Patient Navigator *0.6 FTE Day* REMOTE
Portland, OR jobs
The Coordinator-Assessment, Intake and Referral for Behavioral Health critically assesses the treatment needs of patients, determines the appropriate level of care and secures patient account reimbursement by obtaining complex demographic, insurance and behavioral health clinical information. Additionally, identifies behavioral health services requiring insurance verification and initial insurance authorization for treatment and ensures required authorizations are in place. Communicates all pertinent collateral clinical information to the psychiatrist on call for services, then facilitates the communication/coordination with the unit charge nurse where the respective patient will be placed.
Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Oregon Regional Shared Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
+ Master's Degree in Clinical area such as Counseling, Psychology, Social Work, or Behavioral Health Rehab from an accredited school, or from a school in candidacy status.
+ 3 years of experience working within an Inpatient Acute Behavioral Health environment providing Behavioral Health/psychiatric assessments to patients, or equivalent experience providing similar assessment, intake and referral functions for acute psychiatry services.
Preferred Qualifications:
+ 3 years of experience with payor established level of care criteria.
+ 3 years of Registrar and third party payor experience.
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
About the Team
Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.
Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 396200
Company: Providence Jobs
Job Category: Patient Services
Job Function: Clinical Support
Job Schedule: Part time
Job Shift: Day
Career Track: Clinical Support
Department: 5016 RS SHARED BH INTAKE
Address: OR Portland 4400 NE Halsey St
Work Location: Providence Health Plaza (HR) Bldg 1-Portland
Workplace Type: On-site
Pay Range: $33.63 - $52.22
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Auto-ApplyAssociate Counsel - South Division (Remote)
Irvine, CA jobs
Calling All Strategic Advisors! Are you a legal expert with a passion for healthcare and a strategic vision for the future? Join Providence St. Joseph Health as our Associate Counsel and become a key player in shaping healthcare delivery across our dynamic organization.
The Role:
The Associate Counsel at Providence St. Joseph Health (PSJH) is tasked with providing general legal services and overseeing specific projects under the guidance of Senior Corporate Counsel and Corporate Counsel. This role involves offering legal advice, consultation, policy analysis, and interpretation across various areas of law and policy. Key responsibilities include conducting research and analysis for policy recommendations, preparing written opinions and guidance for executive management and internal clients, and drafting and reviewing contracts, particularly for physician and vendor agreements. The Associate Counsel must stay updated on legal developments affecting hospital and physician requirements and ensure timely responses to client needs, with strong teamwork skills being essential.
What You'll Do:
+ Deliver strategic and pragmatic legal services across PSJH, ensuring practical resolutions to complex legal challenges.
+ Collaborate with Department of Legal Affairs (DLA) colleagues to provide timely and effective legal solutions under the supervision of Senior Corporate Counsel.
+ Serve as the primary legal contact for PSJH hospital administrative teams, addressing their legal needs and challenges.
+ Conduct research and draft legal opinions to resolve complex legal issues, working with senior attorneys on complicated matters.
+ Participate in the supervision and preparation of defense in non-malpractice litigation, developing strategies with outside counsel.
+ Stay informed of legal developments and deepen expertise in healthcare law areas like Stark Law, Anti-kickback Statute, and HIPAA.
+ Provide legal guidance to PSJH's corporate and community Boards.
+ Review and draft routine contracts independently and offer advice on complex contracts collaboratively.
+ Assist in creating presentations and summaries for ongoing legal education on regulatory changes.
+ Draft and review legal documents to ensure compliance with applicable regulations and policies.
+ Guide Providence's Integrity, Audit, and Compliance Services Department in investigations and policy development.
What You'll Bring:
+ Educational Requirement: A J.D. degree from an accredited law school or equivalent.
+ Experience: At least 2 years of experience in a healthcare-related legal field, such as private law firm, in-house legal setting or public/regulatory organization.
+ Bar Admission: Obtain admission to the California State Bar within one year of hire.
Why Join Us?
+ Impactful Work: Contribute to transforming healthcare through strategic legal leadership.
+ Professional Growth: Develop your expertise in healthcare law and collaborate with a dedicated legal team.
+ Collaborative Environment: Engage with PSJH's values and work alongside passionate professionals.
+ Dynamic Setting: Navigate a rapidly evolving industry and enjoy the challenge of impactful legal work.
If you're a strategic advisor with a passion for healthcare, we encourage you to apply and help shape the future of healthcare delivery at PSJH!
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 381314
Company: Providence Jobs
Job Category: Legal
Job Function: Legal/Compliance/Risk
Job Schedule: Full time
Job Shift: Day
Career Track: Leadership
Department: 4015 SS LEGAL
Address: CA Irvine 15480 Laguna Canyon Rd
Work Location: Providence System Offices Discovery Park-Irvine
Workplace Type: Remote
Pay Range: $79.52 - $127.13
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Auto-ApplyHospital Outpatient Coding Educator (1.0)
Remote
Work From HomeWork From Home Work From Home, Indiana 46544
The Hospital Outpatient Coding Educator is responsible for coordinating and conducting coding training and developing training content and materials for the Franciscan Alliance Corporate Coding Department, hospital outpatient and professional coding staff. This position ensures training practices are standardized and result in consistent coding outcomes, as well as provides input regarding the content of policies and procedures. This position ensures all new and existing staff members are trained and adhere to current coding policies and procedures.
WHO WE ARE
With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
Develops and maintains all corporate outpatient coding education, training policies and procedures, and coding reference materials.
Leads training sessions and assess coder comprehension of covered materials.
Makes recommendations for the development of coding resources and policy and procedure development.
Assists corporate coding leadership with training and/or development of a performance improvement track for coding coworkers in the corrective action process related to quality or productivity performance.
Coordinates with Coding Auditors to prepare education material based on audit results.
Develops and maintains a consistent coding operations orientation program, and reports the coders' progress to coding leadership throughout the orientation and training processes
Assists Coding Manager and Supervisor with review and response to external coding audits.
Acts as a nosologist, analyzing and interpreting disease, procedure classifications, and terminologies for the accurate translation of healthcare data.
Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability.
Ability to analyze information, make decisions and exercise independent judgement.
Serves as the subject matter expert with regards to diagnosis and procedure codes, coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payer specific guidelines, public reporting of outcomes, quality of patient care outcome measures, and the interpretation of coded data as it relates to revenue cycle compliance.
