Post job

Molina Healthcare jobs in El Paso, TX

- 453 jobs
  • Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Las Cruces, NM

    The Lead Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & Extracts for rate tracking and other outreach purposes. **ESSENTIAL JOB DUTIES:** -Mentors and leads 2-10 software engineers on multiple projects for project deliverables, assess deliverables' quality, plan and implement corrective and preventive actions to improve application quality. -Evaluates alternative systems solutions and recommends solution that best meets the need of the business. -Develops the BRDs along with business stakeholders, Conceptual Designs for multiple projects concurrently. SOX compliant Project deliveries and Project coordination. -Translates user requirements into overall functional architecture for complex s/w solutions in compliance with industry regulations. -Provides subject matter expertise and reviews applications designs built using .Net Framework 1.1/2.0, C#, VB.NET, ASP.NET, VB6.0, VB Script, Java Script, XML, HTML, DHTML, SharePoint server, BizTalk Server 2004/6, Microsoft SQL Server 2000/5, DTS/SSIS/SSRS on windows platform. -Drives Joint Applications Development session with business stakeholders to define business requirements and provides systems/application expertise for multiple projects concurrently. -Communicates with cross functional teams (and if applicable, vended partners) to coordinate requirements, design and enhancements with the development team(s). -Assesses and analyzes computer system capabilities, work flow and scheduling limitations to determine if requested program or program change is possible within existing system. -Recognizes, identifies and documents potential areas where existing business processes require change, or where new processes need to be developed, and makes recommendations in these areas. -Works independently and resolves complex business problems with no supervision. -Mentors and leads 2-10 systems or programmer analysts on multiple projects for project deliverables, assesses deliverables' quality, plans and implements corrective and preventive actions to improve application quality. -Works with project managers to define work assignments for development team(s). -Identifies, defines and plans software engineering process improvements and verifies compliance. -Mentors and trains systems/programmer analysts on software applications, business domain and design standards. -Conducts peer review of other analysts (internal and contract staff) to ensure standards and quality. -Recommends, schedules and performs software systems/applications improvements and updates. -Conducts studies pertaining to designs of new information systems to meet current and projected needs. -Defines and plans software releases in accordance with other software applications. Assists in the project definition, execution and implementation. Provides application, business process or functional domain leadership/expertise and peer mentoring to IT staff. Provides expertise to one or multiple domain such as application development, business process re-engineering, enterprise integration, logical data modeling, project coordination, estimation, metrics generation, status reporting. Provides thought leadership or hands-on expertise for problem resolution, application enhancements, user training and documentation of business processes. Strong application delivery methodology or SDLC background, functional domain or software engineering expertise or proficiency. Manages small or medium size projects as assigned. -Excellent verbal and written communication skills. -Must be knowledgeable of business processes, industry standard quality norms, systems and applications development best practices, project management methodologies and estimation processes. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree in Computer Science, Finance, Math or Economics or equivalent discipline **Required Experience** **-** 5+ years' experience supporting, designing and/or implementing application changes. **Highly Preferred Experience** - 5+ Years of experience in working with **HEDIS** tools such as **Inovalon** or **ClaimSphere** - 5+ Years of experience in working with HEDIS Domain - such as Measure analysis/reconciliation on data w.r.t measure specifications. - 5+ Years of experience in working with data mapping, scrubbing, scrapping, and cleaning of data. - 5+ Years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL Queries, Functions, Procedures and Data design - 5+ years of experience in working with **Microsoft T-SQL, Databricks SQL and PowerBI.** - Familiarity with Data Science Techniques and languages like Python and R programming would be an added advantage. - Familiarity with Microsoft Azure, AWS or Hadoop. - 3-5 Years of experience with predictive modeling in healthcare quality data. - 5+ Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at least one line of business among Medicaid, Marketplace and Medicare/MMP. - 5+ Years of experience in working with increasingly complex data problems in quantifying, measuring, and analyzing financial/performance management and utilization metrics. - 5+ Years of experience in Statistical Analysis and forecasting of trends in HEDIS rates to provide analytic support for quality, finance, and health plan functions - 5 years of experience in working with complex data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,412 - $188,164 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $80.4k-188.2k yearly 60d+ ago
  • Adjudicator, Provider Claims

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Las Cruces, NM

    Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. - Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. - Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. - Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. - Assists in reviews of state and federal complaints related to claims. - Collaborates with other internal departments to determine appropriate resolution of claims issues. - Researches claims tracers, adjustments, and resubmissions of claims. - Adjudicates or readjudicates high volumes of claims in a timely manner. - Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. - Meets claims department quality and production standards. - Supports claims department initiatives to improve overall claims function efficiency. - Completes basic claims projects as assigned. **Required Qualifications** - At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. - Research and data analysis skills. - Organizational skills and attention to detail. -Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-38.4 hourly 10d ago
  • Come Practice Employed ObGyn in Sunny Texas

    Tenet Healthcare 4.5company rating

    El Paso, TX job

    Tenet Healthcare and The Hospitals of Providence Memorial Campus are actively seeking an OB/GYN physician to join our growing practice. Our campus is the primary hospital for deliveries and has the best reputation for women's services! Our facility houses a 144-bed children's hospital Level IV Maternal and a new 30-bed Level IV NICU, and 24/7 in-house OB coverage! Highlights: Typical Work Schedule: Monday - Friday from 8:00 AM to 5:00 PM No hospital ER Call - OB hospitalist group is utilized for any OB ED patients Call for own clinical patients on a rotating basis - with the ability to use OB Hospitalist Group for triages, if preferred. Group rotates weekday call and weekend call. ER call is backup to OB Hospitalist group Approximately 10-15 deliveries per month initially Outpatient census of 30-35 patients per day (non-surgery days) New provider will be supported by 18 OB/GYN's, 4 Uro-GYNs and 7 APPs Opportunity to teach medical students and residents Benefits: Guaranteed salary with production bonus Comprehensive benefits (health, dental, life, 401k with matching, salary deferment program, etc.) Billing, Coding and Collections done in-house Physician time off (vacation + CME with stipend) Malpractice insurance Candidate requirements: MD/DO degree BE/BC Active Texas license or eligibility to obtain one Spanish Speaking preferred, but not required About the area: Rich with nature, culture, festivals, and historic sites, there is no shortage of activities for the whole family. El Paso is consistently ranked one of the safest large cities in the US and is home to Division I universities and private colleges. Come enjoy 300+ clear days of sunshine and no state income tax! Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status.
    $56k-103k yearly est. 1d ago
  • Come Practice Employed Pediatric Urology in Sunny Texas

