field_job_employment_type

field_job_occupational_field_parents_all

job_organization_name

city

state

Member Liaison Specialist (Customer Service) 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 Member Liaison Specialist (Customer Service) and help shape the future of healthcare where you'll be an integral part of our CS - Member Liaison 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 provide member service to seniors, persons with disabilities or chronic conditions, persons without housing and persons under the age of twenty-one (21) who participate in the Whole-Child Model program. You will also serve as a liaison between members, health networks, providers and community-based organizations to facilitate access to services and help resolve health care and psychosocial issues. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>85% - Member 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>Assesses members' concerns to identify psychosocial or health care issues and facilitate an appropriate resolution.</li>
<li>Intakes information from members, both over the phone and/or in person, to complete requests for assistance cases, grievances and appeals, per departmental guidelines.</li>
<li>Coordinates members' health care and social service needs within and outside the health network and CalOptima Health during the original interaction.</li>
<li>Addresses member and provider inquiries, questions and concerns in all areas, including enrollment, claims, benefit interpretation, coordination of care and referrals/authorizations for medical care related to services covered under the Whole-Child Model program.</li>
<li>Guides members in understanding and accessing the benefits under the Whole-Child Model program.</li>
<li>Maintains documentation of member cases within the FACETS system.</li>
<li>Initiates referrals to internal and external care management departments and government agencies.</li>
<li>Communicates with community-based organizations, health networks, providers and vendors on behalf of members to resolve disputes, helps coordinate access to care and investigates issues preventing members from receiving medical benefits and services. </li>
</ul>
</li>
<li>10% - Administrative Support
<ul>
<li>Collaborates with interdepartmental staff in call resolution as needed.</li>
<li>Identifies calls needing case management or escalation to a supervisor, manager or director and routes them according to established guidelines.</li>
<li>Meets all regulatory key performance indicators, first call resolution requirements and business objectives of CalOptima Health. </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>High school diploma or equivalent PLUS 2 years of experience as a call center agent or customer/member services representative in health 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>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>2 years of experience working with the needs of persons with disabilities and chronic medical conditions in a customer/member service capacity. </li>
<li>Health maintenance organization (HMO), Medi-Cal/Medicaid and health services experience. </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>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: 302 - $49,754 - $69,655 ($23.92 - $33.4880). 
<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 Office (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6757493&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 9, 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/6757493" target="_blank">https://jobs.caloptima.org/jobs/member-liaison-specialist-customer-service-505-city-parkway-west-california-united-states-33e8b0be-b4dd-42d0-9530-e2df2d63a939</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-537ce69475a85e4fb5e079ee955c18f2

Member Liaison Specialist (Customer Service)

PHI’s Senior Workforce Intervention Specialist works to improve job quality for direct care workers by contributing to the development, implementation, and evaluation of PHI’s practice-based employment and training models. As a part of PHI’s Workforce Innovations Team (WIT), they will specialize in leading engagements related to operationalizing and evaluating meaningful advancement opportunities that expand the direct care career ladder; additionally, they may support programs aimed at strengthening recruitment and retention practices, creating a coaching culture, developing adult-learner centered training, and assessing direct care job quality. Outstanding skills in critical thinking, proactive leadership, written and verbal communication, relationship building, and workforce and organizational development are essential for success in this role. &nbsp;
POSITION RESPONSIBILITIES
<ul>
<li>Lead the implementation of PHI practice-based job quality interventions, including creating and maintaining work plans and timelines, managing partner relationships, executing project activities, and reporting progress to PHI’s Vice President of Workforce Innovations through verbal and written communication.</li>
<li>Build and manage relationships with numerous strategic workforce partners – including long-term care employers, payors, advocates, and others - to support collaboration and the successful integration of job quality practices.</li>
<li>Provide technical assistance and consulting to project-based partners to support program design, implementation, and evaluation; this will include intensive, hands-on support to project partners to assess and modify organizational practices in support of implementing and maintaining workplace environments conducive to high-quality direct care jobs.</li>
<li>Routinely meet programmatic deadlines and proactively communicate impediments to the Vice President of Workforce Innovations.</li>
<li>Produce high-quality project deliverables in line with PHI and WIT acceptance criteria including PowerPoint slide deck presentations, external and internal reports, project worksheets, assessment tools, workflows, and other items as needed to meet project goals.</li>
<li>Plan, facilitate, and document meetings, informational sessions, webinars and other interactions with external partners; this could include coordinating planning with WIT and other PHI staff members, sending meeting invitations and conferencing information to attendees, creating and disseminating agendas, facilitation, documenting and archiving associated notes, and establishing next steps.</li>
<li>Collaborate with WIT staff to coordinate team roles, optimize efficiency, and meet project goals.</li>
<li>Work with WIT staff to support the development of PHI’s online and in-person workforce training curricula; act as a subject matter expert to inform the creation of contextualized content that reflects the lived experiences of workers within a PHI intervention.</li>
<li>Work with WIT to apply principles of diversity, equity, and inclusion to PHI’s job quality models; contribute to the development of new workforce training and practice strategies aimed at improving job quality for a diverse direct care workforce.</li>
<li>Collaborate with PHI’s Vice President of Research and Evaluation and Vice President of Workforce Innovations to develop and implement evaluation efforts that build the evidence base for sustained investment in direct care job quality interventions.</li>
<li>Collaborate with PHI’s Director of Philanthropy to provide project data and information as needed to support funder reporting and communication efforts.</li>
<li>Serve as a resource to PHI’s Policy Team on workforce and organizational development practices as needed.</li>
<li>Promote PHI’s school of thought and the dissemination of effective practice models through speaking at conferences, contributing to PHI’s blog, and cultivating external relationships to bring in new business. QUALIFICATIONS</li>
<li>Minimum five years’ experience in workforce and organizational development, preferably within the long-term care, aging, and/or disability sectors.</li>
<li>Proven experience successfully designing, leading, and evaluating complex interventions from inception to completion in alignment with organizational strategic impact aims.</li>
<li>Advanced ability to show proactive, independent leadership while maintaining communication and connection to team members.</li>
<li>Experience working within an Agile framework preferred, though not required.</li>
<li>Experience with adult-learner centered curriculum development and facilitation preferred though not required.</li>
<li>Experience with facilitating interactive adult-learner centered training in-person and online preferred but not required.</li>
<li>Experience working effectively with and facilitating collaboration among diverse individuals and groups.</li>
<li>Ability to manage several complex projects simultaneously, often under tight deadlines.</li>
<li>Excellent writing skills, including the ability to write in a variety of formats for a range of audiences.</li>
<li>Outstanding public speaking skills across a range of audiences.</li>
<li>Strong computer skills, including Microsoft Office Suite.</li>
<li>Commitment to – and experience with – racial, gender, and economic justice.</li>
<li>Moderate travel required.</li>
<li>Bachelor’s degree required, Master’s degree or equivalent experience preferred.</li>
</ul>
REPORTING RELATIONSHIP
The Senior Workforce Intervention Specialist reports to PHI’s Vice President of Workforce Innovations.
LOCATION
PHI’s national headquarters are at 261 Madison Avenue, Suite 913, New York, NY, 10016. This position is remote with a preference for candidates in the NYC area.
ABOUT PHI
PHI is a national organization committed to strengthening the direct care workforce by producing reliable research and analysis, leading federal and state advocacy initiatives, and designing groundbreaking workforce interventions and models. For 30 years, we have brought a 360-degree perspective on the long-term care sector to our evidence-informed strategies throughout the country.
SALARY AND BENEFITS
This is a full-time, salaried position with a base salary range of $90,000 - $105,000 per year, commensurate with skills and experience.
PHI provides a comprehensive benefits package effective on the date of hire. Health benefits include: a sponsored medical plan, an employer-paid dental plan, and an optional vision insurance plan. In addition, PHI offers basic life insurance, an EAP, a 401(k), flexible spending plans for medical, dependent care, and commuter expenses; 27 days of earned leave, paid holidays, a holiday break at the end of December, family leave, parental leave, professional development, and cell phone reimbursement.
TO APPLY
To apply, email a cover letter with your resumé to <a href="mailto:info@PHInational.org" target="_blank">info@PHInational.org</a>. Please indicate “Senior Workforce Intervention Specialist” in the subject line.
Application deadline: August 6, 2023

