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Grievance &amp; Appeals Nurse Specialist CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Grievance &amp; Appeals Nurse Specialist and help shape the future of healthcare where you'll be an integral part of our Grievance &amp; Appeals team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Full Telework. 
<ul>
<li> If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum. </li>
</ul>
 You will participate in managing CalOptima Health's medical appeals and state hearing reviews for all lines of business, including handling expedited and standard requests. You will ensure appeals and state hearing requests are processed in accordance with regulations, compliance standards and policies and procedures. You will investigate and prepare case narratives and statements of position based on clinical information, benefits and applicable regulations related to member or provider disputes of decisions. You will clearly articulate the facts and CalOptima Health's position regarding disputes to the Administrative Law Judge hearing the case. You will be responsible for creating and reviewing resolution letters for appropriateness of clinical criteria and regulatory requirements. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>80% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Prepares clinical reviews based on clinical guidelines and provides monitoring of cases involving medical decisions and quality of care or service decisions.</li>
<li>Ensures all cases are completed in accordance with state and federal regulatory requirements including timelines.</li>
<li>Presents recommendations based on clinical review, criteria and organizational policies to CalOptima Health's physician reviewers for final determination.</li>
<li>Resolves complex and sensitive member issues within established timelines.</li>
<li>Maintains departmental database and the integrity of records by accurately entering case actions to assigned cases.</li>
<li>Analyzes and reports cases through GARS' subcommittee.</li>
<li>Oversees state hearing cases.</li>
<li>Assists with the notification process to members or providers on the clinical decision issued.</li>
<li>Discusses appeal process, medical decisions and hearing rights with members.</li>
<li>Assists members in coordinating their services with providers and communicates the status and outcome to members.</li>
<li>Assigns position statements and represents CalOptima Health at state hearings. </li>
</ul>
</li>
<li>15% - Administrative Support
<ul>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Participates in departmental meetings, trainings and audits as requested. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>High school diploma required PLUS 5 years of health care/managed care experience required, preferably in the following related areas of responsibility: grievances and appeals, utilization management and/or quality management; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Current unrestricted Registered Nurse (RN) license to practice in the state of California. </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese).</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>Current unrestricted Licensed Vocational Nurse (LVN) license to practice in the state of California.</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 313 - $90,820 - $145,312 ($43.66 - $69.8615). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6827312&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is January 13, 2026 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6827312" target="_blank">https://jobs.caloptima.org/jobs/grievance-appeals-nurse-specialist-505-city-parkway-west-california-united-states-15e815c2-3fcd-4db0-a51e-8078f72ffc27</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-6b482c6ee7f7164a8ac6b7e408651c04

Grievance & Appeals Nurse Specialist

Program Manager (Provider Data Operations) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Program Manager (Provider Data Operations) and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will be responsible for facilitating the planning, design and implementation of programs and initiatives that impact the teams within the Provider Data Operations department. You will review and analyze regulatory and operational requirements and be responsible for full cycle implementation. You will develop a framework for execution, ensuring that programs are aligned with the organization's larger strategy, executed according to requirements and meet the needs of the department. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Coordinates the planning, implementation and management of department initiatives and activities and works collaboratively with impacted business departments.</li>
<li>Acts as a liaison and works with the Regulatory Affairs and Compliance department to analyze, track, implement and ensure delivery of regulatory requirements impacting the Provider Data Operations functional areas.</li>
<li>Facilitates end-to-end implementation of regulatory, operational and technical requirement and ensures timelines and deliverables are fulfilled in cooperation with internal teams, third party vendors and health networks.</li>
<li>Conducts data quality checks, validates processes against requirements and identifies risks, gaps and resolutions.</li>
<li>Completes statement of work and work breakdown structure for projects and business plans for all lines of business.</li>
<li>Collaborates with other department analysts in the development of program measures of success and outcome reports for programs.</li>
<li>Creates and maintains thorough documentation, including policies and procedures, standard operating procedures (SOPs), job aids and training materials, following best practices for retention and accessibility.</li>
<li>Provides analytical support and technical expertise on requests for information from management and other staff regarding provider-related issues and trends.</li>
<li>Supports management and leadership by analyzing strategic options and providing data-driven recommendations.</li>
<li>Stays current on the local, state and federal health care environment to identify public policy and market trends that may impact CalOptima Health's provider programs and/or mission. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree in a health-related field PLUS 3 years of experience in program development, including strategic planning for a start-up program and implementing the program required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>3 years of experience working in a health plan or independent physician association (IPA)/medical group required. </li>
<li>2 years of experience working with data and reports required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Master's degree in health administration or related field. </li>
<li>Project management certificate. 
<ul>
<li>Project management experience. </li>
</ul>
</li>
<li>Experience working with provider network operations. </li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>n/a</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 311 - $77,863 - $124,581 ($37.43 - $59.8947). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6823996&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 23, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6823996" target="_blank">https://jobs.caloptima.org/jobs/program-manager-provider-data-operations-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-a2d05cb76b92f84a8e51e3822f450ba8

