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St. Peter's Health Partners Remote jobs - 22 jobs

  • Authorization and Denial Supervisor - REMOTE - FT

    St. Peters Health Partners 4.4company rating

    Albany, NY jobs

    Authorization and Denial Supervisor - Remote - Full Time Looking for a remote colleague to support our Central Surgical Prior Authorization Team. This includes supporting authorization specialists, collaborating with in house pharmacy teams, and trending and reporting denial data. Summary This position is responsible for oversight of authorization and denials within assigned service line ensuring appropriate prior authorization for related services, drugs, treatments, and supplies. Assists in the identification, reporting and resolution of any issues stemming from or with authorization and denial processes. Using data, system reports, and analytics, supports the needs of the authorization team. Instrumental in developing and implementing strategies to optimize all aspects of authorization and denials supporting the revenue integrity team through a comprehensive approach. The scope of prior authorizations may include (but is not limited to) consults, diagnostic testing in office procedures and pharmaceuticals including off label drugs, and drugs for clinical trials. Job Duties and Responsibilities * Leads efforts to ensure staff are properly trained, on-boarded, and regularly evaluated on competencies and quality of work. * Leads oversight of appeals denied claims for elated services, drugs, treatments and supplies. * Obtains and ensures timely prior authorizations for related services, drugs, treatments, and supplies according to care plan as outlined by provider. * Assists interdepartmental teams in troubleshooting accounts that are being held in A/R due to lack of prior authorizations. * Facilitates communication with care team and providers * Appeals denied authorizations for related services, drugs, treatments, and supplies. * Research denials and provide additional supporting documentation to appeal decision. * Communicates appeal decision with care team and obtains additional required documentation to ensure claim is paid. * Identifies opportunities and participates in optimization of EHR to track and submit authorizations to payors. * Partners with leadership to educate providers and clinical staff on payor policy changes as it relates to administration of treatments (i.e. place of service requirements, coverage criteria changes). * Prepares accurate reports and provides departmental summary information to Revenue Cycle Team and leadership that ensures all infusions and laboratory testing performed in the department are reviewed and prior auth or predetermination is obtained. * Contributes to the effective management of the department. * Demonstrates dependability on the job by adhering to departmental performance standards guidelines and attendance standards. * Contributes to the time management of the department and respects fellow employees by being punctual to scheduled meetings and to work, starting work promptly, and adhering to scheduled hours and departmental performance standards guidelines. * Works collaboratively and supports efforts of team members. * Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community. Qualifications * Associate Degree and one to two (1 - 2) years of similar healthcare experience required, or, in lieu of Associate's Degree, a high school diploma/GED and five (5) or more years of similar healthcare experience will be considered. * Preferred certification in CCS, CCS-P, CPC, or specialty coding. * Three to five years' experience in a health care environment with exposure, preferably in an environment with knowledge of the patient population and types of services patients receive. * Prior authorization experience involving drugs and ancillary testing desirable. * Knowledge of managed care and third-party payer benefits designs and reimbursement requirements. * Knowledge of ICD-9 and ICD-10 coding and documentation requirements. * Proficient in Microsoft Office applications including Outlook, Word, and Excel. * Preferred experience in Epic or comparable EMR system * Strong analytical skills with attention to detail and high degree of accuracy to produce reports, analyses, and other details as requested. * Strong communication skills and attention to detail. Knowledge of drug regimens and associated regulations/policies/procedures applicable to insurance coverage and the associated payment for and appeal of procedures/billing rejected. * Two years of experience in reviewing medical records for National Coverage Determinations (NCD) and local Coverage Determinations (LCD) * A strong understanding of HIPAA laws and requirements as they relate to review and reporting of documentation. Pay Range:$25.85 - $37.50 Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, veteran status, or any other status protected by federal, state, or local law.
    $25.9-37.5 hourly 3d ago
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  • Registered Nurse (Hybrid/Remote)-Endocrinology

    St. Peters Health Partners 4.4company rating

    Albany, NY jobs

    Registered Nurse - Endocrinology - Albany, NY If you are looking for a Hybrid RN II position, full time, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places. This position will be located at 63 Shaker Road, Albany NY. Position Highlights: * Quality of Life: Where career opportunities and quality of life converge * Advancement: Strong orientation program, generous tuition allowance and career development * Work/Life: Monday - Friday Office Hours (2 Remote Days a Week) What you will do: The Registered Professional Nurse has the responsibility and accountability to utilize the nursing process to diagnose and treat human responses to actual or potential problems of individuals or groups. The Registered Professional Nurse works within and contributes to an environment where the St. Peter's Healthcare Services mission is actualized, patient outcomes are achieved, and professional practice is realized Responsibilities: * Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record. * Review and update medication list to ensure accurate and complete list in electronic medical record (EMR) available for provider review and submission. * Complete referrals and tracks patients' compliance. * Review prescriptions electronically and send prescriptions to providers for review and submission. * Obtains patient consent for procedures as directed by provider. * Performs pre-visit planning and reviews quality metrics. * Retrieves telephonic clinical information from patients who call into the office. * Monitors task list and completes tasks assigned by provider in a timely manner based on urgency. * Educates patients regarding medication, testing procedures and home care techniques. * Ensure proper labeling, handling and documentation for patient specimens. * Follow up with patient regarding test results based on advice given by provider. * Maintains a clean and safe work environment including disinfecting patient care areas and equipment. * In conjunction with other nursing colleagues, maintains the medical supply cabinet and drug cabinet. * Uses the electronic medical record to communicate effectively. * Performs quality assurance duties as assigned. * Provides a clinical visit summary (Patient Plan) to patient as requested including educational materials. * Participates in daily Patient Care huddles as appropriate. * Works cooperatively with all colleagues to ensure quality patient care at all times. * Performs other duties as assigned. What you will need: * Associates or Bachelor's degree in Nursing preferred * HS Diploma/equivalent required * Current unencumbered NYS RN license * Basic Life Support certification * 6 months previous RN experience * Must be able to lift 20 lbs. Pay Range: $30.00-$43.50 Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, veteran status, or any other status protected by federal, state, or local law.
    $30-43.5 hourly 60d+ ago
  • PFS Customer Service Rep Call Center

    Banner Health 4.4company rating

    Remote

    Department Name: Patient Balance Mgmt Work Shift: Varied Job Category: Revenue Cycle Estimated Pay Range: $17.67 - $26.50 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we're constantly improving to make Banner Health the best place to work and receive care. The PFS Customer Service Rep role coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. We work as a team to ensure reimbursement for services in a timely and accurate manner. This position is for our Call Center Team, answering high call-volume and high-level questions regarding patient billing questions. We are currently looking for experienced professionals with strong customer service skills to join our team. Location: Remote Schedule: Part time, 20hrs/wk. Mon-Fri 1:30pm-5:30pm AZ Time Ideal Candidates: Minimum of 1 year experience in Customer Service and/or Call Center, clearly reflected in resume; Minimum of 1 year Healthcare experience in Finance, Revenue Cycle, or Patient Financial Services This can be a remote position if you live in the following state(s) only: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR PA, SC, TN, TX, UT, VA, WA, WI, WV, WY Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner. CORE FUNCTIONS 1. Responds to incoming calls to provide assistance and excellent customer service to patients, patient families, providers, and other internal and external customers to resolve billing, payment and accounting issues 2. Responsible to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing and PCI compliance. 3. As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company's collection/self-pay policies to ensure maximum reimbursement. 4. Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients. 5. As assigned, works with walk-in patient's with accounts and processing payments. 6. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances. 7. Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately. 8. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members. Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day. NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager. SUPERVISORY RESPONSIBILITIES DIRECTLY REPORTING None MATRIX OR INDIRECT REPORTING None TYPE OF SUPERVISORY RESPONSIBILITIES None Banner Health Leadership will strive to uphold the mission, values, and purpose of the organization. They will serve as role models for staff and act in a people-centered, service excellence-focused, and results-oriented manner. PHYSICAL DEMANDS/ENVIRONMENT FACTORS OE - Typical Office Environment: (Accountant, Administrative Assistant, Consultant, Program Manager) Requires extensive sitting with periodic standing and walking. May be required to lift up to 20 pounds. Requires significant use of personal computer, phone and general office equipment. Needs adequate visual acuity, ability to grasp and handle objects. Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone. May require off-site travel. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge. Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences. Strong knowledge of insurance plans with deductibles and co-insurances. Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required. PREFERRED QUALIFICATIONS Work experience with the Company's systems and processes is preferred. Previous cash collections experience is preferred. Bi-lingual a plus. Additional related education and/or experience preferred. DATE APPROVED 03/30/2025 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $17.7-26.5 hourly Auto-Apply 2d ago
  • Facility Coding Inpatient DRG Quality Analyst

