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Principal Consultant jobs at QuintilesIMS - 2383 jobs

  • Consultant - Commercial Solutions & Insights Hub (CSIH) Analytics

    Iqvia Holdings Inc. 4.7company rating

    Principal consultant job at QuintilesIMS

    To be eligible for this position, you must reside in the same country where the job is located. This role is hybrid and will require going into an IQVIA office several times weekly in PA, NY, NJ or CT. Essential Functions: * Manages project teams including both internal and external resources in the design, development, and delivery of client solutions. * Leads teams to review and analyze client requirements or challenges and develops and costs associated proposals that ensure profitability and high client satisfaction with limited if any senior management input. * Manages the process of proposal preparation and/or modifications including overall bid integrity. * Develop project plans with timelines and deliverables and leads project to successful completion, on-time and on-budget, from start to finish with limited senior management guidance. * Recommend improvements and alternative solutions to resolve problems. * Serves as key point of contact with clients. * Provides high level input to, and ensures the development of, client reports and presentations and delivers all or significant portions of findings to client. * Develops and/or elevates new business opportunities through the identification of follow-on work and new leads. * High ownership with client management and ensure high client satisfaction upon project closure. * Proactively continues to strengthen subject matter expertise through on the job experience, participation in conferences and symposiums and other forums for professional knowledge sharing. * Proactively mentors, coaches, and shares subject matter expertise with others to elevate our capabilities to deliver world-class solutions for clients. Skills & Experience Required: * 3-5 years in analytical support roles within healthcare or life sciences; Strong understanding of healthcare data structures, reporting standards, and strategic advisory. * Hands-on experience with IQVIA data platforms and similar analytics environments. * Expertise in managing report migration from platforms like IQVIA, SHA & DRG and proven success in report migration projects and data harmonization. * Advanced data analysis across diverse healthcare use cases (e.g., Customer Profiling, Reversal/Rejection Analysis, Adherence Curves). * Knowledge of therapeutics areas including Oncology, Auto Immune, Cardiovascular & rare diseases. * Strong ability to identify key performance indicators and metrics and prior working experience in Customer Journey, Segmentation, targeting; Promotion Allocation, Optimization, Sales Force, ROI, SOB, LOT, Forecasting. * Demonstrated ability to translate business needs into analytical solutions and experienced with developing consultative relationships with senior level managers and executives at clients in the life sciences industry. * Strong technical skills in SAS, SQL, R, Python, and/or Excel VBA. * Experience in data visualization software including Power BI & Tableau. * Knowledge of consulting methodologies, statistical techniques, tools and techniques related to functional area. * Ability to travel to client sites. * Work schedule is hybrid and will require you to go into the local tri-state area office weekly. If you do not currently live within driving distance to a Northeast IQVIA office, willingness to relocate. About CSIH: IQVIA CSIH is a market-leading, delivery-oriented division within IQVIA Commercial Solutions. CSIH team members consult with manufacturers in the pharmaceutical and biotechnology industry to meet the challenges of today's complex and evolving healthcare landscape. The Analytics department leverages the power of healthcare data to help its clients formulate methodologies that answer business questions in a broad spectrum of areas of expertise-providing deep insight into patient, payer, and prescriber behaviors. As a member of the Analytics department, you will actively: * Design Analytics and Execute Them: The candidate will acquire knowledge of IQVIA data sources, lead analysis to inform strategic recommendations, develop data analyses systems, and identify trends in complex data sets. * Provide Business Consulting and Project Management: The candidate will apply consulting methodologies to deliver engagements, create presentations for clients, manage projects, cultivate professional relationships with client teams, and work with management to prioritize needs. As a member of the team, you will have the opportunity to not only learn from but also contribute to the vibrant CSIH community. You may recruit new hires, lead and mentor teammates through people management, participate in learning communities to codify subject-matter expertise, and develop training content available to the entire team. You will advance your data analytics skillsets through a combination of classroom-based lectures, interactive case studies, hands-on working sessions, client role-playing scenarios, and real-time project shadowing and support. Competencies: CSIH seeks team members who demonstrate values that predispose them to flourish in our teams and culture: * Ownership * Growth * Innovation * Collaboration IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at ********************** IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. **********************/eoe The potential base pay range for this role, when annualized, is $68,300.00 - $170,000.00. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.
    $68.3k-170k yearly 13d ago
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  • Business Process Support Consultant

    Avanos Medical 4.2company rating

    Alpharetta, GA jobs

    Job Title: Business Process Support Consultant Job Country: United States (US) Here at Avanos Medical, we passionately believe in three things: Making a difference in our products, services and offers, never ceasing to fight for groundbreaking solutions in everything we do; Making a difference in how we work and collaborate, constantly nurturing our nimble culture of innovation; Having an impact on the healthcare challenges we all face, and the lives of people and communities around the world. At Avanos you will find an environment that strives to be independent and different, one that supports and inspires you to excel and to help change what medical devices can deliver, now and in the future. Avanos is a medical device company focused on delivering clinically superior breakthrough solutions that will help patients get back to the things that matter. We are committed to creating the next generation of innovative healthcare solutions which will address our most important healthcare needs, such as reducing the use of opioids while helping patients move from surgery to recovery. Headquartered in Alpharetta, Georgia, we develop, manufacture and market recognized brands in more than 90 countries. Avanos Medical is traded on the New York Stock Exchange under the ticker symbol AVNS. For more information, visit *************** Essential Duties and Responsibilities: The incumbent is responsible for the overall quality of the Global Customer Service Processes and adoption within the teams, identifying and improving business processes as well as providing user support and training to the Global Customer Service teams. This role will provide guidance to Business Process Support Analysts and feedback to Customer Service leadership around individual contributor performance to standards. This individual would also act as a key resource for data mining and analytics related to order management. Key Responsibilities: Provide functional and technical expertise for the Order Management systems and other related projects/initiatives, ensuring that capabilities, limitations, and risks are effectively communicated to the teams Coordinate with IT on system enhancements and testing for SAP and other order management systems Identify and lead continuous improvement efforts and implement process changes that create resource capacity or cost savings by collaborating with cross-functional teams across the supply chain including Customer Care, Distribution, Planning, Sales, and Marketing Management of Global Customer Service continuous education program defining training requirements for Customer Service roles and ensuring compliance. Drive compliance to best practices and standard business processes in Customer Service including the development, communication, training and ongoing updates of policies and procedures. Analyze data and reports to identify improvement opportunities, noncompliance issues or further training or development needs. Your qualifications Required: Bachelor's Degree or equivalent business experience required 5+ years' experience in Customer Service, Distribution, Logistics, or related field Experience in SAP systems and processes Experience in SFDC systems and processes Self-starter with ability to work with little work direction Ability to troubleshoot complex issues, set priorities, and manage projects Strong communication and collaboration skills, specifically in a training environment Preferred: 3+ years' experience in SAP systems and processes 3+ years' experience in SFDC systems and processes Knowledge and previous application of Continuous Improvement and/or LEAN principles Health Care industry experience preferred The statements above are intended to describe the general nature and level of work performed by employees assigned to this classification. Statements are not intended to be construed as an exhaustive list of all duties, responsibilities and skills required for this position. Salary Range: The anticipated average base pay range for this position is $96,000.00 - $112,000.00. In addition, this role is eligible for an attractive incentive compensation program and benefits. In specific locations, the pay range may vary from the base posted. Avanos Medical is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, gender identity or any other characteristic protected by law. If you are a current employee of Avanos, please apply here Join us at Avanos Join us and you can make a difference in our products, solutions and our culture. Most of all, you can make a difference in the lives, people, and communities around the world. Make your career count Our commitment to improving the health and wellbeing of others begins with our employees - through a comprehensive and competitive range of benefits. We provide more than just a salary - our Total Rewards package encompasses everything you receive as an employee; your pay, health care benefits, retirement plans and work/life benefits. Avanos offers a generous 401(k) employer match of 100% of each pretax dollar you contribute on the first 4% and 50% of the next 2% of pay contributed with immediate vesting. Avanos also offers the following: benefits on day 1 free onsite gym onsite cafeteria HQ region voted 'best place to live' by USA Today uncapped sales commissions
    $96k-112k yearly 1d ago
  • Director of Nursing Excellence Professional Practice