Participates in problem identification, performs root cause analysis and recommends a solution to Coding Management.
Assists with development and maintenance of software system workflow for standardization and maximum efficiency.
Oversees system testing with regards to any published software updates or software functionality changes
Identifies template variation within the EMR that has a negative impact on coding edits/errors.
Escalates trends and makes recommendations for template revisions/standardization to FAIS HIM team and Coding Leadership.
Coordinates all testing efforts with coding superusers and FAIS teams.
Assists with annual verification of coding staff credentials.
Orients new physicians with regards to the coding department's role in the revenue cycle, and prepare training material for coding related to physician education.
Assists with identification and implementation of process improvements according to industry best practice standards to make the best use of resources, decrease costs and improve coding services across the specialized service lines.
QUALIFICATIONS
High School Diploma/GED With 5 years of Franciscan coding experience - Required
or
Associate's Degree in Health Information Management - Required
Bachelor's Degree in Health Information Management - Preferred
Surgery Coding Experience - Required
5 Years Franciscan outpatient coding with CCS, CCS-P, CPC - Required
or
3 Years Outpatient Coding Experience with RHIT/RHIA - Required
3 Years Coding Manager or Trainer/Auditor - Preferred
CCS - Required
RHIT/RHIA - Preferred
TRAVEL IS REQUIRED:
Never or RarelyJOB RANGE:Coding Educator - Hospital Outpatient/Professional $51001.60-$75868.00INCENTIVE:
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
Auto-ApplyIntern - Epidemiology
Saint Louis, MO jobs
Additional Information About the Role BJC is hiring for an intern. We are looking for students who are currently pursuing a Masters in Public Health with emphasis in epidemiology. This is a 6 month to year duration and working up to 20 hours/week. It's mostly a remote position with some in person.
Overview
BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.
BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.
BJC's patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children's Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.
Preferred Qualifications
Role Purpose
To support department as special projects/needs arise.
Responsibilities
Provides general support to aide in the completion of department tasks, projects and programs Completes all tasks and projects proactively and independently.Produces presentations, spreadsheets and other documents.
Minimum Requirements
Education
High School Diploma or GED
Experience
No Experience
Supervisor Experience
No Experience
Preferred Requirements
Education
Enrolled-Undergrad degree prg
Benefits and Legal Statement
BJC Total Rewards
At BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
* Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
* Disability insurance* paid for by BJC
* Annual 4% BJC Automatic Retirement Contribution
* 401(k) plan with BJC match
* Tuition Assistance available on first day
* BJC Institute for Learning and Development
* Health Care and Dependent Care Flexible Spending Accounts
* Paid Time Off benefit combines vacation, sick days, holidays and personal time
* Adoption assistance
To learn more, go to our Benefits Summary.
* Not all benefits apply to all jobs
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer
Coding Policy Analyst *Remote*
Portland, OR jobs
Coding Policy Analyst _Remote_ The Coding Policy Analyst is responsible for the coordination of technically detailed work that has a significant impact on all operations and information systems within Providence Health Plan (PHP). This position will update and create Coding Policies and associated edit configurations within the PHP claims editing system. In addition, the Coding Policy Analyst will be responsible for replying to provider and member appeals and providing appropriate CPT, CMS, specialty society, Coding Policy, and/or other official documented rationale for Coding Policy edits. The analyst is responsible for monitoring changes to codes, coding guidelines and regulations, and coding edits from external agencies such as AMA, CMS, Medicaid, and specialty societies, and assists with implementation of such changes to the claims adjudication and editing software. This position requires extensive knowledge of AMA and CMS coding guidelines, policies, and regulations. This person will serve as a coding subject matter expert to other departments within PHP for questions about CPT, HCPCS, and ICD-10 codes, as well as coding guidelines and regulations. The analyst will work closely with the Benefits Management Team and Regulatory Department to ensure coding edits are applied in a manner consistent with member benefits and all state and federal insurance regulations.
Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
_Providence Health Plan welcomes 100% remote work for applicants who reside in the following states:_
+ Washington
+ Oregon
+ California
Required Qualifications:
+ Coding certification through AAPC (CPC) or AHIMA (CCS) upon hire.
+ 5 years of experience directly related to CPT coding from chart extraction with a health care provider, a health insurance company, or a capitated managed care company.
+ 5 years of excellent writing and grammar skills required.
+ 5 years of demonstrated experience in detailed coding applications, as well as Microsoft Office capabilities, such as Excel, Word, and Access.
Preferred Qualifications:
+ Bachelor's Degree or experience in a Healthcare or Health Plan setting coding and auditing will also be considered.
+ 2 years of experience with Facets Claims Adjudication system and/or Optum CES editing software.
Salary Range by Location:
California: Humboldt: Min: $33.05, Max: $51.30
California: All Northern California - Except Humboldt: Min: $37.08, Max: $57.56
California: All Southern California - Except Bakersfield: Min: $33.05, Max: $51.30
California: Bakersfield: Min: $31.71, Max: $49.22
Oregon: Non-Portland Service Area: Min: $29.56, Max: $45.88
Oregon: Portland Service Area: Min: $31.71, Max: $49.22
Washington: Western - Except Tukwila: Min: $33.05, Max: $51.30
Washington: Southwest - Olympia, Centralia & Below: Min: $31.71, Max: $49.22
Washington: Tukwila: Min: $33.05, Max: $51.30
Washington: Eastern: Min: $28.21, Max: $43.80
Washington: South Eastern: Min: $29.56, Max: $45.88
Why Join Providence Health Plan?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 403553
Company: Providence Jobs
Job Category: Coding
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 5018 HCS MEDICAL MANAGEMENT OR REGION
Address: OR Portland 4400 NE Halsey St
Work Location: Providence Health Plaza (HR) Bldg 1-Portland
Workplace Type: Remote
Pay Range: $31.71 - $49.22
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Auto-ApplyUtilization Review Coordinator
Remote
Work From HomeWork From Home Work From Home, Indiana 46544
The Utilization Review Coordinator performs admission screening for patients in a bed for medical necessity, and reviews for appropriateness of setting and utilization. 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 - 4:30pm CST
Perform concurrent reviews for appropriateness of utilization to optimize clinical and financial outcomes.