    Banner Health 4.4company rating

    Remote

    Department Name: Coding-Acute Care Compl & Educ Work Shift: Day Job Category: Revenue Cycle Estimated Pay Range: $29.11 - $48.51 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we're constantly improving to make Banner Health the best place to work and receive care. Interested in joining our Coding team? We have great opportunities, whether you're looking for entry-level or have been coding for years! Requirements for each position noted below. Not the right fit for you? Keep looking! We have a lot different teams with different focuses (Facility vs Profee). In this Inpatient Facility-based HIMS Coding Quality Associate position, you bring your 5 years of acute care inpatient coding background to a team that values growth and development! This is a Quality position, not a day-to-day coding production role but does require coding proficiency and recent Hospital Facility Coding experience. This position is task-production-oriented ensuring quality in the Inpatient Facility Coding department. If you have experience with DRG and PCS coding/denials/audits, we want to hear from you. Schedule: Full time, Monday-Friday 8am-5pm during training. Flexible scheduling after completion of training. Location: REMOTE, Banner provides equipment Ideal candidate: 5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume); DRG and PCS Coding, Auditing experience; Bachelors degree or equivalent; Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. Please upload a copy or provide certification number in your questionnaire. This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY. Interested in joining our Coding team? We have great opportunities, whether you're looking for entry-level or have been coding for years! Requirements for each position noted below. Not the right fit for you? Keep looking! We have a lot different teams with different focuses (Facility vs Profee). Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position is responsible for the interpretation of clinical documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. Works with clinical documentation improvement and quality management staff to: align diagnosis coding to documentation to improve the quality of clinical documentation and correctness of billing codes prior to claim submission; to identify possible opportunities for improvement of clinical documentation and accurate MS-DRG, Ambulatory Payment Classification (APC) or ICD-10 assignments on health records. Provides guidance and expertise in the interpretation of, and adherence to, the rules and regulations for code assignment based on documentation for all levels of complexity to include accounts encountered in Banner's Academic, Trauma, high acuity and critical access facilities, as well as specialized services such as behavioral health, oncology, pediatric. Acts as subject matter expert regarding experimental and newly developed procedure and diagnostic coding. CORE FUNCTIONS 1. Provides guidance on coding and billing, utilizing coding and billing guidelines. Demonstrates extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment Classification (APC) or utilized operational systems. Provides explanatory and reference information to internal and external customers regarding coding assignment based on clinical documentation which may require researching authoritative reference information from a variety of sources. 2. Reviews medical records. Performs an audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete. Provides feedback on coding work and trends, and offers suggestions for improvement where opportunities are identified. Reviews accuracy of identified data elements for use in creating data bases or reporting to the state health department. If applicable, applies Uniform Hospital Discharge Data Set (UHDDS) definitions to select the principal diagnosis, principal procedure, complications and co morbid condition, other diagnoses, and significant procedures which require coding. Apply policies and procedures on health documentation and coding that are consistent with official coding guidelines. 3. Assists with maintaining system wide consistency in coding practices and ethical coding compliance. If applicable, initiates and follows through on physician queries to ensure that code assignment accurately reflects the patient's condition, treatment and outcomes. Identifies training needs for coding staff. Serves as a team member for internal coding accuracy audits and documents findings. 4. Acts as a knowledge resource to ancillary clinical departments, patient financial services and revenue integrity analysts regarding charge related issues, processes and programming. Participates in company-wide quality teams' initiatives to improve coding and clinical documentation. Assists with education and training of staff involved in learning coding. Assists in creating a department-wide focus of performance improvement and quality management. Assists and participates with management through committees to properly educate physicians, nursing, coders, CDM's, etc. with proper and accurate coding based on documentation for positive outcomes. 5. Performs ongoing audits/review of inpatient and/or outpatient medical records to assure the use of proper diagnostic and procedure code assignments. Collaborates on DRG and coding denials, billing edits/rejections to provide coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple platforms and internal tracking tools. Provides findings for use as a basis for development of coding education and audit plans. 6. Maintains a current knowledge in all coding regulatory updates, and in all software used for coding, coding reviews and health information management for the operational group. Identifies and collects data to allow for monitoring and evaluation of trends in DRG (MS/APR-DRG), APC, HCC, other Heath Risk Adjusted Factors, National Correct Coding Initiative (NCCI) and the effect on Case Mix Index by use of specialized software. 7. May code inpatient and outpatient records as needed. Works as a member of the overall HIMS team to achieve goals in days-to-bill. 8. Works independently under limited supervision. Uses an expert level of knowledge to provide coding and billing guidance and oversight for all Banner facilities and services they provide. Internal customers include but are not limited to medical staff, employees, and management at the local, regional, and corporate levels. External customers include but are not limited to, practicing physicians, vendors, and the community. MINIMUM QUALIFICATIONS Requires a level of education as normally demonstrated by a bachelor's degree in Health Information Management or experience equivalent to same. Demonstrated proficiency in hospital coding as normally obtained through 5 years of current and progressively responsible coding experience required. Requires Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Specialist-Physician (CCS-P) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other qualified coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Demonstrated proficiency in hospital coding as normally obtained through 5 years of current and progressively responsible coding experience required. Must possess a thorough knowledge of ICD Coding and DRG and/or CPT coding principles, as recommended by the American Health Information Management Association coding competencies. Requires an in-depth knowledge of medical terminology, anatomy and physiology, plus a thorough understanding of the content of the clinical record. Extensive knowledge of all coding conventions and reimbursement guidelines across services lines, LCD/NCDs and MAC/FIs. Extensive critical and analytical thinking skills required. Ability to organize workload to meet deadlines and maintain confidentiality. Excellent written and oral communication skills are required, as well as effective human relations skills for building and maintaining a working relationship with all levels of staff, physicians, and other contacts. Must consistently demonstrate the ability to understand the Medicare Prospective Payment System, and the clinical coding data base and indices, and must be familiar with coding and abstracting software, claims processing tools, as well as common office software and electronic medical records software. PREFERRED QUALIFICATIONS Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $29.1-48.5 hourly Auto-Apply 16d ago
  • Arizona Long Term Care ALTCS Case Manager

    Banner Health 4.4company rating

    Remote

    Department Name: ALTCS CM Work Shift: Day Job Category: Clinical Care Estimated Pay Range: $26.40 - $44.00 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. **Travel is required for the role, must be located in Graham or Greenlee counties.** Recognized nationally as an innovative leader in health care, Banner Plans & Networks (BPN) integrates Medicare and private health plans to reduce healthcare costs while keeping our members in optimal health. Known for our innovative, collaborative, and team-oriented approach, BPN offers a variety of career opportunities and innovative employment options by offering remote and hybrid work settings. We are part of the insurance division with Banner Health. We service the Arizona long term care AHCCCS population. We case manage beneficiaries to ensure services are identified and authorized according to member's person centered assessments. The Case managers evaluate members and determine what type of services are required and authorize services. Our populations include members in the nursing home, assisted living, behavioral health settings and in member's home. Case managers day include phone calls, data entry, setting appointments for pre assessment call and assessments. Case managers travel to member's home. Assist with schedule medical appointments and transportation. Filing grievance from members. Collaborate with department nurses and behavioral health coordinators. Will attend community functions. 8am to 5pm Monday - Friday **Travel is required for the role, must be located in Graham or Greenlee counties.** Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs. POSITION SUMMARY This position is responsible for assessing, documenting and monitoring the overall functional, physical and behavioral health status of members assigned to them. Based on the assessments, the case manager, collaborating with the member and his/her support system, develops a service plan that meets member needs in the most cost-effective and most integrated setting. CORE FUNCTIONS 1. Is the primary contact for the ALTCS member, explaining the program to members, including their rights and responsibilities, the grievance and appeal system and other information according to regulations. 2. Comprehensively assesses and documents the member's bio psychosocial functioning in accordance with AHCCCS time frames, identifying the individual's strengths and needs. 3. Develop and implements a service plan based on the member's strengths, needs and placement preferences, authorizes and coordinates with provider agencies. 4. Assists the member to define personal goals, identifying barriers to achieving these goals and encouraging the member to resolve the difficulties identified. 5. Acts as a facilitator and/or advocate for the member in dealing with issues with providers, community programs or other organizations. 6. Acts as a gatekeeper to ensure that the member is receiving the most appropriate, cost-effective services in the most appropriate setting. 7. Facility based while remaining within budgetary allowances. Internal customers: all levels of nursing management and staff, medical staff, and all other members of the interdisciplinary healthcare team. External customers: physicians, payers, community agencies, provider networks and regulatory agencies. MINIMUM QUALIFICATIONS Knowledge, skills and abilities as normally obtained through the completion of a bachelor's degree in social work, and two years of experience serving persons who are elderly and/or persons with physical disabilities or who are determined to have a Serious Mental Illness (SMI). PREFERRED QUALIFICATIONS Bilingual, preferred in some assignments. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $26.4-44 hourly Auto-Apply 16d ago
  • Hospice Medical Director - Remote Only, Per Diem, Flexible Schedule

