Public Health - Dayton & Montgomery County jobs - 30 jobs

COMMUNITY HEALTH: Community Health is a primary care network that provides nationally-recognized programs, a focus on wellness, dental, behavioral health and pediatric specialties, walk-in Express Care, a culture of community and quality health care that almost everyone, insured or uninsured, has come to depend on. As an equal opportunity employer, we offer a team-oriented, collaborative work environment for close to 400 employees at eight different locations in Rutland and southern Addison counties. POSITION SUMMARY The A/P and Payroll Specialist is responsible for processing check requests and check disbursements. Answering inquiries from vendors, suppliers, employees and researching discrepancies. Records transactions on internal systems and reconciles applicable financial statements. Proactively resolves escalated/exception invoices and issues with assistance/guidance from Controller as needed. In addition, processes payroll for all CHCRR employees. RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO: Enters invoices and check request forms into Community Health's accounting system Distributes payments to appropriate vendors, requestors Manages the manual 340B pharmaceutical accounts Answers payment inquiries and processes associated correspondence Updates and maintains vendor files Troubleshoots issues and as needed collaborates with finance leader to resolve issues Ensures that all Community Health policies, processes and procedures related to accounts payable are followed Process payroll Balance payroll - including posting checks, general ledger entries for payroll taxes and direct deposits, downloading batches from payroll system and balancing before processing Assists with preparing general ledger entries and preparing monthly financial statements (Standard, McKesson, Credit Cards Create and run payroll reports as needed KNOWLEDGE, SKILLS & EDUCATION: High school diploma/GED Associates degree preferred in accounting or business administration. Minimum of one year experience in accounting, finance and /or auditing. Preferably in a health care organization. Knowledge of accounting principles Knowledge of computer systems relevant to the position including payroll system, Microsoft office products including use of Excel spreadsheets. Must be able to perform mathematical calculations, identify and resolve accounting problems, accurately report accounting information, strong attention to detail and be able to establish and maintain effective working relationships. Proficiently use accounting computer system, Microsoft Office products and/or other computer systems; willing and able to learn new systems. Works well in group problem solving situations. HOW WE SUPPORT YOU: Work Life Balance Generous Time Off Medical, dental, and vision insurance. Health savings account option. Robust 403 (b) retirement savings plan, with employer match and 100% vesting schedule. Comprehensive Wellness Program.

Additional Information About the Role BJC HealthCare is hiring a Full-time Certified Medical Dosimetrist at our Barnes Jewish Hospital Center for Advanced Medicine located in St. Louis, MO!!! Must reside in MO or IL and able to come onsite if needed * Hybrid * Day Shift, M-F, 40 hours per week (Flexible 5-8's or 4-10's) * No Weekends! No Call! * Active Certified Medical Dosimetrist license, RTT preferred Overview Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center. Staff in the Radiation Oncology Department work with leading experts from the Siteman Cancer Center, the first and only National Cancer Institute designated comprehensive cancer center in the St. Louis region. With a staff of approximately 250 medical and allied health professionals, the department of Radiation Oncology offers its hospital staff the opportunity to work in a cutting-edge environment focused solely on delivering exceptional and uncompromising patient care. Preferred Qualifications Role Purpose Performs treatment planning and dosimetry computations, including CT simulations, encountered in daily clinical physics activities as requested by the Radiation Oncologist. Responsibilities Designs a treatment plan with optimal beam geometry to deliver a prescribed radiation dose and spare critical structures in accordance with the Radiation Oncologist's prescription.Provide assistance and technical support to the Medical Physicist, in radiation safety and protection and quality assurance of treatment plans. Operates and performs quality assurance, under the direction of the Medical Physicist and Radiation oncologists. Adheres to Department Quality Assurance Guidelines.Localizes implant sources and special interest dose points.Communicate with the radiation therapist(s) and assume an advisory role in the implementation of the treatment plan including: the correct use of immobilization devices, compensators, field arrangement, and other treatment or imaging parameters. Minimum Requirements Education Associate's Degree - Physical Sci/Health related Experience Supervisor Experience No Experience Licenses & Certifications Certified Medical Dosimetrist Preferred Requirements Education Bachelor's Degree - Physical/Biological Science 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

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Remote Option; Available for any of Partners' NC locations Projected Hiring Range : Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: This position is responsible for ensuring that providers receive timely and accurate payment. Role and Responsibilities: 50%: Claims Adjudication Responsible for finalizing claims processed for payment and maintaining claims adjudication workflow, reconciliation and quality control measures to meet or exceed prompt payment guidelines. Responsible for reconciling provider claims payments through quality control measures, generally accepted accounting principles and agency's policies and procedures. Assess Title XIX and non-Title XIX claims adjustments for correction or recoupment and will coordinate the recoupment process to ensure payment is recovered for inappropriately paid claims. Provide back up for other Claims Analysts as needed. 40%: Customer Service Maintain provider satisfaction by being available during regular business hours to handle provider inquiries; interacting in a professional manner; providing information and assistance; and answering incoming calls. Assist providers in resolving problem claims and system training issues. Serve as a resource for internal staff to resolve eligibility issues, authorization, overpayments, recoupments or other provider issues related to claims payment. 10%: Compliance and Quality Assurance Review internal bulletins, forms, appropriate manuals and make applicable revisions Review fee schedules to ensure compliance with established procedures and processes. Attend and participate in workshops and training sessions to improve/enhance technical competence. Knowledge, Skills and Abilities: Working knowledge of the Medicaid Waiver requirements, HCPCS, revenue codes, ICD-10, CMS 1500/UB04 coding, compliance and software requirements used to adjudicate claims General knowledge of office procedures and methods Strong organizational skills Excellent oral and written communication skills with the ability to understand oral and written instructions Excellent computer skills including use of Microsoft Office products Ability to handle large volume of work and to manage a desk with multiple priorities Ability to work in a team atmosphere and in cooperation with others and be accountable for results Ability to read printed words and numbers rapidly and accurately Ability to enter routine and repetitive batches of data from a variety of source documents within structured time schedules Ability to manage and uphold integrity and confidentiality of sensitive data Education and Experience Required: High School graduate or equivalent and three (3) years of experience in claims reimbursement in a healthcare setting; or an equivalent combination of education and experience. Education and Experience Preferred: N/A Licensure/Certification Requirements: N/A

Additional Information About the Role St. Louis Children's Hospital has a full-time opportunity for a Documentation Specialist. Perfect for someone with experience working with insurance portals to verify benefits. Fast-paced and able to work independently, which requires excellent time-management and communication skills. * Full-time; benefits eligible * Mon-Fri 8am-5pm * Work from Home Overview St. Louis Children's Hospital is dedicated to improving the health and lives of children. As one of the top-ranked children's hospitals in the country, St. Louis Children's provides care in more than 50 specialty areas through a dedicated team of physicians, nurses, staff and volunteers. Along with inpatient and outpatient medical care, the hospital offers education, wellness and injury-prevention programs to fulfill its mission to "do what's right for kids." Providing comprehensive, high-quality care and serving as an advocate for children has been St. Louis Children's commitment since its inception in 1879. Today, the hospital serves patients and families across a 300-mile service area, and has seen patients from all 50 states and more than 80 countries. St. Louis Children's consistently ranks among America's Best Children's Hospitals by U.S.News & World Report in all surveyed categories. In 2021, St. Louis Children's was one of eight children's hospitals to rank in the top 25 of all 10 specialties. The hospital's academic and physician partner, Washington University School of Medicine, is one of the top-ranked medical schools in the United States. Since 2005, St. Louis Children's has been designated as a Magnet hospital for nursing excellence from the American Nurses Credentialing Center (ANCC). Preferred Qualifications Role Purpose Identifies documentation problem areas and creates audits directed at monitoring performance improvement in these areas. Obtain pre-certification for clinical areas and any home care needs. Provides assistance with pre-certification for inpatients that require testing as outpatients. Responsibilities Studies existing agency policies and interviews agency personnel to evaluate effectiveness of quality improvement programs.Facilitates all policies and procedures applicable to documentation process.Develops educational materials to educate team members.Compiles statistical data and creates reports summarizing audit findings as requested.Coordinate initiation of authorization for testing for inpatients and obtain authorization for transport services for patients being transferred to another facility or home. Minimum Requirements Education High School Diploma or GED Experience Supervisor Experience No Experience Preferred Requirements Education Associate's Degree Licenses & Certifications Licensed Practical NurseRN 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