Communicate with physicians, patients, members of the Healthcare team, Coordinated Business Office staff, Denial Management staff, and third-party payors to justify the admission or continued stay.
Notify appropriate staff members of any admission, service, length of stay, lack of medical necessity criteria, as well as denials/appeals and issuing of letters to patients.
Provide Physician, Patient, Family, Staff and Student education.
Act as a resource person for the case management department regarding payer rules, regulations, policies and procedures, and utilization issues.
Perform admission necessity screening using criteria as established by the various federal, state and private sector programs.
QUALIFICATIONS
Associate degree in nursing/patient care required
Bachelor's Degree in nursing/patient care
preferred
Registered Nurse (RN - Indiana AND Illinois licensure) required
3 years of nursing/patient care experience required
2 years of Utilization or Case Management experience
preferred
Must reside within one hour of a Franciscan facility - required
TRAVEL IS REQUIRED:
Never or RarelyJOB RANGE:Utilization Review Coordinator $56971.20-$84749.60INCENTIVE: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.
Auto-ApplyManager Underwriting
Portland, OR jobs
Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team in and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
In support of Plan Association Health Plan & Small Group revenue, profitability and membership goals, the Manager, Underwriting of Association Health Plans and Small Group performs all duties in a manner which promotes the development of Underwriters reporting to this role, maximizing underwriting team dynamic and reflecting the Mission and values of the Plan. The Manager, Underwriting of Association Health Plans & Small Group collaborates with key leaders, consulting on technical underwriting and detailed, complex concepts and implementations while engaging the technical expertise of Underwriters, Actuaries and other Business partners both internal and external to the Plan. Oversees underwriting risk, analysis, pricing models, process and procedures for our Association Health Plans and Small Group commercial fully insured line of business. Maintains a high degree of efficiency and accuracy in all areas of responsibility. Assures that both internal and external service standards are tracked, and that there is effective team management of Service Level Agreements (SLAs). Facilitates a smooth integration with other functional areas within the Plan.
_Providence Health Plan welcomes 100% remote work for applicants who reside in the following states:_
+ Washington
+ Oregon
+ California
Required Qualifications:
+ Bachelor's Degree Finance, Mathematics, or related field.
+ 5 years Management experience in underwriting.
+ 5 years Experienced in developing processes, guidelines, procedures and policies in collaboration with other impacted areas.
+ 5 years Extensive Underwriting and consulting experience in large group (including self-funded and other funding arrangements and association business) and Medicare product lines.
Salary Range by Location:
California: Humboldt: Min: $50.32, Max: $79.45
California: All Northern California - Except Humboldt: Min: $56.46, Max: $89.13
California: All Southern California - Except Bakersfield: Min: $50.32, Max: $79.45
California: Bakersfield: Min: $48.27, Max: $76.22
Oregon: Non-Portland Service Area: Min: $45.00, Max: $71.05
Oregon: Portland Service Area: Min: $48.27, Max: $76.22
Washington: Western - Except Tukwila: Min: $50.32, Max: $79.45
Washington: Southwest - Olympia, Centralia & Below: Min: $48.27, Max: $76.22
Washington: Tukwila: Min: $50.32, Max: $79.45
Washington: Eastern: Min: $42.96, Max: $67.82
Washington: Southeastern: Min: $45.00, Max: $71.05
Why Join Providence Health Plan?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
Requsition ID: 402389
Company: Providence Jobs
Job Category: Underwriting
Job Function: Finance
Job Schedule: Full time
Job Shift: Day
Career Track: Leadership
Department: 5018 SALES UNDERWRITING OR REGION
Address: OR Portland 4400 NE Halsey St
Work Location: Providence Health Plaza (HR) Bldg 1-Portland
Workplace Type: Remote
Pay Range: $see posting - $see posting
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Auto-ApplyCharge Description Master Specialist *Remote - Most states eligible*
Tye, TX jobs
Charge Description Master Specialist \*Remote-Most states eligible* As a member of the PSJH System Revenue Integrity Chargemaster (RICDM) team, the CDM Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided. The CDM Specialist acts as the liaison between the Hospital ministry and the PSJH System Revenue Integrity/Chargemaster (RI/CDM Department), and researches CDM maintenance requests for adherence to the PSJH System standard CDM in a timely manner. The CDM Specialist responds to Hospital ministry inquiries regarding Chargemaster issues and is responsible for the training of Hospital ministry staff regarding the CDM Maintenance process, coding updates and charge capture improvement. The CDM Specialist is entry level RICDM position, and works collaboratively with other CDM Leads, Sr. Specialists and CDM Specialists, to research and resolve requests in a timely manner. The CDM Specialist uses available department CDM tools and resources to ensure chargemaster compliance. The CDM Specialist coordinates the daily CDM maintenance workflow between the PSJH System and the Ministries and monitors the alignment of the individual ministries to the PSJH System's standard CDM. The CDM Specialist is responsible for the documentation of all policies and procedures regarding CDM Maintenance and charge process. The CDM Specialist reviews clinical department charges to ensure Chargemaster and coding compliance. The CDM Specialist also coordinates with Hospital ministry, IS, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge interfaces.
Providence caregivers are not simply valued - they're invaluable. Join our team at Revenue Cycle Business Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
+ Bachelor's Degree in Healthcare, Sciences, Finance, Accounting or other related field of study, or an equivalent combination of education and experience.
+ Minimum 3 years of Hospital chargemaster experience, including the use of CDM Maintenance software and experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare reimbursement methodology. Knowledge of CPT, HCPCS and ICD10 coding principles.
+ 3 years experience with Hospital charging practices.
+ 2 years experience working with EMR related to Chargemaster, preferably EPIC (EAP).
Preferred Qualifications:
+ Upon request: Driving may be necessary as part of this role. Caregivers are required to comply with all state laws and requirements for driving. Caregivers will be expected to provide proof of driver license and auto insurance upon request. See policy for additional information.
+ 1-2 years Operational performance improvement and/or project management experience.
+ 1-2 years Coding experience.
