Steward Health Care jobs - 254 jobs

Are you a current UMass Memorial Health caregiver? Apply now through Workday. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Hiring Range: $175.48/hr - $209.13/hr Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations. UMass Memorial Medical Group is seeking additional Per Diem ED Radiologists to either work onsite or remotely read. We are seeking additional per diem radiologists for all shift types (7a-3p, 3p-11p, 11p-7a). About our Department: Our department is comprised of ~80 Radiologists, 20 residents, 9 fellows and 15 PhDs. In our ED group we have a team of 15. Our health system covers over one million lives and is a Level 1 Trauma Center with 95,000 ED visits per year. Our department has over $6M/year in research funding. Academic pursuits are encouraged and supported both in the realms of research and education. Our department has state of the art imaging equipment, AGFA PACS system, EPIC EMR, Tera-Recon image processing software, Powerscribe 360 and is running several AI algorithms. Radiologist Requirements: ED Radiologists work at the University campus with one resident and/or one Emergency Radiology fellow, and remotely cover several other hospitals. Additional opportunities for internal moonlighting within the department are available if desired. We offer three shift types to include 7am-3pm, 3pm-11pm and 11pm-7am. We can offer hybrid schedules to include remote reading days but an onsite presence is required. You must be comfortable interpreting the following modalities: CT, MRI, ultrasound, and Basic nuclear medicine. Fellowship training in Emergency Radiology is desired but not required. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ***********************************. We will make every effort to respond to your request for disability assistance as soon as possible.

Research Data Associate (Bi-lingual), Infectious Diseases Schedule: 40 hours per week, Hybrid (3-5 days on-site per week) ABOUT BMC: At Boston Medical Center (BMC), our diverse staff works together for one goal - to provide exceptional and equitable care to improve the health of the people of Boston. Our bold vision to transform health care is powered by our respect for our patients and our commitment to ensure everyone who comes through our doors has a positive experience. You'll find a supportive work environment at BMC, with rich opportunities throughout your career for training, development, and growth and where you'll have the tools you need to take charge of your own practice environment. POSITION SUMMARY: The Research Data Associate (RDA) will support research studies and initiatives under the NIH-funded Massachusetts Community Engagement Alliance (MA-CEAL) Program. The RDA will coordinate administrative aspects of the study and will be responsible for coordinating their own travel arrangements to study sites. The RDA aids in analysis of qualitative data and supports the research team with the preparation of data and other reports. The RDA will interact with study subjects, research study coordinators, study investigators, community engagement specialists, work study students/interns and other research staff. The ideal candidate must be bilingual (Spanish/English). JOB RESPONSIBILITIES: Provides assistance in the development of reports, presentations, and data analysis. Assists in qualitative and quantitative data collection and provides feedback on study's progress. Recruits subjects to participate in the study by using approved methodologies. Schedules appointments of study participants; conducts reminder phone calls and/or sends mailouts. Conducts the enrollment of study participants, including explaining research procedures, and obtaining informed consent of subjects and/or their families. Attends off-site events for purposes of data collection, as needed. Events may be on evenings and/or weekends . Conducts qualitative interviews of study participants, employing best practices for qualitative data collection. Reviews the data collection forms for each enrollee for completion and quality; aids in data entry, ensuring timely and accurate entry. Works with translation service vendors to ensure timely and accurate translation of study materials and data, as needed. Conducts literature searches. Assists Investigators with manuscript and presentation preparation and research. ADMINISTRATIVE: Responsible for the administrative aspects of the research study, including: managing program records and handling communication needs of the program. Prepares and maintains Institutional Review Board (IRB) approvals and correspondence, including amendments and renewals as necessary. Performs office-related duties such as answering phones, picking up and delivering mail, ordering and distributing office supplies, handling faxes, scanning, filing, photocopying, collating materials, maintaining the update of policy manuals, etc. Obtains and distributes payment vouchers for participant reimbursements/participation and may provide assistance in the development of reports, presentations, and data analysis. (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). JOB REQUIREMENTS EDUCATION: Bachelor's degree is required. Major in a field related to the research is preferred. EXPERIENCE: Prior experience in human subjects' research preferred. Experience in qualitative and quantitative data collection preferred. KNOWLEDGE AND SKILLS: Excellent English communication skills (oral and written). Bilingual (Spanish and English). The ideal candidate must be fluent in Spanish Cultural sensitivity and comfort with a wide range of social, racial and ethnic populations Organizational ability to perform multiple tasks efficiently and to prioritize duties. Proficiency with Microsoft Office applications including Word, Excel, and Access, PowerPoint, Outlook, database systems, and web browsers Ability to perform basic data management tasks (data entry, data cleaning, retrieval). Ability to perform basic data analysis and reporting (in words, numbers and graphics). Must have a productive and professional location to work remotely. JOB BENEFITS: Competitive pay Tuition reimbursement and tuition remission programs Highly subsidized medical, dental, and vision insurance options Career Advancement/Professional Development: Access a wealth of ongoing training and development opportunities that will not only enhance your skills but also expand your knowledge base especially for individuals pursuing careers in medicine or biomedical research. Pioneering Research: Engage in groundbreaking research projects that are driving the forefront of biomedical science. ABOUT THE DEPARTMENT: As the primary teaching hospital for Boston University Chobanian & Avedisian School of Medicine and BU schools of public health and dentistry, intellectual rigor shapes our inquiries. Our research is led by a belief that skin color, zip code, and financial circumstances shouldn't dictate health. Boston Medical Center is an Equal Opportunity/Affirmative Action Employer. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to ************************* or call ************ to let us know the nature of your request. Compensation Range: $43,000.00- $62,000.00 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

