Presbyterian Remote jobs - 270 jobs

9521 San Mateo NE , Albuquerque, New Mexico 87113-2237, United States of America Compensation Pay Range: Minimum Offer $: 67100.8 is up to $: 102460.8 Now hiring a Cost Strategy Analyst - Cost Accounting - Remote Eligible Summary: Cost Strategy Analysts (CSAs) design, develop and deploy new methodologies, algorithms, maintenance and quality review in support of the cost accounting application. Join a workplace where compassion meets purpose! Type of Opportunity: Full time Job Exempt: Yes Job is based : Reverend Hugh Cooper Administrative Center Work Shift: Days (United States of America) Responsibilities: This fascinating senior-level healthcare accounting position combines both strategic and operational elements in the creation of new and innovative techniques to calculate patient-level cost. This position leads planning sessions and serves as an expert resource and educator to staff and leadership regarding proper development and use of cost data. The CSAs securely manage highly confidential information (both at the patient and employee level) as well as a variety of long and short-term projects, functioning as subject matter experts and key individual contributors. They interface with internal business units and external entities to manage requirements gathering and development of standards while collaborating with all levels of the organization. Some key responsibilities: Strategy: Analyze business challenges/problems requiring strategic cost planning effort for new and changing opportunities. Demonstrate expert analytical/problem solving skills and in-depth understanding of the business and systems to identify and develop innovative strategic cost initiatives, and to remediate and resolve complex design issues and problems within the application. Provide and coordinate analytics for strategic costing initiatives identified by the VP of Finance and other stakeholders. Participate in cost strategy sessions and vet ideas of the strategy team and stakeholders. Facilitate discussions and provide recommendations regarding proper development and use of cost data. Design, develop and deploy new methodologies and algorithms to calculate patient level costs in response to changing and future business requirements. 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 Qualifications: Bachelors degree in finance, accounting or relevant field required. 8 (eight) years of cost accounting experience required. Cost accounting experience in a health care delivery organization is preferred. 6 (six) years experience to include configuration, maintenance, modeling and analytics within a leading cost accounting system (e.g., EPSi, Oracle, TSI, Strata, Siemens, Avega, Cost Plus, Axiom, MedAssets). Competent with business intelligence analytical tools (e.g., Business Objects, SAS, relational databases). Analytical experience in cost planning, cost strategy, cost development, operations, and/or finance. Strong business acumen and technical knowledge. Combination of technical, financial, and business knowledge and experience. Intermediate to expert MS Office skills with emphasis on Excel, Access and PowerPoint. Excellent written and oral communication and presentation skills. All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. 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. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are 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 1600 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. We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: No We are seeking a dynamic Wellness Associate to lead and support community and facility-based health initiatives. This role involves developing and implementing wellness programs, facilitating evidence-based activities, and providing on-site screenings and education. The successful candidate will reside within the geographic area to actively participate in on-site events and community engagement. The position requires flexibility, including early mornings, some evenings, and occasional weekends to support programs and events. Responsibilities include program design, outcome reporting, event coordination, and collaboration with internal teams and community partners. The successful candidate will reside within the geographic area to actively participate in on-site events and community engagement. Job Duties: 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. 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: Bachelor's Degree-Healthcare Related Degree (Required) Experience: Minimum of 1 year-Related work 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.

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.

Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Non-Exempt Hiring Range: $20.94 - $33.59 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: 8:00am - 4:30pm Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5478 Financial Clearance 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 assessing and verifying patient information for scheduled for medical services. This requires verification of patient's demographic, financial and insurance information. Collects co-pays, deductibles, coinsurances, and down payments. Provides estimates for services when appropriate. Receives and processes patient financial liability payments for current and past balances. The focus is to collect patient liabilities prior to service and to resolve any insurance and financial issues prior to services being rendered. Reschedules appointments when appropriate under the guidance of department leader. This position is the front line for customer service, pre-registration and access to care for scheduled services. I. Major Responsibilities: 1. Initiates contact with insurance companies to obtain eligibility, gather accurate patient billing information, and performs collections with outstanding accounts receivable. 2. Accurately estimates the patient financial liability (copayments, deductibles, coinsurances, deposits, etc. via obtaining accurate demographic and financial information). Answers patient inquiries regarding their liability and able to explain the variables involved. 3. Receives and processes patient payments. 4. Ensures pre-certification authorization and or referral is in placement prior to service being rendered. 5. Appropriately referring patients to Financial Counselors or Business Office dependent on need of patient. 6. Reschedules appointments when requested by patient or, under advisement of department leader, when due to financial circumstances appointment requires postponement. 7. Enters clear, concise notes concerning financial clearance status in system based on communications. 8. Demonstrate knowledge and understanding of all job-related policies and procedures and adheres to and consistently applies the Financial Clearance Policy in all patient cases. 9. Assesses gaps in patient coverage to determine patient financial exposure prior to rendering service. 10. Consistently demonstrates ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary. 11. Performs other duties as assigned, or directed, to ensure smooth operation of the department/unit. II. Position Qualifications: License/Certification/Education: Required: 1. Minimum High School Diploma, or G.E.D., business concentration preferred. Preferred: 1. Associate degree, or higher, preferred. Experience/Skills: Required: 1. Four plus (4+) years of experience within a business office setting, hospital revenue cycle preferred, Physician office or collection agency. 2. Prior experience in a healthcare environment required. Preferred: 1. Working knowledge of personal computers and business office applications preferred. 2. Familiarity with hospital computer systems is a plus. 3. Knowledge of third party collections and reimbursement preferred. 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: On-the-job time is spent in the following physical activities: 1. Stand - 1/3 2. Walk - 1/3 3. Sit - 2/3 4. Talk or hear - 2/3 5. Uses hands to finger, handle or feel - 2/3 This job requires that weight be lifted, or force be exerted: 1. Up to 10 pounds - 1/3 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.

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, Certified Coding Specialist from American Health Information Management Association (AHIMA) - Required or CPC, Certified Professional Coder from the American Academy of Professional Coders (AAPC) - Required or CCS-P, Certified Coding Specialist - Physician from the American Health Information Management Association (AHIMA) - Required RHIT, Registered Health Information Technician from American Health Information Management Association (AHIMA) - Preferred or RHIA, Registered Health Information Administrator from American Health Information Management Association (AHIMA) - 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.

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.

Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes Geisinger seeks an outstanding researcher to serve as a Staff Scientist/Biostatistician for the newly created Geisinger Program Evaluation (GPE) team, whose purpose is to conduct rigorous evaluations of potentially high-impact programs intended to improve patient health or improve efficiency at Geisinger. The GPE Staff Scientist/Biostatistician will be responsible for helping lead rigorous, primarily non-randomized (or partially randomized) evaluations of existing or new programs at Geisinger. The Staff Scientist will help lead or participate in study design, analysis (preferably using R), and reporting/dissemination of results to internal stakeholders (e.g., Geisinger leaders) as well as to academic audiences (e.g., at conferences and in academic publications). Evaluations from GPE team members have been published or are forthcoming in high-impact journals, including PNAS, Nature Human Behaviour, JAMA Network Open, and The Journal of Pediatrics. Additionally, the Staff Scientist will coordinate with other team members (e.g., Staff Scientist, Data Analyst, Project Manager). The Staff Scientist/Biostatistician will report to the GPE Associate Director, Neal Goldstein, PhD, under the GPE Director, Amir Goren, PhD, with oversight by Faculty Co-Directors, Christopher Chabris, PhD, and H. Lester Kirchner, PhD. The Staff Scientist will also collaborate with the Behavioral Insights Team (BIT). The BIT was created in 2018 to apply behavioral science methods to the design, implementation, and experimental evaluation of programs and lightweight behavioral interventions intended to improve outcomes and experiences for patients, clinicians, employees, and other stakeholders of Geisinger and other health systems. The BIT now collaborates on randomized prospective evaluations as part of GPE. It is led by Professors Michelle Meyer, PhD, JD, and Christopher Chabris, PhD, the founding Faculty Co-Directors, and Program Director Gail Rosenbaum, PhD. The ideal candidate will have expertise in field(s) related to biostatistics, epidemiology, health economics, and/or health services research in a healthcare, academia, or industry setting, as well as strong methodological training in causal inference using non-randomized (quasi-experimental and observational) study designs. A Ph.D. in biostatistics, epidemiology, health economics, public health, or another relevant scholarly discipline is strongly preferred, with track records of publishing original empirical research, collaborating with others, and disseminating work to technical and non-technical audiences. The GPE Staff Scientist/Biostatistician will be based in Danville, Pennsylvania at the main campus and headquarters of Geisinger. Remote work from another U.S. location (with occasional travel to Danville) may be possible for an exceptional candidate. Geisinger is a large, integrated health services organization founded in 1915. Through its 11 hospital campuses, the Geisinger Health Plan, and the Geisinger College of Health Sciences, which includes the Clinical Education Institute and Research Institute, the Geisinger Commonwealth School of Medicine (GCSOM), and the Geisinger School of Nursing, Geisinger serves more than 1 million residents throughout 46 counties in central, south-central, and northeastern Pennsylvania. The system includes over 26,000 employees, including over 1,700 employed physicians, while Geisinger Health Plan serves over 550,000 members. Geisinger's main campus in Danville, PA, is located within a three-hour drive of New York City, Philadelphia, and Washington, DC. This GPE reports up to the Research Institute within the Geisinger College of Health Sciences. The Research Institute is engaged in investigating a broad range of research topics, including genomics, population health, and bioethics and decision sciences, using a broad range of methods, including data science and informatics, implementation science, and health services research. Research at Geisinger benefits from the system's nearly 30 years of electronic health records, its clinical and genomics data warehouses, and its large, stable patient population. Geisinger's research environment involves over 400 team members including more than 40 research faculty and a growing number of clinicians and learners engaging in collaborative research. In 2024, Geisinger was awarded $41 million in external grant and contract funding, carried out more than 1,400 research studies, including clinical trials, and published over 1,400 scientific articles. Job Duties: Major duties and responsibilities: Assisting the Associate Director in day-to-day operations and development of the GPE Liaising, initiating, and coordinating execution of projects with internal and external stakeholders; this includes Geisinger groups such as clinical departments, the IRB, and the compliance, quality, and legal functions Providing expert level biostatistical knowledge - theoretical and applied - to observational study design and analytic methodologies Staying abreast of methodological developments for program evaluation in healthcare Contributing to or leading manuscript drafting and submission for select evaluation studies (first-author opportunities available) Participating in the design of interventions for evaluation and implementation at Geisinger Participating in data management, analysis, visualization, and reporting to assess the effectiveness of Geisinger programs, including assessing their effects on patient and other outcomes and quantifying the associated costs and return on investment Engaging in open science best practices (e.g., preregistration, preparing and sharing de-identified data and code) Disseminating GPE findings at scientific conferences and to lay audiences (e.g., sharing findings with Geisinger leaders) Required qualifications: Experience using statistical software (preferably R, others acceptable) Training in advanced, quasi-experimental and observational statistics Strong critical thinking skills Curiosity and problem-solving skills to proactively identify solutions to pragmatic challenges in a complex healthcare system environment Ability to work in an independent manner and complete increasingly complex assignments Strong teamwork skills and the ability to work effectively in a group environment Exceptional organizational, planning, and analytical skills Competence in written, oral, and electronic communication skills (interpersonal/communication and technological effectiveness competencies) Desired qualifications: Experience implementing applied research in a healthcare and/or relevant industry setting Experience with open science best practices Training in program evaluation or health services research Experience with econometrics Experience with epidemiology Experience with implementation science Experience in interdisciplinary research and working in collaborative teams Experience in the healthcare industry or academia Experience with programming and databases (e.g., Python, SQL) Education and/or experience: A Ph.D. in biostatistics, epidemiology, health economics, public health, but exceptional candidates with other credentials will be considered Graduate training in non-randomized causal inference methods, including quasi-experimental and observational study designs Minimum 3 years' post-graduate experience managing healthcare or other research projects and supervising or otherwise collaborating actively in a team setting Scholarly publications 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: To apply: Please send a cover letter, C.V. or resume, and two representative scholarly publications in a single email to ****************************************. Please also include names, titles, and contact information for three references (we will contact you before reaching out to your references). Questions about the position may also be sent to the same address. Review of applications will begin immediately and will continue until the position is filled. Dr. Goren: ******************** Professor Kirchner: ***************************************************************************************************************** Professor Chabris: ********************** Education: Doctoral Degree- (Required), Doctoral Degree-Behavioral Science (Preferred) Experience: Minimum of 3 years-Related work experience (Required) Certification(s) and License(s): Skills: Reference Content, Research Analysis, Research And Development Function, Research Documents, Research Methodologies 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.

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.

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.

Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and contracted provider network. In partnership with Director, manages and coordinates the Provider Services activities for the state health plan. Works with direct management, corporate, and staff to develop and implement standardized provider servicing and relationship management plans. Job Duties Manages the Plan's Provider Relations functions and team members. Responsible for the daily operations of the department working collaboratively with other operational departments and functional business unit stakeholders to lead or support various Provider Services functions with an emphasis on contracting, education, outreach and resolving provider inquiries. • In conjunction with the Director, Provider Network Management & Operations, develops health plan-specific provider contracting strategies, identifying specialties and geographic locations on which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of the Plan's patients or members. • Oversees and leads the functions of the external provider representatives, including developing and/or presenting policies and procedures, training materials, and reports to meet internal/external standards. • Manages and directs the Provider Service staff including hiring, training and evaluating performance. • Assists with ongoing provider network development and the education of contracted network providers regarding plan procedures and claim payment policies. • Develops and implements tracking tools to ensure timely issue resolution and compliance with all applicable standards. • Oversees appropriate and timely intervention/communication when providers have issues or complaints (e.g., problems with claims and encounter data, eligibility, reimbursement, and provider website). • Serves as a resource to support Plan's initiatives and help ensure regulatory requirements and strategic goals are realized. • Ensures appropriate cross-departmental communication of Provider Service's initiatives and contracted network provider issues. • Designs and implements programs to build and nurture positive relationships between contracted providers, ancillary providers, hospital facilities and Plan. • Develops and implements strategies to increase provider engagement in HEDIS and quality initiatives. • Engages contracted network providers regarding cost control initiatives, Medical Care Ratio (MCR), non-emergent utilization, and CAHPS to positively influence future trends. • Develops and implements strategies to reduce member access grievances with contracted providers. • Oversees the IHH program and ensures IHH program alignment with department requirements, provider education and oversight, and general management of the IHH program Job Qualifications REQUIRED EDUCATION: Bachelor's Degree in Health or Business related field or equivalent experience. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: • 5-7 years experience servicing individual and groups of physicians, hospitals, integrated delivery systems, and ancillary providers with Medicaid and/or Medicare products • 5+ years previous managed healthcare experience. • Previous experience with community agencies and providers. • Experience demonstrating working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicare or Medicaid lines of business, including but not limited to: fee-for service, value-based contracts, capitation and delegation models, and various forms of risk, ASO, agreements, etc. • Experience with preparing and presenting formal presentations. • 2+ years in a direct or matrix leadership position • Min. 2 years experience managing/supervising employees. PREFERRED EDUCATION: Master's Degree in Health or Business related field PREFERRED EXPERIENCE: • 5-7 years managed healthcare administration experience. • Specific experience in provider services, operations, and/or contract negotiations in a Medicare and Medicaid managed healthcare setting, ideally with different provider types (e.g., physician, groups and hospitals). 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.

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.

Job Description SOUTHCOAST SEEKS A FULL-TIME EXPERIENCED ACCOUNTS RECEIVABLE PENDING INSURANCE REPRESENTATIVE ** ONCE TRAINING IS COMPLETE, REMOTE WORK IS LIKELY. Responsible for the collection of all outstanding pending insurance patient account balances and to resolve patient account issues in order to collect account balances according to department policies and procedures. Responsible for working with self-pay insurance staff to resolve patient account issues in order to collect account balances. Qualifications: Two years of Medical Billing Ability to concentrate and pay close attention to detail when reviewing patient financial data. Knowledge of 3rd party insurance processing. Knowledge of insurance terminology, insurance coverage and benefits. Knowledge of collection techniques. Ability to exercise professionalism in dealing with all levels of personnel, patients and patients' families. Ability to communicate clearly and concisely in person, in writing, or on telephone. Responsibilities: Responds promptly to, and handles all telephone inquiries received from physicians, patients or insurance companies. Processes correspondence in accordance with established Accounts Receivable Department policies and procedures. Coordinates collection process in accordance with established policies. Reviews, researches and resolves all claims denied by insurance companies. Re-files claims as required to receive payment. Reports to work on a regular and consistent basis. Education/ Experience: High school diploma or equivalent. Minimum of 2 years' experience in doctor's office or medical insurance company, preferably in accounts receivable or collections or claims area. Computer experience. Benefits: Health, HSA/FSA, dental, vision, life, long term disability, 401(K) with employer contribution, and voluntary insurance (i.e. critical illness, short term disability, life, identity theft, etc.) PTO, holidays, and bereavement leave. EEO, DFW, MFVD

