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Senior Specialist jobs at Molina Healthcare - 3049 jobs

  • Senior Specialist, Member & Community Interventions (Remote)

    Molina Healthcare 4.4company rating

    Senior specialist job at Molina Healthcare

    The Sr Specialist, Member & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid). Executes health plan's member and community quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes. Acts as a lead specialist within the department and/or collaboratively with other departments. **Job Duties** + Acts as a lead specialist to provide project, program, and/or initiative related direction and guidance for other specialists within the department and/or collaboratively with other departments + Implements evidence-based and data-informed member intervention strategies, which may include initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state-required quality activities + Monitors and ensures that key member intervention activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed + Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions + Creates, manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables + Participates in quality improvement activities, meetings, and discussions with and between other departments within the organization + Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations + Evaluates project/program activities and results to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation + Other tasks, duties, projects, and programs as assigned + This position may require same-day out-of-office travel 0 - 25% of the time, depending upon location + This position may require multiple days out-of-town overnight travel on occasion, depending upon location **Job Qualifications** **REQUIRED QUALIFICATIONS:** + Bachelor's Degree or equivalent combination of education and work experience. + 3 years' experience in healthcare with a minimum of 2 years' experience in health plan member interventions, managed care, or equivalent experience. + Demonstrated solid business writing experience. + Operational knowledge and experience with Excel and Visio (flow chart equivalent) + Demonstrates flexibility when it comes to changes and maintains a positive outlook. + Has excellent problem-solving skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis, and/or interpretation + Certified Professional in Health Quality (CPHQ) + Nursing License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) 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: $54,922 - $107,099 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $54.9k-107.1k yearly 5d ago
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  • ECMO Specialist ($20,000 Sign On Bonus)

    Boston Children's Hospital 4.8company rating

    Boston, MA jobs

    The ECMO Specialist is enrolled and actively participating in the department's ECMO Training Program. This role is responsible for developing and maintaining the skills necessary to proficiently and safely establish, manage, and control extracorporeal membrane oxygenation (ECMO) technology and assist with associated procedures in acutely ill patients of all ages in critical care settings. The specialist will learn to troubleshoot devices and associated equipment under the supervision of experienced ECMO personnel, provide ongoing care through surveillance of clinical and physiologic parameters, adjust ECLS devices as needed, administer and document blood products and medications in accordance with hospital standards, provide airway and ventilator management, and perform the full scope of practice of a Respiratory Therapist II. Schedule: 36 hours per week, rotating day/night shifts, every third weekend. **This position is eligible for full time benefits $20,000 sign-on bonus (not eligible for internal candidates and not eligible for former BCH employees who worked here in the past 2 years) Key Responsibilities: Assemble, prepare, and maintain extracorporeal circuits and associated equipment with assistance. Assist in priming extracorporeal circuits and preparing systems for clinical application. Assist with cannulation procedures. Assist in establishing extracorporeal support; monitor patient response, provide routine assessments, circuit evaluations, patient monitoring, and anticoagulation management. Assist with ECMO circuit interventions, weaning procedures, and transports. Administer blood products per hospital standards. Interact and communicate with caregivers, nursing, surgical and medical teams, patients, and family members. Maintain relevant clinical documentation in the patient's electronic health record. Participate in professional development, simulation, and continuing education. Attend ECMO Team meetings and M&M conferences on a regular basis. Minimum Qualifications Education: Required: Associate's Degree in Respiratory Therapy Preferred: Bachelor's Degree Experience: Required: A minimum of one year of experience as a BCH Respiratory Therapist with eligibility for promotion to RT II, or one year of external ECMO experience Preferred: None specified Licensure / Certifications: Required: Current Massachusetts license as a Respiratory Therapist Required: Current credential by the National Board of Respiratory Care as a Registered Respiratory Therapist (RRT); Neonatal Pediatric Specialist (NPS) credential must be obtained within 6 months of entry into the role Preferred: None specified The posted pay range is Boston Children's reasonable and good-faith expectation for this pay at the time of posting. Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.
    $67k-93k yearly est. 4d ago
  • Quality Improvement Specialist

    Sevita 4.3company rating

    Wichita Falls, TX jobs

    D&S Community Services, a part of the Sevita family, provides community-based services for individuals with intellectual and developmental disabilities. Here we believe every person has the right to live well, and everyone deserves to have a fulfilling career. You'll join a mission-driven team and create relationships that motivate us all every day. Join us today, and experience a career well lived. Quality Improvement Specialist, IDD Social Services Wichita Falls, TX Salary: $50,000 Schedule: Monday-Friday; 8am-5pm (remote with travel) Job Description Provide quality assurance/improvement technical assistance and subject matter expertise with local process improvement initiatives. Verify implementation of effective strategies for improvement designed to measure and improve outcome measures. Monitor quality improvement goals and track outcomes and measurements. Review incident data and prepare and analyze trended reports for management. Conduct incident report training and technical support in a region. Perform internal investigations of incidents and/or allegations. Conduct audits and support operations to prepare for licensing / certification reviews. Qualifications Experience in quality improvement or other related social services (HCS or ICF) field is required. Current driver's license, car registration, and auto insurance. Strong attention to detail, organizational skills, and the ability to multi-task to meet deadlines. Excellent communication and customer service skills. A commitment to quality in everything you do. This position is critical to our success and exemplifies the wonderful mission driven work we do here every day. Why Join Us Full compensation/benefits package for employees working 32+ hours/week. 401(k) with company match. Paid time off and holiday pay. Rewarding work, impacting the lives of those you serve, working alongside a great team of coworkers. Enjoy job security with nationwide career development and advancement opportunities. Come join our amazing team of committed and caring professionals. Apply Today! Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face. We've made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S. As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.
    $50k yearly 4d ago
  • Polysomnographic Specialist - PRN