    Kaweah Health 4.0company rating

    Visalia, CA jobs

    We are excited to announce an opening for the Director of Nursing Excellence Professional Practice at Kaweah Health. This is a pivotal leadership role within the organization, offering a unique opportunity to significantly impact the nursing profession at a large teaching hospital. Company Overview: Kaweah Health is a 613-bed healthcare district dedicated to serving the community. Their campus is extensive, encompassing multiple service lines including Behavioral Health, Rehab, Skilled Nursing, CVICU, ICU, and NICU, and they boast a strong pipeline for new nurses. Position Overview: Here at Peak Recruiter we are seeking a highly experienced and transformational leader to fill the role of Director of Nursing Excellence and Professional Practice. This individual will be instrumental in guiding nursing professional practice, driving improvement in nursing quality, and fostering professional development. The ideal candidate will thrive in a dynamic environment and contribute to our ongoing organizational transformation. We are looking for a candidate with a professional presence, strong critical thinking, and excellent communication skills. The ideal candidate will be able to cultivate a positive work environment, demonstrate strategic thinking, and be highly collaborative and team-oriented. Experience with nursing shared governance, clinical ladders, nursing professional development to support nurse certification, nursing school affiliations, and leading Magnet and Pathway to Excellence initiatives is highly advantageous. We are particularly interested in candidates who are members of associations such as the Association of Nurse Leaders or the Association of Nurse Executives. Primary Responsibilities: The Director will lead and support the engagement and integration of Advanced Practice Registered Nurses (APRNs), Nurse Practitioners, and Clinical Nurse Specialists into high-quality, collaborative care models. This role involves designing, implementing, and managing a comprehensive nursing excellence strategy, aligning with national standards such as Magnet or Pathway to Excellence frameworks. The Director will guide the organization through recognition processes, including document development and site visit preparation. Monitoring and analyzing nursing-sensitive quality indicators, implementing data-driven strategies to improve patient outcomes, and overseeing the development of programs to build nursing knowledge and leadership capacity are also key responsibilities. Additionally, this position supports nursing-led research and innovation, manages budgets for nursing excellence, and ensures compliance with regulatory and accreditation standards. Key Qualifications and Skills: To succeed in this role, candidates must possess a CA RN license and be NEA or NEA-BC certified. A minimum of seven years of progressive leadership experience in professional nursing practice, quality improvement, or Magnet/Pathway designation is required, along with demonstrated success in leading interdisciplinary teams and improving nursing and patient care outcomes. Preferred qualifications include a Master's degree in Nursing, Healthcare Administration, or a related field, or a Doctorate in Nursing Practice (DNP) or PhD, as well as certification in Nursing Professional Development (NPD-BC) or Quality (CPHQ). Team and Reporting Structure: The Director of Nursing Excellence Professional Practice will report directly to the CNO. This role will involve close collaboration with the Education Department, Infection Prevention, and Nursing School Affiliations. Key Priorities in the First Six Months: The top priorities for this role in the first six months include guiding nursing professional practice with a focus on achieving Magnet recognition or Pathway to Excellence, establishing and developing shared governance, and implementing a professional practice model. The Director will also be responsible for driving nursing professional development, raising the bar for nursing excellence, increasing certified nurses, and collaborating with nursing school affiliations. Improving patient care and safety metrics, such as reducing falls, medication error rates, CAUTI, and CLABSI, in partnership with infection prevention, will also be a critical focus. Challenges and Opportunities: This role offers a significant opportunity to positively impact the profession of nursing at Kaweah Health, a large teaching hospital with approximately 130 residents. Key Performance Indicators for this role include improvements in patient care and safety metrics, reduction in staff turnover rates, an increase in the number of nurses achieving certification, and higher employee engagement scores. Active engagement in shared governance, progress on the Magnet journey or Pathway to Excellence initiatives, and the successful development and implementation of a professional practice model are also crucial for success. Kaweah Health is committed to professional development and advancement, supporting continuous improvement in nursing practice and quality, with an emphasis on nurse certification and strong partnerships with numerous nursing school affiliations. If you are passionate about leading nursing excellence and meet the above qualifications, we encourage you to apply and explore joining our clients team at Kaweah Health. To learn more or apply contact Mike Duggan ************ or via *****************************, or simply apply through this posting.
    $165k-219k yearly est. 18h ago
  • LSW Case Management Consultant- Full-Time- Up to $70/hour