Senior Workforce Intervention Specialist

<h3>Job Description</h3>
Job Description
GiaCare Inc., in anticipation of a future government contract award, is currently accepting applications for experienced, civilian Medical Administration Specialists to work alongside the federal government in support of the Air Force Academy (near Colorado Springs, Colorado).
 
Requirements
Degree/Education: A bachelor’s degree in health care administration, business, information management, or a related medical discipline is required
Certifications: Basic Life Support (BLS) certification.
Board Certification:N/A
Licensure: Current, full, active, and unrestricted license to practice medicine.
Experience:
<ul>
<li>Working knowledge of computers including the following software: Microsoft Word, Excel and PowerPoint, EHR Genesis and military database. management and must have the ability to type 30-40 words per minute.</li>
<li>Shall be able to read, understand, speak, and write English well enough to communicate effectively.</li>
<li>Shall perform duties in Refractive Surgery Center.</li>
<li>Requisitions forms required for daily operation of the Refractive Surgery Center. As required, type routine correspondence, progress reports medical statements, and memorandums.</li>
<li>Shall have experience with submitting budget proposals and managing an operating budget. Experience in ophthalmology clinic and/or supply management is required.</li>
</ul>
Duties
• Monitors health care delivery plans; market forces, patient and beneficiary demand and other issues impacting facility capabilities/capacity, access to care compliance and/or quality of care.
• Prepares presentations, project papers, staff and biometric reports and other medical administrative correspondence; delivers to senior management.
• Conducts studies in support of various projects, program, processes or initiatives covering military health care activities.
• Implements policy and initiatives to improve effectiveness, efficiency, productivity and customer satisfaction and quality improvement efforts.
 
As a GiaCare Inc. employee, you may enjoy the following benefits:
<ul>
<ul>
<li>Medical Insurance (GiaCare pays for employee's medical benefits)</li>
<li>Vision Insurance</li>
<li>Dental Insurance</li>
<li>Short-Term Disability Insurance</li>
<li>Life and AD&amp;D Insurance</li>
<li>Paid Time Off (PTO)</li>
<li>401k (Non-matching)</li>
<li>Employee Referral Program</li>
</ul>
</ul>
 
-Apply below or send resume to <a href="mailto:RECRUITMENT@GIACARE.COM" target="_blank">RECRUITMENT@GIACARE.COM</a>, or call (954) 651-9022 to speak with a recruiter immediately. 
 