    Tenet Healthcare 4.5company rating

    El Paso, TX job

    Tenet Healthcare is actively seeking a fellowship trained Pediatric Urologist to join our growing team in El Paso, Texas. Highlights: Employed, full-time opportunity with Tenet Physician Resources Access to advanced pediatric subspecialties and surgical support Light call burden - well-structured ED protocols minimize provider interruptions Competitive compensation package Sign-on bonus and relocation assistance - negotiable We are the largest multi-specialty group in the region with significant market share.We place a strong focus on quality, we are the largest health system in the region with over 50 access points, and a growing national footprint! Candidate requirements: MD/DO degree BE/BC Active Texas license or eligibility to obtain one Benefits: Salary guarantee plus wRVUs Relocation Health, Dental, Vision Deferred Compensation Malpractice Insurance 401k CME Allowance Why Join Us? Regional Leadership: Join the largest multi-specialty medical group in the region, backed by the most expansive health system in West Texas and Southern New Mexico. Unmatched Reach: Our system spans 50+ access points, providing care across a wide geographic area and ensuring robust patient volume and referral networks. National Presence: As part of Tenet Healthcare, we offer the stability and resources of a national health system, with local autonomy and physician-driven care models. High-Quality Focus: Our team is known for its commitment to excellence, safety, and outcomes-driven care in a collaborative and supportive environment. About the area: El Paso is a vibrant and rapidly growing border city with a rich culture, excellent schools, and access to year-round outdoor recreation. This is a family-friendly community with a low cost of living and a strong sense of community. Rich with nature, culture, festivals, and historic sites, there is no shortage of activities for the whole family. El Paso is consistently ranked one of the safest large cities in the US and is home to Division I universities and private colleges. Come enjoy 300+ clear days of sunshine and no state income tax! Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status.
    $109k-188k yearly est. 1d ago
  • Come Practice Employed GI (with ERCP) in Sunny Texas

    Tenet Healthcare 4.5company rating

    El Paso, TX job

    Come to El Paso, Texas and take your career to the next level by joining an established group in the market! Providence Medical Partners is seeking a gastroenterologist to build a practice at The Hospitals of Providence East Campus. Highlights: Monday through Friday, 8:00AM to 5:00PM Call pay is in addition to base salary/wRVUs Group of 16 providers We offer a competitive salary, benefits, and support in an employed environment with the latest, most up-to-date medical procedures and equipment. Among the many benefits to joining Tenet as an employed physician: Guaranteed salary with production bonus Comprehensive benefits (health, dental, life, 401k with matching, salary deferment program, etc.) Billing, Coding and Collections done in-house Physician time off (vacation + CME with stipend) Malpractice insurance Candidate requirements: MD/DO degree BE/BC Active Texas license or eligibility to obtain one ERCP Required & EUS a plus Rich with nature, culture, festivals, and historic sites, there is no shortage of activities for the whole family. El Paso is consistently ranked one of the safest large cities in the US and is home to Division I universities and private colleges. Come enjoy 300+ clear days of sunshine and no state income tax! Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status.
    $90k-112k yearly est. 1d ago
  • Come Practice Employed Hem-Onc in Sunny Texas

    Tenet Healthcare 4.5company rating

    El Paso, TX job

    Tenet Healthcare is actively seeking several Hem-Oncs for an opportunity to lead the medical oncology practice for The Hospitals of Providence, the largest health network in El Paso, TX. The outpatient clinic shares a building with our cancer navigation team, physical therapy, and co-located with our infusion clinic. Our hospital offers in-house labs, imaging, oncology pharmacy, pathology, and collaborative tumor boards. 5+ years' experience required. Highlights: Typical work schedule is Monday through Friday 8-5 in outpatient clinic with planned inpatient consults/rounding. Weekly patient census: Approximately 32 hours patient contact time. Opportunity to lead the medical oncology practice for The Hospitals of Providence, the largest health network in El Paso, TX. The outpatient clinic shares a building with our cancer navigation team, physical therapy, and co-located with our infusion clinic. Our hospital offers in-house labs, imaging, oncology pharmacy, pathology, and collaborative tumor boards. Outpatient: Patient care tech, clinical coordinator, office coordinator and ~6 chemo nurses, oncology pharmacist, certified cancer navigators. Inpatient: Hospitalist team in place to handle admissions, established general and oncology surgeons (breast, thyroid, colorectal, liver) on staff. Candidate requirements: MD/DO degree BE/BC Active Texas license or eligibility to obtain one Benefits: Salary guarantee plus wRVUs Relocation Health, Dental, Vision Deferred Compensation Malpractice Insurance 401k CME About the area: Rich with nature, culture, festivals, and historic sites, there is no shortage of activities for the whole family. El Paso is consistently ranked one of the safest large cities in the US and is home to Division I universities and private colleges. Come enjoy 300+ clear days of sunshine and no state income tax! Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status.
    $42k-85k yearly est. 1d ago
  • Patient Service Center Rep II - Days, Sun-Thurs, THOP Memorial

    Tenet Healthcare Corporation 4.5company rating

    El Paso, TX job

    Spanish Bilingual Preferred The Patient Service Center Representative II is responsible for creating a positive patient experience by accurately and efficiently handling the day-to-day operations relating to both Financial Clearance and Scheduling of a patient. This includes adherence to department policies and procedures related to verification of eligibility/benefits, pre-authorization requirements, available payment options, financial counseling and other identified financial clearance related duties in addition to full scheduling duties. Upon occasion, the PSC REP II may be only assigned to complex pre-registration. The PSC REP II is expected to develop a thorough understanding of assigned function(s). ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Completes both scheduling functions and registration functions with the patient for an upcoming visit during one call: * Scheduling: Responsible for timely scheduling, provide callers with important information related to their appointment (i.e. Prep information for test, directions, order management etc.) * Financial Clearance: up to and including verifying patient demographic, insurance information and securing payment of patients financial liability/performing collection efforts * If assigned to Order Management: verifies order is complete and matches scheduled procedure. Includes indexing and exporting physicians orders to correct account number. If assigned to complex Pre-Reg: * Collect and verify required patient demographic and financial data elements, including determining a patient's financial responsibility and securing pre-payment for future services/performing collection efforts * Create a complete pre-registration account for an upcoming inpatient/surgical admission * Completes all pre-certification requirements by obtaining authorization from insurer and/or healthcare facility * Other duties as assigned based on departmental needs KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to work in a production driven call-center environment * Familiarity with working with dual computer monitors (may be required to use dual monitors) * Must have basic typing ability * Must have working knowledge of Windows based computer environment * Ability to multitask in multiple systems (financial clearance and scheduling) simultaneously * Extensive multitasking ability * Strong written and verbal communication skills Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience preferred to perform the job. * Required: High school diploma or GED * Preferred: Two plus years of college (two years in a professional, customer service-driven environment may substitute for two years of college), completion of related medical certification program * Preferred: Telephone/call center experience * Preferred: Pre-registration and/or scheduling experience * Preferred: 2-3 years of customer service experience PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Must be able to work in sitting position, use computer and answer telephone * Ability to travel WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Office Work Environment * Hospital Work Environment TRAVEL * Approximately 0% travel may be required As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $32k-36k yearly est. 5d ago
  • TRA El Paso Constant Observer PRN