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all withheart, each and every day. Title: Medical Scribe Company: Oak Street Health Location: 7040 E Golf Links Rd Tucson, AZ 85730 Role Description: The purpose of a Clinical Informatics Specialist (CIS or Medical Scribe) at Oak Street Health is to support our primary care providers with clinical documentation so that they can focus on providing exceptional care to our patients. Scribes assist providers throughout the patient care journey - huddling each morning to plan for the day's visits, joining them in the exam room to observe and document, and touching base after the visit to assist with next steps. Beyond the typical Scribe role, these important care team members serve as clinical documentation assistants to their paired provider. Internally, we call them CISs (Clinic Informatics Specialists) in recognition of their important role in supporting accurate, specific, and timely clinical documentation. In addition to observing and documenting all patient encounters in real time, our Scribes become experts in our value-based care model and the documentation and care of chronic conditions, including ICD-10 and CPT coding. Scribes use this expertise to help providers identify and help close care gaps. Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. Because our patients and providers rely on our Scribes, the ideal candidate should commit at least 1-2 years to this role. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields. Responsibilities: Documenting Patient Encounters ~ 80% Joining the provider in the exam room to observe patient visits Documenting patient encounters in a structured note, including the history of the present illness, assessment, plan, and physical exam Assigning appropriate CPT and ICD-10 codes Preparing After Visit Summaries Consulting with provider to ensure accurate and specific documentation Clinical Documentation Improvement ~ 10% Requesting and reviewing medical records Leveraging Oak Street's population health tools to support clinical documentation improvement Preparing for and supporting Daily Huddles and Clinical Documentation Reviews Consulting with provider on clinical documentation opportunities Administrative support for your provider and care team ~ 10% Placing orders and referrals Addressing tasks Supporting the care team with additional responsibilities related to clinical documentation Other duties as assigned What we're looking for Knowledge Knowledge of medical terminology and common medications, either from a pre-medical degree or prior clinical experience [required] Prior clinical experience, including shadowing and/or volunteering [strongly preferred] Prior scribe or transcription experience [preferred but not required] Skills Advanced listening and communication skills [required] Strong computer literacy and ability to learn new technical workflows [required] Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve [required where indicated] Abilities Ability to adapt to new workflows and to quickly learn new concepts and skills [required] Ability to type 70+ words per minute [strongly preferred] Ability and willingness to take direction and be a member of a team providing patient care, including adapting to the provider's working style [required] Ability to be a self-starter within your role scope Excellent job attendance including ability to work in-person in our clinics (Our providers count on you.) [required] Ability to commit to at least 1 year in role (2+ is ideal) [required] Ability to work approximately 40-45 hours per week during clinic hours (full time position) with predictable hours and break times [required] Compliance with hospital and Oak Street Health policies, including HIPAA [required] US work authorization [required] Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $25.65 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit We anticipate the application window for this opening will close on: 03/19/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Available for any of Partners locations; Remote Option Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Provider Engagement & Outreach Specialist serves as a liaison between Partners Health Management and healthcare/physical health providers to drive quality improvement, practice transformation, and provider engagement. This role supports physical health providers in implementing evidence-based workflows, optimizing care delivery models, and aligning with value-based care initiatives. The Specialist also leads outreach efforts to foster collaborative relationships, deliver educational resources, and support providers in meeting performance and compliance benchmarks. Roles and Responsibilities: Support medical providers in transforming care delivery through implementation of patient-centered medical home (PCMH), value-based care models, and quality improvement initiatives. Engage directly with providers and healthcare teams across North Carolina to build strong partnerships, understand their unique challenges, and provide tailored assistance Conduct on-site and virtual practice visits to assess workflows, identify improvement opportunities, and provide technical assistance and resources. Analyze and utilize performance data (e.g., HEDIS, Medicaid measures) to collaborate with providers to design targeted interventions that improve care quality and patient outcomes. Assist practices with change management strategies to enhance patient outcomes and operational efficiency Act as a liaison in supporting providers in adopting value-based care practices, that enhance clinical efficiency and patient outcomes Develop and disseminate outreach materials, toolkits, and communication strategies to strengthen provider relationships. Stay abreast of emerging best practices, payer requirements, and regulatory changes affecting provider performance and transformation. Deliver training and coaching on practice transformation topics, data use, and workflow redesign Track provider progress, document interactions, and report outcomes and barriers to leadership for continuous program improvement. Work directly with physicians, clinical teams, and administrative staff to improve care delivery, enhance patient outcomes, and increase performance. Collaborate with internal stakeholders to align resources and interventions Support practice transformation initiatives that drive sustained improvements in care quality and operational efficiency Work with providers to encourage preventive service utilization and effective chronic condition management among their patient populations Assist clinicians achieve measurable improvements in health outcomes and patient satisfaction by fostering patient engagement and adherence to recommended care plans Knowledge, Skills and Abilities: • Deep understanding of value-based care models, and healthcare quality programs. • Experience in healthcare practice transformation, care delivery redesign or clinical operations • Experience engaging and coaching clinical teams (physicians, nurses, and practice managers) • Familiarity with health equity initiatives and strategies to address social drivers of health. • Experience in Project Management and familiarity in process mapping and workflow analysis tools. • Knowledge of and ability to explain and apply the provisions of contractual practices adopted by Partners Health Management and required by NC Division of Health Benefits. • Demonstrate working knowledge of HEDIS quality measures and reporting requirements to support accurate provider education and engagement • Collaborate with providers and internal teams to close care gaps and ensure compliance with HEDIS and other quality initiatives. • Experience working with large multi-site practices. • Ability to analyze clinical and operational data to drive improvement initiatives. • Excellent facilitation and project management skills and familiarity in process mapping and workflow analysis tools. • Strong problem solving, decision-making and negotiating skills. • Exceptional interpersonal skills and strong written and verbal communication skills. • Excellent organizational skills. • Ability to multi-task and meet deadlines. • Considerable knowledge of the laws, regulations and policies that govern the program, which includes and is not limited to contractual requirements adopted by NC Division of Health Benefits and other governmental oversight agencies. • Strong problem solving, negotiation, arbitration, and conflict resolution skills. • Excellent computer skills and proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint. • Demonstrated ability to verify documents for accuracy and completeness; to understand and apply laws, rules and regulations to various situations; to apply regulations and policies for maintenance of consumer medical records, personnel records, and facility licensure requirements. • Ability to make prompt independent decisions based upon relevant facts. • Ability to establish rapport and maintain effective working relationships. • Ability to act with tact and diplomacy in all situations. • Ability to maintain strict confidentiality in all areas of work. • Experience with Electronic Health Records (HER) for clinical processes Education and Experience Required: Bachelor's degree and a minimum of four years of experience in managed care or a related field with a healthcare provider or insurer/payer. Relevant areas may include provider relations, network development or design, provider engagement services, contract management, or patient financial services. Experience in auditing, accounting, or finance is also applicable. A combination of relevant education and experience may be considered in lieu of a Bachelor's degree. Must be able to travel as required. 4 years of significant and relevant work experience in medical practice management in lieu of educational requirements may be accepted, particularly with significant administrative experience in a clinic setting. Must have the ability to travel as indicated. Other requirements: Must reside in North Carolina or within 40 miles of the NC border. Education and Experience Preferred: Bachelor's degree in Nursing, Public Health, Healthcare Administration, or a related field (Master's degree preferred). Deep understanding of value-based care models, healthcare quality programs, and population health initiatives. Demonstrated experience in practice transformation roles and practice support. Licensure/Certification Requirements: None

