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Clinical Director jobs at Prime Therapeutics

- 544 jobs
  • Recent Graduate - Financial Services

    Farmers Insurance 4.4company rating

    Washington, DC jobs

    Recent Graduate - Financial Services Location: Litchfield, IL, 62015 Salary: $24000.0 - $100000.0/year Experience: 2 Year(s) We are seeking a passionate, self-driven, natural-born salesperson with a desire to make a difference in people's lives. You will be part of a team helping to grow the office's revenue by offering products that people need for their security and peace of mind. Our newest Insurance Sales Representative will pursue and respond to the requests and needs of prospects and clients who need insurance. You will be trained to act as a consultant for businesses and families, evaluating needs and recommending the most appropriate means of meeting those needs. Responsibilities: Meet new business production goals and objectives as established. Treat each customer contact as a cross and up-sell opportunity, including financial products. Maintain knowledge of new products. Prospecting and generating new business through leads & referral sources. Maintain client relationships through follow-up phone calls. Requirements: Possess a genuine willingness to learn, be intuitive and resourceful and be coachable. Proficiency to multi-task, follow-thru and follow-up. Problem-Solving Capabilities. Successful sales background. Driven and goal-oriented individual. Property and Casualty insurance license (must be willing to obtain) Benefits: Base with Commissions Bonus Opportunities Hands-On Training Performance Bonuses Professional Work Environment PIea07ef***********2-39196359
    $24k-100k yearly 3d ago
  • Program Manager Clinical, Principal

    Blue Shield of California 4.7company rating

    El Dorado Hills, CA jobs

    Your Role The Clinical Program Manager, Principal in collaboration with the Regional Medical Director and the CMO Team for Commercial Business will be responsible for collaborating with all internal stakeholders and externally facing partners to transform the way health care is delivered, ensuring best-in-class care for all members. Priority is given to delivering on the Quadruple Aim (lower cost care, increased quality, increased member satisfaction and physician satisfaction) with a focus on execution to drive and accelerate improvements in primary care for all patients. This role will report to the Regional Medical Director. Your Knowledge and Experience Requires a current, active California RN, NP, or PA license Requires a bachelor's degree; advanced degree is preferred Requires a minimum of 10 years of prior relevant clinical or job related experience Requires previous health plan experience with understanding of Accountable Care Organizations (ACO), global versus shared risk financial arrangements, quality metrics and member experience. Experience in case utilization and utilization management and managed care delegated models is a plus. In-depth understanding of data analytics with mastery of excel and an ability to use multiple data platforms for internal and external communication. Strong PowerPoint application skills to create executive summaries and presentation decks. Excellent verbal and written communication style to drive positive outcomes Ability to be resourceful and collaborative; a team collaborator with strong listening skills and the ability to offer creative solutions to drive consensus Your work In this role, you will: Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California's strategic goals Consult with all levels (including senior management) making recommendations and influencing decision-making Leverage cross-functional internal and external relationships to drive initiatives forward Plan and implement multiple and extremely complex projects/programs spanning across business areas Determine key business issues, develop effective action plans, and implement to successful conclusion Perform data analysis for all lines of business: Analyze data in collaboration with Regional Medical Director for trends, drivers, and key initiatives. Incorporate the analysis into meaningful discussions with Group/IPA Identify opportunities around utilization, quality, and clinical initiatives: Work side by side with internal and external partners in the design and launch of clinical programs focused on high-risk members, hospital initiatives, and behavioral health as well as internal innovation programs Partner with medical groups to co-create programs encompassing a full spectrum of initiatives around disease management, complex care management, transitions of care and site of service, ensuring optimal utilization, access, and quality of care for members Lead with a collaborative approach and an understanding of existing resources and relationships between/among partner organizations while moving them towards constructive change Work cross functionally with Blue Shield of California internal teams to provide support both ad hoc and for recurrent initiatives
    $127k-154k yearly est. Auto-Apply 59d ago
  • Senior Director, Prior Authorization & Clinical Care Operations

    Capital Rx 4.1company rating

    Remote

    About Us: JUDI Health is a health technology company offering a wide range of benefits administration solutions for employers and health plans. This includes Capital Rx, a public benefit corporation that provides full-service pharmacy benefit management (PBM) solutions to self-insured employers; JUDI Health™, which offers comprehensive health benefit management solutions for employers, TPAs, and health plans; and JUDI , the industry's leading proprietary Enterprise Health Platform. To learn more, visit **************** Position Summary: We are seeking a visionary and results-driven Director to lead and oversee Prior Authorization Operations, with responsibility for all lines of business (LOBs), including Commercial and Medicare, as well as the Clinical Call Center. This role will manage the end-to-end operations of Prior Authorization processes and ensure optimal efficiency, compliance, and performance across the department. Reporting to the Chief Clinical Officer, the Director will set the strategic direction for the PA and Clinical care teams, drive cross-functional collaboration, and optimize operations to align with the organization's broader business goals. Position Responsibilities: Define and execute the strategic vision for Prior Authorization and Clinical Care Operations teams across all lines of business (Commercial, Medicare, Exchange, Medicaid, etc.) in alignment with overall company objectives. Lead the development and implementation of long-term goals to improve workflow and efficiency while maintaining high-quality standards. Lead and develop a large team of pharmacists, technicians, and support staff to deliver efficient and accurate Prior Authorization and Clinical Care operations. Champion the adaption of advanced automations to improve accuracy, efficiency, and decision making. Lead and manage client needs, requests, and meetings as it pertains to the Prior Authorization and Clinical Care functions including leading and actively participating in calls with clients, consultants, and other external stakeholders. Serve as a liaison with internal stakeholders, including other departments in Clinical Operations, to ensure transparency, collaboration, and effective communication regarding Prior authorization and Clinical Care operations and requirements. Ensure that Prior Authorization and Clinical Care processes comply with regulatory standards, including URAC, NCQA, and federal and state guidelines, managing risks associated with compliance, regulatory audits, and industry certifications. Support the development of Capital Rx's formulary management platform Provide strategic direction and mentorship to PA leadership to foster a culture of collaboration, professional growth, accountability, and team success. Drive the development of KPIs and performance metrics for the PA department, ensuring that progress is measured against both departmental and organizational goals. Prepare and present executive-level reports, highlighting key performance trends, challenges, and recommendations for improvement. Key stakeholder and SME for Prior Authorization to the development team to implement advanced solutions that increase operational agility. Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance. Required Qualifications: Active, unrestricted pharmacist license required Doctor of Pharmacy degree required 8+ years of experience in Prior Authorization or Utilization Management at a PBM, health plan, or healthcare provider organization 5+ years of leadership experience, including direct supervision in a complex, multi-functional environment Proven track record of leading large teams and managing complex prior authorization and clinical care operations Strong knowledge of pharmacy regulations, accreditation standards, and compliance requirements Client facing experience required Experience in overseeing multiple lines of business including Commercial, Exchange, and Medicare Experience in managing Clinical Call Center operations and integrating customer service teams. Proven ability to define and execute strategic operational plans for large-scale operations at a senior leadership level, translating organizational strategy into actionable department-level initiatives Strong financial acumen including the ability to manage unit cost Innovative problem-solver with a continuous improvement mindset Strong proficiency in data analysis and performance reporting, with the ability to leverage insights for decision-making Excellent communication skills, both written and verbal, with significant experience in presenting to executive leadership Proficiency in Microsoft Office Suite and familiarity with other advanced data and reporting tools (e.g., Tableau, Power BI, etc.) In-depth understanding of regulatory compliance and industry standards such as URAC, NCQA, and federal/state requirements Ability to work effectively in a fast-paced, evolving environment and manage complex, cross-functional teams #LI-BC1 Salary Range$170,000-$185,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. JUDIHealth values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************
    $170k-185k yearly Auto-Apply 42d ago
  • Medical Director

