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Presbyterian Remote jobs

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  • Talent Management and Employee Engagement Consultant

    Presbyterian Healthcare Services 4.8company rating

    Albuquerque, NM jobs

    We are seeking a Talent Management & Employee Engagement Consultant to lead strategic initiatives that strengthen performance management and succession planning across our organization. This role combines HR expertise with advanced technology, including AI-driven tools, to deliver innovative solutions that enhance workforce engagement and organizational success. Key Responsibilities * Design and implement evidence-based processes for performance management and succession planning, leveraging AI tools and HR technology platforms. * Align competencies with organizational goals through integrated talent review systems. * Partner with leadership to embed performance management methodologies into everyday practices. * Utilize analytics and AI-driven insights to inform strategic workforce decisions and engagement strategies. * Collaborate across HR Centers of Excellence to ensure seamless integration of talent management initiatives. * Serve as a key advisor on succession planning and workforce development strategies. * Evaluate program effectiveness using data-driven metrics and ROI analysis. * Support technology adoption and vendor integration for talent management platforms. This position is open to remote applicants located within the United States, except residents in California, Illinois, North Dakota, New York, Ohio, Washington, and Wyoming. Candidates residing within a 60-mile radius of Albuquerque, NM will follow a hybrid work schedule: remote work on Mondays and Fridays, and in-office presence required on Tuesdays, Wednesdays, and Thursdays. Qualifications * Bachelor's degree in Human Resources, Organizational Development, Business Administration, or at least 6 years of proven experience in talent management, HR Consulting, or a related field in lieu of a degree. * Ability to exhibit an understanding of healthcare business and care experience. * Knowledge of human resources practices, laws, and regulations preferred. * Expertise in AI tools related to talent management and employee engagement. * Ability to problem solve and build improvement plans. * Ability to act as the front-line change leadership agent to enable and deliver sustainable succession planning and performance management efforts. * Working knowledge of succession management and performance management skills, including the ability to align with organizational goals. * Ability to multitask and work collaboratively with all levels of leadership. * Strong interpersonal and communication skills, analytical thinking, strategic planning, and problem-solving abilities. * Detail oriented * Strong organizational and presentation skills. * Certifications: Professional HR certifications such as SHRM-CP, SHRM-SCP, or PHR are advantageous. * Technical Proficiency: Familiarity with HR software and tools, data analysis platforms, talent management systems, and Microsoft Office. * SHRM AI+HI Specialty Credential, AIHR Artificial Intelligence for HR, or similar programs are a plus. Responsibilities * Develops and is responsible for the administration of best practice evidence-based processes and tools that define and validate performance and succession planning standards, policies, and processes based on talent management/career enhancement strategies. * Aligns leader and team member competencies to performance review, talent review, and succession management/planning. * Develops and implements expedited performance improvement processes for the PHS workforce. * Works collaboratively with the compensation team to align pay-for-performance efforts with established HR processes. * Integrates performance management and talent review/succession management methodologies with the priorities and practices of HR Centers of Excellence (COE), including Talent Acquisition, Benefits, HR Business Partners, and Learning. * Administers and implements the Talent Review process annually with the HR Business Partners. * Proactively consults and engages with PHS leaders on the development and implementation of system-wide Performance and Succession Management programs, including methodologies and operational processes, policies, metrics, and tools. Provides subject matter expertise and change leadership support that helps ensure programs are integrated with other organizational and HR priorities/programs. * Works with PHS leadership to collaboratively embed system-level Performance Management methodologies into regular leader conversations with their direct reports. * Serves as the point person to establish succession planning efforts at all employee levels in the organization. Facilitates, administers, monitors, and reports on Performance and Succession Management efforts. * Partners with Executive Recruiting to broker internal talent using data from the Talent Review. * Facilitates talent review/succession management conversations with PHS leaders; utilizes data from these conversations to build succession management and performance management plans. * Utilizes program and organizational data/measurements to define and demonstrate progress, ROI, and impacts; ensures leader and critical job bench strength throughout PHS. * Consults on and implements as necessary, performance and succession management technologies and vendor relationships, which includes integration into the PHS enterprise resource planning system/processes. * Measures the development and administration of Performance and Succession Management budgets in relation to vendor and tool expenditures. * Ensure all talent management practices are in accordance with legal and regulatory requirements. * Evaluates the effectiveness of talent management and performance management programs. * Builds communication plans related to employee engagement survey implementation and follow-up. * Reviews employee engagement survey data and builds reports based on information so that the organization can create effective plans to address concerns. * Coaches HRBPs to guide leaders through the employee engagement planning process * Steers Talent Development offerings based on employee engagement results * Creates follow-up reports for senior leaders based on employee engagement response and action planning. * Regularly utilizes AI tools to identify, expedite and escalate the processes of talent management. * Applies AI tools to enhance employee engagement processes. * Other duties as assigned. Benefits We offer more than the standard benefits! Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more! Learn more about our employee benefits: ***************************************************** Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more. Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans. About Presbyterian Healthcare Services Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to USD $73.37/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
    $73.4 hourly Auto-Apply 27d ago
  • Expert EPIC Configuration Analyst - Ambulatory - Remote Eligible

    Presbyterian Healthcare Services 4.8company rating

    Albuquerque, NM jobs

    Presbyterian is seeking an Expert EPIC Configuration Analyst - Shape the Future of Healthcare Technology Join a mission-driven organization where innovation meets impact. Presbyterian is looking for a highly skilled Epic Configuration Analyst to lead transformative work in healthcare technology. If you're passionate about optimizing systems that directly improve patient care and operational efficiency, this is your opportunity to make a difference. Position Overview: This role requires deep expertise in Epic System software and a strategic mindset. You'll collaborate closely with Epic, Subject Matter Experts (SMEs), and end users to design and tailor solutions that align with Presbyterian's evolving needs. Your work will directly influence how care is delivered across the organization. Key Responsibilities: * Perform in-depth analysis of workflows, data structures, and technical challenges. * Lead the design, build, testing, and maintenance of Epic solutions. * Serve as a bridge between technical teams and clinical/business stakeholders. * Continuously evaluate system performance and recommend enhancements. Position Details: * Exempt: Yes * Location: Rev Hugh Cooper Admin Center * Schedule: Day Shift * Hybrid: In office expected for individuals within 60 Miles of Albuquerque every Tues, Wed, Thurs * Remote: Open to remote applicants in the United States, except for the following states: California, Illinois, North Dakota, New York, Ohio, Washington and Wyoming Ideal Candidate will have: Epic Ambulatory certification Join a workplace where compassion meets purpose. Apply today! Qualifications * Bachelor's degree plus 3 years of IT or business experience. * 3 years of Epic specific experience. * 6 years' of additional experience can be substituted in lieu of degree. * Epic certified in supporting application plus additional proficiency/certification/badges in related application area Responsibilities * Provide tier-2 support for application incidents, including 24/7 on-call coverage. Troubleshoot complex issues across applications and systems, ensuring timely resolution and adherence to change management and quality assurance processes. * Modify Epic records and master files, implement updates and enhancements, and create integrated workflows in collaboration with SMEs. Analyze new functionality and proactively identify and implement process improvements. * Develop and maintain requirements, specifications, and test cases. Ensure test scripts reflect workflow solutions and support training teams by communicating system changes and new functionality. * Facilitate meetings, drive cross-functional teams to actionable outcomes, and maintain effective documentation. Act as a functional leader and advocate for change management across teams. * Mentor peers and guide analysts across teams, tailoring support to individual needs. Recommend and implement strategies for knowledge transfer and present effectively to large groups. * Demonstrate strong customer service, communication, and project management skills. Analyze data and workflows, manage major projects, and contribute to strategic planning and relationship-building with Epic customers and stakeholders. Benefits About Presbyterian Healthcare Services Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits. The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift to earn gift cards and other incentives. As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships. Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to USD $71.81/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
    $71.8 hourly Auto-Apply 15d ago
  • Supervisor, Support Center Operations - Remote (Bilingual Spanish) PST Hours

