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Claims Examiner CalOptima CalOptima Health is seeking a highly motivated Claims Examiner to join our team. The Claims Examiner will be responsible for analyzing and validating claim data elements and claims processing. The incumbent will be responsible for adhering to the regulatory and internal processing guidelines in conjunction with CalOptima Health policies and procedures related to claims adjudication. Position Information: 
<ul>
<li>Department: Claims Administration </li>
<li>Salary Grade: 301 - $47,840 - $64,584 ($23.00 - $31.0500) </li>
<li>Work Arrangement: Full Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>85% - Claims Support
<ul>
<li>Performs thorough review of pending claims for billing errors and/or questionable billing practices that might include duplicate billing and unbundling of services.</li>
<li>Processes non-institutional claim types.</li>
<li>Corrects system generated errors manually prior to final claims adjudication.</li>
<li>Processes claims based upon CalOptima Health contractual agreements or pricing agreements, applicable regulatory legislation, claims processing guidelines and CalOptima Health policies and procedures.</li>
<li>Analyzes and validates Medi-Cal pricing; researches, adjusts and adjudicates claims; reviews services for accurate charges and utilizes current billing code sets, including International Classification Diseases (ICD10) codes, Current Procedural Terminology (CPT) codes and/or authorization guidelines as reference.</li>
<li>Validates eligibility and other possible health insurance coverage on the claim.</li>
<li>Alerts manager or supervisor of more complex issues that arise.</li>
<li>Processes claim exception reports as assigned. </li>
</ul>
</li>
<li>10% - Administrative 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>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High school diploma or equivalent PLUS 1 year of related claims processing experience 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>
 Preferred Qualifications: 
<ul>
<li>Experience processing online claims in a managed care environment. </li>
<li>Experience processing Medi-Cal claims.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6329575&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is July 11, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6329575" target="_blank">https://jobs.caloptima.org/jobs/claims-examiner-505-city-parkway-west-california-united-states-fd7ed77a-73a4-4bd2-9f12-47d82ac1ed30</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-a4cc42329aeb0d40b1127d796b9ce31e

Claims Examiner

The mission of the Uniformed Services University of the Health Sciences (USU) is to support the readiness of America’s Warfighter and the health and well-being of the military community by educating and developing uniformed health professionals, scientists, and leaders; by conducting cutting-edge, military-relevant research, and by providing operational support to units around the world.
The USU Department of Medical and Clinical Psychology (MPS), F. Edward Hébert School of Medicine (SOM), in Bethesda, Maryland, invites applicants for the position of Assistant or Associate Professor (tenure-eligible track). MPS has a doctoral program in Clinical Psychology accredited by the American Psychological Association. The University and the department value and foster an inclusive environment that is diverse, supportive, and open to differing perspectives. Applicants from diverse backgrounds are strongly encouraged to apply.
