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Specialist jobs at PharmScript - 5350 jobs

  • Nursing Professional Development Specialist NEX

    Akron Children's Hospital 4.8company rating

    Akron, OH jobs

    Covering Pain Center, Sedation, and Radiology Part Time 20 hours/week Dayshift onsite NPD coverage of procedural areas: Pain Center, Sedation and Radiology (including Vascular Access and Interventional Radiology) The Nursing Professional Development (NPD) Specialist is responsible for enhancing the professional growth and development of nursing staff through educational programs, training sessions, and continuous learning opportunities. The NPD Specialist will collaborate with nursing leadership to identify educational needs, develop curricula, and implement strategies to improve nursing practice and patient care outcomes. Responsibilities: • The NPD specialist advances the profession by contributing to the professional development of others, supporting collaborative relationships and supporting life-long learning. • Uses the educational design process to bridge the knowledge, skills and practice gaps identified through needs assessment. • Influences the inter-professional practice and learning environments, the NPD specialty, and the profession of nursing and healthcare through collaboration with leadership in planning and decision making to achieve desired results. • Actively works to transform processes at all levels through inspiration, initiation, adoption and sustainment of and adaptation to change using project management and improvement processes. • Promotes the generation and dissemination of new knowledge and the use of evidence to advance NPD practice, guide clinical practice and improve patient care. • Actively supports, promotes, and demonstrates nursing professional development as a nursing practice specialty through promotion of research, EBP, and QI. • Supports the transitions of nurses and other healthcare team members across learning and practice environments, roles and professional stages. • Other duties as required. Other information: Technical Expertise Experience in project management with interdisciplinary team is preferred. Experience in data analysis and presentations is preferred. Experience working with all levels within an organization is required. Experience in healthcare is required. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. Education and Experience Education: Master's degree in nursing or related field or BSN and in process of attaining master's degree in nursing or related field. Completion of Nurse Education track of MSN program is preferred. Certification: Registered Nurse licensure is required; BLS certification is required; PALS certification may be required by area of service. Professional Nursing certification preferred. Years of relevant experience: Minimum 3 years required. Years of experience supervising: None. Part Time FTE: 0.500000 Status: Onsite
    $43k-65k yearly est. 7d ago
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  • Senior Nursing Professional Development Specialist - Primary Care

    Akron Children's Hospital 4.8company rating

    Akron, OH jobs

    Part-time, 24 hours/week Onsite, travel required to all primary care locations The Senior Nursing Professional Development (NPD) Specialist is a highly experienced educator responsible for advancing nursing practice through leadership in education, professional development, evidence-based practice, and strategic initiatives. This role mentors other professional development staff and plays a critical role in developing and implementing system-wide educational strategies. The Senior NPD Specialist supports the onboarding, orientation, and ongoing competency of nursing staff while cultivating a culture of continuous learning and excellence in practice. Responsibilities: The Senior NPD specialist advances the profession by contributing to the professional development of others, supporting collaborative relationships and supporting life-long learning. Uses the educational design process to bridge the knowledge, skills and practice gaps identified through needs assessment. Influences the inter-professional practice and learning environments, the NPD specialty, and the profession of nursing and healthcare through collaboration with leadership in planning and decision making to achieve desired results. Actively works to transform processes at all levels through inspiration, initiation, adoption and sustainment of and adaptation to change using project management and improvement processes. Promotes the generation and dissemination of new knowledge and the use of evidence to advance NPD practice, guide clinical practice and improve patient care. Actively supports, promotes, and demonstrates nursing professional development as a nursing practice specialty through promotion of research, EBP, and QI. Supports the transitions of nurses and other healthcare team members across learning and practice environments, roles and professional stages. Other duties as required. Other information: Technical Expertise Experience in project management with interdisciplinary team is required. Experience in data analysis and presentations is required. Experience working with all levels within an organization is required. Experience in healthcare is preferred. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. Education and Experience Education: BSN required. Master's degree in nursing or related field required. Certification: Registered Nurse licensure is required; BLS certification is required; PALS certification may be required by area of service. Professional nursing certification required. Years of relevant experience: Minimum 4 years required. Years of experience supervising: None. Part Time FTE: 0.600000 Status: Onsite
    $43k-65k yearly est. 7d ago
  • Associate Spine Specialist (Boston, MA)

    Globus Medical 4.5company rating

    Boston, MA jobs

    Associate Spine Specialist (Boston, MA) page is loaded## Associate Spine Specialist (Boston, MA)locations: Massachusettstime type: Full timeposted on: Posted 25 Days Agojob requisition id: JR104911At Globus Medical, we move with a sense of urgency to deliver innovations that improve the quality of life of patients with musculoskeletal disorders. Our team is inspired by the needs of these patients, and the surgeons and healthcare providers who treat them. We embrace a culture of exceptional response by partnering with researchers and educators to transform clinical insights into tangible solutions. Our solutions improve the techniques and outcomes of surgery so patients can resume their lives as quickly as possible The Associate Spine Specialist will work together with the Spine Territory Manager and will have territory coverage, inventory management, and limited sales responsibilities. The Associate Spine Specialist will represent the company in accordance with the company's quality policy and procedures.**Essential Functions****:*** Gains and consistently increases product knowledge through formal sales training; surgeon speaker programs, attends surgeries/operating room visits, and industry research* Meeting or exceeds all sales goals and objectives assigned* Conducts sales calls to promote, sells, and services Globus Medical products and services to existing and competitive customers based on a strategic plan* Assists the Spine Territory Manager on field calls for assigned geography and address and problems that arise on the account* Performs field ride along with the Area Director and Spine Territory Manager on a regular basis* Develops and increases customer base and continually enhances Globus product market share within assigned territory* Provides feedback regularly on topics such as product development opportunities, new target accounts, sales performance, and market feedback* Maintains conduct that is aligned with company quality policy and procedures, and protects confidentiality with proprietary information* Stays current with all compliance training requirements* Adheres to the letter and spirit of the company Code of Conduct, the AdvaMed Code, MedTech Code, and all other company policies.* Ensures Compliance with applicable governmental laws, rules, and regulations, both in the United States and internationally, by completing introductory and annual training and maintaining knowledge of compliance as it applies to your role* Represents the company in a professional manner and uphold the highest standards of ethical business practices and socially responsible conduct in all interactions with other employees, customers, suppliers, and other third parties*Reasonable accommodations may be made to enable individuals with disabilities to perform these* essential *functions.***Qualifications****:*** 1-2 years' successful spine sales experience preferred, may consider other healthcare related sales and or business to business sales experience* Bachelor's degree in Science or Business* Exemplary ability to listen, communicate and influence* Ability to travel as necessary, which may include nights and/or weekends* Strong understanding of spinal anatomy* Ability to make sales presentations with positive results**Physical Demands****:**The physical demands listed here are representative of those that must be met by and employee to successfully perform the essential functions of this job.* Required to sit; climb or balance; and stoop, kneel, crouch or crawl* Required to regularly lift and/or move up to 10 pounds, and occasionally lift and/or move up to 25 pounds* Required to possess specific visons abilities, including: close vision, distance vision, color vision, peripheral vision, depth perception and capacity to adjust focus.**Our Values:**Our Life Moves Us philosophy is built on four values: Passionate About Innovation, Customer Focused, Teamwork, and Driven.* **Passionate about Innovation**: Improving patient care by delivering advanced technology to our customers is at the core of what we do. We are passionate in our role in improving the lives of patients by continuously developing better solutions.* **Customer Focused**: We listen to our customers' needs and respond with a sense of urgency.* **Teamwork**: Working together, anything is possible. We value every person on our team and treat each other with respect. We are accountable to one another and support each other. Together, we make each other stronger.* **Driven**: We pursue our mission with energy and passion. We are nimble, results-oriented and decisive. We overcome obstacles that arise in our quest to deliver solutions that will improve the lives of our customers and patients. **Equal Employment Opportunity:**Globus Medical is an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, age, disability, marital status, pregnancy, national origin or citizenship. We are committed to a diverse workforce. We value all employees' talents and support an environment that is inclusive and respectful. **Other Duties:**Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. #J-18808-Ljbffr
    $75k-86k yearly est. 5d ago
  • Maternity Care Authorization Specialist (Hybrid Potential)