    Molina Healthcare 4.4company rating

    Santa Fe, NM jobs

    + Provides customer support and stellar service to meet the needs of our Molina members and providers. + Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. + Provides product and service information and identifies opportunities to improve our member and provider experiences. **KNOWLEDGE/SKILLS/ABILITIES** + Supervises a team of employees. Trains, coaches, monitors, and manages the team's performance to meet or exceed company and department performance expectations. + Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. + Ensures compliance with Contractual and Regulatory requirements. + Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care. + Provides exemplary customer service to customers including members, co-workers, vendors, providers, government agencies, business partners, and general public. + Achieves individual performance goals as it relates to call center objectives. + Demonstrates personal responsibility and accountability and leads by example through individual performance. + Support projects and special initiatives as appropriate. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** + 3-5 years' experience in a call center environment + 1-2 years supervisory experience **Preferred Education** Bachelor's Degree or equivalent combination of education and experience **Preferred Experience** 5-7 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $45,390 - $84,086 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $45.4k-84.1k yearly 30d ago
  • Wellness Associate II (Northeast Pennsylvania resident)

    Geisinger Medical Center 4.7company rating

    Remote

    Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: No Serves community or practice/facility-based population management initiatives including on site programs, screening services, fitness classes, evidence based program facilitation and program development for the wellness team and partners. Responsible for the development and oversight, as well as implementation of health and wellness programs at the facility as well as surrounding community initiatives. Job Duties: This role has a 40 hour work week, but the daily schedule varies from week to week with some early mornings, occasional evenings, and occasional weekend hours Develops and designs programs in conjunction with their assigned facility ensuring competencies, training requirements, reporting and documentation requirements are being meet. Supports regional teams, operations, new program design and implementation of new products and services. Develops and implements tools to evaluate the effectiveness of the wellness program to manage outcomes. Reports program participation and outcomes quarterly to stakeholders. Prepares and presents educational information consistent with the mission and objectives of the wellness program and the facility. Provides on site screening support and education as needed. Supports team on site with programs, biometric screenings and phlebotomy support as needed and as appropriate, based on skill set and educational background. Represents the facility at various business and community events as needed or coordinates events at the facility. Serves as a wellness resource and oversees member communication and outreach initiatives within the wellness program. Supports regionally based teams and employers throughout our coverage area, as well strategic opportunities as needed. Monitors changes in employee wellness research, new developments and standards. Researches and creates new program to meet the population needs, as appropriate. Supports reporting needs, data management and outcomes. Assists with other policies which have wellness components. Learns new software applications and maintains databases. Coordinates ongoing record keeping and prepares reports as requested. Works closely with internal departments including, but not limited to Health Services, Marketing, IT, Sales and wellness. Responsible for calendar management, promotion of activities in conjunction with marketing and coordination of all onsite activities. Participates on committees, as assigned, to represent and provide expertise related to the Wellness Program. Provides telephonic and on site health coaching for lifestyle management programs, as needed. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Position Details: Education: High School Diploma or Equivalent (GED)- (Required) Experience: Minimum of 5 years-Relevant experience* (Required) Certification(s) and License(s): Skills: Computer Literacy, Critical Thinking, Interpersonal Communication OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
    $36k-71k yearly est. Auto-Apply 3d ago
  • ED Coding Validator - REMOTE