Duties:&nbsp;The incumbent will serve as an Assistant or Associate Professor in MPS, and as such, will be responsible for teaching MPS graduate-level courses in areas of major expertise, mentoring military and/or civilian doctoral students, overseeing thesis and dissertation studies, and providing lectures to medical and graduate students as needed. The incumbent will engage in programmatic research with the expectation to develop a nationally visible, extramurally supported program of research in support of USU and/or the DoD mission. The incumbent will also assist with curriculum design, engage with multiple administrative assignments, contribute to Equity, Diversity, and Inclusion initiatives across the University, and participate in professional, university, and departmental service activities.
Performs other duties as assigned.
Qualification Requirements: Requires a minimum of an earned Ph.D. degree in Clinical Psychology, Health Psychology, or relevant psychology field from an accredited university or institution; experience in graduate-level teaching and mentorship, curriculum design, and research; demonstrated ability to work with diverse populations in an inclusive manner; exceptional interpersonal skills; outstanding written and oral communication skills; academic accomplishments, reflected by scientific publications in peer-reviewed journals appropriate to the academic rank; and active membership and involvement in scholarly societies.
The successful candidate must be academically qualified for a faculty appointment at the Assistant or Associate Professor level in accordance with SOM and USU academic policies.
The following knowledge and/or experiences are highly desirable but not a requirement:&nbsp;Administrative and/or leadership experience; openness to working with military and/or veteran populations; and grant-writing skills
Nominees for this position shall be required to successfully complete a security background investigation. Failure to meet the background investigation requirements will result in the withdrawal of the position offer or removal from the position.
Relocation expenses i.e., PCS or relocation incentives as described in 5 U.S.C 5733 may be authorized in accordance with applicable travel regulations, command policy and available command funding.
Recruitment Incentive may be authorized.
<a href="https://www.whitehouse.gov/briefing-room/presidential-actions/2021/09/09/executive-order-on-requiring-coronavirus-disease-2019-vaccination-for-federal-employees/" target="_blank">Executive Order (EO) 14043, dated September 9, 2021, “Coronavirus Disease 2019 Vaccination for Federal Employees</a>.&nbsp;To ensure compliance with an applicable preliminary nationwide injunction, which may be supplemented, modified, or vacated, depending on the course of ongoing litigation, the Federal Government will take no action to implement or enforce the COVID-19 vaccination requirement pursuant to Executive Order 14043 on Requiring Coronavirus Disease 2019 Vaccination for Federal Employees. Therefore, to the extent a Federal job announcement includes the requirement that applicants must be fully vaccinated against COVID-19 pursuant to E.O. 14043, that requirement does not currently apply. Federal agencies may request information regarding the vaccination status of selected applicants for the purposes of implementing other workplace safety protocols, such as protocols related to masking, physical distancing, testing, travel, and quarantine.
U.S. Citizenship is required.
Instructions for Applicants: To receive consideration, applicants must specify in their cover letter the academic rank(s) for which they are applying.&nbsp;Review of applications will begin approximately 30 days following the initial job posting and will continue until the position is filled. Applicants should submit (1) a letter of interest, (2) curriculum vitae, and (3) the names of three individuals who can be contacted to provide references,&nbsp;as one combined PDF&nbsp;to:
Ms. Trish Crum Department of Medical &amp; Clinical Psychology (MPS) Uniformed Service University of the Health Sciences (USU) 4301 Jones Bridge Road Bethesda, MD 20814 <a href="mailto:tricia.crum@usuhs.edu" target="_blank">tricia.crum@usuhs.edu</a>&nbsp;
USUHS is an Equal Opportunity Employer with a strong commitment to racial, cultural, and ethnic diversity.