    Banner Health 4.4company rating

    Greeley, CO jobs

    **Per Diem Hospice Medical Directorin Beautiful Northern, CO** **Remote Only & Flexible Schedule** **BANNER HEALTH and the Home Care & Hospice Division** , one of the countrys premier, nonprofit health care networks with more than 1,500 physicians and advance practice providers, **has an excellent opportunity for a compassionate, skilled clinician to join our interdisciplinary team!This position serves the growing community in Northern Colorado in partnership with the current care team.** Utilizing a multidisciplinary approach, the qualified candidate will provide remote support to the Home Care & Hospice team of Advanced Practice Providers. **Position Requirements and Information:** + BC/BE in a relevant specialty + Colorado state licensed + Fellowship training in Hospice & Palliative Medicine - NOT REQUIRED + Experience preferred, new graduates also welcome to apply + Flexible schedule primarily providing back-up coverage for the acting Medical Director **Compensation & Benefits:** + **$140/hr** + Malpractice and Tail Coverage **About the area:** With more than 300 days of sunshine, Northern Colorado is one of the best places to live and work offering spectacular views along the Rocky Mountain Front Range, great weather, endless recreational activities, cultural amenities, education, and professional opportunities. + Within one hour of majestic Rocky Mountain National Park & 90 minutes to world-class ski resorts + Numerous outdoor activities including golf, biking, hiking, camping, rock climbing, hunting, and fishing + Thriving cultural and retail sectors + Highly educated workforce & broad-based business sector leading to substantial growth along the front range + Variety of public and private education options for K-12 and easy access to three major universities **PLEASE SUBMIT YOUR CV TODAY FOR IMMEDIATE CONSIDERATION** As an equal opportunity employer, Banner Health values culture and encourages applications from individuals with varied experiences and backgrounds. Banner Health is an EEO Employer. POS15101 Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability.
    $140 hourly 43d ago
  • PFS CBO Insurance Followup Ambulatory Denials

    Banner Health 4.4company rating

    Remote

    Department Name: Amb Billing & Follow Up Work Shift: Day Job Category: Revenue Cycle Estimated Pay Range: $18.02 - $27.03 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we're constantly improving to make Banner Health the best place to work and receive care. The PFS Insurance Follow-Up Representative (Ambulatory Denials) is responsible for following up with assigned payer for various denials, such as no authorization, eligibility denials, etc. This position is a higher-level PFS role, as it does range across all groups of patients and all types of provider specialties. Experience within medical insurance accounts receivable (AR) and physician fee-for-service billing is ideal. Location: Remote Schedule: Monday-Friday, varying shifts 6am-6pm after successful completion of training program. Ideal Candidate: Minimum of 1 year experience in Medical Insurance AR and/or Physician Fee for Service Billing clearly reflected in uploaded resume; Minimum of 1 year experience writing appeal letters for payer/payor denials; Intermediate to Advanced skill level in Microsoft Excel. This can be a remote position if you live in the following state(s) only: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV, WY Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner. CORE FUNCTIONS 1. May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing. 2. As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company's collection/self-pay policies to ensure maximum reimbursement. 3. May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary. 4. Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients. 5. Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers. 6. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances. 7. Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately. 8. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge. Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences. Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required. PREFERRED QUALIFICATIONS Work experience with the Company's systems and processes is preferred. Previous cash collections experience is preferred. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $18-27 hourly Auto-Apply 2d ago
  • Charge Audit Specialist

    Saint Luke's Health System 4.3company rating

    Remote

    Represents BJC in supporting charging accuracy among clinical departments.Demonstrates knowledge and technical expertise of the PA patient management and case management system to correct charges and promote billing accuracy. Demonstrates critical thinking in CDM data management assignments. Responds to requests serves as a system resource in resolution of charging problems data entry of CDM items and payment error prevention. Serves as a liaison and resource between clinical and PA departments. This position is remote in the Kansas City area. Experience in EPIC WQ's is ideal. Collaborates with Patient Accounts, HIM, UR, Charge Audit, Charge Management and/or other charging departments as appropriate for charge issue resolution and process improvement. Manages assigned work queues and completes accounts in queue in a timely manner. Shares trends with Manager and/or Charge Management service line analyst so they can provide education to staff. Utilizes system and department reference material to ensure appropriate processes and guidelines are being followed. Assists with charge correction projects as needed. Attends and participates in monthly team meetings and attends in person quarterly team meetings. Charge Audit dept. only: Manages metro facility mailboxes and responds to requests to assist charging departments with questions, issues and charge correction. Performs charge capture for non-infusion charges for OB departments as some metro facilities. Reviews patient medical records and validates documentation to support charges. #LI-CM1 Job Requirements Applicable Experience: 3-5 years Job DetailsFull TimeDay (United States of America) The best place to get care. The best place to give care . Saint Luke's 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter. Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.
    $49k-61k yearly est. Auto-Apply 17d ago
  • Profee Coder Educator Physician Coding

    Banner Health 4.4company rating

    Remote

    Department Name: Coding Ambulatory Work Shift: Day Job Category: Revenue Cycle Estimated Pay Range: $30.56 - $50.93 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Our Coding Educators play a critical role at Banner Health. Join our team of forward-looking Physician Coding Educators who support our Physician Practices and Profee Coding Teams. In this role, you will provide valuable coaching to our Physician Coding team, as well as our Providers. Experience in advanced E/M Coding, and wide range of Production Coding experience within different specialties is a must, as well as current certification in Coding through AHIMA or AAPC (as seen in the qualifications below). This is a hybrid position, with the expectation of our educators to go onsite for in-person trainings with our providers. Location: HYBRID AZ or CO, Onsite and in-person trainings required. Banner Health does provide equipment. Shift: Full time, Exempt position, Monday-Friday Ideal Candidate: 3 years recent experience in Profee EM coding within wide range of specialties (clearly reflected in your attached resume); Bachelors Degree or equivalent; Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. Please upload a copy or provide certification number in your questionnaire; This position does require onsite, in-person trainings with our providers so ideal candidate will need to live in or within driving distance of Phoenix, AZ or Greeley, CO. ** Don't quite meet the above requirements? Check out some of our other Coder positions! The hours are flexible with the ability to work your 8-hour shift between 5am-7pm (Monday-Friday). This is a hybrid position with some onsite education/training required. Ideal candidate will be within driving distance of Banner facility within AZ or CO. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position assists with the development of education/training materials, conducts and coordinates training and development of Health Information Management staff and other Banner staff as appropriate, including physicians/providers, and provides technical staff training in the usage of information systems components of the medical records database system. Creates and maintains all department training materials, tools and/or records. Conducts new hire skill assessments, department specific orientation, and initial training for work tasks and functions. Provides continuing education and annual regulatory updates. CORE FUNCTIONS 1. Assesses and identifies skills, competencies and areas of learning and instruction needed for new hires, staff and department management. Assists with the development of education and training within specified area, which may include preparation of related educational materials. 2. Plans and coordinates the orientation programs for new hires to provide an introduction to the department and facility, to define employment expectations and standards, to provide prerequisite knowledge required, and to train in the basic job skills. 3. Develops and maintains an education calendar and individual continuing education and orientation record for each member of the assigned work group. Develops and conducts programs with educational materials, procedures and exercises that are task/function specific using a variety of learning and evaluation strategies for all staff. 4. Provides for onsite support of trainees, and acts as a knowledge resource for all staff. Problem-solves and troubleshoots issues involving HIMS electronic applications. This may include monitoring and reviewing clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete. 5. Works in regional/system-wide teams to develop Health Information Management Systems and Services educational materials and activities, and promotes standardized practices throughout the region and/or company. 6. May collect and/or coordinate the collection of data, compile reports and graphs and present findings at Medical Staff Committee meetings, Clinical Documentation Specialist meetings and/or other appropriate department, facility and system level meetings. May also coordinate and perform clinical pertinence and inter-disciplinary chart reviews, ensuring the reviews meet government and regulatory standards. 7. Maintains a current knowledge relating to Health Information Management Systems by attending educational workshops/conferences, reviewing professional publications, establishing personal networks, and/or participating in professional societies. This may also include performing ongoing research to ensure compliance with clinical documentation and/or regulatory guidelines and standards. 8. Works independently under general supervision and utilizes analytical and creative thinking skills, and influencing abilities. Training responsibilities include, but are not limited to, all HIMS staff and staff assigned to related work teams, as well as physicians/providers. Customers include Health Information Management, Financial Services and Clinical Documentation leadership and staff, as well as other members of the integrated healthcare team. MINIMUM QUALIFICATIONS Must possess a current knowledge of business and/or healthcare as normally obtained through the completion of a bachelor's degree in business administration, healthcare administration or related field, plus advanced training in Health Information Management requirements and systems and in adult learning principles. In the acute care coding environment, requires a Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT) or Certified Coding Specialist (CCS) in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). In the ambulatory coding environment, requires Certified Professional Coder (CPC) certification or Certified Coding Specialist-Physician (CCS-P), with RHIA, RHIT or CCS certification preferred. Requires the knowledge typically acquired over three or more years of work experience in healthcare information management. Must be well versed in regulatory requirements for medical record documentation, as well as Medical Staff Rules and Regulations where applicable. Must have demonstrated education and training skills. Medical terminology and an understanding of the laws and regulations associated with medical records functions are required. Must be able to function as part of a team, using effective interpersonal and instructional skills. Must possess excellent written, verbal, and customer service skills, and have the ability to conduct educational needs analysis and to teach effectively to a wide range of comprehension levels. Must be proficient in the use of common office and presentation software and have an advanced knowledge and experience with computer healthcare applications and hardware. PREFERRED QUALIFICATIONS Previous training/teaching experience and customer service education experience preferred. Creativity and knowledge of adult learning principles preferred. Additional related education and/or experience preferred. Anticipated Closing Window (actual close date may be sooner): 2026-05-13 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $30.6-50.9 hourly Auto-Apply 10d ago
  • Care Transformation Intern