Salary Range by Location:
AK: Anchorage: Min: $35.66, Max: $55.37
AK: Kodiak, Seward, Valdez: Min: $37.17, Max: $57.71
California: Humboldt: Min: $37.17, Max: $57.71
California: All Northern California - Except Humboldt: Min: $41.70, Max: $64.75
California: All Southern California - Except Bakersfield: Min: $37.17, Max: $57.71
California: Bakersfield: Min: $35.66, Max: $55.37
Idaho: Min: $31.73, Max: $49.27
Montana: Except Great Falls: Min: $28.71, Max: $44.57
Montana: Great Falls: Min: $27.20, Max: $42.23
New Mexico: Min: $28.71, Max: $44.57
Oregon: Non-Portland Service Area: Min: $33.24, Max: $51.61
Oregon: Portland Service Area: Min: $35.66, Max: $55.37
Texas: Min: $27.20, Max: $42.23
Washington: Western - Except Tukwila: Min: $37.17, Max: $57.71
Washington: Southwest - Olympia, Centralia & Below: Min: $35.66, Max: $55.37
Washington: Tukwila: Min: $37.17, Max: $57.71
Washington: Eastern: Min: $31.73, Max: $49.27
Washington: South Eastern: Min: $33.24, Max: $51.61
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
Requsition ID: 393906
Company: Providence Jobs
Job Category: Patient Financial Services
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 4001 SS RC CHARGE DECR MSTR
Address: TX Lubbock 3615 19th St
Work Location: Covenant Medical Center
Workplace Type: Remote
Pay Range: $see posting - $see posting
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Auto-ApplyClinical Program Coordinator RN, Medicare / Medicaid *Remote*
Moro, OR jobs
Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare / Medicaid who will:
+ Provide care coordination, case management and care management services to Providence Health Plans(PHP) members
+ Care coordination services include: disease management programs, including educating, motivating and empowering members to manage their disease
+ Case management services include: triage and referral, transition of care planning, end of life care planning, other acute and catastrophic case management These services are offered to members and their families who have acute and complex health care needs; members with chronic conditions at risk for poor health outcomes and members who are terminal and nearing end of life
+ Care management services include: nurse education, care coordination and general assistance with managing day to day functional needs; assisting with the management of member health plan benefits and offering assistance finding alternative services when benefits are exhausted
+ Work within the health plan framework of managing medical expenses
+ Work to improve access and quality care to our members
Providence Health Plan welcomes 100% remote work to residents who reside in the following States:
+ Washington
+ Oregon
Required qualifications for this position include:
+ 5+ years clinical nursing experience
+ Experience working with physicians in the collaboration and management of patient care
+ Current unencumbered Registered Nurse License in state of residency
Preferred qualifications for this position include:
+ Bachelor's Degree in Nursing or Health Education
+ Upon Hire: Current unencumbered Registered Nurse License in Oregon
+ Within six months of hire date: Current unencumbered Registered Nurse License in Washington State
+ Case Management Experience (EX. Triage and Referral, Transition of Care Planning, Discharge Planning, Coordination of Outpatient Care)
+ Utilization Management Experience (EX. Concurrent Review, Prior Authorization, Medical Audits, Appeals or Delegation)
+ Experience working in a health plan, medical insurance plan or another similar work environment
+ Current nursing experience in the following areas: chronic pain management, cardiology, endocrinology, pediatrics, obstetrics, oncology, respiratory, health education
Why Join Providence Health Plan?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 396568
Company: Providence Jobs
Job Category: Clinical Administration
Job Function: Clinical Support
Job Schedule: Full time
Job Shift: Multiple shifts available
Career Track: Nursing
Department: 5018 HCS CASE AND DISEASE GOV PRGM OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Work Location: Murray Business Ctr Beaverton-Beaverton
Workplace Type: Remote
Pay Range: $49.34 - $76.59
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Auto-ApplyPsychotherapist PRN (Remote)
Charlotte, NC jobs
Department:
02040 GCMG Behavioral Health Integration: Abbey Place - Behavioral Health
Status:
Part time
Benefits Eligible:
No
Hours Per Week:
0
Schedule Details/Additional Information:
PRN: Shift times vary by department needs, within business hours of M-F, 8a-7p.
Pay Range
$30.15 - $45.25
Essential Functions
Develops, implements and evaluates patient care according to identified needs.
Manages clients in crisis utilizing appropriate therapeutic skills and assessment techniques.
Writes appropriate treatment plans according to patient diagnosis, age and clinical presentation. Writes appropriate discharge plans based on individual needs of client and follows through with termination process.
Collaborates with appropriate guardians and community agencies to insure effective service delivery.
Completes patient care assignments with attention to detail and accuracy. Provides accurate and consistent documentation of patient care/response in the medical record. Completes accurate and timely billing information.
Designs, plans, implements effective patient education.
Maintains open lines of communication, collaborates with healthcare team for patient outcome.
Physical Requirements
Works in patient care areas including hospital units, emergency room, individual offices and conference areas with exposure to potentially combative and hostile patients. Work requires frequent moving from one area to another, answering pages, and coordinating and communicating with other staff persons in various disciplines and agencies.
Education, Experience and Certifications
Master's degree in a relevant human services field such as Social Work, Counseling, Psychology, or Marriage and Family Therapy from an accredited school of graduate education required. Full licensure in applicable state required. 2 years clinical experience required. CPI and CPR training required for psychotherapist working in inpatient psychiatric setting.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
Compensation
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
Benefits and more
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
Auto-ApplyCoder VI Specialist-Hospital Inpatient
Remote
Work From HomeWork From Home Work From Home, Indiana 46544The Coder VI Specialist- Hospital Inpatient analyzes the ICD 10 codes, suggested by computer assisted coding software, to ensure they align with official coding guidelines and the electronic medical record documentation. In collaboration with the Clinical Documentation Specialist, analyzes the circumstances of the visit to determine the most accurate diagnosis related group (DRG). This position also abstracts key data elements necessary for billing and data analysis.
WHO WE ARE
With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
Accurately reviews and codes patient records in the following clinical areas: hospital inpatient services.
Reviews and analyzes the content of medical records and the autosuggested computer assisted codes (CAC) for the appropriate assignment of ICD diagnosis/procedure codes, present on admission indicators, hierarchical condition categories, complication and comorbidities in the proper sequence in accordance with official coding resources resulting in an accurate DRG assignment.
Auditing the accuracy of the CAC software autosuggested codes.
