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PeaceHealth Remote jobs - 155 jobs

  • Billing/Follow-up Specialist - Government Billing

    Peacehealth 4.1company rating

    Vancouver, WA jobs

    PeaceHealth is seeking a Billing/Follow-up Specialist - Government Billing for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $19.14 - $28.72. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc. **Job Summary** Responsible for all phases of billing/account follow-up using accepted billing practices to ensure thorough and consistent account resolution to promote financial health. This position ensures appropriate reimbursement and days in Accounts Receivable with timely account follow-up and resolution of outstanding charges owed by third party payors. Responsible for all areas of billing and account follow-up including claims submission, account follow-up with insurance payors, and resolution of reimbursement issues for multi-facility, multi-specialty organization. **Essential Functions** + Resolves insurance claim rejections/denials, and non-payment of claims by payors. + Identifies trends in billing and follow-up, in order to expedite resolution of insurance accounts and identify delays in processing. + Drafts appeals to insurance companies for reimbursement of monies owed. + Maintains daily account, follow-up work lists within department while maintaining organization's productivity standards. + Ensures compliance and claims processed in accordance with payer contracts and policies, as well as to settle claims as appropriate. + Identifies, researches and resolves: credit balances, missing payments, payer recoupments, and unposted cash as it pertains to billing account follow-up. + Processes and maintain correspondence received from patients and insurance companies as it pertains to correct and timely billing of claims, and receipt of payment. + Handles submission of issues to coding for review to ensure organizational and revenue cycle processes are followed. + Communicates appropriately with insurance companies, patients, co-workers and supervisors. + Performs other duties as assigned. **Qualifications** **Education** + High School Diploma Required: or equivalent and, + Associate Degree Preferred. **Experience** + Minimum of 2 years Required: Experience in a billing or insurance account follow-up capacity and + : Formal training or college coursework from a medical coding accredited school, specific to medical billing in lieu of experience may be considered and + Required: Medical terminology experience and + Required: Knowledge of insurance processes and billing guidelines regulations and + Preferred: Coding knowledge and + Preferred: Epic experience **Credentials** + Preferred: Medical Billing Certificate or + Preferred: Certified Revenue Cycle Representative or + Preferred: HealthStream Badge **Skills** + Proficient use of computers including Microsoft Office applications (Word, Excel, PowerPoint, etc.) (Required) + Skilled in 10-key by touch and keyboarding (Required) + Ability to operate general office equipment (Required) + Excellent verbal and written communication skills (Required) + Excellent attention to detail and ability to multi-task (Required) + Ability to work with minimal supervision, independently, as well as in a collaborative team setting (Required) + Strong organizational skills with the ability to prioritize and meet deadlines (Required) + Knowledge of Commercial and/or Government Payors (Required) + Ability to identify, research, and resolve credit balances, missing payments and unposted cash and payer recoupments, as it pertains to billing account follow-up. (Required) + Ability to work remotely with minimal oversight, independently, as well as in a collaborative team setting. (Required) **Working Conditions** Lifting + Consistently operates computer and other office equipment. + Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. + Sedentary work. Environmental Conditions + Predominantly operates in an office environment. Mental/Visual + Ability to communicate and exchange accurate information. + The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading. PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program. See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility (********************************************************************************************************************************** . For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws. REQNUMBER: 123210
    $19.1-28.7 hourly 32d ago
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  • Prescription Refill Coord - Pharmacy Refill Administration

    Peacehealth 4.1company rating

    Bellingham, WA jobs

    PeaceHealth is seeking a **Prescription Refill Coord - Pharmacy Refill Administration for a Full Time, 1.00 FTE, Day position.** The salary range for this job opening at PeaceHealth is $17.40 - $26.10. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc. This position will be performed fully remote. If telecommuting, PeaceHealth will provide the caregiver with necessary computer equipment. It is the responsibility of the caregiver to provide Internet access. **This role requires onsite training during the first 120-day introductory period, and occasional onsite work thereafter. Candidates must live within a 1 hour commuting distance of PeaceHealth St. Joseph in Bellingham, WA.** **Job Summary** Responsible for receiving and preparing routine prescription refill requests for provider review. May also be responsible for management of prescription assistance program applications; working closely with team members to ensure optimum utilization and cost containment. Provides clerical support and assistance to staff. **Details of the Position:** + Receives faxed and Electronic Medical Record prescription refill requests. May include controlled and/or non-controlled medications. Researches and documents information required for the provider to make an informed decision to approve or deny the refill request. + Oversees the data entry and completion of prescription refill forms/notifications. Ensures requests are entered within 72 business hours of receipt. + May obtain insurance pre-authorization for patients and reauthorization of medication and additional treatment. Ensures insurance carrier documentation requirements are met and refill support documentation is filed in patient's medical record. + Efficiently manages correspondence with patients, physicians, specialists, insurance companies. Documents pertinent information on appropriate form and/or in medical record. May notify patients of overdue office visit and necessary screenings per refill protocol through written communication. + May assist with identifying and assisting patients with applying for prescription assistance programs. Communicates with third party payers to assure coverage of patient care. + Performs other duties as assigned. **What you bring:** + High School Diploma Preferred: Or equivalent + **Minimum of 3 years Required:** Experience working with insurance in a medical related field, or other related experience and + Preferred: Experience with EMR (Electronic Medical Record) **Skills** + Proficient computer skills including Microsoft Office applications as well as other applicable computer programs. **(Required)** + Knowledge of appropriate release of patient records. **(Required)** + Excellent attention to detail. **(Required)** + Ability to manage a high volume of tasks in a fast-paced environment. **(Required)** + Basic knowledge of office procedures. **(Required)** + Ability to read, understand and follow oral/written instructions. **(Required)** + Ability to sort and file materials correctly by alpha or numeric systems. **(Required)** + Ability to establish and maintain effective working relationships in a team environment. **(Required)** + Ability to plan and prioritize task **(Required)** + Strong communication skills, both verbal and written. **(Required)** + Ability to establish and maintain effective relationships with staff, providers, patients and families. **(Required)** + Ability to provide excellent customer service **(Required)** **Working Conditions** + Consistently operates computer and other office equipment. + Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. + Sedentary work. + Predominantly operates in an office environment. + Ability to communicate and exchange accurate information. + The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading. For additional information or questions, please email Jen Worthington at **************************** or call ************. PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program. See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility (********************************************************************************************************************************** . For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws. REQNUMBER: 122528
    $17.4-26.1 hourly Easy Apply 48d ago
  • Home Base Veteran Outreach Coordinator