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Hybrid option; Available for the Gastonia, NC location Closing Date: Open Until Filled Primary Purpose of Position: To provide executive-level paralegal and administrative services for the Office of Legal Affairs (OLA), including Chief Legal Officer/General Counsel (CLO/GC), Director of Legal Services, staff attorney(s), legal specialist(s) and waiver contract manager. Highly collaborative culture. Under licensed-attorney supervision where required, this position entails professional legal work in a variety of legal/operational areas or functions, including but not limited to legal research; and drafting, reviewing, proofing and communicating legal/regulatory matters regarding litigation, transactions/contracts, regulation, legislation, internal and external dispute resolution, grievances/complaints, and related legal projects. As detailed further below, key role will be managing Partners many complex policies and procedures (P&Ps), as well as program descriptions, plans and even assisting with board guidelines. In addition, position will require successful applicant to field, route and/or address (or to ensure attorney and/or OLA team addresses) legal issues and questions from various Partners' business units and staff. Examples of work include coordinating all aspects of the internal Policy and Procedure process (with assistance of waiver contract manager); preparation and occasional participation in board level and committee meetings; assist legal team with their projects, including, e.g., key OLA metrics and ensure monitoring, prompt routing, payment and reimbursement of legal bills and expenses. Works with extremely sensitive and confidential information and records. Perform other duties as needed consistent with an executive level paralegal. Work closely with Associate General Counsel, Director of Legal Services, Waiver Contract Manager, Legal Specialist, Program Integrity Director, and their teams, also located in OLA. Position reports directly to Director of Legal Services. NOTE: Representation of Partners in a court of law and other acts constituting the practice of law are the responsibilities of attorneys in or for OLA. Position will cooperate with, assist and take significant responsibility for preparation of work by attorneys, but have no authority to act as legal counsel for Partners or to practice law without a license. Role and Responsibilities (percentages are approximations): 50% Policies and Procedures (P&Ps): With assistance and guidance of waiver contract manager, will be directly responsible for Partners' almost 300 P&Ps, that must be regularly reviewed, vetted and approved by management, leadership and Board. This includes oversight of revision and creation of P&Ps by Partners' staff for accreditation, certification, contract and regulatory compliance. Also, can include Program Descriptions, Plans and perhaps assisting with board guidelines. Assist with and/or manage automation and process improvement of P&Ps. As detailed below, this role requires extensive organizational skills, knowledge and comfort with software, critical thinking, and strong writing and collaborative communications skills. 35% Traditional Paralegal Services: With assistance from attorneys, legal specialists, waiver contract manager, and program integrity investigators, provides moderate to complex legal support services. Examples include: performing legal research, both formal from traditional legal research databases (currently Lexis) and from non-traditional resources such as State and Federal legislative and regulatory websites. assisting with obtaining, reviewing, proofing, executing and interpreting contracts and transactions. assisting with drafting, review, proofing and issuing communications with staff, outside counsel and opposing counsel regarding contracts, litigation (subpoenas, hearing notices, pleadings, motions) and related legal projects; assisting with or fielding, routing and and/or addressing legal issues and questions from various Partners' business units and staff, and/or ensuring appropriate OLA staff does so; attending and or assisting attendees with key meetings, hearings and conferences, providing insights to and taking notes for OLA team and Partners. gather, organize and marshal on demand relevant documents, information and evidence to support OLA work and obligations. liaising with Program Integrity staff on legal matters arising to legal staff from or related to investigations of alleged fraud, waste and abuse; consulting OLA attorneys for supervision on matters and in any instance that might be construed as the practice of law. 10% Administrative Support: Provides comprehensive and often sophisticated/complex administrative support to OLA team. Examples include assisting OLA staff or directly to: maintain OLA legal files and records. create, maintain, analyze and report key OLA metrics using various OLA-specific resources and interdepartmental support. routing, payment and reimbursement of legal bills and expenses, including potential assistance with the OLA legal matters management and invoicing software and database (currently CounselLink). communicate with outside counsel regarding pending assigned cases and legal matters, billing guidelines and other needs. coordinate and support highly visible functions and events, including preparation for board, executive, management level and other meetings; provider forums, council and other meetings; legal trainings; and other events involving Team OLA. reserve and arrange meeting space, including IT needs. schedule and coordinate select conference calls, meetings, mediations, and hearings. handle staff expense reimbursements, travel reservations, supplies and miscellaneous OLA operational matters. 5% Other Duties as Assigned: In all roles and responsibilities, assures confidentiality of information of a sensitive nature within the department and organization. Adheres to court, regulatory, Partners' and other deadlines. Highly organized and digitally proficient, and able to multitask in fast-paced, detail-oriented -- but highly collaborative, team-oriented and cross-functional -- environment. Maintains a thorough understanding of legal procedures and documents. Able and authorized to exercise good judgment in a variety of situations when communicating directly with persons within and outside Partners, including leadership, healthcare professionals, attorneys, judges, regulators and others. Strong oral and written communication skills essential. Significant attention to accuracy. Excellent people skills. Knowledge, Skills and Abilities: Considerable knowledge of the principles and practices of NC administrative law specifically and general knowledge of the laws, rules, and regulations applicable to LME/MCOs. Ability to maintain effective working relationships with the public and other persons contacted in the course of work. Ability to anticipate and timely meet deadlines and projects. Considerable knowledge of office practices, techniques, and technology. Working knowledge of and the ability to understand legal documents, contractual language, legal processes and other complex or sophisticated topics and materials. Excellent communication skills, both orally and in writing. Detail oriented with excellent organizational skills, including ability to manage multiple schedules and tasks. Proficiency in Word, Excel, Outlook and PowerPoint, including the ability to design reports and presentations for internal and external recipients; excellent typing skills. Proficiency in law-related and P&P software and database resources, including or comparable to LexisNexis and CounselLink. Ability to manage and uphold integrity and confidentiality of sensitive data, internally and externally. Ability to analyze, understand, and complete tasks related to state and federal rules, regulations and laws. Ability to establish and maintain effective, positive working relationships with staff, other members of the organization and stakeholders. Ability to analyze, interpret and recommend policy, rules, and procedural guidelines. Ability to complete non-routine activities and tasks that might require deviation from established procedures; must be able to choose the appropriate course of action and recognize the existence of and differences among situations; sound judgment and critical thinking. Ability to plan and carry out the day-to-day work of the office based on priorities and knowledge of the departments; and Ability to recognize sensitive or unusual situations that should be referred to another more appropriate staff member or to the supervisors. Commitment to Partners' core culture values. Education and Experience Required: A minimum experience of two years in a law-related role with law firm or law department. Working knowledge of legal database software, e.g., LexisNexus or Westlaw. Extensive knowledge and proficiency of Microsoft Office products (Word, Excel, Outlook, PowerPoint, etc.). Comfort and experience with electronic modes of communication, filing, record keeping and office management. While not frequent, must have ability to travel between counties. Must reside in North Carolina or within 40 miles from its border. Education and Experience Preferred: Associate or higher degree in Legal Studies, Business, Office Administration, Healthcare, Human Services or other relevant field, including, paralegal/legal studies, Criminal Justice, Political Science, or legal assistant. Experience in healthcare, especially public behavioral health, managed Medicaid, and healthcare payor systems and law. Knowledge of and experience/proficiency with LexisAdvance, CounselLink, WestLaw and e-OAH. Substantial prior paralegal, legal assistant or related working experience or credentialing highly preferred, especially certification as paralegal or legal assistant, e.g., NCCP. Licensure/Certification Requirements: Paralegal, Legal Assistant, or similar recognized certification, e.g. NCCP (out of state certification acceptable). Law license not required. JDs welcomed to apply but should not expect promotion to attorney position with or without license.

**City/State:** Saint Louis, Missouri **Categories:** Legal and Audit **Job Status:** Full-Time **Req ID** : 99993 **Pay Range:** $57,304.00 - $93,288.00 / year (Salary or hourly rate is based on job qualifications and relevant work experience) **Additional Information About the Role** + Remote opportunity! + Experience with analyzing provider data and training on current billing guidelines to identify trends is a plus! + Previous auditing experience of evaluation and management and surgical procedures is preferred! + Working knowledge of EXCEL and MS Publisher. **Overview** **BJC Medical Group** is the multi-specialty physician-led organization of BJC HealthCare and includes over 600 doctors and advanced practice providers who are affiliated with top-ranked hospitals in the Midwest region. Since 1994, BJC Medical Group has provided access to extraordinary care in over 145 locations and over 25 specialties in the greater St. Louis, mid-Missouri and southern Illinois areas. Our providers are nationally recognized for excellent patient satisfaction, quality health care, and improving the health and well-being of the communities we serve. The Quality and Compliance Department provides support to the strategic and operational objectives of BJC Medical Group practices is located in Town & Country, MO. **Preferred Qualifications** **Role Purpose** The Senior Compliance Coordinator conducts and coordinates reviews of BJCMG specialty provider documentation to ensure accuracy of services billed. This position prepares reports of findings to be presented to providers. This position also develops educational opportunities for new and existing providers giving instruction on federal and state regulations, documentation guidelines, and coding training in a way that ensures compliance with governmental regulations. Additionally, the Senior Compliance Coordinator collaborates with departments in providing appropriate education to staff as it relates to compliance and privacy of protected health information. **Responsibilities** + Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services identified as part of the review for specialty providers or up on request from management. + Interacts with specialty providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation based on the review. + Develops and/or presents educational training material to specialty providers and coders based on findings and trends identified as a result of the reviews; provides general education on coding and documentation rules and regulations, regulatory provisions, and third party payer requirements to new employees and providers to include Employee and Provider New Employee Orientation. + Interacts with government agencies/contractors, management, employees and others, as necessary, to ensure an understanding of the organization's compliance initiatives. + Conducts and coordinates routinely scheduled reviews of BJCMG specialty providers' documentation involved with professional fee billing for accuracy of coding and physical presence; reviews consist of ambulatory E&M services and office procedures, as well as hospital admissions, subsequent visits, hospital procedures, and all other services performed by BJCMG specialty providers; reviews medical record documentation to identify under-coded and up-coded services, prepares reports of findings, and meets with providers to provide education and training on accurate coding practices and compliance issues; serves as subject matter expert related to specialty coding. + Conducts focused reviews across the BJCMG enterprise based upon the Compliance Department's annual work plan and/or trends identified based upon internal reviews or requests from senior leadership; performs special projects as requested/assigned by management; monitors trends across the organization and develops education and training on accurate coding practices and compliance issues. + Provides guidance and serves as mentor to fellow coordinators related to the audit process, coding, billing and compliance; identifies and notifies management educational opportunities and/or concerns as a result of serving as lead auditor. + Support the HIPAA liaison by tracking and conducting employee investigations when requested. **Minimum Requirements** **Education** + High School Diploma or GED **Experience** + 5-10 years **Supervisor Experience** + No Experience **Licenses & Certifications** + CCS/CPC **Preferred Requirements** **Education** + Associate's Degree - Business/HC Admin/related **Licenses & Certifications** + RHIA/RHIT **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