    Root Center 4.8company rating

    Manchester, CT jobs

    At Root Center, we believe our employees are our greatest asset, and we're committed to creating a supportive and engaging work environment where everyone can thrive. We're driven by a clear purpose and a set of core values that shape everything we do, from nurturing growth and promoting well-being to cultivating connections and making a positive impact. In fact, 97% of our newly hired employees would recommend us to their friends for employment opportunities, and 96% said they strengthened their skills in their first few months. If you share our commitment to these values and want to join a team that lives them every day, Root Center might be the perfect fit for you! Medical Director Salary Range: $350,000 - $400,000 Actual pay will be determined based on several factors. These may include education, work experience and in some instances, certifications. We strive for market alignment and internal equity with our colleagues' pay. Position Summary The Medical Director shall be appointed by the CEO in collaboration with the Board of Directors as stipulated in the By-Laws of the Hartford Dispensary. The Medical Director is the person responsible for the program as outlined in the Food and Drug Administration's Application for Approval of Use of Methadone in a Treatment Program (Form FD 2632 (12/73); and as outlined in the State of Connecticut Health Department's regulations governing licensure of facilities which provide care and treatment for drug dependent persons, Section 17-227-64(4) (b); page 9. The Medical Director oversees all aspects of the program and provides direction and execution of services for the clients. Essential Functions The Medical Director will have the ultimate responsibility for the medical/health aspects of the program and organization as a whole. They are responsible for assuring that the provision of physician coverage as stipulated in the medical guidelines of the Root Center's Policy and Procedures Manual and those Federal Regulations under the Food and Drug Administration, 21 CFR, Part 291, concerning methadone for treating clients with narcotic addiction, effective November 18, 1980, takes place; provides guidance and/or assistance to staff on an as need basis. The essential functions for this position include, but are not limited to: Provide or supervise medical and psychiatric services to clients. Provide or supervise therapeutic interventions including medication management and psychotherapy. Provide oversight and direction for physicians, physician assistants, and APRNs. Provide oversight and direction to undergraduate and graduate medical education students, residents, and fellows Foster a team of compassionate care providers who effectively treat clients in recovery Oversee and ensure clinical programs comply with applicable federal and state regulations, accreditation standards and Root Center policies and procedures. Oversee and foster educational programs for staff including CMO Grand Rounds, Clinical Grand Rounds, Grant Funded and non-Grant Funded Research, and manage our Advanced Recovery Institute (ARI) Coordination of medical services for clients receiving inpatient clinical medical rehabilitation services with community partners. Serve as a community conduit via social media, TV, radio, etc., to help further brand Root Center as experts in the field of addiction and mental health treatment. Administrative responsibilities including staff meetings, medical policy review, clinical case reviews with clinicians, and ensuring physicians are enrolled in and utilizing the Exception Request Process for medication take home exceptions. Serves as the CMS, CLIA Waiver Laboratory Director. Program Development and Implementation. Participate in Executive Leadership and Board level Meetings M inimum Qualification Requirements Must have a valid license to practice medicine in the State of Connecticut with a minimum of five (5) years of clinical practice with at least one year of clinical supervisory/administrative experience. Board Certified in psychiatry with previous experience in a chemical dependency treatment environment. COMPENSATION & BENEFITS For all benefit eligible employees, we offer a prestigious employment package that includes competitive compensation plus a comprehensive array of benefits including: Work Life Balance- Flexibility: Great work life balance with clinics closed on Sundays. No current on-call responsibilities. Time off including PTO (4 weeks), three (3) Paid training days and thirteen (13) paid holidays, including your birthday! 35 hour work week and so much more! Health Insurance & Dental Insurance- with flexible employee contribution options depending upon chosen plan. Voluntary Vision Insurance Life Insurance and AD&D - 100% paid by Root Center for Advanced Recovery Short-Term Disability - 100% paid by Root Center for Advanced Recovery 403(b) Retirement Plan with a 5% employer match after 6 months of employment and an additional 5% employer contribution after 1 year of employment. Reimbursement for tuition, license, certifications and other educational activities, and paid training days for educational activities and conferences. Root Center has approved sites for the following NHSC Loan Repayment Programs: The Loan Repayment Program, Students to Service Loan Repayment Program, Rural Community Loan Repayment Program and Substance Use Disorder Workforce Loan Repayment Program. EEO Statement: Root Center is committed to hiring and retaining a diverse workforce. Root considers applicants for employment without regard to, and does not discriminate on the basis of, an individual's sex, race, color, religion, age, disability, status as a veteran, or national or ethnic origin; nor does Root Center discriminate on the basis of sexual orientation or gender identity or expression.
    $350k-400k yearly Auto-Apply 60d+ ago
  • Clinical Program Manager ePA

    Medica 4.7company rating

    Madison, WI jobs

    Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. This Program Manager will oversee initiatives within Medica's Clinical Services Optimization division, with a primary focus on the electronic prior authorization (ePA) business delivery. The Program Manager is accountable for leading program planning, gathering and documenting business requirements, ensuring seamless daily operations of ePA, and driving process improvements. This role coordinates and guides cross-functional teams-including network, Technology, and claims operations-from concept and requirements through delivery, ongoing maintenance, and validation. The Program Manager is responsible for operationalizing regulatory and business requirements to support both compliance and strategic growth initiatives. Serving as the ePA clinical documentation system subject matter expert, this leader acts as the primary liaison among Clinical Services, other business units, Medica IT, clinical platform vendors, and reporting teams, ensuring alignment of program objectives and successful implementation of solutions. Performs other duties as assigned. Key Accountabilities * Program Manager for ePA delivery * Lead Delivery and Optimization of ePA Workflow * Drive process efficiency and oversee the management of error handling within the electronic prior authorization (ePA) workflow * Lead business validation activities and user acceptance testing (UAT) to ensure that system solutions meet organizational needs and requirements * Assess and ensure that all systems and procedures are operating as designed, maintaining high standards for operational reliability and effectiveness * Evaluate requests for changes to the system, determining feasibility and implications for business operations * Develop actionable recommendations to address business system and reporting issues, ensuring continuous improvement and alignment with program objectives * Implement automation and standardized practices to reduce manual processes, eliminate duplication, and enhance overall operational efficiency * Expert Oversight of Clinical Documentation System as it relates to cross functional ePA delivery * Research system functionality and provide subject matter expertise to business and project teams, supporting informed decision-making and effective system utilization * Support process improvement initiatives by collaborating with stakeholders to identify opportunities for enhancement and innovation * Guide recommendations and facilitate decision-making through active stakeholder engagement, ensuring that program goals and stakeholder interests are aligned * Interpret customer needs and translate them into clear application and operational requirements, serving as a bridge between end users and technical teams * Cross functional Collaboration * Work cross functional with business partner to achieve program delivery * Create strong partner relationship to be successful * Drive Clinical and Health Service business readiness by leading for success strategies Required Qualifications * Bachelor's degree or equivalent experience in related field * 8 years of related work experience beyond degree Skills and Abilities * Implementation and new capabilities delivery experience * Computer proficiencies including Microsoft Office (Word, Excel, Access, Outlook, Visio, Onenote, Teams, etc.) and experience with other * Program functions (workflow, eligibility, claims, etc.) * Ability to lead and be a good role model, influence change, shape and initiate work with colleagues across the organization and external (care systems, community collaborations, and vendors) to achieve department goals * Ability to provide leadership based on teamwork, commitment & creative linkages with organizational business units, external vendors and care system representatives * Excellent written and verbal communication skills with all levels of the organization * Knowledge of computer applications, such as Microsoft Office, Microsoft Project and Vision, Access, and familiarity with using database systems * Managing/Delegating/Measuring Work: Ability to develop and assign clear, appropriate objectives, accountabilities and measures working within cross functional workstreams. Ability to monitor and report progress; identify and address barriers * Quality Focus: Commitment to continuous quality improvement in all aspects of work. Skilled user of quality tools and techniques * Experience setting expectation and direction for program delivery This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, or Madison, WI. The full salary grade for this position is $98,400 - $168,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $98,400 - $147,525. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
    $98.4k-168.6k yearly 4d ago
  • Program Manager Clinical, Principal