Associate/Assistant Professor, Department of Medical & Clinical Psychology (MPS)

Assistant Professor-Tenure System Job no: 870838 Work type: Faculty/Academic Staff Major Administrative Unit / College: College Of Arts AndLetters Department: Religious Studies 10004716 Sub Area: FAS- Fac./Acad Staff Salary: Salary Commensurate with Experience Location: East Lansing Categories: Education/Training, Tenure System Faculty, FullTime (90-100%), Non-Union Working/Functional Title Ast. Prof in Contemporary Islam Position Summary The Department of Religious Studies is hiring a tenure-streamAssistant Professor in the position of Contemporary Islam. Thespecific area of focus is open. We seek a scholar with preferredsubspecialties in any of the following: Islam and racial identity;Islam and gender/sexuality; Islam in the US; Islam and Migration;Transnational Islam; Islamic Thought; Qur'anic Hermeneutics; Islamand new technologies; Digital Islam; and Islam and non-profitleadership. Our preferred time frame is the 20th and 21stcenturies. This position will be in the Department of Religious Studies (100%)in the College of Arts and Letters (CAL). It is a full-time,academic year (9 month) appointment, beginning August 16, 2024. Theduty period runs from August 16 through May 15 of each year. Thesuccessful candidate will be expected to engage in professionalactivities under the broad headings of Research, Teaching, andService. Equal Employment Opportunity Statement All qualified applicants will receive consideration for employmentwithout regard to race, color, religion, sex, sexual orientation,gender identity, national origin, citizenship, age, disability orprotected veteran status. Required Degree Doctorate Minimum Requirements 
<ul>
<li>A Ph.D in Religious Studies or a related field Desired Qualifications </li>
<li>Evidence of teaching excellence </li>
<li>Robust research agenda </li>
<li>Track record of (or articulate plans for) community engagementand/or public-facing scholarship Required Application Materials </li>
<li>a cover letter </li>
<li>current curriculum vitae </li>
<li>A 1-page summary of your philosophy of diversity, equity, andinclusion as it pertains to intellectual leadership in the areas ofteaching/curriculum development, research/creative activities,service, outreach, advising, and/or administration. The statementshould also include an explanation of related past or plannedactivities/endeavors as well as how the candidate will advance ourgoals of inclusive excellence. For more about MSU's DEI efforts,see <a href="https://inclusion.msu.edu/" target="_blank">https://inclusion.msu.edu/</a>. Formore information about writing diversity statements, see <a href="https://cal.msu.edu/documents/cal-guidelines-for-the-writing-of-diversity-statements/" target="_blank">https://cal.msu.edu/documents/cal-guidelines-for-the-writing-of-diversity-statements/</a> </li>
<li>the names and email addresses of 3 potential referees. Special Instructions Review of applications will begin 8/16/2023 and will continue untilthe position is filled. Applications must be submittedelectronically to the Michigan State University Human Resourceswebsite <a href="http://careers.msu.edu" target="_blank">http://careers.msu.edu</a>. Posting number870838. For more information, contact Dr. Mohammad Khalil, Chair of theSearch Committee at <a href="mailto:khalilmo@msu.edu" target="_blank">khalilmo@msu.edu</a>. Persons with disabilities have the right to request and receivereasonable accommodation. Review of Applications Begins On 08/16/2023 Website <a href="http://www.religiousstudies.msu.edu" target="_blank">www.religiousstudies.msu.edu</a> Department Statement The College of Arts &amp; Letters recognizes that only an academicand organizational culture, which actively seeks out andstrengthens diverse voices and perspectives among its membersresults in true excellence. MSU Statement Michigan State University has been advancing the common good withuncommon will for more than 160 years. One of the top researchuniversities in the world, MSU pushes the boundaries of discoveryand forges enduring partnerships to solve the most pressing globalchallenges while providing life-changing opportunities to a diverseand inclusive academic community through more than 200 programs ofstudy in 17 degree-granting colleges. Advertised: Jun 12, 2023 Eastern Daylight Time Applications close: Jun 12, 2025 Eastern Daylight Time To apply, visit <a href="https://apptrkr.com/4291288" target="_blank">https://careers.msu.edu/en-us/job/515244/assistant-professortenure-system</a> jeid-52e638f19475de4e9b3f8295466b210e</li>
</ul>