**City/State:** Saint Louis, Missouri **Categories:** Information Services **Job Status:** Full-Time **Req ID** : 101019 **Pay Range:** $69,326.40 - $112,860.80 / year (Salary or hourly rate is based on job qualifications and relevant work experience) **Additional Information About the Role** BJC is hiring for an EHR Application II Analyst. This role will be focused on charge workflows (hospital and professional) within the labs (clinical and anatomic). Looking for a lab billing expert. This is a remote position. **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** Under moderate direction, the EHR Application Analyst II is responsible for configuring, modifying, testing, and maintaining Epic & other Clinical applications. Builds collaborative relationships with hospital leadership, clinical department users, technology and other corporate departments to facilitate usage and acceptance of the system. May be assigned to more complex build and configuration tasks and resolve advance issues. Provides second-tier support to end users to ensure reliable application system availability and performance. May be responsible for system integrity. Provides solutions or resolves end-user system issues. Epic or applicable certifications will be required within 6 months of hire. **Responsibilities** + Designs, verifies, documents, amends and refactors complex software configurations for deployment. Contributes to the selection of the software configuration methods, tools and techniques. Applies agreed standards and tools, to achieve well-engineered outcomes. Participates in reviews of own work and leads reviews of colleagues' work. + Investigates and resolves issues relating to applications. Follows agreed procedures to identify and resolve issues with applications. Uses application management software and tools to collect agreed performance statistics. Carries out agreed applications maintenance tasks. + Develops and executes test plans and test cases. Collaborates across parties involved in product, systems or service design and development to enable comprehensive test coverage. Analyses and reports on test activities, results, issues and risks, including the work of others. + Evaluates design options and prototypes to obtain user feedback on requirements of developing systems, products, services or devices. Selects appropriate tools and techniques to evaluate user experiences of systems, products, services or devices. + Ensures that incidents are handled according to agreed procedures.Prioritizes and diagnoses incidents. Investigates causes of incidents and seeks resolution. Escalates unresolved incidents.Documents and closes resolved incidents.Contributes to testing and improving incident management procedures. + May be part of an after-hours on-call rotation. **Minimum Requirements** **Education** + High School Diploma or GED **Experience** + 2-5 years **Supervisor Experience** + No Experience **Preferred Requirements** **Education** + Bachelor's Degree **Experience** + 5-10 years **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

Additional Information About the Role * Up to a $2800 Sign on Bonus * Shift: Day Shift Monday - Friday 8 AM - 5 PM * Location: (Hybrid position) 3 days in office and 2 days' work from home - will work from other BJC Behavioral Health locations as needed * Client Group: You and your Staff are working with adults with severe and persistent mental illness You will work on outpatient Competency Restoration that will be used by our programs services like CPR. * Team Dynamic - (number of direct reports): 6 staff working in the St. Louis City Jails and the St. Louis County Jails * MUST HAVE skills for this position: Must be fully licensed - LPC or LCSW and preferred to have previous leadership/supervisory experience * Job responsibilities: * Manages individual(s) including but not limited to: hires, trains, assigns work, manages & evaluates performance, conducts professional development plans. Ensures that the productivity and actions of that group meet/support the overall operational goals of the department as established by department leadership. Reviewing notes, audit records. * May participate in the development of departmental staffing, revenue and/or expense budgets and having direct responsibility for adhering to those goals. This includes responding to changes in the business which may affect the ability to achieve the budget goals. * Supervises and oversees operational services that build on the strengths of clients and their families as they deal with the effects of serious mental illness. * Trains and coaches' direct reports on clinical and case management skills. Overview BJC Behavioral Health is a community health center that provides and coordinates behavioral health services for more than 8,000 seriously mentally ill adults and seriously emotionally disturbed children in St. Louis City, St. Louis County, St. Francois, Iron and Washington counties. As an Administrative Agent of the Missouri Department of Mental Health (DMH), BJC Behavioral Health serves as a major point of entry for people eligible for mental health services funded by DMH and is responsible for serving as gatekeeper to the public mental health system. Preferred Qualifications Role Purpose Provides clinical supervision and hands on instruction of sound, effective clinical skills to direct reports so that services provided build on strengths of clients and their families as they deal with the effects of serious mental illness. Responsibilities Manages individual(s) including but not limited to: hires, trains, assigns work, manages & evaluates performance, conducts professional development plans. Ensures that the productivity and actions of that group meet/support the overall operational goals of the department as established by department leadership.May participate in the development of departmental staffing, revenue and/or expense budgets and having direct responsibility for adhering to those goals. This includes responding to changes in the business which may affect the ability to achieve the budget goals.Supervises and oversees operational services that build on the strengths of clients and their families as they deal with the effects of serious mental illness.Trains and coaches direct reports on clinical and case management skills.Partners with community resources to specifically address treatment needs of the patients. Minimum Requirements Education Master's Degree - Social Work Experience 2-5 years Supervisor Experience No Experience Licenses & Certifications LCSW or LPC Preferred Requirements Experience 5-10 years Supervisor Experience < 2 years 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

Additional Information About the Role BJC is hiring for a Project Manager - Revenue Cycle Management. This person will be responsible for managing a team of 4 people. We are looking for candidates with a broad understanding of the Revenue Cycle. Epic knowledge is preferred. This is a remote position. (applicants must be in MO or IL) 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 Utilizes project management processes and methodologies to ensure projects are delivered on time, within budget, adhere to high quality standards and meet customer expectations. Responsibilities may include leading an operations team responsible for the ongoing maintenance of business and clinical applications. Responsibilities Manages individual(s) including but not limited to: hires, trains, assigns work, manages & evaluates performance, conducts professional development plans. Ensures that the productivity and actions of that group meet/support the overall operational goals of the department as established by department leadership.Leads teams of operational professionals responsible for overseeing application system availability, performance, and enhancements.Consults around the planning and implementation of processes and procedures to achieve cash collection targets, days of credit outstanding and accounts receivable aging goals while maintaining budgeted staffing levels.Implements systems and procedures to insure accurate and timely reimbursements.Assembles project plans and teamwork assignments, directing and monitoring work efforts on a daily basis, identifying resource needs, performing quality review, and escalating issues appropriately.Determines opportunity for operational improvement in patient account functional areas. Minimum Requirements Education Bachelor's Degree Experience 5-10 years Supervisor Experience < 2 years Preferred Requirements Licenses & Certifications Project Management Prof 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