    Saint Luke's Hospital of Kansas City 4.6company rating

    Kansas City, MO jobs

    Are you looking to join a phenomenal team where patient care is at the center of everything we do? Look no further! Day 8-10 hours per week preferred RPSGT or RRT required BLS preferred The Opportunity: The Polysomnographic Specialist performs all aspects of care as outlined in national and departmental clinical standard of practice policy and procedure manual and in accordance with written verbal orders or approved protocol flow charts. This position will assist with MSLT and home sleep study set-ups. Clinical practice activities include but are not limited to the performance of diagnostic polysomnographic testing, assessment based therapeutic interventions and the analysis and scoring of polysomnographic records. The Polysomnographic Specialist accountabilities include the assessment and evaluation of histories and physicals, diagnostic, clinical and sleep related data pursuant to the development and monitoring of planned interventions in collaboration with the medical staff. The Polysomnographic Specialist supports and participates as appropriate in staff meetings, study quality, adherence to departmental protocols, continuing education, and professional growth development activities and performs other duties as assigned. Why Saint Luke's? We believe in work/life balance. We are dedicated to innovation and always looking for ways to improve. We believe in creating a collaborative environment where all voices are heard. We are here for you and will support you in achieving your goals. #LI-CK2 Job Requirements Applicable Experience: Less than 1 year Basic Life Support - American Heart Association or Red Cross, Polysomnographic Technologist - Board of Registered Polysomnographic Technologists Job Details PRN Day (United States of America) The best place to get care. The best place to give care . Saint Luke's 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter. Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.
    $34k-54k yearly est. Auto-Apply 1d ago
  • Senior PM, Identity & Access Platform (Hybrid)

    Hinge-Health 4.4company rating

    San Francisco, CA jobs

    A healthcare technology company in San Francisco seeks a Product Manager to lead the strategy and roadmap for their accounts platform. The ideal candidate has over 6 years of product management experience and is proficient in SQL. This role involves improving user experiences and collaborating across multiple teams. The company provides a hybrid work model, allowing employees to work remote part of the week. #J-18808-Ljbffr
    $98k-150k yearly est. 3d ago
  • Associate Spine Specialist (Boston, MA)

    Globus Medical 4.5company rating

    Boston, MA jobs

    Associate Spine Specialist (Boston, MA) page is loaded## Associate Spine Specialist (Boston, MA)locations: Massachusettstime type: Full timeposted on: Posted 25 Days Agojob requisition id: JR104911At Globus Medical, we move with a sense of urgency to deliver innovations that improve the quality of life of patients with musculoskeletal disorders. Our team is inspired by the needs of these patients, and the surgeons and healthcare providers who treat them. We embrace a culture of exceptional response by partnering with researchers and educators to transform clinical insights into tangible solutions. Our solutions improve the techniques and outcomes of surgery so patients can resume their lives as quickly as possible The Associate Spine Specialist will work together with the Spine Territory Manager and will have territory coverage, inventory management, and limited sales responsibilities. The Associate Spine Specialist will represent the company in accordance with the company's quality policy and procedures.**Essential Functions****:*** Gains and consistently increases product knowledge through formal sales training; surgeon speaker programs, attends surgeries/operating room visits, and industry research* Meeting or exceeds all sales goals and objectives assigned* Conducts sales calls to promote, sells, and services Globus Medical products and services to existing and competitive customers based on a strategic plan* Assists the Spine Territory Manager on field calls for assigned geography and address and problems that arise on the account* Performs field ride along with the Area Director and Spine Territory Manager on a regular basis* Develops and increases customer base and continually enhances Globus product market share within assigned territory* Provides feedback regularly on topics such as product development opportunities, new target accounts, sales performance, and market feedback* Maintains conduct that is aligned with company quality policy and procedures, and protects confidentiality with proprietary information* Stays current with all compliance training requirements* Adheres to the letter and spirit of the company Code of Conduct, the AdvaMed Code, MedTech Code, and all other company policies.* Ensures Compliance with applicable governmental laws, rules, and regulations, both in the United States and internationally, by completing introductory and annual training and maintaining knowledge of compliance as it applies to your role* Represents the company in a professional manner and uphold the highest standards of ethical business practices and socially responsible conduct in all interactions with other employees, customers, suppliers, and other third parties*Reasonable accommodations may be made to enable individuals with disabilities to perform these* essential *functions.***Qualifications****:*** 1-2 years' successful spine sales experience preferred, may consider other healthcare related sales and or business to business sales experience* Bachelor's degree in Science or Business* Exemplary ability to listen, communicate and influence* Ability to travel as necessary, which may include nights and/or weekends* Strong understanding of spinal anatomy* Ability to make sales presentations with positive results**Physical Demands****:**The physical demands listed here are representative of those that must be met by and employee to successfully perform the essential functions of this job.* Required to sit; climb or balance; and stoop, kneel, crouch or crawl* Required to regularly lift and/or move up to 10 pounds, and occasionally lift and/or move up to 25 pounds* Required to possess specific visons abilities, including: close vision, distance vision, color vision, peripheral vision, depth perception and capacity to adjust focus.**Our Values:**Our Life Moves Us philosophy is built on four values: Passionate About Innovation, Customer Focused, Teamwork, and Driven.* **Passionate about Innovation**: Improving patient care by delivering advanced technology to our customers is at the core of what we do. We are passionate in our role in improving the lives of patients by continuously developing better solutions.* **Customer Focused**: We listen to our customers' needs and respond with a sense of urgency.* **Teamwork**: Working together, anything is possible. We value every person on our team and treat each other with respect. We are accountable to one another and support each other. Together, we make each other stronger.* **Driven**: We pursue our mission with energy and passion. We are nimble, results-oriented and decisive. We overcome obstacles that arise in our quest to deliver solutions that will improve the lives of our customers and patients. **Equal Employment Opportunity:**Globus Medical is an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, age, disability, marital status, pregnancy, national origin or citizenship. We are committed to a diverse workforce. We value all employees' talents and support an environment that is inclusive and respectful. **Other Duties:**Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. #J-18808-Ljbffr
    $75k-86k yearly est. 1d ago
  • Senior MSL, New England - Rare Disease CGT