Program Manager (Provider Data Operations)

Regulatory and Contract Compliance Specialist (Contracts Specialist Sr) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Regulatory and Contract Compliance Specialist (Contracts Specialist Sr) and help shape the future of healthcare where you'll be an integral part of our Contracting team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Partial Telework. 
<ul>
<li> If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum. </li>
</ul>
 You will support the development, implementation and ongoing monitoring of the Contracting department's regulatory compliance activities and ensure department policy and procedure updates. You will be responsible for analyzing and interpreting regulatory requirements issued by the Centers for Medicare and Medicaid Services (CMS) and Department of Healthcare Services (DHCS).You will monitor policy updates, DHCS All Plan Letters (APLs) and other regulatory guidance to assess operational impacts. You will recommend appropriate actions to Contracting leadership and support implementation activities to ensure full compliance within the department's policies, procedures, workflows and provider contract templates. You will track department activities and complete required documentation to demonstrate compliance and obtain necessary approvals from the Regulatory Affairs Compliance (RAC) department. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Interacts with staff and leadership to analyze, identify and make recommendations to the Contracting department's policies, procedures and processes pursuant to obligations imposed by CMS, DHCS or other regulatory agencies.</li>
<li>Collaborates with the RAC department to implement regulatory requirements, update policies and procedures, and coordinate department activities as needed.</li>
<li>Tracks and reports on department activities to demonstrate compliance with regulatory updates and company policies.</li>
<li>Leads and monitors multiple small to medium sized projects under tight timelines simultaneously.</li>
<li>Collaborates closely with Contracting leadership on multiple department projects; keeps leadership informed on progress, issues and status of new contracts, policies and regulatory requirements.</li>
<li>Prepares summaries and detailed reports regarding contracted provider network(s) and assigned projects as needed. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Associate degree PLUS 4 years of experience in the health care field interacting with members, physicians, medical groups, health plans or regulatory agencies, overseeing administrative updates, data analytics or provider relations activities required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Managed care contracting, provider relations or grant writing experience. </li>
<li>Regulatory agency experience. </li>
<li>Project leader experience. </li>
<li>Network operations experience managing provider claims, capitation, network expansion or development.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 310 - $72,096 - $115,353 ($34.66 - $55.4582). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6822034&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 31, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6822034" target="_blank">https://jobs.caloptima.org/jobs/regulatory-and-contract-compliance-specialist-contracts-specialist-sr-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-58d6a7b47fde3a4a97d18824fbf37d4f

Regulatory and Contract Compliance Specialist (Contracts Specialist Sr)