Insurance Verification Specialist Department: Insurance Verification Schedule: Per Diem, Part Time The Insurance Verification Specialist role is part of the Revenue Cycle Patient Access team and is responsible for coordinating all financial clearance activities by navigating all referral, precertification, and/or authorization requirements as outlined in payer-specific guidelines and regulations. The role plays an important dual role by helping to coordinate patient access to care while maximizing BMC hospital reimbursement. JOB REQUIREMENTS EDUCATION: High School Diploma or Equivalent required, Associates degree or higher preferred. CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: Case manager and/or coding certification desirable EXPERIENCE: 4-5 years medical billing/denials/coding/and/or inpatient admitting experience desirable KNOWLEDGE AND SKILLS: General knowledge of healthcare terminology and CPT-ICD10 codes. Complete understanding of insurance is preferred. Requires excellent verbal communication skills, and the ability to work in a complex environment with varying points of view. Must be comfortable with ambiguity, exhibit good decision making and judgment capabilities, attention to detail. Knowledge of and experience within Epic is preferred. Demonstrates technical proficiency within assigned Epic work queues and applicable ancillary systems, including but not limited to: ADT/Prelude/Grand Central, HB & PB Resolute. Demonstrates proficiency in Microsoft Suite applications, specifically Excel, Word, and Outlook. Displays a thorough knowledge of various sections within the work unit in order to provide assistance and back-up coverage as directed. Displays a deep understanding of Revenue Cycle processes and applies knowledge to meet and maintain productivity standards. ESSENTIAL RESPONSIBILITIES / DUTIES: Monitors accounts routed to precertification and prior authorization work queues and clears work queues by obtaining all payer specific financial clearance requirements in accordance with established management guidelines. Maintains knowledge of and complies with insurance companies' requirements for obtaining pre-certifications/prior authorizations/referrals, and completes other activities to facilitate all aspects of financial clearance. Acts as subject matter experts in navigating both the BMC Community and the payer world to get the right “permissions” (authorizations, pre-certs, referrals, for example) for the care plan to proceed. Uses appropriate strategies to underscore the most efficient process to obtaining authorizations, including on line databases, electronic correspondence, faxes, and phone calls. Obtains and clearly documents all pre-certifications/prior authorizations for scheduled services prior to admission within the Epic environment. Collaborates with patients, providers, and departments to obtain all necessary information and payer permissions prior to patients' scheduled services. Communicates with patients, providers, and other departments such as Utilization Review to resolve any issues or problems with obtaining required pre-certifications/prior authorizations. Escalates emergent and elective accounts that have been denied or will not be financially cleared within 3 days of admission as outlined by department policy. Keeps current on CMS requirements and guidelines. Coordinates with patients and Patient Financial Counseling to initiate/process Charity Care applications as needed. IND123 Compensation Range: $24.05- $29.31 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