    Tenet Healthcare 4.5company rating

    El Paso, TX job

    Specialty: Patient Care Discipline: Constant Observer Shifts: AM and PM Local Rate: $15.00 Education: Required: High school diploma or GED. Experience: 6 months of hospital experience CPI Certification Certifications: Required: American Heart BLS Preferred Booking Benefits: Weekly Pay 401K with Company Match Referral bonus (TRA Active Employees)
    $15 hourly Auto-Apply 60d+ ago
  • Certified Sterile Processing Technician

    Tenet Healthcare 4.5company rating

    El Paso, TX job

    may qualify for a sign-on bonus. Full Time, Evenings The Sterile Processing Technician is responsible for task-based sterile processing activities. Education: Required: High school diploma or GED. Experience: Preferred: 1 year in sterile processing. Certifications: Required: IAHCSMM or CBSPD certified. #LI-AT1 Responsible for activities including, but not limited to decontamination, assembly, and sterilization of surgical instrumentation including various software applications, assembly, and delivery of surgical and interventional procedure case carts, paring and replenishment of materials, and working in collaboration with surgical partners to provide accurate and complete surgical instrumentation and needed supplies.
    $34k-45k yearly est. Auto-Apply 2d ago
  • Come Practice Employed Neurology in Sunny Texas

    Tenet Healthcare 4.5company rating

    El Paso, TX job

    Tenet Healthcare and The Hospitals of Providence Sierra Campus is actively seeking a Neurologist to join our growing group in El Paso! Our team of 3 neurosurgeons, 1 neurohospitalist, and APPs are dedicated to providing high quality care to the community of El Paso. Highlights: Monday through Friday schedule Call not required - neuro consults required (approximately 8 per day) Complete neuro consults, inpatient rounding, read EEGs, and perform lumbar punctures Equipment/Resources: Gamma Knife, 12 bed Neuro ICU, on-site 24 bed IP Rehab, and Epilepsy Monitoring Unit Highly trained and versatile neuro ICU team Benefits: Guaranteed salary with production bonus Comprehensive benefits (health, dental, life, 401k with matching, salary deferment program, etc.) Billing, Coding and Collections done in-house Physician time off (vacation + CME with stipend) Malpractice insurance Candidate requirements: MD/DO degree BE/BC Active Texas license or eligibility to obtain one Spanish Speaking preferred, but not required About the area: Rich with nature, culture, festivals, and historic sites, there is no shortage of activities for the whole family. El Paso is consistently ranked one of the safest large cities in the US and is home to Division I universities and private colleges. Come enjoy 300+ clear days of sunshine and no state income tax! Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status.
    $154k-259k yearly est. 1d ago
  • Manager, Threat & Crisis Intelligence

