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: $21.65 - $38.37 / 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.
$21.7-38.4 hourly 27d ago
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Strategy Advancement Director
Molina Healthcare Inc. 4.4
Molina Healthcare Inc. job in Phoenix, AZ
The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the Vice President, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development.
This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position.
Job Duties
* Strategy Development & Innovation
* Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements
* Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD
* Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition
* Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning
* Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care
* Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively
* Market Development and Strategy Execution
* Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders
* Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery
* Stakeholder Engagement & Thought Leadership
* Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes
* Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions
* Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations
* Proposal Support & Competitive Differentiation
* Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content
* Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape
* Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements
* Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies
* Operational Excellence & Cross-Functional Coordination
* Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning
* Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements
* Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams
* Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently
* Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership
* Mentorship & Team Development
* Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning
* Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership
* 50% or more Travel required
Job Qualifications
REQUIRED QUALIFICATIONS:
* Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience
* 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field
* Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations
* Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations
* Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation
PREFERRED QUALIFICATIONS:
* Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration
* 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members)
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Conference management experience and participation in industry forums
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 - $208,705 / 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.
$107k-208.7k yearly 9d ago
General Cardiology Opportunity with Established Private Practice in Goodyear, Arizona
Tenet Healthcare 4.5
Phoenix, AZ job
Practice Where the Sun Shines Bright
Tenet Healthcare is working with a well-established and fast-growing private cardiology practice to recruit a full-time Non-Invasive Cardiologist in Goodyear, Arizona - one of the most dynamic and desirable communities in the greater Phoenix area.
This is an excellent opportunity to join a collegial group with strong community ties and advanced in-office diagnostics, and a clear partnership track. Enjoy a balanced schedule with majority outpatient care, supported by a skilled team of professionals.
Position Highlights
Full-Time role with partnership track
Schedule: Monday-Friday, 8AM-5PM + 1 weekend/month
Patient Mix:
80% outpatient
20% inpatient rounding and consults
Call: 1:3 (light and shared with group)
Volume:
15-20 patients/day in clinic
5-10 patients/day in hospital
Support Staff: Dedicated MA and NP for inpatient coverage
Onsite Diagnostics & Tools:
Nuclear stress testing
Echocardiogram
Vascular ultrasound
Heart rhythm monitors
Candidate Requirements
MD or DO
Board Eligible or Board Certified in Cardiology
Arizona medical license or eligibility to obtain one
Why Goodyear?
Goodyear, AZ is one of the fastest-growing cities in the Phoenix metro area, offering a perfect blend of suburban comfort, natural beauty, and metropolitan access. Located just 20 minutes west of downtown Phoenix, it's a thriving, family-friendly community with excellent schools, affordable homes, and a laid-back lifestyle.
Area Perks:
Over 300 sunny days per year
Close to hiking, biking, golf, and spring training games
Award-winning master-planned communities
Top-rated public and charter schools
Quick access to Sky Harbor International Airport
Short drive to Scottsdale, Sedona, and Flagstaff
Ranked among the Top 10 Physician-Friendly States
Whether you're raising a family, growing your career, or simply looking for more balance - Goodyear offers the lifestyle you've been searching for.
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
$92k-143k yearly est. 4d ago
Registered Nurse (RN) - CVICU - $33-41 per hour
Tenet-Az Region 4.5
Glendale, AZ job
This position is for a Registered Nurse (RN) specializing in Cardiovascular Intensive Care Unit (CVICU) at Abrazo Arrowhead Campus in Glendale, AZ. The role involves providing direct bedside care to critically ill post-open heart surgery patients, collaborating within a multidisciplinary team, and managing complex cardiovascular cases during night shifts. Candidates must have at least one year of CVICU acute care experience, current RN licensure in Arizona, and relevant certifications such as BLS and ACLS.
Tenet-AZ Region is seeking a Registered Nurse (RN) CVICU for a nursing job in Glendale, Arizona.
Job Description & Requirements
Specialty: CVICU
Discipline: RN
Duration: Ongoing
36 hours per week
Shift: 12 hours
Employment Type: Staff
? Registered Nurse - CVICU | Full Time Nights (7PM-7:30AM)
?Abrazo Arrowhead Campus | 67th Ave & W. Union Hills Dr, Glendale, AZ
?Includes Night Shift Differentials
Bring your critical care expertise to a hospital that values compassion, teamwork, and clinical excellence. Abrazo Arrowhead Campus is hiring a Full-Time CVICU RN for our Night Shift (7PM-7:30AM). If you're looking for a supportive, high-acuity cardiovascular environment where your advanced skills can make a life-saving difference-we'd love to connect.