    Interim Healthcare Staffing 4.7company rating

    Saint Paul, MN jobs

    LSW Case Management Consultant- Full-Time Professionally develop and enhance your healthcare career at Interim Healthcare Staffing! Gain valuable, industry leading experience working in one of our many specialty areas. Interim Healthcare Staffing offers amazing opportunities for career progression, as well as ongoing education and development programs. Schedule/Shifts: Full-Time, M-F 8:00am - 4:30pm (part-time availability may be considered). Location: This is a remote position servicing the state of Minnesota. Pay rate: Up to 69.96$/hour depending on experience. *This is considered a temporary assignment without a designated end date. Position Summary: Interim Staffing is preparing for an anticipated increase in MSHO enrollment in Q1 2026 and is actively seeking temporary Registered Nurses (RNs) and Social Workers (SWs) who are preferably MnCHOICES Certified Assessors. The primary role of this position is focusing on enrollment for members who are losing their U-Care coverage. What we offer you: Locally Owned and Operated Business Opportunity to work different locations/Diversity in clinic settings Working with Clinics and Hospitals throughout the 7-county area of Minneapolis/Saint Paul Competitive Salary and Benefits Health Coverage Dental Coverage PTO Accrual Based on Hours Worked Job Accountabilities: Primary role is focused on enrollment for members who are losing their U-Care coverage. Ensure all activities are member-focused and individualized, resulting in personalized attention to each patient's unique needs. Identify interventions to assist member in reaching health related goals and identify patterns of care that are predictive of future needs/services. Work with Case Management team, Government Programs Department and Member Services Department to ensure compliance with Medicare regulations. Collaborate with Inpatient/Outpatient and Case Management teams and assist/advise case managers in developing customized care plans. Identify best practices and offer suggestions for alternative approaches to nurse care managers, and participate in case conferences as requested. Develop/recommend/implement follow-up action plans and monitor health action plans as agreed upon with Case Manager. Contribute knowledge of resources available to assist in the achievement of patient goals. Maintain a knowledge of government programs, appropriate paperwork needed for County/State programs, local housing alternatives, employment assistance, etc. Maintain current list of support groups available for various diseases/conditions, and coordinate utilization of community resources available for members/families. Maintain knowledge of new laws/policies that affect member care and care management practices. Complete special projects as assigned by Case Management leadership, and all other duties as assigned. Job Requirements: Social Worker with current unrestricted license in the state of MN (LSW, LISW, LICSW). Experience with MNChoices/MN Choices Certified Assessor is required. Minimum of two years of clinical experience required, one year of experience working with case managers or in case management is preferred. Ability to read and interpret insurance benefits and experience with computer programs including Microsoft Office (Word, Excel), email, etc. Working knowledge of internet based resources and strong background in customer service and care delivery. Strong organizational skills and ability to prioritize tasks, along with excellent oral/written/interpersonal communication skills. Problem solving skills. Ability to function independently and adapt to change, perform critical analysis, plan, organize and evaluate effectively. Maintain a valid driver's license for minimal travel. Who we are: Interim Healthcare is America's leading provider of healthcare staffing. We offer one of the most comprehensive selections of career opportunities in the industry ranging from per diem to full-time. If you're looking for a stable career opportunity, look no further. We offer the security of working for an established company. Nationally, Interim Healthcare has been providing great jobs to great people for over 50 years and there are more than 300 offices across the country. That kind of stability combined with our commitment to integrity makes us your perfect career partner. Interim Healthcare is an Equal Opportunity Employer. Each Interim Healthcare location is independently owned and operated. ©2025 Interim Healthcare Inc. PandoLogic. Category:Healthcare, Keywords:Medical Case Manager, Location:Saint Paul, MN-55103
    $62k-102k yearly est. 4d ago
  • LSW Case Management Consultant- Full-Time- Up to $70/hour

    Interim Healthcare Staffing 4.7company rating

    Maple Grove, MN jobs

    LSW Case Management Consultant- Full-Time Professionally develop and enhance your healthcare career at Interim Healthcare Staffing! Gain valuable, industry leading experience working in one of our many specialty areas. Interim Healthcare Staffing offers amazing opportunities for career progression, as well as ongoing education and development programs. Schedule/Shifts: Full-Time, M-F 8:00am - 4:30pm (part-time availability may be considered). Location: This is a remote position servicing the state of Minnesota. Pay rate: Up to 69.96$/hour depending on experience. *This is considered a temporary assignment without a designated end date. Position Summary: Interim Staffing is preparing for an anticipated increase in MSHO enrollment in Q1 2026 and is actively seeking temporary Registered Nurses (RNs) and Social Workers (SWs) who are preferably MnCHOICES Certified Assessors. The primary role of this position is focusing on enrollment for members who are losing their U-Care coverage. What we offer you: Locally Owned and Operated Business Opportunity to work different locations/Diversity in clinic settings Working with Clinics and Hospitals throughout the 7-county area of Minneapolis/Saint Paul Competitive Salary and Benefits Health Coverage Dental Coverage PTO Accrual Based on Hours Worked Job Accountabilities: Primary role is focused on enrollment for members who are losing their U-Care coverage. Ensure all activities are member-focused and individualized, resulting in personalized attention to each patient's unique needs. Identify interventions to assist member in reaching health related goals and identify patterns of care that are predictive of future needs/services. Work with Case Management team, Government Programs Department and Member Services Department to ensure compliance with Medicare regulations. Collaborate with Inpatient/Outpatient and Case Management teams and assist/advise case managers in developing customized care plans. Identify best practices and offer suggestions for alternative approaches to nurse care managers, and participate in case conferences as requested. Develop/recommend/implement follow-up action plans and monitor health action plans as agreed upon with Case Manager. Contribute knowledge of resources available to assist in the achievement of patient goals. Maintain a knowledge of government programs, appropriate paperwork needed for County/State programs, local housing alternatives, employment assistance, etc. Maintain current list of support groups available for various diseases/conditions, and coordinate utilization of community resources available for members/families. Maintain knowledge of new laws/policies that affect member care and care management practices. Complete special projects as assigned by Case Management leadership, and all other duties as assigned. Job Requirements: Social Worker with current unrestricted license in the state of MN (LSW, LISW, LICSW). Experience with MNChoices/MN Choices Certified Assessor is required. Minimum of two years of clinical experience required, one year of experience working with case managers or in case management is preferred. Ability to read and interpret insurance benefits and experience with computer programs including Microsoft Office (Word, Excel), email, etc. Working knowledge of internet based resources and strong background in customer service and care delivery. Strong organizational skills and ability to prioritize tasks, along with excellent oral/written/interpersonal communication skills. Problem solving skills. Ability to function independently and adapt to change, perform critical analysis, plan, organize and evaluate effectively. Maintain a valid driver's license for minimal travel. Who we are: Interim Healthcare is America's leading provider of healthcare staffing. We offer one of the most comprehensive selections of career opportunities in the industry ranging from per diem to full-time. If you're looking for a stable career opportunity, look no further. We offer the security of working for an established company. Nationally, Interim Healthcare has been providing great jobs to great people for over 50 years and there are more than 300 offices across the country. That kind of stability combined with our commitment to integrity makes us your perfect career partner. Interim Healthcare is an Equal Opportunity Employer. Each Interim Healthcare location is independently owned and operated. ©2025 Interim Healthcare Inc. PandoLogic. Category:Healthcare, Keywords:Medical Case Manager, Location:Maple Grove, MN-55311
    $63k-101k yearly est. 4d ago
  • LSW Case Management Consultant- Full-Time- Up to $70/hour