*MUST BE US CITIZEN

Medical Administration Specialist

<h3>Job Description</h3>
Job Description
Title: Medical Mgmt Intake Specialist - Medical Administration
Location: Remote
Contract: 12+ Months Contract
Will this position be required to work onsite for any reason at any time? Role can be performed offsite, but contractor may be required to come on site to pick up equipment Medical Management Intake Specialist Work Hours: • Schedule: Full-time, 40 hours per week • Hours: Monday through Friday, 8:00 AM to 5:00 PM • Flexibility: Schedules will include some Saturdays, Sundays, and Holidays; overtime may be necessary Required Skills and Experience: • Minimum of 2 years of experience in a healthcare, insurance, or related field • High school graduate and college or university experience • Medical terminology knowledge or a medical background is required • Strong understanding of health insurance processes, including claims management, benefits coordination, and prior authorization procedures • Customer service experience is required • Strong phone skills with experience handling inbound and outbound calls • Experience with healthcare management software and databases • Excellent verbal and written communication skills • Ability to explain complex information in a clear and concise manner • Strong problem-solving skills with the ability to analyze data and identify trends • Attention to detail and accuracy in all work • Ability to work collaboratively with cross-functional teams • Demonstrated ability to build and maintain positive relationships with colleagues, clients, and stakeholders Highly preferred: • Two years of college or associate level degree equivalent • Experience with providing high quality, provider focused servicing to facilities and doctors • Work collaboratively as a team member with peers and nurses • Concisely and accurately enter documentation into Care Advance • Effectively engage over the phone via both inbound and outbound with providers • Process provider requests as needed • Acts as providers first trusted source for UM Prior Auth programs • Assign faxes to designated staff • Process requests for compliance inquiries • Access various UM department mailboxes and voicemail as needed • Ability to function independently • Critical Thinking
About Kyyba:Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances. At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.Kyyba is recruiting for the below mentioned position with our direct client which is one of the major Healthcare Payers in the US.
Disclaimer:
Kyyba is an Equal Opportunity Employer.
Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. Minorities / Females / Protected Veterans / Individuals with Disabilities are encouraged to apply. All employment is decided on the basis of qualifications, merit, and business need.”
It is the policy of Kyyba to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact Kyyba at 248-813-9665
Rewards:
Medical, dental, vision
401k
Term life
Voluntary life and disability insurance
Optional Pre-paid legal plan
Optional Identity theft plan
Optional Medical and dependent FSA
Work-visa sponsorship
Opportunity for advancement
Long-term assignment with opportunity for hire by client
SELECT AWARDS
<ul>
<li>An INC 5000 company for 10 years</li>
<li>Corp! Michigan Economic Bright Spots</li>
<li>Crain’s Detroit Business Top Staffing Service Companies in Detroit</li>
<li>TechServe Alliance Excellence Award- IT and Engineering Staffing &amp; Solutions</li>
<li>Best of MichBusiness winner in HR Wizards &amp; Partnerships</li>
<li>Metro Detroit Elite Category: Recruitment, Selection &amp; Orientation for 101 Best &amp; Brightest</li>
<li>101 Best &amp; Brightest Companies to Work for in Michigan</li>
</ul>
Company DescriptionFounded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances. At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development. Kyyba is an Equal Opportunity Employer. Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b 
<h3>Company Description</h3>
Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.\r\n\r\nAt Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.\r\n\r\nKyyba is an Equal Opportunity Employer.\r\n\r\nKyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b

