Tenet Healthcare jobs in Lincoln, NE

Responsible for maximizing product performance and value to Tenet Patient Financial Services, its clients and the healthcare market through effective supervision, direction and operation of the government programs product and the coordination of its delivery through field operation offices. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Provides overall supervision of Government Programs for assigned division including direction, knowledge, and resources to management and staff to enable them to expedite governmental program recovery and decrease facility bad debt. * Ensures staff understanding and application of local, state and federal laws and guidelines. * Develops and delivers Eligibility Program training to divisional staff and its clients. * Provides direction to staff on issues/questions relating to Government Programs. * Develops, refines, and manages the product to maximize operational goals and objectives while working with the management team and staff. * Monitors and builds team morale and productivity as measured against planned objectives. * Identifies key performance indicators and utilizes them to track and manage product performance. FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense): N/A * Scope: Multiple small locations, or single medium sized location, or single large sized location 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 (titles) Patient Advocate and Lead, EES Financial Counselor and Lead. Typically, a 1:12 ratio * Indirect Reports (titles) Clerical Support, EES KNOWLEDGE, SKILLS, ABILITIES 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. * Working familiarity with the rules and regulations pertaining to Federal, State and County programs * P/C systems literate including Windows, and Microsoft Outlook, Excel and Word programs * Ability to work independently * Detail oriented, with strengths in dealing with multiple facilities, Supervisors, and Hospital platforms * Ability to prioritize and manage multiple tasks with efficiency * Excellent oral and written communication, interpersonal, organizational and management skills 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. * Bachelors Degree in Business Administration, Marketing and/or related field or equivalent experience * 3 - 5 years experience in healthcare finance or revenue cycle * Most recent 3 years experience in Federal, State and Local government programs * 2 - 3 years supervisory experience in Federal, State and Local government programs * Working knowledge of healthcare products 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. * Ability to sit and work at a computer terminal for extended periods of time. * Must be able to walk through a hospital environment, including across broad campus settings and Emergency Department environments, and visit patients at bedside. * Ability to travel. 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. * Both Hospital and Office facilities, in direct contact with Patients and Staff OTHER * Must be able to travel. As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! 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. **********

JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. • Facilitates behavioral health-related regional medical necessity reviews and cross coverage. • Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. • Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. • Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. • Provides second level behavioral health clinical reviews, peer reviews and appeals. • Supports behavioral health committees for quality compliance. • Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. • Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). • Assists with the recruitment and orientation of new psychiatric medical directors. • Ensures all behavioral health programs and policies are in line with industry standards and best practices. • Assists with new program implementation and supports for health plan in-source behavioral health services. Required Qualifications • At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. • Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice. • Board Certification in Psychiatry. • Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. • Ability to work cross-collaboratively within a highly matrixed organization. • Strong organizational and time-management skills. • Ability to multi-task and meet deadlines. • Attention to detail. • Critical-thinking and active listening skills. • Decision-making and problem-solving skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications • Experience with utilization/quality program management. • Managed care experience. • Peer review experience. • Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. #PJHS #LI-AC1 #HTF To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $186,201.39 - $363,092.71 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. - Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. - Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. - Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. - Assists in reviews of state and federal complaints related to claims. - Collaborates with other internal departments to determine appropriate resolution of claims issues. - Researches claims tracers, adjustments, and resubmissions of claims. - Adjudicates or readjudicates high volumes of claims in a timely manner. - Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. - Meets claims department quality and production standards. - Supports claims department initiatives to improve overall claims function efficiency. - Completes basic claims projects as assigned. **Required Qualifications** - At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. - Research and