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Las Cruces, NM

    As the Manager, Protection Services Operations Center (PSOC), you will be a member of Molina Healthcare's Protection Services Operations Center, reporting to the Director. This role is crisis and threat intelligence focused and includes responsibilities for ensuring the execution of the physical security controls, threat/risk analytics, and incident intake and crisis management support for the enterprise. This role drives and manages physical security, incident response and safety operations for Molina facilities and employees in the field. The manager leads the in-house security operations team and coordinates the contract security assets; utilizes video surveillance platforms, access control, visitor management, alarm systems and threat intelligence platforms; safeguarding Molina employees, vendors and visitors, as well as equipment and facilities. This position also oversees Protection Services Operations (PSOC) projects, programs and deliverables to ensure compliance with all regulatory requirements. The manager will assume the role and responsibilities of the next level in the chain of command in their absence. This role will liaise with all enterprise leaders and stakeholders to address security issues or incidents that arise in the field or Molina offices. Activities will ensure alignment with policies, standard and procedures in deliverables. Additionally, this person will support incident response and crisis management activities during disruptive events as needed. **Knowledge/Skills/Abilities** + Manage and oversee consultants and senior consultants to ensure delivery of day-to-day operational and response activities. Monitor incident, intake and work queues to ensure organizational SLAs are meet for enterprise + Act as liaison to business stakeholders and third-parties for developing and implementing operational physical security, threat/risk analytics and incident management programs supporting day-to-day services for Molina business operations + Guide and oversee development of new services to increase effectiveness, and to eliminate or control high risk or unsafe practices, operations and conditions. This person will be responsible for the implementation, delivery, ownership and operations of the PSOC team's policies, standards, procedures and systems + Aligns strategy to meet stakeholder needs and requirements across multiple business units. Recommend, shape and deliver a continuously improving security culture, serving as a thought leader and trusted advisor. Educate and influence on matters involving the promotion of a proactive risk management culture + Leads supplier relationships and services agreements relevant to PSOC operations and technology providers + In partnership with stakeholders, develop annual training and awareness schedule to ensure delivery of ongoing security and safety training for employees and contractors + Model, assess and trend multiple intelligence sources to identify risks and threats to employees, assets, and executives. Identify risks & threats and inform key stakeholders of the threat and the recommended actions for mitigation + Deliver reports, briefings, and presentations on research findings and provide the necessary recommendations + Conduct, and assist, with risk assessments in advance of major company events, employee and executive travel, and in support of major business decisions + Engage in training and outreach to all Affirmers about personal safety and security while travelling domestically and abroad + Ensure appropriate consultation regarding threat mitigation, workplace violence, and regulatory compliance. Regularly report compliance metrics to senior leadership ensuring trends and threats are identified with recommendations for mitigation + Prepares and manages operational budget including forecasting, staffing and third-party expense management + May be required to work outside of normal business hours (nights, evenings, and weekends) if responding to emergencies + Perform other duties as assigned + Up to 10% travel **Job Qualifications** **Required Education:** + Bachelor's degree **Required Experience:** + Minimum 8 years demonstrated leadership in programs at a national or enterprise level + Minimum 5 years' experience with access control, alarm, and threat intelligence platforms including Lenel, Avigilon, Envoy and Everbridge + Minimum 5 years' experience with project management, including implementation/project management of physical security solutions in facilities + Minimum 3 years' experience managing in a matrixed environment + Large scale security operations in a multinational company environment. Worked across functions in a matrixed organization, commensurate with a Fortune 500 **Required Licensure or Certification:** + Nationally recognized physical security certification, and/or FEMA or Department of Homeland Security certifications **Required Knowledge, Skills and Abilities:** You are + Knowledge and ability to think creatively, proactively, and independently + Able to lead, communicate and influence at all management levels and thrive in a cross-functional matrix environment + Able to effectively facilitate meetings, prepare reports and presentations, and manage data + Self-motivated and results oriented. A problem solver. An analytical thinker + Comfortable and capable of developing/presenting data-driven solutions and recommendations + Superb organizational skills and the ability to delegate effectively to meet delivery targets + Able to interact concisely/accurately and positively with stakeholders. Remain calm in challenging business situations + Innately know how to 'get it done' including engaging/motivating others to deliver results. You plan workloads and deliver on commitments + Able to quickly build rapport and gain the respect and cooperation of both technology and business leaders. Possess strong interpersonal and indirect influencing skills, with a demonstrated ability to gain the confidence of individuals at various organizational levels + Someone that thrives in ambiguity and make quality decisions in a dynamic, fast paced environment + Action oriented and driven to achieve results in a positive manner, displaying ethical behavior, integrity, and building trust at all times You have a deep understanding of: + The candidate should have a strong grasp of: + The full spectrum of security operations services: + Access control administration and management + Alarm-intrusion response + Visitor management + Threat analytics + Incident intake and coordination + Investigation support + Security queue and workflow management + Policies, standards and procedures + Metrics, reporting and analysis + Extensive experience with Lenel OnGuard, Avigilon surveillance, Everbridge (including VCC, Notification and SafetyConnect). Envoy experience preferred + Software skills & competencies are required, as well as internet research abilities and strong communication skills. Includes: MS Office (Outlook, Word, Excel, and PowerPoint) and also preferably a familiarity with SharePoint and Visio + Excellent knowledge of security operations best practices, policies, and procedures + Extensive knowledge of project management + Familiarity with industry standards, including ISO 22301, HIPPA, PCI, IOSCO, CMS and Department of Homeland Security guidance To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $77,969 - $171,058 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $35k-70k yearly est. 32d ago
  • Associate Specialist, Provider Contracts HP

    Molina Healthcare Inc. 4.4company rating

    Molina Healthcare Inc. job in Las Cruces, NM

    Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when available, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. Job Duties This role supports negotiations with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. * Sends out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members. * Receives calls from prospective providers and answers questions regarding contracting process, policies and procedures. * Forwards requested information/documentation to prospective providers in a timely manner. * Maintains database of all contracts and specific applications sent to prospective new providers. * Completes and updates Provider Information Forms for each new contract. * Ensures accuracy and completeness of provider demographic information and coordinates communication of such information to Provider Configuration team. * Sends out new provider welcome packets to providers who have contracted with the plan. * Utilizes Plan's system to track and follow up with Providers who have not responded to Contracts and/or Applications sent as directed by management. * Formats and distributes Provider network resources (e.g. electronic specialist directory). Job Qualifications REQUIRED EDUCATION: High School Diploma or equivalent GED REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: 1 year customer service, provider service, contracting or claims experience in the healthcare industry. PREFERRED EDUCATION: Associate's Degree or Bachelor's Degree in a related field or an equivalent combination of education and experience PREFERRED EXPERIENCE: Managed Care experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $42.2 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $21.2-42.2 hourly 5d ago
  • Director of Strategy - The Hospitals of Providence - Sierra Campus