    Blue Shield of California 4.7company rating

    Long Beach, CA jobs

    Your Role The Clinical Program Manager, Principal in collaboration with the Regional Medical Director and the CMO Team for Commercial Business will be responsible for collaborating with all internal stakeholders and externally facing partners to transform the way health care is delivered, ensuring best-in-class care for all members. Priority is given to delivering on the Quadruple Aim (lower cost care, increased quality, increased member satisfaction and physician satisfaction) with a focus on execution to drive and accelerate improvements in primary care for all patients. This role will report to the Regional Medical Director. Your Knowledge and Experience Requires a current, active California RN, NP, or PA license Requires a bachelor's degree; advanced degree is preferred Requires a minimum of 10 years of prior relevant clinical or job related experience Requires previous health plan experience with understanding of Accountable Care Organizations (ACO), global versus shared risk financial arrangements, quality metrics and member experience. Experience in case utilization and utilization management and managed care delegated models is a plus. In-depth understanding of data analytics with mastery of excel and an ability to use multiple data platforms for internal and external communication. Strong PowerPoint application skills to create executive summaries and presentation decks. Excellent verbal and written communication style to drive positive outcomes Ability to be resourceful and collaborative; a team collaborator with strong listening skills and the ability to offer creative solutions to drive consensus. Your work: In this role, you will: Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California's strategic goals Consult with all levels (including senior management) making recommendations and influencing decision-making Leverage cross-functional internal and external relationships to drive initiatives forward Plan and implement multiple and extremely complex projects/programs spanning across business areas Determine key business issues, develop effective action plans, and implement to successful conclusion Perform data analysis for all lines of business: Analyze data in collaboration with Regional Medical Director for trends, drivers, and key initiatives. Incorporate the analysis into meaningful discussions with Group/IPA Identify opportunities around utilization, quality, and clinical initiatives: Work side by side with internal and external partners in the design and launch of clinical programs focused on high-risk members, hospital initiatives, and behavioral health as well as internal innovation programs Partner with medical groups to co-create programs encompassing a full spectrum of initiatives around disease management, complex care management, transitions of care and site of service, ensuring optimal utilization, access, and quality of care for members Lead with a collaborative approach and an understanding of existing resources and relationships between/among partner organizations while moving them towards constructive change Work cross functionally with Blue Shield of California internal teams to provide support both ad hoc and for recurrent initiatives
    $120k-144k yearly est. Auto-Apply 60d ago
  • Clinical Review Manager

    Bluecross Blueshield of Tennessee 4.7company rating

    Chattanooga, TN jobs

    Join the BlueCare team at BCBST as a Clinical Review Manager! In this role, you will complete medical reviews for utilization management within the BlueCare member population. You'll have the opportunity to collaborate with the BlueCare Utilization Management team, Case Managers, and other departments. The ideal candidate for this role is a quick learner who thrives in a role that requires attention to detail and research skills. The role also requires the ability to navigate clinical information and disseminate it in a timely manner. Finally, we're looking for a candidate with strong communication skills to be able to work effectively across multiple teams. Key Schedule Details: Typical schedule is 8-5 pm EST or 9-6 pm EST. Fully remote, at home position. There is an option, upon management approval, for alternative workdays or a compressed work schedule. For example, the Clinical Review Manager may work five 8-hour shifts or four 10-hour shifts, which may include a combination of weekdays and weekends (e.g., Wednesday-Sunday or Thursday-Sunday)." Join our team and make a significant impact on the quality of care our members receive! Job Responsibilities Initiate referrals to ensure appropriate coordination of care. Seek the advice of the Medical Director when appropriate, according to policy. Assists non-clinical staff in performance of administrative reviews Performing comprehensive provider and member appeals, denial interpretation for letters, retrospective claim review, special review requests, and UM pre-certifications and appeals, utilizing medical appropriateness criteria, clinical judgement, and contractual eligibility. Occasional weekend work may be required. Must be able to pass Windows navigation test. Testing/Assessments will be required for Digital positions. Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions. Job Qualifications License Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law. Experience 3 years - Clinical experience required Skills\Certifications Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint) Working knowledge of URAC, NCQA and CMS accreditations Must be able to work in an independent and creative manner. Excellent oral and written communication skills Strong interpersonal and organizational skills Ability to manage multiple projects and priorities Adaptive to high pace and changing environment Customer service oriented Superior interpersonal, client relations and problem-solving skills Proficient in interpreting benefits, contract language specifically symptom-driven, treatment driven, look back periods, rider information and medical policy/medical review criteria Number of Openings Available 1 Worker Type: Employee Company: VSHP Volunteer State Health Plan, Inc Applying for this job indicates your acknowledgement and understanding of the following statements: BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.
    $84k-98k yearly est. Auto-Apply 59d ago
  • Clinical, Manager, Prior Authorization Technician

    Capital Rx 4.1company rating

    Remote

    About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit **************** Location: Remote (For Non-Local) or Hybrid (Local to NYC area) Position Responsibilities: Oversee a dynamic team of pharmacy technicians engaged in the prior authorization process. Analyze available data to provide prior authorization staffing, workflow, and system enhancement recommendations to maximize team agility and performance. Actively participate in the prior authorization technician metric and quality goal setting process. Generate and deliver comprehensive reports on prior authorization technician metrics to both internal and external stakeholders. Assist the talent acquisition team in the hiring, evaluation, training, and onboarding of new employees. Investigate/resolve escalated issues or problems from team members, clients, and other internal teams. Key stakeholder in ensuring the prior authorization review platform is optimized for technician functions. Maintain relationships with external Independent Review Organizations and clinical resource vendors. Support the training and growth of both new and existing staff members in adherence to proper procedures. Collaborate with prior authorization leadership to develop process improvements and support long-term business needs, recommend new approaches, policies, and procedures to influence continuous improvements in department's efficiency and help establish best practices for conflict resolution while actively participating in problem identification and coordinate resolutions between appropriate parties. Assists with in other responsibilities, projects, implementations, and initiatives as needed in accordance with the policies and procedures established within the department. Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines. Maintain compliance with local, state, and federal laws, in addition to established organizational standards. Proactively obtains clinical information from prescribers, referral coordinators, and appropriate staff to ensure all aspects of clinical guidelines are addressed for pharmacist review. Triage phone calls from members, pharmacy personnel, and providers by asking applicable drug and client specific clinical questions. Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies Required Qualifications: Active, unrestricted, National Certified Pharmacy Technician (CPhT) license required Bachelor's or Associate's degree is preferred 4+ years of PBM or Managed Care pharmacy experience required Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint Strong clinical background required Excellent communication, writing, and organizational skills Ability to multi-task and collaborate in a team with shifting priorities Preferred Qualifications: 2+ years of regulated market prior authorization operations experience or knowledge of how to operationalize regulated market requirements Previous prior authorization operations leadership experience Salary Range$80,000-$90,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************
    $80k-90k yearly Auto-Apply 7d ago
  • Clinical Program Manager ePA