    Banner Health 4.4company rating

    Remote

    Department Name: Digital Transform Fdn Clin App Work Shift: Day Job Category: General Operations Estimated Pay Range: $19.00 - $19.00 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Find your path in health care. We want to change the lives of those in our care - and the people who choose to take on this challenge. If you're ready to change lives, we want to hear from you. This is a temporary part-time Internship position working in either Colorado or Arizona, 20hr/wk, typically 8:00a-1:00pm with some flexibility. This opportunity is open to Graduate level students pursuing degrees in Health Informatics, Data Analytics, Public Health, or related field, with strong analytical skills, attention to detail, and experience with Python. In this internship you will have the opportunity to work with our Quality Improvement team by reviewing and validating datasets prior to submission to National and State Registries. * Please note the email you apply with is where all updates and information will be sent to, even after you graduate. We recommend applying with a personal email rather than a school email address. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position typically will be up to one year in length and will work under the direct supervision of a department manager or designee. The position is responsible for expanding experiences and knowledge of practices and procedures as they relate to assigned department and area of study. These activities may include participation in a wide variety of projects. CORE FUNCTIONS 1. Expands and develops knowledge with exposure to a variety of roles related to area of study. 2. Participates on work teams, contributes to projects and initiatives, and performs various tasks as needed by the assigned unit/department. 3. Performs research and prepares reports on assigned topics and /or projects when required. 4. Works as a member of a team providing service to internal and external customers. MINIMUM QUALIFICATIONS Currently enrolled in an accredited college program with course work related to the internship or general knowledge normally obtained through the completion of a college degree. Must demonstrate effective verbal and written communication skills. Must have general knowledge related to the department/unit/area of study. PREFERRED QUALIFICATIONS Proficiency with commonly used office software and personal computers may be necessary, depending on assignment. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $19-19 hourly Auto-Apply 9d ago
  • Care Transformation Program Manager

    Banner Health 4.4company rating

    Remote

    Department Name: Care Transformation Work Shift: Day Job Category: General Operations Estimated Pay Range: $32.09 - $53.48 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN. The Care Transformation Program Manager will support network performance by organizing, structuring and analyzing performance data to identify operational opportunities, trending data and developing reports that will be used in a variety of meetings. Will be responsible for creating solutions, not managing established processes. The ideal candidate will have a strong data analytics and data reporting background with Excel and PowerBI experience. Schedule Generally Monday - Friday 8am - 5pm Hybrid most work can be done remotely with occasional travel to Phoenix Corporate or Mesa Corporate. Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs. POSITION SUMMARY This position provides oversight of the Care Transformation department initiatives, projects, communications and operational work that is provided by the Care Transformation department. This position will support leadership in development and implementation of processes to increase efficiency and effectiveness in successfully achieving department and organizational goals. CORE FUNCTIONS 1. Serves as an example to peers for both behaviors and performance of job functions. Provides Managerial Care Transformation experience and training to Care Transformation representatives, and acts as a knowledge resource for internal customers. Serve as a primary resource in complex and/or sensitive cases. 2. Provides coaching, training, staff development, mentoring and overall support to assigned staff. Participation and responsibilities related to performance evaluation, performance improvement, coaching, training, mentoring, and time card processes. Creates a strong culture of engagement, inclusiveness, creativity, knowledge sharing to support the provider relations team and department. 3. Provides collaborative approach with leadership, partner departments and contracted providers in leading this work. 4. Create, develop, and manage communication materials, letters, content for provider newsletters, power point presentations, and other Care Transformation or provider communication resources as required. 5. Oversee, coordinate, and support provider engagement, and communications. Maintains all levels of communication with network providers, informing them of any operational, procedural, and contractual changes and updates. 6. Support Directors to consistently meet monthly goals as determined by management. Assists Directors with network development in various geographic regions within the organization, negotiates, implements and maintains managed care initiatives with payers and providers. 7. Works cohesively with appropriate parties to ensure delivery of outstanding customer service while facilitating timely research and issue resolution, in a positive work environment, that supports the department's ongoing goals and objectives. 8. Works on special projects as assigned. 9. Assists in the development and maintenance of a comprehensive provider network for Banner Networks. The incumbent must have a thorough understanding of managed care, medical office procedure, provider relations experience, medical claims and contracting. In addition, the incumbent must have excellent verbal and written communication skills, determine work priorities and is expected to accomplish all tasks with minimal supervision and instruction. Experience required in direct supervision and coaching of assigned teams. Analytical knowledge required. MINIMUM QUALIFICATIONS Must possess a strong knowledge of healthcare as normally obtained through the completion of a bachelor's degree in business, healthcare administration, or related work experience. Requires a proficiency level typically acquired through a minimum of four years of experience in healthcare operational/financial management or related field. Must have an excellent understanding of medical terminology and knowledge of CPT and ICD-10 coding. Must have an understanding of HEDIS, STARS and other value-based performance initiatives as required by government programs. Must have the ability to effectively communicate both verbally and in writing. Must know how or learn to program data retrieval utilities and queries. The incumbent must possess the ability to track and analyze statistical data. This position requires a mathematical aptitude, computer experience, typing skills and the ability to work on a variety of projects in an organized fashion. Adept at creating and communicating a clear and detailed program plan to internal/external stakeholders, effectively aligning resources and motivating multi-disciplinary teams to achieve goals and create partnership-style relationships. Demonstrated technical, organizational, project management and negotiation capabilities. Proficient in written communications, power point and presentations. Must be a self-starter with excellent ability to implement and execute. Ability to balance the big picture with the day-to-day delivery details, connecting key project needs and internal resources to prioritize the workload. Strong desire to improve the lives of patients, their care givers, and families. Possesses compassion and empathy coupled with accountability and execution. Requires proficiency in the use of sophisticated software programs. PREFERRED QUALIFICATIONS Five to ten years of experience in the healthcare field preferred, preferably in a managerial or supervisory capacity. Two years of medical office and/or provider representative experience is preferable. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $32.1-53.5 hourly Auto-Apply 3d ago
  • Advocate Health - Chief of Philanthropy

