Senior Medicaid & Medicare Reimbursement Consultant
Columbus, OH jobs
We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities.
Summary:
This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities.
• This position will be responsible for ensuring the appropriate governmental (Medicare and Medicaid) reimbursement is received for OhioHealth.
• This position is primarily responsible for the proactive calculations and modeling of new regulatory changes and impacts as well as variance analysis of third-party liability accounts. Provides supporting work papers and documentation for third-party inquires.
• This position has supervisory oversight of the Reimbursement Analyst daily work schedule including flow of information, teaching of reimbursement fundamentals and principals, review of work and setting daily priorities.
• This positon supports the Director of Revenue and Reimbursement and Manager of Reimbursement with many special analysis throughout the year associated with revenue cycle, charge analysis, regulatory and financial reporting.
• The Senior Reimbursement Consultant will be a subject matter expert in the following areas, S-10, Wage Index, Bad Debts, Medicare Audits, Disproportionate Share, Indirect Medical Education, Graduate Medical Education, and Governmental Logs, (HCAP, UPL and Franchise Fee programs in the state of Ohio) as well as special projects as assigned.
• Extensive knowledge of Medicare and Medicaid cost reporting and reimbursement and remaining up to date with all regulatory requirements, both federal and state is required.
• The Reimbursement Consultant position leads, advises and consults various reimbursement financial projects, as well as special projects throughout the year and needs to be able to delegate direct reports assigned to the project or process while staying connected to both the pertinent details as well as the high level strategic purpose.
• The Senior Reimbursement Consultant is required to use extensive interpersonal skills in communicating with all management levels at OhioHealth.
• This role functions in a heavily matrixed environment and requires strong prioritization, communication and planning skills.
Responsibilities And Duties:
Consulting and oversite of key areas at OhioHealth in the central Ohio facilities as well as non-central Ohio facilities in the reimbursement functions.
Knowledge in the following areas:
Reimbursement functions:
Subject matter expert on CMS cost reporting, disproportionate share (DSH), Uncompensated Care, Bad debt reporting, IME/GME, Medicare Wage Index, S-10 reporting, Tricare and 855's, Ohio Medicaid, HCAP, UPL and Franchise Fee programs. Knowledge of Acute Care Hospitals, Critical Access Hospitals, Sole Community Hospitals and Rural Health Clinics. Knowledge of reimbursement in specialty areas such psych, inpatient rehabilitation units, Home Health and Hospice. Projects as assigned by Director of Revenue and Reimbursement and Manager of Reimbursement. Provide Director of Revenue and Reimbursement and Manager with updates. CGS audits and auditors Working with our legal vendor for Medicare Appeals. Working with OHA and CBSA facilities on wage index opportunities Special projects / analysis as assigned by the Director of Revenue and Reimbursement and Manager of Reimbursement.
Minimum Qualifications:
Bachelor's Degree: Finance (Required)
Additional Job Description:
BS or BA in Accounting or Finance. Hospital and/or healthcare industry experience. Understanding of the CMS prospective payment system and State of Ohio regulations. Minimum of 4 years' experience in the healthcare industry. Strong team development and delegations skills. Excellent communication and presentation skills.
SPECIALIZED KNOWLEDGE
Min: Proficiency in Microsoft applications, knowledge of clinical & financial patient management systems, demonstrated ability in financial analysis and cost reporting.
DESIRED ATTRIBUTES
CPA, MHA or MBA. Experience with Medicare/Medicaid cost reporting 4 - 6 years as a Sr. Reimbursement Analyst or similar position(s).
Work Shift:
Day
Scheduled Weekly Hours :
40
Department
Reimbursement
Join us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in the healthcare industry
Equal Employment Opportunity
OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
Remote Work Disclaimer:
Positions marked as remote are only eligible for work from Ohio.
Senior Epic Systems Analyst- Cadance/GrandCentral/Prelude
Columbus, OH jobs
We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities.
Summary:
The Senior Systems Analyst will be responsible for the design, development, implementation of builds on special projects in Epic Cadence, Prelude and Grand Central
Ideal candidate MUST HAVE PRIOR CERTIFICATION in as such Epic Cadence, Prelude, Grand Central and Welcome modules.
This position requires a deep understanding of healthcare workflows, system integration, and project management to ensure the efficient operation of the healthcare system's IT infrastructure.
Provides technical expertise by enforcing the vision of the application and safeguarding the integrity and security of the application environment in collaboration and partnership with architects, tech leads and engineers.
Collaborates with end users to identify, analyze, and support ongoing needs while achieving Service Level Agreements (SLAs) relative to the supported applications.
Leads in process improvement activities related to Application Management for enterprise applications includes (Epic, Workday, Kronos) and other major applications.
Responsibilities And Duties:
System Analysis and Design:
Analyze and document current business processes and workflows.
Identify system requirements and translate them into detailed specifications.
Design and implement solutions to improve system efficiency and user experience.
Application Support:
Provide advanced support for (Epic, Workday, Kronos,) and other applications.
Troubleshoot and resolve system issues in a timely manner.
Coordinate with vendors and internal teams for system upgrades and patches.
Collaborate with IT and clinical teams to integrate across IT portfolio with other IT systems (e.g., Epic, 3rd Party Imaging Applications, AI, etc.).
Project Management:
Manage smaller projects related to system implementations and upgrades.
Strong knowledge with various project management approaches, e.g. waterfall, agile.
Ability to lead project teams in project methodology.
Training and Documentation:
Create and maintain comprehensive documentation for system configurations and processes.
Mentor junior analysts and provide guidance on best practices.
Integration and Data Management:
Ensure seamless integration between various healthcare applications.
Manage data integrity and security across systems.
Perform data analysis and generate reports as needed.
Minimum Qualifications:
Bachelor's Degree (Required)
Additional Job Description:
degree in computer science, Information Technology, Healthcare Administration, or a related field.
Minimum of 5-7 years of experience in system analysis and support within a healthcare environment.
In lieu of degree, 10+ years of experience in system analysis and support within a healthcare environment.
SPECIALIZED KNOWLEDGE
Extensive experience with Epic, Workday, and Kronos applications.