    Medica 4.7company rating

    Minnetonka, MN jobs

    Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. This Program Manager will oversee initiatives within Medica's Clinical Services Optimization division, with a primary focus on the electronic prior authorization (ePA) business delivery. The Program Manager is accountable for leading program planning, gathering and documenting business requirements, ensuring seamless daily operations of ePA, and driving process improvements. This role coordinates and guides cross-functional teams-including network, Technology, and claims operations-from concept and requirements through delivery, ongoing maintenance, and validation. The Program Manager is responsible for operationalizing regulatory and business requirements to support both compliance and strategic growth initiatives. Serving as the ePA clinical documentation system subject matter expert, this leader acts as the primary liaison among Clinical Services, other business units, Medica IT, clinical platform vendors, and reporting teams, ensuring alignment of program objectives and successful implementation of solutions. Performs other duties as assigned. Key Accountabilities Program Manager for ePA delivery Lead Delivery and Optimization of ePA Workflow Drive process efficiency and oversee the management of error handling within the electronic prior authorization (ePA) workflow Lead business validation activities and user acceptance testing (UAT) to ensure that system solutions meet organizational needs and requirements Assess and ensure that all systems and procedures are operating as designed, maintaining high standards for operational reliability and effectiveness Evaluate requests for changes to the system, determining feasibility and implications for business operations Develop actionable recommendations to address business system and reporting issues, ensuring continuous improvement and alignment with program objectives Implement automation and standardized practices to reduce manual processes, eliminate duplication, and enhance overall operational efficiency Expert Oversight of Clinical Documentation System as it relates to cross functional ePA delivery Research system functionality and provide subject matter expertise to business and project teams, supporting informed decision-making and effective system utilization Support process improvement initiatives by collaborating with stakeholders to identify opportunities for enhancement and innovation Guide recommendations and facilitate decision-making through active stakeholder engagement, ensuring that program goals and stakeholder interests are aligned Interpret customer needs and translate them into clear application and operational requirements, serving as a bridge between end users and technical teams Cross functional Collaboration Work cross functional with business partner to achieve program delivery Create strong partner relationship to be successful Drive Clinical and Health Service business readiness by leading for success strategies Required Qualifications Bachelor's degree or equivalent experience in related field 8 years of related work experience beyond degree Skills and Abilities Implementation and new capabilities delivery experience Computer proficiencies including Microsoft Office (Word, Excel, Access, Outlook, Visio, Onenote, Teams, etc.) and experience with other Program functions (workflow, eligibility, claims, etc.) Ability to lead and be a good role model, influence change, shape and initiate work with colleagues across the organization and external (care systems, community collaborations, and vendors) to achieve department goals Ability to provide leadership based on teamwork, commitment & creative linkages with organizational business units, external vendors and care system representatives Excellent written and verbal communication skills with all levels of the organization Knowledge of computer applications, such as Microsoft Office, Microsoft Project and Vision, Access, and familiarity with using database systems Managing/Delegating/Measuring Work: Ability to develop and assign clear, appropriate objectives, accountabilities and measures working within cross functional workstreams. Ability to monitor and report progress; identify and address barriers Quality Focus: Commitment to continuous quality improvement in all aspects of work. Skilled user of quality tools and techniques Experience setting expectation and direction for program delivery This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, or Madison, WI. The full salary grade for this position is $98,400 - $168,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $98,400 - $147,525. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.  In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
    $98.4k-168.6k yearly 5d ago
  • Clinical Program Manager ePA

    Medica 4.7company rating

    Minnetonka, MN jobs

    Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. This Program Manager will oversee initiatives within Medica's Clinical Services Optimization division, with a primary focus on the electronic prior authorization (ePA) business delivery. The Program Manager is accountable for leading program planning, gathering and documenting business requirements, ensuring seamless daily operations of ePA, and driving process improvements. This role coordinates and guides cross-functional teams-including network, Technology, and claims operations-from concept and requirements through delivery, ongoing maintenance, and validation. The Program Manager is responsible for operationalizing regulatory and business requirements to support both compliance and strategic growth initiatives. Serving as the ePA clinical documentation system subject matter expert, this leader acts as the primary liaison among Clinical Services, other business units, Medica IT, clinical platform vendors, and reporting teams, ensuring alignment of program objectives and successful implementation of solutions. Performs other duties as assigned. Key Accountabilities * Program Manager for ePA delivery * Lead Delivery and Optimization of ePA Workflow * Drive process efficiency and oversee the management of error handling within the electronic prior authorization (ePA) workflow * Lead business validation activities and user acceptance testing (UAT) to ensure that system solutions meet organizational needs and requirements * Assess and ensure that all systems and procedures are operating as designed, maintaining high standards for operational reliability and effectiveness * Evaluate requests for changes to the system, determining feasibility and implications for business operations * Develop actionable recommendations to address business system and reporting issues, ensuring continuous improvement and alignment with program objectives * Implement automation and standardized practices to reduce manual processes, eliminate duplication, and enhance overall operational efficiency * Expert Oversight of Clinical Documentation System as it relates to cross functional ePA delivery * Research system functionality and provide subject matter expertise to business and project teams, supporting informed decision-making and effective system utilization * Support process improvement initiatives by collaborating with stakeholders to identify opportunities for enhancement and innovation * Guide recommendations and facilitate decision-making through active stakeholder engagement, ensuring that program goals and stakeholder interests are aligned * Interpret customer needs and translate them into clear application and operational requirements, serving as a bridge between end users and technical teams * Cross functional Collaboration * Work cross functional with business partner to achieve program delivery * Create strong partner relationship to be successful * Drive Clinical and Health Service business readiness by leading for success strategies Required Qualifications * Bachelor's degree or equivalent experience in related field * 8 years of related work experience beyond degree Skills and Abilities * Implementation and new capabilities delivery experience * Computer proficiencies including Microsoft Office (Word, Excel, Access, Outlook, Visio, Onenote, Teams, etc.) and experience with other * Program functions (workflow, eligibility, claims, etc.) * Ability to lead and be a good role model, influence change, shape and initiate work with colleagues across the organization and external (care systems, community collaborations, and vendors) to achieve department goals * Ability to provide leadership based on teamwork, commitment & creative linkages with organizational business units, external vendors and care system representatives * Excellent written and verbal communication skills with all levels of the organization * Knowledge of computer applications, such as Microsoft Office, Microsoft Project and Vision, Access, and familiarity with using database systems * Managing/Delegating/Measuring Work: Ability to develop and assign clear, appropriate objectives, accountabilities and measures working within cross functional workstreams. Ability to monitor and report progress; identify and address barriers * Quality Focus: Commitment to continuous quality improvement in all aspects of work. Skilled user of quality tools and techniques * Experience setting expectation and direction for program delivery This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, or Madison, WI. The full salary grade for this position is $98,400 - $168,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $98,400 - $147,525. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
    $98.4k-168.6k yearly 4d ago
  • Clinical Program Manager