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Remote Option; Available for any of Partners' NC locations (or within 40 miles of NC border) Closing Date: Open Until Filled Primary Purpose of Position: The HEDIS Coding Specialist plays a critical role in ensuring accurate and compliant coding, documentation improvement, and adherence to National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment requirements. With a background in medical coding and clinical practice, the specialist is responsible for reviewing medical records, identifying appropriate diagnosis codes, and ensuring documentation supports coding accuracy. Additionally, they collaborate with healthcare providers to address incomplete or missing clinical documentation, educate on proper coding practices, and facilitate training sessions as needed. By conducting audits, analyzing data, and communicating with internal and external stakeholders, the specialist helps improve coding accuracy, optimize revenue, and enhance the quality of care delivered to patients. Their meticulous attention to detail, strong analytical skills, and compliance expertise contribute to the organization's success in meeting HEDIS reporting requirements and achieving quality improvement goals. Role and Responsibilities: 1. Coding Review: Conduct thorough reviews of medical records to ensure accurate coding and documentation in compliance with National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment requirements. 2. Documentation Improvement: Identify opportunities for documentation improvement to support accurate coding and ensure alignment with coding guidelines and regulatory standards. 3. Provider Education: Collaborate with healthcare providers to educate them on proper documentation practices, coding guidelines, and HEDIS measures. Provide guidance and support to facilitate accurate coding and documentation. 4. Auditing: Perform audits to assess coding accuracy and completeness. Identify discrepancies, coding errors, and areas for improvement through audit findings. 5. Risk Adjustment Coding: Apply expertise in risk adjustment coding to accurately capture and report diagnosis codes relevant to Hierarchical Condition Categories, Risk Adjustment and Managed Care Contract reimbursement initiatives. 6. Data Analysis: Analyze coding and documentation data to identify trends, patterns, and opportunities for improvement. Use data-driven insights to develop strategies for enhancing coding accuracy and documentation completeness. 7. Quality Assurance: Ensure compliance with coding and documentation guidelines, regulatory requirements, and organizational standards. Monitor coding practices and documentation processes to maintain quality and integrity. 8. Provider Support: Serve as a resource for healthcare providers, offering guidance, feedback, and assistance with coding-related inquiries, coding challenges, and documentation queries. 9. Training and Development: Develop and deliver training sessions, workshops, or educational materials to healthcare providers and coding staff on coding best practices, documentation requirements, and HEDIS measures. 10. Collaboration: Collaborate with cross-functional teams, including Quality Improvement, Provider Relations, and Data Analytics, to support quality improvement initiatives, address coding-related issues, and achieve organizational goals. 11. Reporting: Generate reports and documentation to track coding accuracy, documentation improvement efforts, and compliance with HEDIS measures. Communicate findings and recommendations to stakeholders as needed. 12. Continuous Learning: Stay abreast of updates, changes, and advancements in coding guidelines, documentation standards, and regulatory requirements. Continuously enhance knowledge and skills through professional development opportunities. Knowledge, Skills and Abilities: Knowledge: 1. Medical Coding: Comprehensive understanding of ICD-10-CM, CPT, and HCPCS coding systems, including knowledge of coding conventions, guidelines, and updates. 2. HEDIS Measures: Familiarity with National Committee for Quality Assurance (NCQA) HEDIS measures, specifications, and reporting requirements. 3. Risk Adjustment: Understanding of risk adjustment methodologies and concepts, including Hierarchical Condition Categories (HCCs) and CMS risk adjustment models. 4. Clinical Documentation: Knowledge of clinical documentation standards, terminology, and practices to ensure accurate coding and documentation. 5. Regulatory Compliance: Understanding of healthcare regulations, coding guidelines, and compliance standards related to HEDIS reporting, risk adjustment, and medical coding. Skills: 1. Coding Proficiency: Strong coding skills with the ability to accurately assign diagnosis and procedure codes based on clinical documentation. 2. Attention to Detail: Meticulous attention to detail to identify coding discrepancies, documentation deficiencies, and coding errors. 3. Analytical Skills: Ability to analyze coding and documentation data, identify trends, and draw insights to support quality improvement initiatives. 4. Communication Skills: Effective communication skills, both verbal and written, to convey coding guidelines, provide feedback to providers, and collaborate with cross-functional teams. 5. Problem-Solving: Strong problem-solving skills to address coding challenges, resolve discrepancies, and implement solutions to improve coding accuracy and documentation completeness. Abilities: 1. Adaptability: Ability to adapt to changes in coding guidelines, regulatory requirements, and organizational processes related to HEDIS reporting and risk adjustment. 2. Time Management: Effective time management skills to prioritize tasks, meet deadlines, and manage multiple coding projects simultaneously. 3. Collaboration: Ability to collaborate with healthcare providers, coding staff, quality improvement teams, and other stakeholders to achieve coding accuracy and documentation improvement goals. 4. Continuous Learning: Commitment to continuous learning and professional development to stay updated on coding guidelines, HEDIS measures, risk adjustment methodologies, and regulatory changes. 5. Quality Focus: Strong commitment to quality and accuracy in coding and documentation practices to ensure reliable data for HEDIS reporting and support quality improvement efforts. Education Required: Bachelor's degree in health information management (HIM), Health Information Technology, Medical Coding, Nursing, or related healthcare field; OR Associate's degree in health information management or medical Coding with minimum 3 years of medical coding experience Experience Required: Minimum 2-3 years of experience in medical coding and documentation Minimum 1 year of experience with HEDIS measures and reporting Experience with risk adjustment methodologies and HCC coding preferred Technical Skills: Proficiency in ICD-10-CM/PCS, CPT, and HCPCS coding systems Experience with coding software and audit tools Advanced Excel skills for data analysis and reporting Performance Metrics: Demonstrated coding accuracy rate of 95% or higher Ability to code minimum of 20-25 charts per day while maintaining quality standards Education/Experience Preferred: Master's degree in health information management or related field 5+ years of medical coding experience Previous experience in managed care or health plan environment Experience with Epic, Cerner, or other major EHR systems Knowledge of Medicare Advantage and Medicaid managed care operations Knowledge of SQL or other database query languages preferred Licensure/Certifications Required: Current certification from AHIMA (CCS, RHIA, RHIT) or AAPC (CPC, CRC) HEDIS certification or ability to obtain within 6 months of hire

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Remote option; Available for any of Partners' NC locations Closing Date: Open Until Filled Primary Purpose of Position: This position provides nonclinical administrative support to the PartnersACCESS call center. The Call Center Representative primary responsibility is to answer inbound calls and assist callers by connecting them to the appropriate party, sharing information, providing technical assistance, answering questions, handling and/or resolving complaints. Must maintain a high level of professionalism, patience and empathy working with callers who may be frustrated and may have complex medical, behavioral health, intellectual and other developmental conditions; and must still maintain the highest level of customer satisfaction by seeking first call resolution. Must live in North Carolina and preferably in Partners counties. Role and Responsibilities: Ability to learn complex information about two Medicaid health plans and their benefits. Work in a call center environment and interact with callers who are generally members and providers, to deliver information, answer frequently asked questions, and address complaints. Route calls to the appropriate resource. Including appropriately identifying and elevating those more complex or crisis calls. Understand Health/Mental Health (MH)/Substance Use (SU)/Traumatic Brain Injury (TBI)/Intellectual/Developmental Disability (I/DD) treatment needs, benefit information and referral of members calling to determine if they may potentially qualify for services. Review call notes, enrollments, registrations, or other identified documents for completeness and/or accuracy. Collect and enter demographic data into the electronic record, completion of appropriate forms, explanation of services, benefits and resources, verifies Medicaid and dispatch. Provide follow up calls. This position demands a high level of accuracy and confidentiality. Information must be handled according to NC standards and rules, state and federal laws and LME/MCO and NCQA standards, procedures, policies and protocol. Trained on the requirements, policies and procedures of the BH I/DD Tailored Plan operating in North Carolina and can respond to all areas within the Member Handbook and Provider Manual, including resolving claims payment inquires in one touch. Automation: Screenings are completed using standard and specialized computer programs. Inputs accurate information into the system and unlocks electronic service records with appropriate consents, enters all necessary data elements into data systems. Cooperative Efforts: Must be a team player and have a positive attitude. Establish and maintain effective working relationships within the unit, agency, and service system Consistently demonstrate professionalism, tact and diplomacy in handling volatile callers and/or working with contract providers and other external parties. Participate in Unit Staff meeting, Agency Staff meetings, (All staff meetings) and assigned committees. Interacts by phone with providers to provide information in response to inquiries, concerns, and questions. Interact with providers to provide information in response to inquiries about services and other resources. BH I/DD Tailored Plan eligibility and services. Knowledge, Skills and Abilities: Knowledge/Ability to Learn: Health, mental health, substance use, traumatic brain injury and intellectual/developmental disability service delivery and NC Medicaid Managed Care system as well as the resources available in the community. Call center functions, member population, potential for crisis issues, confidentiality laws and program protocols/policies. High level computer skills. Ability communicate effectively orally and in writing, have good keyboarding skills and be able to multi-task. Ability to provide technical assistance to both members and Providers. Ability to maintain confidentiality when screening and referring calls. Education/Experience Required: High School diploma and at least (1) year of healthcare and/or MH/SU/IDD/TBI experience. Education/Experience Preferred: Associate degree or higher and one (1) year of healthcare or MH/SU/IDD/TBI experience, or Associates Degree in Nursing (ADNs) and at least one (1) year of healthcare and/or MH/SU/IDD/TBI experience. Bilingual preferred (for one of the positions). Licensure/Certification Requirements: N/A