Work From HomeWork From Home Work From Home, Indiana 46544 At Franciscan Health, the Certified Tumor Registrar (CTR) is a data information specialist responsible for the identification, collection, and management of health, medical, and outcome information on oncology patients. Primary responsibilities include abstracting and coding specific patient, cancer, and treatment information from numerous sources, as well as maintaining and updating existing patient records. WHO WE ARE Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. 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 who provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Abstract cancer-related data, according to ICD-10, American College of Surgeons, American Joint Commission On Cancer (AJCC), and other guidelines, to generate reports regarding cancer surveillance and improvement of care. Review patient cases, identify potential cases for the registry, and assess whether the case is reportable, is already reported, or could potentially be recorded in a file of non-reportable cases. Assist with monthly and annual data submissions and quality assurance reviews, to ensure compliance with the American College of Surgeons, American Joint Commission On Cancer (AJCC), and other guidelines. Facilitate and organize tumor board and other case conferences. Monitor, report, and record tumor registry activities, to ensure compliance with Commission On Cancer (CoC) and other accreditations. QUALIFICATIONS Associate's Degree required 1 year of Tumor Registry experience p referred Certified Tumor Registry (CTR) OR Oncology Data Specialist - Certified (ODS-C) required RHIA or RHIT p referred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Tumor Registrar $25.58 - $33.25INCENTIVE: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.

Work From HomeWork From Home Work From Home, Indiana 46544 The Supervisor of Denial Management oversees the daily operations of a team responsible for medical claim denial follow-up and underpayments, and all support activities associated with managing claim denials. This position assists management in maintaining the denial management system, workflows and analysis reporting including the collection and interpretation of patterns to quantify denial causes and their financial impact. The Supervisor of Denial Management collaborates with other system departments to apprise them of trends and process improvement opportunities, with a focus on preventing future claim denials. 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 Supervise the work of others and manage the performance of individuals through feedback and recommendations. Implement process innovations and works closely with Insurance Payers, Revenue Cycle leadership and Department Managers in revenue-producing departments to reduce denials and to improve upon the Revenue Cycle KPIs. Participate in people management activities for direct team members such as conducting performance evaluations, disciplinary actions, and interviews. Analyze reports and use software to track, trend and identify root causes of denials; offer suggestions for process improvement to resolve denial issues, supported by documentation and data. Coordinate department efforts with other departments to align interdepartmental functioning, strategic goals, and expectations. Develop and monitor a structured, organized workflow to ensure actions carried out consistently and accurately. Act as the first point of escalation within the team by acting as a coach and mentor. Prepare operational progress or status reports on a regular basis. Independently develop effective relationships with patients, hospital departments, and other external parties. Coordinate meetings and in-service training with Payor representatives and vendors. Develop reports, policies, procedures and training materials for employee training and business improvements. Ensure compliance with state and federal billing regulations. Review the final documentation for write-offs and adds avoidable write off language. QUALIFICATIONS Preferred Associate's Degree Required High School Diploma/GED 5 years Patient Accounting required 1 year Supervisory or leadership experience Preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Supervisor Denial Management $48,838.40-$72,675.20INCENTIVE: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.

Work From HomeWork From Home Work From Home, Indiana 46544 The Clinical Denial Specialist II functions as a hospital liaison to appeal denied claims for Medicare, Medicaid, Managed and Commercial insurance. This position entails detailed retrospective review via EPIC of patient medical records to analyze and compile data for additional documentation request and claim denials, using trends and patterns identified to support process improvement. 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 Schedule: Monday - Friday, 8am - 5pm Develop reports Review governmental contractor's response Identify underlying root causes for potential denials and works closely with departments and Clinical Documentation Integrity to reduce denials Write and ensure all appeals are filed in a prompt and timely manner for Medicare, Medicaid, Managed, and Commercials Payor Audit medical documentation for adherence to insurance and CMS guidelines relating to inpatient/observation services, or other denial issues Knowledge of inpatient criteria to establish medical necessity letters QUALIFICATIONS Active Indiana RN license required BSN or Associate's with 5 years of nursing experience required 3 years of denial experience required 5 years of nursing or case management experience preferred TRAVEL IS REQUIRED: Never or RarelyJOB RANGE:Clinical Denial Specialist II $52395.20-$77948.00INCENTIVE: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.