Lead Decision Support (Principal Financial Analyst) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Lead Decision Support (Principal Financial Analyst) and help shape the future of healthcare where you'll be an integral part of our Financial Analysis team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Partial Telework. 
<ul>
<li> If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum. </li>
</ul>
 The Principal Financial Analyst (Lead Decision Support) will be responsible for providing highly complex analysis, guidance and expert knowledge on health care finance for various departments within CalOptima Health. You'll be a sought-out expert and company-wide resource on matters of health care finance. Working independently, you'll cast medical cost trends. Additionally, you'll provide expertise for provider contract negotiations, assess actuarial rate development studies, participate in annual budgeting functions, lead ad-hoc teams and serve as a subject matter expert to staff and other consultants within the department. You'll also evaluate high visibility complex issues, perform detailed analysis and communicate well reasoned, thorough solutions to all levels of management within CalOptima Health. Finally, you'll work with large amounts of claims, enrollment and provider data. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Financial Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Shares expert knowledge, mentors, trains and serves as a lead for analytical staff.</li>
<li>Serves as a subject matter expert in the following areas: Medi-Cal provider rate methodology, Medicare provider rate methodology, Department of Health Care Services (DHCS) revenue, Centers for Medicare &amp; Medicaid Services-Medicare Advantage (CMS-MA) revenue, population health member cohort identification, industry standard approaches to health care cost service categorization and metrics.</li>
<li>Forms and leads ad-hoc teams on key initiatives.</li>
<li>Provides expertise and analyses around risk adjustment.</li>
<li>Leads in the design, development, implementation and maintenance of report suites and dashboards for all levels of CalOptima Health management.</li>
<li>Researches, assesses and develops advanced tools, models, reports and approaches to increase accuracy and timeliness of data-driven work projects.</li>
<li>Develops medical expense, revenue and enrollment projections to support the budget process.</li>
<li>Develops financial models and reports to support provider contract negotiations.</li>
<li>Develops return on investment and business case analyses for program initiatives under consideration by management.</li>
<li>Provides clinical and utilization analysis to assist Medical Management with improving outcomes and quality of care for CalOptima Health members.</li>
<li>Collaborates with the Data Warehouse team to design and recommend improvements to the data warehouse. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned.</li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree in business administration, finance, economics, actuarial sciences or related field PLUS 6 years of financial analysis experience in managed care required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>3 years of experience in Provider Contract Modeling, Provider Rate Analysis, Provider Reimbursement Pricing and/or Managed Care Contracting in a health care setting required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>4 years of analytical experience working with Medi-Cal and/or Medicare payer information. </li>
<li>Experience developing annual organizational budgets, forecasts and financial modeling. </li>
<li>Experience in an Independent Physician Association (IPA), hospital or health plan setting. </li>
<li>Intermediate to Advanced proficiency in Excel. </li>
<li>1 year of experience using Tableau, Microsoft SQL Server or any other Relational Database Management System.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 315 - $109,892 - $175,827 ($52.83 - $84.5322). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6824021&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 29, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6824021" target="_blank">https://jobs.caloptima.org/jobs/lead-decision-support-principal-financial-analyst-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-c3e28703c917df459ea598432cf302e8

Lead Decision Support (Principal Financial Analyst)

The University of Wisconsin (UW) Primary Care Research Fellowship is recruiting fellows to join the Fall 2023 cohort. This post-doctoral research fellowship is administratively housed within the UW Dept. of Family Medicine and Community Health and led by faculty from this department as well as from General Internal Medicine and General Pediatrics and Adolescent Medicine. The fellowship has been continuously funded by the Health Resources and Service Administration as a T32 for over 30 years, and typically supports 2 years of research career training.&nbsp;&nbsp;
A principal objective of the Primary Care Research Fellowship is to train primary care physicians and PhD scientists interested in careers in medical research related to the organization, delivery, or effectiveness of primary health care and preventive medicine.&nbsp;
Research project completion, published papers, and grant proposals are the main goals for fellows. The fellowship is open to physicians or PhD-level health professionals aiming for research-centered careers who could benefit from 2 years of protected time, intensive mentorship, and research support. Areas of scholarly focus should be related to primary care but are otherwise not restricted. We encourage fellows to aim for NIH funding, and our trainees have received K-grants, R-grants, or other prestigious awards.&nbsp;
The Department of Family Medicine and Community Health and the School of Medicine and Public Health has a deep and profound commitment to diversity both as an end in itself but, also as a valuable means for eliminating health disparities. As such, we strongly encourage applications from candidates who foster and promote the values of diversity and inclusion.&nbsp;
Qualifications:&nbsp;
Successful candidates must have a medical (MD, DO), doctoral (PhD), or other terminal degree at the start of their appointment.&nbsp;
Please apply on our website:&nbsp;<a href="https://www.fammed.wisc.edu/fellowships/primary-care-research/" target="_blank">https://www.fammed.wisc.edu/fellowships/primary-care-research/</a>&nbsp;