    Interim Healthcare Staffing 4.7company rating

    Burnsville, MN jobs

    LSW Case Management Consultant- Full-Time Professionally develop and enhance your healthcare career at Interim Healthcare Staffing! Gain valuable, industry leading experience working in one of our many specialty areas. Interim Healthcare Staffing offers amazing opportunities for career progression, as well as ongoing education and development programs. Schedule/Shifts: Full-Time, M-F 8:00am - 4:30pm (part-time availability may be considered). Location: This is a remote position servicing the state of Minnesota. Pay rate: Up to 69.96$/hour depending on experience. *This is considered a temporary assignment without a designated end date. Position Summary: Interim Staffing is preparing for an anticipated increase in MSHO enrollment in Q1 2026 and is actively seeking temporary Registered Nurses (RNs) and Social Workers (SWs) who are preferably MnCHOICES Certified Assessors. The primary role of this position is focusing on enrollment for members who are losing their U-Care coverage. What we offer you: Locally Owned and Operated Business Opportunity to work different locations/Diversity in clinic settings Working with Clinics and Hospitals throughout the 7-county area of Minneapolis/Saint Paul Competitive Salary and Benefits Health Coverage Dental Coverage PTO Accrual Based on Hours Worked Job Accountabilities: Primary role is focused on enrollment for members who are losing their U-Care coverage. Ensure all activities are member-focused and individualized, resulting in personalized attention to each patient's unique needs. Identify interventions to assist member in reaching health related goals and identify patterns of care that are predictive of future needs/services. Work with Case Management team, Government Programs Department and Member Services Department to ensure compliance with Medicare regulations. Collaborate with Inpatient/Outpatient and Case Management teams and assist/advise case managers in developing customized care plans. Identify best practices and offer suggestions for alternative approaches to nurse care managers, and participate in case conferences as requested. Develop/recommend/implement follow-up action plans and monitor health action plans as agreed upon with Case Manager. Contribute knowledge of resources available to assist in the achievement of patient goals. Maintain a knowledge of government programs, appropriate paperwork needed for County/State programs, local housing alternatives, employment assistance, etc. Maintain current list of support groups available for various diseases/conditions, and coordinate utilization of community resources available for members/families. Maintain knowledge of new laws/policies that affect member care and care management practices. Complete special projects as assigned by Case Management leadership, and all other duties as assigned. Job Requirements: Social Worker with current unrestricted license in the state of MN (LSW, LISW, LICSW). Experience with MNChoices/MN Choices Certified Assessor is required. Minimum of two years of clinical experience required, one year of experience working with case managers or in case management is preferred. Ability to read and interpret insurance benefits and experience with computer programs including Microsoft Office (Word, Excel), email, etc. Working knowledge of internet based resources and strong background in customer service and care delivery. Strong organizational skills and ability to prioritize tasks, along with excellent oral/written/interpersonal communication skills. Problem solving skills. Ability to function independently and adapt to change, perform critical analysis, plan, organize and evaluate effectively. Maintain a valid driver's license for minimal travel. Who we are: Interim Healthcare is America's leading provider of healthcare staffing. We offer one of the most comprehensive selections of career opportunities in the industry ranging from per diem to full-time. If you're looking for a stable career opportunity, look no further. We offer the security of working for an established company. Nationally, Interim Healthcare has been providing great jobs to great people for over 50 years and there are more than 300 offices across the country. That kind of stability combined with our commitment to integrity makes us your perfect career partner. Interim Healthcare is an Equal Opportunity Employer. Each Interim Healthcare location is independently owned and operated. ©2025 Interim Healthcare Inc. PandoLogic. Category:Healthcare, Keywords:Medical Case Manager, Location:Burnsville, MN-55306
    $62k-101k yearly est. 3d ago
  • Physician / Family Practice / New Mexico / Permanent / Lead, Teach, Care: Full Spectrum Faculty Family Physician in the Heart of Southern New Mexico

    Lifepoint Health 4.1company rating

    Las Cruces, NM jobs

    Family Medicine Faculty Physician ??? Memorial Medical Center | Las Cruces, NM Memorial Medical Center is seeking a dynamic Family Medicine Faculty Physician to join its team. The program provides collaborative, multidisciplinary clinical care services with a strong emphasis on social medicine.
    $79k-101k yearly est. 18h ago
  • LSW Case Management Consultant- Full-Time- Up to $70/hour

    Interim Healthcare Staffing 4.7company rating

    Minnetonka, MN jobs

    LSW Case Management Consultant- Full-Time Professionally develop and enhance your healthcare career at Interim Healthcare Staffing! Gain valuable, industry leading experience working in one of our many specialty areas. Interim Healthcare Staffing offers amazing opportunities for career progression, as well as ongoing education and development programs. Schedule/Shifts: Full-Time, M-F 8:00am - 4:30pm (part-time availability may be considered). Location: This is a remote position servicing the state of Minnesota. Pay rate: Up to 69.96$/hour depending on experience. *This is considered a temporary assignment without a designated end date. Position Summary: Interim Staffing is preparing for an anticipated increase in MSHO enrollment in Q1 2026 and is actively seeking temporary Registered Nurses (RNs) and Social Workers (SWs) who are preferably MnCHOICES Certified Assessors. The primary role of this position is focusing on enrollment for members who are losing their U-Care coverage. What we offer you: Locally Owned and Operated Business Opportunity to work different locations/Diversity in clinic settings Working with Clinics and Hospitals throughout the 7-county area of Minneapolis/Saint Paul Competitive Salary and Benefits Health Coverage Dental Coverage PTO Accrual Based on Hours Worked Job Accountabilities: Primary role is focused on enrollment for members who are losing their U-Care coverage. Ensure all activities are member-focused and individualized, resulting in personalized attention to each patient's unique needs. Identify interventions to assist member in reaching health related goals and identify patterns of care that are predictive of future needs/services. Work with Case Management team, Government Programs Department and Member Services Department to ensure compliance with Medicare regulations. Collaborate with Inpatient/Outpatient and Case Management teams and assist/advise case managers in developing customized care plans. Identify best practices and offer suggestions for alternative approaches to nurse care managers, and participate in case conferences as requested. Develop/recommend/implement follow-up action plans and monitor health action plans as agreed upon with Case Manager. Contribute knowledge of resources available to assist in the achievement of patient goals. Maintain a knowledge of government programs, appropriate paperwork needed for County/State programs, local housing alternatives, employment assistance, etc. Maintain current list of support groups available for various diseases/conditions, and coordinate utilization of community resources available for members/families. Maintain knowledge of new laws/policies that affect member care and care management practices. Complete special projects as assigned by Case Management leadership, and all other duties as assigned. Job Requirements: Social Worker with current unrestricted license in the state of MN (LSW, LISW, LICSW). Experience with MNChoices/MN Choices Certified Assessor is required. Minimum of two years of clinical experience required, one year of experience working with case managers or in case management is preferred. Ability to read and interpret insurance benefits and experience with computer programs including Microsoft Office (Word, Excel), email, etc. Working knowledge of internet based resources and strong background in customer service and care delivery. Strong organizational skills and ability to prioritize tasks, along with excellent oral/written/interpersonal communication skills. Problem solving skills. Ability to function independently and adapt to change, perform critical analysis, plan, organize and evaluate effectively. Maintain a valid driver's license for minimal travel. Who we are: Interim Healthcare is America's leading provider of healthcare staffing. We offer one of the most comprehensive selections of career opportunities in the industry ranging from per diem to full-time. If you're looking for a stable career opportunity, look no further. We offer the security of working for an established company. Nationally, Interim Healthcare has been providing great jobs to great people for over 50 years and there are more than 300 offices across the country. That kind of stability combined with our commitment to integrity makes us your perfect career partner. Interim Healthcare is an Equal Opportunity Employer. Each Interim Healthcare location is independently owned and operated. ©2025 Interim Healthcare Inc. PandoLogic. Category:Healthcare, Keywords:Medical Case Manager, Location:Minnetonka, MN-55345
    $62k-101k yearly est. 4d ago
  • LSW Case Management Consultant- Full-Time- Up to $70/hour