    Christian Healthcare Ministries 4.1company rating

    Barberton, OH jobs

    This role plays a key part in ensuring maternity care bills are processed accurately and members receive timely support during an important season of life. The specialist serves as a detail-oriented professional who upholds CHM's commitment to excellence, compassion, and integrity. WHAT WE OFFER Compensation based on experience. Faith and purpose-based career opportunity! Fully paid health benefits Retirement and Life Insurance 12 paid holidays PLUS birthday Lunch is provided DAILY. Professional Development Paid Training ESSENTIAL JOB FUNCTIONS Compile, verify, and organize information according to priorities to prepare data for entry Check for duplicate records before processing Accurately enter medical billing information into the company's software system Research and correct documents submitted with incomplete or inaccurate details Verify member information such as enrollment date, participation level, coverage status, and date of service before processing medical bills Review data for accuracy and completeness Uphold the values and culture of the organization Follow company policies, procedures, and guidelines Verify eligibility in accordance with established policies and definitions Identify and escalate concerns to leadership as appropriate Maintain daily productivity standards Demonstrate eagerness and initiative to learn and take on a variety of tasks Support the overall mission and culture of the organization Perform other duties as assigned by management SKILLS & COMPETENCIES Core strengths like problem-solving, attention to detail, adaptability, collaboration, and time management. Soft skills such as empathy (especially important in maternity care), professionalism, and being able to handle sensitive information with care. EXPERIENCE REQUIREMENTS Required: High school diploma or passage of a high school equivalency exam Medical background preferred but not required. Capacity to maintain confidentiality. Ability to recognize, research and maintain accuracy. Excellent communication skills both written and verbal. Able to operate a PC, including working with information systems/applications. Previous experience with Microsoft Office programs (I.e., Outlook, Word, Excel & Access) Experience operating routine office equipment (i.e., faxes, copy machines, printers, multi-line telephones, etc.) About Christian Healthcare Ministries Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.
    $31k-35k yearly est. 1d ago
  • Mobility Specialist - Physical Therapy - Full Time

    Guthrie 3.3company rating

    Sayre, PA jobs

    In collaboration with Rehabilitation and Nursing, and under the direction of Rehabilitation, the Mobility Specialist provides mobility to promote maximum function based on AM-PAC Mobility Score and Johns Hopkins Highest Level of Mobility (JH-HLM) goal score. Education, License, & Cert: High school Graduate/GED and must be knowledgeable in use of computers. Prefer successful completion of a CNA training course or currently enrolled in a licensed nurse program or successfully completed a fundamentals of nursing course, or has had experience in the field of Therapy or previously completed internal training for a care partner role or mobility specialist Experience: Experience desired but not necessary Licenses & Certifications: None required School Education: High School Grad or Equivalent Essential functions: Participates in the mobility of all patients based on AM-PAC Mobility Score and JH-HLM Goal Score Openly communicates individual patient progress so all members of the healthcare team are involved and aware of the patient's level of function Collaborate with RN staff prior to mobilizing patient to ensure patient is medically stable for activity. Incorporates proper safe patient handling skills such as body mechanics for safe lifting, turning and positioning of patients Ensure all appropriate patients are out of bed daily utilizing the necessary equipment based on the patients current level of function Assist therapy team as a second set of hands during sessions when warranted Other Duties: Maintain a clean and safe environment for mobilization of the patient Demonstrate the ability to accept other non-routine work assignments as appropriate Maintain PAR level of Safe Patient Handling Equipment on the nursing unit Attend Monthly Rehab staff meetings as appropriate About Us Joining the Guthrie team allows you to become a part of a tradition of excellence in health care. In all areas and at all levels of Guthrie, you'll find staff members who have committed themselves to serving the community. The Guthrie Clinic is an Equal Opportunity Employer. The Guthrie Clinic is a non-profit, integrated, practicing physician-led organization in the Twin Tiers of New York and Pennsylvania. Our multi-specialty group practice of more than 500 physicians and 302 advanced practice providers offers 47 specialties through a regional office network providing primary and specialty care in 22 communities. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine.
    $98k-122k yearly est. 2d ago
  • Transfer Center Specialist (RN)

    Incredible Health 4.0company rating

    San Antonio, TX jobs

    Hospitals on Incredible Health are actively hiring and accepting applications in the San Antonio, TX area for the following position: Transfer Center Specialist (RN). Shift(s) available: day shift, night shift, and mid shift Job types available: full time, part time, and per diem Employer features: 401(K), Cross training, Health Insurance, Offers sign on bonus, PTO, Retirement Plan Qualifications: RN Diploma degree or higher from an accredited school of nursing Active and unencumbered Registered Nurse license in the state of Texas Benefits: Healthcare coverage: Medical, Dental, Vision 401K Paid Time Off Tuition Assistance Salary: $60,150 to $98,020 /year
    $29k-40k yearly est. 2d ago
  • Senior Neurosurgery Scheduling Specialist