Primary Care Research Fellowship

In partnership with Charleston Area Medical Center (CAMC) and West Virginia University School of Medicine – Charleston Division we are seeking an Interventional Pulmonologist at Assistant Professor level to join the Department of Medicine, Pulmonary Critical Care Section.&nbsp;&nbsp; This is an exciting opportunity to join a well-established program with flexibility in the position to suit the needs and expertise of the applicant.&nbsp; In addition to providing excellent patient care, the successful candidate will be actively involved in the teaching of medical students, internal medicine residents, and fellows in the pulmonary critical care fellowship.
Charleston Area Medical Center provides a wide breath of Pulmonary and Critical Care services including a Comprehensive Cancer Center, Renal transplant program, large endoscopy suite providing advanced bronchoscopy techniques, specialty critical care units including Neurosurgical and Cardiothoracic ICUs, and advanced cardiovascular support including TAVR, Mitral Clip, and ECMO.
At CAMC, you will join a distinguished team of extraordinary physicians committed to making a difference in the lives of patients locally and statewide.&nbsp; Practice advanced medicine in a collaborative atmosphere and a highly satisfying academic environment while providing the best possible pulmonary critical care for our patients.&nbsp; We recruit nationally for elite physicians who are recognized leaders in their specialty or subspecialty and utilize the most current techniques in pulmonary critical care; and placing the highest emphasis on achieving great quality outcomes. The community offers the cultural diversity and amenities of a metropolitan area in a safe, family-friendly environment with exceptional schools, affordable housing options and abundant recreational opportunities.
Job Requirements:
<ul>
<li>MD, DO degree or foreign equivalent degree from an accredited program</li>
<li>Completed residency in Internal Medicine; fellowship in Pulmonary Disease Critical Care and one year additional fellowship training in Interventional Pulmonology.</li>
<li>Eligible for unrestricted WV Medical License</li>
<li>Candidates for Assistant Professor rank must be board eligible in Pulmonary Disease Critical Care and in Interventional Pulmonology</li>
<li>Candidate for Associate and Full Professor rank must be board certified in Pulmonary Disease Critical Care and Interventional Pulmonology</li>
<li>All qualifications must be met by time of appointment.</li>
</ul>
Benefits include:
<ul>
<li>Excellent benefits package with generous PTO</li>
<li>Salary commensurate with qualifications and experience</li>
<li>Vibrant community</li>
<li>Superb family environment</li>
<li>Unsurpassed recreational activities&nbsp;</li>
<li>Outstanding school systems</li>
<li>Create your legacy while serving, educating, learning and making a difference from your very first day.</li>
</ul>