    Umass Memorial Health 4.5company rating

    Worcester, MA jobs

    Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Exempt Hiring Range: $67,288.00 - $121,118.40 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: 7:00 a.m. - 3:30 p.m. Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5458 Coding Services This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Performs focused account and quality reviews of coded records to support the ongoing performance management process. Validates the Diagnosis Related Group (DRG) and current editions of ICD-CM, ICD-PCS, and CPT code assignment to ensure consistency and efficiency in the processing, data collection, and quality reporting associated with inpatient and outpatient claims. I. Major Responsibilities: 1. Performs focused account and Coder quality reviews on inpatient and outpatient records to validate the DRG and current editions of ICD-CM, ICD-PCS, and CPT code assignment as well as missed secondary diagnoses or procedures which may impact the Severity of Illness (SOI) and Risk of Mortality (ROM). 2. Ensures compliance with all DRG, outpatient coding, and charging mandates as well as reporting requirements. 3. Validates the DRG and current editions of ICD-CM, ICD-PCS, and CPT code assignment to ensure consistency and efficiency in the processing, data collection, and quality reporting associated with inpatient and outpatient claims. 4. Demonstrates competency in the use of computer applications, DRG grouper software, as well as all coding and abstracting software currently used in HIM. 5. Runs daily reports to ensure all focused account reviews are worked to prevent the unnecessary holding of accounts prior to billing. Informs the Manager of Coding-HIM when backlog situations arise and necessary documents are either incorrect or not received in a timely manner. 6. Provides feedback on Coder quality reviews to the Manager of Coding-HIM, Supervisor of Inpatient Coding, Manager of Emergency Department (ED) Coding, and Manager of Radiology Coding based on the Coding Audit and Performance Management policy and procedure. 7. Creates and monitors Case Mix Index (CMI) reports and accuracy of the top 25 assigned DRGs to identify patterns, trends, and variations. 8. Creates and monitors outpatient reports and accuracy of top 25 assigned principle diagnoses to identify patterns, trends, and variations in the organization's frequently assigned principle diagnoses, evaluation and management codes, modifiers, and CPT procedure changes. 9. Evaluates the root cause of any identified trends or possible problem areas. Reports variances to the Manager of Coding-HIM, Manager of ED Coding, and Manager of Radiology Coding. 10. Acts as a point person for Coding staff on questions or concerns related to ICD-CM (current edition), DRG, Evaluation and Management (E/M) code assignment as well as procedural coding and the retrospective query process. 11. Maintains direct and ongoing communications with Coding personnel to maximize overall effectiveness and efficiency of Coding operations. 12. Informs Manager(s) of any coding irregularities or trends contrary to policies / procedures and communicates with appropriate staff if necessary. 13. Assists the Manager of Coding-HIM in performance improvement initiatives and demonstrates the use of quality improvement in daily operations. 14. Assists the Manager of Coding-HIM in meeting department / unit goals and ensuring compliance with regulatory agencies such as Joint Commission, DPH, etc. 15. Works closely with the Retrospective CDIS Nurse and Clinical Documentation Improvement (CDI) Program team to continuously monitor the quality of clinical documentation to identify incomplete or inconsistent documentation in addition to any changes in DRG assignment and payment. 16. Monitors retrospective queries for appropriateness and may provide Coder feedback. Informs the Manager of Coding-HIM of any identified concerns. 17. Collaborates with the Manager of Coding-HIM as the primary department resource for the dissemination of DRG interpretations. 18. Collaborates with the Coding Educator to provide ongoing education to the Coding staff, Providers, and other clinicians to ensure appropriate assignment of current edition of ICD-CM, DRGs, E/M codes as well as modifiers and CPT procedure changes. 19. Collaborates with the Coding Educator to incorporate improvement efforts into coding in-services throughout the year. 20. Assists the Manager of Coding-HIM in preparing productivity reports and participates in the department's total quality management studies. 21. Maintains DRG and coding accuracy rate of not less than 95% for optimal reimbursement as well as department productivity standards as outlined in department policies. 22. Attends required training classes and coding in-services each year to stay abreast of new regulations and coding guidelines. 23. Participates in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines. 24. Monitors Medicare and other DRG payer bulletins and manuals. Reviews current Office of Inspector General (OIG) work plans for DRG risk areas. 25. Keeps current with all coding updates and information related to correct coding. Standard Staffing Level Responsibilities: 1. Complies with established departmental policies, procedures and objectives. 2. Attends variety of meetings, conferences, seminars as required or directed. 3. Demonstrates use of Quality Improvement in daily operations. 4. Complies with all health and safety regulations and requirements. 5. Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. 6. Maintains, regular, reliable, and predictable attendance. 7. Performs other similar and related duties as required or directed. All responsibilities are essential job functions. II. Position Qualifications: License/Certification/Education: Required: 1. Bachelor's degree in Business or Health Care Administration. 2. Certification as a Certified Coding Specialist (CCS). Preferred: 1. Certification as a Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT). Experience/Skills: Required: 1. Minimum of five (5) years of experience coding in a large, teaching, acute tertiary care setting with demonstrated coding expertise. 2. Extensive knowledge of current editions of DRGs, ICD-CM, ICD-PCS, and CPT coding systems. 3. Through knowledge of third-party payer requirements as well as federal and state guidelines and regulations pertaining to coding and billing practices. 4. General knowledge of hospital information systems as well as extensive knowledge of computer systems / applications used in HIM. 5. General knowledge of the retrospective CDI query process as well as guidelines for achieving a compliant query and associated compliance concerns. 6. Excellent customer service skills with the ability to communicate efficiently. 7. Exceptional organizational skills with attention to detail. 8. Ability to lead, organize, and support the work of less senior Coders is a primary function of this position. 9. Ability to work independently within established guidelines. 10. Excellent oral and written communication skills required. 11. Ability to motivate, train and teach individuals; demonstrating skills in interpersonal relationships and in oral and written communication. 12. Ability to organize and coordinate multiple functions and tasks. 13. Ability to problem solve, organize, and prioritize workload to meet productivity benchmarks. 14. Ability to withstand significant level of on-going pressure, and ability to deal with individuals with tact, discretion and diplomacy. Preferred: 1. Coding review experience in DRG assignment, and current editions of ICD-CM, ICD-PCS and CPT coding with previous claims processing and data management responsibility. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents. III. Physical Demands and Environmental Conditions: Work is considered sedentary. Position requires work indoors in a normal office environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ***********************************. We will make every effort to respond to your request for disability assistance as soon as possible.
    $67.3k-121.1k yearly Auto-Apply 44d ago
  • Per Diem ED Radiologist- Remote Reads

    Umass Memorial Health 4.5company rating

    Worcester, MA jobs

    Are you a current UMass Memorial Health caregiver? Apply now through Workday. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Hiring Range: $175.48/hr - $209.13/hr Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations. UMass Memorial Medical Group is seeking additional Per Diem ED Radiologists to either work onsite or remotely read. We are seeking additional per diem radiologists for all shift types (7a-3p, 3p-11p, 11p-7a). About our Department: Our department is comprised of ~80 Radiologists, 20 residents, 9 fellows and 15 PhDs. In our ED group we have a team of 15. Our health system covers over one million lives and is a Level 1 Trauma Center with 95,000 ED visits per year. Our department has over $6M/year in research funding. Academic pursuits are encouraged and supported both in the realms of research and education. Our department has state of the art imaging equipment, AGFA PACS system, EPIC EMR, Tera-Recon image processing software, Powerscribe 360 and is running several AI algorithms. Radiologist Requirements: ED Radiologists work at the University campus with one resident and/or one Emergency Radiology fellow, and remotely cover several other hospitals. Additional opportunities for internal moonlighting within the department are available if desired. We offer three shift types to include 7am-3pm, 3pm-11pm and 11pm-7am. We can offer hybrid schedules to include remote reading days but an onsite presence is required. You must be comfortable interpreting the following modalities: CT, MRI, ultrasound, and Basic nuclear medicine. Fellowship training in Emergency Radiology is desired but not required. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ***********************************. We will make every effort to respond to your request for disability assistance as soon as possible.
    $175.5-209.1 hourly Auto-Apply 46d ago
  • Hospital Outpatient Coding Educator (1.0)

    Franciscan Health Indianapolis 4.1company rating

    Remote

    Work From HomeWork From Home Work From Home, Indiana 46544 The Hospital Outpatient Coding Educator is responsible for coordinating and conducting coding training and developing training content and materials for the Franciscan Alliance Corporate Coding Department, hospital outpatient and professional coding staff. This position ensures training practices are standardized and result in consistent coding outcomes, as well as provides input regarding the content of policies and procedures. This position ensures all new and existing staff members are trained and adhere to current coding policies and procedures. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Develops and maintains all corporate outpatient coding education, training policies and procedures, and coding reference materials. Leads training sessions and assess coder comprehension of covered materials. Makes recommendations for the development of coding resources and policy and procedure development. Assists corporate coding leadership with training and/or development of a performance improvement track for coding coworkers in the corrective action process related to quality or productivity performance. Coordinates with Coding Auditors to prepare education material based on audit results. Develops and maintains a consistent coding operations orientation program, and reports the coders' progress to coding leadership throughout the orientation and training processes Assists Coding Manager and Supervisor with review and response to external coding audits. Acts as a nosologist, analyzing and interpreting disease, procedure classifications, and terminologies for the accurate translation of healthcare data. Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability. Ability to analyze information, make decisions and exercise independent judgement. Serves as the subject matter expert with regards to diagnosis and procedure codes, coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payer specific guidelines, public reporting of outcomes, quality of patient care outcome measures, and the interpretation of coded data as it relates to revenue cycle compliance. Participates in problem identification, performs root cause analysis and recommends a solution to Coding Management. Assists with development and maintenance of software system workflow for standardization and maximum efficiency. Oversees system testing with regards to any published software updates or software functionality changes Identifies template variation within the EMR that has a negative impact on coding edits/errors. Escalates trends and makes recommendations for template revisions/standardization to FAIS HIM team and Coding Leadership. Coordinates all testing efforts with coding superusers and FAIS teams. Assists with annual verification of coding staff credentials. Orients new physicians with regards to the coding department's role in the revenue cycle, and prepare training material for coding related to physician education. Assists with identification and implementation of process improvements according to industry best practice standards to make the best use of resources, decrease costs and improve coding services across the specialized service lines. QUALIFICATIONS High School Diploma/GED With 5 years of Franciscan coding experience - Required or Associate's Degree in Health Information Management - Required Bachelor's Degree in Health Information Management - Preferred Surgery Coding Experience - Required 5 Years Franciscan outpatient coding with CCS, CCS-P, CPC - Required or 3 Years Outpatient Coding Experience with RHIT/RHIA - Required 3 Years Coding Manager or Trainer/Auditor - Preferred CCS - Required RHIT/RHIA - Preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Coding Educator - Hospital Outpatient/Professional $51001.60-$75868.00INCENTIVE: EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
    $34k-64k yearly est. Auto-Apply 44d ago
  • Manager Reimbursement Services (CPC, CRC, or RHIT), Geisinger Health Plan