    Medica 4.7company rating

    Minnetonka, MN jobs

    Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. The Clinical Program Manager provides support to health system provider partners as well as Medica's product and segment teams. The Clinical Program Manager will work collaboratively with leadership and cross-functional partners to design and develop actionable strategies to address health system specific clinical cost and utilization opportunities. This position is responsible for supporting and maintaining the clinical relationship with Medica's provider partners, working to identify and implement clinical interventions to improve outcomes and quality of care, decrease unnecessary medical spend, and improve care efficiency. The incumbent works in close collaboration with Medica's clinical services, network management, and analytics departments. This position requires understanding of managed care business practices, provider delivery governance, internal and external operations, design thinking, and the development and use of actionable analytics. Strong relationship management skills are critical for this role as is the ability to manage complex clinical projects using established project management tools and methodologies. Performs other duties as assigned. Key Accountabilities Identify and develop clinical interventions and services that positively impact medical trend and quality Identify interventions that improve value of care for our members including improved quality and access to appropriate care, while sustaining appropriate decreases in unnecessary medical trends. Provide insights and recommendations to care system clinical operation teams related to provider clinical operations, with the goal of improving performance in the quadruple aim. Provider partnerships include ACOs (Accountable Care Organizations), TCOC (Total Cost of Care) partnerships, Medicare Advantage, and Medicaid programs Use clinical and financial data analysis to support strategy, tactics, and communication of results to achieve an provider partner's performance KPIs (key performance indicators). Perform and translate data analysis to highlight care system performance and provide insights into areas of impact and improvement throughout the organization. Supports efforts to define and socialize Medica provider analytics strategies and implement analytic methods and tools in support of the strategies. Engage providers in strategic collaborative activities Engage care system population health leaders in strategies and tactics that improve quality and access to appropriate care, including identification of both member and system level opportunities. Works with provider partners to identify transformational and innovative services that become the basis for value-based payments. Provide a forum for our partners to network and share best practices. Influence and motivate provider partner's clinical teams identifying and implementing strategies to reduce variations in performance. Project support across all stages includes planning, communication, implementation, and evaluation of performance of projects. Support Overall Clinical Value Strategy Supports defining and prioritizing business requirements for data requests, data validation, and clinical data analysis. Establishes annual priorities, KPIs, and targets that align with and support clinical leadership and other business units. Collaborates on annual team goals aligned with the priorities of clinical services, Medica and our provider partner care systems. Serves as an effective leader and representative of Clinical Services on various Medica committees. Fosters good communications with staff, customers and other company departments through interpersonal relationships and formal communication skills. Required Qualifications Bachelor's degree in nursing, public health, healthcare administration or related clinical field 5+ years of equivalent work experience beyond degree Preferred Qualifications Master's degree in nursing, public health, healthcare administration or related clinical field Strong proficiently in project management tools, including six sigma Comfortable presenting to executive level stakeholders Proficiency in MS office specifically MS Excel and PowerPoint Demonstrated ability to design, evaluate, and interpret complex clinical programs, with strong problem-solving skills Excellent written and verbal communication skills, capable of conveying complex information clearly and concisely to diverse audiences Experience working both independently and collaboratively in cross functional teams, engaging with individuals from diverse professional backgrounds Skills and Abilities Understanding of clinical care structures/operations Program or Project Management experience Understanding of data, ability to tell the story Innovative, and critical thinker Demonstrated capability to present key findings effectively to a non-technical audience both written and verbal Experience working with claim/employer group data, including John Hopkins ACG Grouper, Milliman HCG Grouper Demonstrated problem solving skills An internal drive to understand root cause and an inherent curiosity to problem solve Ability to function in a fast-paced, dynamic culture is important for success in this role Strong proficiently in project management tools, including six sigma Comfortable presenting to executive level stakeholders Proficiency in MS office specifically MS Excel and PowerPoint Demonstrated ability to design, evaluate, and interpret complex clinical programs, with strong problem-solving skills. Excellent written and verbal communication skills, capable of conveying complex information clearly and concisely to diverse audiences. Experience working both independently and collaboratively in cross functional teams, engaging with individuals from diverse professional backgrounds. This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, Omaha, NE or St. Louis, MO The full salary grade for this position is $87,100 - $149,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $87,100 - $130,620. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.  In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
    $87.1k-149.3k yearly 60d+ ago
  • TPM - (DOR) Rehab Director - Occupational Therapist Preferred

    Ovation Rehabilitation Services, LLC 4.6company rating

    Pinckney, MI jobs

    Reward yourself with a New Career at Ovation Rehabilitation! We have a Full-time, Therapy Program Manager (TPM) opportunity available at our location in Pinckney, MI. This is a salaried position that requires an active state license as an Occupational Therapist, A minimum of 1-2 Years of Management experience. With many years of successful industry experience behind us on a national level, Ovation Rehabilitation has entered the contract rehabilitation industry with a fresh vision and superior culture that recognizes, appreciates, and rewards individual and team contributions. With the focus on those that we care for, Ovation Rehabilitation is a company that you will CHEER for and APPLAUD!! Come join our team as we travel into the future and be a part of the growth and excitement. Enjoy what you do and grow with a company that you can be proud of. When you join our team, we offer the opportunity for a rewarding career, competitive benefits and the potential for career advancement. In addition to our open and supportive culture that is second to none and features our “Round of Applause” employee recognition program as well as individual recognition for YOUR birthday and other personal events we offer dedicated facility-based teams with on-site management and experienced regional management support that is locally based. Our “Clap -Out” events recognize and celebrate resident successes. Our front-loaded PTO program is immediately available for you to use, with no black-out or waiting period. As a Full-Time TPM you will also have the ability to choose: 401(k) Available with a company match Healthcare Packages Paid Time Off - Available Immediately Life Insurance Short Term and Long Term Disability Flexible Spending Account Dependent Care Spending Account Licensure Reimbursement Advancement Opportunities Employee Referral Bonus Program Discounted CEU Program Whether you are looking now or will be in the future, we invite you check out our career page. Go to Careers - OVATION Rehabilitation Ovation Rehabilitation is an equal opportunity employer.
    $62k-90k yearly est. Auto-Apply 14d ago
  • Clinical Dental Director