Proven track record of managing complex projects and leading cross-functional teams.
Experience with system integration and data migration projects.
Previous experience in a leadership or supervisory role.
Strong analytical and problem-solving skills.
Excellent communication and interpersonal skills.
Liaison with managed service providers, vendors, operational leadership.
Ability to work independently and as part of a team.
Proficiency in project management tools and methodologies.
Serve as the primary point of contact for customers, addressing inquiries and resolving issues promptly.
DESIRED ATTRIBUTES
ITIL Foundation certification desired not required.
Certifications in relevant technologies (e.g., Epic)
Advanced degree (Master's or higher) in a related field is a plus.
Experience in a large healthcare system or hospital setting.
Experience with other healthcare applications and systems.
Knowledge of healthcare regulations and compliance standards.
Familiarity with cloud computing platforms (e.g., AWS, Azure).
Experience with business intelligence and analytics tools.
Work Shift:
Day
Scheduled Weekly Hours :
40
Department
IS Revenue Cycle
Join us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in the healthcare industry
Equal Employment Opportunity
OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
Remote Work Disclaimer:
Positions marked as remote are only eligible for work from Ohio.
Advanced Practice Clinician (Hybrid)
New York, NY jobs
Provides clinical leadership to promote increased compliance with a range of quality and cost measures and standards of care. Manages service delivery of inter-professional and para-professional team members working on an individual case or population of cases. Acts as a key resource in providing clinical and operational guidance and support to assigned teams and other staff to achieve and enhance team outcomes. Provides advanced nursing clinical care for patients in accordance with current State and Federal rules and regulations for nurse practitioner's scope of practice and national standards of care. Works under the supervision of the Clinical Director for the Nurse Practitioner Program.
What We Provide
Personal and financial wellness programs
Opportunities for professional growth and career advancement
Internal mobility and advancement opportunities
Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals
What You Will Do
Manages and provides full scope of advanced nursing practice for targeted patient populations. Evaluates patient responses to therapy / interventions. Ensures revision of the inter-professional plan of care as necessary to achieve quality outcomes.
Identifies need for new/revised clinical protocols. Collaborates with physicians and others within the practice to develop protocols and provides training as appropriate.
Manages and provides comprehensive advanced nursing care including physical examination, comprehensive history, screening for physical and/or psychological conditions, emergent interventions, pharmacological and non-pharmacological interventions, ordering treatments and DME, preventative health maintenance activities, care management, referrals, discharge planning, counseling and patient education. Establishes a treatment plan based on clinical findings and. Determines when further evaluation by collaborating physician, specialist or emergency care is warranted.
Collaborates with patients, families, primary care physicians and other team members to provide assessment and care planning. Assesses, plans, and provides intensive and continuous care management across client settings.
Manages and provides clinical services in compliance with standards of Patient-Centered Medical Home standards, meaningful use of medical record data, HEDIS and QARR quality of care measurements.
Qualifications
Licenses and Certifications:
License and current registration to practice as a Registered Professional Nurse in New York State required
Certificate (license) and current registration to practice as a Nurse Practitioner in the State of New York, with a specialty in adult health, family health or gerontology required
Valid driver's license, as determined by operational/regional needs may be required
Maintains credentialed status with VNS Health Medical Care at Home and associated managed care plans required
Maintains NPI, Medicaid and Medicare provider numbers preferred
Maintains a collaborative practice agreement with a physician in compliance with New York State regulations preferred
Must be certified by ANCC or another accrediting Nurse Practitioner body - in order to bill Medicare and meet credentialing requirements required
For Psychiatric Nurse Practitioners only:
Current PMHNP-BC certification required
Education:
Master's Degree of Science in Nursing, or other graduate degree from a nurse practitioner educational program registered by the New York State Education Department as qualifying for NP certification (licensure) required
Current ANCC or AANP certification as an adult, family or geriatric nurse practitioner required
For Psychiatric Nurse Practitioners only:
Master's Degree in psychiatric-mental health Nurse Practitioner required
PhD in psychiatric-mental health Nurse Practitioner preferred
Work Experience:
Minimum of two years of experience as a nurse practitioner utilizing full scope of practice preferred
Clinical home care experience or two years managerial experience preferred
Demonstrated knowledge of Hedis and QARR quality measures, ICD-10 and CPT coding for reimbursement of services required
Bilingual skills, as determined by operational needs required
Pay Range
USD $58.30 - USD $77.72 /Hr.
About Us
VNS Health is one of the nation's largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us - we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.
Talent Selection Specialist
Akron, OH jobs
This is an 18-month temporary assignment with full benefit eligibility.
Must reside in Ohio at the time of hire. This is a remote position; however, occasional onsite presence may be required based on business needs.
The Talent Selection Specialist is responsible for providing the highest level of recruitment and staffing services to hiring leaders by delivering top talent.
Responsibilities:
1. Plans and executes the sourcing, recruiting, selection, and hiring process to ensure a diverse pool of top talent for the organization while maintaining excellent relations with hiring managers, co-workers, candidates, and the community.
2. Sets service level agreements with hiring managers to define roles/responsibilities and control the hiring process.
3. Prepares candidates for interviews with hiring managers by providing information on the hospital, business strategy, department background, job description, and expectations.
4. Maintains accurate and well-ordered documentation on all applicants, searches, hiring manager interactions, and other recruiting activities to ensure accurate reporting of employment activities and successful outcomes of audits.
5. Participates in departmental activities including performance and process improvement.
6. Other duties as required.
Other information:
Technical Expertise
1. Experience in full lifecycle recruiting is required.
2. Experience in applicable State and Federal employment laws is required.
3. Experience in working with all levels within an organization is required.
4. Experience in medium to large sized organizations is preferred.
5. Experience in healthcare is preferred.
6. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. ATS is preferred.
Education and Experience
1. Education: Bachelor's degree in Human Resources or related field is required.
2. Certification: HR certification [PHR, SHRM-CP, CEBS, CCP, etc.] is preferred.
3. Years of relevant experience: 3 years is required.
4. Years of experience supervising: None.
Full Time
FTE: 1.000000
Status: Remote
Staff RN - Hybrid Med/Surg/Intermediate (Nights)
Columbus, OH jobs
We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities.