Assistant Professor-Tenure System

JOB TITLE: &nbsp;Interim Program Director, Physician Assistant Studies
DEPARTMENT:&nbsp;&nbsp;Physician Assistant Studies
REPORTS TO:&nbsp;&nbsp;&nbsp;Dean, Borra College of Health Sciences
JOB STATUS:&nbsp;Full-time (at least 37.5 hours/week), eligible for full benefits
LOCATION:&nbsp;Hybrid: 2-3 days remote
*The successful candidate will be appointed interim for a minimum of six months.&nbsp;
Dominican University (DU) invites applications and nominations for the role of Interim Program Director of the Physician Assistant Studies (PAS) Program in the Borra College of Health Sciences. The Interim Program Director will provide leadership, administrative oversight and oversee all aspects of the PAS program including organization, administration, fiscal management, ongoing review and assessment, program planning and development and continuing accreditation with ARC-PA. The successful candidate will also be responsible for the routine operations of the program including curriculum oversight, scheduling and faculty workload, faculty evaluation, student recruitment and support, and the identification and development of clinical affiliation agreements, working in collaboration with the PAS Director of Clinical Education.&nbsp; The Program Director, reporting to the Dean of the Borra College of Health Sciences, leads the members of the PAS Department which includes the Director of Clinical Education, the Medical Director, and program faculty and staff.&nbsp; There is also an expectation to work with colleagues across the college, university leadership, the program’s Advisory Board and healthcare partners to innovate and promote the program. &nbsp;
EXPECTATIONS FOR ALL DOMINICAN EMPLOYEES:
Support the University's mission of preparing students to pursue truth, to give compassionate service, and to participate in the creation of a more just and humane world.
JOB COMPONENTS/PRINCIPAL DUTIES AND RESPONSIBILITIES:
<ul>
<li>Lead with excellent management and communication skills to articulate and carry out the vision of the program</li>
<li>Provide oversight of program curriculum and policy development and implementation including regular review of student policies in the PAS Student Handbook</li>
<li>Continuously evaluate, analyze and improve the program to ensure ongoing successful accreditation in program’s self-evaluation process and on-going program quality standards</li>
<li>Faculty/staff recruitment, hiring, mentoring, evaluation and development</li>
<li>Manage program budget and provide fiscal management</li>
<li>Provide oversight of the admissions process, student recruitment and orientation</li>
<li>Encourage student excellence in both didactic and clinical years that fosters a positive student experience in the program</li>
<li>Recruit and support a diverse group of students and learners</li>
<li>Work with program faculty, Medical Director to promote and enhance student retention and pathways for remediation</li>
<li>Provide direction for program strategic planning and development, with an attention to the analysis of comprehensive program data</li>
<li>Work with the program directors/chairs and the Director of Simulation Education Center in the Borra College of Health Sciences to develop and implement collaborative interprofessional experiences in the college</li>
<li>Supervision of the medical director, principal and instructional faculty, and staff in activities that directly relate to the PA program including regular review of PAS committee duties and actions</li>
<li>Create and maintain effective relationships with outside stakeholders, particularly for the development and maintenance of clinical affiliations</li>
<li>Foster future growth and expansion of program</li>
<li>Perform other duties as requested, delegated or assigned</li>
</ul>
QUALIFICATIONS:
Minimum Qualifications
<ul>
<li>A graduate of an accredited physician assistant program with a current NCCPA certification and eligibility for licensure in Illinois</li>
<li>At least seven years of clinical experience as a practicing PA with a thorough understanding of the physician assistant role and practice</li>
<li>Minimum of five years of full-time faculty experience and three years of full-time experience in a PAS program with teaching responsibilities at the graduate level</li>
<li>Previous experience with the ARC-PA accreditation process for physician assistant programs</li>
</ul>
Preferred Qualifications
<ul>
<li>Previous experience in education leadership such as Program Director, Associate Program Director, Academic Director, Clinical Director or another director-level role</li>
<li>Demonstrated leadership in the PAS field; Record of excellence in teaching, scholarship, service and fostering empirical research.</li>
<li>Have a vision and the interpersonal skills to build partnerships within and outside the PAS program, and state and regional partners and stakeholders.</li>
</ul>
Application:&nbsp;
Apply online at <a href="http://www.dom.edu/jobs" target="_blank">www.dom.edu/jobs</a>.&nbsp;&nbsp;Applicants will be&nbsp;asked to submit a cover letter,&nbsp;CV,&nbsp;and a list of 3 references.&nbsp;A personal&nbsp;statement will also be required to demonstrate the applicant’s commitment&nbsp;to inclusive&nbsp;and engaged leadership and&nbsp;teaching&nbsp;and&nbsp;how they plan to contribute to the diversity and inclusion on our campus and within the program.&nbsp;
A background screening is required.
Applicants who progress in the search process will be asked to provide letters of recommendation and official transcripts. &nbsp;
EEO Statement
Dominican University is proud to be an equal opportunity employer and is dedicated to the goal of building an equity-centered faculty and staff committed to teaching, working, and learning in a multicultural environment. Dominican University believes that justice, equity, and inclusion are critical to our growth and development and seek to recruit, develop, and retain from a diverse pool of applicants who bring varied experiences, perspectives, and backgrounds.
If you need accommodations due to a disability, you may contact us at&nbsp;<a href="mailto:hr@dom.edu" target="_blank">hr@dom.edu</a>&nbsp;for assistance.