    DCS Clinical 3.9company rating

    Newington, CT jobs

    Job Description The Clinical Dental Director is the primary care provider for a steady stream of patients, while also collaborating with and guiding fellow associates. Our office offers a range of specialty services on-site, such as periodontics, endodontics, oral surgery, and orthodontics. This role presents a distinctive career path, offering the chance to transition to an equity position within just six months. Ideal for dentists seeking to dedicate their attention solely to patient care, this opportunity minimizes non-clinical management responsibilities, allowing you to focus entirely on what you love most-helping patients achieve optimal dental health. Compensation: The average income for a director in our practices was $400K+ last year Benefits: Quarterly bonuses Free CEs + additional CE reimbursement Family health insurance Phone and entertainment allowance Unlimited earning potential Clinical autonomy, do the dentistry you enjoy doing without the burden and pressure of production goals Chance to work with multiple Dentists and Specialists in an in-house multi-specialty practice Mentorship and peer to peer collaboration with an amazing group of Dentists and Specialists 401K When you join 42 North Dental, you will be part of a team that always has your back and trusts your expertise. If you want to make a meaningful impact on patients' lives, apply for the Clinical Dental Director position today! The ideal candidate must have 3+ years of demonstrated success in a fee for service practice setting along with a desire to provide direct patient care while managing day to day operations with the assistance of a proven practice management team. Significant chair-side experience, excellent team building and leadership skills are a must. Directors are the primary care provider of a generous patient flow in addition to working cooperatively with and mentoring associates. Additionally the candidate must be able to work with our specialists to expand growth in specialty departments within the practice. In-office specialty services including periodontics, endodontics, oral surgery and orthodontics are available facilitating access to complete dental care for patients. Providers are responsible for entire clinical patient experience from initial exam and treatment plan to delivery of care. Provide direct patient care while managing day to day operations with the assistance of a proven practice management team Skills & Qualifications 3+ years of demonstrated success in a fee for service practice DMD or DDS degree from a university-based dental education program accredited by the American Dental Association Commission on Dental Accreditation (ADA CODA) Current state license to practice dentistry Documentation of Hepatitis B vaccination Proof of malpractice insurance Current Basic Life Support (BLS) or cardiopulmonary resuscitation (CPR) certification Significant chair-side experience
    $60k-84k yearly est. 13d ago
  • Clinical Dental Director

    DCS Clinical 3.9company rating

    Worcester, MA jobs

    Job Description The Clinical Dental Director is the primary care provider for a steady stream of patients, while also collaborating with and guiding fellow associates. Our office offers a range of specialty services on-site, such as periodontics, endodontics, oral surgery, and orthodontics. This role presents a distinctive career path, offering the chance to transition to an equity position within just six months. Ideal for dentists seeking to dedicate their attention solely to patient care, this opportunity minimizes non-clinical management responsibilities, allowing you to focus entirely on what you love most-helping patients achieve optimal dental health. Compensation: The average income for a director in our practices was $400K+ last year Benefits: Quarterly bonuses Free CEs + additional CE reimbursement Family health insurance Phone and entertainment allowance Unlimited earning potential Clinical autonomy, do the dentistry you enjoy doing without the burden and pressure of production goals Chance to work with multiple Dentists and Specialists in an in-house multi-specialty practice Mentorship and peer to peer collaboration with an amazing group of Dentists and Specialists 401K When you join 42 North Dental, you will be part of a team that always has your back and trusts your expertise. If you want to make a meaningful impact on patients' lives, apply for the Clinical Dental Director position today! The ideal candidate must have 3+ years of demonstrated success in a fee for service practice setting along with a desire to provide direct patient care while managing day to day operations with the assistance of a proven practice management team. Significant chair-side experience, excellent team building and leadership skills are a must. Directors are the primary care provider of a generous patient flow in addition to working cooperatively with and mentoring associates. Additionally the candidate must be able to work with our specialists to expand growth in specialty departments within the practice. In-office specialty services including periodontics, endodontics, oral surgery and orthodontics are available facilitating access to complete dental care for patients. Providers are responsible for entire clinical patient experience from initial exam and treatment plan to delivery of care. Provide direct patient care while managing day to day operations with the assistance of a proven practice management team Skills & Qualifications 3+ years of demonstrated success in a fee for service practice DMD or DDS degree from a university-based dental education program accredited by the American Dental Association Commission on Dental Accreditation (ADA CODA) Current state license to practice dentistry Documentation of Hepatitis B vaccination Proof of malpractice insurance Current Basic Life Support (BLS) or cardiopulmonary resuscitation (CPR) certification Significant chair-side experience
    $50k-70k yearly est. 13d ago
  • Clinical Director of Operations: Sign on Bonus of $10,000!

    Root Center 4.8company rating

    Manchester, CT jobs

    At Root Center, we believe our employees are our greatest asset, and we're committed to creating a supportive and engaging work environment where everyone can thrive. We're driven by a clear purpose and a set of core values that shape everything we do, from nurturing growth and promoting well-being to cultivating connections and making a positive impact. In fact, 97% of our newly hired employees would recommend us to their friends for employment opportunities, and 96% said they strengthened their skills in their first few months. If you share our commitment to these values and want to join a team that lives them every day, Root Center might be the perfect fit for you! Position Summary Under the supervision of the Chief Operating Officer (COO), the Director of Operations is responsible for developing, managing and directing the operations, programs and activities of clinical programs across multiple locations; Oversees implementation of new programs and services, serves as a liaison with external agencies, oversees education and training of clinical staff, and serves as a member of the Corporate Compliance Committee. Salary Range: $100,000 to $125,000 Sign on Bonus of $10,000! Actual pay will be determined based on several factors. These may include education, work experience and in some instances, certifications. We strive for market alignment and internal equity with our colleagues' pay. Essential Functions The Director of Operations has responsibility including but not limited to: Clinic Administration : In collaboration with Clinic Supervisors, responsible for directing, planning, organizing and supervising the clinical operations across multiple sites; Provides consistent supervision and support to Clinic Supervisors to ensure goals are met consistently and timely for all program requirements; Ensure effective implementation and maintenance of concepts, principles and processes across clinics. Develop, review and update policies, procedures, process improvement, training, and evaluation that help support efficient clinic workflows. Supervision and Training: Works with Clinic Supervisors to provide educational oversight and training competency on functions related to care planning, clinic documentation, and quality performance improvement standards; Ensure communication of goals, objectives, policies, and procedures both up and down the chain of command. Planning and Coordination: Participate on the agency's management team; Work closely with the advocacy, residential and legal teams to coordinate services to clients; Maintain a working relationship with outside agencies; Coordinate meetings with other mental health provider programs. Orientation/Training Employee agrees to participate in orientation and training required by both regulatory and funding agencies as well as accreditation standards, to include but not limited to corporate compliance, and HIPAA Privacy and Security. Minimum Qualification Requirements A graduate degree in social work, psychology or allied science with a current and valid license in the state of Connecticut as an LCSW or LPC. The applicant should have at least six years of full-time paid experience in the behavioral health treatment field, preferably in the area of substance abuse, and at least five years of administrative experience. COMPENSATION & BENEFITS For all benefit eligible employees, we offer a prestigious employment package that includes competitive compensation plus a comprehensive array of benefits including: Work Life Balance- Flexibility: Great work life balance with clinics closed on Sundays. No current on-call responsibilities. Time off including PTO (4 weeks), three (3) Paid training days and thirteen (13) paid holidays, including your birthday! 35 hour work week and so much more! Health Insurance & Dental Insurance- with flexible employee contribution options depending upon chosen plan. Voluntary Vision Insurance Life Insurance and AD&D - 100% paid by Root Center for Advanced Recovery Short-Term Disability - 100% paid by Root Center for Advanced Recovery 403(b) Retirement Plan with a 5% employer match after 6 months of employment and an additional 5% employer contribution after 1 year of employment. $2000 provided annually for tuition, license reimbursement, certifications or other educational activities, including 3 paid training days for educational activities and conferences; an additional $1000 available for counselors seeking outside supervision hours when such can not be provided in the organization internally. Annual bonus eligible based on agency performance EEO Statement: Root Center is committed to hiring and retaining a diverse workforce. Root considers applicants for employment without regard to, and does not discriminate on the basis of, an individual's sex, race, color, religion, age, disability, status as a veteran, or national or ethnic origin; nor does Root Center discriminate on the basis of sexual orientation or gender identity or expression. #rcar
    $100k-125k yearly Auto-Apply 60d+ ago
  • Clinical Services Manager - BCBA / IDD Behavior Services