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

The Director of Revenue Integrity serves in a senior leadership capacity and demonstrates client and unit-specific leadership to Revenue Integrity personnel by designing, directing, and executing key Conifer Revenue Integrity processes. This includes Charge Description Master ("CDM") and charge practice initiatives and processes; facilitating revenue management and revenue protection for large, national integrated health systems; regulatory review, reporting and implementation; and projects requiring expertise across multiple hospitals and business units. The Director provides clarity for short/long term objectives, initiative prioritization, and feedback to Managers for individual and professional development of Revenue Integrity resources. The Director leverages project management skills, analytical skills, and time management skills to ensure all requirements are accomplished within established timeframes. Interfaces with highest levels of Client Executive personnel. * Direct Revenue Integrity personnel in evaluating, reviewing, planning, implementing, and reporting various revenue management strategies to ensure CDM integrity. Maintain subject-matter expertise and capability on all clinical and diagnostic service lines related to Conifer revenue cycle operations, claims generation and compliance. * Influence client resources implementing CDM and/or charge practice corrective measures and monitoring tools to safeguard Conifer revenue cycle operations; provide oversight for Revenue Integrity personnel monitoring statistics/key performance indicators to achieve sustainability of changes and compliance with regulatory/non-regulatory directives. * Assume lead role and/or provide direction/oversight for special projects and special studies as required for new client integration, system conversions, new facilities/acquisitions, new departments, new service lines, changes in regulations, legal reviews, hospital mergers, etc. * Serve as primary advisor to and collaboratively with Client/Conifer Senior Executives to ensure requirements are met in the most efficient and cost-effective manner; provides direction to clients for implementation of multiple regulatory requirements. * Serve as mentor and coach for Revenue Integrity personnel and as a resource for manager-level associates. * Maintain a high-level understanding of accounting and general ledger practices as it relates to Revenue Cycle metrics; guide client personnel on establishing charges in appropriate revenue centers to positively affect revenue reporting FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense): Adherence to established/approved annual budget SUPERVISORY RESPONSIBILITIES This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Direct Reports (incl. titles) : Revenue Integrity Manager/Supervisor Indirect Reports (incl. titles) : Charge Review Specialist I-II, Revenue Integrity Analyst I-III, Charge Audit Specialist To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to set direction for large analyst team consistent with Conifer senior leadership vision and approach for executing strategic revenue management solutions * Demonstrated critical-thinking skills with proven ability to make sound decisions * Strong interpersonal communication and presentation skills, effectively presenting information to executives, management, facility groups, and/or individuals * Ability to present ideas effectively in formal and informal situations; conveys thoughts clearly and concisely * Ability to manage multiple projects/initiatives simultaneously, including resourcing * Ability to solve complex issues/inquiries from all levels of personnel independently and in a timely manner * Ability to define problems, collect data, establish facts, draw valid conclusions, and make recommendations for improvement * Advanced ability to work well with people of vastly differing levels, styles, and preferences, respectful of all positions and all levels * Ability to effectively and professionally motivate team members and peers to meet goals * Advanced knowledge of external and internal drivers affecting the entire revenue cycle * Intermediate level skills in MS Office Applications (Excel, Word, Access, Power Point) Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Include minimum education, technical training, and/or experience required to perform the job. * Bachelor's degree or higher; seven (7) or more years of related experience may be considered in lieu of degree * Minimum of five years healthcare-related experience required * Extensive experience as Revenue Integrity manager * Extensive knowledge of laws and regulations pertaining to healthcare industry required * Prior healthcare financial experience or related field experience in a hospital/integrated healthcare delivery system required * Consulting experience a plus CERTIFICATES, LICENSES, REGISTRATIONS * Applicable clinical or professional certifications and licenses such as LVN, RN, RT, MT, RPH, CPC-H, CCS highly desirable PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * While performing the duties of this job, the employee is regularly required to sit for long periods of time; use hands and fingers; reaching with hands and arms; talk and hear. * Must frequently lift and/or move up to 25 pounds * Specific vision abilities required by this job include close vision * Some travel required WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Normal corporate office environment TRAVEL * Approximately 10 - 25% Compensation and Benefit Information Compensation Pay: $104,624- $156,957 annually. Compensation depends on location, qualifications, and experience. * Position may be eligible for an Annual Incentive Plan bonus of 10%-25% depending on role level. * Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, life, and business travel insurance * Management time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Non-Exempt Hiring Range: $19.74 - $30.80 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: 8-430 Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5436 Med Specs Ancillary Pod Ar Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Responsible for follow-up of complex claims for payment. I. Major Responsibilities: 1. Calls insurance companies and utilizes payor web-sites while working detailed reports to secure outstanding payments. 2. Reviews rejections in assigned payors and plans to determine validity of rejection and takes appropriate action to resolve the invoice. 3. Calculates and posts adjustments based on third party reimbursement guidelines and contracts. 4. Makes appropriate payor and plan changes to secondary insurers or responsible parties. 5. Inputs missing data as required and corrects registration and other errors as indicated. Standard Staffing Level Responsibilities: 1. Complies with established departmental policies, procedures and objectives. 2. Attends variety of meetings, conferences, seminars as required or directed. 3. Demonstrates use of Quality Improvement in daily operations. 4. Complies with all health and safety regulations and requirements. 5. Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. 6. Maintains, regular, reliable, and predictable attendance. 7. Performs other similar and related duties as required or directed. All responsibilities are essential job functions. II. Position Qualifications: License/Certification/Education: Required: 1. High School Diploma Experience/Skills: Required: 1. Previous Revenue Cycle knowledge in one of the following areas including PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding and/or 3rd party Reimbursement. 2. Ability to perform assigned tasks efficiently and in timely manner. 3. Ability to work collaboratively and effectively with people. 4. Exceptional communication and interpersonal skills. Preferred: 1. One or more years of experience in health care billing functions. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents. III. Physical Demands and Environmental Conditions: Work is considered sedentary. Position requires work indoors in a normal office environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ***********************************. We will make every effort to respond to your request for disability assistance as soon as possible.