Medical Mgmt Intake Specialist - Medical Administration

<h3>Job Description</h3>
Job Description
PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center.
Position Summary:
This position is located within the Tohono O'odham Nation Health Care (TONHC) Hospital and Clinics. The work involves developing new or improved solutions to complex technical problems; establishing criteria; formulating projects; assessing program effectiveness; investigating and analyzing unusual conditions, concerns, or questions for Health Information Management Services (HIMS).
Scope of Work: This is the senior Health Information Management Services position for TONHC Hospital and Clinics. Under the Director's general direction, the incumbent functions as the Health Information Management Services (HIMS) and has full program responsibility to set and carry out the strategic direction, mission, and vision for TONHC Hospital and Clinics Health Information Management Services.
Essential Duties and Responsibilities: (Depending on the area of assignment, an incumbent may not be required to perform some of the duties listed below): 
<ul>
<li>Interpret national health record policies and standards for application at the Hospital and Health Centers level. At local and national meetings, the incumbent represents Tohono O'odham Nation Health Care (TONHC) Hospital and Clinics.</li>
<li>Formulates health record policies specific to the Tohono O'odham Nation Health Care (TONHC) Hospital and Clinics and directs their application; writes policy and procedures for medical records and coding for electronic health records and paper records as applicable.</li>
<li>Evaluate Health Center level of compliance with the Joint Commission (TJC) applicable continuous quality improvement standards and monitors operation of Health Center record centers under HIPAA (Health Insurance Portability and Accountability Act), Privacy Act, and Freedom of Information Act.</li>
<li>Directs the overall operations of the HIMS program and provides leadership and guidance to the other TONHC Hospital and Clinics facilities; and ensures TONHC Hospital and Clinics has an integrated, consistent, and comprehensive patient health records system.</li>
<li>The incumbent develops, analyzes, and implements procedures for assuring proper inter-departmental and intra-departmental workflow. </li>
<li>Continually evaluates and reviews procedure adequacy; and, if necessary, modifies to meet latest technical requirements and techniques; evaluates statistical data identifying program adequacy to management.</li>
<li>Ensures departmental goals and objectives are consistent with the TONHC strategic plan and provides advice and assistance in health information requirements and medicolegal aspects to the Sells Hospital and Health Centers.</li>
<li>Serve as an advisor to management on all phases of health information management. Serve as the CO-Chair (with Medical Staff) of the TONHC Hospital and Clinics Health Information Management Committee (HIMC), composed of medical and professional services members. </li>
<li>Advise on the adequacy of health records and medicolegal aspects of health record operations at Health Centers. Responsible for medical statistical reports to assist hospital management and accrediting agencies in evaluating the quality of clinical care.</li>
<li>Assist Compliance Officer to train and educate staff on the key requirements of Privacy Standards, including limits on use and disclosure of protected health information, individual rights under regulations, and administrative requirements.</li>
<li>Accepts subpoena duces tecum, as custodian of the health record, reviews subpoenaed records for completeness with medicolegal requirements. Confers with TON attorney, when necessary, appears in court to fulfill legal requirements. Prepare records in tort claims.</li>
<li>Utilizing Electronic Health Record template approval criteria ensures that EHR templates are acceptable for use.</li>
<li>The incumbent is responsible for the administration and management of the TONHC Hospital and Clinics Medical Coding Program. Coordinates, manages, monitors, and performs all functions necessary to ensure coding complies with internal control standards.</li>
<li>Incumbent utilizes and implements various auditing mechanisms to ensure coding compliance. Develops and implements a comprehensive internal quality control system within the HIMS program. Determine the effectiveness of such controls and their impact on the program.</li>
<li>Responsible for the RPMS software packages managed by the HIMS discipline: Discharge and Transfer (ADT), Patient Care Component (PCC), Release of Infom1ation (ROI); Sensitive Patient Tracking (SPT), Text Integration Utility (TIU) of EHR, and other HIM package developed by TONHC. </li>
<li>Responsible for the review, analysis, and technical evaluation of clinical records concerning the Standards of the Joint Commission (TJC) and state and federal reporting requirements for vital statistics.</li>
<li>Assures that diagnoses are written in the language of Standard Terminology of Diseases and Operation, and coding of diseases and operations are in the proper grouping of International Classification of Diseases and Operations for research and administrative evaluation.</li>
<li>Aids in projects by advising on procedures to efficiently collect data and assisting staff in defining their objectives in terms of the available information. Collection of data may consist of searching files or recommending special computer reports.</li>
<li>Designs and administers the health information program, including managing work processes, personnel, and planning for transition to the EHR.</li>
<li>Responsible for conducting and submitting (to CEO) specific assessments related to Third Party Internal Controls self-assessment and audits.</li>
<li>The incumbent supervises a staff engaged in administrative and technical work. Ensure the timely performance of satisfactory quality and quantity of work through the following supervisory tasks.</li>
<li>Plans work to be done by subordinates; sets priorities and establishes schedules and deadlines. Assign work based on anticipated difficulty and the capabilities of available employees. Advises, counsels, and instructs employees on technical and administrative matters.</li>
<li>Ensures HR (competency) files are in place and up-to-date, meeting all TONHC Joint Commission requirements.</li>
<li>Recommends personnel actions such as promotion, reassignment, or termination. Recommends awards and disciplinary actions.</li>
<li>Submit requests for personnel action timely. Interviews applicants and recommends selections.</li>
<li>Hears and resolves employee complaints (or refers the complaint to the level of resolve.</li>
<li>Determines individual training and development needs and seeks out ways to satisfy them.</li>
<li>The incumbent is responsible for furthering the goals of Equal Employment Opportunity (EEO) by taking positive steps to ensure adherence to non-discriminatory employee practices regarding race, color, sex, religion, national origin, age, or handicap. </li>
<li>Contribute to a team effort.</li>
<li>Performs other job-related duties as assigned.</li>
</ul>
Knowledge, Skills, and Abilities:
<ul>
<li>Knowledge of the Tohono O'odham culture, customs, and traditions.</li>
<li>Thorough knowledge of medical records administration and management to apply established principles, concepts, and techniques of hospital operations.</li>
<li>Thorough knowledge of policies, procedures, applicable Federal statutes on legislation governing health records. </li>
<li>Advanced knowledge and understanding of health information management: including coding, medical terminology, documentation standards, electronic health record (EHR), and medicolegal issues of the health record.</li>
<li>Advanced analytic skills to be able to solve problems covering the diverse issues that are involved in the health records management field. </li>
<li>Advanced knowledge of medical terminology, understanding the standard practices of the clinical medical field and communicating effectively with the clinical .staff in interpreting and comprehending medical documentation in health records. Practical knowledge of anatomy, physiology, and medical procedures and diagnosis.</li>
<li>Ability to plan, organize and cope with complex management issues. Ability to handle technical problems analytically and systematically, especially in times of medical or administrative emergencies.</li>
<li>Ability to communicate effectively, orally, and in writing to all levels of personnel. Effective communication is needed to coordinate with various department personnel, patients, agency personnel, and outside entities requesting or requiring information related to health records.</li>
<li>Expert knowledge in developing procedures, planning, organizing, and monitoring studies involving data analysis and preparing reports. </li>
<li>Thorough knowledge of Public Law 94-437, Title IV of the Indian Health Care Improvement Act, PL 99-272, Federal Medical Care Cost Recovery Act, the Drug Abuse Office and Treatment Act of 1972; hospital policies and procedures governing the recovery of the cost of medical care provided to specific individuals.</li>
<li>Knowledge of reimbursable insurance procedures and requirements, including interpreting provisions of individual health plans and group plans.</li>
<li>Knowledge of proper coding procedures, ICD-10 and CPT.</li>
<li>Thorough knowledge of the Resource Patient Management System (RPMS). </li>
<li>Expert knowledge of regulatory, licensing, accrediting agency requirements, and medical/legal responsibilities of medical records (including electronic health records).</li>
<li>Expert knowledge of the interrelationships between medical records programs and other medical care services to evaluate and modify/adapt new procedures to meet changing regulatory requirements and health care practices.</li>
<li>Knowledge of supervisory personnel management responsibilities, including recruitment and staffing, training, incentive awards, discipline, position classification, pay administration. </li>
</ul>
Minimum Qualifications:
<ul>
<li>Associates in Medical Billing and Coding or closely related field, and</li>
<li>Three years of supervisory experience in Health Information Management Services (HIMS). </li>
</ul>
Licenses, Certifications, Special Requirements:
<ul>
<li>Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) is desirable.</li>
<li>Upon recommendation for hire, a criminal background and a National FBI fingerprint check are required to determine suitability for employment, including a 39-month driving record. </li>
<li>May require possessing and maintaining a valid driver's license (no DUIs or major traffic citations within the last three years). </li>
<li>If required, must meet the Tohono O'odham Nation tribal employer's insurance requirements to receive a driver's permit to operate program vehicles.</li>
<li>Based on the department's needs, incumbents may be required to demonstrate fluency in both the Tohono O'odham language and English as a condition of employment.</li>
</ul>