    Houston Methodist 4.5company rating

    Houston, TX jobs

    A leading healthcare provider in Houston is seeking a Senior Scheduler to manage appointment scheduling for complex services. The role involves clear communication with patients and medical staff, ensuring timely access to healthcare services, and training new staff members. Candidates should have a high school diploma and relevant experience in medical scheduling or a call center environment. This position offers opportunities for personal growth and a dynamic team environment. #J-18808-Ljbffr
    $28k-32k yearly est. 1d ago
  • Transportation Claims & Carrier Qualifications Specialist

    Patterson Companies 4.7company rating

    Lakeland, FL jobs

    Patterson Companies was founded in 1985 and has grown from a single office specializing in transporting perishable goods to a comprehensive supply chain solutions company. Serving thousands of customers annually, Patterson expertly handles Full Truckload (FTL), Less-Than-Truckload (LTL), Expedited, Refrigerated, Flatbed, and Dry Van transport markets. The company is committed to ensuring every shipment is delivered efficiently and in optimal condition. In addition to being a leading logistics company, Patterson boasts large asset divisions with refrigerated and dry van fleets, as well as warehouse and distribution locations. Role Description This is a full-time, on-site role located in Plant City, FL, for a Transportation Claims & Carrier Qualifications Specialist that plays a critical role in protecting Patterson Companies from operational, financial, and reputational risk. This position is responsible for managing all Overages, Shortages, and Damages (OS&D), processing and resolving freight claims, qualifying and onboarding carriers, maintaining carrier insurance compliance, and overseeing organizational risk management procedures. This role ensures that Patterson Companies operate within industry regulations while building strong partnerships with carriers and safeguarding our customers' freight. Key Responsibilities Claims & OS&D Management Serve as the first point of contact for all OS&D and freight claims from shippers, carriers, and internal teams. Investigate, document, and process claims in compliance with company policies, federal regulations, and industry best practices. Communicate with carriers, customers, and internal stakeholders to resolve disputes promptly and fairly. Maintain detailed claim files, documentation, and reporting for trend analysis and process improvement. Carrier Vetting & Qualification Conduct thorough vetting of new carriers, including verifying MC/DOT authority, safety ratings, insurance coverage, and operational capabilities. Ensure carriers meet Patterson Companies' safety and compliance standards before onboarding. Monitor ongoing carrier compliance, including insurance renewals, safety performance, and regulatory changes. Manage the carrier onboarding process in collaboration with the operations team, utilizing TMS-integrated vetting tools (e.g., Highway). Insurance & Compliance Management Track and verify carrier insurance policies, ensuring timely renewals and appropriate coverage. Coordinate with carriers and insurance providers to update coverage documents in company systems. Monitor regulatory requirements and ensure company compliance with FMCSA, DOT, and other governing bodies. Organizational Risk Management Identify operational risks and recommend preventive strategies to mitigate exposure. Develop and update company policies related to risk, claims, and carrier compliance. Provide regular risk and claim trend reports to leadership to inform decision-making. Collaborate with sales, operations, and leadership to ensure contractual agreements protect company interests. Carrier Relations & Partnership Management Serve as a primary point of contact for carriers regarding qualification requirements, insurance compliance, claims processes, and risk-related inquiries Communicate Patterson's carrier standards, documentation requirements, and expectations clearly and professionally Build and maintain respectful, solutions-oriented relationships with approved carriers while enforcing compliance and risk policies consistently Support carrier onboarding and requalification by providing guidance on required documentation, timelines, and corrective actions Manage carrier communications during claims, incidents, or service failures with a focus on transparency, resolution, and professionalism Collaborate with Operations and Carrier Sales teams to balance carrier partnership, service reliability, and risk mitigation Identify recurring carrier issues or trends and proactively recommend improvements to processes, standards, or communication De-escalate disputes when necessary while protecting Patterson's interests and maintaining long-term carrier trust Qualifications Strong Analytical Skills for evaluating claims, problem-solving, and ensuring data accuracy Excellent Communication and Customer Service abilities to effectively collaborate with clients and carriers Ability to work in a fast-paced, detail-oriented environment Proficiency in using standard office software and transportation management systems Previous experience in logistics, supply chain, or transportation management is preferred Minimum 3 years of experience in transportation, logistics, risk management, or claims processing
    $41k-52k yearly est. 4d ago
  • Family Engagement Specialist

    Lifegift 3.7company rating

    Lubbock, TX jobs

    Would You Like a Life-Changing Career with LifeGift Where You Can Grow as a Family Engagement Specialist I? Kick-start the career of a lifetime where you can be a part of our mission of hope, working with an incredible team saving lives while modeling our values of Passion, Compassion, and Professionalism to the LifeGift community. LifeGift is currently looking for a Family Engagement Specialist I in Lubbock who serves as a critical link between LifeGift and the families whose loved ones are considering or have opted for organ donation. This role encompasses providing emotional support, education about the donation process, and facilitating meaningful conversations between families and healthcare personnel. The Family Engagement Specialist will work collaboratively with medical professionals, social workers, and bereavement coordinators to ensure families receive comprehensive and compassionate care during emotionally challenging times. Do you possess the attributes to be a successful Family Engagement Specialist I and perform the following essential functions? Provide compassionate support to families during the organ donation process, addressing their questions and concerns with empathy and understanding. Educate families on the process of organ donation, including the medical, ethical, and emotional aspects, to help them make informed decisions. Act as a liaison between families and medical providers, ensuring effective communication and clarity regarding the donation process. Offer immediate support and resources to families in crisis, assisting them in navigating complex emotions and providing grief counseling as necessary. Collaborate with the Family Engagement Manager to develop and refine educational materials, resources, and training programs to enhance family engagement strategies. Maintain accurate records and documentation of family interactions, ensuring confidentiality and compliance with all regulatory standards. Participate in community outreach initiatives to promote organ donation awareness and educate the public about LifeGift's mission and the importance of donor families. Work closely with multidisciplinary teams to advocate for families' needs and ensure their voices are heard in policy and operational discussions. Do you have the education and experience to be a Family Engagement Specialist I? Bachelor's degree in Social Work, Nursing, Psychology, Public Health, Human Services, Communications, Counseling, Education, or a related field; Master's degree preferred. Minimum of 2-3 years' experience in family support, grief counseling, or a related field, preferably in healthcare or organ donation settings. Backgrounds that demonstrate advanced interpersonal communication, conflict resolution, and the ability to guide individuals through complex, emotionally charged decisions Knowledge of the organ donation process and relevant regulatory frameworks is highly desirable. Ability to navigate sensitive and complex situations with professionalism and poise. Proficient in Microsoft Office Suite and experience with data management systems. Bilingual (English/Spanish) is a plus. This is NOT a remote position. This role requires frequent travel and ability to commute to different hospital partners within our service area. As a condition of employment, you must be able to attain Hospital Badge and EMR Access from all of the LifeGift Hospital Partners, as well as the availability to work 12-hour shifts, including nights, weekends and holidays. The Heart of Our Culture Established in 1987, LifeGift offers hope to the thousands of people in Texas and beyond who need lifesaving organ and tissue transplants. Our organization is diverse by nature, and inclusive by choice. LifeGift strives to reflect the communities where we live and work, and our multi-cultural and diverse team contributes an abundance of talent, abilities, and innovation that have continued to elevate our success. Rewards and Benefits for Your Career and Well-Being LifeGift values its team members and offers a variety of highly competitive benefits. Full-time team members have the opportunity to enroll in the following insurance plans: medical, dental, and vision, as well as life insurance, LTD and STD, and FSAs and HSAs that are pre-tax and to which LifeGift contributes. LifeGift also offers an exceptional retirement package that includes 403(b) and 401(a) retirement plans with the opportunity for a generous match. Additionally, LifeGift offers a tuition reimbursement program to encourage team members to expand their knowledge and further their education. LifeGift recognizes the importance of a work-life balance and encourages team members to take advantage of a generous vacation and sick leave plan. LifeGift is an equal opportunity employer! If you are qualified and want to be considered for a career that is life-changing, has purpose, and where you can be a part of an organization that cares about its employees, we encourage you to apply by completing the application at ************************* LifeGift is a drug-free workplace.
    $32k-41k yearly est. 4d ago
  • Operations Specialist