Assistant Professor Internal Medicine Interventional Pulmonology Critical Care 

The Chief of Endocrinology will provide strategic leadership and direction for all aspects of the&nbsp;Division. The Division Chief will be responsible for all planning, policy, operations, and&nbsp;oversight of academic, research, and clinical programs of the Division. The Chief of Endocrinology&nbsp;will have financial authority over the division&nbsp; budget, including extramural research and&nbsp;philanthropic funding received and other financial matters for the division, in accordance with&nbsp;applicable University policies and practices. The Chief of Endocrinology will have discretion in&nbsp;the recruitment and retention of division faculty who will have a direct reporting line. Qualified&nbsp;candidates must possess a Doctor of Medicine (MD), Doctor of Osteopathic (DO) or equivalent degree&nbsp;from an accredited institution and be eligible for a University of Arizona academic appointment at&nbsp;the Associate or Full Professor rank. The Chief of Endocrinology will also play a prominent role in&nbsp;the establishment of a Diabetes Research Center with the support of an ongoing University of&nbsp;Arizona (UA) capital campaign and the continued development of an NIH - T32 training program in&nbsp;diabetes, endocrine, and metabolism.
The Endocrinology division is one of twelve within the Department of Medicine, which leads the&nbsp;University of Arizona, College of Medicine-Tucson in research funding, and has two residency&nbsp;programs, 15 fellowship programs including endocrinology, and numerous mentorship opportunities in&nbsp;multidisciplinary health science graduate programs. The College anchors the University of Arizona&nbsp;Health Sciences (UAHS) campus, which also houses the UA Colleges of Public Health, Pharmacy, and&nbsp;Nursing, as well as multiple research Centers of Excellence, and includes a research partnership&nbsp;with the Veterans Affairs (VA) Tucson Medical Center, which serves all Southern Arizona. The&nbsp;College inspires and trains individuals to become exemplary physicians, scientists and leaders who&nbsp;are life-long learners and inquisitive scholars. We embrace professionalism, innovation, and&nbsp;collaboration to optimize health and health care for all. The University of Arizona Health&nbsp; Sciences&nbsp;embodies the University’s priorities of engagement, partnership, innovation, and synergy in its&nbsp;world-class academic and research initiatives, with clinical facilities throughout Greater Tucson.&nbsp;Building on an established partnership with Banner Health, the fourth largest non-profit healthcare&nbsp;system in the U.S., the division and department are well- positioned as the sole academic health&nbsp;care provider in southern Arizona to provide transformative health care to the communities that we&nbsp;serve by achieving excellence in clinical care, education, and individual and team-based research.&nbsp;The incumbent will work collaboratively with the leaders of the College and Banner – University&nbsp;Medical Group (B-UMG) to further this tripartite mission and position the division for continued&nbsp;growth through innovation.
Duties &amp; Responsibilities:
<ul>
<li>Provide leadership and management of day-to-day operations of the Division of Endocrinology.</li>
<li>Responsible for recruitment, management, compensation, and retention of faculty in consideration of&nbsp;UA, UHSC, College, and B—UMG strategic plans and initiatives in balance of the multiple, tripartite&nbsp;mission of the University.</li>
<li>Collaborate with Academic Affairs and other educational offices at the College to ensure the&nbsp;division and their faculty are advancing the mission of the medical student, graduate student, and&nbsp;graduate medical education teaching programs.</li>
<li>Responsible for maintaining liaison with other clinical and/or basic science departments to foster&nbsp;an integrated teaching environment for the College.</li>
<li>Has the responsibility to support and expand research activities within the division, and across&nbsp;the Department, College and UAHS, working with key partners.</li>