Interim Program Director, Physician Assistant Studies

Program/Policy Analyst Sr (Medi-Cal Compliance) CalOptima CalOptima Health is seeking a highly motivated Program/Policy Analyst Sr (Medi-Cal Compliance) to join our team. The Program/Policy Analyst Sr (Medi-Cal Compliance) will coordinate and maintain CalOptima Health's relationship with regulatory agencies and ensure CalOptima Health and its First Tier, Downstream and Related Entities (FDRs) comply with all appropriate standards, regulations, contractual provisions, federal waivers and laws. Specifically, the incumbent works to enhance and strengthen CalOptima Health's policy infrastructure, platform and strategies at the state level, including contract compliance, statutory and regulatory obligations with the Department of Health Care Services (DHCS). The incumbent requires the ability to complete a variety of independent detailed analyses, including the development, review and response to corrective action plans. The incumbent will be responsible implementing Corrective Action Plans (CAPs), supporting regulatory audits, validating regulatory guidance and developing regulatory communications for CalOptima Health stakeholders. The incumbent will interact with CalOptima Health's executives and department management, FDR's management, legal counsel and state and federal regulatory agencies. The incumbent will also support other key CalOptima Health staff on related projects. Position Information: 
<ul>
<li>Department: OOC - MediCal Regulatory Affairs &amp; Compliance </li>
<li>Salary Grade: 311 - $77,863 - $124,581 ($37.43 - $59.8947) </li>
<li>Work Arrangement: Full Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>85% - 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>Works with all of CalOptima Health's departments in response to inquiries, problem-solving and promoting CalOptima Health's mission and message.</li>
<li>Assists in the management of CalOptima Health's daily relationship with the DHCS for CalOptima Health's Medi-Cal program.</li>
<li>Maintains open lines of communication to ensure the ongoing trust and confidence of regulators in the program and management.</li>
<li>Researches, analyzes and makes recommendations regarding the policy implications of major initiatives for CalOptima Health's Medi-Cal program, e.g., integration of new benefits and populations.</li>
<li>Works with business areas at all levels of leadership to validate regulatory communications from regulators impacting CalOptima Health's Medi-Cal program.</li>
<li>Supports process improvements for the Office of Compliance department.</li>
<li>Serves as a Medi-Cal regulatory subject matter expert and lead for CalOptima Health's compliance issues and investigations.</li>
<li>Supports management in the readiness, coordination, oversight and remediation of regulatory audits, including but not limited to validating business area submissions, additional audit requests and written daily reports.</li>
<li>Researches and responds in a professional manner to questions pertaining to the Medi-Cal program.</li>
<li>Works with the director and manager with interactions and responses to regulatory representatives on compliance-related issues as needed.</li>
<li>Reviews and retains working knowledge of Medi-Cal policies and procedures related to assigned programs and projects.</li>
<li>Assists in the creation of communications and strategic alliances with regulators.</li>
<li>Researches and keeps current on the local, state and federal health care environment and health policy, identifying issues that may impact CalOptima Health's Medi-Cal program.</li>
<li>Coordinates the maintenance of public program benefit updates for accurate and consistent application by CalOptima Health and its provider community.</li>
<li>Participates and represents CalOptima Health in meetings and calls with regulators and associations and summarizes key points and impact to CalOptima Health's Medi-Cal program as needed. </li>
<li>10% - Administrative Support</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>Initiates, facilitates and promotes activities to foster compliance awareness and encourages the reporting of compliance issues within the organization and related entities. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned.</li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in health services administration, public health, public policy or a related field PLUS 4 years of experience in government, public or government affairs role in health care compliance or health plan requirements 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>
 Preferred Qualifications: 
<ul>
<li>Master's degree. </li>
<li>Experience working with regulatory agencies in California. </li>
<li>Experience with Medi-Cal regulatory requirements and/or compliance in the areas of Customer Service, Grievance &amp; Appeals, Quality Improvement, Case Management, Claims Administration and/or Utilization Management. </li>
<li>Certification in Healthcare Compliance (CHC) or other compliance related certifications such as Certified Compliance and Ethics Professional.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>n/a</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6296744&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 25, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6296744" target="_blank">https://jobs.caloptima.org/jobs/program-policy-analyst-sr-medi-cal-compliance-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-c10c0223e159b943b7243c210753f920

Program/Policy Analyst Sr (Medi-Cal Compliance)

The Department of Government at New Mexico State University invites applications for the position of Tenure Track Assistant Professor in Political Science with a focus on American government. Employment will start August 19, 2024.
Applicants must have a Ph.D. or have ABD status in Political Science or a related field. Preferred qualifications are teaching experience in Political Science and American government.&nbsp;The Tenure Track Assistant Professor will teach a mix of undergraduate and graduate classes in the areas of political science and American government, totaling three classes per semester, as well as serve on the MA committee within the Department of Government.
The Department of Government offers a BA in Government, a Supplementary Major in Law and Society, an MA in Government, and a nationally accredited Masters of Public Administration (MPA). It is also one of the lead departments for the new Interdisciplinary Ph.D. Program in Transborder and Global Human Dynamics. The department has a proud tradition of enhancing student success and social mobility, outstanding research and valuable work in service and outreach.
For inquiries, please contact the search committee chair, Dr. Seong Kang, at <a href="mailto:sckang@nmsu.edu" target="_blank">sckang@nmsu.edu</a>. To be considered, applications must be submitted online by September, 28, 2023&nbsp;at: <a href="https://careers.nmsu.edu/jobs/assistant-professor-las-cruces-new-mexico-united-states" target="_blank">https://careers.nmsu.edu/jobs/assistant-professor-las-cruces-new-mexico-united-states</a>
New Mexico State University is an Equal Opportunity/Affirmative Action Employer; Minorities, Females, Veterans, and those with a Disability are encouraged to apply.