    Grip 4.0company rating

    Miami, FL jobs

    We are seeking a dedicated and enthusiastic Operations Specialist to join our team. You will be the face of the company for our clients, responsible for ensuring customer satisfaction through exceptional customer service and experience. You will play a pivotal role in fostering strong relationships with our clients, understanding their needs, and ensuring that their interactions with Grip are positive and rewarding. This role requires a proactive approach to problem-solving, a deep commitment to customer care, and the ability to work seamlessly with various internal teams to enhance the overall client experience. Specific responsibilities: Serve as the primary point of contact for clients, responding to chats, emails, and calls. Build sustainable, long-term relationships with clients and ensure satisfaction by providing professional client support. Collaborate with the operations team on fulfillment requests and warehouse-related tasks. Schedule regular meetings with clients and document these meetings with well-written notes. Identify opportunities to improve the client experience and propose new ideas or solutions when appropriate. Utilize our task creation and project management system to ensure all client requests are completed on time. Handles proactive communication to clients for events impacting orders and on-time delivery. Oversee projects, which include client reports, client onboardings, and claims. Qualifications: Excellent oral and written communication skills. Experience in retail/customer service. Ability to multi-task, prioritize, and manage time effectively. Proactive approach to enhancing the client experience. Strong attention to detail and problem-solving skills. Excellent problem-solving and critical-thinking skills. Experience in 3PL, Client Experience, or Account Management is preferred. Equal Employment Opportunity Statement: Grip is an equal opportunity employer, dedicated to complying with all applicable non-discrimination laws. We are committed to providing an inclusive workplace environment, where all employees and applicants are treated with respect and without discrimination based on race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), national origin, age, disability, genetic information, or any other characteristic protected by law.
    $38k-68k yearly est. 4d ago
  • Media Relations Specialist III (Pacific Time Zone)

    Caresource 4.9company rating

    Dayton, OH jobs

    The Media Relations Specialist III is responsible for maximizing earned media opportunities in both traditional news and across a variety of platforms, tracking the benefits of these efforts to drive awareness and business goals. Essential Functions: Responsible for identifying new story opportunities to position CareSource with media outlets and build brand awareness with target audiences Develop and manage content for media and external audiences, including news stories, news releases and other communications Manage agencies in markets to support company initiatives Respond to media inquiries in a timely and appropriate manner Provide support during crisis situations with strategic communications Monitor daily local, regional and national news coverage about CareSource, health care and related issues Manage ongoing earned media intelligence platforms and develops quarterly reports Support social media strategy Responsible for promoting CareSource locally in all markets and nationally including developing award entries, coordinating media events and providing support to company spokespeople/ presenters Develop and maintain relationships with key internal stakeholders, including executives, to ensure successful collaboration Responsible for ensuring all external materials are consistent with brand positioning, established guidelines Serve as a liaison with key departments to provide effective communication strategy Maintain a leadership role on project teams Perform any other job duties as requested Education and Experience: Bachelor's degree or equivalent in Communications, Public Relations, Journalism, or related field or equivalent work experience is required Minimum of five (5) years of experience in media relations is required; healthcare communications experience is preferred Previous professional writing experience is preferred as demonstrated by portfolio Competencies, Knowledge and Skills: Intermediate proficiency level with Microsoft Office Intermediate proficiency level with visual software programs, such as PowerPoint or other related software program is required Ability to communicate effectively through oral and written communications Ability to articulate thoughts with all levels of management and in pressure intense situations Ability to handle sensitive and confidential matters with discretion. Effective decision making and problem resolution skills Strong critical listening and thinking skills Advanced writing and editing skills Experienced technical writing skills preferred Ability to work on and meet tight deadlines Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time May require minimal travel Compensation Range: $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-RW1
    $62.7k-100.4k yearly 6d ago
  • Family Engagement Specialist