    Interim Healthcare Staffing 4.7company rating

    Eden Prairie, MN jobs

    LSW Case Management Consultant- Full-Time Professionally develop and enhance your healthcare career at Interim Healthcare Staffing! Gain valuable, industry leading experience working in one of our many specialty areas. Interim Healthcare Staffing offers amazing opportunities for career progression, as well as ongoing education and development programs. Schedule/Shifts: Full-Time, M-F 8:00am - 4:30pm (part-time availability may be considered). Location: This is a remote position servicing the state of Minnesota. Pay rate: Up to 69.96$/hour depending on experience. *This is considered a temporary assignment without a designated end date. Position Summary: Interim Staffing is preparing for an anticipated increase in MSHO enrollment in Q1 2026 and is actively seeking temporary Registered Nurses (RNs) and Social Workers (SWs) who are preferably MnCHOICES Certified Assessors. The primary role of this position is focusing on enrollment for members who are losing their U-Care coverage. What we offer you: Locally Owned and Operated Business Opportunity to work different locations/Diversity in clinic settings Working with Clinics and Hospitals throughout the 7-county area of Minneapolis/Saint Paul Competitive Salary and Benefits Health Coverage Dental Coverage PTO Accrual Based on Hours Worked Job Accountabilities: Primary role is focused on enrollment for members who are losing their U-Care coverage. Ensure all activities are member-focused and individualized, resulting in personalized attention to each patient's unique needs. Identify interventions to assist member in reaching health related goals and identify patterns of care that are predictive of future needs/services. Work with Case Management team, Government Programs Department and Member Services Department to ensure compliance with Medicare regulations. Collaborate with Inpatient/Outpatient and Case Management teams and assist/advise case managers in developing customized care plans. Identify best practices and offer suggestions for alternative approaches to nurse care managers, and participate in case conferences as requested. Develop/recommend/implement follow-up action plans and monitor health action plans as agreed upon with Case Manager. Contribute knowledge of resources available to assist in the achievement of patient goals. Maintain a knowledge of government programs, appropriate paperwork needed for County/State programs, local housing alternatives, employment assistance, etc. Maintain current list of support groups available for various diseases/conditions, and coordinate utilization of community resources available for members/families. Maintain knowledge of new laws/policies that affect member care and care management practices. Complete special projects as assigned by Case Management leadership, and all other duties as assigned. Job Requirements: Social Worker with current unrestricted license in the state of MN (LSW, LISW, LICSW). Experience with MNChoices/MN Choices Certified Assessor is required. Minimum of two years of clinical experience required, one year of experience working with case managers or in case management is preferred. Ability to read and interpret insurance benefits and experience with computer programs including Microsoft Office (Word, Excel), email, etc. Working knowledge of internet based resources and strong background in customer service and care delivery. Strong organizational skills and ability to prioritize tasks, along with excellent oral/written/interpersonal communication skills. Problem solving skills. Ability to function independently and adapt to change, perform critical analysis, plan, organize and evaluate effectively. Maintain a valid driver's license for minimal travel. Who we are: Interim Healthcare is America's leading provider of healthcare staffing. We offer one of the most comprehensive selections of career opportunities in the industry ranging from per diem to full-time. If you're looking for a stable career opportunity, look no further. We offer the security of working for an established company. Nationally, Interim Healthcare has been providing great jobs to great people for over 50 years and there are more than 300 offices across the country. That kind of stability combined with our commitment to integrity makes us your perfect career partner. Interim Healthcare is an Equal Opportunity Employer. Each Interim Healthcare location is independently owned and operated. ©2025 Interim Healthcare Inc. PandoLogic. Category:Healthcare, Keywords:Medical Case Manager, Location:Eden Prairie, MN-55347
    $62k-101k yearly est. 4d ago
  • Principal Cloud & DevOps Architect

    Beacon Healthcare Systems 4.5company rating

    Huntington Beach, CA jobs

    As a Principle Cloud & DevOps Architect, you'll be the technical backbone of our infrastructure and DevOps strategy, driving scalable, secure, and compliant environments for our SaaS platform serving Medicare and Medicaid health plans. You'll play a key role in our AWS cloud migration, automation initiatives, and AI-enablement across mission-critical products. Key Responsibilities: · Cloud Infrastructure Leadership Lead the design and implementation of AWS-based infrastructure, supporting high availability, disaster recovery, and elastic scaling for healthcare-grade SaaS applications. · DevOps & CI/CD Optimization Architect and continuously improve CI/CD pipelines for Compliance, Appeals & Grievances, and Universe Scrubber products. Champion automation across build, test, and deployment workflows. · AI-Ready Infrastructure Collaborate with engineering and data teams to support AI/ML workloads, including model training environments, data pipelines, and GPU provisioning. · Security & Compliance Engineering Implement infrastructure-level controls aligned with CMS, HIPAA, and HITRUST standards. Integrate monitoring, logging, and alerting systems to ensure auditability and proactive issue resolution. · Environment Management Maintain and optimize production, QA, and development environments. Ensure consistency, reliability, and performance across all stages of the software lifecycle. · Tooling & Automation Leverage tools like Jenkins, Ansible, Terraform, and GitHub Actions to drive infrastructure-as-code and configuration management. Support version control and release management best practices. Qualifications: · Bachelor's degree in computer science, Engineering, or related field · 8+ years of experience in DevOps, infrastructure engineering, or site reliability · Deep expertise in AWS services, Linux/Windows systems, and cloud-native architecture · Strong scripting skills (Python, Bash, etc.) and familiarity with healthcare data workflows · Experience supporting regulated environments (CMS, HIPAA, HITRUST, SOC 2)
    $131k-184k yearly est. 2d ago
  • Revenue Integrity Manager