    Brigham and Women's Hospital 4.6company rating

    Boston, MA jobs

    Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds - including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service - for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research. The Home Base Veteran Outreach Coordinator is a point of contact for veterans and their families seeking care and/or education regarding Post Traumatic Stress (PTS), Traumatic Brain Injury (TBI) and other combat-related stress. When not assigned to the Intensive Clinical Program, the Veteran Outreach Coordinator role changes to educate and provide outreach to New England-based veterans and their families about Post Traumatic Stress (PTS), Traumatic Brain Injury (TBI), and encourages the community to take advantage of services available through the Home Base Program. The Coordinator is an employee of MGH and works alongside a team of world class medical professionals to help educate veterans, their families, social workers, employers, community service providers, veterans' groups, and others as to how to recognize symptoms of PTS/TBI and the ways in which they or their loved ones can seek help. The Veteran Outreach Coordinator guides veterans through the treatment evaluation process in the Home Base Clinic and works closely with the clinical staff in the Home Base Program around patient case management and ongoing monitoring of patient needs. The Coordinator provides active patient outreach, including phone, email, in-person meetings and text messaging. Job Summary Summary Responsible for community outreach, engagement, and support to enhance access to behavioral health programs. The Outreach Coordinator collaborates with community partners, healthcare professionals, and social service agencies to promote mental health awareness and address the behavioral health needs of individuals. Does this position require Patient Care? Yes Essential Functions * Conduct proactive outreach within the community to identify individuals in need of behavioral health services. * Establish relationships with community organizations, schools, primary care providers, and other relevant stakeholders to enhance outreach efforts. * Conduct initial assessments to identify the behavioral health needs of individuals. * Provide information and referrals to appropriate behavioral health services and resources. * Respond to crisis situations and provide immediate support and intervention. * Collaborate with crisis intervention teams, law enforcement, and emergency services as needed. * Advocate for individuals with behavioral health needs to ensure they receive timely and appropriate care. * Conduct community education and awareness programs on mental health topics. Qualifications Education Bachelor's Degree preferred Experience * minimum of 1-3years of military experience with at least one deployment preferred but not required * must have honorable discharge (proof of DD 214 required). Knowledge, Skills and Abilities * Strong knowledge of behavioral health services, resources, and crisis intervention techniques. * Excellent communication, interpersonal, and organizational skills. * Ability to work independently and collaboratively within a team. * Sensitivity to the understanding of the social determinants of health. * Proficiency in using electronic health records and documentation systems. * Valid driver's license and reliable transportation for community outreach. Additional Job Details (if applicable) Physical RequirementsStanding Frequently (34-66%) Walking Frequently (34-66%) Sitting Occasionally (3-33%) Lifting Frequently (34-66%) 35lbs+ (w/assisted device) Carrying Frequently (34-66%) 20lbs - 35lbs Pushing Occasionally (3-33%) Pulling Occasionally (3-33%) Climbing Rarely (Less than 2%) Balancing Frequently (34-66%) Stooping Occasionally (3-33%) Kneeling Occasionally (3-33%) Crouching Occasionally (3-33%) Crawling Rarely (Less than 2%) Reaching Frequently (34-66%) Gross Manipulation (Handling) Frequently (34-66%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) Remote Type Hybrid Work Location One Constitution Wharf Scheduled Weekly Hours 40 Employee Type Regular Work Shift Rotating (United States of America) Pay Range $20.43 - $29.21/Hourly Grade 4 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: The General Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $20.4-29.2 hourly Auto-Apply 4d ago
  • Business Process Consultant (Revenue Cycle)

    McKesson 4.6company rating

    Remote

    McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. The Business Process Consultant plays a pivotal role in the Revenue Cycle Operational Transformation by serving as a subject matter expert and change agent within the organization. This position is integral to the shift toward a Center of Excellence model, supporting the development and implementation of standardized practices and procedures across the revenue cycle. Consultants analyze and measure the effectiveness of existing business processes, research best practices, and recommend sustainable improvements that enhance safety, productivity, and cost efficiency. Their work includes benchmarking, process analysis, reengineering, and change management, all aimed at driving operational excellence and supporting large-scale transformation initiatives. By collaborating with regional and central business offices, as well as practice management teams, Business Process Consultants facilitate seamless integration, optimize workflows, and promote knowledge sharing across diverse practices. Their expertise is crucial in supporting technology transitions, such as the implementation of new practice management systems, and in ensuring that transformation efforts align with enterprise goals and regulatory requirements. Ultimately, the Business Process Consultant helps foster a culture of continuous improvement, innovation, and accountability, which is essential for achieving the strategic objectives of revenue cycle transformation. Key Responsibilities Partner with Practice Operations and Revenue Cycle leadership, project champions, and process owners to embrace change management initiatives, operationalize key projects and deliver results that are sustainable, repeatable, and quantifiable Facilitate complex meetings, presentations, and trainings with varied audiences across all levels of management Engage in onsite visits to locations across the United States to collaborate on and resolve complex workflow challenges across the Regional Billing Offices and practices Collaborate with corporate teams to drive innovation operational transformation Support system training initiatives and participate in curriculum development Develop and publish workflow documentation (Reference Guides, Job Aids, SOPs, etc.) Serve as a trusted advisor to members of Regional Billing Offices, Practice Operations and Revenue Cycle Leaders Monitor and communicate the results of process improvement projects/initiatives to management and the Executive Leadership Teams Minimum Requirement Degree or equivalent and typically requires 4+ years of relevant experience. Education BS Degree or equivalent Critical Skills Experience leading projects and collaborating with stakeholders Subject matter expert in Revenue Cycle Operations (Patient Facing and Non-Patient Facing) DX Experience - Agent of change and transformation Experience coaching others in process improvement frameworks Excellent communication, presentation, and organizational skills Proficient in Microsoft Office Suite Process improvement and workflow development experience Data Analysis experience- Identify sources for, gather and analyze data relevant to process change initiatives Additional Skills Experience working with Athena IDX (Centricity Business) and Centricity Practice (G4) Experience working with iKnowMed (G2) - Preferred Six Sigma Certification - Preferred Project Management - Preferred Partner with optimization and quality improvement Able to work independently Have a consulting and project management mindset High level of organization and attention to detail Travel Ability to travel up to 50% We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here. Our Base Pay Range for this position $88,100 - $146,900 McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind: McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application. McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates. McKesson job postings are posted on our career site: careers.mckesson.com. McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!
    $88.1k-146.9k yearly Auto-Apply 6d ago
  • Health Plan Medical Director

    Brigham and Women's Hospital 4.6company rating

    Somerville, MA jobs

    Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. Under the direction of the Senior Medical Director, the Medical Director leads as a senior physician at the health plan. This position works closely with the Senior Medical Director in providing medical management leadership for clinical services operations and programs. This role focuses on and has expertise in utilization management, health plan quality and accreditation, care management, and other health plan functions. Qualifications Licensure and Credentials: Must maintain an active full physician license in Massachusetts Experience: * 3-5 years of Health Plan experience * at least 5 years of clinical practice experience Job Duties: Handles utilization management initial determinations, appeals and grievances within the scope of their expertise as defined by Medicare, MassHealth, NCQA and the Division of Insurance and within the compliance requirements of key regulatory and accreditation entities * Reviews clinical services and quality incidents when sufficiently serious to merit physician involvement * Coverage of medical necessity determinations to support special investigations/fraud waste and abuse cases * Collaborates on health plan medical policy development * Assesses new, emerging, and existing technologies to determine appropriateness of health plan coverage * Partners with clinical leaders to ensure medical service expenditures remain within budget * Collaborates with business development, quality, finance and medical management teams to promote improvements in the quality and cost efficiency of care throughout the MGB Health Plan provider network * Delivers consultation to network management staff and deployment of education programs for network clinicians * Develops and delivers presentations for clinical staff on current topics relevant to MGB Health Plan members and network * May represent MGB Health Plan at a variety of external forums and committees * Interact, communicate and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees * Monitors performance metrics and audits to identify areas for continuous improvement and ensure compliance * Anticipates and meets or exceeds internal and/or external customer expectations and requirements; establishes and maintains positive relationships with customers and gains their trust and respect * Build strong relationships and infrastructure that designate MGB Health Plan as a people-first organization * Ensure diversity, equity and inclusion are integrated as a guiding principle * Other duties as assigned with or without accommodation Additional Job Details (if applicable) Primarily remote position, exempt * In person meetings as requested for business needs * Participates in after hours and weekend call rotation as assigned Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) EEO Statement: Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $179k-266k yearly est. Auto-Apply 4d ago
  • Lead Technical Project Manager