<li>Provide leadership oversight and effective management of an active program of independent,&nbsp;extramurally funded basic, translational or clinical research in area of research&nbsp;expertise/specialization.</li>
<li>Is the clinical role model and leader of the division’s clinical activities and works with the&nbsp;Dean, Department Head, and the B—UMG CEO to coordinate the clinical activities of the division and oversee inpatient and outpatient clinical services.</li>
<li>Responsible for maintaining appropriate standards of care appropriate to the discipline.</li>
<li>Provide direct patient care in the inpatient and/or ambulatory (outpatient) setting as a licensed and fully credentialed provider as a member of Banner—University Medical Group.</li>
<li>Responsible for ensuring the fiscal accountability and sustainability of the division working with the&nbsp;College’s Business Affairs Office.</li>
<li>Responsible for encouraging and supporting diversity among the division’s constituents, creating an&nbsp;environment of professionalism, respect, tolerance, and acceptance and work in partnership with the Office of Diversity and Inclusion.</li>
</ul>
As a land-grant, Hispanic-serving institution and active NIH-partner for the All of Us Research program, the University of Arizona College of Medicine-Tucson champions diversity as a core value central to its&nbsp;mission. We are committed to promoting and supporting diversity and inclusion in our research, clinical&nbsp;and educational missions to meet the needs of the students, faculty, staff, and the communities we serve.&nbsp;We believe diversity at the University of Arizona College of Medicine-Tucson creates role models,&nbsp;broadens perspectives, combats negative stereotyping, and optimizes our ability to provide health care for&nbsp;all. We also respectfully&nbsp; acknowledge the University of Arizona is on the land and territories of Indigenous&nbsp;peoples. Today, Arizona is home to 22 federally recognized tribes, with Tucson being home to the&nbsp;O’odham and the Yaqui.
Outstanding UA benefits include health, dental, and vision insurance plans; life insurance and disability&nbsp;programs; paid vacation, sick leave, and holidays; UA/ASU/NAU tuition reduction for the employee and&nbsp;qualified family members; state and optional retirement plans; access to UA recreation and cultural&nbsp;activities; and more. Tucson, a UNESCO-designated city of gastronomy set in the high Sonoran Desert in&nbsp;the midst of five mountain ranges, offers a culturally rich scene, including opera, theatre and professional&nbsp;sports teams, as well as some of the top- rated K-12 schools in Arizona and the nation, boasting an&nbsp;average 340 sunny days a year in a warm dry climate ideal for year-round outdoor recreation.
Requirements
<ul>
<li>MD, DO, or equivalent.</li>
<li>Board certified by the American Board of Internal Medicine/Medical Subspecialties and eligible for&nbsp;unrestricted medical licensure in the State of Arizona.</li>
<li>Three to five years of progressively complex administrative experience (e.g., program leader,&nbsp;center/section director, etc.) in an academic medical center setting.</li>
<li>Demonstrated track record of distinction in teaching, clinical care, and/or research in an academic&nbsp;department of medicine or equivalent environment.</li>
<li>Demonstrated commitment to patient care, reflecting a service-oriented, team-based philosophy with&nbsp;hospital administration and health professional colleagues from all disciplines, departments, and&nbsp;specialties.</li>
<li>Successful track record of recruitment and development of faculty, trainees, and students.</li>
<li>A record of solid performance as a skilled manager with the ability to grow revenues, meet budgets,&nbsp;measure, and improve productivity and outcomes, and undertake appropriate business strategies to&nbsp;achieve division, unit, department and/or enterprise goals.</li>
<li>If the individual selected for employment does NOT currently hold a faculty title with The University of&nbsp;Arizona, College of Medicine-Tucson, they will be required to obtain faculty status. This will include&nbsp;obtaining letters of recommendation and review by the appropriate College review committee.</li>
</ul>