Summary:
This unit sees a blend of medical patients who often have consultant specialists for procedures or interventions. Examples include GI for endoscopy procedures, or Interventional Radiology for lines, drains, and injections. This unit being med/surg sees a large variety of diagnosis including but not limited to many with cardiac, renal, infectious disease, and gastrointestinal diagnosis.
This position provides general nursing care to patients and families along the health illness continuum in diverse health care settings while collaborating with the health care team. He/She is accountable for the practice of nursing as defined by the Ohio Board of Nursing.
Responsibilities And Duties:
Assessment/Diagnosis - Performs initial, ongoing, and functional health status assessment as applicable to the population and or individual (30%).
Outcomes Identification/Planning - Based on nursing diagnoses and collaborative problems, documents planned nursing interventions to achieve outcomes appropriate to patient needs (30%).
Implementation/Evaluation - Evaluates and documents response to nursing interventions and achievement of outcomes at appropriately determined intervals; as part of a multidisciplinary team, revises plan of care based on evaluative data (20%).
Leadership - Actively participates in process improvement activities to achieve targeted measures of clinical quality, customer satisfaction, and financial performance (10%).
Operations (10%).
As a High Reliability Organization (HRO), responsibilities require focus on safety, quality and efficiency in performing job duties.
The job profile provides an overview of responsibilities and duties and is not intended to be an exhaustive list and is subject to change at any time.
Minimum Qualifications:
BLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing
Additional Job Description:
State Driver's License. RN - Registered Nurse BLS - Basic Life Support CPR - Cardiopulmonary Resuscitation Field of Study: Nursing Years of Experience 0
Work Shift:
Night
Scheduled Weekly Hours :
36
Department
Medical Unit 2
Join us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in the healthcare industry
Equal Employment Opportunity
OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
Senior Associate Counsel
Medina, OH jobs
Full-Time, 40 hours/week
Monday - Friday 8 am - 5 pm
Onsite
The Senior Associate Counsel provides legal support for hospital information technology operations, including comprehensive legal and strategic guidance on the procurement, deployment, and governance of information technology systems (ISD) and artificial intelligence. This position reports to the Vice President, Senior Associate Counsel with a reporting matrix to the Chief Information Officer.
Responsibilities:
Advise hospital leadership and procurement teams on the legal implications of acquiring new technologies, such as electronic health records (EHR), telemedicine platforms, cybersecurity tools, and medical devices and the implementation of artificial intelligence tools.
Draft, review, and negotiate a broad array of information technology contracts-such as software-as-a-service (SaaS) agreements, cloud hosting terms, data processing addenda, and business associate agreements. Identify and address legal risks in vendor offerings and technology solutions.
Advise hospital leadership on legal considerations surrounding digital transformation initiatives, innovation adoption, and strategic partnerships with technology providers.
Collaborate with hospital IT and security teams to develop policies and protocols for safeguarding patient data and critical systems. Advise on incident response plans, breach notification procedures, and risk mitigation strategies. Stay abreast of emerging threats and evolving best practices.
Provide legal support for hospital-wide policies on technology use, social media, device management, remote work, mobile access to sensitive information, and enterprise risk for information technology. Ensure policies reflect current legal requirements and operational needs.
Support the hospital in managing disputes or litigation related to technology vendors, data breaches, intellectual property claims, and other technology-related matters. Coordinate with litigation counsel as needed.
Education and Training: Provide ongoing education to staff and leadership on legal implications of technology adoption, emerging regulatory requirements, and evolving risks in the health technology landscape.
Identify and assess legal, operational, and compliance risks in IT contract.
Other duties as assigned.
Other information:
Technical Expertise
Openness to learning and keeping pace with rapid changes in both healthcare delivery and technological innovation.
Aptitude for working effectively with clinicians, IT professionals, administrators, vendors, and regulators.
Capacity to guide organizational leadership through complex legal and strategic decisions regarding technology investments.
Resourcefulness and creativity in navigating novel legal challenges emerging from digital health transformation.
Education and Experience
Education: Juris Doctor (JD) degree from an accredited law school; Ohio bar admission or ability to obtain admission prior to start date.
Experience: Minimum of 5 years of legal practice advising in healthcare Information technology contracts is required.
Technical Knowledge: Familiarity with healthcare IT systems, data privacy and security laws, and emerging technologies (such as artificial intelligence, cloud computing, and IoT).
Skills: Strong contract negotiation, drafting, and analytical skills. Excellent verbal and written communication abilities. Competency in risk assessment and strategic thinking.
Demonstrated integrity, discretion, and ability to work collaboratively with multidisciplinary teams.
Full Time
FTE: 1.000000
Status: Onsite
Business Development Executive Healthcare
Rochester, NY jobs
Location: Rochester, NY (In-person preferred; Remote option available for the right candidate) Employment Type: Full-time | Seniority Level: Executive Industry: Healthcare Staffing | Functions: Sales, Business Development, Operations
About the Role:
We are seeking a highly motivated, strategic, and results-driven Business Development Executive to join our executive sales team. As a rapidly expanding healthcare management and staffing firm, we are looking for an experienced sales executive to drive aggressive business growth, strengthen client partnerships, and spearhead the strategic expansion of the DelphiHealthcare business line in a pure "hunter" role.
This executive role will focus on identifying new business opportunities, cultivating relationships with hospital and healthcare system leadership, and executing high-level growth and operational strategies. The ideal candidate brings proven experience in healthcare staffing, possesses existing relationships with key healthcare executives, demonstrates exceptional business development leadership, and exhibits a true business ownership mentality.