? Position Summary
As a Registered Nurse in our Cardiovascular Intensive Care Unit (CVICU), you'll deliver individualized, direct bedside care to critically ill patients, including immediate post-open heart surgery recovery. You'll work closely with a collaborative, multidisciplinary team and apply your advanced clinical knowledge to drive high-quality outcomes. Your responsibilities include:
Monitoring and managing patients with cardiac, neuro, ventilator, and hemodynamic support
Leading care for post-CABG, valve replacements, and open-heart recovery
Developing care plans using evidence-based practices
Delegating and supervising care within the healthcare team
Participating in hourly rounding and promoting a safe, patient-centered environment
Taking on charge nurse duties as needed
? Why Abrazo Arrowhead?
High-acuity CVICU with active open-heart surgical program
Supportive leadership that encourages autonomy and continuing education
Strong teamwork culture across ICU, CVOR, respiratory, and cardiac teams
Night shift differentials offered in addition to base pay
Conveniently located in Glendale, AZ, serving the Northwest Valley
Qualifications
Education:
• Required: Nursing Degree from an accredited nursing school
• Preferred: Bachelor of Science in Nursing (BSN)
Experience:
• Required: Minimum 1 year of acute care CVICU experience (we cannot take new grads at this time)
• Preferred:
- Immediate open-heart recovery experience
Proficiency with hemodynamic monitoring and ventilator support
Experience in Cardiac Stepdown or Neuro ICU
Specialty certification (e.g., CCRN) preferred
Licensure/Certifications:
• Current Registered Nurse License in the State of Arizona
• BLS and ACLS (required per department/facility guidelines)
? What You Bring
Strong clinical judgment in high-stakes environments
Excellent communication and leadership skills
Confidence under pressure and a calm, focused demeanor
Dedication to patient safety and compassionate care
Join a CVICU team where every heartbeat matters-especially during nights.
Apply today and take advantage of night shift differentials while working with one of the top cardiovascular care teams in the region.
#LI-TW2
Tenet AZ Job ID #. Posted job title: RN CVICU Specialty FT Nights
Keywords:
Registered Nurse, CVICU, Cardiovascular Intensive Care, Critical Care Nursing, Open Heart Surgery Recovery, Acute Care, BLS, ACLS, Night Shift Nursing, Patient Care
$56k-118k yearly est. 2d ago
Clinical Documentation Specialist II FT Days
Tenet Healthcare 4.5
Phoenix, AZ job
Welcome to Abrazo Health Network, where making a real difference in people's lives is at the heart of everything we do. Beyond just medical treatments, we believe in the power of genuine relationships and heartfelt compassion. It's what sets us apart and makes us truly special.
When you join our team, you're not just stepping into a job - you're becoming part of a community that uplifts and supports each other every day. We know that healthcare requires a unique blend of talent and dedication, and we are fully committed to providing an environment that enriches and rewards your journey.
Picture yourself among the brightest healthcare professionals, all united by a common purpose: caring for our community with unwavering commitment. At Abrazo Health, you won't just find colleagues; you'll find awe-inspiring teammates who share your passion for making a meaningful impact.
If you're ready to go above and beyond, to embrace the energy and camaraderie that Abrazo Health offers, then join us on this incredible adventure. Together, we'll embrace a healthier world - one patient at a time. Let your career find its purpose here at Abrazo.
Clinical Documentation Specialist II Full Time Days Position Summary
Intermediate level position for experienced CDS. Demonstrates all skills of CDS I with < 5% error rate
Job Responsibilities
Is an intermediate level position for experienced CDS.
THE CLINICDOCUMENTATION SPECIALIST II FULL TIME DAYS CANDIDATE WILL POSSESS THE FOLLOWING EDUCATION, LICENSE/CERTIFICATIONS, AND EXPERIENCE.
MINIMUM EDUCATION:
Required: Graduate of an accredited school of nursing, AHIMA accredited school, United States or international school of medicine
MINIMUM EXPERIENCE:
Required: 2-5 years CDS experience and 2 years recent acute care experience in a clinical or inpatient coding setting; or, MBBS and USMLE in lieu of experience.
REQUIRED CERTIFICATIONS/LICENSURE:
Required: RN, LVN, LPN, RHIA, RHIT, CCS, CIC, MD, DO, PA, NP*
#LI-MB1
$45k-66k yearly est. Auto-Apply 48d ago
Associate Specialist, Appeals & Grievances
Molina Healthcare 4.4
Molina Healthcare job in Phoenix, AZ
Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).
**Essential Job Duties**
- Enters denials and requests for appeals into information system and prepares documentation for further review.
- Researches claims issues utilizing systems and other available resources.
- Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines.
- Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research.