Supervisory Medical Records Administration Specialist

<h3>Job Description</h3>
Job Description
The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel.
This is a remote position.
ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:
<ul>
<li>Receives claim, confirms policy coverage and acknowledgement of the claim</li>
<li>Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies</li>
<li>Establishes reserves and authorizes payments within reserving authority limits</li>
<li>Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim</li>
<li>Coordinates early return-to-work efforts with the appropriate parties</li>
<li>Manages subrogation and litigation of claim as it applies</li>
<li>Manages potential claim recoveries of all types</li>
<li>Reports claims to the excess carrier when applicable</li>
<li>Communicates claim status with the customer and claimant</li>
<li>Adheres to client and carrier guidelines and participates in claims review as needed</li>
<li>Develops and maintains professional customer relationships</li>
<li>Complies with rules and regulations of applicable state</li>
<li>Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”)</li>
<li>Additional duties as assigned</li>
</ul>
KNOWLEDGE &amp; SKILLS:
<ul>
<li>Excellent written and verbal communication skills</li>
<li>Ability to assist team members to develop knowledge and understanding of claims practice</li>
<li>Ability to identify, analyze and solve problems</li>
<li>Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets</li>
<li>Strong interpersonal, time management and organizational skills</li>
<li>Ability to work both independently and within a team environment</li>
<li>Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation</li>
</ul>
EDUCATION &amp; EXPERIENCE:
<ul>
<li>Bachelor's degree or a combination of education and related experience</li>
<li>Minimum of 3 years’ industry experience and claim handling</li>
<li>Self-Insured Certificate preferred</li>
<li>State Certification as an experienced Examiner</li>
</ul>
PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $28.69 - $46.21 per hour
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL:
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote

CA Senior Claims Specialist

<h3>Job Description</h3>
Job Description
Summary:
The Safe Horizon Clinical Supports Program is made possible by a 3-year grant from the New York City Administration for Children’s Services. The primary function of the program is to provide the ACS Staten Island Field Office Child Protective Specialist (CPS) staff with expert clinical support in the areas of Mental Health, Intimate Partner Violence, and Substance Use. Specifically, the Safe Horizon Clinical Partners affiliated with program provide direct support to individuals, families, and the CPS Team in the form of training, family engagement, assessments of family strengths and needs, service planning, connection to community resources, and services to address safety and other risks. The Senior Director Clinical Supports provides strategic, clinical, and operational leadership for Safe Horizon’s partnership. This leadership role is responsible for ensuring high-quality, trauma-informed, and culturally responsive clinical support services. The Senior Director Clinical Supports will oversee program fidelity, staffing, and quality assurance in accordance with ACS contractual requirements and Safe Horizon’s mission to provide holistic, survivor-centered support to children and families.
Responsibilities:
Because the responsibilities and objectives of this position align with those of Safe Horizon’s child and family services cluster, the Senior Director Clinical Supports reports to the Vice President Child Advocacy and Mental Health Programs. This facilitates the Senior Director’s ability to coordinate and leverage decades of experience at Safe Horizon in mental health, Intimate Partner violence and substance use. The Senior Director will supervise and collaborate with the Training and Development Coordinator to achieve these goals. Serving the Staten Island community, the Senior Director will: 
<ul>
<li>Recruit, retain and deploy credentialed experienced Clinical Partners in the three priority areas</li>
<li>Recruit, retain, supervise and deploy the Training Coordinator</li>
<li>Share the ACS concern that Black and Hispanic families are overrepresented in the child welfare system and hold a race equity lens in training and support with Safe Horizon staff as well as CPS partners </li>
<li>Working with multiple data systems </li>
<li>Provide case-specific clinical advice to the CPS Team</li>
<li>Directly screen and assess both risks and strengths of families</li>
<li>Collaborate with CPS staff to develop family-centered, individualized service recommendations to address safety and other needs</li>
<li>Facilitate the warmest of handoffs</li>
<li>Lead data-driven quality assurance and performance improvement efforts </li>
<li>Review service metrics, satisfaction surveys, and outcome data to identify trends and develop corrective action plans as needed.</li>
<li>Oversee development of quarterly and annual reports </li>
<li>Partner with the CPS Team to identify their training needs</li>
<li>Develop and provide training related to mental health, interpersonal violence and substance use</li>
<li>Develop and maintain linkages with providers on Staten Island that address the needs of families </li>
<li>Track the provision of services by the Safe Horizon Partners</li>
<li>Work with CPS to agree upon quality indicators for the Clinical Support Partnership</li>
<li>Partner with Safe Horizon’s Research &amp; Evaluation to track and evaluate the achievement of the program’s objectives</li>
<li>Perform other duties as necessary</li>
</ul>
Qualifications:
Required
<ul>
<li>An advanced degree (MSW, PhD, MPA or related field) required. </li>
<li>An LCSW or other mental health license</li>
<li>A minimum of 5 years of experience in mental health and/or substance use</li>
<li>A minimum of 5 years of experience with direct service with survivors of interpersonal violence</li>
<li>A minimum of 2 years of management experience </li>
<li>Ability to provide high-level strategic leadership, expert consultation and management to a diverse, multi-disciplinary team including internal and external stakeholders</li>
<li>Excellent interpersonal, team building, organizational and conflict-resolution skills</li>
<li>Significant experience working with criminal justice and/or child protection and/or social service systems </li>
<li>Knowledge of domestic violence and/or child abuse and/or child trauma with a strong commitment to Safe Horizon’s mission and strategic goals, including our anti-racism work</li>
</ul>
Desired:
<ul>
<li>CASAC strongly preferred</li>
<li>Large scale project management experience</li>
<li>Expertise or an appreciation for acute, trauma-focused, evidence-informed practices working with children and families impacted by domestic violence and trauma</li>
<li>Strong preference for bilingual individuals and candidates experienced working with diverse communities</li>
</ul>
Safe Horizon is committed to providing a reasonable accommodation to ensure individuals with disabilities can meet any physical demand requirement(s) of the position, or otherwise perform the corresponding task(s), where possible. If you require a reasonable accommodation, including participating in the job application or interview process, please indicate this on your application questionnaire for next steps.
ADA/EEO/OSHA Statement:
Safe Horizon is committed to the principles of equal employment opportunity and compliance with all Federal, State, and Local laws concerning employment discrimination, harassment and retaliation including the Americans with Disabilities Act. Safe Horizon ensures equal opportunity to all employees and applicants regardless of race, color, age, gender, sexual orientation, sexual and other reproductive health decisions, religion, marital status, national origin or ancestry, citizenship, lawful immigrant status, physical, mental, and medical disability, veteran status, or liability for service in the United States Armed Forces. We are dedicated to providing an inclusive and welcoming environment for all members of our staff and clients.
If hired, I agree to abide by all of Safe Horizon’s rules and regulations, and understand that, if employed, my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either the company or me. I further understand that no representation, whether oral or written by any representative or agent of the organization, at any time, constitutes a contract of employment. AmeriCorps, Peace Corps and other national service alumni are encouraged to apply.
Technology Statement:
Applicants may be responsible for providing the equipment and tools they need to work remotely as required, such as access to a computer, internet service, and phone service. Safe Horizon will discuss potential solutions with candidates and may assist where needed and agreed to in advance.
Please follow this link to view complete EEO Law and complaint filing information: 
Know Your Rights: Workplace discrimination is illegal 
Hiring Pay Range: $80,000 - $90,000
Full-time Hours: 35 Hours per week 
Full-time Benefits: Vacation Time, Paid Sick Time, Holidays, Medical, Dental, Vision, 403(b) Retirement Plan, Company Life Insurance, Medical/Dependent Care Flexible Spending Accounts, Tuition Assistance Program, Commuter Benefits Program, Gym Reimbursement, Parental Leave, Employee Learning Center