data analysis skills. - Organizational skills and attention to detail. -Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when available, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** This role supports negotiations with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. - Sends out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members. - Receives calls from prospective providers and answers questions regarding contracting process, policies and procedures. - Forwards requested information/documentation to prospective providers in a timely manner. - Maintains database of all contracts and specific applications sent to prospective new providers. - Completes and updates Provider Information Forms for each new contract. - Ensures accuracy and completeness of provider demographic information and coordinates communication of such information to Provider Configuration team. - Sends out new provider welcome packets to providers who have contracted with the plan. - Utilizes Plan's system to track and follow up with Providers who have not responded to Contracts and/or Applications sent as directed by management. - Formats and distributes Provider network resources (e.g. electronic specialist directory). **Job Qualifications** **REQUIRED EDUCATION** : High School Diploma or equivalent GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 1 year customer service, provider service, contracting or claims experience in the healthcare industry. **PREFERRED EDUCATION** : Associate's Degree or Bachelor's Degree in a related field or an equivalent combination of education and experience **PREFERRED EXPERIENCE** : Managed Care experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $42.2 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Responsible for providing business process redesign, communication and change management for operations. Backend operationalization of policies, standardization of system set-up and a resource for all departments and health plans company-wide. **Knowledge/Skills/Abilities** + Conduct interviews with staff and management to assess internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures and other internal guidelines. + Review, research, analyze and evaluate information to assess compliancy between a process or function and the corresponding written documentation. Use analytical skills to identify variances. Use problem solving skills and business knowledge to make recommendations for process remediation or improvement. + Summarize and document assessment outcomes and recommendations. Ensure that they are appropriately communicated (written and verbal) to process owners and management. + Collaborate with process owners to maintain and/or create business process documentation and workflows related to Core Operations functions. + Serve as liaison between Core Operations and internal and external auditors for all formal Core Operations audits that are not compliance related. + Coordinate, facilitate and document audit walkthroughs. + Research, collect or generate requested documentation. Provide timely and accurate responses, both written and verbal. + Research and respond to clarifying questions submitted by internal and external auditors. Work in partnership with other functional areas as needed.. + Ability to write SQL queries + Experience with QNXT configuration + Experience with troubleshooting and analyzing issues. + Experience working in a Medicare environment is highly preferred. + Claims adjudication experience is highly preferred. **Job Qualifications** **Required Education** Associate's Degree or two years of equivalent experience **Required Experience** - Four years proven analytical experience within an operations or process-focused environment. Additional required experience for Corporate Operations: - Analytical experience within managed care operations. - Knowledge of managed care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** Bachelor's Degree **Preferred Experience** - Six years proven analytical experience within an operations or process-focused environment. - Previous audit and/or oversight experience. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $77,969 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

This position will be responsible for supporting the execution of merger and acquisition transactions and will actively contribute in advancing Molina Healthcare's overall growth strategy. The role entails working closely with the senior members of the Corporate Development team and will actively interact with the business leaders and senior management team at Molina. The ideal candidate will have at least two years of experience as an analyst at an investment bank or similar firm. Knowledge/Skills/Abilities * Develop financial models and perform analyses to assess potential acquisition, joint venture and other business development opportunities (i.e., discounted cash flow, internal rate of return and accretion/dilution) * Prepare ad-hoc analyses and presentations to help facilitate various discussions * Research and analyze industry trends, competitive landscape and potential target companies * Coordinate deal activities among internal cross-functional teams and external parties * Coordinate due diligence and closing-related activities * Actively participate in reviewing and negotiating transaction agreements * Prepare board and senior management presentations Job Qualifications REQUIRED EDUCATION: Bachelor's degree in Accounting or Finance or related fields REQUIRED EXPERIENCE: * Minimum 5 years' experience in financial modeling and analysis * Ability to synthesize complex ideas and translate into actionable information * Strong analytical and modeling skills * Excellent verbal and written communication skills * Highly collaborative and team-oriented with a positive, can-do attitude * Ability to multi-task, set priorities and adhere to deadlines in a high-paced organization PREFERRED EXPERIENCE: * Prior analyst experience in investment banking strongly preferred * Healthcare industry experience preferred PHYSICAL DEMANDS: Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #PJCorp #LI-AC1 Pay Range: $80,412 - $156,803 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