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Key Responsibilities
Business Development Leadership
· Develop and implement a comprehensive business development strategy
· Lead new client acquisition and build long-term partnerships with target hospitals, health systems, clinics, and other healthcare organizations
· Represent all lines of Delphi management business, including hospitalist, emergency medicine, anesthesia, and urgent care staffing services
· Create and deliver compelling sales presentations, proposals, and marketing materials
Strategic Relationship Management
· Identify and drive opportunities for expansion within existing accounts
· Attend client meetings, conferences, and industry events to enhance company visibility
· Serve as a key liaison between executive leadership, business development, and recruiting teams
Operational Oversight
· Partner with internal teams to ensure operational excellence and fulfillment of client needs while identifying cross-selling opportunities
· Track performance, KPIs, and growth metrics across DelphiHealthcare business line
· Maintain and manage a structured sales pipeline using CRM systems for accurate forecasting of new accounts/contracts
· Document calls, emails and meetings using CRM system and maintain accurate account records/notes for active opportunities and target lists
Outreach & Market Growth
· Conduct targeted outreach including cold calling, digital prospecting, in-person visits, and strategic follow-up. Some travel required for in-person visits/cold calling
· Analyze industry trends to identify emerging markets, service lines, and competitive opportunities
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Required Qualifications
· Minimum 5 years of successful business development or sales experience in the healthcare staffing industry preferred
· Demonstrated success in generating new business, scaling operations, and managing key accounts
· Bachelor's degree required; Master's degree preferred
· Exceptional communication, negotiation, and presentation skills
· Proficiency with CRM platforms and Microsoft Office Suite
· Ability to manage multiple priorities and work cross-functionally in a fast-paced environment
· Willingness to travel up to 50%
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Work Location
· Rochester, NY office preferred
· Remote option available for highly qualified candidates with strong industry experience
Remote Radiology
Beachwood, OH jobs
Job Description & Requirements Remote Radiology
A leading not-for-profit health system in the Cleveland, OH area is seeking multiple physicians to join a thriving Department of Radiology.
Remote ER Coverage for the following schedules. 126 Shifts Expected annually.
6PM-4AM EST
7PM-5AM EST
9PM-7AM EST
Salary position plus annual quality incentive bonus and an additional bonus for covering ER
Base salary starting at $465,000
Option to work other shifts during (2) weeks off block.
Very Reasonable Volumes
Comprehensive benefits package
Job Benefits
About the Company
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.
Teleradiologist, Teleradiology, Radiologists, Teleradiology Specialist, Telemedicine, Hospital, radiology,, radiology, radiologist
AMN Healthcare is a digitally enabled workforce solutions partner focused on solving the biggest challenges affecting healthcare organizations today. We offer a single-partner approach to optimize labor sources, increase operating margins, and provide technologies to expand the reach of care.
Insurance Eligibility Coordinator
New York, NY jobs
The Insurance Eligibility Coordinator is responsible for verifying patient insurance coverage, ensuring accurate benefit information, and supporting efficient revenue cycle operations. This role works closely with patients, insurance carriers, clinical staff, and billing teams to confirm eligibility, resolve coverage discrepancies, and help prevent claims denials.
Essential Functions:
Verify patient insurance eligibility and benefits using electronic systems, payer portals, and direct insurance carrier communication.
Accurate document coverage details, copayments, deductibles, prior authorization requirements, and plan limitations. Prepare and submit claims in a timely and accurate manner.
Obtain Authorizations as required.
Identify and correct rejected claims for prompt resubmission
Submit and follow up on authorization requests.
Follow up on denied or unpaid claims and work to resolve discrepancies.
Post payments and adjustments to patient accounts in a timely manner.
Communicate with insurance companies and internal staff regarding billing inquiries or issues.
Maintain up-to-date knowledge of payer rules, policy changes, and medical coverage guidelines.
Protect patient privacy and maintain compliance with HIPAA and organizational standards.
Support revenue cycle improvement initiatives related to eligibility and insurance workflows.
Participate in team meetings and contribute to quality improvement initiatives.
Adhere to practice policies, procedures, and protocols including confidentiality.
Other tasks as assigned.
Travel: 100% Remote
Supervisory Responsibilities:
N/A
Qualities & Skills:
Strong understanding of insurance plans, terminology, HMOs, PPOs, Medicare/Medicaid and commercial payer policies in NJ, NY, & PA.
Excellent communication, customer service, and problem-solving skills.
Proficiency with medical practice management software, EHR systems, and payer portals.
Ability to multitask and work in a fast-paced environment.
Strong Knowledge of Microsoft Office Suite.
Comfortable working independently and collaboratively.
Outstanding problem solver and analytical thinking skills.
Attention to detail and ability to prioritize.
Ability to maintain confidentiality.
Experience in Behavioral health is preferred.
Education & Experience:
High School diploma or equivalent required.
1-2 years of experience in medical insurance verification, medical billing, or related roles
Compensation details: 20-24 Hourly Wage
PI99bd830c2701-37***********5
Talent Selection Specialist
Medina, OH jobs
This is an 18-month temporary assignment with full benefit eligibility.
Must reside in Ohio at the time of hire. This is a remote position; however, occasional onsite presence may be required based on business needs.
The Talent Selection Specialist is responsible for providing the highest level of recruitment and staffing services to hiring leaders by delivering top talent.
Responsibilities:
1. Plans and executes the sourcing, recruiting, selection, and hiring process to ensure a diverse pool of top talent for the organization while maintaining excellent relations with hiring managers, co-workers, candidates, and the community.
2. Sets service level agreements with hiring managers to define roles/responsibilities and control the hiring process.
3. Prepares candidates for interviews with hiring managers by providing information on the hospital, business strategy, department background, job description, and expectations.
4. Maintains accurate and well-ordered documentation on all applicants, searches, hiring manager interactions, and other recruiting activities to ensure accurate reporting of employment activities and successful outcomes of audits.
5. Participates in departmental activities including performance and process improvement.
6. Other duties as required.
Other information:
Technical Expertise
1. Experience in full lifecycle recruiting is required.
2. Experience in applicable State and Federal employment laws is required.
3. Experience in working with all levels within an organization is required.
4. Experience in medium to large sized organizations is preferred.
5. Experience in healthcare is preferred.
6. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. ATS is preferred.
Education and Experience
1. Education: Bachelor's degree in Human Resources or related field is required.
2. Certification: HR certification [PHR, SHRM-CP, CEBS, CCP, etc.] is preferred.
3. Years of relevant experience: 3 years is required.
4. Years of experience supervising: None.
Full Time
FTE: 1.000000
Status: Remote
Maternity Care Authorization Specialist (Hybrid Potential)
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.