    Beam Therapeutics 4.0company rating

    Boston, MA jobs

    A leading biotechnology company is seeking a Medical Science Liaison for the New England region. This role involves developing territory strategies and building relationships with key opinion leaders in sickle cell disease. Candidates should have an advanced scientific degree and 10+ years of experience in Medical Affairs, with a strong focus on rare diseases and hematology. The position requires outstanding communication skills and the ability to translate complex science into clear narratives. The company offers a competitive salary range of $180,000 to $220,000 USD. #J-18808-Ljbffr
    $180k-220k yearly 3d ago
  • Senior AI Digital Operations Specialist

    Generali Global Assistance | Travel Insurance 4.4company rating

    Pembroke Pines, FL jobs

    Embark on a Journey That Makes a Difference. At Generali Global Assistance (GGA), every day is an opportunity to help people explore the world with confidence. We're not just in the business of protection-we're in the business of adventure and peace of mind. Whether it's a backpacker trekking through the Andes, a family cruising the Mediterranean, or a solo traveler chasing the Northern Lights, we're there to ensure their journey is safe and supported. From assisting with emergency medical claims to guiding customers through trip disruptions or ID theft, your work helps turn travel challenges into stories of resilience. Set Sail on a Career Path to Success. Our teams value curiosity and collaboration while priding ourselves on fostering a welcoming and inclusive atmosphere for our employees. Elevate your journey through our internal programs, including: Diversity, Equity, and Inclusion (DEI) Committee Career pathing and Individual Development Plans Internal training and intern opportunities Women in Business Mentorship Program Employee awards and recognition Education and professional development assistance program Passport to Perks Includes: Generous Employer contribution for health, dental, and vision insurance Paid Maternity and Paternity Leave Scholarship Program for Employee Dependents Company match on 401k Employee Assistance Program (EAP) Company paid short-term and long-term disability insurance Company paid life insurance Voluntary Pet Insurance Voluntary Legal Benefit Discounts on travel insurance Time off policies including vacation days, sick days, personal days, holidays and volunteer days (VTO) Your Role on the Expedition: The Sr AI Digital Operations Specialist oversees the efficiency and development of Generali's digital assets. As the Sr AI Digital Operations Specialist, this incumbent will be responsible for implementing digitization initiatives, overseeing their implementation, and evaluating their effectiveness. The Senior AI Digital Operations Specialist will focus on both enhancing existing digital assets and identifying and deploying new assets with a strong focus on AI. The role will also be responsible for analyzing market data and interacting with internal and external stakeholders. This role will report directly to the Senior Manager, Digital Operations. Chart Your Course: Lead digital initiatives, including identifying and prioritizing projects and overseeing project execution. Develop and implement solutions to digitize services with a focus on Operations. Work closely with Operations, IT, and third-party technology partners to leverage data and reporting, optimize efficiencies, and drive improvements using technology. Ongoing research of potential use cases for Generative AI technologies (e.g., customer service support...) and implementation at scale, including KPI monitoring, efficiency optimization and impact measurement. Analyze and evaluate tool performance to identify areas for improvement and implement key digital transformation strategies to improve efficiency, productivity, and employee/customer experience. Manage process optimization and automation tools (preferably able to modify workflows, etc. within existing or future tools). Responsible for delivering digital/automation roadmaps by mapping companies' needs with available technology, with strong focus on AI. Analyze and evaluate existing business processes and digital solutions to identify areas for automation and improvement. Extract, transform, and load data to facilitate automation processes and generate insights for decision-making. Conduct rigorous testing of automated processes and digital assets to ensure accuracy, reliability, and compliance with quality and security standards. Stay up to date with emerging automation technologies and best practices to continuously enhance our automation capabilities. Frequently benchmark competition and Insurance market automation practices. Stay updated with the latest trends, you will communicate clear and actionable recommendations to stakeholders. Your Ticket to Success: Required Qualifications: High School Diploma or Equivalent (GED) required. Bachelor's degree in business management, Information Technology, or related field. 