/safety/financial goals. + Communication/Advocacy? Manages communications and clinical literature research to support product utilization, product conversions and additions, trials and committee activities. + Monitors, implements and support utilization of electronic product request system (MedApproved) across UPMC entities. + Prepares product and service utilization reports and updates. + Support end-users and Inventory and Logistics in remediation of complex supply availability disruptions (backorders/recalls). + Performs regular business reviews with key vendors and assesses vendor performance (score cards) and impact on UPMC operating goals. + Promotes UPMC philosophy for implementing supply chain cost improvement initiatives, new product introductions and organizational goals. + Plans, coordinates and facilitates meetings, work groups, and committees within various levels of staffing and management. + Negotiations/Product Screening + Serve as intermediary between vendors and end users, helping to screen and analyze new product introductions. + Coordinate in-servicing with end users for Supply Chain initiated new product introductions, trials and product conversions. + Work with Group Purchasing Organization(s) to identify cost savings opportunities, program initiatives and best practices. + Bachelors degree in relevant fields. i.e. Supply Chain Management, Finance, Nursing, Health Care Management, or other healthcare related fields and 6-8 years of relevant experience required. + Associates degree in relevant fields. i.e. Supply Chain Management, Finance, Nursing, Health Care Management, or other healthcare related fields and 8 to 10 years of relevant experience required. + High School diploma and 10 to 12 years of relevant experience + Understanding of financial analysis and quantitative/qualitative assessment data. + Advance skills in spreadsheet, word and presentation computer applications (PowerPoint). + Consulting or group presentation skills.? Ability to organize workload and set priorities. + Strong communication skills, negotiating skills a plus. + Deliver presentations to a variety of audiences at various levels. + Demonstrated ability to facilitate change and achieve savings goals. + Ability to effectively mentor team members 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.

is eligible for a $2500 retention bonus. The Providence Center Clinical Therapist Home Base Assertive Community Treatment Team (ACTT) will provide outpatient psychotherapy either at The Providence Center or in the community, on a multidisciplinary ACT team. Duties and Responsibilities: Perform, crisis intervention, counseling, screening, client education, referral, treatment planning, and consultation for clients in the program. Perform a comprehensive psychosocial assessment of assigned consumers. Perform and record mental status examination. Assess clinical emergencies, including suicide and danger to others. Collect pertinent data from appropriate collateral sources in accordance with confidentiality guidelines. Maintain confidentiality in accordance with TPC policy and legal requirements. Develop and present, verbally and in writing, a clear clinical formulation based on behavioral data and relevant theory while incorporating psychosocial and family issues. Provide individual, group, and family mental health and/or substance abuse therapy. Develop and implement a plan of care with ongoing client input. Assess clinical emergencies, including suicide and danger to others. Identify specific therapeutic interventions appropriate for specific problems. Carry a small caseload when needed and provide direct service. Provide support counseling, problem-solving, contracts and limit setting. Establish attainable goals with the clients. Encourage clients to attain the highest possible levels of independence. Participate as a member of a multi-disciplinary team in the development and implementation of therapeutic services, to include working with people with substance use challenges. Present verbally a synopsis of actual cases as required. Collaborate with other providers, agencies, and individuals in the consumers' network of care. Maintain knowledge and familiarity of mental health and/or substance abuse and other related community agencies. Perform record keeping in accordance with Health Information Services and TPC requirements. Attend trainings, case presentations and conferences. Participate in the education of other TPC staff. Attend mandatory in service trainings and other trainings required for renewal of licensure. Maintain cooperative relationships with TPC staff, clients, community agencies and the public. Serve on appropriate Center committees. Provide mental health consultation to other community agencies. Requirements: Master s degree in social work or related field and clinical experience required. LICSW, LCSW, LMHC or LMFT preferred. Ability to write reports and correspondence. Ability to speak effectively with consumers, community agencies and Center employees. Bilingual Spanish preferred. Insured auto and valid driver's license. Care New England Health System (CNE) and its member institutions; Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health. Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis. EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.

UPMC Community Care Behavioral Health is hiring a full-time Contract Specialist III. This role will work in a hybrid structure, reporting to the office a few days per week. Occasional travel may also be required at times. The Contract Specialist III is responsible for facilitating a seamless process from the time a provider is identified as needed in the network to contracting with the provider for services. The Contract Specialist III reviews and approves any alterations in the status of contracted providers that may impact on their ability to continue to be in the provider network including changes in license, certifications, Medical Assistance enrollment and completing precedential requirements. Maintains the contract files for all provider types. The Contract Specialist III will provide full training for new staff. Responsibilities: + Respond to inquiries regarding provider network from other internal departments such as Marketing and Government Programs. + Assure that provider contracts are fully executed by both parties and that contract copies are filed. + Coordinate the addition of new provider demographic information into UPMC Health Plan systems. + Review and approve specific inquiries related to credentialing and/or provider data maintenance. + Participate in projects as assigned by Supervisor or Manager. + Provide support to the Network and Vendor Relations Department by responding to inquiries from internal and external customers. + Review provider applications, request missing information, and submit completed application to credentialing. + Understand and train new staff on UPMC Health Plan products, policies and procedures including departmental policies. + Coordinate the execution of electronic contracts to providers relating to contracting issues or contract changes. + Coordinate provider file changes with the provider information department. + Bachelor's degree and 5 years relevant experience or 9 years of equivalent work experience required. Preference will be given to those with a Bachelors degree. + Behavioral health experience is strongly preferred. + Prior contracting and/or provider networking experience is a bonus. + Prior experience in health insurance is a bonus. + Thorough knowledge of NCQA standards and other relevant external quality standards. + Knowledge of state and federal standards for contracting. + Knowledge of Provider Types. + Knowledge with experience in contracting with providers for services. + Excellent written and oral communication skills. + Ability to work independently and to analyze complex situations accurately and in a timely manner. + General knowledge of managed care functions and management techniques preferred. + Computer Skills with proficiency in Microsoft Office including: Internet Explorer, Excel, Word, Powerpoint, Visio and Access Software packages.Licensure, Certifications, and Clearances:UPMC is an Equal Opportunity Employer/Disability/Veteran