Senior Director Clinical Supports Program

<h3>Job Description</h3>
Job Description
Associate Document Control Specialist
Hillsboro, OR 97124
Duration:12+ Months
Pay rate: $30- $41.27/hr.
 
Job description:&nbsp;
RESPONSIBILITIES
<ul>
<li>Responsible for the administration and management of Facilities Engineering records in an effective and efficient manner within the company’s Hillsboro, Oregon facility.</li>
<li>Prepare and organize documentation procedures following company quality policies.</li>
<li>Assist departments with equipment and system documentation.</li>
<li>Coordinate system implementation and prepare required documentation.</li>
<li>Identify process improvements and provide recommendations related to established workflows.</li>
<li>Work directly with Facilities Engineering and various Quality teams.</li>
<li>Maintain open communication with management, co-workers, customers, and counterpart staff across other company sites.</li>
<li>Conduct work in an FDA-regulated environment.</li>
<li>Take ownership of responsibilities and drive change both locally and within the broader company network.</li>
<li>Manage all Turn-Over-Packages (TOPs) and Commissioning Packages for site projects.</li>
<li>Maintain consistent communication with management, co-workers, customers, and counterpart staff across sites.</li>
</ul>
 
QUALIFICATIONS / REQUIREMENTS
<ul>
<li>Proficient in Enterprise Content Management (ECM) applications for archiving, managing, and accessing engineering documents, drawings, and project documentation (including TOPs and commissioning records).</li>
<li>Proficient in FileMaker Pro.</li>
<li>Serve as a point of contact for managing and archiving maintenance activities using QualityDocs Document Management.</li>
<li>Advanced knowledge of ECM and EDMS to support Business Process Management activities.</li>
<li>Ability to develop and document workflow practices and routine task activities.</li>
<li>Provide documentation support for investigations, discrepancies, and corrective actions.</li>
<li>Provide daily assistance to site personnel as needed.</li>
<li>Ability to read, interpret, and produce Facilities Engineering documents.</li>
<li>Thorough knowledge of cGMP compliance.</li>
<li>Advanced documentation skills ensuring all project files and system documentation are maintained at a superior level.</li>
<li>Proficient in EDMS (QualityDocs) for change management of Facilities Engineering documents.</li>
<li>Strong technical writing skills, including preparing technical reports and revising technical documentation and procedures.</li>
<li>Proficient in Microsoft Word and general office productivity tools.</li>
<li>Ability to work overtime or temporarily modify work schedule to meet site obligations.</li>
<li>Able to work effectively with minimal or no supervision.</li>
<li>Ability to lift 50 pounds.</li>
</ul>
 
TRAINING DUTIES
<ul>
<li>Attend all required cGMP training as specified by department policy.</li>
<li>Attend all required Safety training according to department guidelines.</li>
<li>Complete on-the-job training following established training procedures.</li>
</ul>
 