    McKesson 4.6company rating

    Remote

    McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. Lead Technical Project Manager Summary The Lead Technical Project Manager plays a critical role in driving the successful delivery for AI/ML & Advanced Analytics initiatives across the organization. This role bridges business stakeholders, data science teams, and engineering groups to ensure projects are aligned with strategic objectives, well-scoped, and delivered on time. The TPM will manage the end-to-end project lifecycle including intake of requests, requirement gathering, prioritization, roadmap development, milestone tracking, and status communication to leadership. What You'll Do Program Leadership & Road Mapping - Define and own the end-to-end roadmap for AI/ML initiatives, translating business objectives into actionable programs such as demand forecasting models, NLP-driven chatbots, or predictive analytics. Manage the intake of new requests, gather necessary information for accurate sizing, confirm business value, and ensure alignment with strategic priorities. Evaluate and prioritize initiatives by balancing business value, technical feasibility, resource availability, and associated risks. Use portfolio management tools (Jira, Confluence, MS Project, Smartsheet) to maintain visibility and alignment from ideation through deployment. Cross-Functional Orchestration - Serve as the central coordinator, orchestrating collaboration across data scientists, ML engineers, data engineers, business analysts, and IT teams. Ensure high-quality pipelines and seamless integration into production systems through APIs, cloud ML services, and CI/CD pipelines. Execution & Delivery Management - Oversee day-to-day delivery of AI/ML projects using Agile practices (Scrum, SAFe, Kanban). Manage sprints, backlogs, epics, and stories within Jira/Confluence, tracking dependencies and deliverables. Identify risks (e.g., limited data availability, model performance gaps, infrastructure bottlenecks) and implement mitigation strategies. Enforce robust testing standards including unit testing, model validation, A/B testing, and performance benchmarking. Business Alignment & Stakeholder Management - Act as a trusted partner to business stakeholders and product teams, translating business use cases into clear technical AI/ML requirements. Establish measurable KPIs (accuracy, ROI, adoption rates, productivity impact). Provide regular executive-level updates, communicating technical progress clearly and concisely. Governance & Compliance - Ensure compliance with regulatory frameworks (HIPAA, GDPR, SOC 2, FDA). Promote Responsible AI principles (fairness, transparency, explainability). Drive documentation, audit readiness, model cataloging, data lineage traceability, and reproducibility. Establish governance for MLOps including model versioning, drift monitoring, and automated retraining. Metrics & Reporting - Define and track KPIs across technical, business, and delivery dimensions (accuracy, precision/recall, F1 score, ROI, adoption). Provide transparent portfolio health reporting to leadership. Innovation Enablement - Champion innovation by promoting emerging technologies (Generative AI, LLMOps, AutoML). Collaborate with architecture teams to modernize ML stack (Databricks Lakehouse, Vertex AI, Azure ML). Drive accelerators such as reusable code libraries, pre-trained models, and standardized MLOps pipelines. What You Bring Strong technical acumen in AI/ML and analytics Excellent project management skills Ability to communicate effectively with technical and non-technical audiences Proven ability to align cross-functional teams and remove delivery bottlenecks Minimum Requirements Degree or equivalent and typically requires 10+ years of relevant experience. Less years required if has relevant Master's or Doctorate qualifications. Preferable Skills & Experience Experience with Generative AI, LLMOps, AutoML Familiarity with platforms like Databricks, Vertex AI, Azure ML Knowledge of governance frameworks and Responsible AI principles We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here. Our Base Pay Range for this position $134,900 - $224,800 McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind: McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application. McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates. McKesson job postings are posted on our career site: careers.mckesson.com. McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!
    $134.9k-224.8k yearly Auto-Apply 16d ago
  • Certified Instrument Processing Tech, SPD, Full-time, First Shift

    Uc Health 4.6company rating

    Remote

    At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is an EEO employer. Performs all activities associated with decontamination, clean prep, tray assembly, sterilization, distribution and acquiring of instruments and supplies for the OR and L/D Departments Minimum Required: Graduate of CRCST program or graduate of Surgical Technology program. | CRCST required along with annual maintenance for non-Surgical Technology graduates. | 1 year sterile processing experience preferred. Perform all level I tech duties and responsibilities Train and precept new staff Responsible for oversight of processing department equipment Identify specialty instruments and supplies Complete all paperwork associated with sterilization processes for patient safety and accreditation purposes Attention to detail in performing job duties and responsibilities Maintain and recognize sterility of supplies and trays Deliver and interpret requested supplies/items Must be able to prioritize and respond appropriately to a variety of situations Able to perform and organize high volume cases
    $35k-42k yearly est. Auto-Apply 5d ago
  • JR0062540 Associate Customer Service Rep

    McKesson 4.6company rating

    Louisville, KY jobs

    Key Responsibilities: Serves as the point of contact for customer queries and resolution. Provides customer services relating to sales, sales promotions, installations and communications. Ensures that good customer relations and seamless turnaround in problem resolution are maintained and customer claims, product orders and complaints are resolved fairly, effectively and in accordance with the consumer laws. May answer questions and provide prompt information related to potential concerns. Develops organization-wide initiatives to proactively inform and educate customers. ***Shift Details - 11:30pm - 8:00pm Minimum Requirements: High School Diploma or GED Required Skills: Ability to complete multiple activities while utilizing excellent customer service skills Demonstrate ability to communicate clearly in both written and oral communication Maintains all patient confidentiality Other duties and responsibilities as assigned by supervisor. Career Level - IC-Business Support - B1 Additional Information ALL ANSWERS MUST BE "YES" Do you have a High School Diploma or GED? Are you able/comfortable working from home?
    $30k-37k yearly est. 60d+ ago
  • Pharmacy Sales Consultant

    McKesson 4.6company rating

    Remote

    McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. The Pharmacy Sales Consultant (PSC) is an individual contributor and results-driven account management/sales professional responsible for growing McKesson's portfolio of products and services within independent and long-term care pharmacies in an assigned geographic territory. This highly consultative role requires the ability to lead all interactions with pharmacists in charge and/or business owners positioning McKesson as a trusted, expert partner. The PSC will develop tailored strategies for each assigned account and prospect, driving the coordinated execution of products and services throughout the sales process. This is a field-based position with daily customer-facing responsibilities and significant travel requirements. The territory for this position will cover Western and Northern MI. Key Responsibilities: Achieve annual budget objectives for assigned sales territory. Build a comprehensive business plan to optimize short- and long-term territory performance. Lead the execution of a consultative sales process from qualification to contract negotiations for all opportunities within assigned territory. Build a robust opportunity funnel by organic (cold calling) and coordinated efforts. Contribute insights and feedback to support the ongoing improvement and development of McKesson products and services, leveraging pharmacy partner experiences. Provides customers with strategic marketing guidance, financial analysis to support planning, managed care insights, competitive intelligence, and profit-enhancing opportunities. Utilizes consultative sales methodologies and tailored programs to clearly demonstrate the value and benefits of the company's products, services, and technologies. Create and deliver sales proposals, business reviews, sales presentations of specific products and services, demonstrations of products, merchandising plans, and sales promotions to grow existing business or capture new accounts. Achieve success in line with our ICARE principles. Cultivate and maintain strong relationships with key customers to ensure long-term retention and credibility. Collaborate with internal teams-including operations, delivery, inventory, credit, pricing, and finance-to resolve issues and provide expert support for existing accounts. Participate in team selling opportunities and joint presentations to enhance business growth, improve selling skills, and deepen customer knowledge. Maintain current, detailed, and accurate data in our Salesforce.com CRM, providing an accurate sales forecast in real-time. Special projects as assigned. Minimum Requirement: Degree or equivalent and typically requires 4+ years of relevant experience. Education: Bachelor's degree in business related field or equivalent work experience with an emphasis in sales, marketing, business management, account management or healthcare related field preferred. Critical Skills: 4+ years of business-to-business field sales or account management experience, preferably in healthcare. 3+ years of proven sales experience with a track record of meeting or exceeding goals. Strong analytical, problem-solving, and negotiation skills. Proficiency in CRM tools (e.g., Salesforce, ACT). Skilled in MS Office Suite (Excel, PowerPoint, Word, Outlook). Ability to interpret and analyze P&L statements. Additional Skills: Experience in retail/distribution, healthcare, pharmacy, community pharmacy, benefits, or insurance industry preferred. Consultative sales approach with the ability to identify customer needs. Skilled in articulating the organization's value proposition to customers. Willingness to travel extensively (up to 80%) with occasional overnight stays. Strong business and financial acumen. Demonstrated teamwork and collaboration, fostering trust and open communication. Influential communicator with active listening skills and ability to tailor messages for diverse audiences. Ability to navigate complex environments effectively. Self-starter with a proactive mindset and commitment to continuous learning. Strong relationship-building skills focused on trust and transparency. Highly organized and adaptable to changing priorities. Working Conditions: Must be authorized to work in the US unrestricted - This position is not eligible for sponsorship. Able to travel extensively overnight in region to customers 80% of the time by car. Must have a valid driver's license with a clean driving record/MVR. Primary territory is Western and Northern Michigan. Ideal candidate will live in this territory. Remote/Home Office work environment. We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here. Our Total Target Cash (TTC) Pay Range for this position: $119,700 - $199,500 Total Target Cash (TTC) is defined as base pay plus target incentive. McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees and is committed to a diverse and inclusive environment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!
    $119.7k-199.5k yearly Auto-Apply 60d+ ago
  • Home Base SOF Admissions Social Worker