    Geisinger Medical Center 4.7company rating

    Remote

    Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes We are seeking a strategic and experienced leader to oversee our Reimbursement Services team. This role is responsible for guiding the planning, analysis, and implementation of reimbursement methodologies for healthcare providers. The ideal candidate will manage both short- and long-term reimbursement initiatives, collaborate with senior leadership to align financial strategies, and lead forecasting efforts to assess the impact of reimbursement changes. Additionally, this position provides daily support for coding and reimbursement needs across negotiations, claims processing, and provider setup. A minimum of one certification is required: CPC, CRC, or RHIT. Job Duties: Oversees the Reimbursement Services team members who lead the planning, analysis, consultation and direction of the reimbursement methodology for healthcare providers. Oversees short and long term reimbursement initiatives with the ability to work closely with senior management to develop strategic goals and implement reimbursement initiatives. Leads the forecasting process related to changes in reimbursement methodology and associated financial impact. Oversees daily coding and reimbursement support to negotiations, claims processors and provider set-up representatives. A minimum of one certification is required: CPC, CRC, or RHIT. Coordinates and provides oversight for the ongoing analysis and planning of industry reimbursement changes. Coordinates ongoing physician fee changes and primary care capitation analysis. Provides impact analysis as fee changes occur. Coordinates the ongoing fee revision process. Ensures efficient and timely processing of problem claims for all lines of business and all markets, including new and expansion markets. Monitors and evaluates provider-specific payment waivers and distinctive edit exclusions negotiated within the provider network. Consultative activities with internal and external customers to assist with the development of reimbursement strategies related to TPA or new market relationships. Provides consultative support on all financial planning issues related to provider reimbursement. Evaluates reimbursement initiatives and changes in payment to control medical expense. Leads implementation of new or existing predictive modeling software tools, as well as, supports the accuracy and integrity of reimbursement related information. Assists with presentations to provider network managers to educate on industry trends in reimbursement, reimbursement changes and tools and templates available for requesting reports on historical provider reimbursement. Ensures that accurate predictive modeling is done by line of business (Medicare versus Commercial). Recommends reimbursement opportunities by utilizing statistical reports, reimbursement summary documents and industry information to conduct review and analysis of coding practices or fee levels. Determines appropriateness of provider coding and charging practices and associated claims processing payment accuracy to validate actual provider payment against contracted payment terms. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. #LI-REMOTE Position Details: Education: Bachelor's Degree- (Required), Bachelor's Degree-Business Administration/Healthcare Management (Preferred) Experience: Minimum of 3 years-Managing people, processes, or projects (Required) Certification(s) and License(s): Certified Professional Coder - American Academy of Professional Coders (AAPC), Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC), Registered Health Information Technician (RHIT) - American Health Information Management Association Skills: Builds Relationships, Computer Literacy, Manages Conflict And Crisis, Manages Projects And Functions, Mathematics OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
    $79k-112k yearly est. Auto-Apply 44d ago
  • Home Health/Hospice and Palliative Scheduling Liaison-ABQ

    Presbyterian Healthcare Services 4.8company rating

    Albuquerque, NM jobs

    Presbyterian Healthcare Services is seeking a dedicated and detail-oriented Scheduling Liaison to support our Home Health, Hospice, and Palliative Care teams. This role plays a critical part in ensuring timely, coordinated, and high-quality care delivery to patients in their homes. Key Responsibilities * Collaborate with Patient Care Managers to process referrals and schedule Field Clinician visits. * Coordinate staffing across departments to optimize clinician productivity and patient care outcomes. * Manage daily scheduling tasks related to the intake workflow, including direct patient communication. * Share responsibility for managing the department's phone queue alongside team members. * Provide scheduling and operational support for the Albuquerque Home Health and Hospice Agency, with extended support to regional agencies within the Presbyterian Health System. * Participate in cross-training initiatives to support interdisciplinary teams, including Nursing, Rehabilitation, and other clinical services. What We're Looking For * Strong organizational and communication skills. * Ability to work collaboratively in a fast-paced, remote environment. * Flexibility to work varied hours, including weekends. * Commitment to learning and supporting across multiple disciplines. * This is a Full Time position - Exempt: No * Job is based at Remote Presbyterian El Camino * Work hours: Varied Days and Hours- includes weekend day Qualifications * High School Diploma or GED required; Associates degree preferred. * Two (2) or more years clinical experience as a Clinical Scheduler required. * Short-term training in Medical Terminology * Customer service and scheduling experience. * Advanced computer skills with Microsoft Office Platform. Responsibilities * Utilizes EMR scheduling applications to manage patient appointments and validate demographics. * Coordinates scheduling for RDS Home Health and Hospice, including provider block time across sites. * Ensures compliance with CMS guidelines for clinician scheduling and documentation. * Maintains positive relationships with statewide agency personnel, internal and external. * Handles afterhours/weekend pass-downs and manages clinician schedules using time and attendance systems. * Produces required reports such as Supervisory Visits and Geographic Team Reports. * Answers agency phone queue, resolves inquiries, and supports message routing. * Supports onboarding by managing EMR schedule templates and mentoring new CSC staff. * Secures signed provider orders to ensure timely billing and regulatory compliance. Benefits About Presbyterian Healthcare Services Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits. The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift to earn gift cards and other incentives. As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships. Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to USD $23.76/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
    $23.8 hourly Auto-Apply 37d ago
  • PFRT Rev Integrity Specialist - REMOTE