Clinical Program Manager RN * Hybrid*
Happy Valley, OR jobs
Clinical Program Manager RN
Hybrid.
Candidates residing in the areas of Portland, OR, Spokane, WA or Lubbock, TX are encouraged to apply.
In collaboration with the Division Director, the Clinical Practice Manager RN supports nursing practice, quality initiatives, and clinical improvement efforts across the division. This role is responsible for leading teams in developing and implementing evidence-based nursing and clinical practices, utilizing established standards, research findings, and quality improvement principles.
Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Strategic And Management Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
Bachelor's Degree: Nursing
Master's Degree: Nursing (Practice or Education)
5 years - Nursing experience in an acute care setting.
3 years - Clinical practice development, quality, or education experience.
active RN License for WA, OR or TX
Preferred Qualifications:
Ph.D.: Nursing or DNP (Doctor of Nursing Practice)
Salary Range by Location:
Oregon: Portland Service Area: Min: $59.39, Max: $93.75
Texas: Min: $45.30, Max: $71.51
Washington: Eastern: Min: $52.85, Max: $83.42
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 403508
Company: Providence Jobs
Job Category: Clinical Administration
Job Function: Clinical Support
Job Schedule: Full time
Job Shift: Day
Career Track: Nursing
Department: 4007 SS CNTRL DIV EDU ADMIN
Address: OR Portland 4400 NE Halsey St
Work Location: Providence Health Plaza (HR) Bldg 1-Portland
Workplace Type: Hybrid
Pay Range: $see posting - $see posting
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
PandoLogic. Category:Healthcare, Keywords:Healthcare Program Manager, Location:Clackamas, OR-97015
Radiologist, Breast Imaging, Hybrid
New York, NY jobs
A top community hospital serving a culturally diverse area of New York City, is seeking a Radiologist, Breast Imaging, to join their team. The Mammography and Women's Imaging department handles a significant number of studies and biopsies annually, providing crucial services to the community. State-of-the-art equipment, including 3-D Hologic Dimension machines, CT scanners, MRI, ultrasound, and nuclear medicine, is available to support the diagnostic and screening needs.
Job Responsibilities
Collaborate with the Mammography and Women's Imaging department, performing approximately 11,000 Mammogram studies and around 1,100 biopsies each year.
Utilize advanced equipment, including 3-D Hologic Dimension machines, Hologic stereotactic machine, CT scanners, PET/CT scanner, MRI, ultrasound, and diagnostic x-rays/fluoroscopy suites.
Work alongside a team of full-time Mammographers, supported by Nurses, technologists, and Breast Imaging Supervisor.
May involve faculty appointment at a top medical school.
Full time or Part time
Hybrid schedule
Job Requirements
Board-certified or eligible in Radiology.
Must be licensed to practice in the State of New York.
Job Perks
Competitive salary, great benefits, and other attractive incentives
Generous PTO
All major insurances (health, life, disability)
Work-life balance is valued
Visa (J1/H1B) sponsorship is available.
Supportive and experienced leadership.
Collaborative, flexible, and academically focused environment.
Unionized Position: Promotes a healthy work-life balance and robust employee support.
Diverse and Inclusive Environment: The hospital staff speaks over 130 languages, fostering a culturally rich and inclusive workplace.
Stability and Collaboration: Opportunity to work with a long-term, stable, and collaborative multidisciplinary team.
View all jobs online at: *******************************
The likely salary for this position will be based on qualifications, experience, and education.
If you are passionate about what you could accomplish in this role, we would love to hear from you!
Social Worker - Hybrid Flex (LMHC- LMSW - LCSW)
Utica, NY jobs
The Licensed Mental Health Counselor/Social Worker will assess mental illnesses, recommend, develop and implement therapeutic treatment plans for individuals experiencing emotional or psychological distress, address mental health disorders, offer individualized treatment plans, and engage patients in therapy sessions to manage and overcome mental health issues. Runs group and individual therapy sessions.
This role may work in either a hospital or outpatient setting.
Clinical Assessment and Treatment:
Conduct thorough assessments of patients' mental health status and needs.
Develop and implement individualized treatment plans based on assessment findings.
Provide evidence-based therapeutic interventions, including individual, group, and family therapy.
Monitor and evaluate patients' progress, adjusting treatment plans as necessary.
Patient Care:
Establish and maintain therapeutic relationships with patients, demonstrating empathy and understanding.
Provide crisis intervention and support as needed, including managing emergencies and coordinating care.
Provide direct counseling services and recommendations to facilitate movement through the continuum of care.
Educate patients and their families about mental health conditions and treatment options.
Documentation and Compliance:
Maintain accurate and up-to-date patient records, including assessment notes, treatment plans, and progress reports.
Ensure all documentation meets regulatory and organizational standards.
Comply with confidentiality and ethical guidelines in accordance with HIPAA and other relevant regulations.
Collaboration and Coordination:
Collaborate with psychiatrists, psychologists, social workers, and other healthcare professionals to ensure comprehensive care.
Participate in multidisciplinary team meetings and contribute to care planning.
Liaise with community resources and agencies to facilitate additional support and services for patients.
Professional Development:
Stay current with developments in the field of mental health counseling through continuing education and professional training.
Participate in supervision and peer review processes to enhance clinical skills and professional growth.
REQUIRED:
Master's in counseling, psychology or a closely related field from a program accredited by the Commission on the Accreditation of Counseling Related Education Programs (CACREP).
Experience with diverse patient populations and a variety of mental health issues.
Strong clinical assessment and therapeutic skills.
Excellent communication and interpersonal skills, with the ability to build rapport with patients and collaborate effectively with a team.
Proficient in EHR (Epic) systems and basic computer applications.
Ability to handle crisis situations with composure and professionalism.
Compassionate, empathetic, and non-judgmental approach to patient care.
Strong organizational skills and attention to detail.
Ability to work independently and manage time effectively in a fast-paced environment.