    Atrium Health 4.7company rating

    Remote

    Primary Purpose As part of the CEO Cabinet at Advocate Health, the Chief Philanthropy Officer is responsible for the vision, planning, implementation, and management of all development programs across all divisions, academics, service lines, national service lines, community/mission-based programs, and enterprise-wide initiatives. This role provides strategic oversight of all philanthropy activities across the system, including infrastructure, staff and financial reporting, in order to maximize fundraising potential and establish, measure, and enhance fundraising goals and strategies. This role will also serve as the President of the Advocate Health Philanthropy Institute. Major Responsibilities Oversee strategic planning around philanthropy and the role it plays in achieving enterprise goals and strategic differentiators. Develop a comprehensive, integrated philanthropy strategy for all Divisions, Academics, Service Lines and National Services Lines, incorporating academic fundraising into the framework, inclusive of developing programs to accept local and enterprise-wide gifts Establish the Advocate Health Philanthropy Institute with a philanthropic vision and framework to elevate the importance of philanthropy across the Enterprise that enables continued growth. Establish annual goals, objectives, and strategies for fundraising programs, ensuring fundraising efforts are aligned with organizational goals and strategic differentiators. Develop system-wide processes whereby national and regional initiatives and projects are identified, prioritized and aligned with various types of funding, including traditional philanthropy and non-research government grants. Partner with senior leaders and executives to engage teams in philanthropy efforts locally and at an enterprise level. Provide professional fundraising guidance and create a strong development program with measurable goals. Oversee staff responsible for preparing proposals and materials to secure major gifts from individuals, corporations and foundations. Ensure smooth operations and data management systems and processes for all foundations. Manage accounts and provide periodic reports to the all appropriate boards. Streamline and, where appropriate, simplify Board governance and recruitment by creating a consistent policies and processes for selection criteria, while preserving important local nuances. Establish a framework to secure philanthropic support from both international and national foundations, corporations and prominent philanthropists. Develop system-wide policies, administer the annual operating budget, and maximize resources. Build strong relationships with donors, patients, business, and community leaders. Ensure local philanthropic efforts are honored and donor intent is respected. Represent Advocate Health at public functions and special events. Enhance community awareness and understanding of philanthropy and the Institute. Provide donor recognition programs to enhance donor morale and repeat giving. Minimum Job Requirements Education Bachelors Degree required. Work Experience Required a minimum of 12 years of experience, with at least 10 years of management experience. Knowledge / Skills / Abilities Proven ability to lead and inspire a fundraising team, develop strategic plans, and consistently surpass fundraising targets. Skilled in cultivating relationships with major donors, corporations, and foundations, fostering trust and strong connections. Extensive knowledge of healthcare philanthropy, including donor cultivation and stewardship, as well as best practices in grant writing. Experience in setting and executing a strategic vision for a new or expanding fundraising program, with a demonstrated ability to innovate, scale, and adapt fundraising efforts to align with organizational goals and objectives. Proven success in working within complex integrated organizations to achieve internal consensus on the importance of philanthropy, resulting in collaborative fundraising efforts. Proficient in analyzing data, identifying funding opportunities, and aligning philanthropic efforts with institutional goals. Excellent communication skills to effectively convey the healthcare system's mission and vision, and advocate for its community impact. Well-versed in the healthcare industry, understanding its challenges and unique needs within an academic setting. Preferred Job Requirements Education: Masters degree preferred. DISCLAIMER All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities. This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.
    $28k-36k yearly est. Auto-Apply 60d+ ago
  • DevOps Engineer IV

    Banner Health 4.4company rating

    Remote

    Department Name: Cloud Platforms/Infrastructure Work Shift: Day Job Category: Information Technology Estimated Pay Range: $53.63 - $89.38 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Health care is constantly changing, and at Banner Health, we are at the front of that change. We are leading health care to make the experience the best it can be. We want to change the lives of those in our care - and the people who choose to take on this challenge. If changing health care for the better sounds like something you want to be part of, we want to hear from you. The Digital Business Technology team is responsible for enabling technology to that enhances consumer, Patient, Provider and Employee experiences across Banner Health. The Digital Business Technology team takes pride in being obsessed with enabling self-service, eliminating time-consuming transactional and manual tasks, and implementing innovative solutions to solve complex problems. This can be a remote position if you live in the AZ or CO only. Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options, so you can focus on being the best at what you do and enjoying your life. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position is a highly experienced individual contributor in Development Operations. The position will lead a project team to perform the tasks necessary to analyze, design, configure, implement and support PaaS solutions, related services, processes, applications, and integrations. This will involve influencing IT functional areas, product owners and vendors to develop detailed design, execution and troubleshooting of strategic solutions in support of these systems. The position leads the efforts of resolving application and configuration issues/concerns, providing ongoing analysis of performance, implementation of approved changes, and ensuring continual service improvements. Will be responsible for Architect Cloud services that span storage, security, networking, and compute cloud capabilities. Responsible for all aspects of application production support, deployment and monitoring and develop tools to support these activities. Leads mission critical applications and associated platforms, ensuring the highest levels of availability, security, performance and stability are always maintained. Designs and builds tools and solutions with a strong bias towards automating as many aspects of support as possible to reduce or eliminate trivial support activities. CORE FUNCTIONS 1. Anticipates internal and external business challenges and recommends best practices to improve services, processes or products. Manages projects or programs. Recognized as an expert within the organization and within their field or function. 2. Solves unique and complex problems that have a broad impact on the business. Presents complex ideas, anticipates potential objectives and persuades others to adopt a different point of view. 3. Develops innovative services, technologies, processes or products that address current and future customer problems or needs. Interacts primarily with customers, peers, peers' managers, patients and physicians across the organization. 4. Makes decisions with general functional, company and industry guidelines. May manage budget for large and/or complex projects or programs. MINIMUM QUALIFICATIONS Bachelor's degree or equivalent working knowledge. Must have in-depth knowledge of concepts within job function as would normally be obtained in eight to twelve years' work experience developing Enterprise Applications. Must possess strong knowledge of programming and cloud technology. Needs experience in medium scale project planning. Successful candidate will have skills to mentor less experienced team members. Requires strong communication and presentation skills to explain and resolve complex technical issues to technical and non-technical audiences. Requires ability to influence and interact across facilities and at various levels. As is typical in this industry, variable shifts and hours and carrying/responding to a pager may be required. PREFERRED QUALIFICATIONS Cloud platform Certifications: AZ-301, AZ-400, and AZ-500. Significant development and operations / engineering experience with the ability to apply that knowledge to solve complex problems. Three to four years' experience implementing Enterprise Cloud Solutions. Strong working knowledge of Java/C++/C#/.Net Core, hardware environment, and use of program logic. Additional related education and/or experience preferred. Anticipated Closing Window (actual close date may be sooner): 2026-05-21 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $53.6-89.4 hourly Auto-Apply 2d ago
  • Cybersecurity Network Security Engineer III