- Determines appropriate language for letters and prepares responses to member appeals and grievances.
- Elevates appropriate appeals to the next level for review.
- Generates and mails denial letters.
- Provides support for interdepartmental issues to help coordinate problem-solving in an efficient and timely manner.
- Creates and/or maintains appeals and grievances related statistics and reporting.
- Collaborates with provider and member services to resolve balance bill issues and other member/provider complaints.
**Required Qualifications**
- At least 1 year of experience in claims, and/or 1 year of customer/provider service experience in a health care setting, or equivalent combination of relevant education and experience.
- Customer service experience.
- Organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
- Effective verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
**Preferred Qualifications**
- Customer/provider experience in a managed care organization (Medicaid, Medicare, Marketplace and/or other government-sponsored program), or medical office/hospital setting experience.
- Completion of a health care related vocational program (i.e., certified coder, billing, or medical assistant).
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: $21.65 - $34.88 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$21.7-34.9 hourly 6d ago
Supervisor, Pharmacy Operations/Call Center
Molina Healthcare 4.4
Molina Healthcare job in Scottsdale, AZ
Leads and supervises a team of pharmacy call center representatives and operations staff responsible to ensure that members have access to medically necessary prescription drugs. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care.
**Essential Job Duties**
- Hires, trains, develops, and supervises a team of pharmacy service representatives supporting processes involved with Medicare Stars and Pharmacy quality operations.
- Ensures that average phone call handle time, average speed to answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations.
- Ensures that adequate staffing coverage is present at all times of operation.
- Assists pharmacy leadership with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager (PBM) for pharmacy contractually delegated functions.
- Responsible for key performance indicators (KPI) reporting to department leadership on a monthly basis.
- Participates, researches, and validates materials for both internal and external program audits.
- Acts as liaison to internal and external customers to ensure prompt resolution of identified issues.
- Assists pharmacy leadership in the collection and tabulation of data for reporting purposes and maintains files of confidential information submitted for review.
- Assures that activities and processes are compliant with CMS, National Committee of Quality Assurance (NCQA) guidelines, and Molina policies and procedures.
- Participates in the daily workload of the department, performing Representative duties as needed.
- Facilitates interviews with pharmacy service representative job applicants, and provides hiring recommendations to leadership.
- Provides coaching for pharmacy representatives, and helps identify and provide for training needs in collaboration with pharmacy leadership.
- Communicates effectively with practitioners and pharmacists.
- Collaborates with and keeps pharmacy leadership apprised of operational issues, including staffing resources, program and system needs.
- Assists with development of and maintenance of pharmacy policies and procedures
- Participates in the development of programs designed to enhance preferential or required targeted drugs or supplies.
**Required Qualifications**
- At least 5 years of experience in health care, preferably within a health-related call center environment, or equivalent combination of relevant education and experience.
- Knowledge of prescription drug products, dosage forms and usage.
- Experience designing, implementing, monitoring, and evaluating metrics that measure call center agent productivity.
- Working knowledge of medical/pharmacy terminology
- Excellent verbal and written communication skills.
- Microsoft Office suite, and applicable software program(s) proficiency.
**Preferred Qualifications**
- Supervisory/leadership experience.
- Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice.
- Call center experience.
- Managed care 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: $55,706.51 - $80,464.96 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$55.7k-80.5k yearly 26d ago
Abrazo Central Hiring Event 1.22.26
Tenet Healthcare Corporation 4.5
Phoenix, AZ job
Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the opportunity to make a meaningful impact in patients' lives while enjoying a supportive work environment that fosters professional growth and work-life balance. Ready to be a vital part of our mission? Apply today and bring your passion for nursing to a place where it truly matters!
At Abrazo Central Hospital, 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
Launch Your Career!
Abrazo Central is blasting into 2026 with Career Opportunities for you!
Thursday, 1/22/2026
12PM-2PM
2000 W. Bethany Home Road, Phoenix, AZ 85015
Located in the Wellness Center (across the breezeway from the main entrance)
Now Hiring:
* Experienced Registered Nurses (RN's) Cath Lab, Emergency Dept, Cardiac, Stepdown, OR
* ICU
* Charge Cardiac
* Paramedics
* Surgical Techs
* Central Sterile techs
* Occupational and Physical therapist
* Lead Respiratory Tech
* CT Techs
* Radiology techs
* IR techs
* Dietician
* Endo Techs
* Lab Asst
* Cath Lab Tech
Abrazo offers competitive compensation packages. We offer signing bonuses on select positions. Bring a resume and a smile and c'mon down for an opportunity to check us out and meet the team. Same day interview and offers.
Come see the difference, and why we call Central campus "the Gem in North Central". It's all about the team!