"A Day in the Life" video (***************************** **Opportunities with Genoa Healthcare.** A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start **Caring. Connecting. Growing together.** We seek a **Pharmacy Technician** to support all functions of the Genoa mental health and specialty pharmacy primarily through dispensing medical prescriptions and performing necessary clerical duties while under the direct supervision of a registered pharmacist. **Schedule** : Monday - Friday 8:30am - 5pm (Lunch 12:30pm - 1pm) **Location:** 13917 Gold Circle, Suite P, Omaha, NE, 68144 **Primary Responsibilities:** + Provides exceptional customer service to all consumers and members of the clinic staff + Fills prescription orders and makes them available for verification under direct supervision of the registered pharmacist + Orders, receives and stores incoming pharmacy supplies + Receives and processes wholesaler medication orders + Verifies medication stock and enters data in computer to maintain inventory records + Works with the Pharmacist to assist in the pharmacy functions and keeping the pharmacy in compliance with all federal and state requirements + Performs various clerical duties relating to the department + Communicates with strong professional verbal and written communication skills + Other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Active and unrestricted Pharmacy Technician license in the state of Nebraska + Access to reliable transportation **Preferred Qualifications:** + National Pharmacy Technician Certification + 6+ months of Pharmacy Technician experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #RED

**Capstone Behavioral Health, part of the Optum family of businesses, is seeking a Drug Testing Specialist to join our team in Omaha, NE. Optum is a clinician-led care organization that is changing the way clinicians work and live.** **As a member of the Optum Behavioral Care Team, you'll be an integral part of our vision to make healthcare better for everyone.** **Explore opportunities at Optum Behavioral Care** . We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while **Caring. Connecting. Growing together.** The Drug Testing Specialist will have face-to-face contact with a client to perform specimen collection. Will help prepare and send collected specimens for lab confirmation. Drug Testing Specialist will follow all guidelines and reporting requirements established by the Department of Health and Human Services. **Primary Responsibilities:** + Perform drug testing specimen collection and handle all specimens in accordance with instructions and training provided + Engage clients in healthy conversation around abstinence and provide encouragement, positive reinforcement, and ongoing support + Attend and participate in team meetings + Complete required trainings as assigned by supervisor + Complete reporting requirements including documentation of each service provided, travel logs and monthly reports as requested by supervisor to ensure timely billing + Maintain a caseload of clients as agreed upon with supervisor + Provide written and/or oral communication with referral sources on a consistent basis + Turning in billing on a weekly basis to their direct supervisor by midnight on Sunday + Monitor caseload authorizations and coordinate with case manager for necessary update + Contacting assigned client within 24 hours of supervisor assignment + Scheduling sessions to meet the needs of the family/client + Complete documentation within 24 hours of service + Notify caseworker regarding the attempted drug test on client within 24 hours You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma/GED + Reliable vehicle and proof of liability insurance + Valid Driver's License in good standing **Preferred Qualification:** + Experience working with DHHS, criminal justice, and/or individuals with substance use issues Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $24.23 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient, by improving the quality of the physicians' clinical documentation. Exhibits a sufficient knowledge of clinical documentation requirements, MS-DRG Assignment, and clinical conditions and/or procedures. Educates members of the patient care team regarding documentation guidelines, including the following: attending physicians, allied health practitioners, nursing, and case management. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. 1. Record Review: * Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified patient population to: (a) evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) record in business partner designated CDI tool and/or host medical record system. * Conducts follow-up reviews of patients every 24-48 hours or as needed up through discharge to support assigned working MS-DRG assignment upon patient discharge, as necessary. * Formulate physician queries regarding missing, unclear, or conflicting health record documentation by requesting and obtaining additional documentation within the health record, as necessary. * Collaborates with providers, case managers, nursing staff and other ancillary staff regarding documentation and to resolve physician queries prior to discharge. 