    Banner Health 4.4company rating

    Remote

    Department Name: IT Data Protection-Corp Work Shift: Day Job Category: Information Technology Estimated Pay Range: In accordance with State Pay Transparency Rules. Banner Health was named to Fortune's Most Innovative Companies in America 2025 list for the third consecutive year and named to Newsweek's list of Most Trustworthy Companies in America for the second year in a row. We're proud to be recognized for our commitment to the latest health care advancements and excellent patient care. The Cybersecurity Network Engineering Team at Banner Health plays a critical role in safeguarding one of the most vital sectors-healthcare. As part of Banner Health's broader cybersecurity and business strategy, this team is dedicated to detecting, mitigating, and preventing network threats before they can impact patient care or sensitive data. By leveraging advanced technologies and modern security frameworks, the department ensures that the organization's digital infrastructure remains resilient, compliant, and aligned with the mission of delivering safe, uninterrupted healthcare services. Team members are key contributors to implementing the organization's Zero Trust Network Access (ZTNA) vision, engineering secure solutions that protect both internal and external access to systems and applications. A day in the life of a Cybersecurity Network Engineer at Banner Health is dynamic and impactful. You'll collaborate with cross-functional teams to analyze network traffic, fine-tune security controls, and respond to real-time detections that help prevent potential cyber incidents. Your toolkit will include industry-leading technologies such as Zscaler, Cloud Browser Isolation (CBI), Web Application Firewalls (WAFs), IDS/IPS, and API security platforms, all essential to defending against evolving threats. Beyond operational responsibilities, you'll design and implement new security architectures, contribute to the development of secure access models, and ensure certificate management and governance are seamlessly executed. Each day presents the opportunity to enhance both your technical expertise and Banner Health's cybersecurity maturity-protecting what matters most: patient trust and safety. Schedule: Monday - Friday 8am - 5pm AZ Time This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MD,MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WV, WA, WI & WY. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position leads the designs, develops, configures, implements, tunes, maintains solutions, resolve technical and business issues related to cybersecurity threat & vulnerability management, identity management, security operations center, forensics, and data protection. Cybersecurity Engineers work with Cybersecurity Architects to execute strategic cyber initiatives, evaluate security components of the network, applications and end-user devices, and provides guidance to ensure new systems meet regulatory and technical standards. Cybersecurity Engineers leads root-cause analysis on Cyber systems to determine improvement opportunities when failures occur. Cybersecurity Engineers work closely with other IT organizations to ensure cyber products are working and integrating with non-cyber environments (apps, networks, End User devices, Servers, etc). CORE FUNCTIONS 1. Proactively initiates the design and implementation of cybersecurity solutions, upgrades, enhancements, while looking forward three to five years. 2. Leads in providing technical expertise and support for cybersecurity solutions, including operational aspects of the software. 3. Serves as subject matter expert in the design, implementation, and compliance of secure baseline configurations for applications and infrastructure components. 4. Proactively initiates technical assessments of systems and applications to ensure compliance with policy, standards and regulations. 5. Authors new cybersecurity standards and procedures. Leads the revision of existing cybersecurity policies, standards, and procedures, as needed. 6. Serves as technical leader for cybersecurity projects, including the development of project scope requirements, budgeting, work breakdown and operational handoff. 7. Identify threats and develop suitable defense measures, evaluate system changes for security implications, and recommend enhancements, research, and draft cybersecurity white papers, and provide first-class support to the cybersecurity operations staff for resolving difficult cybersecurity issues. 8. Under limited direction, self starter, this position is responsible for cybersecurity across multiple departments system-wide and requires interaction at all levels of staff and management. Work closely on cross functional IT Teams. Leads work through indirect leadership across other cyber resources. Articulate complex Security functions into simple business ease. MINIMUM QUALIFICATIONS Must possess strong knowledge of business, information security and/or computer science as normally obtained through the completion of a bachelor's degree. Bachelor's Degree in Computer Science, Information Security, Information Systems, or related field, or equivalent. Experience normally obtained through seven plus years of experience of enterprise-scale information security engineering, preferably in healthcare. Must also possess three plus years' experience in a healthcare environment or an equivalent combination of relevant education, technical, business and healthcare experience. Experience with IT operations, automation of security processes, coding and scripting languages, ability to document security processes as well as use case development. Experience with the assessing cyber products, including vendor selection, define requirements, contractual documentation development. Experienced assessing and reaching out to vendors for needed features via enhancement requests. Expert understanding of regulatory and compliance mandates, including but not limited to HIPAA, HITECH, PCI, Sarbanes-Oxley. Experienced in planning, designing and implementing cybersecurity solutions, operating, maintaining and managing the lifecycle of cybersecurity solutions. Advanced knowledge of Security Engineering Principles, including risk management, resilience, vulnerability management, Information Security, NIST, MITRE ATT@CK, etc. Advanced expertise in Cyber products supporting Data Loss Prevention, EDR, AntiVirus, Perimeter services, threat systems, cyber platform analytics, SIEM, CASB, CLOUD Security, ETC. Proven Cloud Security experience. Requires independent judgment, critical decision making, excellent analytical skills, with excellent verbal and written communications. Ability to think quickly under difficult or complex conditions and clearly communicate to appropriate staff; ability to balance project workloads with customer support and on-call demands. Must demonstrate deep knowledge of information technology and information security principles and practices. Requires communication and presentation skills to engage technical and non-technical audiences. Requires ability to communicate and interact across facilities and at various levels. Incumbent will have skills to mentor less experienced team members. As is typical in this industry, variable shifts and hours and responding to after-hours notifications may be required. PREFERRED QUALIFICATIONS Certification in two or more of the following areas Systems Security Certified Practitioner (SSCP), HealthCare Information Security & Privacy Practitioner, (HCISPP), CompTIA Security+, Certified Information Systems Security Professional (CISSP) - Engineering (ISSEP), Certified Ethical Hacker (CEH), SANS GIAC, or Certified Information Systems Auditor (CISA). Four plus years as a System Administrator or in IT Operations. Or four plus years in risk management or GRC experience in the healthcare/medical environment. Five plus years' experience in a healthcare environment or an equivalent combination of relevant education, technical, business and healthcare experience. Additional related education and/or experience preferred. Anticipated Closing Window (actual close date may be sooner): 2026-05-20 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $52k-66k yearly est. Auto-Apply 3d ago
  • Health Plans Licensed Practical Nurse LPN Auditor

    Banner Health 4.4company rating

    Remote

    Department Name: Banner Staffing Services-AZ Work Shift: Day Job Category: Risk, Quality and Safety Estimated Pay Range: $26.40 - $44.00 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Banner Staffing Services (BSS) also offers Registry/Per Diem opportunities within Banner Health. Registry/Per Diem positions are utilized as needed within our facilities. These positions are great way to start your career with Banner Health. As a BSS team member, you are eligible to apply (at any time) as an internal applicant to any regular opportunities within Banner Health. Banner Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs while keeping our members in optimal health. BPN is known for its innovative, collaborative, and team-oriented approach to healthcare. We offer diverse career opportunities, from entry-level to leadership positions, and extend our innovation to employment settings by including remote and hybrid opportunities. As a Health Plans Licensed Practical Nurse (LPN) Auditor, you will be an integral part of the Health Plan Quality Management Team. This assignment-based role focuses on independent chart review, clinical assessment, and site visits. Key Responsibilities: Independently review patient medical charts to assess compliance to AHCCCS and other regulatory rules. Make initial determinations based on clinical findings and documentation. Provide feedback and assistance to help the facilities reach compliance or maintain compliance. Additional Details: This is a Banner Staffing Services assignment-based position. Schedule: Monday-Friday, 8:00 a.m.-4:30 p.m. Expected Hours: 40 hours per week Benefits: This role does not include Medical or Paid Time Off (PTO) benefits. This is a hybrid position, and Arizona Residency is required. (preferred candidate in the phoenix area) Some work can be done remotely with travel up to 50% of the time to assigned facilities. Usually, 3 sites visit a week. With this hybrid/remote work, candidates must be self-motivated, possess moderate to strong tech skills and be able to meet daily and weekly productivity metrics. As a valued and respected Banner Health team member, you will enjoy: Competitive wages Paid orientation Flexible Schedules (select positions) Fewer Shifts Cancelled Weekly pay 403(b) Pre-tax retirement Employee Assistance Program Employee wellness program Discount Entertainment tickets Restaurant/Shopping discounts Auto Purchase Plan BSS Registry positions do not have guaranteed hours and no medical benefits package is offered. BSS requires Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes; employment, criminal and education). POSITION SUMMARY This position coordinates and performs quality medical record reviews of the ambulatory medical record for PCP's, OBGYN and High Volume Specialists (HVS). This position is also responsible for assisting the QM RN with the investigation and research of quality of care concerns that have been referred to the Quality Management Department for review and resolution. In addition, the position is also responsible for abstracting medical records, analyzing data and importing data to ensure that all contract requirements and UAHN/MHP initiatives are completed successfully and timely. CORE FUNCTIONS 1. Assists in the development of clinical medical record audit tools and processes. Conducts data analysis using Microsoft Excel; Requests, compiles, sorts, prepares, reviews, validates, and analyzes data extracted from ManagedCare.com, TCS, medical records and survey tools using statistically reliable sampling methods. 2. Coordinates, retrieves, and performs medical record audits to determine provider compliance with established AHCCCS standards for documentation in conjunction with the re-credentialing process. 3. Monitors and tracks Corrective Active Plans (CAPs), in collaboration with the Manager, Supervisor or QM RN and communicates audit results to providers along with education about best practices and recommendations for improvement as outlined in established guidelines. 4. Provides written documentation and Corrective Action Plans as directed by the Credentials Committee to providers when necessary, and coordinates communication with the Credentialing Department. 5. Reports potential risk or compliance issues identified in the audit process to the Manager/Supervisor of QM. Assists in the development of QM policies and desktop procedures. Provides input and feedback on opportunities for improvement; Aggregates and analyzes medical record audit results on an annual basis for OFR required data. Participates in system-focused analyses in response to error identification. 6. Coordinates, collects data and prepares monthly provider profile data reports for the Credentialing Department. Coordinates, abstracts, and assists with the analysis of data from medical records in accordance with HEDIS specifications. Actively works with the HEDIS team to ensure understanding of performance measures, methodology and processes. 7. In collaboration with Director, Manager, Supervisor of Quality Management and Information Systems, creates datasets for review by the Quality and Medical Management Administration Staff and other department studies as assigned, including but not limited to setting up database and associated data entry programs, and retrieving data from the database for purposes of analysis or data review. 8. Supports the continuous improvement of the department, Medical Management, and UAHP through active participation in strategies to enhance organizational structure and processes. Responsible for working toward achieving full compliance in assigned areas for the annual AHCCCS operation review and complete all assigned work plan tasks. 9. This position works under supervision, prioritizing data from multiple sources to provide quality care and support. Incumbents work in a fast-paced, sometimes stressful environment with a strong focus on customer service. Interacts with staff at all levels throughout the organization. MINIMUM QUALIFICATIONS Current, unrestricted State of Arizona LPN license. Two years of experience, preferably in a family practice or pediatric medical office setting, with the ability to travel to all contracted sites, which may necessitate occasional overnight stays. The ability to function both as a member of an interdisciplinary team as well as the ability to function independently. Excellent verbal and written communication skills and the ability to develop a strong rapport with providers and staff in a variety of clinical settings; Strong collaborative skills (ability to work with a team or individually). An aptitude for accuracy with attention to detail. Knowledge and understanding of HEDIS specifications; Strong leadership skills (can construct a vision, thinks creatively to solve issues and is goal oriented); the ability to maintain strict confidentiality along with good problem solving and investigative skills is required. Ability to set appropriate priorities relative to work load in a fast paced environment; to implement standards and data sources, research tools, and other data collection instruments; to collect, analyze, describe, evaluate data, and write reports; to implement and track the effectiveness of process improvement; to recognize risk management concerns; and to review and extract significant data from medical records is required. Must be knowledgeable of the National Committee for Quality Assurance (NCQA), Health Plan Employer Data Information Set (HEDIS), Arizona Health Cost Containment System (AHCCCS) and Centers for Medicare and Medicaid Services (CMS) standards and reporting requirements. PREFERRED QUALIFICATIONS Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $26.4-44 hourly Auto-Apply 10d ago
  • Chief Nursing Officer - NC & GA Division