    Tenet Healthcare Corporation 4.5company rating

    El Paso, TX job

    ORGANIZATIONAL LEADERSHIP - EXPECTATIONS & REQUIREMENTS: As a leader in healthcare, Tenet is committed to providing the best possible care to every patient, with a clear focus on quality and service. Strong leadership is essential to delivering on this commitment, and we believe that the quality of our leaders can give us a significant long-term competitive advantage. We want to ensure every current and future leader in Tenet is successful, and we support that through our selection and hiring process and by providing coaching and training to our leaders. In this regard, we have identified core competencies that will enable a leader to succeed at Tenet, and have defined them within the following five areas critical to performance: Tenet Core Leader Competencies Builds Quality Relationships Build trust and manage conflict with key stakeholders to maintain collaborative internal and external partnerships (e.g., with staff, other departments, regional and corporate partners, physicians, and the community) and engage staff in driving key decisions and initiatives. Communicates Effectively Thoughtfully plan messages and uses a variety of methods to match communication effectively with situation and setting to engage staff and colleagues (e.g., large group, small group, 1:1). Influences Behaviors and Outcomes Considered a trusted advisor and functional expert who builds consensus in a collaborative way; confronting difficult business decisions in a way that preserves relationships. Inspires desired behaviors and acts as a coach to others. Drives Organizational Performance Translates complex strategies into focused and achievable goals and takes decisive action when needed (e.g., times of uncertainty, organizational transitions). Acts as a change leader and creates clarity, energy, and commitment to initiatives by gaining buy-in and removing barriers. Exercises Critical Judgment Uses a fact-based, analytical, system-thinking approach to assessing and designing solutions by gathering input from various sources and considering the impact of decisions. Practices due diligence to critically evaluate alternatives that deliver the highest quality and service while applying risk management principles to mitigate cost and maximize revenue potential. Shapes Organizational Strategy Builds compelling business cases and plans for strategic initiatives, creating vision, objectives, goals, and specific strategies to achieve outcomes; anticipates and adjusts for obstacles. Develops and communicates progressive organizational performance strategies that achieve a competitive advantage (e.g., productivity, quality, culture, talent, internal/external volume, and revenue growth). Build High Performing Teams Focuses on developing talent by regularly providing performance and professional development feedback, coaching and guidance. Practices workforce planning and anticipating staffing needs and creates plans to fill key positions through focused selection methods. Technical Expertise Possesses the practical and technical functional knowledge and skills to be effective in their current role. Seeks continuous education, training, and growth within functional role. Business Excellence Understands the balanced scorecard and drives results to meet or exceed target in key department metrics. Focuses on streamlining and improving processes and effectively utilizes labor management tools to achieve budgeted staffing targets. Drives high quality in a cost-conscious manner, understands key clinical components and regulatory requirements, and inspires a culture of compliance. Tenet Leader Behaviors Care: At the center of caring is empathy. Leaders connect with others and learn how to individualize care based on circumstances. Always treating all with respect while showing personal humility. Serve: Servant leadership enables achievement of higher purpose. Always keeping those, we serve at the center to provide priorities. Success that is shared will create momentum that engages all colleagues. Share: Always connecting people with the plan and creating positive relationships. Frequent honest communication creates an inclusive high-performance environment. Adapt: Agility in the face of continuous change defines leadership. Encouraging risk and experimentation enables people to be innovative in the face of the evolving marketplace. Learn: Leaders are inspired by curiosity and learning, seeking to develop themselves and others. They reflect on their experience and are eager to find new sources of knowledge to increase their effectiveness. Achieve: Through prioritization based on our overall aligned direction, leaders focus resources on things that are most relevant for the organization and communities served. Focusing on the future and acting without ambiguity creates a climate of accomplishment. MARKET SUMMARY: El Paso Group The Hospitals of Providence - Sierra Campus Sierra Medical Center has been on the forefront of Cardiac and Neurological services for more than 30 years. The hospital has more than 350 beds and offers a full range of advanced medical and surgical services to El Paso, and to the outlying communities of west Texas, southern New Mexico and to our international neighbors in northern Mexico. Sierra is accredited as a Chest Pain Center with a PCI designation from the Society of Chest Pain Centers. Our nationally recognized surgery department offers El Paso's only Stereotactic Radiosurgery.The Hospitals of Providence Sierra Campus in El Paso, Texas, has once again earned the HeartCARE Center National Distinction of Excellence, the highest cardiology designation possible by the American College of Cardiology (ACC). This achievement makes Sierra Campus one of only nine hospitals in the U.S. to achieve and maintain this designation for the seventh consecutive year, and the only hospital in El Paso and the surrounding area to hold this recognition. Our reputation for providing families with quality health care in an advanced acute care setting is evident in the dedication our physicians, nurses and staff have for the well-being of our consumers in our community. Specialties * Advanced Cardiac Care - includes a robust structural heart program, balloon angioplasty, open-heart surgery, coronary stent placement and coronary bypass surgery. * Chest Pain Reaccreditation - The Sierra Campus was evaluated and reaccredited by the Society of Cardiovascular Patient Care for its ability to assess, diagnose, and treat patients who experience a heart attack. * Advanced Neurological Care - includes MinOp System-Endoscopic Neurosurgery, Deep Brain Stimulation and Stereotactic Radiosurgery * Teleneuro - puts stroke patients in the care of a specialized neurologist within 15 minutes. * Gamma Knife Radiosurgery - a non-invasive surgical procedure that is used to treat brain tumors and other intracranial malformations. * Regional Lung Institute - an outpatient-based center that helps patients with chronic lung disease get the most comprehensive range of consultative pulmonary care services using some of the newest lung disease diagnosis and therapy methods. * MAKOplasty - The Sierra Campus was the first health care provider in El Paso to provide this innovative robotic procedure that allows surgeons to partially resurface the arthritic portion of the knee while preserving healthy bone and tissue, relieving pain, restoring range of motion, and decreasing recovery time. * Robotic surgery with the da Vinci Xi platform; focused on general surgical, oncological, and urological procedures * ACC HeartCARE Center Designation * Advanced Certification for Comprehensive Stroke Center Sierra Medical Center also offers advanced health care services in the following areas: * Neurosciences * Cardiac Rehabilitation * Acute Rehabilitation * Advanced Outpatient Imaging * Autologous Blood Storage * Diagnostic Lab & Imaging * Stereotactic Breast Biopsy * VIAS - Ventana Image Analysis System for detecting breast cancer cells. ******************************************************************** POSITION SUMMARY: Leads in development and implementation of facility business strategy. * Develops and implements strategy which leads to improvement in market share consistent with Tenet Healthcare's mission and core values. * Use data to analyze market dynamics, trends and competition and implement strategies to meet market demand. * Assesses market development strategy and industry trends as appropriate, leading to the generation of innovative ideas to improve the current business plan and achieve desired results. * Demonstrate exceptional financial management and analytical skills while leading the annual business planning process and preparing forecasts. * Effectively advises CEO in the development and execution of short- and long-term strategies. * Establishes and influences others to achieve goals, targets, and metrics consistent with strategic and operational objectives. * Demonstrates excellent formal presentation and interpersonal communication skills that result in understanding of, and commitment to, strategic initiatives. * Leads senior executive team in advancing the system's short- and long-term strategic plans. Aids in Service Line Development * Identifies, evaluates, and gains consensus for development of new or expansion of current inpatient and/or outpatient services and programs based on lack of current supply, quality, growth, and/or service in the market. * Works in collaboration with health system/hospital/department leaders to develop strategic service lines ensuring physician engagement to achieve desired results in quality, service, operations, and financial metrics. * Understands all operational components necessary to implement a new or expand a current service line, including but not limited to capital, equipment, people, education, quality metrics and costs. * Monitors understand and assess service line performance by key performance indicators (volume, outcomes, market shares, etc.). * Gathers competitive intelligence from the community on service line opportunities. * Leads discussions with physicians, community-based facilities, local payers, providers, and employers to gain information related to collaboration and support for strategic initiatives and service line development/enhancement to meet the needs of the community served. * Work in collaboration with other Tenet and Tenet JV facilities (hospitals and USPI locations) to develop network opportunities and service line enhancements. Effectively manages the Provider Outreach Program and works to meet community needs through recruitment of physicians. * Builds targeted performance objectives for Provider Outreach team which identifies opportunities for greater collaboration to achieve common goals of better serving our shared patients. * Supports Provider Outreach Program priorities, identifies outreach partners across the care continuum, and develops strategies and metrics while monitoring progress to plan (e.g., physician manpower plan and progress toward service line goals). * Ensures community, physician and longitudinal care partners, awareness of new initiatives and identification and remediation of service issues that may impact program development. * Plans, organizes, and directs strategies that develop physician relationships and physician manpower plans consistent with facility service line plans and community need. * Works in collaboration with physician recruiters to fulfill community needs in a manner consistent with service line requirements. * Maintains high visibility among physician community and earns a reputation for effectively listening and leading facility changes efforts that build physician loyalty and enhance the patient experience. Analyzes data to make fact-based decisions and monitors variances to understand facility trends. * Studies internal and external data trends to realize opportunities to better serve the community. * Identifies and vets' new business opportunities based on research and analysis. * Monitors internal data to understand the driving forces of business variables and then implements corrective action when/where appropriate. * Understands and demonstrates competency utilizing all data available. Leads an effective consumer engagement plan and partners to ensure improvement in consumer experience. * Executes effective marketing plans that differentiate services based on quality, service, and/or outcomes and have measurable positive ROI. * Leads efforts that provide consumer education around care options and collectively enhance patient experience. * Serves on the patient advisory, physician leadership group and patient satisfaction committees. * Lead an effective consumer engagement strategy, within budgeted guidelines, which creates differentiation and awareness in the facility's market. CANDIDATE EXPERIENCE, ATTRIBUTES AND EDUCATION REQUIREMENTS A minimum of five years of experience in Strategic Planning and Healthcare Strategy/Development is required. Experience developing complex business plans and using data to drive strategy is a must. * Knowledge of healthcare organization and administration and of standards and laws applicable to managing strategy and planning issues with facility operations. * Knowledge of healthcare, strategic and financial planning. * Proven financial management skills, capable of reaching closure and timely accomplishment of objectives with a focus on P & L. * Knowledge of principles of interactive planning, participatory management, and influence management. * Skilled at executing strategy and problem solving; asks the right questions, follows up and determines the facts, setting priorities based on business opportunity. Skilled at spotting trends and developments. Able to direct the development of business plans and proformas. Professional Attributes * Strong project management skills and follow-through from vision to execution, with measurable results to the bottom line. * An individual highly motivated to work cross-functionally in order to accomplish goals and effect change. Someone skilled at uniting various constituencies to work together harmoniously to achieve high quality patient care. * One who believes in reaching out to physicians in a unique and innovative manner. He/she strives to be inclusive with physicians on key decisions and meets frequently with physicians to ascertain their needs. * Excellent at team building and motivating people. Able to identify the right people to execute strategic opportunities and motivate people to act whether they are peers, subordinates, physicians, or administrators. Skilled at accomplishing goals through others. * Someone who understands the dynamics and politics of a hospital environment and has the ability to navigate between disparate entities to successfully unite constituencies toward a common cause. * An individual who is a "pre-emptive communicator" and one that strives to proactively address issues before they become problems. * Proven ability to provide high-quality, cost-effective care through innovation, reputation and positive employee and physician relations. Personal Attributes * Excellent interpersonal skills; and a dedicated listener, comfortable in a variety of settings dealing with diverse constituencies; a broad thinker. The ability to communicate clearly and effectively both verbally and in writing. * An individual of the highest personal and professional integrity, principle, and knowledge, earning respect and support when making difficult decisions and choices. Able to establish immediate credibility with peers, senior leadership, medical staff, and the Board. * A collaborative and operational manager who will give employees a voice and encourage full participation of all team members. * A team player, good listener and consensus builder who truly values the input of others and their contributions and positively responds to such input. Education/Certifications * An undergraduate degree in Business, or appropriately relevant field, is required. An advanced degree in Business, Healthcare Administration, or Public Health is strongly preferred. Travel * Approximately 5 percent. * The selected candidate will be required to pass a Motor Vehicle Records check. #LI-KN1 Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $124k-164k yearly est. 24d ago
  • Respiratory Therapist - Student Extern