Medical Dosimetrist position in Pittsburgh, PA - Hybrid work schedule
Lebanon, PA jobs
UPMC Hillman Cancer Center is currently hiring for a regular Full-Time Staff/Sr. Medical Dosimetrist to join our team in the Central Region of the UPMC Hillman Cancer Center Network. The dosimetrist in this position will be based out of the UPMC Hillman Cancer Center at UPMC Shadyside in Pittsburgh, PA, and will provide planning services for the clinic.
This role offers a hybrid work arrangement with on-site duties, work-from-home capability and will work a regular Full-Time schedule Monday through Friday.
This position joins 6 other medical dosimetrists dedicated to this department and a larger team of 40+ dosimetrists across the UPMC Hillman Cancer Center Network.
Collaboration and remote support across the group is facilitated by our integrated ARIA/Eclipse and Citrix-based IT infrastructure, as well as standardized policies, procedures, and care pathways across UPMC.
The medical dosimetrist is responsible for generating clinically optimal treatment plans for radiation therapy patients in collaboration with radiation oncologists, radiation therapy technologists, and medical physicists.
This includes participating in CT simulation, radiation treatment planning, quality management for radiation oncology patients, and communicating with the clinical team during treatment planning and treatment plan implementation.
Treatment techniques include 3DCRT, IMRT, VMAT, SBRT, and motion management (e.g., respiratory gating and DIBH). UPMC Shadyside delivers radiotherapy treatments with a variety of platforms(2 Varian TrueBeams, 1 Varian Halcyon, and 1 Reflexion).
We offer a Dosimetry career ladder which allows our staff to grow within the field at UPMC Hillman Cancer Center. The incumbent will be placed into the appropriate level of our Dosimetry Career ladder based on education and experience.
Staff/Sr. Dosimetrist salary range between $48.08/hr. to $73.65/hr.
Sr. level requires three (3) years of post-graduate clinical medical dosimetry experience.
Responsibilities:
Participates in acquisition of patient data via computer generated data sets from medical imaging devices such as CT, PET, MR, etc., or manual methods such as physical measurements and wire contours, and incorporation of these data into radiation treatment plans, calculations, and treatment devices.
Assists the RTT in the treatment simulation process including the use or necessity of ancillary treatment devices, patient immobilization techniques, and other patient positioning techniques as needed for simulation and treatment. Assists in fabrication of these ancillary treatment devices.
Contours and delineates clearly discernable normal critical structures and expanded planning structures using different imaging modalities.
Performs rigid and deformable image registration for multi-modality image sets.
Applies the principles and concepts of radiation physics in radiation treatment planning, which includes, but is not limited to: 2D treatment planning, 3D conformal treatment planning, intensity modulated radiation therapy (IMRT) treatment planning, 4D treatment planning, volumetric modulated arc therapy (VMAT) planning, stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) planning, and brachytherapy treatment planning.
Applies knowledge of radiobiology with respect to dose tolerances, time dose fractionation calculations, hypofractionation, BED and EQD2 calculations and other applications of radiobiology to the radiation therapy treatment process.
Accurately performs radiation dose calculations, both manual and computer generated, for treatment delivery including the effects of beam modifying devices, irregular fields, gaps for adjacent fields, and off-axis calculations.
Participates in special treatment procedures including, but not limited to, total body irradiation (TBI), total skin electron irradiation (TSEI), intra-operative radiation therapy (IORT).
Assists with quality assurance procedures as directed by a qualified medical physicist.
Performs or assists with patient-specific radiation measurement including, but not limited to diodes, optically stimulated luminescent dosimeters (OSLD), ion chambers, thermo-luminescent dosimeters (TLD), or film measurements as directed by the MP.
Assists with high dose rate (HDR) and low dose-rate (LDR) brachytherapy procedures including patient set up, simulation, and treatment planning.
Participates in quality management in accordance with departmental policies, national guidelines, and accreditation standards.
Performs routine chart checks per departmental policy.
Participates in charge capture and generates documentation for billing in accordance with departmental policies.
Participates in clinical research for the development and implementation of new techniques in radiation therapy.
Participates in educational activities such as providing instruction and training to new staff members, physician residents, physicist residents, RTT trainees, and medical dosimetrist trainees.
Maintains an atmosphere of caring, concern, and support for patients, visitors, medical staff, and colleagues.
Performs miscellaneous job-related duties as directed by supervising medical physicists.
Adheres to high ethical standards in relation to patients, students, trainees, and colleagues.
Ensures accurate data transfer of patient and treatment plan information to clinical systems including but not limited to record and verify systems, imaging guidance systems, surface guidance systems, treatment delivery systems, and electronic medical record systems.
UPMC Hillman Cancer Center is internationally recognized for its leadership in the prevention, detection, diagnosis, and treatment of cancer and is the region's only comprehensive cancer center designated by the National Cancer Institute. As the preeminent institution in western Pennsylvania for the delivery of cancer care, the performance of basic, translational, and clinical research, and the education of the next generation of cancer researchers and physicians, UPMC Hillman Cancer Center is exceptionally well-positioned to contribute to the global effort to reduce the burden of cancer.
Qualifications:
Qualifications:
Bachelor's degree preferred.
Completion of a Medical Dosimetry educational program accredited by the Joint review Committee on Education in Radiologic Technology (JRCERT)
Board certified by the Medical Dosimetrist Certification Board (MDCB).
Board eligible candidates must become board certified within two attempts in the first two consecutive years of employment.
Licensure, Certifications, and Clearances:
Certified Medical Dosimetrist (CMD) or board eligibility required. Must maintain adequate CE credits to retain certification. CPR required based on AHA standards that include both a didactic and skills demonstration component within 30 days of hire
Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR)
UPMC is an Equal Opportunity Employer/Disability/Veteran
Bilingual (Spanish) Mental Health Therapist (Hybrid Schedule)- Jackson Heights
Jackson, NY jobs
*Named City and State's Top Place to Work in NY (2025) Join a mission-driven mental health leader serving 15,000+ clients each month!* *Celebrating over 50 years of excellence, New York Psychotherapy and Counseling Center (NYPCC) is a leader in community mental health, serving over 15,000 clients each month across four locations. We operate the largest mental health clinic in New York State and are committed to innovation and *_*Caring for the Community*_ *through both in-person and telehealth services.*
*NYPCC is proud to be certified as a Platinum Bell Seal organization by Mental Health America the highest distinction for workplace mental health. We were also named one of the Top Places to Work in New York in 2025, reflecting our commitment to supporting, valuing, and investing in our dedicated team through competitive compensation, excellent benefits, and a mission-driven culture.*
*Why Work at NYPCC:*
* We Pay Down Your Student Loans!