    Lifegift 3.7company rating

    Houston, TX jobs

    Would You Like a Life-Changing Career with LifeGift Where You Can Grow as a Family Engagement Specialist I? Kick-start the career of a lifetime where you can be a part of our mission of hope, working with an incredible team saving lives while modeling our values of Passion, Compassion, and Professionalism to the LifeGift community. LifeGift is currently looking for a Family Engagement Specialist I in Houston who serves as a critical link between LifeGift and the families whose loved ones are considering or have opted for organ donation. This role encompasses providing emotional support, education about the donation process, and facilitating meaningful conversations between families and healthcare personnel. The Family Engagement Specialist will work collaboratively with medical professionals, social workers, and bereavement coordinators to ensure families receive comprehensive and compassionate care during emotionally challenging times. Do you possess the attributes to be a successful Family Engagement Specialist I and perform the following essential functions? Provide compassionate support to families during the organ donation process, addressing their questions and concerns with empathy and understanding. Educate families on the process of organ donation, including the medical, ethical, and emotional aspects, to help them make informed decisions. Act as a liaison between families and medical providers, ensuring effective communication and clarity regarding the donation process. Offer immediate support and resources to families in crisis, assisting them in navigating complex emotions and providing grief counseling as necessary. Collaborate with the Family Engagement Manager to develop and refine educational materials, resources, and training programs to enhance family engagement strategies. Maintain accurate records and documentation of family interactions, ensuring confidentiality and compliance with all regulatory standards. Participate in community outreach initiatives to promote organ donation awareness and educate the public about LifeGift's mission and the importance of donor families. Work closely with multidisciplinary teams to advocate for families' needs and ensure their voices are heard in policy and operational discussions. Do you have the education and experience to be a Family Engagement Specialist I? Bachelor's degree in Social Work, Nursing, Psychology, Public Health, Human Services, Communications, Counseling, Education, or a related field; Master's degree preferred. Minimum of 2-3 years' experience in family support, grief counseling, or a related field, preferably in healthcare or organ donation settings. Backgrounds that demonstrate advanced interpersonal communication, conflict resolution, and the ability to guide individuals through complex, emotionally charged decisions Knowledge of the organ donation process and relevant regulatory frameworks is highly desirable. Ability to navigate sensitive and complex situations with professionalism and poise. Proficient in Microsoft Office Suite and experience with data management systems. Bilingual (English/Spanish) is a plus. This is NOT a remote position. This role requires frequent travel and ability to commute to different hospital partners within our service area. As a condition of employment, you must be able to attain Hospital Badge and EMR Access from all of the LifeGift Hospital Partners, as well as the availability to work 12-hour shifts, including nights, weekends and holidays. The Heart of Our Culture Established in 1987, LifeGift offers hope to the thousands of people in Texas and beyond who need lifesaving organ and tissue transplants. Our organization is diverse by nature, and inclusive by choice. LifeGift strives to reflect the communities where we live and work, and our multi-cultural and diverse team contributes an abundance of talent, abilities, and innovation that have continued to elevate our success. Rewards and Benefits for Your Career and Well-Being LifeGift values its team members and offers a variety of highly competitive benefits. Full-time team members have the opportunity to enroll in the following insurance plans: medical, dental, and vision, as well as life insurance, LTD and STD, and FSAs and HSAs that are pre-tax and to which LifeGift contributes. LifeGift also offers an exceptional retirement package that includes 403(b) and 401(a) retirement plans with the opportunity for a generous match. Additionally, LifeGift offers a tuition reimbursement program to encourage team members to expand their knowledge and further their education. LifeGift recognizes the importance of a work-life balance and encourages team members to take advantage of a generous vacation and sick leave plan. LifeGift is an equal opportunity employer! If you are qualified and want to be considered for a career that is life-changing, has purpose, and where you can be a part of an organization that cares about its employees, we encourage you to apply by completing the application at ************************* LifeGift is a drug-free workplace.
    $31k-41k yearly est. 4d ago
  • Electronic Visit Verification Specialist

    365 Health Services 4.1company rating

    Pennsylvania jobs

    Job Title: Electronic Visit Verification Specialist Description- Responsible for maintaining office payroll data in compliance with state, federal and local regulations. Properly document all manual corrections. Ensure office payroll is completed in a timely manner. Utilize system reports to ensure compliance. Extensive software skills are required, as well as Internet research abilities and strong communication skills. Position Qualifications- Two (2) year college degree preferred. High school diploma accepted with relevant experience. One (1) year verifiable work experience, preferably in a related capacity. Proficient in Microsoft computer products including Word, Excel and Outlook. Demonstrated record of strong interpersonal skills. Competence in basic PC skills required to perform job functions. Ability to read, write and effectively communicate in English. Essential Job Functions/Responsibilities- Able to work in a fast-paced work environment. Focus on consumer needs: Anticipate, understand, and respond appropriately to the needs of consumers to meet or exceed their expectations within the organizational parameters. Ability to handle confidential information in compliance with HIPAA. Ability to handle sensitive information in a calm and professional manner. Ability to lead change and innovation. Ability to manage multiple tasks daily and manage time efficiently. Public relations ability, interpersonal skills and professional telephone manner. Review and process all pending approvals in the EVV system. Review completion of care plan for accuracy and alignment with care plan. Address EVV setup issues with office staff. Review over authorizations and discrepancies with schedules to prevent overpayments. Escalate over authorizations and discrepancies with schedule to appropriate representatives. Run visit compliance report as final check of tasks and visits completed.
    $25k-32k yearly est. 3d ago
  • Patient Relations Support Specialist

    NYC Health + Hospitals/Correctional Health Services 4.7company rating

    New York, NY jobs

    NYC Health + Hospitals is the largest public health care system in the nation. We are a network of 11 hospitals, trauma centers, neighborhood health centers, nursing homes, post-acute care centers, and correctional health services. We are a home care agency and a health plan, MetroPlus. Our health system provides essential services to 1.4 million New Yorkers every year in more than 70 locations across the city's five boroughs. Our diverse workforce of more than 42,000 employees are uniquely focused on empowering New Yorkers. NYC Health + Hospitals/Correctional Health Services is one of the nation's leading correctional health care systems in quality of and innovations to care, and access from pre-arraignment through compassionate release. In-jail services include medical, nursing, mental health, substance use treatment, social work, dental and vision care, discharge planning, and reentry support. In addition to providing direct patient care in the jails, CHS leverages the resources of the nation's largest municipal health care system to help discharged patients successfully return to their communities. CHS is also a pivotal partner in New York City's criminal justice reform efforts. NYC Health + Hospitals/Correctional Health Services is one of the nation's leading correctional health care systems in quality of, and innovations and access to care. In-jail services include medical, mental health, nursing, substance use treatment, social work, dental and vision care, discharge planning, and reentry support. In addition to providing direct patient care in the jails, CHS conducts enhanced pre-arraignment screening and forensic psychiatric examinations; and leverages the resources of the Health + Hospitals system to help discharged patients successfully return to their communities. CHS is also a pivotal partner in New York City's criminal justice reform efforts. Our workforce is comprised of more than 1,500 dedicated professionals, with locations in all five boroughs and on Rikers Island. Under the direction of the Director and/or Deputy Director of Patient Relations, the Assistant Coordinating Manager will be responsible for documenting, managing incoming phone calls and emails, maintaining accurate records, updating the databases and coordinating complaints and requests relating to health care provided in the City's jails. Examples of work: Review dashboard on a daily basis, notify emergency contact for patients with specific serious injuries, hospitalizations and enter into database. Assist in coordinating the bi-monthly QIC meetings by recording meeting minutes and updating the database with relevant outcomes and follow-up action items. Answer incoming calls, compose email identifying case as a complaint and/or request. Review voicemails, transcribing messages and email. Enter and update new cases into the Patient Relations database. Monitor and maintain the Patient Relations email in-box for all correspondences received and appropriately handle according to standardized procedures and policies. Complete day-end reconciliation of inquiries received, assigned and sent. Perform additional tasks as assigned. Minimum Qualifications: 1. A Baccalaureate Degree from an accredited college or university in Business Administration, Community Health, Psychology or related discipline with one year of full-time experience in a supervisory or administrative capacity in business management systems, general administration, health care and medical/patient systems administration; or, 2. A satisfactory combination of education, training and experience. NYC Health and Hospitals offers a competitive benefits package that includes: Comprehensive Health Benefits for employees hired to work 20+ hrs. per week Retirement Savings and Pension Plans Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts Loan Forgiveness Programs for eligible employees College tuition discounts and professional development opportunities College Savings Program Union Benefits for eligible titles Multiple employee discounts programs Commuter Benefits Programs
    $40k-61k yearly est. 3d ago
  • RCM OPEX Specialist