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Schedule Details: Scheduled Hours: Shift: Hours: 0 Cost Center: This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. This position engages in a program of field training to observe and provide therapeutic interventions in a variety of placement settings. Observes, learns, and uses basic skills for behavioral health interventions consistent with the requirements of their academic institution. About Internships at Community Healthlink 1. CHL interns are those looking for their first field placement 2. Interns at CHL work in supportive roles, closely with supervisors. 3. They assist with comprehensive assessment activities, collaborate on treatment plans, provide brief therapeutic 1:1 interventions, milieu management, case management to support aftercare referrals and discharge planning, as well as crisis intervention and de-escalation. 4. Generally, these interns are placed within programs that have a therapeutic milieu, and interns are not completing directly billable activities. Hiring Range: $15.00 - $15.50 Please note that the final offer may vary within this range based on the candidate's experience, skills, qualifications and internal equity considerations. I. Major Responsibilities: 1. Provides clinical support as defined by the level of care and service needs of the population served. Specific treatment expectations are defined by licensing and accreditation standards for each level of care and internship expectations as agreed upon between the student, school, and program. 2. Assists with comprehensive assessments consistent with needs of the population served. 3. Collaborates on the development of treatment plans consistent with regulations as required by the funder/licensor. Participates in treatment planning conferences. 4. Provides case management through brief therapeutic 1:1 interventions to coordinate aftercare referrals and discharge planning consistent with regulations and the level of care. Consults and collaborates with collateral contacts and providers as appropriate for the level of care. 5. Coordinates and facilitates individual or group interventions to address the clinical needs of the needs of the population served. II. Position Qualifications: License/Certification/Education: Required: 1. Undergraduate student must be in a Bachelor's degree program in social work, counseling, public health, or related field. Or may be a practicum student in a Masters or Doctoral degree level program in Mental Health Counseling, Social Work, Marriage and Family Therapy, Clinical Psychology, or related program. 2. Some positions require a current valid US-issued driver's license and a registered, inspected, and insured automobile for work related purposes. 3. For MCI programs, a current valid US-issued driver's license and reliable transportation for work related purposes. Experience/Skills: Required: 1. Strong communication and organizational skills. 2. Detail oriented. 3. Willingness to learn. 4. Able to effectively work alone, and as part of a team. III. Physical Demands and Environmental Conditions: 1. Work is considered medium. May have to lift up to 10 lbs. frequently and up to 50 lbs. occasionally. 2. Work occurs in an indoor, patient-focused environment. ADDENDUM CCBHC-IA Intern Job Summary: Assists the CCBHC IA team in improving access to evidence-based services for behavioral health clients from diverse communities. Major Responsibilities: 1. Assists in tracking grant goals. 2. Gathers information from clients and data entry per grant requirements. 3. Contributes to infrastructure development to support sustainability. 4. Participates in training opportunities. 5. Participates on a CHL committee. 6. Identifies and carries out a special project. 7. Performs other related duties. License/Certification/Education: Required: 1. Undergraduate student must be in their 3rd or 4th year of completing a bachelor's degree in social work, counseling, public health, or related field. Experience/Skills: Required: 1. Interest in health equity and serving marginalized communities. 2. Strong communication and organizational skills. 3. Detail oriented. 4. Willingness to learn. 5. Able to effectively work alone, and as part of a team. 6. Available during business hours (9 a.m. to 5 p.m.)- number of hours per week are negotiable. 7. We will be working in a hybrid model with some time onsite and remote work from home. 8. Community Healthlink (CHL) recognizes the power of a diverse community and seeks applications from individuals with varied experiences, perspectives, and backgrounds. III. Physical Demands and Environmental Conditions: 1. Must be able to remain seated for extended periods of time. 2. Must be able to hear, understand, and distinguish speech and/or other sounds (e.g., machinery alarms, medicals codes or alarms). 3. Must be able to work on a computer 80% of the shift. 4. The characteristics above are representative of those encountered while performing the essential functions of the position. Reasonable accommodations may be made if necessary in order to perform the essential functions. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ***********************************. We will make every effort to respond to your request for disability assistance as soon as possible.

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

* Performs compliance audits of Inpatient and Outpatient medical records in accordance with all coding guidelines. Writes and presents concise recommendation worksheets with appropriate findings and coding references to coders during education exits. Writes Executive Summaries and must communicate with different administrative levels within the hospital. Responsibilities Reviews records assigned to ensure all codes reported are accurate to ICD-10 CM/PCS and/or CPT coding conventions Reviews additional chart documentation to validate admission order, admission and discharge dates, point of origin, patient status, present on admission indicator, and coder queries to ensure accuracy Uses various software applications, groupers, 3M and other coding tools to analyze and ensure appropriate codes, sequencing and edits Runs preliminary and final statistical and coder specific reports Completes client rebuttals and makes appropriate changes in database Prepares for Exit Conference using Teams Conducts Exit Conference with Administration Conducts Exit Conference with Coding Staff Prepares summation of Exit Conference Meets with HIM Director following Exit Qualifications High School Diploma with RHIA, RHIT, or CCS credential Minimum 5 years inpatient and outpatient coding experience in an acute care facility. I-10-CM/PCS proficient Computer proficiency, able to research coding questions and utilize HIA's internal educational resources Experience using Electronic Health Record (EHR) High Speed Internet via Cable (no Satellite or wireless cell based) Independent, focused individual able to work remotely. Sound organizational, communication and critical thinking skills

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Hiring Range: $30.76 - $55.36 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations. Schedule Details: Monday through Friday Scheduled Hours: Flexible Shift: 4 - Mixed Shift, 8 Hours (United States of America) Hours: 0 Cost Center: 25080 - 4263 Outpatient Mental Health Svcs This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Provide quality treatment to patients within Behavioral Health Services. I. Major Responsibilities: 1. Provide individual & group therapy to patients with varied mental health/ co-occurring disorders. 2. Responsibilities include completing initial assessments, counseling, group therapy, case presentations to the treatment team, treatment planning, and aftercare planning. 3. Clinicians are also responsible for identifying the need for medication evaluations and making referrals to the on-site providers. 4. Complete all documentation and paperwork specific to the department and in compliance with hospital requirements, DMH, BSAS, The Joint Commission, and insurance providers. 5. Responsible for managing caseload which may include consultations, collateral contact, and following up with the patient on missed appointments. 6. Maintain independent professional licensure and maintain credentialing necessary for specific role. Standard Staffing Level Responsibilities: (STANDARD UMMH) 1. Complies with established departmental policies, procedures, and objectives. 2. Attends variety of meetings, conferences, seminars as required or directed. 3. Demonstrates use of Quality Improvement in daily operations. 4. Complies with all health and safety regulations and requirements. 5. respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. 6. Maintains, regular, reliable, and predictable attendance. 7. Performs other similar and related duties as required or directed. All responsibilities are essential job functions. II. Position Qualifications: License/Certification/Education: Required: 1. Graduation and training from an accredited graduate (Masters) program. 2. Active unrestricted independent license by the Massachusetts Board of Registration: LICSW/LMHC/LMFT/Licensed Clinical Psychologist. Experience/Skills: Required: 1. 2+ years of experience working within the Human Services field. 2. Strong diagnostic skills and abilities. 3. Must have strong and effective communication, organization and time management skills. 4. Must be able to work as part of a robust multi-disciplinary clinical team. Preferred: 1. 2+ years of experience working within behavioral health and/ or addictions treatment. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents. III. Physical Demands and Environmental Conditions: Work is considered sedentary. Position requires work indoors in a normal office environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at ***********************************. We will make every effort to respond to your request for disability assistance as soon as possible.