* Supervision is provided by our Licensed Clinicians; Your hours will count toward licensure
* Productivity Bonus
* Medical, Dental, and Vision Insurance is Paid for by NYPCC 100%
* Paid Time Off and Company Paid Holidays
* Annual Rate Increases
* 403B Retirement Plan with Match!
* Continuing Education Opportunities Available
* Professional Development through NYPCC Academy
* Amazing Workplace Culture
* NYPCC Health and Wellness Events
* One Mental Health Day per quarter to focus on wellness
*Job Description:*
*This is a full-time position that will be located at our new Child and Family Mental Health Clinic in Jackson Heights (Queens, NY).*
*Responsibilities:*
* Provide therapy to an ethnically and culturally diverse population of children, adolescents, and adults
* Develop, implement, and review treatment plans
* Write progress notes for all sessions conducted
* Evaluate and assess clients
* Maintain and update clinical records
* Provide case management and/or crisis intervention
* Attend clinical supervision and staff meetings
* Perform other duties as assigned by Supervisor
*Qualifications:*
* Master's Degree from an accredited school in Social Work, or Mental Health Counseling is a *must*
* *MSW-Permit, LMSW, LCSW, MHC, or LMHC's *are welcome to apply
* *Bilingual English/Spanish is a must*
* Outstanding engagement, interpersonal communication skills, and ability to work collaboratively with other disciplines, including clinical and clerical staff
* Ability to manage time effectively to ensure documentation compliance
* Exceptional writing skills
* Proficient in Microsoft Office, including Outlook, Word, Excel, and PowerPoint
* Strong entrepreneurial work ethic
* Dedication to workplace mentorship, education, and team-based care
* Maintains a positive attitude and is friendly, upbeat, and has a great can do personality
* Able to work well in a fast-paced environment
* Adheres to professional ethics
* Passionate about NYPCCs mission and values
Job Type: Full-time
Pay: $71,000.00 - $100,000.00 per year
Benefits:
* Dental insurance
* Employee assistance program
* Flexible spending account
* Health insurance
* Paid time off
* Professional development assistance
* Retirement plan
* Vision insurance
Education:
* Master's (Required)
Experience:
* Mental health counseling: 1 year (Preferred)
Language:
* Spanish (Required)
License/Certification:
* LMHC (Preferred)
* LMSW (Preferred)
Location:
* Jackson Heights, NY (Preferred)
Shift availability:
* Day Shift (Preferred)
* Night Shift (Preferred)
Ability to Commute:
* Jackson Heights, NY (Required)
Work Location: Hybrid remote in Jackson Heights, NY
by Jobble
Hybrid Outpatient Psychiatrist - Erie, PA
Erie, PA jobs
The Allegheny Health Network (AHN) Psychiatry & Behavioral Health Institute is seeking a motivated psychiatrist eager to work at the forefront of behavioral health care as we continue growing our presence in the Erie region. AHN will support the continued expansion of your skillset as you build a patient panel with myriad diagnoses or craft a sub-specialty niche. Join a vertically integrated fiscal and clinical delivery system that is revolutionizing behavioral health service models, providing evidence-based treatments, and measurement-based care.
Highlights:
Flexible, hybrid options for in-person and virtual work
Bi-monthly, multidisciplinary treatment team meetings which include peer case consultation
Onsite opportunity for interventional psychiatry with transcranial magnetic stimulation (TMS)
Continuing Medical Education (CME) allowance: $3500 and five paid CME days annually
Emphasis on collaboration between behavioral health disciplines, including psychiatry and psychology, within the Institute
Weekly Grand Rounds with free CME offerings
Opportunities to train and supervise advanced practice providers (APPs), psychiatry residents, medical students, and APP students
Qualifications:
Completion of ACGME approved Psychiatry residency program
Board eligible/board certified in Psychiatry
Doctor of Medicine (MD) or Doctor of Osteopathy (DO)
Licensed in the state of Pennsylvania prior to employment
AHN Proudly Offers
Competitive salary and comprehensive medical benefits
Sign-on bonus
CME allowance
EY Financial Planning Services - student loan, PSLF assistance
Retirement plans; vested immediately in 401K, 457B.
Malpractice insurance with tail coverage
A diverse & inclusive workforce with respective loan repayment for qualified candidates
Why Erie?
Located directly on one of our Great Lakes, Erie is home to Presque Isle State Park offering 7 miles of beaches, 14 miles of trails, and endless water activities. Enjoy our local wineries and breweries, diverse eateries and ski resorts. The city has become home to a variety of educational institutions including top ranked school system. Benefit from the area's low cost of living and international airport. Erie's cultural scene and diverse job market make it an ideal place for healthcare professionals to grow.
Why Saint Vincent Hospital?
Nationally recognized for innovative practices and quality care, Allegheny Health Network is one of the largest healthcare systems serving Western PA. AHN's Saint Vincent Hospital is a 350- bed tertiary care hospital currently serving the tristate area. Our facilities are equipped with state-of-the-art technology and robotic capabilities
.
Saint Vincent Hospital has been proud to open a brand new 39-bed Emergency Department, on-site Cancer Institute facility, four state-of-the art 700 sq. ft. Operating Rooms and more! Recently voted Erie's Choice as the ‘Best Hospital' and ‘Best Place to Work', AHN Saint Vincent continues to shine in its commitment to its employees and the Erie community.
Email your CV and direct inquiries to:
Carissa Johnston | Physician Recruiter
************************
Epic Principal Trainer
Columbus, OH jobs
We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities.