    Dungarvin, Inc. 4.2company rating

    Vacaville, CA jobs

    At Dungarvin, we are more than a provider of support services-we're a mission-driven team rooted in respect, response and choice. Since 1976, we've been dedicated to meeting people where they are, working alongside them to provide person centered supports that allow people to live independently as possible. You'll work directly with people in need of assistance, and/or living with intellectual or developmental disabilities, or other complex medical needs. With services in 15 states, our team is united by a shared commitment to making a real difference-one person, one voice, one choice at a time. We encourage you to embrace this opportunity to impact someone's life. As a Clinical Services Manager at Dungarvin, you'll play a vital role in leading and modeling the delivery of person-centered services that empower individuals to thrive. BENEFITS: * Starting Salary: $106,449 / year * Full Wage Scale: $106,449 - $115,474.76 (Future increases within the posted range are based on tenure and performance per Dungarvin's compensation guidelines.) * Schedule: 8am - 5pm M-F * Medical, Vision and Dental Insurance * Supplemental Insurance * Flex Spending and HSA Account * Pet Insurance * Life Insurance * 401 K plan with up to 3% employer match based on eligibility requirements * Generous Paid Time Off (PTO) * Growth and Development Opportunities * Employee Referral Program * Employee Assistance Program * Paid training and orientation Job Description As a Clinical Services Manager at Dungarvin, you'll be providing person-centered behavioral services within our adult day programs in Fairfield and Vacaville. In this dynamic role, you'll collaborate closely with participants and support staff, breaking down barriers, amplifying strengths, and fostering health and personal growth. You'll oversee clinically related care in partnership with program leaders, ensuring that every service provided aligns with Dungarvin's mission, state and federal guidelines, BACB standards, and evidence-based best practices. What You Get To Do: * Implementing and monitoring systems that support people who are engaging in challenging behaviors. * Participating as a team member in order to facilitate enriched quality of life, desired lifestyles, increased levels of independence and productivity, and social/physical integration. * Providing direct clinical services * Supervising behavioral staff, including but not limited to Behavior Analysts, Behavior Specialists, Registered Behavior Technicians, and Direct Support Professionals. * Participating as a member of our professional interdisciplinary clinical team which provides assessments, intervention strategies, and consultation for individuals with intellectual and developmental disabilities * Participating in the development of new behavior support services Qualifications * Certification: Must be a Board Certified Behavior Analyst (BCBA), recognized by the Behavior Analyst Certification Board (BACB). * Experience: * 2 years of experience as a BCBA, specifically in developing and implementing behavior support plans. * 2 years of experience working with individuals with intellectual or developmental disabilities. * Supervisory experience preferred, including direction and development of Registered Behavior Technician and other clinical staff. * Education: Master's degree in Applied Behavior Analysis, Psychology, or a related field. * Skills: Strong communication (verbal and written), analytical, administrative, and organizational abilities. Must have effective listening and interpersonal skills to work both independently and collaboratively within a team. * Additional Requirements: A valid driver's license and auto insurance. Additional Information At Dungarvin, diversity and inclusion are a part of what makes our organization strong. Together, we can continue to work towards an inclusive culture that supports our employees and persons served. Compass and Dungarvin are affirmative action and equal opportunity employers. #LI-KF1 #DCAJ 12/4
    $106.4k-115.5k yearly 10d ago
  • Clinical Supervisor (Part-Time with Growth Opportunity)

    Connect Home Health 3.9company rating

    Temple, TX jobs

    Connect Pediatrics is hiring immediately for a Clinical Supervisor in our Temple office! At Connect Pediatrics, we don't just hire - we inspire nurses to tap into their full potential, offering a vibrant work environment that boosts career growth and enhances nursing skills in the realm of in-home care. Health and Wellness Benefits: Health Insurance (for FT employees) Dental and Vision Insurance Company-paid life insurance Disability and other Supplemental Insurance Paid Time Off (PTO) Accrual 401(k) Clinical Supervisor will lead new nurse orientations, complete in-home check-offs, assist in nurse/patient relationship management (assisting with clinical questions, patient charting questions, care in the patient home setting, etc.), and help build brand awareness in an effort to increase patient census. Additionally, the Clinical Supervisor will demonstrate individualized creativity in educating the patient and/or caregiver, follow nursing policy and procedure per agency standards, follow the plan of care according to physician orders, and demonstrate understanding Medicaid regulations. Requirements Qualifications/Educational Requirements: 1. Licensed Registered Nurse (RN) with current license. 2. 1 year of direct patient care experience is preferred. 3. Ability to relate positively and favorably with patients and staff. 4. Demonstrate good oral and written communication along with good documentation skills. 5. Minimum of 2 professional references. 6. Current CPR certificate from American Heart Association or other approved source that meets the AHA guidelines. 8. Must be able to comply with all policies and procedures outlined in employee handbook. Responsibilities/essential functions: The person in this position must be able to perform the following essential job functions with or without reasonable accommodations. 1. Demonstrate efficient teamwork with the staff. 2. Demonstrate organizational and time management skills. 3. Support quality improvement practices. 4. Perform nursing procedures according to agency policy and procedures. 6. Monitor reactions and patient progress using observation, assessment, and evaluation skills. 7. Educate patients and family members according to disease process, medications, treatment options, and home care procedures according to the plan of care. 9. Follow Medicaid regulations. 10. Coordinate and monitor patient care and services. 11. Comply with HIPAA regulations in and out of the office. 12. Follow infection control policy in and out of the office. 13. Document skilled care according to Medicaid guidelines. 14. Maintain patient records according to policy and procedures. 15. Participate in in-services, workshops, seminars, and self-study courses annually. Connect Pediatrics Vision: Connect Pediatrics went from being the best-kept secret in Pediatric Home Health to becoming a key provider of Pediatric Private Duty Nursing across the state of Texas. We are nurse-owned and operated, which gives our team first-hand experience in the roles we ask our nurses to fill. We strive to be the preferred provider of care for our patients and the preferred employer for our talented team of clinicians. Connect Pediatrics is an equal-opportunity employer. Salary Description $30 - $32
    $56k-76k yearly est. 60d+ ago
  • Clinical Supervisor (Part-Time with Growth Opportunity)