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

The Absence Management Specialist is to provide excellent customer service to employees regarding all aspects of absence management. This position is a subject matter expert regarding all types of employee's leave of absence, including Short Term Disability, FMLA, MMLA, ERISA, FLSA and ADA, etc. The ideal candidate will demonstrate a high level of professionalism, possess the ability to work well in a fast-paced environment and the flexibility to easily adapt to changing priorities. This role requires two full days in-office. Position: Absence Management Specialist Department: Human Resources Schedule: Full Time (Hybrid) Onsite Requirement: 2 Day Per Week ESSENTIAL RESPONSIBILITIES / DUTIES: The Absence Management Specialist ensures and supports completion of compliance related duties in accordance with company policy, state and federal leave laws Investigates claim issues providing resolution within departmental and regulatory guidelines Accurately codes all system fields with correct financial, diagnosis and duration information Coordinates with other departments to ensure appropriate claims transition or facilitates timely return to work Document leave updates in the Kronos Leave Case ensuring accuracy Actively contributes to, and maintains, customer service, quality and performance objectives Proactively engages in departmental trainings to remain current with all leave management practices The Absence Management Specialist will work with Case Managers to update Leave Cases and complete PFML Forms Supports the approval/denial process for employee's leave cases based on relevant medical information Works with the employee's leave team to ensure proper management of all administrative aspects of leave claims to include: tracking hours used/taken; return to work data; file reviews and working closely with the Managers, HR and Payroll to ensure that key dates, details and status for employee's are accurate and correct Counsels and assists employees from the initial application process through return-to-work or separation procedure. Explains employees their rights and responsibilities. Provides all necessary documents. Contacts employees or healthcare provider's to gather and clarify information during the interactive dialogue or return to work process. Provides assistance with wage replacement. Develops strong working relationships with various internal and external partners including the medical community, Occupational Health, EAP, payroll, legal and others to ensure accurate, efficient, and timely leave administration. Actively manages all tasks in absence management system to ensure completion within appropriate timeframes. Ensure accurate status in LOA, Payroll and HRIS systems. Ensures accurate, timely and professional legal recordkeeping and documentation within the absence management system and all communication tools. Responsible and accountable for maintaining and protecting Personal Health Information (PHI) of employees. Provides excellent customer service. Answers questions for employees regarding absence and leave policies, programs, and transactions. Works with department to investigate, mediate, and resolve complex issues or employee disputes with carriers. Works with employees to ensure that return-to-work and end-of-employment processes are appropriately managed. Works with employee's manager regarding leave and return to work options, in coordination with Employee Relations and Occupational & Environmental Medicine. Assist in developing new and revised processes, procedures and template letters or forms related to leave of absence General Adheres to department and hospital standards, including the following: Adapts to changes in the departmental needs including but not limited to: re-prioritizing assignments, assisting other areas during the times of high work volumes, staffing shortage, etc. Conforms to hospital standards of performance and conduct, including those pertaining to patient rights, so that the best possible customer service and patient care may be provided. Utilizes hospital's behavioral standards as the basis for decision making and to support the department and the hospital's mission and goals. Follows established hospital infection control and safety procedures. Perform other duties and projects as assigned (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). JOB REQUIREMENTS EDUCATION: Associate's degree in Human Resources or related discipline (or equivalent years of experience in the field) CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: None required. EXPERIENCE: 1 -2 years' experience with Absence Management KNOWLEDGE AND SKILLS: Strong understanding of benefits and payroll principles and practices, disability plan administration, paid time off, FMLA, PFML, STD, ADA, and other applicable federal and state regulations. Excellent communication skills including strong oral, written and presentation skills. Ability to coordinate and provide direction to vendors, insurers, and third party administrators. Proven technical expertise in absence management - to include tracking FMLA, workers' compensation, short- and long-term disability. Effective multitasking skills in a high volume, fast paced, team-oriented environment. Strong decision making capabilities and ability to resolve issues in a logical and timely manner. Computer and HRIS skills. Proficiency in the use of Microsoft Word, Excel and Outlook. Ability to work independently, use good judgement and complete assignments on time Ability to handle difficult employment issues in a professional manner Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone support to Sutter Health patients, other callers, in-basket and other remote support for physicians, and limited in-clinic support. Uses the nursing process, input from physicians, and Sutter Health's approved telephone nursing guidelines and protocols to maintain highly efficient operations, to provide quality care, and to ensure positive patient outcomes. Assesses patients' needs, appropriately dispositions cases, collaborates with the clinic and hospital-based providers to renew electronic prescriptions, identifies hospital and community resources, consultations and referrals, and preforms nursing follow-up activities. Clinical support includes assisting physician partners with message management and other communications within the electronic medical record (EMR) system, as well as limited patient care in an outpatient setting. Job Description: DISCLAIMER Applicants must be a resident of one of the following states to be eligible for consideration for this position: Utah, Idaho, Arizona, Arkansas, Louisiana, Tennessee, Missouri, Montana, or South Carolina. DISCLAIMER 2 This is a Work from Home position, therefore internet minimum speeds of 15 mbps download and 5 mbps upload are required. EDUCATION Graduate of an accredited school of nursing CERTIFICATION & LICENSURE RN-Registered Nurse of California (You can submit application without the CA RN license, but must acquire it prior to your start date if selected). RN-Registered Nurse in State of Residence PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN: 2 years' experience of practical nursing in a hospital, clinic, urgent care, or emergency room/department 2 years' experience with several specialties and subspecialties. OB/GYN experience helpful SKILLS AND KNOWLEDGE Professional knowledge of clinical nursing protocols, regulations and institutional standards of care and risk management with an emphasis in the areas of disease processes, emergencies, health sciences and pharmacology. Advanced clinical knowledge of medical diagnoses, procedures, protocols, treatments, and terminology, including a working knowledge of state and federal regulations and guidelines. Solid analytical and project management skills, including the ability to analyze problems, situations, practices, and procedures, reach practical conclusions, recognize alternatives, provide solutions, and institute effective changes. Communication, interpersonal, and interviewing skills, including the ability to build rapport and explain medical lab results or sensitive information clearly and professionally to diverse audiences (patients). Proficient computer skills, including Microsoft Office Suite and experience working electronic medical/health records. Work independently, as well as part of a multidisciplinary team, while demonstrating exceptional attention to detail and organizational skills. Manage multiple priorities/projects simultaneously, sometimes with rapidly changing priorities, while maintaining event/project schedules. Recognize unsafe or emergency situations and respond appropriately and professionally. Ensure the privacy of each patient's protected health information (phi). Analyze possible solutions using precedents, existing departmental guidelines and policies, experience and good judgment to identify and solve standard problems. Build collaborative relationships with peers, physicians, nurses, administrators, and public to provide the highest quality of patient care. Pay Range: Starting wage is $37.19 hourly Job Shift: Varied Schedule: Part Time Shift Hours: 8/10 Blended Days of the Week: Variable Weekend Requirements: Rotating Weekends Benefits: Yes Unions: No Position Status: Non-Exempt Weekly Hours: 32 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $0.00 to $0.00 / hour The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