- not eligible for benefits Projected Hiring Range : Depending on Experience Closing Date : Open Until Filled Work Schedule: Mon-Fri, 9:30a-6p (PRN) Primary Purpose of Position: This position provides the initial screening, referral and or scheduling of members who call the toll-free PartnersACCESS Member Services number seeking health and behavioral health services and as appropriate, transfers the member to a clinician who will clinically triage/assess the member's acuity and will determine what type and intensity of service the member needs and/or is eligible to receive. Role and Responsibilities: Screening, scheduling and referral: Initial screening of Health/Mental Health (MH)/Substance Use (SU)/Traumatic Brain Injury (TBI)/Intellectual/Developmental Disability (I/DD) treatment needs, benefit information and referral of members calling to determine if they may potentially qualify for services Collect and enter demographic data into the electronic record, completion of appropriate forms, explanation of services, benefits and resources, verifies Medicaid and dispatch Provide follow up calls to referral sources and members to ensure that members have been successfully engaged in services Make referrals to clinical homes and crisis providers that meet the timeliness standards as defined by NC Medicaid Provide information about local community resources, independent practitioners, and related providers for referrals for basic benefit services This position demands a high level of accuracy and confidentiality. Information must be handled according to NC standards and rules, state and federal laws and LME/MCO and NCQA standards, procedures, policies and protocol Authorizations: Assists with authorizations/admissions to state hospitals, ADATC, Three Way Hospitals, Level III Detox, Facility Based Crisis and all referrals to crisis services Process other acute care authorizations as requested by supervisor or other Access to Care Licensed Clinician Automation: Screenings are completed using standard and specialized computer programs Inputs accurate information into the system and unlocks electronic service records with appropriate consents, enters all necessary data elements into data systems Provide technical assistance to First Responders, clinical home providers, and Mobile Crisis Management Cooperative Efforts: Establish and maintain effective working relationships within the unit, agency, and service system Consistently demonstrate professionalism, tact and diplomacy in handling irate callers and/or working with contract providers and other external parties Participate in Unit Staff meeting, Agency Staff meetings, (All staff meetings) and assigned committees Knowledge, Skills and Abilities: Sound knowledge of health/MH/SU/TBI/I/DD for the appropriate determination of eligibility for Medicaid and State supported services, appropriateness of referrals for treatment and assessment and the level of danger of the members calling for assistance Knowledge of the laws governing the treatment of health, mental illness, substance abuse and intellectual/developmental disabilities as well as the resources available in the community for treatment Knowledge of call center functions, member population, potential for crisis issues, confidentiality laws and program protocols/policies Excellent computer skills Ability to complete tasks independently, define problems, apply laws, policies and procedures to agency activities and must use sound judgment in conducting screening, triage and referral Ability to use sound judgment when conducting a screening and be able to determine when it is necessary and appropriate to transfer a member to a Licensed Access to Care Clinician Ability to communicate effectively orally and in writing, have good keyboarding skills and be able to multi-task (that is: converse while entering screening information into the electronic medical record and evaluating the member's need) Ability to take highly complicated criteria and apply it to cases in determining eligibility for services and appropriate scheduling referrals Ability to assist members in highly stressful situations which may be life threatening to the member or public while at the same time facilitating a connection to crisis services and/or a Licensed Access to Care Clinician Ability to provide technical assistance to both members and Providers Ability to maintain confidentiality when screening and referring calls/callers Education/Experience Required: Bachelor's Degree in related field or Licensed Practical Nurse (LPN) and at least two (2) years of healthcare or MH/SU/IDD experience. Education/Experience Preferred: Licensed practical nurses (LPNs) and at least four (4) years of healthcare and/or MH/SU/IDD experience. Licensure/Certification Requirements: N/A

**This is a mobile position which will work primarily out in the assigned communities.** Join a Mission That Moves With You: Mobile/Remote Care Management across NC Why You'll Love Working Here In 2026, the future of healthcare is in the community. As an I/DD Care Manager at Partners, you aren't just managing files-you are the architect of a better life for individuals with Intellectual and Developmental Disabilities. We offer a role that balances clinical excellence with geographic flexibility , supported by one of the most stable and competitive benefits packages in North Carolina. The Perks of Joining Our Team: Work Where You Live: Fully mobile/remote role serving the counties you live in, work in and call home. Financial Security: State Retirement Pension plan, 401(k) with employer match, company paid life and disability insurance, and an annual incentive bonus. Health & Wellness: Low-deductible medical/dental plans and generous vacation + sick time accruals. Student Loan Relief: We are a Public Service Loan Forgiveness (PSLF) Qualifying Employer -let your work pay off your education. Celebrate Life: 12 paid holidays and dedicated wellness programs. See attachment for additional details. Location: Available for Gaston, Cleveland, Rutherford NC locations; Mobile/Remote position Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Your Impact & Role As a Partners Care Manager, you will serve as the primary point of contact and navigator for members with I/DD and/or dually diagnosed members. You will lead "Team Based Care," ensuring our members receive holistic support that integrates physical health, behavioral health, and long-term supports and services. What a Typical Week Looks Like: Meet Members Where They Are: Meet members in their communities to assess their current and projected needs to build Person-Centered Care Plans/Individual Support Plans (ISP) to get them closer to achieving their vision for their lives. Integrative Leadership: Facilitate interdisciplinary team meetings to ensure doctors, specialists, providers and families are all moving in the same direction to meet the member's needs. Transition Expert: Guide members through life's big changes-moving from school to adulthood, returning home from care facilities, gaining optimal independence and finding the right combination of paid supports to maintain or increase overall health and wellness. Empowerment: Educate members and families on their rights and connect them to the array of services and our network of providers to secure their future. Who You Are A Mobile Professional: A North Carolina resident and you thrive on the road and value the autonomy of a community-based role. Travel is an essential part of how you connect with those you serve. A Systems Navigator: You understand (or are eager to master) Medicaid regulations, 1915i services, and the Tailored Plan landscape. A Person-Centered Planner: You believe there is no "one size fits all" solution in care management. You bring a voice to vulnerable individuals through your strengths of observation, connecting the dots, supporting their journey through your planning skills. Qualified Candidate to apply : You've earned your degree and put it to work! Congratulations! You are who we are looking for if one of these many different scenarios describe you… You have earned a Bachelor's degree in a human services field like psychology, social work, nursing or other relevant human services field: and you bring with you a minimum of 2 years full-time experience working with individuals with Intellectual and Developmental Disabilities and at least 2 years of your work experience was with people with significant Long-Term Services and Supports (LTSS) needs due to their disability in a setting where they receive care in the community OR You earned a Bachelor's degree outside the human services field and you have at least 4 years full-time experience working with individuals with Intellectual and Developmental Disabilities. and at least 2 years of your work experience was with people with significant Long-Term Services and Supports (LTSS) needs due to their disability in a setting where they receive care in the community OR You earned a Master's degree and have a minimum of 1 year full time experience working with individuals with Intellectual and Developmental Disabilities and at least 2 years of your work experience was with people with significant Long-Term Services and Supports (LTSS) needs due to their disability in a setting where they receive care in the community

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Hybrid/Remote option; Available for any of Partners' NC locations Closing Date: Open Until Filled Primary Purpose of Position: This position will assist the Provider Network Contract Manager in identifying, negotiating, and contracting with Medicaid healthcare providers to join Partners' health plan network. This position will be responsible for drafting, implementing, and monitoring of all provider contracts, ensuring all financial requirements and obligations are accurately identified and executed. Role and Responsibilities: Perform healthcare provider contracting services. Recruitment and contracting efforts may include, but not be limited to, telephone calls, email, regular mail, facsimile transmissions and visits to targeted provider offices to initiate, negotiate, and procure executed participating provider agreements. Leads all aspects of negotiations for facility, physician and network managed care agreements under general supervision from management Coordinates, analyzes and develops all financial and operational aspects of contract proposals, including drafting and nominally redlining agreements and amendments. Works with the Contracts Managers and Contracting Director for Provider Network to develops a negotiation strategy, assessing the strengths of each party in the negotiation. Coordinates with internal departments and contracted providers to implement and maintain contract compliance. Prepares correspondence to managed care providers. Works with the Contract Coordinators to ensure a workflow and contract management process follows the contracting to include loading into contract management system and preparation of contract summaries outlining contract terms for internal stakeholders. Establishes and maintains relationships with providers and support them through connection with the Provider Relations team. Acts as a professional resource to answer all contractual questions and facilitate issue resolution with internal and external stakeholders. Assists with development and maintenance of reports used to track contracting activity and report outcomes. Performs other duties as assigned. Knowledge, Skills and Abilities: Considerable knowledge of state and federal fiscal rules and regulations Knowledge of and ability to explain and apply the provisions of contractual practices adopted by State Government Strong problem solving, decision-making and negotiating skills Strong written and verbal communication skills Excellent organization skills Ability to multi-task and meet deadlines Considerable knowledge of the laws, regulations and policies that govern the program Exceptional interpersonal and communication skills Strong problem solving, negotiation, arbitration, and conflict resolution skills Excellent computer skills and proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint Demonstrated ability to verify documents for accuracy and completeness; to understand and apply laws, rules and regulations to various situations; to apply regulations and policies for maintenance of consumer medical records, personnel records, and facility licensure requirements Ability to make prompt independent decisions based upon relevant facts Ability to establish rapport and maintain effective working relationships Ability to act with tact and diplomacy in all situations Ability to maintain strict confidentiality in all areas of work Education and Experience Required: Bachelor's Degree and four years of negotiation experience in managed care or a related field (such as healthcare finance or patient financial services) with a healthcare provider or insurer/payer, auditing, accounting, finance, or contract management; or an equivalent combination of education and experience. A combination of relevant experience may be considered in lieu of a Bachelor's degree. Must have ability to travel as indicated. Must reside in North Carolina or within 40 miles of the NC border. Education and Experience Preferred: Familiarity with State health care programs preferred.