Reviews clinical documentation to validate accurate representation of the patient's clinical picture, treatment, and diagnoses. Identifies when documentation relevant to the coding process is missing, lacks specificity or is inconsistent and take steps to obtain the documentation.
Identifies and enters data elements for abstracting.
Meets defined coding accuracy standards.
Meets defined coding productivity standards.
Basic understanding of how natural language processing engine works.
Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability.
Understands how diagnosis and procedure codes, and reimbursement methodologies are used to determine reimbursement, public reporting of outcomes, quality of patient care, financial modeling, strategic planning, and marketing.
Remains current with coding and industry changes through participation in educational opportunities to maintain coding credentials.
Demonstrates a thorough knowledge of hospital inpatient coding guidelines, medical terminology, anatomy/physiology, and payer specific coding guidelines.
Notifies coding leadership of trends and topics for education and feedback to physicians and departments.
Assists with identification and implementation of process improvements, according to industry best practice standards, to make the best use of resources, decrease costs and improve coding services across the specialized service lines.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.
Qualifications
Required High School Diploma/GED
Preferred Associate's Degree Health Information Management
Preferred Bachelor's Degree Health Information Management
2 years Coding Required
Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA)
Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA)
Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA)
TRAVEL IS REQUIRED:
Never or RarelyJOB RANGE:Coder VI Specialist - Hospital Inpatient $22.70-$33.77INCENTIVE:
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
Auto-ApplyPhysician - Remote Emergency Radiologist
Marshfield, WI jobs
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Physician - Remote Emergency RadiologistCost Center:201641261 System Radiology-ProfScheduled Weekly Hours:40Time Type:Full time Job Description:
Marshfield Medical Center is looking for a BC/BE Radiologist to join our ED section in Wisconsin.
Fellowship training in Body, Neuro, ED or MSK is required.
Must be comfortable with all emergent diagnostic imaging modalities including Neuro CTA/perfusion, trauma (including MRI), Ultrasound (including OB), pediatrics and occasional musculoskeletal MRI/CT.
No CVIR, nuclear medicine or mammography.
Choose to work remote as a Non-Associate on a casual contract or may have the option to work locally at one of our centers as an Associate physician with additional salary and benefits.
If working onsite, you will need to be comfortable with and will be responsible to occasionally perform some local minor procedures.
Service coverage includes a level 2 soon to be level 1 trauma center and stroke center as well as additional regional hospitals and urgent care centers.
Coverage needed for afternoons and evenings. No midnight shifts required.
Yearly work requirement is 182 shifts a year - typically 7 on/7 off schedule/26 weeks per year
Compensation/Benefits:
Competitive Salary
Flexible shift based model
Health, Dental, Life, and Occurrence Based Malpractice insurance
Relocation support available if working onsite
Marshfield Clinic Health System is a non-profit 501(c)(3) organization. This may qualify you for additional state and/or federal education loan forgiveness programs.
MCHS strongly encourages our physicians to be involved in medical education and research to continue building our strong foundation of patient care, research, and education for years to come.
Marshfield Clinic Research Institute: **********************************
Marshfield Clinic Division of Education: ******************************************
Marshfield, Wisconsin
Nestled in the heart of Wisconsin, Marshfield is a safe, clean community with a population of about 20,000 people. The region boasts a solid economy and a low cost of living, which includes below national average costs for housing and transportation. Community pride is evident in the private and city funds invested in making Marshfield a great place to live. Located one mile outside of town, you will have access to 6,500 acres for hiking, biking, hunting, canoeing, cross-country skiing, berry picking, and wildlife or bird watching or simply enjoying the fresh air. With excellent schools and high school graduation rates high above the national average, Marshfield is committed to offering and preparing students for top-notch educational opportunities. Those of us that have chosen to call Marshfield home have come to enjoy the benefits of short commutes, safe and friendly neighborhoods, fresh air and water, bountiful nature, and so much more. Come and see for yourself.
Fun Fact: Marshfield is known as the HEART of Wisconsin!
Marshfield Clinic Health System physicians and staff are motivated by our mission to enrich lives. We serve more than 350,000 unique patients each year through accessible, high quality health care, research and education. With more than 1,600 providers in 170 medical specialties and subspecialties as well as over 13,000 employees in 65 clinical locations in 45 communities serving Wisconsin and Michigan's Upper Peninsula, Marshfield Clinic Health System is nationally recognized for innovative practices and quality care.
The Marshfield Promise
Motivated by our mission to enrich lives, we use common values to ensure those we serve feel supported in their healthcare journey and staff and providers are actively engaged with one another. Together through our actions, we promise to deliver compassionate, safe and expert care to everyone.
The Marshfield Promise is centered around 5 core values; Patient-Centered, Trust, Teamwork, Excellence and Affordability.
For more information, please contact:
Lindsay Becker, Physician and Advanced Practice Clinician Recruiter
Phone: ************
***********************************
Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.
Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.
Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
Auto-ApplyRisk Adjustment Revenue Manager (Remote)
Marshfield, WI jobs
Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title:Risk Adjustment Revenue Manager (Remote) Cost Center:682891390 SHP-Strategic FinanceScheduled Weekly Hours:40Employee Type:RegularWork Shift:Mon-Fri; 8:00 am - 5:00 pm (United States of America) Job Description:
The Risk Adjustment Revenue Manager is responsible for risk adjustment strategy and related revenue management for Security Health Plan's Medicare, Affordable Care Act and Medicaid business. This individual provides development and implementation of programs and initiatives to improve the accuracy of the coding, including education; retrospective and prospective review processes; and vendor contract management; accountability for preparation for and management of the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Services (DHS) auditing processes; management of encounter data processes; and management of applicable state and federal guidance. The Risk Adjustment Revenue Manager works collaboratively with Security Health Plan executives and leadership as well as Marshfield Clinic Health System (MCHS) executives and leadership to lead risk adjustment strategy and process.
JOB QUALIFICATIONS
EDUCATION
Minimum Required: Bachelor's Degree in Business Administration, Finance, Health Care Administration, Management or related field required.
Preferred/Optional: Post graduate degree(s) desirable.
EXPERIENCE
Minimum Required: Five years of experience in risk adjustment or related area. Three years of experience in a management or leadership role and experience in the healthcare industry. Demonstrate a broad understanding of healthcare and health insurance. Demonstrate proficiency with verbal and written communication, strategic planning and business acumen.