Division Chief of Endocrinology (Associate/Full Professor) (NTE/TE/T)

<h3>Job Description</h3>
We are actively seeking a Family Medicine Physician to join our new FQHC Health Center in 3763 White Plains Road, Bronx, NY, 10467&nbsp;
This is an extraordinary opportunity to practice patient care and become part of our amazing team of dedicated health workers!
Bronx Community Health Network (BCHN) was founded in 1996 to ensure that the socio-economically depressed and medically underserved residents of the Bronx have access to high-quality and comprehensive healthcare services, Bronx Community Health Network (BCHN) is a not-for-profit, community-based organization and Federally Qualified Health Center. The organization provides a wide range of comprehensive, coordinated primary medical, oral, and mental health care and related diagnostic, pharmacy, social support, and enabling services for medically underserved/uninsured residents. 
BCHN’s mission is to improve the health of people and families in the Bronx; provide access to affordable, quality health care, especially for uninsured persons; promote disease prevention, early treatment and healthful lifestyles; and obtain financial and other resources for programs and services. BCHN’s service area includes the entire borough of the Bronx, including all 25 zip codes. Within this area, Health Center sites focus on the low-income and underserved populations.

Family Physician

<h3>Job Description</h3>
Job Description
Job Title: Family Medicine Physician
Employment Type: Full-Time Work Setting: On-site | Outpatient Clinic Schedule: Monday–Friday | Day Shift Compensation: $228,000 – $350,000 per year (DOE) Location: Lancaster, CA
Position Overview
We are seeking a compassionate and dedicated Family Medicine Physician to join a busy outpatient primary care clinic. This role plays a vital part in delivering comprehensive, patient-centered care while supporting preventive health, chronic disease management, and acute care needs.
The ideal candidate is committed to serving diverse and underserved populations, practices evidence-based medicine, and thrives in a collaborative, team-oriented environment.
Key Responsibilities
Clinical Care
<ul>
<li>Provide comprehensive outpatient primary care services to patients of all ages</li>
<li>Evaluate, diagnose, and treat acute and chronic medical conditions</li>
<li>Develop and implement individualized care plans and preventive health strategies</li>
<li>Review, interpret, and sign off on laboratory and diagnostic imaging results</li>
<li>Ensure timely patient follow-up and continuity of care</li>
</ul>
Documentation &amp; Compliance
<ul>
<li>Maintain accurate, concise, and timely documentation in the electronic medical record (EMR)</li>
<li>Close all patient encounters and clinical notes within required timeframes</li>
<li>Ensure patient information is secure and maintained with strict confidentiality</li>
</ul>
Care Coordination &amp; Collaboration
<ul>
<li>Initiate and manage referrals to specialty providers and coordinate care as needed</li>
<li>Communicate effectively with consulting providers and care team members</li>
<li>Participate in daily care team huddles, provider meetings, and staff meetings</li>
</ul>
Leadership &amp; Productivity
<ul>
<li>Serve as a clinical supervisor for advanced practice providers as assigned</li>
<li>Meet productivity expectations, typically 16–24 patients per day</li>
<li>Support a culture of service excellence, accountability, and patient safety</li>
</ul>
Additional Duties
<ul>
<li>Perform other related duties as assigned</li>
<li>Occasional travel may be required</li>
</ul>
Required Qualifications
Education &amp; Licensure
<ul>
<li>MD or DO degree</li>
<li>Active and unrestricted California medical license</li>
<li>Active DEA registration</li>
<li>Current CPR certification</li>
</ul>
Experience &amp; Skills
<ul>
<li>Strong interest in serving underserved or diverse patient populations</li>
<li>Experience in outpatient primary care settings preferred</li>
<li>FQHC experience is a plus</li>
<li>Familiarity with quality metrics and performance measures preferred</li>
<li>Strong interpersonal, communication, and teamwork skills</li>
<li>Bilingual (English/Spanish) preferred</li>
</ul>
Company DescriptionLanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch. 
<h3>Company Description</h3>
LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Family Physician- V

<h3>Job Description</h3>
Job DescriptionDescription:
POSITION TITLE: Family Physician
LOCATION: HOPE Clinic
REPORTS TO: Medical Director
EDUCATION: Doctor of Medicine (MD or DO)
WORK EXPERIENCE: Minimum of 3 years experience preferred.
SALARY RANGE: Based on experience
FLSA STATUS: Exempt
POSITION TYPE: Full-Time
LANGUAGE: Fluent in English; Bilingual in English and Spanish, Arabic, Burmese, Chinese or other languages is required
 
HOPE Clinic provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
 
JOB SUMMARY:
Examine and treat patients with a wide range of conditions and refer those with serious ailments to a specialist or appropriate facility. Typical job duties include taking patient histories, performing or requesting diagnostic tests, making diagnoses, prescribing treatment, administering vaccinations and performing follow-up examinations, as well as educating patients in disease prevention and health maintenance. Additional duties include preparing medical records, clinical reports and correspondences.
 