Work From HomeWork From Home Work From Home, Indiana 46544 The Corporate Coding Manager develops and implements coding strategies and provides operational leadership to manage and maintain efficient coding processes. This position supervises staff, prepares and forecasts budgets and strategic plans oversees quality assurance programs, and ensures regulatory compliance. 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 Provides oversight and leadership to the Coding Supervisors within the department, and manages the performance of coworkers through ongoing coaching, feedback, and development to motivate, engage and drive a high performing team. Oversees the auditing and education program to ensure accurate and compliant coding and billing practices. Makes decisions regarding changes to coding staff day-to-day functions; aligns all aspects of coding operations to align acute and ambulatory corporate initiatives, including standardized corporate coding policy and procedure development and enforcement. Participates in problem identification, performs root cause analysis, and develops a solution that produces expected outcomes and intended results. Assists with the development of the organizational wide standardization and implementation of a corporate coding compliance plan to include compliance with external regulatory and accreditation requirements. Creates an environment that coworkers want to work in and maintain a high level of coworker satisfaction. Serves as department liaison for regional meetings and projects and to other teams that interact with the coding team; assists with items specific to coding needs for planning of new department builds and department revisions. Assists the Coding Manager with inquiries/audits and denials from third party agencies related to coding. Function Purpose Orientation to coding fundamental support role in business operations in supporting the revenue cycle and how coding influences. (ex. Physicians, Clinical Operations teams, BPCI, quality measures Acts as a nosologist, analyzing and interpreting disease and 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. 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. Maintains expert knowledge of Franciscan Alliance coding software tools; assists with development and maintenance of software system workflow for standardization and maximum efficiency. 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. Director with development and manages departmental budgets, including making budget allocations, approving expenditures and ensuring expenses are within budget. 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 Associate's Degree Health Information Management - Required Bachelor's Degree Health Information Management - Preferred 4 years Coding Manager - Required 4 years Franciscan Coding Supervisor - Required 3 years Coding Experience - Required Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) - Required - OR - Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) - Required TRAVEL IS REQUIRED: Up to 20%JOB RANGE:Coding Manager $77,750.40 - $121,492.80INCENTIVE: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.

Work From HomeWork From Home Work From Home, Indiana 46544 The 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 review and code patient records in the following clinical areas: hospital acute inpatient services. Meet defined coding accuracy and production standards and demonstrate a thorough knowledge of coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, and Payor specific guidelines. Review and analyze the content of medical records to appropriately assign ICD diagnosis procedure codes, CPT procedure codes, and modifiers to meet coding guidelines. Notify coding leadership of trends and topics for education and feedback to physicians and departments. Identify and enter data elements for abstracting. Participate actively in performance improvement teams, projects, and committees. Serve as a Superuser and assist with system testing. Serve as a backup to coding reimbursement specialist. QUALIFICATIONS High School Diploma/GED - Required Associate's degree - Preferred 2 years Coding - Required CCS, Certified Coding Specialist from American Health Information Management Association (AHIMA) - Required or RHIT, Registered Health Information Technician from American Health Information Management Association (AHIMA) - Preferred or RHIA, Registered Health Information Administrator from American Health Information Management Association (AHIMA) - Preferred 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.

Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes Responsible for development, review and maintenance of contracts according to applicable regulations, policies and standards. Job Duties: Responsible for development, review and maintenance of contracts that (i) comply with applicable regulations, policies and standards; and (ii) contain complete and accurate terms and conditions of a business relationship that benefit the System by identifying, reducing, shifting or eliminating risk using department standards, professional discretion and independent judgment. Identifies and notifies management of potential operational, legal and financial issues and recommends alternatives throughout document development. Develops and manages the maintenance of contract template documents and/or reference materials to be utilized as an initial foundation to assist in the generation and review of commonly requested agreements and coordinates managing and maintaining accurate records of important contracting reference materials. Maintains precise documentation of contractual records and retention of resolutions for future situations. Manages all database requirements with respect to contracts. Monitors contract anniversaries for renewal and coordinates the renewal with the departments and any recommended or department requested renegotiation. Provides accurate inventory and filing of current and pending contracts awaiting completion. 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 degree obtained (Bachelor's Degree = 2 years). Position Details: Education: Graduate from Specialty Training Program- (Required), Associate's Degree-Related Field of Study (Preferred) Experience: Minimum of 2 years-Relevant experience* (Required) Certification(s) and License(s): Skills: Analytical Thinking, Customer Service, Investigative Skills, Legal-Contracts Review, Multitasking, Negotiation, Oral Communications, Researching, Team Player, Written 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.

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.