    Tenet Healthcare Corporation 4.5company rating

    El Paso, TX job

    Embark on a rewarding career with The Hospitals of Providence - Trans Mountain Campus hospital. If you are a compassionate healthcare professional eager to contribute to patient care, this is your opportunity where your skills make a difference every day. Join us in delivering exceptional healthcare with a personal touch. At The Hospitals of Providence - Trans Mountain Campus, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include: * Medical, dental, vision, and life insurance * 401(k) retirement savings plan with employer match * Generous paid time off * Career development and continuing education opportunities * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance Note: Eligibility for benefits may vary by location and is determined by employment status * Ensures professional business operation of the department. * Ensures each patient assigned receives the highest quality care possible. * Is knowledgeable and complies with all policies and procedures, objectives and safety regulations within the department and hospital; maintaining an optimally safe environment, recognizing potential hazards, initiating appropriate actions and follow-through to resolution; participating in safety education programs provided; keeping the work and break areas clean, stocked, free of clutter and in compliance with environmental rounds requirements; promptly reporting unsafe conditions, injuries or malfunctioning equipment. * Contributes to department quality/performance improvement. * Is knowledgeable and complies with The Joint Commission National Patient Safety Goals and Standards. * Familiar with Evidence Based Medicine (EBM) and Core Measures patient care standards and outcome results. Per Diem, Rotate Job Summary The Respiratory Care Student (RCS) is responsible for providing Respiratory Care to non-critical patients in the hospital. Training and services provided by this position are appropriate to patients of all age groups. Applies clinical respiratory judgment to implement a clinical respiratory program and maintains standards for professional respiratory practice in the clinical setting. The RCS communicates necessary information and makes needed recommendations to the physician and nurses as appropriate. Education * Student currently enrolled and pursuing a course of study leading to graduation from the program. * Enrolled for credit in clinical portion of an approved respiratory care education program or graduate of approved respiratory care education program with active application for licensure with Texas Medical Board (TMB) and eligible for National Board of Respiratory Care (NBRC) credentialing as Certified Respiratory Therapist (CRT) and/or Registered Respiratory Therapist (RRT) Required Licenses/Certifications * Must have a current BLS Certification for Healthcare. Required Skills, Knowledge, and Abilities * Must speak and write English fluently. #LI-MS4 Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $36k-56k yearly est. 2d ago
  • Associate Analyst, Clinical Informatics (Bilingual in Spanish Required) - Monday - Friday 7AM - 4PM PST (REMOTE)