MAJOR DUTIES &amp; RESPONSIBILITIES:
<ul>
<li>Provide quality care to patients according to clinical medical protocols and funding source guidelines; </li>
<li>Initiate an appropriate assessment of the patient's health status, ranging from focused to comprehensive, depending upon the setting; </li>
<li>Provide and manage comprehensive medical care, including diagnosis and nonsurgical treatment of diseases, common health problems, such as infections, influenza, and pneumonia, as well as serious, chronic, and complex illnesses, in adolescents, adults, and the elderly; </li>
<li>Provide prenatal care for uncomplicated OB patients;</li>
<li>Monitor patients' conditions and progress and reevaluate treatments as necessary;</li>
<li>Explain procedures and discuss test results or prescribed treatments with patients;</li>
<li>Advise patients and community members concerning diet, activity, hygiene, and disease prevention and educate patients about preventative measures to avoid illness;</li>
<li>Collect, record, and maintain patient information, such as medical history, reports, and examination results, and prepares reports and correspondence related to the work;</li>
<li>Refer patient to medical specialist or other practitioners when necessary; </li>
<li>Prescribe medication by Texas statute and professional practice guidelines;</li>
<li>Immunize patients to protect them from preventable diseases;</li>
<li>Participate in formulating, interpreting, implementing, and evaluating objectives, policies, and procedures; </li>
<li>Assist with quality improvement activities as required and participates in Quality Assurance and Utilization Reviews;</li>
<li>Perform diagnostic tests and procedures and therapeutic procedures, within the scope of practice, including but not limited to venipuncture; intradermal tests; intramuscular and subcutaneous injections; electro-cardiogram; application of dressings and bandages; administration of medications; cardiopulmonary resuscitation; auditory screening; visual screening; and aseptic techniques; </li>
<li>Analyze accumulated health information and collects additional observational, interview, historical, physical examination, and diagnostic data, modifying treatment as appropriate;</li>
<li>Have a working knowledge of ICD10, CPT, and HCPCS coding and managed care, and be available for training as necessary; </li>
<li>Maintain and complete patient’s health records or charts legibly, concisely, and close them within 48 hours and/or by the end of the serviced week;</li>
<li>Work as an integral part of the HOPE Clinic clinical team; </li>
<li>Participate in the on-call/Saturday rotation schedule as needed; </li>
<li>Be flexible to work between different sites;</li>
<li>Comply with the regulations and policies required of a Federally Qualified Health Center;</li>
<li>Complete administrative assignments as requested by Medical Director and/or HOPE Clinic;</li>
<li>Participate in clinical activities including but not limited to the Compliance Performance Improvement team;</li>
<li>Participate in the community health events, health education initiatives, training, and/ or physical/screenings activities conducted by HOPE Clinic, or in collaboration with community partners as needed;</li>
<li>Participate in community partners meetings in an effort to plan and work on collaborative initiatives as needed;</li>
<li>Report to the Medical Director or assigned supervisor;</li>
<li>Perform other duties as assigned to support HOPE Clinic’s Mission, Vision, and Values.</li>
</ul>
 
Requirements:
QUALIFICATION REQUIREMENTS:
<ul>
<li>Successful completion of an accredited Family Medicine Residency with 3 or more years of expenence;</li>
<li>Current D.E.A certificate;</li>
<li>Previous experience in a hospital and/or clinic setting;</li>
<li>Understanding of Texas mandated reporting laws;</li>
<li>Ability to relate to culturally diverse patients and communities;</li>
<li>Keep up with CME requirements for Texas License and Board Certification.</li>
<li>Must be fully vaccinated against COVID-19.</li>
</ul>
 
EDUCATION and/or EXPERIENCE:
<ul>
<li>Doctor of Medicine (MD or DO);</li>
<li>Current board certification by the American Board of Family Medicine (ABFM) or the American Osteopathic Board of Family Medicine (AOBFM);</li>
<li>Experience working in Family Practice environment, community health experience preferred;</li>
<li>Valid Texas State Medical License.</li>
</ul>

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