    Brigham and Women's Hospital 4.6company rating

    Boston, MA jobs

    Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. LCSW: starting pay rate $68,224 LICSW: starting pay rate $92,227 SIGN ON BONUS AVAILABLE for eligible Non-MGB employees: $3,000 FOR LCSW, $10,000 FOR LICSW/LMHC, Please ask about the details! Job Summary Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds - including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service - for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research. The Massachusetts General Hospital seeks a dynamic Licensed Clinical Social Worker (LCSW)/Licensed Independent Clinical Social Worker (LICSW) to serve on the Special Operations Team. In this role, the LCSW/LICSW will provide and oversee the provision of psychiatric, psychosocial, and overall mental health services and referrals for military Special Operators into the Home Base program. They will also be dedicated to supporting the Special Operations Forces (SOF) program and will provide coverage to other clinical operations as needed. The LCSW/LICSW may help cover approximately 2-3 weekend shifts per year. Summary This position will collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs as part of the interdisciplinary team. They work collaboratively with all healthcare team members to develop and implement treatment plans that support patient-centered plans of care for both individual patients and the medical community. Does this position require Patient Care? Yes Essential Functions * Provides psychosocial assessments of patients and families with social, emotional, interpersonal, and/or environmental issues. Formulates biopsychosocial assessment, disposition, and treatment plans. * Collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs as part of the interdisciplinary team. * Monitor, evaluate, and record client progress according to measurable goals described in the treatment and care plan. * Coordinate care for Special Operations Forces (SOF) veterans and military-connected family members seeking care at Home Base with the appropriate internal or external clinicians in a multi-disciplinary team, coordinated care model. * Serve as a contact point for accepting and triaging SOF referrals from internal clinicians, outside clinicians and self-referred patients. * Serve as primary case manager for patients in SOF admissions process in collaboration with Admissions Coordinator, including, but not limited to, the following responsibilities: conduct pre-screening to assess treatment and evaluation needs for SOF patients referred; coordinate signing of Release of Information forms, acquire relevant medical records, and coordinate with SOCOM where applicable; serve as point of contact for ongoing questions from the patient as they arise. * Monitor patient's status in admissions process using appropriate documentation. * May be asked to collaborate with SOF/ComBHaT team, patients, clinical team, and Resource Specialist to identify clinical and psychosocial needs in patients' home communities and identify appropriate resources. * May provide direct clinical services to Veterans and/or family members, which may include group or individual therapy. * May provide psychoeducation regarding PTSD, TBI, and related conditions to Veteran patients and family members as clinically appropriate within the context of the Intake and triage duties. * Collaborate with an inter-disciplinary team of clinical staff (social workers, psychologists, nurses, psychiatrists, physiatrists, physical therapists, etc.) to coordinate patient care and plan for discharge/aftercare when needed. * Consult with team to facilitate mandated assessments when abuse is suspected (child, disabled adult, elder), and safety assessment when violence is reported. Collaborates with MGH resources (HAVEN and Child Protection Team). * May assist with crisis intervention and management. * Documents timely and relevant information in patient electronic medical record and Home Base database. * Provide coverage for social work responsibilities in Outpatient Clinic as needed. * For LICSWs: provide clinical supervision to LC-level and/or MSW students as needed. * Additional responsibilities as assigned. Qualifications Education Master's Degree Social Work required or Master's Degree Mental Health & Behavioral Medicine required Can this role accept experience in lieu of a degree? No Licenses and Credentials Current professional licensure in Massachusetts (LCSW required, LICSW preferred). Experience Clinical Social Worker I Clinical Experience in a medical setting 0-1 years required Clinical Social Worker II Clinical Experience in a medical setting 2-3 years required Knowledge, Skills and Abilities * Excellent organizational and time management skills. * Excellent crisis intervention skills. * Good problem solving and conflict resolution skills. * Ability to work well collaboratively and independently. * Strong written and verbal communication skills. * Knowledge of community resources and the aging process. * Demonstrates basic foundational skills, showing fundamental knowledge and a commitment to the application of professional values and ethics. * Demonstrates fundamental skills in formulation, assessment of risks, crisis intervention completion of psychosocial treatment plans, and appropriate documentation. * May need assistance and guidance in ensuring the patient's needs, safety measures, and concerns are brought forward. Emerging knowledge of internal and external resources. * Developing and demonstrating interpersonal collaboration in a medical setting- inpatient or outpatient. * May need coaching/guidance in this area. * May provide some assistance and support with onboarding for new team members. * Aware of opportunities in department/service initiatives; participates in initiatives at an entity level. Uses data to measure progress. * Demonstrate fundamental skills under supervision. May need assistance in promoting collaboration among healthcare team members, other colleagues, and the organization to support and enhance patient care. Additional Job Details (if applicable) Physical Requirements * Standing Frequently (34-66%) * Walking Frequently (34-66%) * Sitting Occasionally (3-33%) * Lifting Frequently (34-66%) 35lbs+ (w/assisted device) * Carrying Frequently (34-66%) 20lbs - 35lbs * Pushing Occasionally (3-33%) * Pulling Occasionally (3-33%) * Climbing Rarely (Less than 2%) * Balancing Frequently (34-66%) * Stooping Occasionally (3-33%) * Kneeling Occasionally (3-33%) * Crouching Occasionally (3-33%) * Crawling Rarely (Less than 2%) * Reaching Frequently (34-66%) * Gross Manipulation (Handling) Frequently (34-66%) * Fine Manipulation (Fingering) Frequently (34-66%) * Feeling Constantly (67-100%) * Foot Use Rarely (Less than 2%) * Vision - Far Constantly (67-100%) * Vision - Near Constantly (67-100%) * Talking Constantly (67-100%) * Hearing Constantly (67-100%) Remote Type Hybrid Work Location One Constitution Wharf Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $56,992.00 - $82,992.00/Annual Grade 6 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: The General Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $57k-83k yearly Auto-Apply 4d ago
  • Clinical Review Specialist, Remote