Please RSVP to the event (walk-ins will be welcome) *******************************
#LI-CB4
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.
**********
$28k-34k yearly est. Easy Apply 14d ago
Director Supply Chain
Tenet Healthcare 4.5
Goodyear, AZ job
Welcome to Abrazo Health Network, where making a real difference in people's lives is at the heart of everything we do. Beyond just medical treatments, we believe in the power of genuine relationships and heartfelt compassion. It's what sets us apart and makes us truly special.
When you join our team, you're not just stepping into a job - you're becoming part of a community that uplifts and supports each other every day. We know that healthcare requires a unique blend of talent and dedication, and we are fully committed to providing an environment that enriches and rewards your journey.
Picture yourself among the brightest healthcare professionals, all united by a common purpose: caring for our community with unwavering commitment. At Abrazo Health, you won't just find colleagues; you'll find awe-inspiring teammates who share your passion for making a meaningful impact.
If you're ready to go above and beyond, to embrace the energy and camaraderie that Abrazo Health offers, then join us on this incredible adventure. Together, we'll embrace a healthier world - one patient at a time. Let your career find its purpose here at Abrazo.
Supply Chain Director Position Summary
Directs an organization's overall supply chain operations for a facility or multiple facilities, including purchasing, inventory and distribution of supplies and equipment. Responsible for the financial performance, including the evaluation of spend to established targets, including contract compliance, budget, forecast etc. Develops strategic plans to improve productivity, quality, and efficiency of operations. Ensures that issues regarding existing and new products are resolved in a timely and cost-efficient manner. Direct product conversion efforts at the hospital. Build relationships with peers and administrative leadership. Participate on various committees and meetings. Leads and directs the work of others. Reports to the CFO of the Hospital with an indirect reporting relationship to the Regional Supply Chain Leader. Performs a variety of tasks as assigned.
THE SUPPLY CHAIN DIRECTOR CANDIDATE WILL POSSESS THE FOLLOWING EDUCATION, LICENSE/CERTIFICATIONS, AND EXPERIENCE.
EDUCATION
Bachelor's degree
EXPERIENCE
6 yrs Supply Chain experience in lieu of degree
Required: Healthcare, acute experience
Required experience: 2yrs Director level experience.
LICENSURE/CERTIFICATION
Certified Materials and Resources Professional (CMRP), preferred
#LI-ST2
$104k-134k yearly est. Auto-Apply 60d+ ago
Primary Care Physician (Bilingual Spanish)
Humana 4.8
Phoenix, AZ job
The Physician serves as a health-care professional and capable of handling a variety of health-related problems. The Physician work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Responsibilities
Humana's Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country, operating over 175 centers across eight states under two brands: CenterWell & Conviva. Operating as a payor-agnostic, wholly owned subsidiary of Humana, our centers put the unique needs of seniors at the center of everything we do. Our Clinics offer a team-based care model where our physicians lead a multi-disciplinary care team supporting patient's physical, emotional, and social wellness.
At CenterWell Senior Primary Care we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all.
The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value-based care provider focused on quality of care for the patients we serve. Our care team consists of Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators and more. Our approach allows us to provide an unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes for seniors by providing a concierge experience, multidisciplinary services, coordinated care supported by analytics and tools, and deep community relationships. This robust support allows our PCP to see fewer patients and spend more time with those they do.
Responsibilities
Evaluates and treats center patients in accordance with standards of care.
Follows level of medical care and quality for patients and monitors care using available data and chart reviews.
Assists in the coordination of patient services, including but not limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care.
Acts as an active participant and key source of medical expertise with the care team through daily huddles.
Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in practice by displaying a professional and approachable demeanor.
Completes all medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity.
Follows policy and protocol defined by Clinical Leadership.
Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.
Participates in potential growth opportunities for new or existing services within the Center.
Participates in the local primary care “on-call” program of CenterWell as needed.
Assures personal compliance with licensing, certification, and accrediting bodies.
Spend 100% of your time clinically focused on direct patient care, inclusive of patient facing time and general administrative time (charting, meetings, etc.) as it relates to direct patient care.
Required Qualifications
Current and unrestricted medical license or willing to obtain a medical license in state of practice; eligible and willing to obtain licenses in other states in the region of assignment, as required.
Graduate of accredited MD or DO program of accredited university.
Excellent verbal and written communication skills
Bilingual English & Spanish Required.
Demonstrate a high level of skill with interpersonal relationships and communications with colleagues/patients.
Fully engaged in the concept of “Integrated team-based care” model
Willingness and ability to learn/adapt to practice in a value-based care setting.
Superior patient/customer service
Basic computer skills, including email and EMR.