5+ years of digital transformation, project management or operational excellence. Exceptional quantitative and problem-solving skills. Ability to analyze data, overcome data noise, and make data-driven decisions. Experience working with complex projects with high quality deliverables and rollout of new technology solutions. Organized, efficient and a critical thinker who can work on complex projects, break them down logically, and own them from start to finish. A strong communicator that can efficiently convey takeaways and insights to drive improvements. Flexibility to learn, understand, and evaluate new concepts in unfamiliar functional areas and new technologies. Excellent project management skills with proven ability to meet deadlines, comfortable with a fast-paced environment. Preferred Qualifications: Strong experience in Data Analysis, Excel is mandatory, PowerBI/Python. Good understanding and proven experience with Generative AI. Requires IT knowledge, project management and business/operations skills, experience working at the intersection between IT and business departments. Position Coordinates: This is a hybrid role based out of our Pembroke Pines, FL office. As a hybrid role, you will be working onsite 2-3 days a week and working from home 2-3 days a week. Time for Take-off: While there is some flexibility in the hours, this position will be Monday-Friday during regular business hours (approximately 8:00am-5:00pm). Occasional overtime may be required according to business need. One team. Every destination. Generali Global Assistance is proudly part of the Europ Assistance Group and our products utilize a number of corporate and product brands. The brands for our North American team include the following: CSA: US travel insurance brand for retail, tour operator, cruise and lodging partners. Learn more here. Generali Global Assistance (GGA): The primary Corporate brand in the United States for our travel insurance, travel assistance, identity and cyber protection, and beneficiary companion products. Learn more here. GMMI: the industry standard for global medical cost containment and medical risk management solutions. Learn more here. Iris, Powered by Generali: identity and digital protection solution. Learn more here. Explore new horizons - apply today! Don't meet every single requirement? At Generali Global Assistance, we are dedicated to building a diverse, inclusive and enriching workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles. California Residents - Privacy Notice for California Residents Seeking Employment with Generali Global Assistance is available here: *************************************************************************************************** The Company is committed to providing equal employment opportunity in all our employment programs and decisions. Discrimination in employment on the basis of any classification protected under federal, state, or local law is a violation of our policy. Equal employment opportunity is provided to all employees and applicants for employment without regard age, race, color, religion, creed, sex, gender identity, gender expression, transgender status, pregnancy, childbirth, medical conditions related to pregnancy or childbirth, sexual orientation, national origin, ancestry, ethnicity, citizenship, genetic information, marital status, military status, HIV/AIDS status, mental or physical disability, use of a guide or support animal because of blindness, deafness, or physical handicap, or any other legally protected basis under applicable federal, state, or local law. This policy applies to all terms and conditions of employment, including, but not limited to, recruitment and hiring, classification, placement, promotion, termination, reductions in force, recall, transfer, leaves of absences, compensation, and training. Any employees with questions or concerns about equal employment opportunities in the workplace are encouraged to bring these issues to the attention of Human Resources. The Company will not allow any form of retaliation against individuals who raise issues of equal employment opportunity. All Company employees are responsible for complying with the Company's Equal Opportunity Policy. Every employee is to treat all other employees equally and fairly. Violations of this policy may subject an employee to disciplinary action, up to and including termination of employment.
    $54k-88k yearly est. 4d ago
  • Senior PMM, B2B Software & Services Storytelling

    El Camino Health 4.4company rating

    San Jose, CA jobs

    A leading technology company is seeking a Senior Product Marketing Manager to craft compelling narratives for their software and services. This role involves collaborating with product teams, delivering impactful storytelling through various media, and leading sales education initiatives. Candidates should possess exceptional writing and communication skills, and a strong understanding of product positioning. A hybrid work model is available, allowing flexibility in the workplace. #J-18808-Ljbffr
    $69k-89k yearly est. 2d ago
  • Senior HRBP, Commercial Talent & Org Strategy

    Gilead Sciences, Inc. 4.5company rating

    Santa Monica, CA jobs

    A leading biopharmaceutical company is seeking a Senior Director, HR Business Partner to shape talent strategies for their Commercial Organization in Santa Monica, CA. This role involves organizational development, advising leaders, and enhancing talent acquisition and development processes. The ideal candidate will have extensive experience in Human Resources, strong leadership competencies, and a commitment to inclusion and diversity. The position requires on-site presence three days a week. #J-18808-Ljbffr
    $103k-135k yearly est. 5d ago
  • Operations Specialist