    Brigham and Women's Hospital 4.6company rating

    Somerville, MA jobs

    Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary General Summary: Under the general direction of the Director of Risk Capture, the Pre-Visit Clinical Review Specialist (CRS) facilitates the accurate and appropriate identification of patient medical conditions through comprehensive chart review combined with review of coding output data sources (internal and external claims) that results in improvement in the overall quality, completeness and accuracy of problem lists, visit documentation and disease registry assignments. The CRS utilizes both clinical and coding knowledge of Hierarchical Condition Categories (HCCs) to inform accurate and appropriate diagnosis considerations for suspect condition identification and recapture opportunities. This role serves to educate providers and the clinical care team on all aspects of risk capture and linkages with quality. Qualifications Principle Duties: Drive Clinical Delivery * Performs accurate and timely pre-visit review of selected ambulatory encounters to identify opportunities to recapture medical conditions that meet criteria as HCC diagnoses and to capture new, suspected HCC conditions. * Accurately interprets clinical information in the medical record, evaluating clinical indicators to identify potential diagnoses * Presents clear HCC Consideration Communication to provider and educates providers to obtain greatest possible diagnostic specificity to accurately reflect the patient's condition(s) Identify Education Opportunities * Identifies themes through chart review that might present education opportunities for individual or groups of providers * Gathers feedback from periodic post-visit chart reviews and incorporates these learnings into educational opportunities with providers * Identifies opportunities for Process Improvement and Quality Improvement, as needed Foster collaborative relationships across the enterprise * Communicates appropriately and compliantly with physician or care team through Epic resources to improve medical record documentation * Participates in ambulatory unit/organizational programs and meetings as needed * Maintains professional competency by keeping abreast of new coding issues and guidelines. Attends classes and meetings as assigned. Reviews professional CDI and coding literature regularly * Maintains clinical licensure and/or medical coding credentials (e.g. RN, PA, NP, CRC, CDEO, CCS, CPC) and completes all required Organizational Competencies and trainings (if applicable) * Meets with providers on an as-needed basis to address concerns or areas of opportunity, and performs chart reviews as needed * Maintains good rapport and professional relationships, as outlined in MGB Code of Conduct - * Approaches conflict in a constructive manner, helps identify problems, offers solutions and participates in resolution * Responsible to perform any other assigned duties as requested Qualifications: * Minimum three (3) - five (5) years' experience required in either, case management, outpatient coding, utilization review, CDI or other disciplines with either coding experience however, an equivalent combination of education and experience, which provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements. * 2 years' experience in Primary Care, medical coding, risk adjustment or CDI preferred * Current certification in Clinical Documentation Improvement (CDIP, CCDS, CCDS-O or CDEO) preferred * Certification in medical coding and or risk adjustment (i.e., CRC, CPC, CCS, CDEO, or CCS-P or other pertinent to outpatient) preferred (CRC Required training within 1 year of employment) * Medical licensure (RN, PA, NP) preferred * Bachelor's degree healthcare related preferred * Strong PC skills / Microsoft applications, including Outlook, Teams, Excel, PowerPoint Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $62,400.00 - $90,750.40/Annual Grade 6 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: 0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $62.4k-90.8k yearly Auto-Apply 4d ago
  • Regulatory Affairs Manager

    McKesson 4.6company rating

    Remote

    McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve - we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow's health today, we want to hear from you. We are seeking a Regulatory Affairs Manager. This role is a remote work-from-home position to be located in Florida, Georgia, Tennessee, North Carolina, South Carolina, Alabama, Louisiana, Mississippi, Arkansas, Texas, Oklahoma, or Missouri. This role's primary responsibility is to support the regional Director of Regulatory Affairs (DRA) by conducting customer due diligence assessments focused on McKesson's Pharmaceutical Solutions and Services accounts, and in accordance with McKesson's Controlled Substances Monitoring Program (CSMP). This will require interaction and partnership with internal teams, report writing, data analysis, and interaction with program leadership to evaluate findings from the aforementioned activities. Key Responsibilities Conduct customer site visits as necessary to support CSMP processes. Perform customer due diligence reviews that include assessments of prospective customers and ongoing assessments of current customers. Review and analyze data to support due diligence efforts and identify/validate controlled substance trends and sourcing profiles. Prepare written reports to document reviews and statistical analysis. Engage with account managers and customers, as well as internal team personnel, as needed to support the CSMP process. Drive CSMP process awareness and communication with Sales and individual Account Managers. Seek opportunities to improve CSMP operational excellence through people, processes, or technology. Minimum Requirement Degree or equivalent and typically requires 4+ years of relevant experience. Critical Skills Multiple years' experience with responsibility for regulatory compliance in the supply chain for the pharmaceutical industry (Controlled substance compliance experience, Pharmacy, DEA experience, or law enforcement background a plus). In-depth understanding of retail pharmacy operations, controlled substance compliance, and diversion control programs. Possess a working knowledge of Federal and State governmental regulations pertaining to controlled substance compliance. Advanced proficiency with MS Office (Word, PowerPoint, Excel). Experience with Tableau, SAP, and Salesforce. Additional Skills Ability to make strategic, logic-based, and educated decisions leveraging data, analysis, and information from a variety of sources. People engagement and relationship-building skills. Ability to learn quickly and work effectively in fast-paced environments. Ability to collaborate with various teams. Excellent communication, collaboration, and influencing skills at all levels of the organization. Proficient in interviewing and technical writing skills, with attention to detail. Strong Analytical Skills. Results Orientation and Energy. Building Relationships. Mature Confidence and Integrity. Assertiveness and Influence. Travel 20% Travel Physical Requirements General Office demands Ability to operate a laptop We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here. Our Base Pay Range for this position $78,800 - $131,300 McKesson has become aware of online recruiting-related scams in which individuals who are not affiliated with or authorized by McKesson are using McKesson's (or affiliated entities, like CoverMyMeds or RxCrossroads) name in fraudulent emails, job postings or social media messages. In light of these scams, please bear the following in mind: McKesson Talent Advisors will never solicit money or credit card information in connection with a McKesson job application. McKesson Talent Advisors do not communicate with candidates via online chatrooms or using email accounts such as Gmail or Hotmail. Note that McKesson does rely on a virtual assistant (Gia) for certain recruiting-related communications with candidates. McKesson job postings are posted on our career site: careers.mckesson.com. McKesson is an Equal Opportunity Employer McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson's full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. Join us at McKesson!
    $78.8k-131.3k yearly Auto-Apply 5d ago
  • Senior Application Specialist- Revenue Cycle Analytics