    Femwell Group Health 4.1company rating

    Miami, FL jobs

    The RCM OPEX Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that revenue cycle management processes are efficient and compliant with industry regulations. This position requires detail-oriented professionals who can navigate complex insurance claims and reimbursement processes. Essential Job Functions Manage internal and external customer communications to maximize collections and reimbursements. Analyze revenue cycle data to identify trends and proactively remediate suboptimal processes. Maintain fee schedule uploads in financial and practice operating systems. Review and resolve escalations on denied and unpaid claims. Collaborate with healthcare providers, payors, and business partners to ensure revenue best practices are promoted. Monitor accounts receivable and expedite the recovery of outstanding payments. Prepare regular reports on refunds, under/over payments. Stay updated on changes in healthcare regulations and coding guidelines. *NOTE: The list of tasks is illustrative only and is not a comprehensive list of all functions and tasks performed by this position. Other Essential Tasks/Responsibilities/Abilities Must be consistent with Femwell's core values. Excellent verbal and written communication skills. Professional and tactful interpersonal skills with the ability to interact with a variety of personalities. Excellent organizational skills and attention to detail. Excellent time management skills with proven ability to meet deadlines and work under pressure. Ability to manage and prioritize multiple projects and tasks efficiently. Must demonstrate commitment to high professional ethical standards and a diverse workplace. Must have excellent listening skills. Must have the ability to maintain reasonably regular, punctual attendance consistent with the ADA, FMLA, and other federal, state, and local standards and organization attendance policies and procedures. Must maintain compliance with all personnel policies and procedures. Must be self-disciplined, organized, and able to effectively coordinate and collaborate with team members. Extremely proficient with Microsoft Office Suite or related software; as well as Excel, PPT, Internet, Cloud, Forums, Google, and other business tools required for this position. Education, Experience, Skills, and Requirements Bachelor's degree preferred. Minimum of 2 years of experience in medical billing, coding, revenue cycle or practice management. Strong knowledge of healthcare regulations and insurance processes. Knowledgeable in change control. Proficiency with healthcare billing software and electronic health records (EHR). Knowledge of HIPAA Security preferred. Hybrid rotation schedule and/or onsite as needed. Medical coding (ICD-10, CPT, HCPCS) Claims management (X12) Revenue cycle management Denials management Insurance verification Data analysis Compliance knowledge Comprehensive understanding of provider reimbursement methodologies Billing software proficiency
    $34k-49k yearly est. 4d ago
  • Billing Specialist

    Spooner Medical Administrators, Inc. 2.7company rating

    Westlake, OH jobs

    Spooner Medical Administrators, Incorporated (SMAI) is a family owned and operated company that offers rewarding career opportunities for motivated individuals who are passionate about excellence and growth. Since 1997, SMAI's proactive philosophy and best practices have set the standard in workers' compensation by continuously improving the delivery of case management, utilization review and billing services to help facilitate a successful return to work for the injured worker. The Billing Specialist is primarily responsible for reviewing, auditing and data entry of bills submitted by medical providers for compliance with proper billing practices. Essential Functions Review bills to determine if the information needed to process the bill has been received and contact the medical provider for any missing information. Perform fee bill audits according to established procedures and guidelines. Data enter fee fills accurately for electronic transmission. Adhere to established billing performance requirements. Review electronic response to transmitted bills and make modifications accordingly. Respond to telephone inquiries from customers regarding bill payment status. Participate in continuous improvement activities and other duties as assigned. Supervision Received Reports to the Billing Supervisor Experience and Education Required Medical billing certification or at least 2 years of experience working in the medical billing field Data entry experience Additional Skills Needed Effective written and verbal communication Detail oriented Strong organizational ability Basic computer literacy skills Working Environment The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job. While performing the duties of this job, the employee typically works in a normal office environment. The noise level in the work environment is usually quiet.
    $28k-33k yearly est. 2d ago
  • Outpatient Specialist - Denver