The Contract Specialist is responsible for the lifecycle management of low to moderate risk vendor goods and services agreements, maintains applicable contract records, correspondence, and files, and monitors contracts for expiration taking action to amend, extend, or close-out as appropriate. Position: Contracts Specialist Department: Supply Chair Corp Procurement Schedule: Full Time ESSENTIAL RESPONSIBILITIES / DUTIES: Handles routine or standard form contract agreements and related documentation in accordance with established contract policies and procedures; executes low to moderate risk contracts. Able to negotiate basic business terms in accordance with prescribed templates and guidelines. Reviews solicitations and prepares routine response for proposals, bids, and contract modifications. May prepare basic requests for proposal, information or quotation as directed. Prepares and administers routine correspondence, negotiation memoranda, and contract documentation to ensure timely and coordinated submittal. Prepares, organizes and maintains contract records and files to ensure business continuity and optimization of the contract lifecycle management and ERP systems. Documents contract performance and compliance where required, escalates non-conformance to leadership for follow up. Communicates contract policy and practice to internal business teams; ensures contract review, approval and execution in accordance with guidelines and policies. Assists internal or external business teams on issues and developments relative to assigned contracts. Coordinates with Supply Chain and Accounts Payable teams to rectify pricing discrepancies; ensures accurate and timely processing of vendor payments utilizing purchase orders. (The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required). JOB REQUIREMENTS EDUCATION: Bachelor's degree or equivalent education and experience preferred CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED: Certification from National Contract Management Association (NCMA) or International Association for Contract and Commercial Management (IACCM) or similar credential preferred. EXPERIENCE: 1-3 years related business or contract experience KNOWLEDGE, SKILLS & ABILITIES (KSA): Strong written and verbal communication skills; detail oriented in all notes and documentation. Intermediate to advanced skill in use of Microsoft products including Word, Excel, PowerPoint, Forms, etc. Proficient using contract lifecycle management and ERP systems. Basic analytical skills necessary to make sound recommendations based on data. Able to develop accurate and precise summary information. Compensation Range: $50,500.00- $73,000.00 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being. NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location. Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