    Aurora Health Care 4.7company rating

    Remote

    Department: 13492 Enterprise Revenue Cycle - Billing Operations Reporting and Analytics Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Mon- Fri 9am-5pm Remote from: WI, IL Divisions(Org 581/600) : AL, AK, AR, AZ, DE, FL, /GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY. Pay Range $44.15 - $66.25 Job Summary Responsible for building, maintaining, and analyzing reporting tools for Revenue Cycle customers. An effective application specialist will build relationships with customers to best understand operational needs and will work collaboratively or independently to complete projects. Essential Functions Coordinates with clients and peers to enhance system functionality while understanding the possible ramifications to the client's business processes and Information Services. Ensures client requests are properly evaluated and responded to in a timely manner. Leads teams of one or more members in accordance with project demands. Ability to recognize individual team member competencies and assign tasks accordingly. Plans work effort of one's self and possibly other project team members. Manages training when necessary, inclusive of course development and delivery. Ability to break down complex problems into manageable tasks. Demonstrates knowledge of applications and their integration (interface) with and effect on other systems. Provides feedback to management to be used during the evaluation and counseling of team members. Leads projects in one or more aspects of the information systems lifecycle (product selection, business requirement definition, communication, implementation, issue resolution, production support). Develops workplans, estimates tasks, and properly records time tracking for one's self and possibly other team members. Ensures successful completion of assigned projects on schedule, within budget, and in accordance within System standards. Physical Requirements Must be able to lift objects that weigh up to 35 lbs. This position is subject to high-level visibility through verbal and written communications with senior hospital management, associated project deadlines, personnel evaluation, and counseling. Must be available for on-call support on a regular basis. Due to project requirements, overtime will be required, as needed. Required 3 years of experience in Revenue Cycle Analytics Strong Microsoft Office Skills (Excel, Word, PowerPoint, Outlook) Cogito Epic Certification, or other applicable Epic Certification Ability to communicate effectively with customers Preferred Epic Certification in Clarity/Caboodle Data Models Experience building dashboards in PowerBI/Tableau Experience creating SQL queries Education, Experience and Certifications High School Diploma or GED required; Bachelor's Degree in Computer Science, Business Administration, or related field preferred. Formal training in Information systems, desktop applications, databases, software development packages and programming languages preferred. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
    $44.2-66.3 hourly Auto-Apply 13d ago
  • Cancer Registrar, Certified - FT - Days - Remote

    Sanford Health 4.2company rating

    Fargo, ND jobs

    Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Work Shift: Scheduled Weekly Hours: 40Salary Range: $21.50 - $34.50 Union Position: No Department Details Remote Fargo only Summary The Cancer Registrar, Certified holds the Oncology Data Specialist (ODS) certification and independently abstracts all cancer sites into the Cancer Registry while meeting quality standards. This role efficiently and effectively performs all cancer registry workflows including case finding, abstracting, patient follow-up, and safety net workflows. Job Description Independently analyzes and interprets clinical and demographic data and determine appropriateness of case inclusion in cancer database. Identifies, codes and abstracts records of all eligible cancer patients (analytic and non-analytic), utilizing the cancer registry data system within the guidelines and requirements of the American College of Surgeons CoC, State, Cancer Registry standard setters, and other applicable requirements. Completes abstracting in a multi-facility database structure, analyzes cases for inclusion or exclusion, performs patient follow-up analysis, and is able to complete all safety net workflows. Maintains work performance within production and quality guidelines. Works proficiently in Epic workflows. Completes necessary continuing education to maintain ODS certification, compliance with CoC accreditation standards, and maintains current knowledge of guidance/updates issues by cancer registry standard setters. Possesses knowledge of ICD-10, ICD-0, and morphology coding. Requires extensive knowledge of anatomy, physiology, disease processes, and current standards of care. Adheres to, displays and upholds the Sanford Values. Serves as a role model on professionalism, attitude, knowledge, demeanor and execution of duties. Regularly uses critical thinking skills, problem solving and decision making skills in the course of work. Possesses attributes to include: Skillful and flexible at managing change. Understands a systems approach to problem solving. Possesses excellent written and oral communication skills. Well organized. Willingness and ability to make decisions and be accountable for same. Flexibility, creativity and a willingness to implement new ideas. Knowledgeable in computer hardware and software applications including Microsoft Office, electronic medical records (EMR) and Cancer Registry database. Ability to work with team members in remote locations using a variety of technologies. Works extensively with electronic medical records and protected health information and is required to adhere to Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations and policies related to the same. Qualifications Oncology Data Specialist certified through the National Cancer Registrars Association is required and must meet post-secondary education requirements of NCRA. Minimum of one year Cancer Registry experience is preferred. Oncology Data Specialist certified through the National Cancer Registrars Association is required. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
    $21.5-34.5 hourly Auto-Apply 14d ago
  • Principal Cybersecurity Strategist - IS Mod

    Mayo Clinic 4.8company rating

    Rochester, MN jobs

    **Why Mayo Clinic** Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans (************************************** - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. **Benefits Highlights** + Medical: Multiple plan options. + Dental: Delta Dental or reimbursement account for flexible coverage. + Vision: Affordable plan with national network. + Pre-Tax Savings: HSA and FSAs for eligible expenses. + Retirement: Competitive retirement package to secure your future. **Responsibilities** The Principal Cybersecurity Strategist - IS Mod leads the development and management of Mayo's enterprise-wide cybersecurity services, strategy and innovation. Partner with leadership to align security with business goals, drive adoption of emerging technologies, and strengthen the organization's security posture. Lead and drive innovative security projects while collaborating cross functionally. Initial assignments will include leading coordination, planning and execution to ensure specific digital initiatives are secure throughout the lifecycle of product development. The position will include leadership, high level communications, coordination amongst cross functional and high visibility teams. Critical information security & cybersecurity skills and experiences include application protection, API security, S-SDLC, IAM, AI Security, Data Security, Cloud Security, etc. Key Responsibilities: - Develop and manage multi-year cybersecurity strategy and roadmaps - Advise leadership on cyber priorities, risk, and investment - Lead innovation in securing novel and emerging technology. - Guide strategic programs such as identity modernization, OT/IoT security, application protection, etc. - Foster cross-functional collaboration and mentor security professionals - Represent the organization in industry forums and contribute thought leadership Core Competencies: - Executive communication and strategic vision - Technical breadth across modern security and IT domains - Promote a culture of innovation and change, ensuring continuous improvement in quality, cost-effectiveness, and service excellence. - Ability to translate technical risk for business leaders. This is a full time, remote position within the United States. Mayo Clinic will not sponsor or transfer visas for this position including F1 OPT STEM. **Qualifications** **Required Qualification:** Bachelor's degree and 7+ years of experience with digital strategy, digital product strategy, experience strategy, healthcare administration, business administration, strategic development experience, or related field; or Master's degree and 5+ years of related experience in the preceding or related fields. Experience must include several of the following areas of expertise: digital product strategy and/or management, strategic planning, business plan development, consulting, customer experience or experience design, project management, stakeholder engagement, process change management, scorecard and dashboard development, financial analysis, new service/product planning and development, market research, and data management, analysis, and statistics. Management experience and experience with value-driven digital product management is preferred; experience navigating transformation in highly regulated industries is a plus. Strong analytical skills with the ability to synthesize and capture the essence of complex information in order to discern meaning, trends, and the big picture quickly. Experience in consulting or advisory functions; demonstrated success in analyzing situations and using various methodologies to develop high-value strategies and plans methodically. Working knowledge of Design Thinking, experience design, and digital analytics as inputs to digital strategy processes and artifacts; able to bridge digital disciplines to develop novel strategy solutions that balance the needs of multiple stakeholders. Experience in successfully managing stakeholders in complex, matrixed, and strategic initiatives. Demonstrated success in effective decision-making that drives progress toward ambitious goals while managing complexity, ambiguity, risk, and uncertainty. Demonstrated ability to lead, influence and collaborate across disciplines, including business strategy, experience design, analytics, and technology. Expert story-telling skills. Strong written and verbal communication and persuasion skills. Strong interpersonal and active listening skills; ability to quickly establish high-trust relationships and facilitate group/team activities. Professional approach that reflects Mayo Clinic values. Strong planning, organizational, and problem-solving skills; attention to detail; ability to self-direct with minimal supervision, demonstrate judgement in delegating responsibilities, and work well under pressure. Servant leader; gifted collaborator with demonstrated cultural competence and strong skills in negotiation, change, and conflict management. **Preferred Qualification:** Working knowledge of the Mayo technical environment and core business operations is strongly preferred. Advanced professional and culturally astute communication skills (both written and verbal) are required including ability to generate and deliver executive-level presentations. Must possess interpersonal skills to interact effectively with both technical and non-technical personnel at all levels of the organization, including proven ability to confidently lead discussion and negotiate on high risk and high-pressure issues while simultaneously building credibility & rapport. Demonstrated ability to tolerate & deal effectively with ambiguous situations and the varying political/cultural environments within the institution, department, divisions. Proven ability to offer guidance on business processes, technology capability and vulnerability assessments, and control enhancements or mitigation approaches. Solid knowledge of information security concepts and trends, project management methodologies, and relevant healthcare security regulatory requirements is required. Certified as CISSP, GSEC, CISM, or security equivalent; or will obtain certification within 2 years of hire. **Exemption Status** Exempt **Compensation Detail** $152,443.20 - 221,062.40 / year **Benefits Eligible** Yes **Schedule** Full Time **Hours/Pay Period** 80 **Schedule Details** Monday - Friday, 8am - 5pm **Weekend Schedule** As needed **International Assignment** No **Site Description** Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. (***************************************** **Equal Opportunity** All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law" (**************************** . Mayo Clinic participates in E-Verify (******************************************************************************************** and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. **Recruiter** Ted Keefe **Equal opportunity** As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.
    $152.4k-221.1k yearly 3d ago
  • Home Base Family Support Specialist

