35 Health Care jobs

Job description We have a great opportunity for an  Analyst, Actuary!  The ideal candidate is responsible for leading the  actuarial analysis  of existing and new commercial integrated kidney care programs. Specifically, this teammate will review and model medical claims and membership data received from external partners. Duties also include applying predictive models, researching health care industry trends, and developing executive-level presentations. Essential Function : Complete program financial and membership reconciliations and monitor developing program experience Analyze drivers of program performance and communicate results to leadership team and internal stakeholders Apply actuarial underwriting principles to value-based contracting efforts, including baseline and trend calculations Create internal performance benchmarks and assist in actuarial process and capability development. Other duties as assigned....

Job description   Job Summary: Manages 24-hour departments providing patient care services. Ensures staff provide high quality, accessible, cost effective care, and patient focused services to members across the continuum, which comply with local, state, and federal requirements. Develops and maintains clinical standards of care and practice; responsible for all resource budgeting, selection and development. Essential Responsibilities: Manages the operations of 24-hour departments that may be at multiple locations. Ensures Assistants and staff provide the highest quality of care and are in compliance with the Nursing Practice Act, The Joint Commission, federal, state, and local requirements. Establishes, implements, and maintains patient care and service standards to meet members and internal clients expectations. Designs and evaluates processes to improve systems and patient care results across the continuum of care. Develops and...

Job description   Responsible for the home health, hospice, and bereavement social services programs. Provides fiscal management, designs and provides training, and monitors the on-going volunteer activities.   Essential Functions: • Consults and provides resource to designated interdisciplinary team members to maximize patient care outcomes and resource utilization. • Ensures compliance with federal, state, and local regulations. • Provides supervisory oversight regarding skills development, individual competency, capability and positive outcome participation as a team member in the development of integrated care plans, focusing on collaboration, and results oriented implementation functions. • Manages staff to meet administrative expectations in the areas of standards of practice, policies and procedures, annual departmental goals and objectives, quality improvement, and licensure and accreditation. • Designs,...

Job description   Job Summary: Manages 24-hour departments providing patient care services. Ensures staff provide high quality, accessible, cost effective care, and patient focused services to members across the continuum, which comply with local, state, and federal requirements. Develops and maintains clinical standards of care and practice; responsible for all resource budgeting, selection and development. Essential Responsibilities: Manages the operations of 24-hour departments that may be at multiple locations. Ensures Assistants and staff provide the highest quality of care and are in compliance with the Nursing Practice Act, The Joint Commission, federal, state, and local requirements. Establishes, implements, and maintains patient care and service standards to meet members and internal clients expectations. Designs and evaluates processes to improve systems and patient care results across the continuum of care. Develops and monitors...

Job description Job Summary: Manages staff in providing delivery of high quality, patient-focused, and cost-effective pulmonary care services in a widely diverse culture across the CSA. Accountable for service area and across the continuum of care. Ensures compliance with federal, state, and local regulations. Essential Responsibilities: Develops, implements, and monitors quality of CSA pulmonary standards across the continuum of care. Ensures all programs support the organizations goals and strategic plans. Coordinates plans of treatment, customer focused delivery of services, and cost effective utilization of services. Ensures all patient care is in compliance with administrative, legal, and regulatory requirements and follows established policies and procedures. Works with other health care providers to develop, implement, and provide efficient pulmonary care services and outcomes. Reviews best practice models including systems development and cost...

Job description   Job Summary: For one large unit or more than one smaller unit within a 24 hour department, supervises the implementation, delivery and evaluation/improvement of quality patient care/nursing operations and services that add value and are integrated with nursing standards of practice, service priorities and performance/outcomes measures, as well as with departmental, business and organizational goals/objectives. Essential Responsibilities: Supervises the delivery of nursing services and patient care within one unit(s) which are integrated with business and department plans and meet or exceed cost, quality, clinical and utilization standards and performance measures. Ensures that unit(s) services meet members, physician and internal clients needs in a changing, competitive health care market. Supervises a single unit (8 to 24 hours) of approximately 20 or more employees or more than one smaller unit. Ensures patient care and...

Job description   Job Summary: Manages the delivery of nursing services and safe patient care within assigned department and across the continuum of care. Manages the delivery of services that add value and are integrated with nursing standards of practice, service priorities and performance/outcome measures, as well as with strategic, business and organizational goals/objectives. Essential Responsibilities: Manages on a 24 hour basis the delivery of nursing services and safe patient care which meet or exceed cost, quality, and clinical and utilization standards and performance measures. Establishes, implements, and maintains patient care and service standards to meet members and internal clients expectations and needs in a changing, competitive health care market.  Holds staff accountable in providing the highest quality of care while in compliance with the Nursing Practice Act, TJC, federal, state, and local requirements. Works with...