Preferred/Optional: Working knowledge of CMS and/or Medicaid risk adjustment methodologies.
CERTIFICATIONS/LICENSES
The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.
Minimum Required: Certifications in professional coding and risk adjustment coding from American Academy of Professional Coders. State of Wisconsin driver's license with an acceptable driving record.
Preferred/Optional: None
Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.
Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.
Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
Auto-ApplyCoding Quality Auditor, HEDIS *Remote - Many States Eligible*
Lubbock, TX jobs
_Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them._
Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:
+ Be responsible for conducting clinical quality audits/overreads for the Quality Department
+ Identify and reports issues related to clinical audits to determine potential areas for quality improvement within the HEDIS project
+ Collect data by way of chart extraction, using objective specifications for the Healthcare Effectiveness and Data Information Set (HEDIS) program
+ Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab and pharmacy records
+ Be responsible for collecting data based on standardized methodologies
+ Organize the data to identify and address opportunities for improvement
+ Perform chart audits electronically during the audit season
+ Complete HEDIS training prior to performing chart abstractions
+ Be provided direction regarding charts requiring auditing
+ Maintain all collected records in a confidential manner
+ Performs all duties in a manner which promotes team concept and reflects the Sisters of Providence mission and philosophy
+ Communicate in a collaborative manner with clinic and other staff with whom they interact, in a manner that represents Sisters of Providence
_Please note the following important detail regarding this HEDIS Seasonal Role:_
+ This posting is for multiple openings of a Coding Quality Auditor, HEDIS
+ This position is affiliated with Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon
+ Position Type: Temporary, Per Diem, Non Benefitted
+ Length of Program Anticipated to last between: January 2026 - May 2026
+ Work Schedule: Monday - Friday
+ Work Hours Scheduled Weekly: 40
+ Additional Info:
+ This position will require a full time commitment to the project, meaning no extended time off during the HEDIS Season (January 2026 - May 2026)
+ Positions specified as "on call/per diem" refer to employment consisting of shifts scheduled on an "as needed basis" to fill in for staff vacancies.
Providence welcomes 100% remote work for applicants who reside in the following states:
+ Alaska
+ Washington
+ Montana
+ Oregon
+ California
+ Texas - Levelland, Lubbock or Plainview area
+ New Mexico
+ Alabama
+ Arizona
+ Delaware
+ Florida
+ Iowa
+ Idaho
+ Michigan
+ Minnesota
+ North Carolina
+ New Jersey
+ Utah
Required Qualification:
+ Technical certification/licensure in the area of Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse upon hire.
+ H.S. Diploma or GED.
+ 3 years - Medical record audit experience, experience with extraction of clinical data points from medical records, experience with electronic medical records (EMR), comfortable with use of technology. Ability to interpret and understand medical knowledge/terminology in a medical record.
+ 2 years - HEDIS, Quality management/quality improvement/utilization review auditing experience, including experience in auditing within electronic health records.
+ 1 year - Experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse (LPN).
Preferred Qualifications:
+ Associate's Degree - Nursing or Healthcare related field, Health Information Management degree.
+ Experience with health plans, project management, data analysis, and/or case review.
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 403837
Company: Providence Jobs
Job Category: Coding
Job Function: Revenue Cycle
Job Schedule: Part time
Job Shift: Multiple shifts available
Career Track: Business Professional
Department: 5018 HCS QUALITY MANAGEMENT OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Work Location: Murray Business Ctr Beaverton-Beaverton
Workplace Type: Remote
Pay Range: $See Posting - $See Posting
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Auto-ApplyData System Engineer III
Remote
Work From HomeWork From Home Work From Home, Indiana 46544
We are seeking a Site Reliability & DevOps Systems Engineer to design, automate, and maintain the infrastructure supporting our enterprise data and analytics platforms, including Power BI, Tableau, Databricks, and Epic Cogito.
This role bridges systems engineering, DevOps development, and data operations - ensuring our analytics ecosystems are resilient, automated, secure, and high-performing.
You will manage Azure DevOps and GitHub environments for CI/CD, infrastructure-as-code (IaC), and environment deployments, while collaborating with BI, data engineering, and cloud teams to standardize and optimize platform operations.
Data Systems Engineer III (DSE) is responsible for making intuitive, high-level decisions in designing data analytics infrastructure to extract and organize data for authorized individuals to access. Responsibilities include identifying a company's internal and external data sources, collaborating with department heads to determine their data needs and using the information to create and maintain data analytics infrastructure for company employees. Is responsible for software design and implementation for the development team. The Architect will design and develop a unified vision for software characteristics and functions, with the goal of providing a framework for the development of software or systems that result in high-quality IT solutions. DSE III takes direction and guidance from lead data systems architect and department leadership to work towards enhancement of self and the team's capabilities around data and analytic competencies. Mentors junior architects and guides users across the organization to promote data education and a data-driven culture in all aspects of clinical and business operation.
WHO WE ARE
With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
Facilitate the establishment and execution of the roadmap and vision for information delivery and management; including the modernizing the data platforms, on-prim and cloud data, BI & analytics, content management and data management
Work with stakeholders to understand their vision, challenges, and pain points.
Work with data and analytics experts to strive for greater functionality in our data systems; consults with data systems management teams to get a big-picture idea of the data needs.
Conduct detailed assessments of the data landscape including data platforms, technology architecture, data flows, data consumption, data integration and documentation
Identifying installation solutions for new databases; determining the requirements for a new database.
Develop future state architecture and process/data flows to realize the modern data strategy
Design modern data supply chain, and evaluate and recommend new tools and technologies
Guide the decision making of selecting cloud vs on-premise environments and assist with cloud service provider selection
Document and present data strategies to stakeholders, gain buy in, and grow strategic relationships
Assist in the development of capability roadmaps
Identifying areas for improvement in current systems; participate in setting objectives and scope, and developing a roadmap for the data initiatives that support the client leadership in meeting their objectives
Auditing database regularly to maintain quality; creating systems to keep data secure
Own the technical relationship with the client, be a technical subject matter expert and principal data evangelist across the planning efforts that intersect the data discipline.
Educate clients and internal constituents on the available technologies and general best practices.
Mentor others as they build complex strategy and solutions
Provide specialized expertise, cross-industry perspective, and thought leadership in big data, cloud, enterprise information management, and other next generation technology offerings
Provides maintenance and support; performs other duties, as assigned.