    Biomerieux Inc. 4.7company rating

    Durham, NC jobs

    The Outpatient Specialist's main mission is to maintain and grow the current customer base while creating new opportunities through selling the BIOFIRE product line. This includes the sales of instruments, reagents and other services to drive increased adoption and market share within a defined geographical region. The Outpatient Specialist is directly responsible for achieving the territory sales goal through outpatient clinics affiliated with IDNs and clinics not affiliated with IDNs within their assigned territory. Additionally, the Outpatient Specialist will manage both direct sales as well as sales through our distribution partners to achieve high performance in the areas of customer satisfaction, revenue, and profitability. Primary Responsibilities Deliver effective sales call management, opportunity management, pipeline management and forecast accuracy. Identify and establish relationships with key customers and opinion leaders within defined territory. Establish and maintain relationships with our distribution partners to support and advance opportunities and closes. Assess, clarify, validate, and quantify the customer's existing and unmet needs on an ongoing basis. As a part of the Regional Sales team, the Outpatient-Market specialist will identify high value targets within assigned territory and develop strategies to close new business those accounts. Maintain existing customer business to minimize lost business. Work cooperatively in a matrix team and other colleagues to advance and close opportunities. Serve as a liaison between the Outpatient market and Marketing. Channel competitive intel from the field to Marketing and participate as needed in marketing projects and new product launch request. Identify key opinion leaders (KOLs) within defined territory. Manage opportunity pipeline to ensure the timing of closes matches the monthly forecast as it is represented in our CRM tool and related dashboards. Ensure the compliance of business activities meet the most stringent requirements of legal and ethical standards and current company policies. Education and Experience Associates degree and a minimum of 4 years of professional sales experience ORBachelors degree and a minimum of 2 years of professional sales experience required Bachelors degree with 4 years of customer facing experience within the IVD market in lieu of professional sales experience will receive consideration. Strong Knowledge of molecular biology technologies, techniques, and disciplines preferred. In vitro diagnostic (IVD) capital equipment preferred. Point-of-care (POC) sales experience preferred. Distribution-sales experience preferred. Knowledge, Skills, and Abilities Business Skills Functional skills including critical thinking, adaptability, time management, communication, problem-solving and digital literacy. Leading without authority through influence and guidance of others towards a common goal by using expertise, persuasion, and personal qualities to inspire action. Business acumen to understand how a business operates and how to make it successful. Intellectual Horsepower Effective and efficient problem analysis that leads to high-quality decisions. Understand complex information and interpret it accurately, often requiring critical thinking and analysis to grasp the full picture. Manage and meet competing deadlines, requiring careful prioritization and time management to ensure all tasks are completed on time. Creating the New and Different Influence change using skills and relationships to persuade others to adopt new ideas, behaviors, or processes. Perspective to see the world from another person's viewpoint thus gaining new insights and finding creative solutions to challenges. Effectively deal with ambiguity requiring adaptability, critical thinking, and proactive communication to navigate situations with limited details Maintaining Focus Make timely decisions by quickly choosing effective solutions in high-pressure situations for optimal outcomes Priority setting that align with business objectives Thriving in a fast-paced environment by managing tasks, multitasking, and adapting quickly to maintain productivity. Getting Organized Organizing work and resources efficiently to ensure smooth operations Planning objectives and strategies to achieve them within a set timeline Practicing time management to allocate tasks, balance priorities, and meet deadlines efficiently Getting Work Done Through Others Informing others by sharing clear, timely information to ensure alignment. Managing and measuring work by tracking progress, performance, and goal achievement using metrics and KPIs. Managing Work Processes Collect and analyze data to drive informed decision-making to improve performance and identify issues Dealing with Complex Situations Communicates instructions clearly and effectively Demonstrates assertiveness and confidence in the face of a challenge Conflict Management Solution oriented in the face of conflict Comfortable giving clear, direct, and actionable feedback Ability to deal with difficult situations in a timely and bold manner Focusing on the Bottom Line Drive for Results: Drive for Results while successfully removing barriers Action Oriented: Takes action even when facing challenges Being Organizationally Savvy Ability to cooperate with others at all levels including leadership Ability to work cross-functionally allowing for better collaboration and communication when working across teams to achieve shared objectives Communicating Effectively Effective verbal communication skills Written Communications - including the ability to communicate technical data in written form Effective Presentation Skills - including the ability to present technical data Relating Skills Build and maintain positive, productive interactions with colleagues Easily accessible and open to communication Effectively navigate social interactions in the workplace Developing and Inspiring Others Reach mutually beneficial agreements through effective communication and compromise Managing Diverse Relationships Participate in a way that enhances team performance and cohesion. Fosters a culture of inclusiveness among all team members Acting with Honor and Being Open Consistently uphold and reflects the core ethical principles and values that bio Merieux promotes Actively and attentively listen to others, ensuring a clear understanding of their messages, needs, and concerns. Emotional intelligence by having the ability to recognize, understand, and manage one's own emotions, as well as the emotions of others. Maintain composure by having the skill of staying calm, focused, and professional in high-pressure or stressful situations. Working Conditions and Physical Requirements Ability to remain in stationary position, often standing, for prolonged periods. Ability to ascend/descend stairs, ladders, ramps, and the like. Ability to adjust or move objects up to 50 pounds in all directions. Domestic travel required 70% of time Location dependent the selected incumbent will be required to be masked while working in client locations for extended periods when on site in hospitals. Ability to conduct client visits which entails the safe operation of motor vehicles, physically accessing customer facilities and frequent air travel in performance of assigned duties. The estimated salary range for this role is between $87,700 - $140,000. This role is eligible to receive a variable annual bonus based on company, team, and individual performance per bio Merieux's bonus program. This range may differ from ranges offered for similar positions elsewhere in the country given differences in cost of living. Actual compensation within this range is determined based on the successful candidate's experience and will be presented in writing at the time of the offer.In addition, bio Merieux offers a competitive Total Rewards package that may include: A choice of medical (including prescription), dental, and vision plans providing nationwide coverage and telemedicine options Company-Provided Life and Accidental Death Insurance Short and Long-Term Disability Insurance Retirement Plan including a generous non-discretionary employer contribution and employer match. Adoption Assistance Wellness Programs Employee Assistance Program Commuter Benefits Various voluntary benefit offerings Discount programs Parental leaves #LI-US#biojobs Please be aware that recruitment related scams are on the rise. Fraudulent job postings are being placed on other websites, and individuals posing as bio Merieux Talent Acquisition team members are reaching out via email or text message in an attempt to collect your personal and confidential information. In some cases, these scammers are also conducting bogus interviews prior to extending fraudulent offers of employment. Beware of individuals reaching out using general phone numbers and non-bio Merieux email domains (i.e. Hotmail.com, Gmail.com, Yahoo.com, etc.). If you are concerned that an interview experience or offer of employment might be a scam, please make sure you are searching for the posting on our careers site or contact us at [emailprotected]. BioMerieux Inc. and its affiliates are Equal Opportunity/Affirmative Action Employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Please be advised that the receipt of satisfactory responses to reference requests and the provision of satisfactory proof of an applicant's identity and legal authorization to work in the United States are required of all new hires. Any misrepresentation, falsification, or material omission may result in the failure to receive an offer, the retraction of an offer, or if already hired, dismissal. If you are a qualified individual with a disability, you may request a reasonable accommodation in BioMerieux's or its affiliates' application process by contacting us via telephone at , by email at [emailprotected], or by dialing 711 for access to Telecommunications Relay Services (TRS).
    $87.7k-140k yearly 3d ago
  • MRO Specialist

    Quest Global 4.4company rating

    Windsor Locks, CT jobs

    Who We Are: Quest Global delivers world-class end-to-end engineering solutions by leveraging our deep industry knowledge and digital expertise. By bringing together technologies and industries, alongside the contributions of diverse individuals and their areas of expertise, we are able to solve problems better, faster. This multi-dimensional approach enables us to solve the most critical and large-scale challenges across the aerospace & defense, automotive, energy, hi-tech, healthcare, medical devices, rail and semiconductor industries. We are looking for humble geniuses, who believe that engineering has the potential to make the impossible possible; innovators, who are not only inspired by technology and innovation, but also perpetually driven to design, develop, and test as a trusted partner for Fortune 500 customers. As a team of remarkably diverse engineers, we recognize that what we are really engineering is a brighter future for us all. If you want to contribute to meaningful work and be part of an organization that truly believes when you win, we all win, and when you fail, we all learn, then we're eager to hear from you. The achievers and courageous challenge-crushers we seek, have the following characteristics and skills: What You Will Do: Preparation and maintenance of program tracking metrics Utilize SAP to run reports and analyze large volumes of data Understand and appropriately allocate critical detail parts across repair facilities to facilitate on time delivery metrics and engine centers testing requirements Prepare status reports as required, present weekly data packages and complete monthly MRO overdue reports Lead status and operational meetings for internal and external stakeholders What You Will Bring: Bachelor's degree in engineering 10+ years of experience working within an MRO facility Strong emphasis on data management, analysis, forecasting, and SAP knowledge. Strong communication and presentation skills Ability to work within both a shop floor and office environment Ability to work independently Pay Range: $70,000 to $80,000 per year Compensation decisions are made based on factors including experience, skills, education, and other job-related factors, in accordance with our internal pay structure. We also offer a comprehensive benefits package, including health insurance, paid time off, and retirement plan. Work Requirements: This role is considered an on-site position located in Windsor Locks, CT You must be able to commute to and from the location with your own transportation arrangements to meet the required working hours. Shop floor environment, which may include but not limited to extensive walking, and ability to lift up to 40 lbs. Travel requirements: Due to the nature of the work, no travel is required. Citizenship requirement: Due to the nature of the work, U.S. citizenship is required. Benefits: 401(k) matching Dental insurance Health insurance Paid time off Vision insurance Employer paid Life Insurance, Short- & Long-Term Disability
    $70k-80k yearly 3d ago
  • Enterprise Accreditation Specialist III