This role is considered patient facing and is a part of our Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Preferred Qualifications
Board Certification or Eligible to become certified (ABMS or AOA) in Family Medicine, Internal Medicine or Geriatric Medicine preferred.
Active and unrestricted DEA license
Medicare Provider Number
Medicaid Provider Number
Minimum of two to five years directly applicable experience preferred.
Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value-based relationship environment.
Knowledge of Medicare guidelines and coverage
Knowledge of HEDIS quality indicators
Additional Information
Guaranteed base salary + quarterly bonus.
Excellent benefit package - health insurance effective on your first day of employment
CME Allowance/Time
Occurrence Based Malpractice Insurance
Relocation
401(k) with Employer Match
Life Insurance/Disability
Paid Time Off/Holidays
Minimal Call
COVID Policy
For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If Progressed to Offer, You Will Be Required To
Provide proof of full vaccination or commit to testing protocols OR
Provide proof of applicable exemption including any required supporting documentation
Medical, religious, state and remote-only work exemptions are available.
#physiciancareers
Scheduled Weekly Hours
40
$185k-257k yearly est. 4d ago
Informaticist
Humana 4.8
Phoenix, AZ job
**Become a part of our caring community and help us put health first** The Provider Analytics organization's vision is to improve member healthcare through innovative analytics and actionable insights, which empower members, and providers to drive higher quality, lower cost of care, and improved health outcomes. Provider Analytics develops and applies actionable analytics and insights, which are integral to business needs, to drive informed provider network strategy and is looking for an Informaticist 2 to join their team.
The Informaticist 2:
+ Designs and constructs models to estimate impact of contractual changes tied to ancillary and industry leading innovative care delivery models
+ Collates, models, interprets and analyzes data in order to identify, explain, and influence variances and trends
+ Explains variances and trends and enhances modeling techniques
+ Utilizes multiple data sources such as SQL, Power BI, Excel, etc., to create advanced analytics to facilitate contracting initiatives
+ Uses a consultative approach to collaborate effectively with the markets, and other customers, building productive cross-functional relationships
+ Extracts historical data, performs data mining, develops insights to drive provider contracting strategy and reimbursement terms for National Ancillary Contracting
+ Develops tools and automates processes to model financial implications of ancillary contracted rate changes, including changes in capitated arrangements
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
+ Medical Benefits
+ Dental Benefits
+ Vision Benefits
+ Health Savings Accounts
+ Flex Spending Accounts
+ Life Insurance
+ 401(k)
+ PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
+ And more
**Use your skills to make an impact**
**Required Qualifications**
+ 3+ years of demonstrated healthcare analytical experience
+ 1+ years SQL experience
+ 1+ years' experience in data visualization (ie. Power BI, Tableau, etc.)
+ Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends
+ Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues
+ Possess a working knowledge and understand department, segment and organizational strategy
**Preferred Qualifications**
+ Bachelor's Degree in analytics or related field
+ Advanced Degree
+ Understanding of healthcare membership, claims, and other data sources used to evaluate cost and other key financial and quality metrics
**Additional Information**
Work at Home/Remote Requirements
**Work-At-Home Requirements**
+ To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
+ Wireless, Wired Cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
+ Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
**Our Hiring Process**
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
\#LI-LM1
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$73,400 - $100,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-21-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$73.4k-100.1k yearly 6d ago
Medical Records Collector
Molina Healthcare Inc. 4.4
Molina Healthcare Inc. job in Phoenix, AZ
JOB DESCRIPTION Job SummaryProvides support for medical records collection activities. Supports quality improvement activities through outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
* Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records.
* Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application.
* Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database.
* Provides project management support to leadership via coordination, identification, pursuit and collection of medical records and other required data with other HEDIS staff.
* Participates in meetings with vendors related to the medical record collection process.
* Some medical records collection related travel may be required.
Required Qualifications• At least 1 year customer service experience, preferably in an administrative support capacity in a health care setting, or equivalent combination of relevant education and experience.
* Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements.
* Excellent customer service and active listening skills.
* Proficiency with data analysis tools (e.g., Excel).
* Ability to manage files, schedules and information efficiently.
* Ability to effectively interface with staff, clinicians, and leadership.
* Strong prioritization skills and detail orientation.
* Strong verbal and written communication skills, including professional phone etiquette.
* Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs.
Preferred Qualifications
* Registered Health Information Technician (RHIT).
* Medical records collection experience.
* Managed care experience.
* Basic knowledge of Healthcare Effectiveness Data Information Set (HEDIS) and National Committee for Quality Assurance (NCQA).
* Project planning 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: $21.65 - $31.71 / 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.