Qualifications
Required Bachelor's Degree Business, Computer Science, Engineering, Information Systems, Public Health, or related field
Preferred Master's Degree Computer Science, Business, Healthcare Management, Information Systems, or related field
6 years Systems, Application, and/or Database platforms administration experience with platforms such as Epic, SQL Server, Tableau, SAS, BusinessObjects etc. Experience architecting data management, analytics, business intelligence and application integration solutions. Required
TRAVEL IS REQUIRED:
Never or RarelyJOB RANGE:Data Systems Engineer III $82,931.74 - $114,031.14INCENTIVE:Not Applicable
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
Auto-ApplyInsurance Representative - Remote IA, MN, ND, SD
Lily, SD jobs
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Work Shift:
Day (United States of America)
Scheduled Weekly Hours:
40Salary Range: $16.00 - $25.50
Union Position:
No
Department Details
Flexible scheduling after training is completed. Fully remote/work from home.
Summary
The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement.
Job Description
Must understand and be able to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Proactively identifies and performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials. Uses advanced knowledge and understanding to process payer rejections. Conducts trend analyses, appeals and resolves low payment or underpaid accounts. Provides input for payer-specific meetings. Handles difficult account situations and resolves issues delaying or preventing payments from payers. Performs miscellaneous job related duties as requested. Consistently demonstrates accuracy in correcting (identified through pre-edits) and submitting claims to payers. Ensures accounts are billed in timely manner. Consistently reports to a manager any accounts that cannot be finished in a timely manner. When claims are disputed, consistently utilizes the correct resources to ensure the completion of the claim. Accurately and completely follows claim through entire billing process. Ensures all claims consistently meet compliance regulations. Demonstrates accountability by consistently using appropriate resources and channels to problem solve issues. Consistently demonstrates ability to input data accurately into the computer system. Consistently answers the telephone courteously. Maintains and updates computer skills as needed for work assignments. Demonstrates the ability to utilize software applications for maximum efficiency. Consistently ensures verbal communication is courteous, complete, and professional whether using phone or personal contact. Consistently ensures written communication is accurate, complete and professional in presentation whether word processing or using email. Identifies and promptly resolves billing complaints. Directs issues to supervisor when unable to resolve. Documents in computer system all contacts regarding patient accounts. Depending on location, may verify demographics, identify appropriate third-party insurance/payers, set up insurance, initiate patient financial assistance. Contact the insured or financially responsible party to obtain missing information. Verify, create or update patient accounts for billing, prepare insurance claims forms or related documents, and verify completeness and accuracy.
Qualifications
High school diploma or equivalent preferred; post-secondary or trade courses in accounting, business, and communications would be helpful for this position.
Six months' related work experience required. Computer skills essential.
When applicable and if desired, leadership may require related experience to the Associate Insurance Representative at Sanford Health for internal applicants.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
Auto-ApplyUPMC Enterprises & UPMC Clinical Marketing Intern
Pittsburgh, PA jobs
UPMC is seeking a motivated individual to join our team as an intern and gain hands-on experience in health care marketing and digital communications. In this role, you will contribute to high-visibility initiatives that elevate UPMC's clinical excellence, breakthrough research, and cutting-edge innovation.
You will collaborate with two dynamic teams: UPMC Enterprises Marketing, which supports the innovation and commercialization arm of UPMC by developing marketing strategies and communications that showcase emerging digital health solutions, artificial intelligence platforms, medical technologies, and life science ventures to investors, partners, and health care leaders; and UPMC Clinical Marketing, which develops compelling campaigns and educational content to promote UPMC's world-class clinical programs and services.
Together, these groups shape UPMC's mission to improve patient outcomes and define the future of medicine. As a marketing associate, you will help create impactful content, support strategic marketing campaigns, and tell powerful stories about health care innovation.
This internship offers valuable hands-on experience in a professional environment, with flexibility to work remotely up to two days per week depending on departmental needs. The paid internship will be at the hourly rate of $20/hour. Apply today!
Responsibilities:
+ Develop patient-centered stories and digital content for UPMC channels
+ Produce marketing materials such as physician profiles, brochures, and fact sheets
+ Draft and publish blog content for UPMC HealthBeat and UPMC Enterprises Insights
+ Assist with social media strategy, planning, and content creation
+ Assist in planning, organizing, and coordinating corporate events
+ Support multi-channel marketing campaigns across print, digital, and web platforms
+ Research industry trends and competitive positioning to inform strategy
+ Ensure brand consistency, accuracy, and compliance across all materials
+ Track, analyze, and report key campaign performance metrics
+ Contribute creative ideas during planning and brainstorming sessions
+ Current enrollment in a bachelor's or master's program in marketing, communications, journalism or business field preferred.
+ Looking for individuals entering their junior or senior year as well as those within a master's program.
+ Exceptional writing, editing, and storytelling skills with strong attention to detail preferred.
+ Familiarity with digital marketing tools and major social media platforms preferred.
+ Ability to manage multiple assignments and meet deadlines in a fast-paced environment.
+ Proficiency in Microsoft Office; experience with Canva or Adobe Creative Suite preferred.
+ Interest in health care, technology, innovation, and emerging digital trends.
+ Strong communication, organization, and collaboration skills.
+ Ability to work both independently and as part of a team.Licensure, Certifications, and Clearances:
+ Act 34UPMC is an Equal Opportunity Employer/Disability/Veteran
Associate Discharge Planner - Remote FT Days
Torrance, CA jobs
Under the general supervision of the Director, the Associate Discharge Planner supports the care management team by coordinating discharge planning and assisting with the operational functions of the department, ensuring efficient transitions for patients from hospital to home or alternative care settings.
Providence caregivers are not simply valued - they're invaluable. Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualification:
+ Clinical or administrative experience in healthcare industry.
Preferred Qualification:
+ Associate's Degree
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
Requsition ID: 403888
Company: Providence Jobs
Job Category: Behavioral Health
Job Function: Clinical Care
Job Schedule: Full time
Job Shift: Multiple shifts available
Career Track: Clinical Support
Department: 7000 UTILIZATION MGMT CA SOCAL
Address: CA Torrance 20555 Earl St
Work Location: Providence Administrative Offices-Earl Street
Workplace Type: On-site
Pay Range: $31.43 - $48.08
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Auto-ApplySenior Cyber Security Engineer - Network Security
Remote
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Work Shift:
Scheduled Weekly Hours:
40Salary Range: $40.00 - $66.00Pay starts at $40 and increases according to years of applicable experience.