    Memorial Healthcare System 4.0company rating

    Hollywood, FL jobs

    The Manager of Revenue Integrity is responsible for overseeing the daily operations, performance, configuration, and development of assigned applications to ensure alignment with departmental goals and objectives. This role manages a team of Revenue Integrity Analysts who provide technical expertise to support charge capture processes, system functionality, and compliance requirements. The Manager also designs, implements, and tests controls to optimize revenue capture, enhance net revenue, and ensure regulatory compliance across people, processes, and technology. Responsibilities: Manages the planning of application development and deployment; educates and promotes adherence to the organization's software compliance standards within the team. Strategic focus: based on regulatory and industry updates, MHS strategic initiatives, end-user feedback, and other information, identifies and achieves opportunities to improve charge capture efficiency and accuracy, eliminate missed charges, eliminate billing rework, and improve MHS net revenue. Keeps current, timely reads, and analyzes Medicare, Medicaid, and other technical guidance to determine how they affect Memorial Healthcare System (MHS) capture. Develops, recommends, and implements plans to comply with regulatory updates as approved by the Director of Revenue Integrity and in collaboration with responsible MHS leaders. Develops annual CDM CPT/HCPCS updates and implements as approved by the Director of Revenue Integrity. Includes working with operational departments to identify applicable new or revised codes. Oversees the maintenance of CDM-driven CPT/HCPCS coding requirements. Develops annual CDM Fee Schedule updates and implements as approved by the Director of Revenue Integrity. Updates Price Transparency Standard Charges file in accordance with regulatory requirements. Manages and monitors staffing activities including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives. Periodically tests samples of departmental charges to evaluate whether staff members are performing correctly, and controls are operating as designed. Works with RCM and departmental staff to provide as-needed retraining as well as regular periodic updates for all charge capture staff. Monitors and provides training, support and troubleshooting to both application teams and end-users to facilitate proper usage and continuous learning. Manages applications projects including workflow analysis, end-user validation, acceptance, go‑live, and maintenance using standard project management methodology. Sets project deadlines and deliverables for specific modules and analysis. Manages the debugging and enhancements processes including the design and upgrades to existing systems in order to ensure up‑to‑date and reliable functionality. Utilizes subject matter expert skills to assist MHS leaders with analyses of billing, coding, and documentation requirements for payer coverage and payment of services affecting their service lines and initiatives. Designs and evaluates the tools and processes used to capture charges in each MHS department. Updates the design of tools to empower departmental staff to accurately post charges efficiently, without rework. Designs and implements controls to empower departmental leaders to ensure staff have captured charges accurately and timely. Ensures Epic charge-related work queues are timely and correctly cleared. Selects opportunities identified by team to implement and improve existing processes using information technology and ensures alignment with strategic initiatives of the organization. Education and Certification Requirements: Associates (Required) Epic Charge Router Certification (EPIC CHG ROUTER) - EPIC Certification (EPIC), Epic Resolute Billing Certification (EPIC BILLING) - EPIC Certification (EPIC) Required Work Experience: Minimum of five (5) years' Epic charge master (preferred) and/or billing experience. Able to build charge records (EAP) and controls (charge router, charge handler, and revenue guardian). Minimum of three (3) years' experience of supervising/managing a team. Other Information: Additional Education Info: Associate's degree required; Bachelor's preferred Certification Requirements: Epic Resolute Billing Certification Epic Charge Router Certification Candidate must have or be pursuing a coding credential (AHIMA or AAPC) which must be obtained within a year of taking the position.
    $86k-109k yearly est. 18h ago
  • Reimbursement Consultant (Managed Care)

    Henry Ford Health 4.6company rating

    Troy, MI jobs

    Under minimal supervision of the Manager, independently leads financial and data analysis to evaluate rate proposals, contract terms, and health plan reimbursement. This position will proactively identify rates, methodologies, and processes that need improvement and will develop and implement solutions to optimize reimbursement. EDUCATION/EXPERIENCE REQUIRED: Bachelor's degree in Finance, Accounting, Business Administration, Managed Care Contracting, Reimbursement, or related field. Master's Degree preferred. Five to seven (5-7) years of experience in healthcare finance, managed care contracting, or reimbursement in a professional capacity including experience with various reimbursement methodologies (DRGs, per diems, fee schedules, case rates, etc.). Report writing capabilities or ability / willingness to learn. Strong Analytical and Critically Thinking skills (via curiosity, creativity, skepticism, and adept in use of logic) relative to accomplishing business objective and problem solving. Detail oriented. Proficient in Microsoft Excel (queries, reports, pivots, What If scenarios and database mgmt. a plus). Proficient in Data extraction & reporting tools (EPSi, SQL, Clarity, etc.). Excellent oral and written communication skills. Strong organizational and interpersonal skills. Strong Understanding of Managed Care Reimbursement methodologies, coding, and terminology.
    $69k-93k yearly est. 18h ago
  • Senior Business Operations Consultant (Consumer Digital Innovation) - Remote

    Cedars-Sinai 4.8company rating

    Los Angeles, CA jobs

    **Grow your career at Cedars-Sinai!** Cedars-Sinai Medical Center has been named to the Honor Roll in U.S. News & World Report's "Best Hospitals 2025-2026" rankings . When you join our team, you'll gain access to our groundbreaking biomedical research facilities and sophisticated medical education programs. We offer learning programs, tuition reimbursement and performance-improvement projects so you can achieve certifications and degrees while gaining the knowledge and experience needed to advance your career. The Consumer Digital Innovation team at Cedars-Sinai understands that true mobile and web transformation and the optimization of a digital platform implementation is fueled through the alignment of the right people, processes, and technologies. **Why work here?** Beyond an outstanding benefit package and competitive salaries, we take pride in hiring the best, most committed employees. Our staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a multifaceted, inclusive environment that fuels innovation and the gold standard of patient care we strive for. **What will you be doing in this role:** The Senior Business Operations (Digital Transformation) Consultant for Consumer Digital Innovation Team is responsible for supporting our digital front door capabilities, access enablement and other initiatives. This role is critical to driving growth, expansion, and innovation of digital capabilities and improving the customer experience at Cedars-Sinai. + Enhance our ability to deliver seamless digital experiences to our patients. + In partnership with product managers, lead the business and clinical operations planning, stakeholder and implementation, change management, and analytics components of consumer-facing digital products and services, ensuring a delightful user experience that drives patient acquisition and retention. + Support the integration of frictionless digital experiences within the organization and collaborate with various digital competencies to define and prioritize product features that cross the portfolio. + Monitoring project schedules, defining appropriate resources, and recommending vital adjustments to improve project efficiency. + Developing metrics and measurements to evaluate the success of digital strategies, products, and services, ensuring continuous improvement and alignment with Cedars-Sinai's strategic goals. _*Approved Remote States: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, Texas_ * **Qualifications** **Experience Requirements:** Three (3) plus years of experience in consulting, strategy, and/or business development experience in a healthcare organization or consulting organization providing services to the healthcare industry. 5 years experience preferred. Healthcare environment experience required. Familiar working with product and clinical operational teams. Understanding of Web technologies and functions. **Educational Requirements:** Bachelor's degree in Healthcare Leadership/Management, Business, or related field. Master's degree preferred. Project Management Professional (PMP) Certification preferred. \#Li-Remote **Req ID** : 13273 **Working Title** : Senior Business Operations Consultant (Consumer Digital Innovation) - Remote **Department** : CDI Product and Operations **Business Entity** : Cedars-Sinai Medical Center **Job Category** : Strategic Plan / Business Dev **Job Specialty** : Strategic Planning **Overtime Status** : EXEMPT **Primary Shift** : Day **Shift Duration** : 8 hour **Base Pay** : $112,673.60 - $185,910.40 Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.
    $112.7k-185.9k yearly 14d ago
  • Senior Business Operations Consultant (Consumer Digital Innovation) - Remote