    Umass Memorial Health 4.5company rating

    Worcester, MA jobs

    Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Exempt Hiring Range: $64,084.80 - $115,336.00 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: 8-5 Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5452 RI and Charge Capture This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Serves as a Charge Generation Tracker (CGT) and regulatory gatekeeper to ensure compliance with coding and billing guidelines. Reviews all assigned edits within prescribed timeframe and routes to appropriate owner for resolution. Provides regulatory (coding and billing) support to clinical charge capture specialists to address CGT, coding, charge capture and billing questions. Acts as primary resource for providers, clinical and administrative staff for coding questions and research related to revenue enhancement and correct coding. I. Major Responsibilities: 1. Serves as a gatekeeper to ensure that regular and annual CGT updates compliant with third party regulatory and coding billing guidelines and reflect clinical practice. 2. Collaborates with clinical / ancillary departments to facilitate proper use of CGT files as well as synchronization of preference lists and orders in IT applications. 3. Ensures system wide compliance with federal, state and local regulations with regard to charge codes and related information in the CGT. 4. Ensures standardized CGT request processes are followed. 5. Reviews all assigned edits within prescribed timeframe and routes to appropriate owner for resolution. 6. Provides support and guidance to clinical and RI / Charge Capture staff to resolve outstanding edits. 7. Monitors daily edits reports and alerts clinical departments of delinquencies. 8. Provides regulatory (coding and billing) support to clinical charge capture specialists to address CGT, coding, charge capture and billing questions. 9. Utilizes subject matter knowledge to support proper interpretation and analysis of performance report(s). 10. Utilizes reporting and data analysis in combination with standard benchmarks and criteria to identify and follow-up on potential revenue integrity issues. 11. Ensures the CGT structure supports effective capture of all chargeable services based on a thorough knowledge of the regulatory requirements, IT applications and charge capture processes. 12. Provides subject matter knowledge related to the CGT for clinical departments, revenue cycle team, finance, compliance and administrative staff. 13. Provides accurate feedback and documentation to support educational needs. 14. Develops and conducts educational courses and seminars focusing on professional documentation, coding and billing for physicians, clinicians, administrative staff and Professional Billing Central Billing Office (PBCBO) staff. 15. Develops training programs and supporting materials relative to physician coding and billing guidelines and protocols to ensure that specific areas of need are addressed and that all materials comply with applicable rules and regulations. 16. Participates in PBCBO staff training on coding and billing guidelines. 17. Monitors CMS and applicable third party coding and billing publications, and abstracts key information relative to established coding and billing policies and procedures for distribution to UMMMG stakeholders (clinical, administrative, compliance, PFS, finance). 18. Researches third party coding and billing guidelines and ensures timely and accurate compliance with federal, state, local payer requirements as well as UMMMG contracts specific to charging, coding, bundling and unbundling, modifier reporting requirements. 19. Leads annual review process by providing updates regarding CPT, CMS regulatory updates, professional society publications (e.g., ASA) for clinical, administrative, compliance, revenue cycle, and finance. 20. Performs quality audits and reviews of focused patient accounts to identify improvement opportunities in clinical documentation, charge capture and coding. 21. Provides audit feedback to key clinical and revenue cycle stakeholders for continuous improvement. 22. Monitors downtime forms for each billing area. 23. Collaborates with clinical charge capture analyst to ensure that downtime procedure is maintained. Standard Staffing Level Responsibilities: 1. Complies with established departmental policies, procedures and objectives. 2. Attends variety of meetings, conferences, seminars as required or directed. 3. Demonstrates use of Quality Improvement in daily operations. 4. Complies with all health and safety regulations and requirements. 5. Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. 6. Maintains, regular, reliable, and predictable attendance. 7. Performs other similar and related duties as required or directed. All responsibilities are essential job functions. II. Position Qualifications: License/Certification/Education: Required: 1. Associate's degree. 2. Certification in Professional Coding. (CPC) Certified Professional Coder. 3. EPIC Credentialed in Ambulatory within 12 months of hire date. Experience/Skills: Required: 1. Three to five (3-5) years of work experience related to professional billing and coding. 2. Knowledge of industry standard practices, including CPT / HCPCS codes and third-party reimbursement policies. 3. Knowledge of coding and billing requirements based on third party publications, including Blue Shield, Medicare, Medicaid, commercial insurers and HMOs / PPOs. 4. Strong interpersonal and communication skills required. Ability to speak and present in front of groups required. 5. Detail oriented, strong analytical skills with the ability to multi task and prioritize required. 6. A working knowledge of Microsoft Office applications, ability to develop reports and create presentations. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents. III. Physical Demands and Environmental Conditions: Work is considered sedentary. Position requires work indoors in a normal office environment. **Travel required based on business need from campus to campus** All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ***********************************. We will make every effort to respond to your request for disability assistance as soon as possible.
    $64.1k-115.3k yearly Auto-Apply 44d ago
  • RN - Registered Nurse - Senior Clinical Documentation Improvement Specialist - CCDS Certification

    Geisinger Medical Center 4.7company rating

    Remote

    Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes The Clinical Documentation Improvement Program (CDI) is designed to improve the physician's documentation in the patient's medical record, supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. The role of the Clinical Documentation Improvement Specialist (CDIS) is to assist the providers with accurately identifying and documenting the healthcare services provided to the patient. This is accomplished with the recognition of complete and accurate diagnoses, procedures performed, and the treatment provided. The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded post discharge in a timely and accurate manner. A highly successful CDI program is based on a highly interactive process between physicians, CDIS staff and other support services. The program does not challenge the provider's medical judgement, but rather provides a methodology in which to clarify existing documentation. Acts as a liaison between the clinical and coding functions. Provides education to the medical staff and other clinical professional on documentation relevant to the Revenue Management processes and Discharge Not Final Billed reduction. Provides daily interactions with physicians and clinical professionals regarding documentation clarification and optimization. It is expected that the CDIS have previous clinical skills, including an understanding of Anatomy and Physiology in order to appropriately discuss with the physician such issues as the underlying etiology, principal diagnosis, diagnostic studies, treatment modalities, to name a few. The essential focus of this position is to analyze the clinical information, using the documentation as the primary driver for overall System Case Mix Index. Job Duties: Applicants must currently hold the required CDI certification in order to be considered for this position. Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP). This is a work from home position. The position is full-time, 40 hours weekly; Dayshift; Monday through Friday. Candidates must hold a Registered Nurse license in Pennsylvania or a Multistate License. A minimum of 3 years RN work experience is required; BSN is strongly preferred. Benefits at Geisinger: We offer a comprehensive benefits package starting on day one, including: Health, dental, and vision insurance Three medical plan choices, including expanded network options Pre-tax savings plans (FSA & HSA) Company-paid life, short-term, and long-term disability insurance 401(k) with automatic Geisinger contributions Generous PTO that accrues quickly Up to $5,000 in tuition reimbursement per calendar year MyHealth Rewards wellness program with financial incentives Family-friendly support: adoption/fertility assistance, parental leave, military leave, and Care.com membership Employee Assistance Program (EAP): mental health, legal guidance, childcare/eldercare referrals, and more Voluntary benefits: accident, critical illness, hospital indemnity, identity theft protection, pet insurance, and more The Senior CDI Specialist improves the physician's documentation in the patient's medical record, supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. Assists the providers with accurately identifying and documenting the healthcare services provided to the patient. The position will, through ongoing education, support the improvement and continue to sustain clinical documentation related to relative patient acuity, risk reduction, ad overall improvement and accuracy of Case Mix Index. Acts as documentation liaison to physician staff as a means of finalizing information in the medical record. Job Duties: Reviews inpatient medical records within 24-48 hours of admission for a specified patient population to: evaluate the documentation in order to assign the principal diagnosis, relevant secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality, severity of illness Formulates queries when it is determined there is missing documentation, conflicting documentation or unclear documentation. Attends physician rounds on assigned units, as well as interdisciplinary team meetings as appropriate to daily patient assignment. Provides on-going education to physicians and essential healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the patient's record. Collaborates with the nursing staff, clinical nutrition, pharmacist, along with the physicians on documentation in an attempt to resolve queries prior to the patient's discharge. Identifies strategies for sustained work process changes that facilitate complete, accurate clinical documentation. Maintains the confidentiality of all information acquired, pertaining to the patient, physician, associates, and visitors to Geisinger. Promotes a partnership with the Inpatient Coding staff, to provide clinical education, to assure documentation of discharge diagnosis and any secondary diagnoses' to reflect the accuracy of the patient's clinical status and care. Acts as a resource person for the interdisciplinary team in order to promote collaboration and coordination of patient care considering age specific, developmental, cultural, and spiritual needs of the patient. Complies with established hospital and Department Policies, Procedures Assists the Director with daily organization of CDI work flow at all Geisinger facilities. Communicates and partners with the CDI Director regarding issues in need of a coordinated resolution. Position Details: Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position. Education: Bachelor's Degree-Healthcare Related Degree (Required) Experience: Minimum of 3 years-Nursing (Required) Certification(s) and License(s): Basic Life Support Certification - Default Issuing Body, Certified Clinical Documentation Specialist - Default Issuing Body, Clinical Documentation Improvement Practitioner - Default Issuing Body, Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania Skills: Communication, Computer Literacy, Medical Records Management, Medical Records Systems, Teamwork, Working Independently OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
    $63k-79k yearly est. Auto-Apply 47d ago
  • AR Specialist I - REMOTE