which will work primarily out in the assigned communities.** Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Location: Available for Gaston, Cleveland, Rutherford NC locations; Mobile/Remote position Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Intellectual and Developmental Disabilities (I/DD) Care Manager is responsible for providing Tailored Care Management and/or care coordination to members/recipients with I/DD to help secure and coordinate a variety of physical health, developmental disability, behavioral health and long-term services and support (LTSS) services. The I/DD Care Manager actively engages with members/ recipients through comprehensive assessment, care planning, health promotion, and comprehensive transitional care. Tailored Care Management is comprehensive and longitudinal for members with Medicaid coverage. Recipients with no Medicaid receive Tailored Care Management based on specified triggers and for a duration not to exceed ninety (90) days. Travel is an essential function of this position. Role and Responsibilities: Duties of the I/DD Care Manager include, but are not limited to, the following: Comprehensive Care Management Provide assessment and care management services aimed at the integration of primary, behavioral and specialty health care and community support services, using a comprehensive person-centered care plan which addresses all clinical and non-clinical needs and promotes wellness and management of chronic conditions in pursuit of optimal health outcomes Complete a care management comprehensive assessment within required timelines and update as needed Develop a comprehensive Individual Support Plan and update as needed Provide diversion activities to support community tenure Care Coordination Facilitate access to and the monitoring of services identified in the Individual Support Plan to manage chronic conditions for optimal health outcomes and to promote wellness. Facilitate communication and regularly scheduled interdisciplinary team meetings to review care plans and assess progress. Monitors services for compliance with state standards and Medicaid regulations, including home and community-based standards for 1915i services Verify that services are delivered as outlined in ISP and addresses any deviations in services Individual and Family Supports Provide education and guidance on self-management and self-advocacy Provide information about rights, protections, and responsibilities, including the right to change providers, the grievance and complaint resolution process, and fair hearing processes Educate members and recipients about the Registry of Unmet Needs, with referral as indicated Utilize person centered planning methods/strategies to gather information and to get to know the members supported Ensure that members/legally responsible persons are informed of services available, service options available, processes (e.g. requirements for specific service), etc. Promote prevention and health through education on the member's chronic conditions and/or disabilities for the member, family members, and their caregivers/support members Promote culturally competent services and supports. Health Promotion Educate and engage the member/recipient and caregivers in making decisions that promote his/her maximum independent living skills, good health, pro-active management of chronic conditions, early identification of risk factors, and appropriate screening for emerging health problems Closely coordinate care with the member's I/DD, behavioral health, and physical health providers, including in person visits to Emergency Departments and Skilled Nursing Facilities Support medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment Transitional Care Management Proactive and intentional care management when the member/recipient is experiencing care transitions (including, but not limited to transitions related to hospitalization, nursing facility, rehabilitation facility, community-based group home, etc.), significant life changes including, but not limited to loss of primary caregiver, transition from school services, etc.) or when a member/recipient is transitioning between health plans. Create and implement a 90-day transition plan as an amendment to the ISP that outlines how services will be maintained or accessed and includes a process to transition to the new care setting and integrate into his or her community. Referral to Community/Social Supports Provide information and assistance in referring members/recipients to community-based resources and social support services, regardless of funding source, which can meet identified needs Provide comprehensive assistance securing health-related services, including assistance with initial application and renewal with filling out and submitting applications and gathering and submitting required documentation, including in-person assistance when it is the most efficient and effective approach. Time-Limited Care Coordination for Member Excluded from Receiving Tailored Care Management Assist member who are receiving care management from other entities (e.g., CCNC, CAP/C, CAP/DA) with referral/linkage to I/DD services available through the Tailored Plan or Medicaid Direct contract Provide transitional care management Participate in weekly conference with CCNC, as needed, to share information on high-risk members, including members with a behavioral health transitional care need and members with special health care needs, who are receiving care coordination and care management from both entities or require referrals Coordinate with each member's care manager to the extent the member is engaged in care management through another entity (e.g. PCCM Vendor, Skilled Nursing Facility, CAP/C or CAP/DA, etc.) Share the results of the any assessments completed, the member's person-centered plan, and the member's Care Plan (to the extent one exists) with entity providing care management Notify the member's care manager that the member is undergoing a transition and engage the member's assigned care manager to assist with transitioning the member into the community, including in the development of the ninety (90) day post-discharge transition plan to the extent there are items within the care manager's scope. With the assistance of the care management entity, encouraging, supporting, and facilitating communication between primary care providers and the Partners network providers regarding medication management, shared roles in care transitions and ongoing care, the exchange of clinically relevant information, annual exams, coordination of services, case consultation, and problem-solving as well as identification of a medical home for persons determined to have need. Other: Assist state-funded recipients apply for Medicaid Coordinate Medicaid deductibles, as applicable, with the member/legally responsible person and provider(s) Proactively monitor documentation/billing to ensure that issues/errors are resolved as quickly as possible Ensure all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency and Medicaid requirements Maintain medical record compliance/quality, as demonstrated by ≥90% compliance on Qualitative Record Reviews Recognizes and reports critical incidents Promotes member satisfaction through ongoing communication and timely follow-up on any concerns/issues Collaborates with providers to ensure accurate/timely submission of authorization requests for all Tailor Plan-funded services/supports Document within the grievance system any expression of dissatisfaction/concern expressed by member/recipient supported or others on behalf of the member/recipient supported Ensure strong leadership to care team for each member/recipient, including effectively communicating with and providing direction to Care Management extenders Knowledge, Skills, and Abilities: Demonstrated knowledge of the assessment and treatment of I/DD needs, with or without co-occurring physical health, mental health or substance use disorder needs Ability to develop strong, person-centered plans Exceptional interpersonal skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts and established processes Demonstrated ability to collaborate and communicate effectively in team environment Ability to maintain effective and professional relationships with member/recipients, family members and other members of the care team Problem solving, negotiation and conflict resolution skills Excellent computer skills including proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) Detail oriented Ability to learn and understand legal, waiver and program practices/requirements and apply this knowledge in problem-solving and responding to questions/inquiries Ability to independently organize multiple tasks and priorities and to effectively complete duties within assigned timeframes Ability to manage and uphold integrity and confidentiality of sensitive data Sensitivity and knowledge of different cultures, ethnicities, spiritual beliefs and sexual orientation. Education/Experience Required: Bachelor's degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area and two (2) years of full-time experience with I/DD population OR Bachelor's degree in a field other than human services and four (4) years of full-time experience with I/DD population OR Master's degree in human services and one (1) year of full-time experience with I/DD population OR Licensure as a registered nurse (RN) and four (4) years of full-time accumulated experience with I/DD AND Two (2) years of prior Long-Term Services and Supports (LTSS)and/or Home and Community Based Services (HCBS) coordination, care delivery monitoring and care management experience. This experience may be concurrent with the two years of experience working with I/DD population described above AND Must reside in North Carolina Must have ability to travel regularly as needed to perform job duties Education/Experience Preferred: Experience working with member/recipients with co-occurring physical health and/or behavioral health needs preferred. Licensure/Certification Requirements: If a Registered Nurse (RN), must be licensed in North Carolina.