**This is a mobile position which will work primarily out in the assigned communities.** Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Mobile/Remote position; Available for any of Partners' NC locations Projected Hiring Range : Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Mental Health Substance Use Care Manager focuses on working closely with community hospitals, providers, and stakeholders to engage adults and/or children/adolescents in mental health/substance use services. This position is responsible for providing proactive intervention and care management (treatment planning, assessment, referral/linkage, and monitoring) to ensure that members and recipients receive appropriate assessment, oversight and services. This is a mobile position with work done in a variety of locations. Role and Responsibilities: Provide education, referrals, care management activities surrounding available services and supports including Physical Health, Behavioral Health, I/DD, LTSS, TBI, Pharmacy, Vision, and Dental services/supports. Link to needed behavioral health and physical health care services and facilitating appropriate connections to primary healthcare services through Community Care of North Carolina, the Health Department, or other community health resources Coordinating and linking members to benefits Complete initial and yearly Care Management Comprehensive Assessment and Care Plan Conduct Care Team meetings and ensure treatment team members participate in treatment team meetings to address the needs of the member Conduct continuous monitoring of progress towards goals identified in Care Plan through in-person and collateral contacts with the member and member's supports, including family, information and formal caregivers and routine care team reviews Identify the gaps in needed services and intervene as needed to ensure the member receives appropriate care Identify and refer member to community resources Oversee care transitions for members who are moving from one clinical setting to another Maintain accurate tracking and data information for care management activities and outcomes including tracking of individuals in and out of services, those who are on waiting lists, those who need follow-up, and those on outpatient commitments Collaboration Serves as a collaborative partner in identifying system barriers through work with community stakeholders Manages and facilitates Child/Adult High Risk Team meetings in collaboration with DSS, DJJ, school systems, CCNC Care Managers, and other community stakeholders as appropriate The MHSU Care Manager may work with members in the communities Works in partnership with other LME/MCO departments to address identified needs within the catchment area Knowledge, Skills and Abilities: Extensive understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) Considerable knowledge of the MHSU/IDD service array provided through the network of the LME/MCO's providers Knowledge of LME/MCO's implementation of the 1915(b/c) waivers and accreditation Highly skilled at assuring that both long and short-range goals and needs of the individual are addressed and updated, while assuring through monitoring activities that service implementation occurs appropriately Exceptional interpersonal and communication skills Excellent computer skills including proficiency in Microsoft Office products (Word, Excel, Outlook, and PowerPoint) Excellent problem solving, negotiation, arbitration, and conflict resolution skills Detail-oriented, able to organize multiple tasks and priorities and effectively manage projects from start to finish Ability to make prompt independent decisions based upon relevant facts, to establish rapport and maintain effective working relationships Ability to change the focus of his/her activities to meet changing priorities A high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance Education/Experience Required: *Qualified Professional Care Manager: Bachelor's degree in a human service field and at least two years of full-time experience with the population served -or- Bachelor's degree in a field other than human services with at least four years of full-time experience with the population served -or- Master's degree in a human service field and one year of full-time experience with the population served *Provisionally Licensed Care Manager: Master's degree in a human service field and one year of full-time experience with the population served Current unrestricted LCSW-A, LCMHC-A, LCAS-A, LMFT-A Employee is responsible for complying with respective licensure board's continuing education/training requirements in order to maintain an active provisional license (prior to obtaining full licensure). *Licensed Care Manager: Master's degree in a human service field and one year of full-time experience with the population served -or- Licensure as a registered nurse (RN) and four (4) years of full-time accumulated experience with the population served Current unrestricted LCSW, LCMHC, LPA, LMFT, LCAS, or RN licensure with the appropriate professional board of licensure in the state of North Carolina. Employee is responsible for complying with respective licensure board's continuing education/training requirements in order to maintain an active license. Other requirements: Must reside in North Carolina. Must have ability to travel as needed to perform the job duties Education/Experience Preferred: Above requirements Licensure/Certification Requirements: Above requirements

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Available for any of Partners locations; Remote Option Projected Hiring Range : Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Provider Engagement & Outreach Specialist serves as a liaison between Partners Health Management and healthcare/physical health providers to drive quality improvement, practice transformation, and provider engagement. This role supports physical health providers in implementing evidence-based workflows, optimizing care delivery models, and aligning with value-based care initiatives. The Specialist also leads outreach efforts to foster collaborative relationships, deliver educational resources, and support providers in meeting performance and compliance benchmarks. R oles and Responsibilities : Support medical providers in transforming care delivery through implementation of patient-centered medical home (PCMH), value-based care models, and quality improvement initiatives. Engage directly with providers and healthcare teams across North Carolina to build strong partnerships, understand their unique challenges, and provide tailored assistance Conduct on-site and virtual practice visits to assess workflows, identify improvement opportunities, and provide technical assistance and resources. Analyze and utilize performance data (e.g., HEDIS, Medicaid measures) to collaborate with providers to design targeted interventions that improve care quality and patient outcomes. Assist practices with change management strategies to enhance patient outcomes and operational efficiency Act as a liaison in supporting providers in adopting value-based care practices, that enhance clinical efficiency and patient outcomes Develop and disseminate outreach materials, toolkits, and communication strategies to strengthen provider relationships. Stay abreast of emerging best practices, payer requirements, and regulatory changes affecting provider performance and transformation. Deliver training and coaching on practice transformation topics, data use, and workflow redesign Track provider progress, document interactions, and report outcomes and barriers to leadership for continuous program improvement. Work directly with physicians, clinical teams, and administrative staff to improve care delivery, enhance patient outcomes, and increase performance. Collaborate with internal stakeholders to align resources and interventions Support practice transformation initiatives that drive sustained improvements in care quality and operational efficiency Work with providers to encourage preventive service utilization and effective chronic condition management among their patient populations Assist clinicians achieve measurable improvements in health outcomes and patient satisfaction by fostering patient engagement and adherence to recommended care plans Knowledge, Skills and Abilities: • Deep understanding of value-based care models, and healthcare quality programs. • Experience in healthcare practice transformation, care delivery redesign or clinical operations • Experience engaging and coaching clinical teams (physicians, nurses, and practice managers) • Familiarity with health equity initiatives and strategies to address social drivers of health. • Experience in Project Management and familiarity in process mapping and workflow analysis tools. • Knowledge of and ability to explain and apply the provisions of contractual practices adopted by Partners Health Management and required by NC Division of Health Benefits. • Demonstrate working knowledge of HEDIS quality measures and reporting requirements to support accurate provider education and engagement • Collaborate with providers and internal teams to close care gaps and ensure compliance with HEDIS and other quality initiatives. • Experience working with large multi-site practices. • Ability to analyze clinical and operational data to drive improvement initiatives. • Excellent facilitation and project management skills and familiarity in process mapping and workflow analysis tools. • Strong problem solving, decision-making and negotiating skills. • Exceptional interpersonal skills and strong written and verbal communication skills. • Excellent organizational skills. • Ability to multi-task and meet deadlines. • Considerable knowledge of the laws, regulations and policies that govern the program, which includes and is not limited to contractual requirements adopted by NC Division of Health Benefits and other governmental oversight agencies. • Strong problem solving, negotiation, arbitration, and conflict resolution skills. • Excellent computer skills and proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint. • Demonstrated ability to verify documents for accuracy and completeness; to understand and apply laws, rules and regulations to various situations; to apply regulations and policies for maintenance of consumer medical records, personnel records, and facility licensure requirements. • Ability to make prompt independent decisions based upon relevant facts. • Ability to establish rapport and maintain effective working relationships. • Ability to act with tact and diplomacy in all situations. • Ability to maintain strict confidentiality in all areas of work. • Experience with Electronic Health Records (HER) for clinical processes Education and Experience Required: Bachelor's degree and a minimum of four years of experience in managed care or a related field with a healthcare provider or insurer/payer. Relevant areas may include provider relations, network development or design, provider engagement services, contract management, or patient financial services. Experience in auditing, accounting, or finance is also applicable. A combination of relevant education and experience may be considered in lieu of a Bachelor's degree. Must be able to travel as required. 4 years of significant and relevant work experience in medical practice management in lieu of educational requirements may be accepted, particularly with significant administrative experience in a clinic setting. Must have the ability to travel as indicated. Other requirements: Must reside in North Carolina or within 40 miles of the NC border. Education and Experience Preferred: Bachelor's degree in Nursing, Public Health, Healthcare Administration, or a related field (Master's degree preferred). Deep understanding of value-based care models, healthcare quality programs, and population health initiatives. Demonstrated experience in practice transformation roles and practice support. Licensure/Certification Requirements: None