EDUCATION / TRAINING
<ul>
<li>High school diploma or GED required; one to three years of related experience and/or training, or an equivalent combination of education and experience.</li>
<li>Proficient with relational database systems (e.g., MS Access, Oracle).</li>
<li>Experience with project management systems such as TouchPoint, Condor, Trackwise, MS Project.</li>
<li>Experience with data reporting tools (e.g., MS Access, Excel).</li>
<li>Basic knowledge of SAP or similar CMMS programs.</li>
<li>Advanced knowledge of Windows environments.</li>
<li>Must be detail-oriented, accurate, and thorough.</li>
<li>Must have a helpful, friendly, and outgoing personality with strong customer service skills.</li>
<li>Excellent problem-solving skills with persistence to resolve outstanding issues.</li>
<li>Strong analytical abilities.</li>
<li>Excellent organizational skills.</li>
<li>Strong interpersonal skills.</li>
<li>Proficiency in both oral and written communication is essential. </li>
</ul>
 
 Benefits: Russell Tobin offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life &amp; disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors. &nbsp;
Company DescriptionPride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life &amp; disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors. 
<h3>Company Description</h3>
Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life &amp; disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

Document Control Specialist

<h3>Job Description</h3>
Job Description
orthern Light Radiology Associates is seeking an experienced Medical Staff Director to join our growing team. We are a successful hospital-based medical management company dedicated to operational excellence and collaborative teamwork. We’re looking for a driven professional who values partnership, leadership, and high-quality outcomes to support our continued growth.
The Medical Staff Services Director is responsible for overseeing all medical staff services functions for a large multi-state radiology practice, ensuring compliance with regulatory and accreditation requirements. This role leads credentialing, privileging, and ongoing compliance activities for radiologists. The Director serves as a key liaison between physicians, practice leadership, hospitals, and regulatory bodies, supporting high-quality, compliant, and efficient clinical operations.&nbsp;
Key Responsibilities
Medical Staff Services &amp; Governance&nbsp;
<ul>
<li>Direct all medical staff services operations for the radiology practice, including credentialing, privileging, reappointment, and peer review support. </li>
<li>Develop, implement, and maintain medical staff policies, bylaws, rules, and procedures in alignment with best practices and regulatory standards. </li>
<li>This position oversees the medical staff office staff of four credentialing coordinators</li>
</ul>
Credentialing &amp; Privileging&nbsp;
<ul>
<li>Oversee initial and ongoing credentialing and privileging for radiologists across hospitals, imaging centers, and practice locations. </li>
<li>Ensure compliance with state specific licensure, supervision, scope of practice and telemedicine requirements. </li>
<li>Ensure timely completion of reappointments, license renewals, board certifications, CME tracking, and sanction monitoring. </li>
<li>This position is responsible for streamlining the credentialing and state licensing process.&nbsp;</li>
</ul>
Regulatory &amp; Accreditation Compliance&nbsp;
<ul>
<li>Ensure compliance with applicable regulations and standards, including CMS Conditions of Participation, Joint Commission, NCQA, URAC, and state medical board requirements. </li>
<li>This position must have a complete and full understanding of the Joint Commission standards and guidelines. </li>
<li>Monitor changes in regulatory requirements affecting radiology and medical staff services; update policies and processes accordingly.&nbsp;</li>
</ul>
Quality, Risk &amp; Peer Review Support&nbsp;
<ul>
<li>Ensure appropriate documentation, confidentiality, and due process for professional practice evaluations. </li>
<li>This position interacts with hospital medical staff offices, Clinical Operations, Physician Scheduling, Revenue Cycle Management, Project Management, Market Expansion, Quality and Legal departments.&nbsp;</li>
</ul>
Leadership &amp; Operations&nbsp;
<ul>
<li>Lead, mentor, and develop medical staff services and credentialing team members. </li>
<li>Establish performance metrics, workflows, and service-level expectations to ensure timely, accurate processing. </li>
<li>Collaborate with operations, compliance, HR, legal, and IT teams to streamline provider onboarding and ongoing management.&nbsp;</li>
</ul>
Required Qualifications&nbsp;
<ul>
<li>Bachelor’s degree in healthcare administration, business administration, or a related field; Master’s degree preferred. </li>
<li>Minimum of 5-8 years of progressive experience in medical staff services, credentialing, or provider management, preferably in a large multi-site and specialty radiology practice. </li>
<li>Demonstrated leadership experience managing teams and complex credentialing operations. </li>
<li>In-depth knowledge of medical staff bylaws, credentialing standards and privileging requirements.&nbsp;</li>
</ul>
Preferred Certifications (not required)&nbsp;
<ul>
<li>Certified Provider Credentialing Specialist (CPCS) </li>
<li>Certified Medical Staff Services Professional (CPMSM)&nbsp;</li>
</ul>
Skills &amp; Competencies&nbsp;
<ul>
<li>Strong understanding of radiology practice operations and hospital-based medical staff relationships. </li>
<li>Exceptional organizational skills with the ability to manage multiple deadlines and high provider volumes. </li>
<li>Excellent written and verbal communication skills, including interaction with physicians and executives. </li>
<li>High attention to detail with a strong commitment to confidentiality and compliance. </li>
<li>Proficiency with credentialing and provider data systems (e.g., Cactus, MD-Staff, Echo, VerityStream) and Microsoft Office/Excel. </li>
<li>Must be organized, able to proactively identify the needs of practice, well spoken, an excellent writer, logical, tactical and must at all times represent NL in a positive light.&nbsp;</li>
</ul>
Working Conditions&nbsp;
<ul>
<li>On site </li>
<li>Occasional extended hours during audits, surveys, or peak onboarding periods.&nbsp;</li>
</ul>
Reporting Relationship&nbsp;
<ul>
<li>Reports to the Chief Administrative Officer or equivalent senior leader. </li>
</ul>
To learn more about Northern Light we encourage you to visit our website: <a href="http://www.northernlightmm.com" target="_blank">www.northernlightmm.com</a>.