    Connect Home Health 3.9company rating

    Temple, TX jobs

    Job DescriptionDescription: Connect Pediatrics is hiring immediately for a Clinical Supervisor in our Temple office! At Connect Pediatrics, we don't just hire - we inspire nurses to tap into their full potential, offering a vibrant work environment that boosts career growth and enhances nursing skills in the realm of in-home care. Health and Wellness Benefits: Health Insurance (for FT employees) Dental and Vision Insurance Company-paid life insurance Disability and other Supplemental Insurance Paid Time Off (PTO) Accrual 401(k) Clinical Supervisor will lead new nurse orientations, complete in-home check-offs, assist in nurse/patient relationship management (assisting with clinical questions, patient charting questions, care in the patient home setting, etc.), and help build brand awareness in an effort to increase patient census. Additionally, the Clinical Supervisor will demonstrate individualized creativity in educating the patient and/or caregiver, follow nursing policy and procedure per agency standards, follow the plan of care according to physician orders, and demonstrate understanding Medicaid regulations. Requirements: Qualifications/Educational Requirements: 1. Licensed Registered Nurse (RN) with current license. 2. 1 year of direct patient care experience is preferred. 3. Ability to relate positively and favorably with patients and staff. 4. Demonstrate good oral and written communication along with good documentation skills. 5. Minimum of 2 professional references. 6. Current CPR certificate from American Heart Association or other approved source that meets the AHA guidelines. 8. Must be able to comply with all policies and procedures outlined in employee handbook. Responsibilities/essential functions: The person in this position must be able to perform the following essential job functions with or without reasonable accommodations. 1. Demonstrate efficient teamwork with the staff. 2. Demonstrate organizational and time management skills. 3. Support quality improvement practices. 4. Perform nursing procedures according to agency policy and procedures. 6. Monitor reactions and patient progress using observation, assessment, and evaluation skills. 7. Educate patients and family members according to disease process, medications, treatment options, and home care procedures according to the plan of care. 9. Follow Medicaid regulations. 10. Coordinate and monitor patient care and services. 11. Comply with HIPAA regulations in and out of the office. 12. Follow infection control policy in and out of the office. 13. Document skilled care according to Medicaid guidelines. 14. Maintain patient records according to policy and procedures. 15. Participate in in-services, workshops, seminars, and self-study courses annually. Connect Pediatrics Vision: Connect Pediatrics went from being the best-kept secret in Pediatric Home Health to becoming a key provider of Pediatric Private Duty Nursing across the state of Texas. We are nurse-owned and operated, which gives our team first-hand experience in the roles we ask our nurses to fill. We strive to be the preferred provider of care for our patients and the preferred employer for our talented team of clinicians. Connect Pediatrics is an equal-opportunity employer.
    $56k-76k yearly est. 2d ago
  • Clinical Supervisor (Msw)

    General 4.4company rating

    Lecanto, FL jobs

    ✨Join a group of passionate advocates on our mission to improve the lives of youth! Rite of Passage Team is hiring for a Clinical Director at Cypress Creek Youth Academy, in Lecanto, FL ✨ Cypress Creek is a residential commitment program located in Citrus County Florida. It serves high-risk and max-risk youth ages 15 to 21. The goal of the program is to provide services utilize evident-based practices to provide comprehensive care, treatment and supervision. We offer clinical supervision to qualified applicants. Performance Based Compensation reviews are conducted annually (2%,4%, or 6%) Eligible for Medical, Dental, Vision, and Life Insurance (at 60 days for Hourly employees and 90 days for Salaried) Choice of Supplemental benefits, including Short Term Disability and increased Life Insurance. Eligible for 100% 401k match of up to 6% of your salary after 1 year of employment. Paid Time Off that can be used as soon as it accrues. ************************************************* ROP-benefits-and-perks-2 The Clinical Supervisor works as the primary supervisor of the Clinical Team. Primarily responsible for all clinical functions to ensure that treatment continuity is maintained for students and families. The Clinical Supervisor reports to the Clinical Director or Program Director. In some instances, may supervise designated staff. Masters Degree in Psychology, Family Therapy or Social Work with current state licensure. Licensure must be maintained with photocopies on file. Prior clinical and administrative experience in a residential setting, and a background in working with adolescent offenders and their families is preferred. Rite of Passage is a leading national provider of programs and opportunities for troubled and at-risk youth from social services, welfare agencies and juvenile courts. With an emphasis on evidence-based practices and positive skill development, combined with our supportive and therapeutic approach, our organization is respected by industry experts as a highly effective solution for our youth. Since 1984, over 70,000 youths have entered and completed our programs. ROP has built its reputation on running life-changing educational treatment programs that positively contribute to the community. Apply today and Make a Difference in the Lives of Youth! After 40 years of improving the lives of youth, we are looking for passionate advocates to continue the legacy of helping young people become successful adults. As a Clinical Supervisor, you will have the unique opportunity to create a positive, safe and supportive environment for the youth we serve while building a career rich in growth opportunities and self-fulfillment. Follow us on Social! Instagram / Facebook / Linkedin / Tik Tok / YouTube
    $46k-70k yearly est. 60d+ ago
  • Clinical Supervisor (Part-Time with Growth Opportunity)

    Connect Home Health 3.9company rating

    Denver, CO jobs

    Connect Pediatrics is hiring immediately for a Clinical Supervisor in our Denver, CO office! At Connect Pediatrics, we don't just hire - we inspire nurses to tap into their full potential, offering a vibrant work environment that boosts career growth and enhances nursing skills in the realm of in-home care. Health and Wellness Benefits: Health Insurance (for FT employees) Dental and Vision Insurance Company-paid life insurance Disability and other Supplemental Insurance Paid Time Off (PTO) Accrual 401(k) Clinical Supervisor will lead new nurse orientations, complete in-home check-offs, assist in nurse/patient relationship management (assisting with clinical questions, patient charting questions, care in the patient home setting, etc.), and help build brand awareness in an effort to increase patient census. Additionally, the Clinical Supervisor will demonstrate individualized creativity in educating the patient and/or caregiver, follow nursing policy and procedure per agency standards, follow the plan of care according to physician orders, and demonstrate understanding Medicaid regulations. Requirements Qualifications/Educational Requirements: Licensed Registered Nurse (RN) with current license. 1 year of direct patient care experience is preferred. Ability to relate positively and favorably with patients and staff. Demonstrate good oral and written communication along with good documentation skills. Minimum of 2 professional references. Current CPR certificate from American Heart Association or other approved source that meets the AHA guidelines. Must be able to comply with all policies and procedures outlined in employee handbook. Responsibilities/essential functions: The person in this position must be able to perform the following essential job functions with or without reasonable accommodations. Demonstrate efficient teamwork with the staff. Demonstrate organizational and time management skills. Support quality improvement practices. Perform nursing procedures according to agency policy and procedures. Monitor reactions and patient progress using observation, assessment, and evaluation skills. Educate patients and family members according to disease process, medications, treatment options, and home care procedures according to the plan of care. Follow Medicaid regulations. Coordinate and monitor patient care and services. Comply with HIPAA regulations in and out of the office. Follow infection control policy in and out of the office. Document skilled care according to Medicaid guidelines. Maintain patient records according to policy and procedures. Participate in in-services, workshops, seminars, and self-study courses annually. Connect Pediatrics Vision: Connect Pediatrics went from being the best-kept secret in Pediatric Home Health to becoming a key provider of Pediatric Private Duty Nursing across the state of Texas. We are nurse-owned and operated, which gives our team first-hand experience in the roles we ask our nurses to fill. We strive to be the preferred provider of care for our patients and the preferred employer for our talented team of clinicians. Connect Pediatrics is an equal-opportunity employer.
    $52k-69k yearly est. 60d+ ago

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