2.CDI * Communicates/Completes Clinical Documentation Integrity (CDI) activities and coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up, provider education and DRG Miss-Match reconciliation. * Assists with Provider education, rounding and communication regarding open queries for resolution. 3. Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD10-CM and PCS coding. Attends CDI Boot camp, CDI/coding trainings annually and quarterly for inpatient coding. Attends monthly education lecture series (MELS) and all CDI/coding assigned learn share modules as well as any additional required CDI education. 4. Assist in training department staff new to CDI 5. Performs other duties as assigned KNOWLEDGE, SKILLS, ABILITIES 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. * CDI Specialist must display teamwork and commitment while performing daily duties * Must demonstrate initiative and discipline in time management and medical record review. * Travel may be required to meet the needs of the facilities. * Proficient knowledge of disease pathophysiology and drug utilization * Intermediate knowledge of MS-DRG classification and reimbursement structures * Critical thinking, problem solving and deductive reasoning skills. * Effective written and verbal communication skills * Excellent computer skills including MS Word/Excel * Knowledge of coding compliance and regulatory standards * Excellent organizational skills for initiation and maintenance of efficient workflow * Regular and reliable attendance * Capacity to work independently in facility on-site setting. * Capacity to work independently in a virtual office setting if required for specific assignment. * Exhibit flexibility as needed to meet program needs. * Understand and communicate documentation strategies. * Recognize opportunities for documentation improvement. * Formulate clinically, compliant credible queries. * Ability to successfully comply to robust auditing and CDI program monitoring * Ability to apply coding conventions, official guidelines, and Coding Clinic advice to health record documentation. 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. * Preferred: Acute Care nursing and/or Provider relevant experience * Zero (0) to two (2) years CDI experience * Two (2) plus years' nursing experience - Medical/Surgical/Intensive Care and/or Case/Utilization Review * Two (2) plus years' Provider experience - Medical/Surgical/Intensive Care and/or Case/Utilization Review * Graduate from a Nursing program, BSN, or graduate program; OR * Graduate from Medical Doctor and/or Foreign Medical Doctor Program CERTIFICATES, LICENSES, REGISTRATIONS * Active state Registered Nurse license; OR * Graduate MD and/or FMD license * Preferred: CDIP or CCDS 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. * Ability to sit for extended periods of time. * Ability to stand for extended periods of time. * Must be able to efficiently use computer keyboard and mouse. * Good visual acuity 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. OTHER * Must be able to travel as needed, not to exceed 10%. 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. **********

The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems. **Knowledge/Skills/Abilities** + Facilitates the resolution of claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. + This role is involved in member enrollment, provider information management, benefits configuration and/or claims processing. + Responds to incoming calls from providers regarding claims inquiries and provides excellent customer service; documents calls and interactions. + Assists in the reviews of state or federal complaints related to claims. + Supports the other team members with several internal departments to determine appropriate resolution of issues. + Researches tracers, adjustments, and re-submissions of claims. + Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards. + Manages defect reduction by supporting the identifying and communicating error issues and potential solutions to management. + Handles special projects as assigned. + Other duties as assigned. Knowledgeable in systems utilized: + QNXT + Pega + Verint + Kronos + Microsoft Teams + Video Conferencing + Others as required by line of business or state **Job Function** Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating Molina values in their actions. Responsible for effectively managing and documenting calls and responding to providers regarding issues with claims and inquiries. Handles escalated inquiries, complex provider claims payments, records, and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. **Job Qualifications** **REQUIRED EDUCATION:** Associate's Degree or equivalent combination of education and experience; **REQUIRED EXPERIENCE:** 2-3 years customer service, claims, provider and investigation/research experience. Outcome focused and knowledge of multiple systems. 1+ years of claims research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry **PREFERRED EDUCATION:** Bachelor's Degree or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 4 years **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when available, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** This role supports negotiations with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. - Sends out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members. - Receives calls from prospective providers and answers questions regarding contracting process, policies and procedures. - Forwards requested information/documentation to prospective providers in a timely manner. - Maintains database of all contracts and specific applications sent to prospective new providers. - Completes and updates Provider Information Forms for each new contract. - Ensures accuracy and completeness of provider demographic information and coordinates communication of such information to Provider