    Atrium Health 4.7company rating

    Remote

    The Division Chief Nursing Officer - NC & GA, as a member of the senior executive nursing leadership team, is responsible for the advancement and innovation for the delivery of care across the North Carolina and Georgia Division, Atrium Health delivery care brand (inclusive of legacy Atrium Health, Floyd Health, Navicent Health, and Wake Forest Baptist Health brands) with a focus on both strategy and operations. This position works collaboratively with site CNOs and Area health care teams to position Advocate Health - Atrium Health patient/client care services as the destination of choice for populations as well as the workplace of choice for nurses and support team members. The Division Chief Nursing Officer - NC & GA in collaboration with site CNOs is responsible for alignment of nursing care across the division's clinical settings through the identification and adoption of evidence-based practice to reduce variation in practice. This position has leadership responsibility for nursing services division-wide and with the site CNOs and CMOs ensures industry-leading outcomes in quality of care, patient safety and patient and family experience. The Division Chief Nursing Officer - NC & GA assures excellence in nursing practice, and standards of care and leads efforts in leadership development, succession planning and fiscal responsibility for the North Carolina and Georgia Division of Advocate Health. The Site CNOs have a matrixed reporting to this role. Major Responsibilities: In partnership with the Enterprise Chief Nursing Officer and Enterprise Nursing Leadership Council, develops a Divisional Nursing Strategic plan and is accountable for the execution of the plan for the North Carolina and Georgia Division and achieving targeted outcomes. Effectively represents patient/client and nursing perspective and vision to division governing bodies, leadership team meetings and external audiences on behalf of Atrium Health, now part of Advocate Health. Ensures that patient care delivery models and clinical and staffing standards for nursing are consistent with current research in nursing practice and professional standards, compliant with state and federal regulations, accreditation standards and aligned with the Mission, Vision and Values of Atrium Health, now part of Advocate Health and in collaboration with other enterprise and division leaders, leads the efforts to design new care models to ensure value-based care in the future health care delivery system Leads Nursing Quality and Safety initiatives to achieve top decile performance level and uses evidence-based or best practice standards and ensures consistency of policies across the continuum of care in collaboration with site CNOs, CMOs and other leaders. In collaboration with Division, Area and Site CNOs, prepares system operations and capital budgets for nursing and patient care services in designated region and sets priorities for allocation of resources and demonstrates leadership in forecasting trends in the effective management of human, financial, material and informational resources Develops and ensures effective services and tools services to support nursing operations including staffing/scheduling models, leadership, reporting and monitoring on labor productivity, nursing balanced scorecard (SCOUT) , NDNQI reporting, nurse recruitment and retention, performance management systems, professional development, and bed-side care-support tools. Ensure systems that provide for the effective orientation, transitions to practice and ongoing education of the clinical and managerial nursing staff; Establishes and maintains professional liaisons with educational institutions to promote the exchange of resources and to promote collaboration between service and educational arenas and advocates for, and leads, the continued advancement of nursing professionalism. Builds strong, collaborative partnerships between functional areas, including but not limited to HR, Quality, Compliance, IT and Finance to deliver strong operational performance and establishes credibility and trust throughout the nursing enterprise including but not limited to individual hospital CNOs, CEOs, clinical staff, boards, medical staffs, corporate peers, and corporate boards through a variety of communication strategies. Leads and is accountable for Division operations for areas of responsibility. Licensure: Registered Nurse license issued by the state in which the leader practices. Certification from an ANCC approved body within one year of hire Issued by (Governing Body): State Board of Nursing Education/Experience Required: Bachelor of Science in Nursing and Masters in related field or Bachelor's degree and a Masters in Nursing Years of Experience: 15 years plus experience in progressive health care leadership roles Describe Type Experience: 3-5 years minimum at a system level; 7-10 years in executive clinical leadership positions Knowledge, Skills & Abilities Required: • Excellent written and oral communications including strong presentation/speaking skills and the ability to communicate effectively with all levels of leadership and staff • Excellent interpersonal, negotiation, leadership, critical-thinking and decisions-making skills • Strong operational, financial and business acumen • Effectively handles multiple demands simultaneously • Ability to work collaboratively with others from multi-disciplines and levels of the organization • Proven record to navigate change implementation and execute on strategic planning • Ability to foresee and quickly resolve operational and organizational issues that have system impact • Proven organizational skills and the ability to prioritize effectively • Proficient computer skills including Microsoft office suite or similar applications
    $85k-132k yearly est. Auto-Apply 60d+ ago
  • Pediatric Speech Language Pathologist - Carolinas Rehab Telehealth, Remote

    Atrium Health 4.7company rating

    Huntersville, NC jobs

    is a remote position, supporting our Pediatric patient population. Provides patient evaluation and care planning for speech-language pathology. Delivers patient care appropriate to age specific and other population needs. Provides clinical leadership. Essential Functions Assesses and documents patient's medical, mental and emotional needs at admission and on an on-going basis. Develops and implements a plan of care to meet patient and family needs, to include discharge planning and utilization of available resources. Acts as patient advocate; treats patients and families with compassion and implements plan of care in a safe and timely manner. Demonstrates clinical reasoning, coupled with clinical skills to conduct accurate clinical assessments and perform patient care activities; evaluates effectiveness of therapy interventions, identifies and prioritizes patient/family strengths, needs and priorities. Identifies the normal course of illness in assigned patient population recognizing and intervening appropriately when deviations occur. Communicates patient information and thoroughly documents therapist's actions and plan of care. Provides clinical leadership and mentoring. Physical Requirements Hearing (corrected) adequate for oral/aural communication. Vision (corrected) adequate for reading. Intelligible speech and adequate language/cognitive skills to perform job duties. Sitting, standing, and walking required throughout the day. Job duties sometimes require climbing stairs, kneeling, twisting, bending; on occasion, crouching, crawling and reaching overhead. Lifting of patients, equipment or supplies will be required up to 20 pounds frequently and 50 pounds occasionally. Must be able to demonstrate any appropriate exercise and activities to patients/caregivers. Personal Protective Equipment such as gloves, goggles, gowns, and masks are sometimes required due to possible exposure to hazardous chemicals or blood and body fluids. Work is in a fast-paced clinical environment. The work environment is primarily indoors but occasionally outdoors. Education, Experience and Certifications Master's Degree in Speech Language Pathology required. NC license for Speech Language Pathology required. BLS required per policy guidelines.
    $45k-70k yearly est. Auto-Apply 60d+ ago
  • Registered Nurse RN Case Manager