    Brigham and Women's Hospital 4.6company rating

    Boston, MA jobs

    Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds - including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service - for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research. The Family Support Specialist (FSS) Role is multifaceted. The FSS engages with veterans, service members and military-connected family members to spread awareness about the impacts of military service on entire family systems. They encourage family members to take advantage of clinical, wellness and educational services available through the Home Base Program. The Family Support Team (FST) is the first point of contact for military connected family/supports seeking information or care at Home Base. FSS provide peer support for military connected family/supports participating as part of their service member/veteran's clinical programming. Finally, the FST team delivers/facilitates resiliency offerings in addition to hosting recreational activities for families in New England. In addition to patient-facing outreach, the FST works to build and maintain relationships with other local, regional and national military-serving organizations in an effort to collaborate in support of military families. The FST may need to work outside of normal working hours, to include some nights and weekends. Travel may also be required for this role. Job Summary Summary Responsible for community outreach, engagement, and support to enhance access to behavioral health programs. The Outreach Worker collaborates with community partners, healthcare professionals, and social service agencies to promote mental health awareness and address the behavioral health needs of individuals. Does this position require Patient Care? Yes Essential Functions * Conduct proactive outreach within the community to identify individuals in need of behavioral health services. * Establish relationships with community organizations, schools, primary care providers, and other relevant stakeholders to enhance outreach efforts. * Conduct initial assessments to identify the behavioral health needs of individuals. * Provide information and referrals to appropriate behavioral health services and resources. * Respond to crisis situations and provide immediate support and intervention. * Collaborate with crisis intervention teams, law enforcement, and emergency services as needed. * Advocate for individuals with behavioral health needs to ensure they receive timely and appropriate care. * Conduct community education and awareness programs on mental health topics. Qualifications Education Bachelor's Degree Related Field of Study required Can this role accept experience in lieu of a degree? No Experience * Experience in behavioral health outreach or related field 1-2 years preferred * Lived experience as a military family member * Minimum of 3 years working with military families Knowledge, Skills and Abilities * Knowledge of military structure * Knowledge of community services and resources available to military families * Familiarity with PTSD and TBI and the challenges that accompany such diagnoses * Compassionate and empathetic spirit * Ability to listen and manage stressful situations and respond calmly and professionally in a safe and reassuring manner * Strong knowledge of behavioral health services, resources, and crisis intervention techniques. * Excellent communication, interpersonal, and organizational skills. * Ability to work independently and collaboratively within a team. * Proficiency in using electronic health records and documentation systems. * Valid driver's license and reliable transportation for community outreach. Additional Job Details (if applicable) Physical Requirements * Standing Frequently (34-66%) * Walking Frequently (34-66%) * Sitting Occasionally (3-33%) * Lifting Frequently (34-66%) 35lbs+ (w/assisted device) * Carrying Frequently (34-66%) 20lbs - 35lbs * Pushing Occasionally (3-33%) * Pulling Occasionally (3-33%) * Climbing Rarely (Less than 2%) * Balancing Frequently (34-66%) * Stooping Occasionally (3-33%) * Kneeling Occasionally (3-33%) * Crouching Occasionally (3-33%) * Crawling Rarely (Less than 2%) * Reaching Frequently (34-66%) * Gross Manipulation (Handling) Frequently (34-66%) * Fine Manipulation (Fingering) Frequently (34-66%) * Feeling Constantly (67-100%) * Foot Use Rarely (Less than 2%) * Vision - Far Constantly (67-100%) * Vision - Near Constantly (67-100%) * Talking Constantly (67-100%) * Hearing Constantly (67-100%) Remote Type Hybrid Work Location One Constitution Wharf Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $20.43 - $29.21/Hourly Grade 4 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: The General Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
    $20.4-29.2 hourly Auto-Apply 4d ago
  • Provider Relations Specialist (Remote Option within SHP Service Area)

    Sanford Health 4.2company rating

    Marshfield, WI jobs

    Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Provider Relations Specialist (Remote Option within SHP Service Area) Cost Center:682891544 SHP-Provider Network MgmtScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; day shifts (United States of America) Job Description: JOB SUMMARY The Provider Relations Specialist works in cooperation with the Contracting Manager - Marshfield Clinic Health System Provider Network and other department and organization colleagues to deliver superior service to our comprehensive network of affiliated health care providers. This individual serves as the primary liaison between Security Health Plan (SHP) and affiliated providers for escalated and contractual issues across various lines of business, with limited supervision. The Provider Relations Specialist is responsible for relationship management activities for hospital, professional, vendor, care system and/or ancillary providers including: development and execution of issue escalation strategies, educational programs, onsite visit criteria, special initiatives, and building and preserving strong provider relationships JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: Associate degree or 60+ credits in health care, business, marketing, education, or related field. Preferred/Optional: Bachelor's degree in business administration, accounting, health care, finance, or related field. EXPERIENCE Minimum Required: Three years' experience in a medical group practice or health insurance/Health Maintenance Organization (HMO) environment. Experience with healthcare claims and insurance reimbursement methods, and understanding of contract terminology. Working knowledge of health care delivery systems and concepts of managed care. Demonstrated proficiency with the Microsoft Office suite. Excellent written and verbal communication skills. Demonstrated ability to take initiative, utilize critical thinking, and bring forth solutions to identified issues. Preferred/Optional: Experience in provider relations, including well-defined communication skills and a demonstrated aptitude for communicating with both business users and technical staff. Strong interpersonal, problem solving and relationship building experience. Credentialing or claims experience preferred. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: None Preferred/Optional: None Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
    $46k-59k yearly est. Auto-Apply 6d ago
  • Physician - Remote Emergency Radiologist