    Caresource 4.9company rating

    Dayton, OH jobs

    The Enterprise Accreditation Specialist III is responsible for supporting the organization to obtain and maintain appropriate accreditations, distinctions and recognitions through NCQA, URAC or other accrediting bodies. This person will serve as the subject matter expert for various accreditations, including but not limited to NCQA Health Plan Accreditation, LTSS Distinction, Health Equity, UM, and Population Health. This person will work cross-functionally with business owners to identify gaps and deficiencies between current processes and the accreditation requirements and assist in implementing any necessary mitigation activities as needed. They will also ensure all changes made by accrediting bodies are communicated and incorporated into business processes. Essential Functions: Serve as subject matter expert in accreditation standards, including NCQA Health Plan, LTSS Distinction, Health Equity, UM and Population Health. Clearly define deliverables associated with delegation agreements including appropriate responsible parties Maintain a strong understanding of the business processes within the assigned Market Collaborate with the business owners to obtain documents, reports, and materials for accreditation submission Provide oversight and monitoring of all surveys and deliverables within assigned Market Monitor, track, and document deliverables related to accreditation process by applying accreditation standards to CareSource processes and documents in conjunction with the business owners Act as advisor to business areas on appropriate documentation and data analysis needs for required improvement opportunities to meet the intent of the NCQA standards Maintain an in-depth knowledge of the standards within the scope of work and ensure that changes made by NCQA are communicated and incorporated into business processes Review and analyze documents, reports, and materials for submission. Ensures accuracy prior to submission Facilitate ongoing annual qualitative and quantitative analyses, assuring business owners are acting on their opportunities for improvement Responsible for preparing materials including but not limited to updating and reformatting for submission to accrediting entities in accordance with standards, coordinating efforts with internal business owners, and tracking readiness against work plans and timelines Manage survey submission process for assigned Market Maintain accreditation roadmaps/workplans Identify and communicate survey status, gaps, and escalations and ensure mitigation plans are implemented, gaps are closed and escalations are resolved Provide management recommendations for improvement related to accreditation processes and document processes Ensure all workplans and dashboards are updated for reporting Manage and execute on multiple module activities consistency Perform a variety of complex work in planning, coordinating, and managing accreditation activities Provide education to staff and business owners on accreditation standards and provide timely updates to affected departments including accreditation activities, survey dates and timelines for deliverables Act as a mentor to the Accreditation Specialist II Assist with the onboarding of new team members on module and Market specific requirements Participate in Market Quality Committees and other applicable committees as required Perform any other job duties as assigned Education and Experience: Bachelor's degree in science, arts, healthcare or other related field or equivalent years of relevant work experience is required. Minimum of three (3) years of experience in a Managed Care Organization or other healthcare related field is required Project Management Experience is preferred Accreditation experience is required Knowledge of IHI, DMAIC, or other process improvement methodologies preferred Competencies, Knowledge and Skills: Knowledge of accreditation bodies and various forms of accreditations, distinctions and recognitions. Expert knowledge of the NCQA Submission process Strong interpersonal skills and high level of professionalism Strong critical thinking/listening skills Excellent problem-solving skills with strong attention to detail Excellent written and verbal communication skills Ability to work independently and within a team environment Ability to develop, prioritize and accomplish goals Analytical and organizational skills Ability to coordinate complex projects and multiple meetings Proficient in Microsoft Office Suite to include Word, Excel, Adobe Pro and SharePoint Excellent written and verbal communication skills Proficient knowledge of the healthcare field and with Medicaid, Medicare, and Marketplace Training/teaching and technical writing skills Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-JM1
    $62.7k-100.4k yearly 3d ago
  • Grievance & Appeals Specialist II (Must live in Indiana)

    Caresource 4.9company rating

    Indianapolis, IN jobs

    The Grievance & Appeals Specialist II reviews appeals submitted by Medicaid and Medicare providers and all future providers contracted with CareSource. Must live in Indiana. . Essential Functions: Prepare the appeals for clinical review and be responsible for recording and tracking on a regular basis Review submitted appeals daily for validation of the appeal Identify appropriate claim problem within the appeal Prepare all clinical edit appeals for review by computer research, print claim from Facets system, and print off all the code descriptions to assist the reviewer in decision making for committee meetings Attend and participate in Appeals Committee meetings as needed Maintain spreadsheet of all appeals reviewed with the outcomes resulting from the Appeals Committee Meetings Document within Facets the detailed information as to the outcome of the claim appeal Identify System changes, log the ticket and track the resolution Complete claim appeal through claim adjustments or letters of denials Review claim appeals for possible fraud and abuse and report to SIU Research and release claim appeals with other health insurance, notifying the COB unit when there is other insurance Process a variety of appeals, including but not limited to: dental appeals, low difficulty appeals, non-clinical appeals - (i.e. tobacco surcharge, etc.), medically frail appeals, RCP appeals, member and provider appeals Resolve assigned appeals within regulatory timeframes, achieve departmental quality expectations, and meet daily production requirements Identify and log any related issues Perform UAT testing when necessary Perform any other job related instructions, as requested Education and Experience: High school diploma or equivalent is required Associates Degree or equivalent years of relevant work experience preferred Minimum of two (2) years of healthcare customer service, claims, compliance or related experience is required Competencies, Knowledge and Skills: Technical writing skills Intermediate level skills in Microsoft Word & Excel with Access skills a plus Communication skills (written, oral and interpersonal) Multitasking ability Able to work independently and within a team environment Familiarity of the Healthcare field Knowledge of Medicaid Time Management Decision-making and/or problem solving skills Proper grammar skills Phone etiquette skills Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $41,200.00 - $66,000.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Hourly Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-SD1
    $41.2k-66k yearly 4d ago

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