    Grip 4.0company rating

    Miami, FL jobs

    We are seeking a dedicated and enthusiastic Operations Specialist to join our team. You will be the face of the company for our clients, responsible for ensuring customer satisfaction through exceptional customer service and experience. You will play a pivotal role in fostering strong relationships with our clients, understanding their needs, and ensuring that their interactions with Grip are positive and rewarding. This role requires a proactive approach to problem-solving, a deep commitment to customer care, and the ability to work seamlessly with various internal teams to enhance the overall client experience. Specific responsibilities: Serve as the primary point of contact for clients, responding to chats, emails, and calls. Build sustainable, long-term relationships with clients and ensure satisfaction by providing professional client support. Collaborate with the operations team on fulfillment requests and warehouse-related tasks. Schedule regular meetings with clients and document these meetings with well-written notes. Identify opportunities to improve the client experience and propose new ideas or solutions when appropriate. Utilize our task creation and project management system to ensure all client requests are completed on time. Handles proactive communication to clients for events impacting orders and on-time delivery. Oversee projects, which include client reports, client onboardings, and claims. Qualifications: Excellent oral and written communication skills. Experience in retail/customer service. Ability to multi-task, prioritize, and manage time effectively. Proactive approach to enhancing the client experience. Strong attention to detail and problem-solving skills. Excellent problem-solving and critical-thinking skills. Experience in 3PL, Client Experience, or Account Management is preferred. Equal Employment Opportunity Statement: Grip is an equal opportunity employer, dedicated to complying with all applicable non-discrimination laws. We are committed to providing an inclusive workplace environment, where all employees and applicants are treated with respect and without discrimination based on race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), national origin, age, disability, genetic information, or any other characteristic protected by law.
    $38k-68k yearly est. 5d ago
  • ONCOLOGY DATA SPECIALIST(TUMOR REGISTRAR) - VALLEY HEALTH SYSTEM (PER DIEM)

    Valley Health System Consolidated Services 4.2company rating

    Las Vegas, NV jobs

    Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1979, the Valley Health System has grown to include Centennial Hills Hospital Medical Center, Spring Valley Hospital Medical Center, Summerlin Hospital Medical Center,Henderson Hospital, Valley Health Specialty Hospital, and West Henderson Hospital. Benefit Highlights: Comprehensive education and training center Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan Career opportunities within VHS and UHS Subsidies Challenging and rewarding work environment Job Description: Responsible for establishing and maintaining a hospital-based cancer registry that meets or exceeds the standards for cancer registries of the American College of Surgeons Commission on Cancer. Qualifications Education: Associates Degree or a minimum of 2 years experience required. Experience: One or more years of cancer registry experience required. Technical Skills: Computer proficiency to include word processing, databases, spreadsheets and knowledge of the International Classification of Diseases for Oncology (ICD-0) coding system. Knowledge of medical terminology, anatomy and physiology, and disease processes rela License/Certification: Oncology Data Specialist - Certified (ODS-C) or ODS eligible. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: or 1-800-###-####.
    $43k-80k yearly est. 6d ago
  • Organizational Quality Nurse Specialist

    Hospice of Michigan 4.7company rating

    Ann Arbor, MI jobs

    Responsible for maintaining compliance with all State, Federal regulatory guidelines and third party payers; Accreditation standards and quality activities of the organization. Provides leadership and expertise to facilitate and support staff competency through best practice teaching, consultation, collaboration and the use of current knowledge, research and technology. Essential Functions: Ensures that there are processes in place to monitor and measure all activities related to quality assessment and performance improvement (QAPI). Provides direction and coordination of quality improvement activities utilizing continuous quality improvement principles and methodologies. Provides education and training to organization personnel on the QAPI plan, and team development. Performs clinical record review activities for data collection. Compiles, analyzes, trends and reports quality data in the following areas: hospice & palliative care quality reporting, patient care, safety, risk management, infection control, outcomes and customer satisfaction. Works collaboratively with nursing supervisors/managers/directors to assure documentation is complete and consistent with care and reflects legal requirements. Promotes professional standards of care, compliance with regulatory requirements, third-party payor reimbursement models, and organization policies and procedures through use of performance improvement methodology. Ensures complete responses to Additional Development Requests (ADRs), Comprehensive Error Rate Testing (CERT), Recovery Audit Contractor (RAC) etc., requests and participates in appeal processes. Participates in the development and annual revision of Quality Assessment and Improvement Plans and Program Evaluation. Participates in analyzing, developing, coordinating and implementing plans of correction for noted deficiencies. Makes recommendations to the education committee for mandatory education related to accreditations and compliance topics. Acts as a mentor and resource for staff with regard to performance improvement methodology, regulatory, educational and patient care issues. Participates in the evaluation, development and revision of policies and procedures for hospice. Participates on various committees related to Organizational Quality and Education. Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal and professional networks. Adheres to organizational Code of Conduct, policies, procedures, protocols and processes and all regulatory and legal requirements Adheres to the C.A.R.E. Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: Registered Nurse with a baccalaureate degree in nursing, preferably a Master's Degree in a health-related discipline. Minimum three (3) years' direct hospice experience may be considered in lieu of BSN degree. Requires two to three years related quality and accreditation experience. Current RN licensure in State of Michigan and maintain such licensure in accordance with applicable laws and regulations and perform within the scope specified. Extensive knowledge of Hospice regulations and standards preferred. Excellent written, verbal and interpersonal skills necessary to interact with a wide variety of staff. Is self-directed and able to work with minimal supervision. Requires knowledge of quality assessment and utilization review functions, principles and practices. Theoretical and practical knowledge of principles of adult learning and ability to develop and present educational programs. Quantitative, analytical and computer skills to collect, analyze, display and present data. The physical and sensory demands of the position include: vision, effective speech and hearing for extensive telephone contact; repetitive motion; traveling; driving or riding in motor vehicle; standing, sitting, walking, bending, reaching, and stretching; lifting up to forty five (45) pounds unassisted and the ability to assist in lifting patients using appropriate lifting techniques and/or devices. Must be able to work variable hours/shifts and/or days, including weekends. Must have ability to occasionally work extended days. Must be eligible to work in the United States.
    $80k-97k yearly est. 4d ago
  • Quality Improvement Specialist