    Umass Memorial Health 4.5company rating

    Worcester, MA jobs

    Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Non-Exempt Hiring Range: $19.74 - $30.80 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: 8-430 Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5436 Med Specs Ancillary Pod Ar Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Responsible for follow-up of complex claims for payment. I. Major Responsibilities: 1. Calls insurance companies and utilizes payor web-sites while working detailed reports to secure outstanding payments. 2. Reviews rejections in assigned payors and plans to determine validity of rejection and takes appropriate action to resolve the invoice. 3. Calculates and posts adjustments based on third party reimbursement guidelines and contracts. 4. Makes appropriate payor and plan changes to secondary insurers or responsible parties. 5. Inputs missing data as required and corrects registration and other errors as indicated. Standard Staffing Level Responsibilities: 1. Complies with established departmental policies, procedures and objectives. 2. Attends variety of meetings, conferences, seminars as required or directed. 3. Demonstrates use of Quality Improvement in daily operations. 4. Complies with all health and safety regulations and requirements. 5. Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. 6. Maintains, regular, reliable, and predictable attendance. 7. Performs other similar and related duties as required or directed. All responsibilities are essential job functions. II. Position Qualifications: License/Certification/Education: Required: 1. High School Diploma Experience/Skills: Required: 1. Previous Revenue Cycle knowledge in one of the following areas including PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding and/or 3rd party Reimbursement. 2. Ability to perform assigned tasks efficiently and in timely manner. 3. Ability to work collaboratively and effectively with people. 4. Exceptional communication and interpersonal skills. Preferred: 1. One or more years of experience in health care billing functions. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents. III. Physical Demands and Environmental Conditions: Work is considered sedentary. Position requires work indoors in a normal office environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ***********************************. We will make every effort to respond to your request for disability assistance as soon as possible.
    $19.7-30.8 hourly Auto-Apply 3d ago
  • Compliance Auditor Senior - Healthcare Legal and Regulatory (Eastern United States resident)

    Geisinger Medical Center 4.7company rating

    Remote

    Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes The Senior Compliance Auditor ensures the integrity and accuracy of facility and professional compliance audits, monitoring, and provides compliance education for facility and professional documentation, coding, and billing. The Senior Compliance Auditor serves as a mentor for Compliance Auditors and assists management with the onboarding process for new Compliance Auditors. This position requires the use of judgement and critical thinking skills to determine appropriate corrective actions for non-compliance and ensure corrective actions are fully implemented by the entity service line area. Job Duties: One of the following coding or auditing certifications are required (CCS, CPC, RHIA, RHIT or CPMA). Performs scheduled facility and/or professional audits on the adequacy of medical record documentation to support coding (DRG, CPT, ICD 10) and billing as required by the Compliance work plan reflecting scheduled activities and target dates. Performs audits resulting from unplanned investigations. Q/A work products of peers and serve as a mentor for compliance staff. Serves as primary lead for facility/professional billing compliance education, including auditing, trending, providing audit feedback to facility/professional coding staff and providers working in the hospital and office setting. Coordinates the development and implementation of corrective action and improvement plans with critical attention to performing a root cause analysis. Prepares responses to governmental audits, evaluate findings, and manage the appeals process. Assess compliance risk areas across Geisinger entities and assist with creating the Compliance Department's work plan. Performs research as needed to ensure organizational compliance with all applicable coding and diagnostic guidelines. Provides compliance guidance to Geisinger staff and serve as an institutional resource for Geisinger leadership, management and medical staff with a focus on federal payor billing compliance. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. #LI-REMOTE Position Details: Education: Associate's Degree-Related Field of Study (Required) Experience: Minimum of 7 years-Related work experience (Required) Certification(s) and License(s): Skills: Communication, Critical Thinking, Medical Billing and Coding, Organizing, Problem Solving, Training and Education OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
    $58k-76k yearly est. Auto-Apply 23d ago
  • Licensed Therapist (LICSW/LMFT/LMHC), Adult Mental Health - Remote, Fee For Service, Various Shifts

    Umass Memorial Health 4.5company rating

    Northbridge, MA jobs

    Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Hiring Range: $30.76 - $55.36 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: Flexible Shift: 4 - Mixed Shift, 8 Hours (United States of America) Hours: 0 Cost Center: 25080 - 4263 Outpatient Mental Health Svcs This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Provide quality treatment to patients within Behavioral Health Services. I. Major Responsibilities: 1. Provide individual & group therapy to patients with varied mental health/ co-occurring disorders. 2. Responsibilities include completing initial assessments, counseling, group therapy, case presentations to the treatment team, treatment planning, and aftercare planning. 3. Clinicians are also responsible for identifying the need for medication evaluations and making referrals to the on-site providers. 4. Complete all documentation and paperwork specific to the department and in compliance with hospital requirements, DMH, BSAS, The Joint Commission, and insurance providers. 5. Responsible for managing caseload which may include consultations, collateral contact, and following up with the patient on missed appointments. 6. Maintain independent professional licensure and maintain credentialing necessary for specific role. Standard Staffing Level Responsibilities: (STANDARD UMMH) 1. Complies with established departmental policies, procedures, and objectives. 2. Attends variety of meetings, conferences, seminars as required or directed. 3. Demonstrates use of Quality Improvement in daily operations. 4. Complies with all health and safety regulations and requirements. 5. respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. 6. Maintains, regular, reliable, and predictable attendance. 7. Performs other similar and related duties as required or directed. All responsibilities are essential job functions. II. Position Qualifications: License/Certification/Education: Required: 1. Graduation and training from an accredited graduate (Masters) program. 2. Active unrestricted independent license by the Massachusetts Board of Registration: LICSW/LMHC/LMFT/Licensed Clinical Psychologist. Experience/Skills: Required: 1. 2+ years of experience working within the Human Services field. 2. Strong diagnostic skills and abilities. 3. Must have strong and effective communication, organization and time management skills. 4. Must be able to work as part of a robust multi-disciplinary clinical team. Preferred: 1. 2+ years of experience working within behavioral health and/ or addictions treatment. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents. III. Physical Demands and Environmental Conditions: Work is considered sedentary. Position requires work indoors in a normal office environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ***********************************. We will make every effort to respond to your request for disability assistance as soon as possible.
    $30.8-55.4 hourly Auto-Apply 46d ago
  • Abdominal Imaging Opportunities (Remote or Onsite)