Configuration team. - Sends out new provider welcome packets to providers who have contracted with the plan. - Utilizes Plan's system to track and follow up with Providers who have not responded to Contracts and/or Applications sent as directed by management. - Formats and distributes Provider network resources (e.g. electronic specialist directory). **Job Qualifications** **REQUIRED EDUCATION** : High School Diploma or equivalent GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 1 year customer service, provider service, contracting or claims experience in the healthcare industry. **PREFERRED EDUCATION** : Associate's Degree or Bachelor's Degree in a related field or an equivalent combination of education and experience **PREFERRED EXPERIENCE** : Managed Care experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $42.2 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryLeads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc. - Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes. - Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance. - Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement. - Assists in the development and implementation of internal desktop processes and procedures. - Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers. Required Qualifications- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience. - Strong analytic and problem-solving abilities. - Strong organizational and time-management skills. - Ability to multi-task and meet project deadlines. - Attention to detail. - Ability to build relationships and collaborate cross-functionally. - Excellent verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Supervisory/leadership experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $77,969 - $106,214 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. • Facilitates behavioral health-related regional medical necessity reviews and cross coverage. • Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. • Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. • Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. • Provides second level behavioral health clinical reviews, peer reviews and appeals. • Supports behavioral health committees for quality compliance. • Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. • Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). • Assists with the recruitment and orientation of new psychiatric medical directors. • Ensures all behavioral health programs and policies are in line with industry standards and best practices. • Assists with new program implementation and supports for health plan in-source behavioral health services. Required Qualifications • At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. • Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice. • Board Certification in Psychiatry. • Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. • Ability to work cross-collaboratively within a highly matrixed organization. • Strong organizational and time-management skills. • Ability to multi-task and meet deadlines. • Attention to detail. • Critical-thinking and active listening skills. • Decision-making and problem-solving skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications • Experience with utilization/quality program management. • Managed care experience. • Peer review experience. • Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. #PJHS #LI-AC1 #HTF To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $186,201.39 - $363,092.71 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Responsible for providing business process redesign, communication and change management for operations. Backend operationalization of policies, standardization of system set-up and a resource for all departments and health plans company-wide. **Knowledge/Skills/Abilities** + Conduct interviews with staff and management to assess internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures and other internal guidelines. + Review, research, analyze and evaluate information to assess compliancy between a process or function and the corresponding written documentation. Use analytical skills to identify variances. Use problem solving skills and business knowledge to make recommendations for process remediation or improvement. + Summarize and document assessment outcomes and recommendations. Ensure that they are appropriately communicated (written and verbal) to process owners and management. + Collaborate with process owners to maintain and/or create business process documentation and workflows related to Core Operations functions. + Serve as liaison between Core Operations and internal and external auditors for all formal Core Operations audits that are not compliance related. + Coordinate, facilitate and document audit walkthroughs. + Research, collect or generate requested documentation. Provide timely and accurate responses, both written and verbal. + Research and respond to clarifying questions submitted by internal and external auditors. Work in partnership with other functional areas as needed.. + Ability to write SQL queries + Experience with QNXT configuration + Experience with troubleshooting and analyzing issues. + Experience working in a Medicare environment is highly preferred. + Claims adjudication experience is highly preferred. **Job Qualifications** **Required Education** Associate's Degree or two years of equivalent experience **Required Experience** - Four years proven analytical experience within an operations or process-focused environment. Additional required experience for Corporate Operations: - Analytical experience within managed care operations. - Knowledge of managed care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** Bachelor's Degree **Preferred Experience** - Six years proven analytical experience within an operations or process-focused environment. - Previous audit and/or oversight experience. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $77,969 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