Union Position:
No
Department Details
***Working remotely is an option if you currently live in SD, ND, MN, IA, NE or WI.
Required Skills and Qualifications:
Strong communication skills to explain complex concepts to various stakeholders
Excellent documentation skills for development of diagram, requirements, process mapping and overall design solutions
Strong team player with curious and flexible nature.
Strong understanding of network protocols (TCP/IP, OSI model) and network security concepts
Expertise in network switch, routing, and security technologies (firewalls, VPNs, IDS/IPS, etc.)
Experience with security frameworks and standards (NIST, CIS, ISO 27001)
Proficiency in scripting languages (Python, Perl, PowerShell)
Strong problem-solving and analytical skills
Excellent communication and interpersonal skills
Summary
Responsible for the technical and operational delivery of enterprise cybersecurity solutions. Focuses on the development and implementation of processes and tools for identifying, evaluating, implementing, troubleshooting, and maintaining technical security controls for the organization. These controls are designed to prevent, detect, and contain security threats; enabling Sanford to be productive while maintaining a secure environment that optimizes Sanford's return on investment.
Job Description
Lead the building, configuring, and maintaining of cybersecurity systems to ensure our operational environments stay compliant and secure. Implements security controls using industry best practices across numerous technologies including, but not limited to SIEM, email filtering, web and content filtering, firewall, IPS/IDS systems, identity and access management, SSO/MFA, vulnerability management, and data protection. Skillfully maintains the existing security systems, including implementing new features, performing upgrades, and managing technical configurations/policies across a variety of business-critical systems. Proficiently monitors and responds to security system health alerts. Respond to day-to-day operational work such as managing security tools while simultaneously multitasking with strategic project initiatives.
Provide security consulting services to other Sanford health groups. Provide assistance to a 24x7 team of dedicated security engineers focused on maintaining operational stability while reducing risk. Build and maintain key vendor and supplier relationships. Lead strategic project initiatives ensuring the processes and procedures are well defined and documented. Recognize both internal and external threats and understand/communicate risks to Sanford Assets. Make strategic recommendations to enhance and improve overall security posture. Advise on methods to increase efficiency of current toolsets (such as script automation or process improvement recommendations). Mentor others within the team as well as receive instruction and guidance from others within the team. Write documentation that can be used by all team members and other employees. Identify gaps in established/documented process and update as needed.
Works under limited guidance due to previous experience/breadth of knowledge of processes and organizational knowledge. Acts independently to determine methods and procedures on new assignments. Regularly presented with new assignments and projects that require the application of independent judgement/interpretation of policies/practices. Checks own work and the work of other team members.
Qualifications
Bachelor's degree in cyber security or an information technology related field.
Minimum of 4 years experience working in Cyber Security field.
Security Certifications (CISSP, CISA, CISM, Security+, CEH, etc.) are highly desired
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call ************** or send an email to ************************.
Auto-ApplyCoding Policy Analyst *Remote*
Moro, OR jobs
Coding Policy Analyst _Remote_ The Coding Policy Analyst is responsible for the coordination of technically detailed work that has a significant impact on all operations and information systems within Providence Health Plan (PHP). This position will update and create Coding Policies and associated edit configurations within the PHP claims editing system. In addition, the Coding Policy Analyst will be responsible for replying to provider and member appeals and providing appropriate CPT, CMS, specialty society, Coding Policy, and/or other official documented rationale for Coding Policy edits. The analyst is responsible for monitoring changes to codes, coding guidelines and regulations, and coding edits from external agencies such as AMA, CMS, Medicaid, and specialty societies, and assists with implementation of such changes to the claims adjudication and editing software. This position requires extensive knowledge of AMA and CMS coding guidelines, policies, and regulations. This person will serve as a coding subject matter expert to other departments within PHP for questions about CPT, HCPCS, and ICD-10 codes, as well as coding guidelines and regulations. The analyst will work closely with the Benefits Management Team and Regulatory Department to ensure coding edits are applied in a manner consistent with member benefits and all state and federal insurance regulations.
Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
_Providence Health Plan welcomes 100% remote work for applicants who reside in the following states:_
+ Washington
+ Oregon
+ California
Required Qualifications:
+ Coding certification through AAPC (CPC) or AHIMA (CCS) upon hire.
+ 5 years of experience directly related to CPT coding from chart extraction with a health care provider, a health insurance company, or a capitated managed care company.
+ 5 years of excellent writing and grammar skills required.
+ 5 years of demonstrated experience in detailed coding applications, as well as Microsoft Office capabilities, such as Excel, Word, and Access.
Preferred Qualifications:
+ Bachelor's Degree or experience in a Healthcare or Health Plan setting coding and auditing will also be considered.
+ 2 years of experience with Facets Claims Adjudication system and/or Optum CES editing software.
Salary Range by Location:
California: Humboldt: Min: $33.05, Max: $51.30
California: All Northern California - Except Humboldt: Min: $37.08, Max: $57.56
California: All Southern California - Except Bakersfield: Min: $33.05, Max: $51.30
California: Bakersfield: Min: $31.71, Max: $49.22
Oregon: Non-Portland Service Area: Min: $29.56, Max: $45.88
Oregon: Portland Service Area: Min: $31.71, Max: $49.22
Washington: Western - Except Tukwila: Min: $33.05, Max: $51.30
Washington: Southwest - Olympia, Centralia & Below: Min: $31.71, Max: $49.22
Washington: Tukwila: Min: $33.05, Max: $51.30
Washington: Eastern: Min: $28.21, Max: $43.80
Washington: South Eastern: Min: $29.56, Max: $45.88
Why Join Providence Health Plan?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act."
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID: 403553
Company: Providence Jobs
Job Category: Coding
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 5018 HCS MEDICAL MANAGEMENT OR REGION
Address: OR Portland 4400 NE Halsey St
Work Location: Providence Health Plaza (HR) Bldg 1-Portland
Workplace Type: Remote
Pay Range: $31.71 - $49.22
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Auto-Apply