    Geisinger 4.7company rating

    Danville, PA jobs

    Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes For over a century, Geisinger has been dedicated to caring for our communities-not just through exceptional healthcare, but by fostering meaningful connections and treating every individual with dignity and respect. Now, we're inviting passionate radiologists to join our dynamic Cardiothoracic/Body/Abdominal Imaging team. As part of our team of 80+ radiologists and advanced practitioners, you'll thrive in an academic environment that supports teaching and mentorship of residents, fellows, and medical students. Whether you prefer working remotely or onsite, you'll enjoy a collaborative culture, cutting-edge technology, and a favorable call schedule. Job Duties: Join a team of 20 radiologists across the Geisinger system Practice all aspects of Abdominal Imaging: MR, CT, Ultrasound, and GI Fluoroscopic studies Access to state-of-the-art imaging tools including 3T MRI and TeraRecon thin client Dedicated 3D Lab & 3D Printing capabilities Participate in multidisciplinary conferences Work in a diverse and inclusive environment Position Details: Competitive compensation and incentive package Comprehensive benefits starting day one: medical, dental, vision, and pharmacy Generous time off: PTO, holidays, CME time and allowance Retirement plans: 401(k), Roth TSA-403(b), 457(b) Paid malpractice insurance with tail coverage Full relocation assistance for qualified candidates #NCHN Education: Doctor of Medicine or Doctor of Osteopathic Medicine- (Required) Experience: Certification(s) and License(s): Licensed Medical Doctor - State of Pennsylvania Skills: Patient Care And Procedural Skills, Professional Etiquette, Systems-Based Practice OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
    $59k-85k yearly est. Auto-Apply 60d+ ago
  • Research Contracts Specialist

    Geisinger Medical Center 4.7company rating

    Remote

    Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes The Research Contracts Specialist position supports principal investigators, research teams, and other internal customers by drafting, reviewing, and negotiating contractual agreements related to research projects. Job Duties: Drafts, reviews, and negotiates research contracts in collaboration with legal and other system teams, including but not limited to, clinical trial agreements, data sharing agreements, sponsored research agreements, material transfer agreements, confidential disclosure agreements, consulting agreements, research participation agreements, and master service agreements as they relate to Research and Sponsored Projects. Coordinates and requests the establishment of research study awards for accounting, monitoring, and informational purposes. Performs coverage analysis for clinical studies, including billing determination review and Medicare coverage analyses to ensure regulatory compliance. Creates clinical research study budgets collaboratively with study teams and negotiates with industry and other sponsors/external entities. Guides in use of fair market value rates for external contracts, as applicable. Performs reconciliation between contracts, budgets, billing documents, and informed consent forms prior to full IRB approval to ensure all documentation is accurate and consistent prior to study startup. Maintains an understanding of current local, state, federal, and institutional regulations pertinent to research agreements, as well as industry best practices and trends related to clinical trials and sponsored research. Understands Geisinger legal and contractual standards and collaborates closely with other contract teams across the organization. Develops and implements best practices related to contract management and negotiation processes. Maintains active partnerships with the Office of Research Compliance, IRB Operations, Research Finance, Insurance Risk Services Corporate Office, Research Cores, Legal, Supply Chain and other key stakeholders. Provides risk assessment in terms of contractual language, and financial success to study teams and leadership for decision making. Monitors timelines and communicates with study teams and external partners to ensure goals can be met. Assist with the development, presentation, and implementation of educational materials related to research contracts operations for principal investigators, project managers, and study teams. Develops and reports research contracts metrics to research leadership. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and/or Master's degree obtained (Master's Degree = 2 years relevant experience). Position Details: Education: Bachelor's Degree- (Required) Experience: Minimum of 3 years-Relevant experience* (Required) Certification(s) and License(s): Skills: Communication, Multitasking, Organizing, Research Regulatory Environment, Teamwork OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
    $54k-81k yearly est. Auto-Apply 60d+ ago
  • Coder VI Specialist-Hospital Inpatient

    Franciscan Health Indianapolis 4.1company rating

    Remote

    Work From HomeWork From Home Work From Home, Indiana 46544The Coder VI Specialist- Hospital Inpatient analyzes the ICD 10 codes, suggested by computer assisted coding software, to ensure they align with official coding guidelines and the electronic medical record documentation. In collaboration with the Clinical Documentation Specialist, analyzes the circumstances of the visit to determine the most accurate diagnosis related group (DRG). This position also abstracts key data elements necessary for billing and data analysis. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Accurately reviews and codes patient records in the following clinical areas: hospital inpatient services. Reviews and analyzes the content of medical records and the autosuggested computer assisted codes (CAC) for the appropriate assignment of ICD diagnosis/procedure codes, present on admission indicators, hierarchical condition categories, complication and comorbidities in the proper sequence in accordance with official coding resources resulting in an accurate DRG assignment. Auditing the accuracy of the CAC software autosuggested codes. Reviews clinical documentation to validate accurate representation of the patient's clinical picture, treatment, and diagnoses. Identifies when documentation relevant to the coding process is missing, lacks specificity or is inconsistent and take steps to obtain the documentation. Identifies and enters data elements for abstracting. Meets defined coding accuracy standards. Meets defined coding productivity standards. Basic understanding of how natural language processing engine works. Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability. Understands how diagnosis and procedure codes, and reimbursement methodologies are used to determine reimbursement, public reporting of outcomes, quality of patient care, financial modeling, strategic planning, and marketing. Remains current with coding and industry changes through participation in educational opportunities to maintain coding credentials. Demonstrates a thorough knowledge of hospital inpatient coding guidelines, medical terminology, anatomy/physiology, and payer specific coding guidelines. Notifies coding leadership of trends and topics for education and feedback to physicians and departments. Assists with identification and implementation of process improvements, according to industry best practice standards, to make the best use of resources, decrease costs and improve coding services across the specialized service lines. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines. Qualifications Required High School Diploma/GED Preferred Associate's Degree Health Information Management Preferred Bachelor's Degree Health Information Management 2 years Coding Required Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Coder VI Specialist - Hospital Inpatient $22.70-$33.77INCENTIVE: EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
    $32k-38k yearly est. Auto-Apply 19d ago
  • Specialty Pharmacy Clinical Pharmacy Specialist