$21.7-31.7 hourly 2d ago
Analyst, Data
Molina Healthcare Inc. 4.4
Molina Healthcare Inc. job in Mesa, AZ
JOB DESCRIPTIONJob Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. KNOWLEDGE/SKILLS/ABILITIES
* Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers.
* Sets up process for monitoring, tracking, and trending department data.
* Prepares any state mandated reports and analysis.
* Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes.
* Implements and uses the analytics software and systems to support the departments goals.
JOB QUALIFICATIONS
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
1-3 years
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
3-5 years
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: $80,168 - $116,835 / 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.
$80.2k-116.8k yearly 9d ago
Registered Nurse (RN) - Manager, Trauma - $29-38 per hour
Tenet-Az Region 4.5
Avondale, AZ job
The Registered Nurse (RN) Manager, Trauma position at Abrazo Health Network involves leading and supporting nursing practices within the trauma center, ensuring high-quality patient care and efficient resource management. The role requires at least two years of progressive hospital management experience, active RN licensure, effective communication, leadership skills, and the ability to support clinical staff competency. This full-time position includes 12-hour day shifts and focuses on trauma specialty care within a hospital setting.
Tenet-AZ Region is seeking a Registered Nurse (RN) Manager, Trauma for a nursing job in Avondale, Arizona.
Job Description & Requirements
Specialty: Trauma
Discipline: RN
Duration: Ongoing
36 hours per week
Shift: 12 hours
Employment Type: Staff
Welcome to Abrazo Health Network, where making a real difference in people's lives is at the heart of everything we do. Beyond just medical treatments, we believe in the power of genuine relationships and heartfelt compassion. It's what sets us apart and makes us truly special.
When you join our team, you're not just stepping into a job - you're becoming part of a community that uplifts and supports each other every day. We know that healthcare requires a unique blend of talent and dedication, and we are fully committed to providing an environment that enriches and rewards your journey.
Picture yourself among the brightest healthcare professionals, all united by a common purpose: caring for our community with unwavering commitment. At Abrazo Health, you won't just find colleagues; you'll find awe-inspiring teammates who share your passion for making a meaningful impact.
If you're ready to go above and beyond, to embrace the energy and camaraderie that Abrazo Health offers, then join us on this incredible adventure. Together, we'll embrace a healthier world - one patient at a time. Let your career find its purpose here at Abrazo.
RN Manager Trauma Center Full Time Days Position Summary
This role provides leadership and support to the senior executive position (CNO) responsible for all nursing and other designated patient care functions/services within the hospital organization. The role will assume responsibility for assisting in assessing, planning, coordinating, implementing, and evaluating nursing practice on a unit level. Role assumes 24/7 responsibility of manager's assigned areas. The role is accountable to support CNO to ensure high quality, safe and appropriate nursing care, competency of clinical staff, and appropriate resource management related to patient care.
Active and current registered nurse license in the state of residence/practice. Has highly effective interpersonal and communication skills, proven leadership ability and hospital operational ability, and ability to serve as role model and advocate for the professional discipline of nursing.
THE RN MANAGER TRAUMA CENTER FULL TIME DAYS CANDIDATE WILL POSSESS THE FOLLOWING EDUCATION, LICENSE/CERTIFICATIONS, AND EXPERIENCE
Education:
Required: Academic degree in nursing.
Preferred: Bachelor's or master's degree.
Experience:
Required: 2 years of progressive management experience in a hospital environment as a manager or full-time charge nurse/related position.
Certifications:
Required: Currently licensed, certified, or registered to practice profession as required by law, regulation in state of practice or policy. AHA BLS.
#LI-SW2
Tenet AZ Job ID #. Posted job title: RN Manager Trauma Center FT Days
Keywords:
Registered Nurse, RN Manager, Trauma Nurse, Nursing Leadership, Hospital Management, Patient Care, Clinical Staff Management, Healthcare Supervisor, Trauma Center, Nursing Administration
$94k-113k yearly est. 2d ago
Manager, IT Services
Molina Healthcare Inc. 4.4
Molina Healthcare Inc. job in Phoenix, AZ
Responsible for all information technology operations activities, including computer operations, data and operations support. Monitor budgets and expenses within department and accountable for meeting budget goals. Recommends input to policy principles and budget constraints. Provides expertise to departments regarding policies and procedures, problem resolution, and methods.
KNOWLEDGE/SKILLS/ABILITIES
* Analyzes, reviews and measures service level performance against agreed upon service level agreements (Service Level Agreements) with the business and operating-level agreements with service providers (internal and external).
* Works closely with the business and service providers to negotiate and agree on service level requirements off any proposed new services and changes to existing services.
* Works with the business and service providers to define the proper metrics and KPIs in evaluating service delivery quality and performance levels. Produces regular reports on service performance and achievement to stakeholders.