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Location: Available for any Partners' NC locations; Remote option in NC or within 40 miles of NC border Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Provider Relations Physical Health Supervisor provides oversight and supervision to a team of Provider Account Specialists responsible for supporting relationships for providers in the Partners Health Management Network that primarily provide services to Physical Health Providers. This position is expected to build and sustain strong working relationships with cross functional departments, physical health plan partners, both physical and behavioral health providers, and essential providers. The Physical Health Provider Network Relations Supervisor supports successful operations of primarily physical health providers but also providers who deliver both physical and behavioral health services, and essential health providers within our healthcare delivery model. This position assists and promotes problem solving, communication, excellent customer service, process improvement and education/development. The position requires inter and intra departmental collaboration on projects, business development, network requirements, network expansion and fortification including knowledge of care management, contracting, value-based programs along with state and departmental reporting. Managed Care experience in the State of North Carolina is desired. Role and Responsibilities: Network Support and Development Supervise and provide oversight to provider account specialists to support the needs of primarily Physical Health Providers but can include Behavioral Health and Essential Health Providers in the Partners Health Management Network. Assist Physical Health Provider Network Relationship Manager in needed training and/or consultation related to provider issues. Provide assistance with value-based and fee-for-service provider contracting. Assist in development and enhancement of the provider network through engagement with Physical Health providers both in and out of the Partners Health Management network. Work collaboratively with internal departments to increase knowledge and development opportunities for the network. Provide technical assistance and guidance as necessary to Provider Account Specialists and Physical Health providers in the network. Create reports as requested or needed for support of the provider network. Provide support and assistance to the Physical Health Provider Network Relationship Manager. Provide strong and comprehensive support in the area of Physical Health to ensure the best potential outcomes for the Physical Health providers and members. Provider Relations Ability to establish and maintain relationships with providers in and out of the network. Facilitate and provide assistance as requested by both providers and other internal departments to mitigate provider issues or concerns. Participate in provider meetings across the agency when appropriate or needed to foster and support the relationship between providers and Partners Health management. Serving as a resource to other departments within the organization on provider-related issues. Coordinate/attend meetings with providers and internal staff. Participating in Provider Forums as requested and providing technical support and assistance to Provider Council as needed Assist the Physical Health Provider Network Relationship Manager by participating in internal workgroups that involve Physical Health providers. Collaborate with all levels of the organization including Executive Leadership Team, Departmental Directors, and Managers to assist with problem resolution. Enhance relationships with providers by assisting in investigating, documenting, and resolving provider issues and concerns. Knowledge, Skills and Abilities: Considerable knowledge of the laws, regulations and policies that govern the program General knowledge of Physical Health business practices, rules, and regulations Exceptional interpersonal and communication skills Strong problem solving, negotiation, arbitration, and conflict resolution skills Excellent computer skills and proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint Demonstrated ability to verify documents for accuracy and completeness; to understand and apply laws, rules and regulations to various situations; to apply regulations and policies for maintenance of consumer medical records, personnel records, and facility licensure requirements Demonstrated ability to lead and manage workload distribution. Ability to make prompt independent decisions based upon relevant facts Ability to establish rapport and maintain effective working relationships Ability to act with tact and diplomacy in all situations Ability to maintain strict confidentiality in all areas of work Education/Experience Required: Bachelor's Degree in mental health, public health, social work, psychology, education, sociology, business, or public administration and five (5) years of experience in a community, business, or governmental program in health-related fields, social work or education including experience in network operations, provider relations, and management experience. Three (3) three years of supervisory, consultative, or administrative experience. A combination of relevant experience may be considered in lieu of a bachelor's degree. NC Residency is required. Education/Experience Preferred: Master's Degree and two(2) years' experience directly interacting in clinical environment. Licensure/Certification Requirements: None

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

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

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