Assistant Professor - New Mexico State University Job No# 498239 and Position No# 197401

The Assistant Director (AD) for Residential Education reports to the Associate Director for Residential Education and is responsible for oversight and leadership of 2-4 residentially-based Learning Communities (LCs) that house between 1300 to 1900 students (roughly one-third of the on-campus population). The responsibilities of this position include training, supervision, development, and evaluation of 2-3 frontline full-time professional staff members (including Area Coordinators and/or Residence Directors) and 1 Graduate Coordinator. As a member of the Residential Education Leadership Team, the AD is responsible for overseeing the administrative and management functions of their Campus Area, as well as assisting in the development of policies and procedures for the department. The AD supports the ACs/RD to establish Learning Communities that foster community and civic engagement, enhance learning, advance diversity and inclusion, and promote student health, engagement, and success. This is a required live-on position.&nbsp; Successful candidates will be subject to background check due to the live-in nature of this position. Non-standard work hours are required, External candidates must complete a 4-month probationary period, A probationary period may be required for current UVM employees.
Minimum Qualifications: A Master’s Degree is required in Higher Education and Student Affairs, Student Personnel, Counseling, Education, and related field, and at least 3-year full-time experience is required.
Desired Qualifications: Previous experience in residential life and/or learning communities is preferred. Preference will be given to candidates who embrace the concepts of Restorative Practices and who have a demonstrated commitment to intercultural competency development and fostering a collaborative multicultural environment.
The University of Vermont is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other category legally protected by federal or state law.

Assistant Director for Residential Education

Staff Assistant/Behavioral Health Counselor
Posting:&nbsp; July 2023 Position:&nbsp; FY24-04 Deadline for application:&nbsp; 26 August 2023 Start Date:&nbsp; ASAP Division:&nbsp; Student Services Union Affiliation:&nbsp; Association of Professional Administrators (APA) Supervision Received:&nbsp; Reports to the Director of Counseling Supervision Exercised:&nbsp; Supervises subordinate professional, classified and student personnel in area of responsibility as assigned General Statement of Duties: The general duties include delivering counseling services, as well as alcohol screening and intervention to the undergraduate student body, providing consultation and training to faculty and staff, and developing and facilitating educational outreach and programming to the student body. The position is available for a licensed psychologist or an independently licensed social worker or mental health counselor. Potential to consider a 10-month employment option. Responsibilities:&nbsp;
<ul>
<li>Provide counseling care in an individual therapy format. Providers should be comfortable working in a brief therapy model Support alcohol screening and brief intervention that dovetails with the Academy’s conduct system Provide consultation and training to faculty and staff on issues affecting the social and emotional needs of students Develop and facilitate outreach programming in the form of health promotion events, psychoeducational presentations, or therapy groups, with a particular focus on substance use education. Flexibility to occasionally work outside of normal business hours to facilitate such events Related case management duties include coordinating with students, their families, off-campus treatment providers, and on campus support services Risk assessment and related crisis intervention duties Participation in a portion (maximum of 3 weeks) of Sea Term, providing counseling and programming aboard the Academy’s training ship Working in partnership with student-led organizations and committees which focus on campus wellness initiatives While rare, the provider could also be responsible for coordinating emergency psychiatric evaluations, including involuntary psychiatric holds (“Section 12”) with staff eligible to apply for such holds, or in coordination with other Academy clinicians and local emergency services Follow all related departmental and Academy protocols and procedures, including standards for documentation and</li>
</ul>
emergencies Required Qualifications: 
<ul>
<li>Master’s degree Valid professional licensure in the state of Massachusetts in clinical or counseling psychology, social work or mental health counseling Experience working with an adolescent population Experience in risk assessment and crisis intervention Previous experience or willingness to acquire knowledge and skills in the area of substance use assessment Preferred Qualifications: Experience working in a college or university mental health counseling center Experience in substance use prevention, assessment, treatment and recovery support Knowledge of BASICS – Brief Alcohol Screening and Intervention for College Students Experience in the development and delivery of psychoeducational outreach and related programming</li>
</ul>
Salary: $68,000 to $75,000. The Academy offers generous benefits policies and a competitive salary commensurate with qualifications and experience. The Academy is not sponsoring immigration visas at this time.&nbsp; FLSA Status: Exempt
To apply, please submit a cover letter, a resume, an MMA application, Affirmative Action form, and the contact information of five (5) professional references.&nbsp; These forms are located on the employment opportunities link under Human Resources on the MMA website <a href="http://www.maritime.edu.&amp;nbsp" target="_blank">www.maritime.edu.&amp;nbsp</a>; Application materials may be attached and sent electronically to <a href="mailto:hr@maritime.edu" target="_blank">hr@maritime.edu</a>.&nbsp; Alternatively, you may send your application materials by USPS to:&nbsp; Human Resources, Massachusetts Maritime Academy, 101 Academy Drive, Buzzards Bay, MA 02532. Finalists must complete a pre-employment drug screening and CORI.
Massachusetts Maritime Academy is an Equal Opportunity Employer. We strongly encourage members from historically underrepresented communities, women and veterans to apply.