Job description At us, we find that our best leaders are those who create an inspiring vision for the future and empower their team to achieve success. They have always enjoyed tackling difficult problems and believe that the best way to solve them is through collaborative, team efforts. They take ownership of results and instill accountability in those they lead. They are driven, strong communicators, relationship builders, and find real fulfillment in challenging work. Sound like you? Then you might be a great fit for Senior Analyst, Compliance (Clinical Documentation and Billing Investigations) with us.     Here’s what you can expect as a Compliance Senior Analyst at us: This position reports to the Manager, Corp Compliance overseeing Clinical Documentation and Billing Investigations and will apply their experience with investigations, audits, and/or consulting projects to identify and evaluate compliance and regulatory risks associated with...

Job description Job Summary: In collaboration with the clinical lead, provides analytical support and coordinates quality management and performance improvement processes related to quality assessment; performance improvement; clinical documentation review; risk management; infection prevention and control; patient safety; and/or accreditation, regulation and licensing. Under the guidance of a program director or manager, responsible for collecting and researching data, performing data analysis, providing recommendations on data collection/reporting and presenting results. Essential Responsibilities: Partners with clinical quality service lines to identify issues within operations for focus improvement efforts.  Supports workgroups or committees (e.g. peer review). Prepares meeting materials including agendas and minutes; coordinates conference room logistics; monitors and follows up with action plans). In collaboration with the clinical lead,...

Job description     Job Summary: Provide emergency and routine mental health psychotherapy services to consumers, including assessment and treatment. Provide clinical consultation within and outside the Behavioral Health Services Clinic. May participate in the training and clinical supervision of psychotherapy interns. Essential Responsibilities: Assess clinical needs of consumers calling in crisis, determine appropriate crisis intervention, and provide consultation and referral as necessary. Able to conduct psychosocial assessment, Mental Status Exam, identify chemical dependency and other special / high-risk issues. Utilizing clinical assessment information, formulate a 5 axis DSM IV diagnosis. Assess client needs and issues for focus, determine appropriate level of care, provide consultation / referral, coordinate care between providers and coordination of treatment planning. Work with client to develop realistic, measurable treatment...

Job description Job Summary: Manages staff in providing delivery of high quality, patient-focused, and cost-effective pulmonary care services in a widely diverse culture across the CSA. Accountable for service area and across the continuum of care. Ensures compliance with federal, state, and local regulations. Essential Responsibilities: Develops, implements, and monitors quality of CSA pulmonary standards across the continuum of care. Ensures all programs support the organizations goals and strategic plans. Coordinates plans of treatment, customer focused delivery of services, and cost effective utilization of services. Ensures all patient care is in compliance with administrative, legal, and regulatory requirements and follows established policies and procedures. Works with other health care providers to develop, implement, and provide efficient pulmonary care services and outcomes. Reviews best practice models including systems development and cost...

Job description Job Summary: Manages staff in providing delivery of high quality, patient-focused, and cost-effective pulmonary care services in a widely diverse culture across the CSA. Accountable for service area and across the continuum of care. Ensures compliance with federal, state, and local regulations. Essential Responsibilities: Develops, implements, and monitors quality of CSA pulmonary standards across the continuum of care. Ensures all programs support the organizations goals and strategic plans. Coordinates plans of treatment, customer focused delivery of services, and cost effective utilization of services. Ensures all patient care is in compliance with administrative, legal, and regulatory requirements and follows established policies and procedures. Works with other health care providers to develop, implement, and provide efficient pulmonary care services and outcomes. Reviews best practice models including systems development and cost...

Job description   Job Summary: For one large unit or more than one smaller unit within a 24 hour department, supervises the implementation, delivery and evaluation/improvement of quality patient care/nursing operations and services that add value and are integrated with nursing standards of practice, service priorities and performance/outcomes measures, as well as with departmental, business and organizational goals/objectives. Essential Responsibilities: Supervises the delivery of nursing services and patient care within one unit(s) which are integrated with business and department plans and meet or exceed cost, quality, clinical and utilization standards and performance measures. Ensures that unit(s) services meet members, physician and internal clients needs in a changing, competitive health care market. Supervises a single unit (8 to 24 hours) of approximately 20 or more employees or more than one smaller unit. Ensures patient care and...