    Cedars-Sinai 4.8company rating

    Remote

    Grow your career at Cedars-Sinai! Cedars-Sinai Medical Center has been named to the Honor Roll in U.S. News & World Report's “Best Hospitals 2025-2026” rankings. When you join our team, you'll gain access to our groundbreaking biomedical research facilities and sophisticated medical education programs. We offer learning programs, tuition reimbursement and performance-improvement projects so you can achieve certifications and degrees while gaining the knowledge and experience needed to advance your career. The Consumer Digital Innovation team at Cedars-Sinai understands that true mobile and web transformation and the optimization of a digital platform implementation is fueled through the alignment of the right people, processes, and technologies. Why work here? Beyond an outstanding benefit package and competitive salaries, we take pride in hiring the best, most committed employees. Our staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a multifaceted, inclusive environment that fuels innovation and the gold standard of patient care we strive for. What will you be doing in this role: The Senior Business Operations (Digital Transformation) Consultant for Consumer Digital Innovation Team is responsible for supporting our digital front door capabilities, access enablement and other initiatives. This role is critical to driving growth, expansion, and innovation of digital capabilities and improving the customer experience at Cedars-Sinai. Enhance our ability to deliver seamless digital experiences to our patients. In partnership with product managers, lead the business and clinical operations planning, stakeholder and implementation, change management, and analytics components of consumer-facing digital products and services, ensuring a delightful user experience that drives patient acquisition and retention. Support the integration of frictionless digital experiences within the organization and collaborate with various digital competencies to define and prioritize product features that cross the portfolio. Monitoring project schedules, defining appropriate resources, and recommending vital adjustments to improve project efficiency. Developing metrics and measurements to evaluate the success of digital strategies, products, and services, ensuring continuous improvement and alignment with Cedars-Sinai's strategic goals. *Approved Remote States: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, Texas * Experience Requirements: Three (3) plus years of experience in consulting, strategy, and/or business development experience in a healthcare organization or consulting organization providing services to the healthcare industry. 5 years experience preferred. Healthcare environment experience required. Familiar working with product and clinical operational teams. Understanding of Web technologies and functions. Educational Requirements: Bachelor's degree in Healthcare Leadership/Management, Business, or related field. Master's degree preferred. Project Management Professional (PMP) Certification preferred. #Li-Remote
    $112k-157k yearly est. Auto-Apply 15d ago
  • Medicare Senior Business Consultant - Hybrid

    Health Care Service Corporation 4.1company rating

    Richardson, TX jobs

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** The Medicare Senior Business Consultant is responsible for providing internal consulting services, business analysis and provides direction to ensure alignment and integration across functional areas in support of organizational goals. This position ensures consistency and efficiency requiring leadership of major, complex, and strategic cross-divisional and enterprise-wide projects from inception to completion. This includes oversight coordination, and ability to implement projects according to dynamic and critical timelines. This also includes oversight of project teams, resources, and budget, and interacting with all levels of management including senior management. This position supports the prioritization of Medicare activities and tracks progress to goals. **Required Job Qualifications:** + Bachelor's degree and 5 years of experience OR 9 years of experience in business analysis, process improvement, project management, business operations or relevant health care industry experience. + 3 years of experience leading with large and complex multi-million dollar projects. + Experience communicating with senior management from multiple divisions. + Experience developing and delivering presentations. + Problem resolution experience and skills. + Knowledge of strategic planning techniques and industry trends + Experience interpreting business and financial information + Negotiations skills. + Verbal and written communications skills including establishing working relationships across departments, preparing presentations to senior management, and establishing team environment. + Organizational skills. + Experience managing multiple complex projects successfully. + Detail oriented. + PC proficiency to include Microsoft Office products **Preferred Required Job Qualifications:** + Health insurance or healthcare industry experience strongly with an emphasis on Medicare Operations is strongly preferred. + Proven analytical thinking and the ability to move from strategy to action. + Prior internal or external consulting experience preferred. + Understanding of Software Development Life Cycle (SDLC) in the project management process preferred. + **Schedule:** This is a Flex (Hybrid) role: 3 days in office; 2 days remote. + **Location:** Richardson, TX or Chicago, IL. + Sponsorship: Sponsorship is not available. \#LI-Hybrid \#LI-JR2 **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $60,300.00 - $133,400.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $60.3k-133.4k yearly 60d+ ago
  • Medicare Senior Business Consultant - Hybrid

    Health Care Service Corporation 4.1company rating

    Chicago, IL jobs

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** The Medicare Senior Business Consultant is responsible for providing internal consulting services, business analysis and provides direction to ensure alignment and integration across functional areas in support of organizational goals. This position ensures consistency and efficiency requiring leadership of major, complex, and strategic cross-divisional and enterprise-wide projects from inception to completion. This includes oversight coordination, and ability to implement projects according to dynamic and critical timelines. This also includes oversight of project teams, resources, and budget, and interacting with all levels of management including senior management. This position supports the prioritization of Medicare activities and tracks progress to goals. **Required Job Qualifications:** + Bachelor's degree and 5 years of experience OR 9 years of experience in business analysis, process improvement, project management, business operations or relevant health care industry experience. + 3 years of experience leading with large and complex multi-million dollar projects. + Experience communicating with senior management from multiple divisions. + Experience developing and delivering presentations. + Problem resolution experience and skills. + Knowledge of strategic planning techniques and industry trends + Experience interpreting business and financial information + Negotiations skills. + Verbal and written communications skills including establishing working relationships across departments, preparing presentations to senior management, and establishing team environment. + Organizational skills. + Experience managing multiple complex projects successfully. + Detail oriented. + PC proficiency to include Microsoft Office products **Preferred Required Job Qualifications:** + Health insurance or healthcare industry experience strongly with an emphasis on Medicare Operations is strongly preferred. + Proven analytical thinking and the ability to move from strategy to action. + Prior internal or external consulting experience preferred. + Understanding of Software Development Life Cycle (SDLC) in the project management process preferred. + **Schedule:** This is a Flex (Hybrid) role: 3 days in office; 2 days remote. + **Location:** Richardson, TX or Chicago, IL. + Sponsorship: Sponsorship is not available. \#LI-Hybrid \#LI-JR2 **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $60,300.00 - $133,400.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $60.3k-133.4k yearly 60d+ ago
  • Senior Business Operations Consultant (Consumer Digital Innovation)