Staff Assistant/Behavioral Health Counselor 

Positions:&nbsp; Assistant Professor of Law&nbsp;
Preferred Subjects: Contracts, Business Organizations, Commercial Law (and other transactional law), Property, Family Law, Environmental Law, Criminal Law, Civil Rights/Race and the Law
Start Date:&nbsp; August 2024
Samford University’s Cumberland School of Law invites individuals interested in serving in a Christian university environment to apply for a tenure-track professor of law position.&nbsp; The tenure-track faculty position is a nine-month appointment that will begin in August 2024 at the rank of Assistant Professor.&nbsp;&nbsp;
Required qualifications&nbsp;include outstanding academic credentials, including a J.D. from an ABA-accredited law school or equivalent degree and demonstrated experience in a relevant subject matter. &nbsp;&nbsp;
Applicants with demonstrated expertise in business organizations, contracts, commercial law (and other areas of transactional law), property law, environmental law, family law, criminal law, civil rights/race and the law, and negotiation and mediation are especially encouraged to apply.&nbsp;
Preferencewill be given to candidates with teaching experience (or significant and relevant experience in private practice, government, or public service) and a demonstrated publication record and research agenda.
Cumberland School of Law prides itself on its commitment to teaching and to ensuring not only the success of its students upon graduation but their recognition of the ethical obligations that flow from being an officer of the court and a servant of the community.&nbsp; The ideal candidate will thus demonstrate the ability and motivation to develop meaningful mentoring relationships with students both in and out of class.
Samford University (<a href="http://www.samford.edu" target="_blank">www.samford.edu</a>) is the largest privately supported and fully accredited institution for higher learning in Alabama. Located in suburban Birmingham, the University was founded in 1841 and has 425 full-time faculty and more than 5,700 students representing 48 states, the District of Columbia, Puerto Rico and 22 countries. Samford has been nationally recognized for academics, affordability and value by a number of prestigious publications and rankings. The Wall Street Journal and Times Higher Education rank Samford 1st nationally for student engagement and Kiplinger’s Personal Finance ranks Samford 34th among private universities in the United States for value and affordability. The University is dedicated to the promotion of rigorous academic inquiry in a Christian setting. TheUniversity seeks and prefers employee applicants of the Christian faith and offers competitive salaries with a generous benefits package.
Review of applications will begin August 1, 2023, and applications will be accepted until October 15, 2023. Application materials should include a letter of interest, curriculum vita, Application for Faculty Position and the Faculty Applicant Christian Mission Statement. Salary is dependent upon qualifications and experience.&nbsp; The successful candidate must pass a background check. Applicants must be authorized to work in the United States, as Samford will not sponsor any employment visas for this position. Samford University and the Cumberland School of Law embrace diversity in their faculty, students, and staff and encourage applications from those who would add to the diversity of our academic community.&nbsp;&nbsp;
“Application for Faculty Position” can be found at:
<a href="https://www.samford.edu/departments/files/Human_Resources/application-for-faculty-employment.pdf" target="_blank">https://www.samford.edu/departments/files/Human_Resources/application-for-faculty-employment.pdf</a>
“Faculty Applicant Christian Mission Statement” can be found at:
<a href="https://www.samford.edu/departments/files/academic-affairs/Faculty-Applicant-Christian-Mission-Statement.docx" target="_blank">https://www.samford.edu/departments/files/academic-affairs/Faculty-Applicant-Christian-Mission-Statement.docx</a>
Please submit all materials in PDF format to:
<a href="mailto:FACAPP@samford.edu" target="_blank">FACAPP@samford.edu</a>
Subject:&nbsp; Assistant Professor of Law
For questions about the position please contact:
<a>Brannon Denning, Chair, Faculty Appointments Committee</a>
<a href="mailto:bpdennin@samford.edu" target="_blank">bpdennin@samford.edu</a> &nbsp;
205-726-2411
Except as specifically exempted by federal law requirements, Samford University does not unlawfully discriminate on the basis of race, color, sex, national or ethnic origin, disability or age in the administration or application of its educational programs and policies, admissions policies, employment policies, scholarship and loan programs. Consistent with its Christian mission and organizations, Samford is exempt from the religious provisions of Title VII pursuant to 42 U.S.C. Sections 2000e-1(a) and 2000e-2(e).