    Sevita 4.3company rating

    Phoenix, AZ jobs

    Tungland, a part of the Sevita family, provides community-based services for individuals with intellectual and developmental disabilities. Here we believe every person has the right to live well, and everyone deserves to have a fulfilling career. You'll join a mission-driven team and create relationships that motivate us all every day. Join us today, and experience a career well lived. Quality Improvement Specialist Do you want to work in a dynamic environment where no day is ever the same as the next? In this role your tasks will be diversified and you will be supporting our mission. Provide quality assurance/improvement technical assistance and subject matter expertise with local process improvement initiatives. Verify implementation of effective strategies for improvement designed to measure and improve outcome measures. Monitor quality improvement goals and track outcomes and measurements. Review incident data and prepare and analyze trended reports for management. Conduct incident report training and technical support in a region. Perform internal investigations of incidents and/or allegations. Conduct audits and support operations to prepare for licensing / certification reviews. Qualifications: Bachelor's degree or an equivalent combination of education and experience. Three years' experience in quality improvement or other related social services field is required. Current driver's license, car registration, and auto insurance. Strong attention to detail, organizational skills, and the ability to multi-task to meet deadlines. Excellent communication and customer service skills. A commitment to quality in everything you do. This position is critical to our success and exemplifies the wonderful mission driven work we do here every day. Why Join Us? Full, Part-time, and As Needed schedules available. Full compensation/benefits package for full-time employees. Salary: $52,000 401(k) with company match. Paid time off and holiday pay. Rewarding work, impacting the lives of those you serve, working alongside a great team of coworkers. Enjoy job security with nationwide career development and advancement opportunities. Come join our amazing team of committed and caring professionals. Apply Today! Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face. We've made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S. As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.
    $52k yearly 2d ago
  • RCM OPEX Specialist

    Femwell Group Health 4.1company rating

    Miami, FL jobs

    The RCM OPEX Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that revenue cycle management processes are efficient and compliant with industry regulations. This position requires detail-oriented professionals who can navigate complex insurance claims and reimbursement processes. Essential Job Functions Manage internal and external customer communications to maximize collections and reimbursements. Analyze revenue cycle data to identify trends and proactively remediate suboptimal processes. Maintain fee schedule uploads in financial and practice operating systems. Review and resolve escalations on denied and unpaid claims. Collaborate with healthcare providers, payors, and business partners to ensure revenue best practices are promoted. Monitor accounts receivable and expedite the recovery of outstanding payments. Prepare regular reports on refunds, under/over payments. Stay updated on changes in healthcare regulations and coding guidelines. *NOTE: The list of tasks is illustrative only and is not a comprehensive list of all functions and tasks performed by this position. Other Essential Tasks/Responsibilities/Abilities Must be consistent with Femwell's core values. Excellent verbal and written communication skills. Professional and tactful interpersonal skills with the ability to interact with a variety of personalities. Excellent organizational skills and attention to detail. Excellent time management skills with proven ability to meet deadlines and work under pressure. Ability to manage and prioritize multiple projects and tasks efficiently. Must demonstrate commitment to high professional ethical standards and a diverse workplace. Must have excellent listening skills. Must have the ability to maintain reasonably regular, punctual attendance consistent with the ADA, FMLA, and other federal, state, and local standards and organization attendance policies and procedures. Must maintain compliance with all personnel policies and procedures. Must be self-disciplined, organized, and able to effectively coordinate and collaborate with team members. Extremely proficient with Microsoft Office Suite or related software; as well as Excel, PPT, Internet, Cloud, Forums, Google, and other business tools required for this position. Education, Experience, Skills, and Requirements Bachelor's degree preferred. Minimum of 2 years of experience in medical billing, coding, revenue cycle or practice management. Strong knowledge of healthcare regulations and insurance processes. Knowledgeable in change control. Proficiency with healthcare billing software and electronic health records (EHR). Knowledge of HIPAA Security preferred. Hybrid rotation schedule and/or onsite as needed. Medical coding (ICD-10, CPT, HCPCS) Claims management (X12) Revenue cycle management Denials management Insurance verification Data analysis Compliance knowledge Comprehensive understanding of provider reimbursement methodologies Billing software proficiency
    $34k-49k yearly est. 5d ago
  • Cancer Specialist