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Las Cruces, NM

    Provides entry level analyst support for clinical information systems activities. Responsible for provision of application technical support and design for clinical information systems - ensuring creation of workflows and enhancements that support process improvement and change management initiatives. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Assists in the development and support of clinical, practice management and operational workflows. - Assists in the design of workflow analysis, device integration, planning and implementation of clinical systems. - Participates in the system implementation life cycle including: planning, implementation, training, and post-implementation support. - Assists in issue resolution related to the clinical information system. Required Qualifications - At least 1 year of system implementation experience, or equivalent combination of relevant education and experience. - Knowledge of systems design methods and techniques. - Knowledge base in health care informatics. - Ability to work independently, within a team and collaboratively across teams. - Analysis, synthesis and problem-solving skills. - Attention to detail and accuracy. - Multi-tasking, planning, and workload prioritization skills. - Verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $42.2 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.2-42.2 hourly 31d ago
  • Director, Clinical Data Acquisition

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Las Cruces, NM

    The Director, Clinical Data Acquisition for Risk Adjustment, is responsible for the implementation, monitoring, and oversight of all chart collection for Risk Adjustment, RADV, or Risk Adjustment-like projects, and other state specific audit projects and deliverables related to accurate billing and coding. This role also works with the Health Plan Risk/Quality leaders to strategically plan for supplemental data source (SDS) acquisition from providers as well as Electronic Medical Record (EMR) access. This position oversees management of training for all CDA team members as well as company Risk Adjustment retrieval and data completeness training, onboarding for CDA team members, vendor management for chart collection vendors, Supplemental data, and chart collection research. **Job Duties** + Plans and/or implements operational processes for Risk Adjustment operations that meet state and federal reporting requirements/rules and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans. + Develops and implements targeted collection of clinical data acquisition related to performance reporting and improvement, including member and provider outreach. + Serves as operations subject matter expert and lead for Molina Risk Adjustment, using a defined roadmap, timeline and key performance indicators. + Collaborates with the national intervention collaborative analytics and strategic teams to deliver value for both prospective and retrospective risk programs. + Communicates with the Molina Plan Senior Leadership Team, including the Plan President, Chief Medical Officer, national Risk Adjustment teams and strategic teams about key deliverables, timelines, barriers and escalated issues that need immediate attention. + Presents concise summaries, key takeaways and action steps about Molina Risk Adjustment processes, strategy and progress to national, regional and plan meetings. + Demonstrates ability to lead and influence cross-functional teams that oversee implementation of Risk Adjustment projects. + Possesses a strong knowledge in Risk Adjustment and RADV to implement effective operations that drive change. + Functions as key lead for clinical chart review/abstraction and team management. This includes qualitative analysis, reporting and development of program materials, templates or policies. Maintains productivity reporting, management and coaching. + Maintains advanced ability to collaborate and Manage production vendor relationships, including oversight, data driven KPI measurement and performance mitigation strategies. **Job Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree in a clinical field, Public Health, Healthcare, or equivalent. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** - 8+ years' experience in managed healthcare, including at least 4 years in health plan Risk Adjustment or clinical data acquisition/chart retrieval roles - Operational knowledge and experience with Excel and Visio (flow chart equivalent). **PREFERRED EXPERIENCE:** - 10+ years' experience with member/ provider (Risk Adjustment) outreach and/or clinical intervention or improvement studies (development, implementation, evaluation) - 3-5 years Supervisory experience. - Project management and team building experience. - Experience developing performance measures that support business objectives. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** - Certified Professional in Health Quality (CPHQ) - Nursing License (RN may be preferred for specific roles) - Certified Risk Adjustment Coder (CRC) To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $71k-91k yearly est. 53d ago
  • Supervisor, Healthcare Services Operations Support

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Las Cruces, NM

    JOB DESCRIPTION Job SummaryLeads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc. - Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes. - Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance. - Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement. - Assists in the development and implementation of internal desktop processes and procedures. - Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers. Required Qualifications- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience. - Strong analytic and problem-solving abilities. - Strong organizational and time-management skills. - Ability to multi-task and meet project deadlines. - Attention to detail. - Ability to build relationships and collaborate cross-functionally. - Excellent verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Supervisory/leadership experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $77,969 - $106,214 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $78k-106.2k yearly 35d ago
  • Phlebotomist

    HCA Healthcare 4.5company rating

    El Paso, TX job

    **Introduction** Do you want to join an organization that invests in you as a(an) Phlebotomist? At Del Sol Medical Center, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. **Benefits** Del Sol Medical Center offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny and adoption assistance. + Referral services for child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity and Consumer Discounts + Retirement readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) + Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits (********************************************************************** **_Note: Eligibility for benefits may vary by location._** You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Phlebotomist like you to be a part of our team. **Job Summary and Qualifications** POSITION SUMMARY: Assumes the responsibility for performing phlebotomy skills appropriately and efficiently, under the philosophy, policies and procedures established by the hospital and the laboratory department. Performs general clerical duties and minor technical duties as assigned. POPULATION SERVED: Core competencies will be assessed primarily on the following patient population(s) served: All diagnoses/conditions of patients admitted to the hospital. + Demonstrates ability in accurately identifying patient and patient specimens. + Demonstrates skill, knowledge and accuracy in obtaining specimens. + Demonstrates ability to perform phlebotomy in a timely manner. + Demonstrates ability to perform complicated phlebotomy procedures. + Demonstrates ability to perform clerical duties. + Demonstrates ability to perform A.I.D.E.T. customer service 100% of the time. + Is able to operate Point of Care instruments and perform point of care testing per standard operating procedures. + Participates in the unit based Quality Improvement process. (Emergency Room Only) + Continuous monitoring of supplies in the ED, replace and restock as needed. (Emergency Room Only) + Knowledgeable with 100% compliance with core measures in the Emergency Department. (Emergency Room Only) **What qualifications you will need:** + BLS (Emergency Room Only) + High School diploma or GED required. + General knowledge and education in phlebotomy acquired through and accredited training program is required. + Completion of formal training through an accredited phlebotomy training program or one year of phlebotomy experience Del Sol Medical Center (*********************************************************************** is a full service, acute-care hospital in east El Paso, Texas. We have **a Level II trauma designation** . This facility has **300+ patient beds** . Our range of services (************************************************************************************ include emergency care, cardiac care, women's services, Level III NICU, rehabilitation, a bariatric clinic (****************************** , and a **Minimally Invasive Surgery Center** . Del Sol Medical Center is part of Las Palmas Del Sol Healthcare. We are a leading healthcare provider for El Paso and the surrounding region that is part of HCA Healthcare. HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "Good people beget good people."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Phlebotomist opening. Qualified candidates will be contacted for interviews. **Submit your resume today to join our community of caring!** We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
    $29k-35k yearly est. 11d ago
  • Manager, Growth & Community Engagement (Southern New Mexico)