    Cedars-Sinai Medical Center 4.8company rating

    Los Angeles, CA jobs

    Grow your career at Cedars-Sinai! Cedars-Sinai Medical Center has been named to the Honor Roll in U.S. News & World Report's “Best Hospitals 2025-2026” rankings. When you join our team, you'll gain access to our groundbreaking biomedical research facilities and sophisticated medical education programs. We offer learning programs, tuition reimbursement and performance-improvement projects so you can achieve certifications and degrees while gaining the knowledge and experience needed to advance your career. The Consumer Digital Innovation team at Cedars-Sinai understands that true mobile and web transformation and the optimization of a digital platform implementation is fueled through the alignment of the right people, processes, and technologies. Why work here? Beyond an outstanding benefit package and competitive salaries, we take pride in hiring the best, most committed employees. Our staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a multifaceted, inclusive environment that fuels innovation and the gold standard of patient care we strive for. What will you be doing in this role: The Senior Business Operations (Digital Transformation) Consultant for Consumer Digital Innovation Team is responsible for supporting our digital front door capabilities, access enablement and other initiatives. This role is critical to driving growth, expansion, and innovation of digital capabilities and improving the customer experience at Cedars-Sinai. Enhance our ability to deliver seamless digital experiences to our patients. In partnership with product managers, lead the business and clinical operations planning, stakeholder and implementation, change management, and analytics components of consumer-facing digital products and services, ensuring a delightful user experience that drives patient acquisition and retention. Support the integration of frictionless digital experiences within the organization and collaborate with various digital competencies to define and prioritize product features that cross the portfolio. Monitoring project schedules, defining appropriate resources, and recommending vital adjustments to improve project efficiency. Developing metrics and measurements to evaluate the success of digital strategies, products, and services, ensuring continuous improvement and alignment with Cedars-Sinai's strategic goals. *Approved Remote States: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, Texas * Qualifications Experience Requirements: Three (3) plus years of experience in consulting, strategy, and/or business development experience in a healthcare organization or consulting organization providing services to the healthcare industry. 5 years experience preferred. Healthcare environment experience required. Familiar working with product and clinical operational teams. Understanding of Web technologies and functions. Educational Requirements: Bachelor's degree in Healthcare Leadership/Management, Business, or related field. Master's degree preferred. Project Management Professional (PMP) Certification preferred. #Li-Remote
    $124k-166k yearly est. Auto-Apply 15d ago
  • Coordinator- Medication Therapy Management Pharmacy Support

    Healthpartners 4.2company rating

    Saint Paul, MN jobs

    Park Nicollet is looking to hire a Medication Therapy Management Coordinator to join our Pharmacy team! Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day. Position Summary: To provide support for MTM operations within the health system. Assist patients and staff with initiating complex specialty medications. Coordinate with patients and staff to apply for medication assistance programs. Works with multiple teams across the organization and with external pharmacies to ensure patients maintain access to their specialty medications. Assists MTM pharmacists with administrative duties allowing them to focus efforts on patient care. Work Schedule: 5 days per week/40 hours per week 8:00am - 4:30pm In-clinic 2 days per week ( Park Nicollet Minneapolis) Remote 3 days per week Required Qualifications: Education, Experience or Equivalent Combination: Associate's degree with a focus on healthcare or finance and a minimum 3 years of experience working in a health care setting. An approved equivalent combination of education and experience Licensure/ Registration/ Certification: Certified pharmacy technician through the PTCB required Preferred Qualifications: Experience working with specialty medications Experience in assisting with manufacturer medication assistance programs Previous experience working in an environment where medical and pharmaceutical terminology is used regularly highly preferred. Previous experience working with computerized medical systems and electronic medical records or experience in a pharmacy or customer service-related environment preferred. Knowledge and experience utilizing the Epic electronic health record Benefits: Park Nicollet offers a competitive benefits package (for eligible positions) that includes medical insurance, dental insurance, a retirement program, time away from work, insurance options, tuition reimbursement, an employee assistance program, onsite clinic and much more!
    $60k-88k yearly est. Auto-Apply 20d ago
  • Risk Management Coordinator, Risk Management, FT, 08A-4:30P

    Baptist Health South Florida 4.5company rating

    Homestead, FL jobs

    Responsible for maintaining and supporting the BHSF electronic systems that support incident and claims management processes. Must work independently with general guidance on a wide variety of special projects. Must demonstrate a thorough knowledge of Risk Management priorities and take initiative to assist in supporting these priorities. Must maintain basic knowledge of trends, data, laws, policies and procedures relevant to Risk Management. Degrees: * High School,Cert,GED,Trn,Exper. Additional Qualifications: * Must have Word, Excel, Access, PowerPoint, and Microsoft skills. * Must demonstrate excellent communication skills and a general understanding of healthcare practices, policies, and procedures. * Must understand confidentiality and the importance of privacy in regards to all communication in any and all forms. Minimum Required Experience: 1 Year
    $39k-57k yearly est. 20d ago
  • Sr Business Operations Consult

    Health Alliance of Hudson Valley 4.1company rating

    Valhalla, NY jobs

    As a Sr. Business Operations Consultant within the Operational Excellence Department, you will serve as an internal management consultant working collaboratively to achieve substantial improvement in operations by managing projects throughout the project lifecycle, collaborating with operational leaders to achieve agreements, produce actionable insights with lifecycle analytics development, and map, evaluate, design and improve processes throughout the network. You will help shape the growth of the Operational Excellence by promoting new and innovative solutionsl and expanding the department's project portfolio. Responsibilities: * Serve as a change agent and transformation leader for WMC, providing leaders, teams, and departments with a wide range of state of the art analytics solutions and process improvement methodologies in order to transform operational processes. * Oversee process assessments through observations and system reporting and prepare documents, including workflow and process flows diagrams. * Support the development of analytics solutions and visualizations to assess operational performance and drive data driven decision making.Develop a deep understanding of the organization, the primary workforce components, leadership structure and their interdependency and impacts on one another. * Collect and translate all operational business requirements to be included in future state process design. * Manage a variety of improvement and implementation projects throughout their lifecycle, balancing the priorities and needs of all stakeholders as well as those of the organization. * Lead performance improvement activities that align with the strategic direction of the WMC Health Network based on the analysis of current state operations, anticipated needs, and innovative approaches to the future. * Scope improvement initiatives, acquiring consensus & leadership support, and establishes metrics and landmarks; create and update project plans, action items, and meeting minutes. * Work closely with a variety clinical and non-clinical stakeholders across the network to better understand their departmental processes and needs and to build constructive relationships. * Work collaboratively with leaders throughout the organization to ensure the highest quality of patient services, maintain cost effective resource allocation, efficient and responsive flow of patients, information and materials, facilitating lean and highly reliable processes. * Develop unique information flow solutions to streamline information handoff. * Menotr junior members of the Operational Excellence team and help develop their skills. * Support the Operational Excellence leadership team in shaping the project portfolio. * Identify & implement ways of expanding the team skillset through learning and development opportunities and/or new software solutions to ensure the Operational Excellence team is continuously improving it's skillset for transforming the organization. Qualifications/Requirements: Experience: Minimum of 3 years of experience in Health Administration, Business Administration, Healthcare Management, Consulting or other healthcare-related field(s). Experience with Tableau / Power BI or similar data viualization software required. Education: Bachelor's degree required, Master's degree preferred. Licenses / Certifications: N/A Other: Agile skills that draw from other disciplines such as management, business administration, organization development, information technology, and computer science. Strong process mapping and visualization (Microsoft Visio). Excellent written and verbal communication with a strong drive for perfection / professionalism in delivery and presentation. Proven ability to work both independently on projects and as part of the larger team. Advanced proficiency in Microsoft Office Suite. Ability to visualize data for improvement/performance monitoring. Experience with Tableau and Power BI required.
    $114k-159k yearly est. 48d ago

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