Job description We are seeking a Compliance Investigator, responsible for conducting investigations on compliance related matters submitted through our compliance hotline or other reporting avenues.  Investigations include potential compliance policy or federal healthcare law-related matters, including Anti-Kickback Statute, False Claims Act, and other laws and regulations related to healthcare compliance. The Compliance Investigator will coordinate with our other departments, including legal and human resources, to handle all aspects of investigations, including gathering relevant documentation, conducting interviews, documenting investigations, and recommending corrective action as necessary.   SUPERVISORY RESPONSIBILITIES: None   ESSENTIAL DUTIES AND RESPONSIBILITIES: Conduct compliance investigations across business areas.  Investigations process may include research, data analysis, process analysis, interviews, follow-up,...

Job description Job Summary:   Manages the delivery of nursing services and safe patient care within assigned department and across the continuum of care. Manages the delivery of services that add value and are integrated with nursing standards of practice, service priorities and performance/outcome measures, as well as with strategic, business and organizational goals/objectives.    Essential Responsibilities: Manages on a 24 hour basis the delivery of nursing services and safe patient care which meet or exceed cost, quality, and clinical and utilization standards and performance measures. Establishes, implements, and maintains patient care and service standards to meet members' and internal clients' expectations and needs in a changing, competitive health care market.  Holds staff accountable in providing the highest quality of care while in compliance with the Nursing Practice Act, TJC, federal, state, and local requirements....

Job description   Job Summary: Manages the delivery of nursing services and safe patient care within assigned department and across the continuum of care. Manages the delivery of services that add value and are integrated with nursing standards of practice, service priorities and performance/outcome measures, as well as with strategic, business and organizational goals/objectives. Essential Responsibilities: Manages on a 24 hour basis the delivery of nursing services and safe patient care which meet or exceed cost, quality, and clinical and utilization standards and performance measures. Establishes, implements, and maintains patient care and service standards to meet members and internal clients expectations and needs in a changing, competitive health care market.  Holds staff accountable in providing the highest quality of care while in compliance with the Nursing Practice Act, TJC, federal, state, and local requirements. Works with...

Job description Job Summary:   Manages the delivery of nursing services and safe patient care within assigned department and across the continuum of care. Manages the delivery of services that add value and are integrated with nursing standards of practice, service priorities and performance/outcome measures, as well as with strategic, business and organizational goals/objectives.    Essential Responsibilities: Manages on a 24 hour basis the delivery of nursing services and safe patient care which meet or exceed cost, quality, and clinical and utilization standards and performance measures. Establishes, implements, and maintains patient care and service standards to meet members' and internal clients' expectations and needs in a changing, competitive health care market.  Holds staff accountable in providing the highest quality of care while in compliance with the Nursing Practice Act, TJC, federal, state, and local requirements....

Job description   Manages activities of the unit(s), monitors quality, service and utilization standards. Supervises the day to day shift activities. Essential Responsibilities: Manages the units day to day clinical operations including practice standards, staffing, payroll, budgets, fiscal management, and quality improvement.  Ensures the highest quality of care is provided and is in compliance with federal, state, and local regulatory requirements and established departmental policies and procedures. Develops and implements action plans to improve staff development. Supervises a single unit (8 to 24 hours) of approximately 20 - 60+ employees. Monitors the allocation and utilization of personnel based on continual changes in patient population/needs and provides the best level of patient care while identifying savings opportunities. Supervises the daily unit operations, including human resources management, department and employee...

Job description Job Summary: Accountable for management of a patient care unit 20-bed Level 3 NICU under the direction of the Director of Maternal Child Women's Health. Partners with healthcare team to assure quality patient/family centered care. Essential Responsibilities: Communication: Uses established channels of communication to share information, receive feedback and report problems. Communicates plans and decisions to staff and providers to facilitate linkages and flow of information to others. Builds credibility with physicians as a champion for patient care, quality, and nursing professionalism. Effectively facilitates consensus building to accomplish goals and objectives. Provides constructive feedback and effectively manages conflict. Creates and articulates a shared vision and goals. Follows up on feedback and reports problems as well as positive comments. Creates an environment which recognizes and values differences in staff, physicians,...

Job description Job Summary: In collaboration with Anesthesia and Surgical Services (SAS) management team, participates in developing, planning, implementing of departmental goals and objectives. Assess, plans, implements, evaluates and ensures optimal patient care is delivered to surgical patients according to established standards of care provided during all operative phases of process. Provides and supports functional direction through effective leadership and Quality Improvement principles to insure quality patient care and employee satisfaction. Plans, directs, and supervises daily operational activities of assigned staff in Operating Rooms. Serves as a liaison between supervisors, physicians, nursing personnel, patients/families and other departments to direct smooth transitions of patient care activities during perioperative experience. Coordinates departmental activities to ensure optimum patient care. Directs flow of Surgical Schedule. Supervises assigned...