    Franciscan Health Indianapolis 4.1company rating

    Michigan City, IN jobs

    Franciscan Health Michigan City Campus3500 Franciscan Way Michigan City, Indiana 46360 The Clinical Pharmacy Specialist provides comprehensive pharmacotherapy services for patient populations, responds to complex drug therapy issues, and provides leadership to improve medication use. The Specialist leads education efforts for Clinical Staff Pharmacists, Pharmacy Students, Pharmacy Residents, and other healthcare professionals. This position collaborates with other Franciscan Alliance medical staff and facilities to achieve best practices and optimal outcomes for all patients. REMOTE POSITION. POSSIBLE ONSITE WORK AT FRANCISCAN HEALTH MICHIGAN CITY. MUST HAVE ACTIVE INDIANA PHARMACIST LICENSE. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Collaborate with allied health disciplines to provide quality patient care. Consult with and advise other Healthcare professionals and patients on matters pertaining to selection, procurement, distribution, and safe and appropriate use of medications. Coordinate and deliver ongoing staff education for clinical staff pharmacist. Direct and precept students and/or residents. Lead cost effective formulary management initiatives. Review adverse events related to the medication use process, recommend improvements to the medication use process, as needed, and ensure improvements are implemented. Review literature and publications in area of specialization, and recommend improvements to the medication use process. Review prescriptions and medication orders, check for appropriateness, and provide information needed to properly and safely administer the medication. Attend and participate in local and system-wide committees to improve the medication use process. Draft, review, and revise medication related policies, procedures, guidelines and protocols. Provide clinical pharmacy services as outlined in approved hospital policies, including but not limited to: pharmacokinetic consults, renal dosing, parenteral nutrition management, anticoagulation management, neonatal/pediatric/geriatric dosing management, route optimization, antimicrobial stewardship, and reviewing medications at transitions of care. QUALIFICATIONS Required Bachelor's Degree Pharmacy Preferred Doctorate Pharmacy 1 year PGY1 Pharmacy Residency Required 3 years In area of specialization Required 1 year PGY-2 Pharmacy residency Preferred Registered Pharmacist (RPh) - State Licensing Board Board Certified in applicable area of specialty or pharmacotherapy (if specialty area not available) - . Required within 24 months Basic Life Support Program (BLS) - American Heart Association As required by unit TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Clinical Pharmacy Specialist $128960.00-$153140.00INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
    $71k-122k yearly est. Auto-Apply 60d+ ago
  • Care Coordinator IV

    Presbyterian Healthcare Services 4.8company rating

    Las Cruces, NM jobs

    Presbyterian is seeking a Care Coordinator IV. The Care Coordinator facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, member s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes * This is a Full Time position - Exempt: Yes * Job is based at Las Cruces, NM * Remote work from home: this job is intended to be conducting in the state of New Mexico. * Work hours: Weekday Schedule Monday-Friday Ideal Candidate: * Must have a valid driver license, clean driving record and able to travel locally. * Experience in utilization management, home care, community health, long term care or occupational health required. Qualifications * Masters degree & 4 years of exp, Bachelors degree and 8 yrs of exp, Associates degree and 9 years of exp, 12 years of exp may be utilized in lieu of other education and experience reqs. * Proficiency in Microsoft Word, Excel and Outlook required. * Experience in analyzing trends based on decision support systems. * Business management skills to include, but not limited to, cost/benefit analysis,negotiation, and cost containment. * Knowledge of referral coordination to community & private/public resources. Responsibilities * Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across thecontinuum. Collaborates with the Interdisciplinary Care Plan Team which may include member, caregivers, members legal representative, physician, care providers, andancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term careservices. * Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but not limited to psycho-social, physical, medical, behavioral,environmental, and financial parameters. * Provides care coordination to members with chronic or complex conditions which require intensive interventions and oversight include multiple, clinical, social and communityresources. Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes. * Develops and communicates plan for authorization of services, and serves as point of contact to ensure services are rendered appropriately, (i.e. during transition to homecare, back up plans, community based services). * Conducts face to face home visits, as required, * Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; collects clinical path variance data that indicatespotential areas for improvement of case and services provided; works with members and the interdisciplinary care plan team to adjust plan of care, when necessary. * Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Generates reports in accordance with care coordination goals. Benefits About Presbyterian Healthcare Services Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits. The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift to earn gift cards and other incentives. As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships. Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to USD $49.26/Hr. Compensation Disclaimer The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
    $33k-48k yearly est. Auto-Apply 21d ago
  • Data System Engineer III

    Franciscan Health Indianapolis 4.1company rating

    Remote

    Work From HomeWork From Home Work From Home, Indiana 46544 We are seeking a Site Reliability & DevOps Systems Engineer to design, automate, and maintain the infrastructure supporting our enterprise data and analytics platforms, including Power BI, Tableau, Databricks, and Epic Cogito. This role bridges systems engineering, DevOps development, and data operations - ensuring our analytics ecosystems are resilient, automated, secure, and high-performing. You will manage Azure DevOps and GitHub environments for CI/CD, infrastructure-as-code (IaC), and environment deployments, while collaborating with BI, data engineering, and cloud teams to standardize and optimize platform operations. Data Systems Engineer III (DSE) is responsible for making intuitive, high-level decisions in designing data analytics infrastructure to extract and organize data for authorized individuals to access. Responsibilities include identifying a company's internal and external data sources, collaborating with department heads to determine their data needs and using the information to create and maintain data analytics infrastructure for company employees. Is responsible for software design and implementation for the development team. The Architect will design and develop a unified vision for software characteristics and functions, with the goal of providing a framework for the development of software or systems that result in high-quality IT solutions. DSE III takes direction and guidance from lead data systems architect and department leadership to work towards enhancement of self and the team's capabilities around data and analytic competencies. Mentors junior architects and guides users across the organization to promote data education and a data-driven culture in all aspects of clinical and business operation. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Facilitate the establishment and execution of the roadmap and vision for information delivery and management; including the modernizing the data platforms, on-prim and cloud data, BI & analytics, content management and data management Work with stakeholders to understand their vision, challenges, and pain points. Work with data and analytics experts to strive for greater functionality in our data systems; consults with data systems management teams to get a big-picture idea of the data needs. Conduct detailed assessments of the data landscape including data platforms, technology architecture, data flows, data consumption, data integration and documentation Identifying installation solutions for new databases; determining the requirements for a new database. Develop future state architecture and process/data flows to realize the modern data strategy Design modern data supply chain, and evaluate and recommend new tools and technologies Guide the decision making of selecting cloud vs on-premise environments and assist with cloud service provider selection Document and present data strategies to stakeholders, gain buy in, and grow strategic relationships Assist in the development of capability roadmaps Identifying areas for improvement in current systems; participate in setting objectives and scope, and developing a roadmap for the data initiatives that support the client leadership in meeting their objectives Auditing database regularly to maintain quality; creating systems to keep data secure Own the technical relationship with the client, be a technical subject matter expert and principal data evangelist across the planning efforts that intersect the data discipline. Educate clients and internal constituents on the available technologies and general best practices. Mentor others as they build complex strategy and solutions Provide specialized expertise, cross-industry perspective, and thought leadership in big data, cloud, enterprise information management, and other next generation technology offerings Provides maintenance and support; performs other duties, as assigned. Qualifications Required Bachelor's Degree Business, Computer Science, Engineering, Information Systems, Public Health, or related field Preferred Master's Degree Computer Science, Business, Healthcare Management, Information Systems, or related field 6 years Systems, Application, and/or Database platforms administration experience with platforms such as Epic, SQL Server, Tableau, SAS, BusinessObjects etc. Experience architecting data management, analytics, business intelligence and application integration solutions. Required TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Data Systems Engineer III $82,931.74 - $114,031.14INCENTIVE:Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
    $83k-107k yearly est. Auto-Apply 53d ago

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