    Sanford Health 4.2company rating

    Marshfield, WI jobs

    Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Physician - Remote Emergency RadiologistCost Center:201641261 System Radiology-ProfScheduled Weekly Hours:40Time Type:Full time Job Description: Marshfield Medical Center is looking for a BC/BE Radiologist to join our ED section in Wisconsin. Fellowship training in Body, Neuro, ED or MSK is required. Must be comfortable with all emergent diagnostic imaging modalities including Neuro CTA/perfusion, trauma (including MRI), Ultrasound (including OB), pediatrics and occasional musculoskeletal MRI/CT. No CVIR, nuclear medicine or mammography. Choose to work remote as a Non-Associate on a casual contract or may have the option to work locally at one of our centers as an Associate physician with additional salary and benefits. If working onsite, you will need to be comfortable with and will be responsible to occasionally perform some local minor procedures. Service coverage includes a level 2 soon to be level 1 trauma center and stroke center as well as additional regional hospitals and urgent care centers. Coverage needed for afternoons and evenings. No midnight shifts required. Yearly work requirement is 182 shifts a year - typically 7 on/7 off schedule/26 weeks per year Compensation/Benefits: Competitive Salary Flexible shift based model Health, Dental, Life, and Occurrence Based Malpractice insurance Relocation support available if working onsite Marshfield Clinic Health System is a non-profit 501(c)(3) organization. This may qualify you for additional state and/or federal education loan forgiveness programs. MCHS strongly encourages our physicians to be involved in medical education and research to continue building our strong foundation of patient care, research, and education for years to come. Marshfield Clinic Research Institute: ********************************** Marshfield Clinic Division of Education: ****************************************** Marshfield, Wisconsin Nestled in the heart of Wisconsin, Marshfield is a safe, clean community with a population of about 20,000 people. The region boasts a solid economy and a low cost of living, which includes below national average costs for housing and transportation. Community pride is evident in the private and city funds invested in making Marshfield a great place to live. Located one mile outside of town, you will have access to 6,500 acres for hiking, biking, hunting, canoeing, cross-country skiing, berry picking, and wildlife or bird watching or simply enjoying the fresh air. With excellent schools and high school graduation rates high above the national average, Marshfield is committed to offering and preparing students for top-notch educational opportunities. Those of us that have chosen to call Marshfield home have come to enjoy the benefits of short commutes, safe and friendly neighborhoods, fresh air and water, bountiful nature, and so much more. Come and see for yourself. Fun Fact: Marshfield is known as the HEART of Wisconsin! Marshfield Clinic Health System physicians and staff are motivated by our mission to enrich lives. We serve more than 350,000 unique patients each year through accessible, high quality health care, research and education. With more than 1,600 providers in 170 medical specialties and subspecialties as well as over 13,000 employees in 65 clinical locations in 45 communities serving Wisconsin and Michigan's Upper Peninsula, Marshfield Clinic Health System is nationally recognized for innovative practices and quality care. The Marshfield Promise Motivated by our mission to enrich lives, we use common values to ensure those we serve feel supported in their healthcare journey and staff and providers are actively engaged with one another. Together through our actions, we promise to deliver compassionate, safe and expert care to everyone. The Marshfield Promise is centered around 5 core values; Patient-Centered, Trust, Teamwork, Excellence and Affordability. For more information, please contact: Lindsay Becker, Physician and Advanced Practice Clinician Recruiter Phone: ************ *********************************** Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
    $282k-517k yearly est. Auto-Apply 60d+ ago
  • Senior Business Intelligence Developer - Rev Cycle-Remote

    Mayo Clinic Health System 4.8company rating

    Rochester, MN jobs

    Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. Benefits Highlights * Medical: Multiple plan options. * Dental: Delta Dental or reimbursement account for flexible coverage. * Vision: Affordable plan with national network. * Pre-Tax Savings: HSA and FSAs for eligible expenses. * Retirement: Competitive retirement package to secure your future. Responsibilities Uses advanced Business Intelligence tools, cloud technologies, and statistical software to assemble, manipulate, and format data for actionable insights. Maintains and optimizes Business Intelligence models to design, develop, and generate both standard and ad-hoc reports and dashboards for internal and external customers to support business performance monitoring and decision-making. Works within established controls to ensure the accuracy, timeliness, and confidentiality of all reports, views, dashboards, analyses, and user data. Adheres to development standards and protocols including change management, code review, documentation, and testing. Educates and advises internal customers on how to leverage available data for consumption. Develops, maintains, reviews, and explains data models while staying current with business operations and Business Intelligence processes. Builds relationships with Business Intelligence partners to understand data needs and execute with excellence on documented user requirements and prototypes. Demonstrates strong SQL skills with extensive experience in developing Business Intelligence solutions. Designs, develops, and troubleshoots extract, transform and load processes that implement complex programming logic. Extracts operational, performance, statistical, and other data from various information systems, but primarily Epic. Develops and delivers reports, dashboards, and visualizations that clearly communicate insights. Manages multiple tasks simultaneously and responds quickly to problems, translating concepts and directions into practical solutions. Possesses development experience with relational and multi-dimensional database structures, data warehouse design architecture, and modern cloud platforms. Performs data development and integration using Google Cloud services such as BigQuery, and Dataflow, as well as Microsoft Fabric technologies including OneLake, lakehouses, pipelines, and semantic models. Determines Business Intelligence and data warehousing solutions to meet business needs and identifies and resolves data reporting issues in a timely manner. Qualifications Bachelor's degree and a minimum of 8 years' revenue cycle, system, or data delivery experience required. Master's degree preferred. Epic Certification is required within first year of job acceptance. Epic Cogito Certification is preferred. Healthcare Financial Management Association (HFMA) Certification Preferred. Previous healthcare experience required. Requires knowledge and experience in reporting and analytics delivery software, such as Business Objects, Crystal Reports, SQL Server Management Studio, Tableau or Epic Cogito reporting framework. Requires knowledge of database and data structure in regard to reporting efficiencies. Experience with cloud-based data development in Google Cloud (BigQuery, Cloud Storage, Dataflow), Microsoft Fabric (OneLake, lakehouses, pipelines) and AI technology is highly desirable. Experience with AI-driven analytics or machine learning applications is a plus. Preferred knowledge of physician and hospital billing systems for governmental, managed care, and commercial payers. Must be customer-service oriented, able to respond promptly to requests, manage multiple priorities, work independently, and demonstrate strong problem-solving and leadership skills. * This position is a 100% remote work. Individual may live anywhere in the US. This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position. Exemption Status Exempt Compensation Detail $91,000 - $127,400 / year Benefits Eligible Yes Schedule Full Time Hours/Pay Period 80 Schedule Details Standard Days M-F International Assignment No Site Description Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. Equal Opportunity All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the 'EOE is the Law'. Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. Recruiter Ronnie Bartz
    $91k-127.4k yearly 20d ago
  • Risk Adjustment Revenue Manager (Remote)

    Sanford Health 4.2company rating

    Marshfield, WI jobs

    Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Risk Adjustment Revenue Manager (Remote) Cost Center:682891390 SHP-Strategic FinanceScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; 8:00 am - 5:00 pm (United States of America) Job Description: The Risk Adjustment Revenue Manager is responsible for risk adjustment strategy and related revenue management for Security Health Plan's Medicare, Affordable Care Act and Medicaid business. This individual provides development and implementation of programs and initiatives to improve the accuracy of the coding, including education; retrospective and prospective review processes; and vendor contract management; accountability for preparation for and management of the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Services (DHS) auditing processes; management of encounter data processes; and management of applicable state and federal guidance. The Risk Adjustment Revenue Manager works collaboratively with Security Health Plan executives and leadership as well as Marshfield Clinic Health System (MCHS) executives and leadership to lead risk adjustment strategy and process. JOB QUALIFICATIONS EDUCATION Minimum Required: Bachelor's Degree in Business Administration, Finance, Health Care Administration, Management or related field required. Preferred/Optional: Post graduate degree(s) desirable. EXPERIENCE Minimum Required: Five years of experience in risk adjustment or related area. Three years of experience in a management or leadership role and experience in the healthcare industry. Demonstrate a broad understanding of healthcare and health insurance. Demonstrate proficiency with verbal and written communication, strategic planning and business acumen. Preferred/Optional: Working knowledge of CMS and/or Medicaid risk adjustment methodologies. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: Certifications in professional coding and risk adjustment coding from American Academy of Professional Coders. State of Wisconsin driver's license with an acceptable driving record. Preferred/Optional: None Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
    $72k-94k yearly est. Auto-Apply 23d ago

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