    Christian Healthcare Ministries 4.1company rating

    Barberton, OH jobs

    As an Advantage Care Cancer Specialist, you'll be the initial point of contact for members diagnosed with cancer. Your role involves providing emotional support, actively listening, and offering prayers as they process this difficult news. You'll walk alongside members and their families throughout their cancer journey. Additionally, you'll collaborate with various CHM departments and work closely with our nurse navigator to connect members with high-quality treatment providers at cost-effective rates. What We Offer Compensation based on experience. Faith and purpose-based career opportunity! Fully paid health benefits Retirement and Life Insurance 12 paid holidays PLUS birthday Lunch is provided DAILY. Professional Development Paid Training Role and Responsibilities Obtain necessary treatment details. Assess membership level, CHM Plus, offer pertinent programs based on the membership details and the type of cancer diagnosis. Acquire necessary documentation for a sharing determination. Effectively communicate with the members, supervisors, team members, the nurse navigator, and various departments. Multitask and maintain strong attention to detail. Interact with members to understand their needs, provide information, and help throughout the sharing determination process. Respond to member inquiries, issues, and concerns in a timely and professional manner through various communication channels, including communication with the nurse navigator, phone and/or email. Maintain accurate and organized records of members interactions, inquiries, orders, and other relevant information in CHM's database Collaborate with various internal teams to ensure effective communication, smooth transitions, and a seamless member experience. Seek opportunities for process improvement, suggest enhancements to processes, and provide feedback to member experience and overall effectiveness. Set up negotiating agreements with providers. Bill processing of cancer related Single Case Agreements and Memorandum of Understandings. Guide members to financial assistance program options specific to diagnosis. Assist members to help optimize their lifetime maximum amount when limitations exist. Qualifications High school diploma or successful completion of a high school equivalency Must possess excellent verbal and written communication skills to effectively interact with CHM members and team members across various channels. Proficient PC operating routine office equipment (e.g., faxes, copy machines, printers, multi-line telephones, etc.) Experience with medical bills preferred. Strong analytical and problem-solving skills. Demonstrated history of effective phone communication skills. Obtain knowledge of CHM guidelines. Ability to handle stressful and sensitive situations. Knowledge of cancer related benefit programs is helpful but not required. Note: The qualifications and responsibilities outlined above are subject to change as the needs of the organization evolve. About Christian Healthcare Ministries Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.
    $27k-35k yearly est. 1d ago
  • CMM Specialist 2nd shift

    Quest Global 4.4company rating

    Windsor Locks, CT jobs

    Who We Are: Quest Global delivers world-class end-to-end engineering solutions by leveraging our deep industry knowledge and digital expertise. By bringing together technologies and industries, alongside the contributions of diverse individuals and their areas of expertise, we are able to solve problems better, faster. This multi-dimensional approach enables us to solve the most critical and large-scale challenges across the aerospace & defense, automotive, energy, hi-tech, healthcare, medical devices, rail and semiconductor industries. We are looking for humble geniuses, who believe that engineering has the potential to make the impossible possible; innovators, who are not only inspired by technology and innovation, but also perpetually driven to design, develop, and test as a trusted partner for Fortune 500 customers. As a team of remarkably diverse engineers, we recognize that what we are really engineering is a brighter future for us all. If you want to contribute to meaningful work and be part of an organization that truly believes when you win, we all win, and when you fail, we all learn, then we're eager to hear from you. The achievers and courageous challenge-crushers we seek, have the following characteristics and skills: What You Will Do: Analyze the current state of CMM programs Write CMM programs to support operations Develop CMM inspection strategies for high-precision aerospace components to ensure compliance with engineering requirements Create new and modify existing CMM programs using off-line systems. Preferably utilizing PC-DMIS, open to multiple programming language Output new and edit existing code to run articulated automatic CMM machines Organize and plan work effectively to produce output according to budget and schedule constraints Troubleshoot programming result errors and work holding issues with production personnel to optimize automated inspection results Employment is contingent on passing a customer administered certification course on CMM programming and GD&T What You Will Bring: 2-7 years' experience in CMM setup, inspection, and programming techniques Competency using CMM software. PC-DMIS software preferred Competency with machines and tools required to fabricate and manufacture sheet metal Understanding of Manufacturing Engineering core processes (e.g. process planning, inspection planning, tooling, creation of operator instructions) Ability to characterize various tools, gages, and fixtures Knowledge of GD&T and can integrate it within a production process. A keen understanding of blueprint interpretation is desired as well Solid background in manufacturing Knowledge of Siemens NX solids and NX CMM or other CAD/ CAM, DEMIS, and MODUS tools Proficient in reading and interpreting blueprints Understanding of GD&T Excellent communication and teamwork skills Must be able to communicate effectively with manufacturing engineering, precision inspection personnel, and shop floor employees Must be able to pass a customer administered certification course on CMM programming and GD&T. Pay Range: $90,000-$110,000 a year Compensation decisions are made based on factors including experience, skills, education, and other job-related factors, in accordance with our internal pay structure. We also offer a comprehensive benefits package, including health insurance, paid time off, and retirement plan. Work Requirements: This role is considered an on-site position located in Windsor Locks, CT. You must be able to commute to and from the location with your own transportation arrangements to meet the required working hours. Shop floor environment, which may include but not limited to extensive walking, and ability to lift up to 40 lbs. Typical 8-hour days plus lunch / 40-hour weeks / hours are 3 PM to 11:30 PM for 2nd Shift Travel Requirements: Due to the nature of the work, no travel is required Citizenship Requirement: Due to the nature of the work, U.S. citizenship is required. Benefits: 401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Referral program Vision insurance Short/Long Term Disability
    $90k-110k yearly 4d ago
  • Polysomnographic Specialist - PRN