Medical Staff Services Director

<h3>Job Description</h3>
Job DescriptionSalary: 
Community Outreach and Patient Referral Specialist
US Health Partners/ Stuart Cardiology
 
Location:Stuart, FL area- to include Vero through West Palm. This position will primarily be working in the offices and throughout the community with about 15% remotely.
Compensation:Base salary with bonus potential
 
Who we are:
US Health Partners (USHP) seeks to redefine high-quality specialty care in the United States and establish a high-performing, technology-enabled care delivery platform. USHP is partnering with the countrys leading physicians to build a comprehensive, out-patient focused specialty care network targeting the nations cardiovascular concerns. Our physician-led organization is passionate about supporting exceptional care and enriching the lives of patients across the United States. We envision the opportunity to create a scaled, cutting-edge, technology-enabled healthcare services platform that leverages a value-based delivery model.
 
Position Summary:
We are seeking a dynamic and highly motivated Community Outreach and Referral Specialist to join our growing cardiovascular care practice. This role will be primarily responsible for driving new patient referrals to the practice through building strong relationships with local healthcare providers, hospitals, and community organizations to increase these referrals, raise awareness of our cardiovascular services, and foster community engagement. The ideal candidate will have experience in healthcare marketing or community outreach, a passion for making a positive impact on community health, and strong social media management and event coordination skills.
 
Responsibilities may include:
Develop and Implement Referral Programs: Design and execute referral programs targeting local physicians, hospitals, and community health centers, with the goal of increasing new patient referrals to the practice. These responsibilities are:
<ul>
<li>Build and Maintain Relationships:Establish and nurture relationships with local physicians, specialists, healthcare providers, and organizations to drive referral opportunities for cardiovascular care. Support new physicians by accompanying them to offices and establishing their practices locally.</li>
<li>Outreach and Education:Promote the cardiovascular care practice within the community through outreach efforts such as lunch and learns, health fairs, seminars, community events, and partnerships with local organizations. Provide educational resources and presentations about heart health, our services, and the importance of timely cardiovascular care.</li>
<li>Collaboration with Internal Teams:Collaborate with clinical staff, marketing, and operations teams to ensure a seamless referral process, timely follow-ups with referred patients, and patient satisfaction.</li>
<li>Data and KPIs:Partner with the enterprise marketing function to establish and track KPIs to ensure patient referral volumes are meeting goal.</li>
<li>Customer Service and Relationship Management: Provide excellent customer service to referring providers, ensuring all referral inquiries are addressed promptly and professionally.</li>
<li>Patient Experience Focus:Advocate for patients referred to the practice, ensuring they receive high-quality care and a positive experience from initial referral to treatment.</li>
</ul>
 
Other Responsibilities: While this role is largely focused on increasing new patient referrals to the practice, this person will also partner with the enterprise marketing function to:
<ul>
<li>Social Media Management and Content Creation:Manage and grow the practice's presence on social media platforms (Facebook, Instagram, LinkedIn, Twitter, etc.) by developing engaging content that promotes cardiovascular health, services, and patient testimonials. Create and schedule social media posts, monitor engagement, and respond to inquiries in a timely manner. Track social media analytics to assess campaign effectiveness, identify trends, and adjust strategies to increase patient engagement and referral opportunities.</li>
<li>Coordinate Practice-Specific Events:Plan, organize, and coordinate practice-sponsored events, including health screenings, seminars, workshops, and local cardiovascular awareness campaigns. Work with internal teams to ensure smooth execution of events, including logistics, attendee outreach, and follow-up communications. Represent the practice at community events, local health fairs, and other outreach activities to engage with potential patients and healthcare partners.</li>
</ul>
 
Minimum Qualifications:
 Bachelors degree in Marketing, Healthcare Administration, Public Relations, or a related field (preferred).
 Minimum of 2-3 years of experience in healthcare marketing, community outreach, or a related field. Previous experience in cardiovascular care or healthcare marketing is a plus.
 
Competencies:
<ul>
<li>Strong interpersonal and communication skills with the ability to build relationships with healthcare professionals, patients, and community members.</li>
<li>Knowledge of healthcare marketing, patient referral systems, and outreach programs.</li>
<li>Proficiency with social media platforms, content creation, and engagement strategies.</li>
<li>Ability to create and execute strategic outreach campaigns and events.</li>
<li>Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint), social media management tools, and CRM software.</li>
<li>Strong organizational skills with the ability to manage multiple tasks, events, and deadlines.</li>
</ul>
 
Physical Demands and Work Environment:
This is a full-time position based in office with community based travel required for community events, physician meetings, and outreach activities.
Occasional evening or weekend hours may be required for community events, social media posts, and outreach activities.
While performing the duties of this job, the employee is regularly required to sit, use hands and fingers to handle or feel, as well as talk and hear. The employee is regularly required to reach with hands and arms. The employee is required to stand and walk. The employee may lift and/or move up to 20 pounds.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
 
EEO Statement:
US Health Partners is an equal opportunity employer. Employment and processes, including decisions to hire, promote, discipline, or discharge, are based on merit, competence, performance, and business needs. We do not discriminate based on race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.
This job description may not be inclusive of all assigned duties, responsibilities, or aspects of the job described, and may be amended at any time at the sole discretion of the Employer.

9,420 medical-administration-specialist Jobs