This position will be responsible for supporting the execution of merger and acquisition transactions and will actively contribute in advancing Molina Healthcare's overall growth strategy. The role entails working closely with the senior members of the Corporate Development team and will actively interact with the business leaders and senior management team at Molina. The ideal candidate will have at least two years of experience as an analyst at an investment bank or similar firm. Knowledge/Skills/Abilities * Develop financial models and perform analyses to assess potential acquisition, joint venture and other business development opportunities (i.e., discounted cash flow, internal rate of return and accretion/dilution) * Prepare ad-hoc analyses and presentations to help facilitate various discussions * Research and analyze industry trends, competitive landscape and potential target companies * Coordinate deal activities among internal cross-functional teams and external parties * Coordinate due diligence and closing-related activities * Actively participate in reviewing and negotiating transaction agreements * Prepare board and senior management presentations Job Qualifications REQUIRED EDUCATION: Bachelor's degree in Accounting or Finance or related fields REQUIRED EXPERIENCE: * Minimum 5 years' experience in financial modeling and analysis * Ability to synthesize complex ideas and translate into actionable information * Strong analytical and modeling skills * Excellent verbal and written communication skills * Highly collaborative and team-oriented with a positive, can-do attitude * Ability to multi-task, set priorities and adhere to deadlines in a high-paced organization PREFERRED EXPERIENCE: * Prior analyst experience in investment banking strongly preferred * Healthcare industry experience preferred PHYSICAL DEMANDS: Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #PJCorp #LI-AC1 Pay Range: $80,412 - $156,803 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

"A Day in the Life" video Opportunities with Genoa Healthcare. A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together. We seek a Pharmacy Technician to support all functions of the Genoa mental health and specialty pharmacy primarily through dispensing medical prescriptions and performing necessary clerical duties while under the direct supervision of a registered pharmacist. Schedule: Monday - Friday 8:30am - 5pm (Lunch 12:30pm - 1pm) Location: 13917 Gold Circle, Suite P, Omaha, NE, 68144 Primary Responsibilities: * Provides exceptional customer service to all consumers and members of the clinic staff * Fills prescription orders and makes them available for verification under direct supervision of the registered pharmacist * Orders, receives and stores incoming pharmacy supplies * Receives and processes wholesaler medication orders * Verifies medication stock and enters data in computer to maintain inventory records * Works with the Pharmacist to assist in the pharmacy functions and keeping the pharmacy in compliance with all federal and state requirements * Performs various clerical duties relating to the department * Communicates with strong professional verbal and written communication skills * Other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Active and unrestricted Pharmacy Technician license in the state of Nebraska * Access to reliable transportation Preferred Qualifications: * National Pharmacy Technician Certification * 6+ months of Pharmacy Technician experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #RED

Capstone Behavioral Health, part of the Optum family of businesses, is seeking a Drug Testing Specialist to join our team in Omaha, NE. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Behavioral Care Team, you'll be an integral part of our vision to make healthcare better for everyone. Explore opportunities at Optum Behavioral Care. We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together. The Drug Testing Specialist will have face-to-face contact with a client to perform specimen collection. Will help prepare and send collected specimens for lab confirmation. Drug Testing Specialist will follow all guidelines and reporting requirements established by the Department of Health and Human Services. Primary Responsibilities: * Perform drug testing specimen collection and handle all specimens in accordance with instructions and training provided * Engage clients in healthy conversation around abstinence and provide encouragement, positive reinforcement, and ongoing support * Attend and participate in team meetings * Complete required trainings as assigned by supervisor * Complete reporting requirements including documentation of each service provided, travel logs and monthly reports as requested by supervisor to ensure timely billing * Maintain a caseload of clients as agreed upon with supervisor * Provide written and/or oral communication with referral sources on a consistent basis * Turning in billing on a weekly basis to their direct supervisor by midnight on Sunday * Monitor caseload authorizations and coordinate with case manager for necessary update * Contacting assigned client within 24 hours of supervisor assignment * Scheduling sessions to meet the needs of the family/client * Complete documentation within 24 hours of service * Notify caseworker regarding the attempted drug test on client within 24 hours You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * High School Diploma/GED * Reliable vehicle and proof of liability insurance * Valid Driver's License in good standing Preferred Qualification: * Experience working with DHHS, criminal justice, and/or individuals with substance use issues Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $24.23 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Responsible for duties in support of departmental efficiencies which may include: but not limited to performing scheduling, registration, patient pre-admission and admission, reception and discharge functions. Must obtain complete and accurate patient demographic information. Patient Access representatives also must employ proper, compliant patient liability collection techniques before, during & after date of service. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Greeting patients following Conifer Standards of Care, provides world-class customer service, completes full patient registration at date of service, adheres to financial & cash control policies & procedures, thoroughly explains and secures Hospital & patient legal forms (i.e., Advance Directives, Conditions of services, Consent for treatment, Important Message from Medicare, EMTALA, etc.). Scan Protected Health Information, create and file patient information packets/folders for upcoming Hospital services. May also assist with scheduling diagnostic procedures (enters data in scheduling system, provide customer with appointment instructions, other tasks as needed). * Educates patients about patient financial liabilities, employs proper, compliant patient liability collection techniques before, during & after date of service, performs Hospital cash reconciliation & secured payment entry in adherence to financial & cash control policies & procedures. * Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors. May also assist with scheduling and coordinating post discharge care for patients. KNOWLEDGE, SKILLS, ABILITIES 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. * Minimum typing skills of 35 wpm * Demonstrated working knowledge of PC/CRT/printer * Knowledge of function and relationships within a hospital environment preferred * Customer service skills and experience * Ability to work in a fast paced environment * Ability to receive and express detailed information through oral and written communications * Understanding of Third Party Payor requirements preferred * Understanding of Compliance standards preferred * Must be able to perform essential job duties in at least two Patient Access service areas including Emergency Department. * Uses proper negotiation techniques to professionally collect money owed by our Patients/Guarantors. * Builds and maintains collaborative relationships with both internal and external Clients that lead to more effective communication and a higher level of productivity and accuracy. * Must be able to appropriately interpret physician orders, medical terminology and insurance cards while maintaining Conifer Standards of Care. 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 preferred to perform the job. * High School Diploma or GED required. * 0 - 1 year in a Customer Service role. * 0 - 1 year administrative experience in medical facility, health insurance, or related area preferred * Some college coursework is preferred 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. * Must be able to sit at computer terminal for extended periods of time. * Resolves Physician's office and Patient issues. May experience extreme patient volumes and uncooperative Patients. * Occasionally lift/carry items weighing up to 25 lbs. * Frequent prolonged standing, sitting, and walking. * Occasionally push a wheelchair to assist patients with mobility problems. 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. * Hospital administration * Can work in patient care locations which include potential exposure to life-threatening patient conditions. OTHER * Must be available to work hours and days as needed based on departmental/system demands. 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. **********

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when available, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** This role supports negotiations with assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. - Sends out contracts/applications to prospective providers upon request of Director or Manager and/or Provider Contracting and/or Provider Relations team members. - Receives calls from prospective providers and answers questions regarding contracting process, policies and procedures. - Forwards requested information/documentation to prospective providers in a timely manner. - Maintains database of all contracts and specific applications sent to prospective new providers. - Completes and updates Provider Information Forms for each new contract. - Ensures accuracy and completeness of provider demographic information and coordinates communication of such information to Provider Configuration team. - Sends out new provider welcome packets to providers who have contracted with the plan. - Utilizes Plan's system to track and follow up with Providers who have not responded to Contracts and/or Applications sent as directed by management. - Formats and distributes Provider network resources (e.g. electronic specialist directory). **Job Qualifications** **REQUIRED EDUCATION** : High School Diploma or equivalent GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : 1 year customer service, provider service, contracting or claims experience in the healthcare industry. **PREFERRED EDUCATION** : Associate's Degree or Bachelor's Degree in a related field or an equivalent combination of education and experience **PREFERRED EXPERIENCE** : Managed Care experience To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $42.2 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.