    Saint Luke's Health Systems 4.3company rating

    Kansas City, MO jobs

    Are you looking to join a phenomenal team where patient care is at the center of everything we do? Look no further! Day 8-10 hours per week preferred RPSGT or RRT required BLS preferred The Opportunity: The Polysomnographic Specialist performs all aspects of care as outlined in national and departmental clinical standard of practice policy and procedure manual and in accordance with written verbal orders or approved protocol flow charts. This position will assist with MSLT and home sleep study set-ups. Clinical practice activities include but are not limited to the performance of diagnostic polysomnographic testing, assessment based therapeutic interventions and the analysis and scoring of polysomnographic records. The Polysomnographic Specialist accountabilities include the assessment and evaluation of histories and physicals, diagnostic, clinical and sleep related data pursuant to the development and monitoring of planned interventions in collaboration with the medical staff. The Polysomnographic Specialist supports and participates as appropriate in staff meetings, study quality, adherence to departmental protocols, continuing education, and professional growth development activities and performs other duties as assigned. Why Saint Luke's? We believe in work/life balance. We are dedicated to innovation and always looking for ways to improve. We believe in creating a collaborative environment where all voices are heard. We are here for you and will support you in achieving your goals. #LI-CK2 Job Requirements Applicable Experience: Less than 1 year Basic Life Support - American Heart Association or Red Cross, Polysomnographic Technologist - Board of Registered Polysomnographic Technologists Job Details PRN Day (United States of America) The best place to get care. The best place to give care . Saint Luke's 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter. Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.
    $37k-47k yearly est. 6d ago
  • MRI Specialist

    Texas Childrens Hospital 4.7company rating

    Houston, TX jobs

    We are searching for an MRI Specialist-- someone who works well in a fast-paced setting. In this position, you will perform quality routine and specialized radiographic procedures at the request licensed independent practitioner for interpretation by radiologists. As members of the health care team, they must participate in quality improvement processes and continually assess their professional performance. Maintains a safe and hazard free environment. They are responsible for patient care, appropriate documentation, quality control, and quality improvement, and they provide training, education and mentoring to students, technologists, nursing, residents, fellows, staff and others. Think you have what it takes? Responsibilities: • Broad knowledge of MRI physics and procedures; understanding of MRI principles that are developmentally appropriate for ages 0 - adulthood • Operation of all required equipment including troubleshooting, when necessary, of the equipment, including automated processors, copying/digitizing film equipment, R.I.S., and PACS • Basic Life support and medical terminology understanding is required. • Successful demonstration of the professional fundamental competencies • Must be articulate, courteous and supportive in dealing with patients, parents, nursing, faculty, administrative and departmental personnel so that excellent customer service and positive guest relations are achieved • Must honor confidentiality • Must independently scan patients by following the established protocols • Must demonstrate excellent verbal and written skills • Must utilize basic office equipment • Preferable if able to demonstrate bilingual skills • The MRI Specialist will be responsible for multiple duties including: • integrates scientific knowledge; technical skills, patient interaction and compassionate care resulting in diagnostic information, and recognizes patient conditions essential for successful completion of the procedure. • possess, utilize, maintain, and enhance knowledge of MRI safety and protection for self, patients, and others. • demonstrate a detailed understanding of human anatomy, physiology, pathology and medical terminology. • liaison between patients, radiologist and other members of the support team. • maintain a high degree of accuracy in positioning and exposure technique. • prepares, administers and documents activities related to mediations in accordance with state regulations and institution policy. Skills and Requirements: • 3yrs Radiology experience • Graduate of a formal diagnostic Radiology program required • MR-ARRT certification from the American Registry of Radiologic Technologists required • R-AART preferred • CMRT from the Texas Medical Board preferred • BLS certification from the American Heart Association preferred ABOUT US Since 1954, Texas Children's has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children's hospital in Texas, and among the top in the nation by U.S. News & World Report as well as recognition from Houston Business Journal as one of this city's Best Places to Work for ten consecutive years. Texas Children's comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research; Texas Children's Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children's Hospital West Campus, a community hospital in suburban West Houston; Texas Children's Hospital The Woodlands, the first hospital devoted to children's care for communities north of Houston; and Texas Children's Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children's Health Plan, the nation's first HMO focused on children; Texas Children's Pediatrics, the largest pediatric primary care network in the country; Texas Children's Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children's Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation. To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
    $34k-65k yearly est. 19h ago
  • Senior Specialist, Member & Community Interventions (Remote in TX)

    Molina Healthcare 4.4company rating

    Senior specialist job at Molina Healthcare

    The Sr Specialist, Member & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid). Executes health plan's member and community quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes. Acts as a lead specialist within the department and/or collaboratively with other departments. **Job Duties** + Acts as a lead specialist to provide project, program, and/or initiative related direction and guidance for other specialists within the department and/or collaboratively with other departments + Implements evidence-based and data-informed member intervention strategies, which may include initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state-required quality activities + Monitors and ensures that key member intervention activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed + Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions + Creates, manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables + Participates in quality improvement activities, meetings, and discussions with and between other departments within the organization + Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations + Evaluates project/program activities and results to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation + Other tasks, duties, projects, and programs as assigned + This position may require same-day out-of-office travel 0 - 30% of the time, depending upon location + This position may require multiple days out-of-town overnight travel on occasion, depending upon location **Job Qualifications** **REQUIRED QUALIFICATIONS:** + Bachelor's Degree or equivalent combination of education and work experience. + 3 years' experience in healthcare with a minimum of 2 years' experience in health plan member interventions, managed care, or equivalent experience. + Demonstrated solid business writing experience. + Operational knowledge and experience with Excel and Visio (flow chart equivalent) + Demonstrates flexibility when it comes to changes and maintains a positive outlook. + Has excellent problem-solving skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis, and/or interpretation + Certified Professional in Health Quality (CPHQ) + Nursing License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) 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: $54,922 - $107,099 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $54.9k-107.1k yearly 9d ago

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