Summary:
Supports the curriculum development and maintenance lifecycle for assigned applications including participation in workflow evaluation, development of new curriculum and related documentation (e.g., tip sheets, quick start guides, knowledge articles). Collaborate with user departments to identify, analyze, and support ongoing needs while achieving Service Level Agreements (SLAs) relative to the supported curriculum.
Responsibilities And Duties:
System Analysis and Design:
Analyze and document current business processes and workflows.
Identify system requirements and translate them into detailed specifications.
Design and implement solutions to improve system efficiency and user experience.
Application Support:
Provide support for (Epic, Workday, Kronos,) and other applications.
Troubleshoot and resolve system issues in a timely manner.
Coordinate with vendors and internal teams for system upgrades and patches.
Collaborate with IT and clinical teams to integrate across IT portfolio with other IT systems (e.g., Epic, 3rd Party Imaging Applications, AI, etc.).
Project Management:
Under the direction of the Sr. Systems Analyst strong participation smaller projects related to system implementations and upgrades.
Knowledge with various project management approaches, e.g. waterfall, agile.
Training and Documentation:
Contribute to comprehensive documentation for system configurations and processes.
Assist and provide guidance on best practices.
Integration and Data Management:
Contribute to seamless integration between various healthcare applications.
Manage data integrity and security across systems.
Perform data analysis and generate reports as needed.
Minimum Qualifications:
Bachelor's Degree: Computer and Information Science (Required)
Additional Job Description:
EDUCATION and/or EXPERIENCE:
Knowledge typically acquired through a associate degree in a healthcare field (e.g., nursing, respiratory therapy, health information management, etc.), computer science, education, business, or related field; equivalent experience will be considered.
SPECIALIZED KNOWLEDGE:
Healthcare operations, basic knowledge of computers, education theory
KIND & LENGTH OF EXPERIENCE:
1 to 3 years experience in systems analysis, programming, or business / clinical operations
SPECIALIZED KNOWLEDGE
Knowledge typically acquired through a Field of Study: a healthcare field (e. g. , nursing, respiratory therapy, health information management, etc. ), computer science, education, business, or related field; equivalent Experience will be considered
DESIRED ATTRIBUTES
Application management lifecycle, Clinical / Hospital Operational experience Additional experience
Work Shift:
Day
Scheduled Weekly Hours :
40
Department
CareConnect Training
Join us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in the healthcare industry
Equal Employment Opportunity
OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
Remote Work Disclaimer:
Positions marked as remote are only eligible for work from Ohio.
RN Utilization Management remote - MediGold Health Plan
Columbus, OH jobs
*Employment Type:* Full time *Shift:* *Description:* *Why MediGold?* [MediGold]( is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.
*Position Purpose*
RN Utilization Management MCHP is responsible for the coordination of the medical care provided to Plan members with Plan providers, the member's family and other resources as appropriate. Assist in the development of the Plan's UM Program and the review of the Plan's Utilization Management Plan.
*What you will do*
* Participates in designated committees and task forces according to the UM Program and at the direction of the Director, Utilization Management.
* Coordinates with the utilization review, case management, discharge planning staff within network facilities.
* Coordinates with Medical Director/Associate Medical Directors on case-specific issues.
* Coordinates with Claims, Member Services, Grievance Coordinator and other operational departments regarding case management issues.
* Documents and communicates to QM staff appropriately all identified quality concerns related to Members.
* All other duties as assigned.
*Minimum Qualifications*
* Education: Associate or Bachelor's Degree in Nursing
* Licensure / Certification: Current license to practice as a Registered Nurse in their home state or hold a compact nursing license.
* Experience: Minimum of 5-7 years of clinical nursing experience with at least 2 years' experience in utilization review or case management. Nursing experience in an HMO insurance setting preferred· Demonstrated ability to analyze, summarize and concisely report medical utilization and medical chart audit results.
* Ability to compare approved criteria with clinical information to determine appropriateness of service and to document all related information according to department policies and procedures.
* Conducts claim review as required for appropriate claims processing
*Position Highlights and Benefits:*
* Mount Carmel Health System recognized by Forbes in 2025 as one of America's Best State Employers.
* Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
* Retirement savings account with employer match starting on day one.
* Generous paid time off programs.
* Employee recognition programs.
* Tuition/professional development reimbursement starting on day one.
* RN to BSN tuition 100% paid at Mount Carmel's College of Nursing.
* Relocation assistance (geographic and position restrictions apply).
* Employee Referral Rewards program.
* Mount Carmel offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday. You deserve to get paid every day!
* Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.
*Ministry/Facility Information:*
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
*Our Commitment *
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Clinical Program Manager RN * Hybrid*
Gresham, OR jobs
Clinical Program Manager RN
Hybrid.
Candidates residing in the areas of Portland, OR, Spokane, WA or Lubbock, TX are encouraged to apply.
In collaboration with the Division Director, the Clinical Practice Manager RN supports nursing practice, quality initiatives, and clinical improvement efforts across the division. This role is responsible for leading teams in developing and implementing evidence-based nursing and clinical practices, utilizing established standards, research findings, and quality improvement principles.
Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Strategic And Management Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
Bachelor's Degree: Nursing
Master's Degree: Nursing (Practice or Education)
5 years - Nursing experience in an acute care setting.
3 years - Clinical practice development, quality, or education experience.
active RN License for WA, OR or TX
Preferred Qualifications:
Ph.D.: Nursing or DNP (Doctor of Nursing Practice)
Salary Range by Location:
Oregon: Portland Service Area: Min: $59.39, Max: $93.75
Texas: Min: $45.30, Max: $71.51
Washington: Eastern: Min: $52.85, Max: $83.42
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 403508
Company: Providence Jobs
Job Category: Clinical Administration
Job Function: Clinical Support
Job Schedule: Full time
Job Shift: Day
Career Track: Nursing
Department: 4007 SS CNTRL DIV EDU ADMIN
Address: OR Portland 4400 NE Halsey St
Work Location: Providence Health Plaza (HR) Bldg 1-Portland
Workplace Type: Hybrid
Pay Range: $see posting - $see posting
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
PandoLogic. Category:Healthcare, Keywords:Healthcare Program Manager, Location:Gresham, OR-97030