    Banner Health 4.4company rating

    Remote

    Department Name: BMA-D Work Shift: Day Job Category: Clinical Care Estimated Pay Range: $35.43 - $59.05 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Recognized nationally as an innovative leader in health care, Banner Plans & Networks (BPN) integrates Medicare and private health plans to reduce healthcare costs while keeping our members in optimal health. Known for our innovative, collaborative, and team-oriented approach, BPN offers a variety of career opportunities and innovative employment options by offering remote and hybrid work settings. The Care Management team supports Banner Plans and Networks by coordinating care, developing individualized care plans, and providing member education to ensure a seamless care experience. Our fully remote team uses systems such as Innovaccer, Cerner, and Microsoft Office applications to streamline communication and documentation. We value flexibility, independence, and strong collaboration, making this a great fit for candidates with Case Management or Home Health experience who want to contribute to high quality, member focused care. Team members spend much of their day completing administrative tasks and making phone calls to assess needs, coordinate services, and educate members. Call volume varies, offering a mix of consistency and variety. The role is hybrid/remote (must reside in AZ), Monday-Friday from 8:00 a.m. - 5:00 p.m. AZ time, with some flexibility with training provided during business hours. We mirror the Banner corporate holiday schedule. Ideal candidates are independent, adaptable, proficient in Microsoft Office, and comfortable working in a supportive virtual environment without direct patient-facing responsibilities. This is a Hybrid/Remote role. AZ Residency is required. Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs. POSITION SUMMARY This position provides comprehensive care coordination for patients as assigned. This position assesses the patients plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating options and services to meet the patients health care needs. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the quality of clinical services delivered by both them and others and identifies/resolves barriers which may hinder effective patient care. CORE FUNCTIONS 1. Manages individual patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes. 2. Acts in a leadership function with process improvement activities for populations of patients to achieve the optimal clinical, financial, operational, and satisfaction outcomes. 3. Acts in a leadership function to collaboratively develop and manage the interdisciplinary patient discharge plan. Effectively communicates the plan across the continuum of care. 4. Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes. Assesses patient admissions and continued stay utilizing standard criteria. Identifies issues that may delay patient discharge and facilitates resolution of these issues. 5. Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts into daily practice. 7. May supervise other staff. 8. Has freedom to determine how to best accomplish functions within established procedures. Confers with supervisor on any unusual situations. Positions are entity based with no budgetary responsibility. Internal customers: All levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External Customers: Physicians and their office staff, payers, community agencies, provider networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse (R.N.) license in state worked. For assignments in an acute care setting, Basic Life Support (BLS) certification is also required. Requires a proficiency level typically achieved with 3-5 years clinical experience. Must have a working knowledge of care management, acute care and/or home care environments, community resources and resource/utilization management. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format. For assignments in an acute care setting, must be able to work flexible hours and take rotating call after hours. Banner Registry and Travel positions require a minimum of one year experience in an acute care hospital and/or home care setting. Experience must include working in an acute care and/or home care setting within the past 12 months as a Case Manager in the specialty area. PREFERRED QUALIFICATIONS Certification for CCM (Certified Case Manager) preferred. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $35.4-59.1 hourly Auto-Apply 3d ago
  • Clinical Coder IV/Acute Care - Medical Records

    Atrium Health 4.7company rating

    Charlotte, NC jobs

    00153661 Employment Type: Full Time Shift: Day Shift Details: Monday-Friday 1st shift Standard Hours: 40.00 Department Name: Medical Records Location Details: Onboarding at Arrowpoint, after training able to work remote Carolinas HealthCare System is Atrium Health. Our mission remains the same: to improve health, elevate hope and advance healing - for all. The name Atrium Health allows us to grow beyond our current walls and geographical borders to impact as many lives as possible and deliver solutions that help communities thrive. For more information, please visit carolinashealthcare.org/AtriumHealth Job Summary To support World Class Service Lines, and with Documentation Excellence (DE) as the primary objective, the Clinical Coder IV reviews clinical documentation and diagnostic results as appropriate to extract data and apply appropriate codes for billing, internal and external reporting, research and regulatory compliance. An option to work as part of the clinical team and perform high level, service line based concurrent coding is also available. This position also enjoys the advantages of free CEUs and one paid professional membership. Essential Functions Reviews medical records of high complexity to identify the appropriate principal diagnosis and procedure codes, all other appropriate secondary diagnoses and procedure codes. Assign and present on Admission, Hospital Acquired Condition and Core Measure Indicators for all diagnosis codes. Facilitates appropriate MS-DRG for inpatient medical records and appropriate APC assignment for outpatient medical records using UHDDS and other facility guidelines. Demonstrates the technical competence to use the facility encoder as it interfaces with the hospital mainframe and/or EMR in an on-site or remote setting. Reviews charges and Evaluation and Management levels. Demonstrates proficiency with Microsoft Office Applications and in using required computer systems with minimal assistance. Abstracts coded data and other pertinent fields in the hospital electronic health record. Ensures the accuracy of data input. Meets established quality and productivity standards. Facilitates peer review and training for all Acute Clinical Coders in the coding department. Provides support to management. Stay abreast of coding principles and regulatory guidelines related to inpatient and/or outpatient coding. Physical Requirements Must be able to concentrate and sit for long periods of time while reviewing electronic health records. Daily and weekly deadlines must be met in a fast paced office environment and/or at home environment. Education, Experience and Certifications. High school diploma or GED required; Bachelors degree preferred. Advanced knowledge in Medical Terminology, Anatomy and Physiology and Pharmacology required. 4 years coding experience in acute care setting required. Current RHIA, RHIT, CCS, CPC-H, CPC or CIC required plus a passing score on the CHS Coding test. At Atrium Health, formerly Carolinas HealthCare System, our patients, communities and teammates are at the center of everything we do. Our commitment to diversity and inclusion allows us to deliver care that is superior in quality and compassion across our network of more than 900 care locations. As a leading, innovative health system, we promote an environment where differences are valued and integrated into our workforce. Our culture of inclusion and cultural competence allows us to achieve our goals and deliver the best possible experience to patients and the communities we serve. Posting Notes: Not Applicable Carolinas HealthCare System is an EOE/AA Employer
    $43k-62k yearly est. 60d+ ago
  • Profee Senior Coder Surgical Cardiology

    Banner Health 4.4company rating

    Remote

    Department Name: Coding Ambulatory Work Shift: Day Job Category: Revenue Cycle Estimated Pay Range: $26.40 - $44.00 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we're constantly improving to make Banner Health the best place to work and receive care. We are looking for a motivated, experienced Profee Coder | Physician Practice Senior Coder with 5+ years of Cardiology Complex Coding experience (ideally Surgical Cardiology) to join our talented team. This position does require Certified Professional Coder (CPC) in active status (this position requires more than an apprentice CPC-A) with recent/consistent coding work history of 3 years or more. Location: REMOTE, Banner provides equipment Schedule: Full time; Flexible scheduling after training completed Ideal Candidates: 5 years recent experience in Surgical Cardiology Profee EM coding (clearly reflected in your attached resume); Specialty Cardiology coding experience preferred; Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. Please upload a copy or provide certification number in your questionnaire. Please note, this is a COMPLEX role, requiring more than a CPC-A level certification. ** Don't quite meet the above requirements? Check out some of our other Coder positions! This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY. The hours are flexible with the ability to work your 8-hour shift between 4am-7pm (Monday-Friday). Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position performs full range of complex professional coding in support of specialty or multi-specialty physician practices by evaluating medical records and validating that appropriate clinical diagnosis and procedure codes are assigned in accordance with nationally recognized coding guidelines. Utilize coding knowledge and expertise to support department projects, validation edits and revisions. Participates and leads in training and onboarding of new staff. Participates and leads coding round table discussions. CORE FUNCTIONS 1. Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required. 2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic medical records. Seeks out missing information and creates complete records, including items such as disease and procedure codes, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations. Refers inconsistent patient treatment information/documentation to coding quality analysts, supervisor or individual department for clarification/additional information for accurate code assignment. 3. Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards. 4. As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes. 5. Able to identify validation edits and revision issues to ensure compliant coding. 6. Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding, reimbursement, and compliance. 7. Provides mentoring for less experienced staff members and act as subject matter experts for complex coding. Will assist in onboarding of new coders to include but not limited to daily functions, system training, policies and procedures. 8. Works independently with the ability to manage and prioritize work assignments. Uses specialized knowledge to ensure accurate assignment of ICD/CPT codes according to national guidelines. Ability to address complex coding matters independently with regard to correct interpretation of coding guidelines and LCDs (Local Coverage Determinations) prior to referral to coding analyst, coding educator or coding manager/supervisor. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate's degree in a related health care field. Requires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification may also include a general area of specialty. Requires five or more years of specialized, complex professional coding experience for clinical specialty areas. Must demonstrate an elevated level of knowledge and understanding of ICD and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as required for the assigned practice areas. Requires the ability to work autonomously while maintaining a high level of accountability and quality performance outcomes. Must demonstrate excellent critical thinking and organization skills. Requires attention to detail. Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems. PREFERRED QUALIFICATIONS Preferred Radiology Certified Coder (RCC) if employed in the Imaging space. Specialty coding certification. Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
    $26.4-44 hourly Auto-Apply 16d ago

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