Assistant Professor of Law (9-Mo-TT)

Position Description
The Department of Sociology at the University of Washington invites applications for a tenure-track Assistant Professor specializing in the study of environmental inequality and/or climate change. Positive factors for consideration include, but are not limited to: a promising record of scholarly accomplishment; research interests that complement other areas of departmental and university strength; promise of effective undergraduate teaching and graduate training; and potential for engagement with professional, university, and community life. All University of Washington faculty engage in teaching, research, and service.
The Department of Sociology is located on the Seattle campus of the University of Washington. We are a collaborative and generous scholarly community with an outstanding track record of mentoring junior scholars and a strong commitment to diversity, equity, and inclusion. Both our undergraduate and graduate student bodies include many first-generation students, immigrants, and people of color. Members of the department are involved in numerous successful cross-department and interdisciplinary initiatives and research activities, and we have durable ties to the Department of Law, Societies and Justice, the West Coast Poverty Center, UW’s NIH- funded center for population studies (CSDE), the Center for Statistics and the Social Sciences, the eScience Institute, UW’s Population Health Initiative, the College of the Environment, the Department of Real Estate, the Jackson School of International Studies, the QUAL Initiative, the Department of Statistics, and the Schools of Nursing, Medicine, and Public Health.
Washington State Law requires that this ad list a binding salary range.&nbsp;The base salary range for this position will be $9650 - $13500&nbsp;per month on a 9-month basis ($86,850 - $121,500 annually), commensurate with experience and qualifications, or as mandated by a U.S. Department of Labor prevailing wage determination.&nbsp;
The position will begin on September 16, 2024, and is full time with a 9-month service period.
Qualifications
Applicants must have a Ph.D., or foreign equivalent, in sociology or closely related field by the start of the appointment.
Application Instructions
Both the University of Washington and the Department of Sociology are committed to creating a community that embraces and benefits from the diversity of its faculty, staff and students. Successful applicants should be able to thrive in and contribute to this environment. Therefore, application materials must include a separate statement that describes how you will contribute to creating an inclusive, equitable and diverse department.
Complete applications will include: 1) curriculum vita; 2) cover letter; 3) a description of research experience and plans; 4) a statement of teaching, including a description of teaching approach and evidence of teaching effectiveness; 5) a statement of contributions to diversity, equity, and inclusion; and 6) at least two samples of recent scholarly work.&nbsp; Candidates selected during the initial round of review will be contacted to provide a list of three professional references.
All application material should be submitted to <a href="http://apply.interfolio.com/128619" target="_blank">http://apply.interfolio.com/128619</a>. Review of applications will begin on October 16, 2023. However, the position will remain open, and applications may be considered, until the position is filled.
Questions about the search should be sent to: Fatema Mookhtiar, Administrator, Department of Sociology, <a href="mailto:fatemakm@uw.edu" target="_blank">fatemakm@uw.edu</a>.
Equal Employment Opportunity Statement
University of Washington is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, sex, sexual orientation, marital status, pregnancy, genetic information, gender identity or expression, age, disability, or protected veteran status.
Benefits Information
A summary of benefits associated with this title/rank can be found at <a href="https://hr.uw.edu/benefits/benefits-orientation/benefit-summary-pdfs/" target="_blank">https://hr.uw.edu/benefits/benefits-orientation/benefit-summary-pdfs/</a>. Appointees solely employed and paid directly by a non-UW entity are not UW employees and are not eligible for UW or Washington State employee benefits.
Commitment to Diversity
The University of Washington is committed to building diversity among its faculty, librarian, staff, and student communities, and articulates that commitment in the UW Diversity Blueprint (<a href="http://www.washington.edu/diversity/diversity-blueprint" target="_blank">http://www.washington.edu/diversity/diversity-blueprint</a>/). Additionally, the University’s Faculty Code recognizes faculty efforts in research, teaching and/or service that address diversity and equal opportunity as important contributions to a faculty member’s academic profile and responsibilities (<a href="https://www.washington.edu/admin/rules/policies/FCG/FCCH24.html#2432" target="_blank">https://www.washington.edu/admin/rules/policies/FCG/FCCH24.html#2432</a>).
Privacy Notice
Review the University of Washington <a href="https://www.washington.edu/cms/privacy/notices/demographics/" target="_blank">Privacy Notice for Demographic Data of Job Applicants and University Personnel</a> to learn how your demographic data are protected, when the data may be used, and your rights.
Disability Services
To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or <a href="mailto:dso@uw.edu" target="_blank">dso@uw.edu</a>.

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