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Hybrid option; Available for the Gastonia, NC location Closing Date: Open Until Filled Primary Purpose of Position: To provide executive-level paralegal and administrative services for the Office of Legal Affairs (OLA), including Chief Legal Officer/General Counsel (CLO/GC), Director of Legal Services, staff attorney(s), legal specialist(s) and waiver contract manager. Highly collaborative culture. Under licensed-attorney supervision where required, this position entails professional legal work in a variety of legal/operational areas or functions, including but not limited to legal research; and drafting, reviewing, proofing and communicating legal/regulatory matters regarding litigation, transactions/contracts, regulation, legislation, internal and external dispute resolution, grievances/complaints, and related legal projects. As detailed further below, key role will be managing Partners many complex policies and procedures (P&Ps), as well as program descriptions, plans and even assisting with board guidelines. In addition, position will require successful applicant to field, route and/or address (or to ensure attorney and/or OLA team addresses) legal issues and questions from various Partners' business units and staff. Examples of work include coordinating all aspects of the internal Policy and Procedure process (with assistance of waiver contract manager); preparation and occasional participation in board level and committee meetings; assist legal team with their projects, including, e.g., key OLA metrics and ensure monitoring, prompt routing, payment and reimbursement of legal bills and expenses. Works with extremely sensitive and confidential information and records. Perform other duties as needed consistent with an executive level paralegal. Work closely with Associate General Counsel, Director of Legal Services, Waiver Contract Manager, Legal Specialist, Program Integrity Director, and their teams, also located in OLA. Position reports directly to Director of Legal Services. NOTE: Representation of Partners in a court of law and other acts constituting the practice of law are the responsibilities of attorneys in or for OLA. Position will cooperate with, assist and take significant responsibility for preparation of work by attorneys, but have no authority to act as legal counsel for Partners or to practice law without a license. Role and Responsibilities (percentages are approximations): 50% Policies and Procedures (P&Ps): With assistance and guidance of waiver contract manager, will be directly responsible for Partners' almost 300 P&Ps, that must be regularly reviewed, vetted and approved by management, leadership and Board. This includes oversight of revision and creation of P&Ps by Partners' staff for accreditation, certification, contract and regulatory compliance. Also, can include Program Descriptions, Plans and perhaps assisting with board guidelines. Assist with and/or manage automation and process improvement of P&Ps. As detailed below, this role requires extensive organizational skills, knowledge and comfort with software, critical thinking, and strong writing and collaborative communications skills. 35% Traditional Paralegal Services: With assistance from attorneys, legal specialists, waiver contract manager, and program integrity investigators, provides moderate to complex legal support services. Examples include: performing legal research, both formal from traditional legal research databases (currently Lexis) and from non-traditional resources such as State and Federal legislative and regulatory websites. assisting with obtaining, reviewing, proofing, executing and interpreting contracts and transactions. assisting with drafting, review, proofing and issuing communications with staff, outside counsel and opposing counsel regarding contracts, litigation (subpoenas, hearing notices, pleadings, motions) and related legal projects; assisting with or fielding, routing and and/or addressing legal issues and questions from various Partners' business units and staff, and/or ensuring appropriate OLA staff does so; attending and or assisting attendees with key meetings, hearings and conferences, providing insights to and taking notes for OLA team and Partners. gather, organize and marshal on demand relevant documents, information and evidence to support OLA work and obligations. liaising with Program Integrity staff on legal matters arising to legal staff from or related to investigations of alleged fraud, waste and abuse; consulting OLA attorneys for supervision on matters and in any instance that might be construed as the practice of law. 10% Administrative Support: Provides comprehensive and often sophisticated/complex administrative support to OLA team. Examples include assisting OLA staff or directly to: maintain OLA legal files and records. create, maintain, analyze and report key OLA metrics using various OLA-specific resources and interdepartmental support. routing, payment and reimbursement of legal bills and expenses, including potential assistance with the OLA legal matters management and invoicing software and database (currently CounselLink). communicate with outside counsel regarding pending assigned cases and legal matters, billing guidelines and other needs. coordinate and support highly visible functions and events, including preparation for board, executive, management level and other meetings; provider forums, council and other meetings; legal trainings; and other events involving Team OLA. reserve and arrange meeting space, including IT needs. schedule and coordinate select conference calls, meetings, mediations, and hearings. handle staff expense reimbursements, travel reservations, supplies and miscellaneous OLA operational matters. 5% Other Duties as Assigned: In all roles and responsibilities, assures confidentiality of information of a sensitive nature within the department and organization. Adheres to court, regulatory, Partners' and other deadlines. Highly organized and digitally proficient, and able to multitask in fast-paced, detail-oriented -- but highly collaborative, team-oriented and cross-functional -- environment. Maintains a thorough understanding of legal procedures and documents. Able and authorized to exercise good judgment in a variety of situations when communicating directly with persons within and outside Partners, including leadership, healthcare professionals, attorneys, judges, regulators and others. Strong oral and written communication skills essential. Significant attention to accuracy. Excellent people skills. Knowledge, Skills and Abilities: Considerable knowledge of the principles and practices of NC administrative law specifically and general knowledge of the laws, rules, and regulations applicable to LME/MCOs. Ability to maintain effective working relationships with the public and other persons contacted in the course of work. Ability to anticipate and timely meet deadlines and projects. Considerable knowledge of office practices, techniques, and technology. Working knowledge of and the ability to understand legal documents, contractual language, legal processes and other complex or sophisticated topics and materials. Excellent communication skills, both orally and in writing. Detail oriented with excellent organizational skills, including ability to manage multiple schedules and tasks. Proficiency in Word, Excel, Outlook and PowerPoint, including the ability to design reports and presentations for internal and external recipients; excellent typing skills. Proficiency in law-related and P&P software and database resources, including or comparable to LexisNexis and CounselLink. Ability to manage and uphold integrity and confidentiality of sensitive data, internally and externally. Ability to analyze, understand, and complete tasks related to state and federal rules, regulations and laws. Ability to establish and maintain effective, positive working relationships with staff, other members of the organization and stakeholders. Ability to analyze, interpret and recommend policy, rules, and procedural guidelines. Ability to complete non-routine activities and tasks that might require deviation from established procedures; must be able to choose the appropriate course of action and recognize the existence of and differences among situations; sound judgment and critical thinking. Ability to plan and carry out the day-to-day work of the office based on priorities and knowledge of the departments; and Ability to recognize sensitive or unusual situations that should be referred to another more appropriate staff member or to the supervisors. Commitment to Partners' core culture values. Education and Experience Required: A minimum experience of two years in a law-related role with law firm or law department. Working knowledge of legal database software, e.g., LexisNexus or Westlaw. Extensive knowledge and proficiency of Microsoft Office products (Word, Excel, Outlook, PowerPoint, etc.). Comfort and experience with electronic modes of communication, filing, record keeping and office management. While not frequent, must have ability to travel between counties. Must reside in North Carolina or within 40 miles from its border. Education and Experience Preferred: Associate or higher degree in Legal Studies, Business, Office Administration, Healthcare, Human Services or other relevant field, including, paralegal/legal studies, Criminal Justice, Political Science, or legal assistant. Experience in healthcare, especially public behavioral health, managed Medicaid, and healthcare payor systems and law. Knowledge of and experience/proficiency with LexisAdvance, CounselLink, WestLaw and e-OAH. Substantial prior paralegal, legal assistant or related working experience or credentialing highly preferred, especially certification as paralegal or legal assistant, e.g., NCCP. Licensure/Certification Requirements: Paralegal, Legal Assistant, or similar recognized certification, e.g. NCCP (out of state certification acceptable). Law license not required. JDs welcomed to apply but should not expect promotion to attorney position with or without license.