    Molina Healthcare Inc. 4.4company rating

    Molina Healthcare Inc. job in Las Cruces, NM

    Molina Healthcare is hiring for a Manager of Growth & Community Engagement in southern New Mexico. This position will work alongside leadership and the other Managers to ensure team and department goals are met. They will work closely to lead and execute Molina signature events, manage the day-to-day activities and support the team. They will interact with public officials, external organizations, and internal departments. If you have passion and enthusiasm for building relationships within the community that foster growth all while improving the health and lives of the community, we want to talk with YOU! This position is fast paced and requires someone who is versatile, creative, and can lead by example. They will be a mentor, a leader and need to be hands on. The duties will range from doing ride-a-longs with team members (Community Engagement Reps), leading and facilitating meetings, events, and department activities. This position will interact with other department management and leads. This position is primarily in the Medicaid space, however, will cross over to Marketplace and Medicare. This role will lead by example, working alongside their team. There may be evening and weekend events that the Manager will be needed at. Prior experience working with the community in some capacity is highly desired * Must live in Southern New Mexico* * NM State Driver's License and Reliable Transportation Required KNOWLEDGE/SKILLS/ABILITIES * Responsible for achieving established goals improving Molina's enrollment growth objectives encompassing all lines of business. Works collaboratively with key departments across the enterprise to improve overall choice rates and assignment percentages. * Works closely with the AVP/Director to develop and execute the enrollment growth strategy for a specific area, while also being accountable to achieve assigned membership growth targets. * Accountable for achieving established goals with the primary responsibility for improving the plan's overall "choice" rate. In addition, works collaboratively with other key departments to increase Medicaid assignment percentages for Molina. * Responsible for day-to-day operations and management of team members, including hiring, training, developing, coaching and mentoring, etc. Creates and regularly reviews team performance metrics/scorecards to ensure team performance contributes to overall enrollment growth, while providing clear direction and intermittent steps to achieve success. * Contributes to the development, implementation, and evaluation of the enrollment growth plan for assigned territory; plans enrollment activities to promote membership growth. * Collaborates with other Lines of Business' sales teams to identify growth opportunities focused on key providers and Community Based Organizations. * Leads team in the development of relationships with key providers, Community Based Organizations (CBOs), Faith Based Organizations (FBOs), School Based Organizations (SBOs) and Business Based Organizations (BBOs) and how to move them through the enrollment pipeline. * Directs the coordination, development and approval of State/Federal guidelines for all marketing and promotional materials for all product lines. * Demonstrates thorough understanding of Molina's product lines, Medicaid, CHIP, Medicare SNP, Marketplace, MMP, etc JOB QUALIFICATIONS REQUIRED EDUCATION: Bachelor's Degree or equivalent experience. PREFERRED EDUCATION: Bachelor's degree in marketing or healthcare administration. REQUIRED EXPERIENCE: * 5-10 years' experience in business development, community relations or health care related activities. * 3 years Managed-Care, Medicaid experience; knowledge of advertising requirements pertaining to the Medicaid and Medicare media campaigns. * Prior work experience in a supervisory capacity, demonstrating excellent organizational, prioritizing, and motivational skills. * Experience in negotiation, sales or marketing techniques. * Must live in San Diego County PREFERRED EXPERIENCE: * Previous healthcare enrollment, marketing and/or sales experience. * Fluency in a second language is highly desirable. * Prior demonstrated work experience in a managerial capacity. REQUIRED LICENSE, CERTIFICATION, ASSOCIATION: * Completion of Molina /DHS/MRMIB Marketing Certification Program * Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation. PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: * Active Life & Health Insurance * Marketplace Certified To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #PJHPO Key Words: Medicare, Medicaid, Managed Care, Manager, Leader, Marketing, Duals, Enroll, Enrollees, Coverage, #LI-TR1, NY York State, NY State Department of Health, Star Plus, Reimbursement, community, health coach, community health advisor, nonprofit, non-profit, family advocate, health educator, liaison, promoter, outreach worker, peer counselor, patient navigator, health interpreter and public health aide, NY Care, community lead, HMO, PPO, community advocate, nonprofit, non-profit, social worker, housing counselor, human service worker, Sales, Navigator, Assistor, Connecter, Promotora, Marketing, Growth, Manager, Supervisor, Leader, Management, Medicare Advantage Pay Range: $66,456 - $129,590 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $66.5k-129.6k yearly 32d ago
  • QNXT Configuration Analyst

    Molina Healthcare 4.4company rating

    Molina Healthcare job in Las Cruces, NM

    Responsible for providing business process redesign, communication and change management for operations. Backend operationalization of policies, standardization of system set-up and a resource for all departments and health plans company-wide. **Knowledge/Skills/Abilities** + Conduct interviews with staff and management to assess internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures and other internal guidelines. + Review, research, analyze and evaluate information to assess compliancy between a process or function and the corresponding written documentation. Use analytical skills to identify variances. Use problem solving skills and business knowledge to make recommendations for process remediation or improvement. + Summarize and document assessment outcomes and recommendations. Ensure that they are appropriately communicated (written and verbal) to process owners and management. + Collaborate with process owners to maintain and/or create business process documentation and workflows related to Core Operations functions. + Serve as liaison between Core Operations and internal and external auditors for all formal Core Operations audits that are not compliance related. + Coordinate, facilitate and document audit walkthroughs. + Research, collect or generate requested documentation. Provide timely and accurate responses, both written and verbal. + Research and respond to clarifying questions submitted by internal and external auditors. Work in partnership with other functional areas as needed.. + Ability to write SQL queries + Experience with QNXT configuration + Experience with troubleshooting and analyzing issues. + Experience working in a Medicare environment is highly preferred. + Claims adjudication experience is highly preferred. **Job Qualifications** **Required Education** Associate's Degree or two years of equivalent experience **Required Experience** - Four years proven analytical experience within an operations or process-focused environment. Additional required experience for Corporate Operations: - Analytical experience within managed care operations. - Knowledge of managed care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** Bachelor's Degree **Preferred Experience** - Six years proven analytical experience within an operations or process-focused environment. - Previous audit and/or oversight experience. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $77,969 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $78k-116.8k yearly 16d ago

Learn more about Molina Healthcare jobs

Most common locations at Molina Healthcare