* Organizes and maintains the service level review process with the business and service providers. Initiates any actions required to maintain or improve service levels.
* Acts as a change agent to implement and manage quality improvement processes in service delivery management.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
5-7 years
Preferred Education
Graduate Degree or equivalent combination of education and experience
Preferred Experience
7-9 years
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.
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.
$80.4k-188.2k yearly 6d ago
Analyst, Compliance (Sales)
Molina Healthcare 4.4
Molina Healthcare job in Phoenix, AZ
**(Sales) Compliance Analyst** Molina Healthcare's Medicare Compliance team supports sales operations for the Molina Medicare product lines. It is a centralized corporate function supporting compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** is primarily responsible for Sales Oversight.
· Provide regulatory expertise to the Sales Organization: both State and Federal
· Have working knowledge of federal and state guidelines pertaining to Sales and Marketing.
· Perform internal Sales/Marketing Compliance Reporting.
· Perform internal Sales/Marketing monitoring.
· Detailed oriented to conduct thorough Sales allegations investigations.
· Recommend applicable corrective action(s) when applicable to business partners.
· Process improvement driven.
· Create, update, and retire P&Ps, Standard Operating Procedures and Training documents.
· Lead regularly scheduled Sales & Compliance leadership meetings.
· Interpret and analyze Medicare, Medicaid, and MMP Required Sales & Marketing Reporting Technical Specifications.
· Create and maintain monthly and quarterly Sales Complaint Key Performance Indicator (KPI) reports.
· Review and interpret internal Sales dashboards for outliers and deeper dive research.
· Manage compliance Sales Allegations, Secret Shops, and recommend corrective action plans for deficiencies found.
· Responds to legislative inquiries/ Sales complaints (state insurance regulators, Congressional, etc.).
· Leads projects to achieve Sales compliance objectives.
· Interprets and analyzes state and federal regulatory manuals and revisions.
· Interpret and analyze federal and state rules and requirements for proposed & final rules for Sales Oversight.
· Interact with Molina external customers, via verbal and written communication.
· Ability to work independently and set priorities.
**Experience**
· 2-4 years' related compliance work experience
· Exceptional communication skills, including presentation capabilities, both written and verbal.
· Excellent interpersonal communication and oral and written communication skills.
· High level Interaction with Leadership.
· Sales Allegation Investigations
· Policy & Procedures
Pay Range: $80,168 - $116,835 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$80.2k-116.8k yearly 29d ago
Exercise Physiologist FT Days
Tenet Healthcare Corporation 4.5
Phoenix, AZ job
Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story
We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care.
We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others.
Our Impact Today
Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions.
Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions.
Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day.
Welcome to Abrazo Health Network, where making a real difference in people's lives is at the heart of everything we do. Beyond just medical treatments, we believe in the power of genuine relationships and heartfelt compassion. It's what sets us apart and makes us truly special.
When you join our team, you're not just stepping into a job - you're becoming part of a community that uplifts and supports each other every day. We know that healthcare requires a unique blend of talent and dedication, and we are fully committed to providing an environment that enriches and rewards your journey.
Picture yourself among the brightest healthcare professionals, all united by a common purpose: caring for our community with unwavering commitment. At Abrazo Health, you won't just find colleagues; you'll find awe-inspiring teammates who share your passion for making a meaningful impact.
If you're ready to go above and beyond, to embrace the energy and camaraderie that Abrazo Health offers, then join us on this incredible adventure. Together, we'll embrace a healthier world - one patient at a time. Let your career find its purpose here at Abrazo.
Exercise Physiologist Full Time Days Position Summary
* Supervising and monitoring outpatient cardiac rehab Phase 2 and 3 -observation and evaluation of adult chronic cardiovascular disease patients during exercise.
* Monitoring and assessing blood pressure and EKG rhythm strips during exercise session
* Completing individualized treatment plans including: risk factor assessment, risk factor management, goal setting and exercise prescription.
* Processing patient referrals from cardiology offices and hospitals
* Solid understanding and the ability to explain cardiac medications, cardiac procedures and the CAD process
* Understanding of cardiovascular emergency procedures and cardiac medications
* Applies concepts of customer relations and advocacy.
* Promotes positive relationships.
* Provide weekly outpatient education.
* Periodic cardiac inpatient education.
* Maintaining national program certification standards including fitness assessment, optimal blood pressure management, smoking cessation management, and psychosocial assessment.
SPECIAL SKILLS: Excellent communication skills. Effective interpersonal skills and ability to work with team members required. Computer skills preferred. Well-defined organizational and time management skills. EKG monitoring and interpretation skills, Vitals assessment, understanding of cardiac medications, pathophysiology and cardiac risk factors, and cardiac exercise programming.
LICENSE/CERTIFICATIONS, AND EXPERIENCE.
MINIMUM EDUCATION: Bachelor's degree in Exercise Physiology or related field required.
PREFERRED EDUCATION:
MINIMUM EXPERIENCE: Cardiac Rehabilitation internship or employment experience required
PREFERRED EXPERIENCE: 2-4 years of Cardiac Rehabilitation experience. Certification or application for, or experience equivalent to those specified for a Certified Exercise Physiologist or Certified Clinical Exercise Physiologist from ACSM (American College of Sports Medicine).
REQUIRED CERTIFICATIONS/LICENSURE: BLS.
REQUIRED COURSE(S) TRAINING: ACLS if required by facility
#LI-AL2
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.
**********
$41k-68k yearly est. 22d ago
Corporate Development Manager
Molina Healthcare Inc. 4.4
Molina Healthcare Inc. job in Phoenix, AZ
Provides lead level support in the execution of merger and acquisition transactions and actively contributes to the advancement of Molina Healthcare's overall growth strategy. Duties include strategically identifying, sourcing, evaluating, and executing Molina Healthcare's inorganic growth initiatives, including acquisitions, divestitures, joint ventures, and strategic partnerships. Collaborates closely with Molina Healthcare's Mergers and Acquisitions (M&A) and operational leadership to evaluate and execute meaningful growth initiatives.
Job Duties
* Partners with internal stakeholders to research and assess potential acquisition opportunities.
* Develops financial and valuation models and perform comprehensive analyses to assess potential transaction opportunities and influence decision-making.
* Coordinates all aspects of the M&A process, including due diligence, data rooms, transaction documents, internal updates, and senior management/board presentations.
* Coordinates deal activities among internal cross-functional teams and external parties.
* Embraces ad-hoc assignments and projects across Corporate Development and in support of post-acquisition integration efforts.
* Actively participates in reviewing and negotiating transaction agreements.
* Establishes a robust understanding of customer segments, industry trends, market positioning, and emerging opportunities.
Required Qualifications
* At least 5 years' experience in investment banking, private equity, management consulting, corporate development, or similar environments, or equivalent combination of relevant education and experience
* Exceptional financial modeling, interpersonal, and project management skills.
* Attention to detail. Strong work ethic. Proactive self-starter. Calm under pressure. Able to adapt to fast-paced, ambiguous environments. High learning agility. Consummate teammate.
* Excellent written communication skills. Strong spoken communication skills.
Preferred Qualifications
* Bachelor's degree in Finance, Economics, Mathematics, or a similar field.
* Previous healthcare 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: $88,453 - $206,981 / 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.
$88.5k-207k yearly 2d ago
EEG Tech
Tenet Healthcare 4.5
Goodyear, AZ job
A non-exempt medical office position that prepares patients for and conducts EEG studies used for diagnosis and treatment.
Education: High school graduation and completion of a training course or on-the-job training.
Certification: Current R. EEGT certification through ABRET per state requirement. CPR Certification through AHA.
Experience: Work requires a level knowledge of patient care methods, procedures and techniques. One year of experience performing EEG experience preferred.
#LI-KK1
Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Physician Resources.
Adheres to the Tenet HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.
Demonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
Prepare patient by gathering medical history and necessary information, able to explain testing.
Perform various neurology studies
$51k-84k yearly est. Auto-Apply 8d ago
Associate Specialist, Appeals & Grievances
Molina Healthcare Inc. 4.4
Molina Healthcare Inc. job in Scottsdale, AZ
Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS).
Essential Job Duties
* Enters denials and requests for appeals into information system and prepares documentation for further review.
* Researches claims issues utilizing systems and other available resources.
* Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines.
* Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research.
* Determines appropriate language for letters and prepares responses to member appeals and grievances.
* Elevates appropriate appeals to the next level for review.
* Generates and mails denial letters.
* Provides support for interdepartmental issues to help coordinate problem-solving in an efficient and timely manner.
* Creates and/or maintains appeals and grievances related statistics and reporting.
* Collaborates with provider and member services to resolve balance bill issues and other member/provider complaints.
Required Qualifications
* At least 1 year of experience in claims, and/or 1 year of customer/provider service experience in a health care setting, or equivalent combination of relevant education and experience.
* Customer service experience.
* Organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
* Effective verbal and written communication skills.
* Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
* Customer/provider experience in a managed care organization (Medicaid, Medicare, Marketplace and/or other government-sponsored program), or medical office/hospital setting experience.
* Completion of a health care related vocational program (i.e., certified coder, billing, or medical assistant).
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: $21.65 - $34.88 / 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.