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<p>At American Express, our culture is built on a 175-year history of innovation, shared values and Leadership Behaviors, and an unwavering commitment to back our customers, communities, and colleagues. As part of Team Amex, you'll experience this powerful backing with comprehensive support for your holistic well-being and many opportunities to learn new skills, develop as a leader, and grow your career.</p><p>Here, your voice and ideas matter, your work makes an impact, and together, you will help us define the future of American Express.</p><p>Global Commercial Services (GCS) is the global leader in providing payments solutions for Small, Medium and Large businesses. The mission of the Business Checking team within GCS is to create checking products &amp; features that are the best choice for our business customers. We achieve this by being customer and competitor obsessed, delivering market leading value, and creating great experiences for our customers. This Senior Product Manager of Banking/Payments will help drive the roadmap for money movement through customer research, identifying customer need, data, competitive analysis, and customer feedback.</p><p><strong>Key Responsibilities:</strong></p><ul><li>Define, communicate and execute on the strategy &amp; roadmap of money movement features and products to support Business Checking product goals</li><li>Define the customer experience and create a compelling value proposition for money movement to drive loyalty and engagement</li><li>Define customer needs, metrics, controls &amp; monitoring, key risk indicators and key performance indicators to track the success of the features launched</li><li>Partner with Design, Product Development, &amp; Engineering teams to drive the evolution of the payment &amp; banking capabilities to address small and mid-sized business needs</li><li>Partner with regulatory teams to ensure adherence to product controls &amp; monitoring</li><li>Collaborate with key stakeholders and cross-functional partners across the organization including Product Development, Technology, Financial Partners, Marketing, Risk, Operations, Compliance, Legal, Finance and other regulatory partners to deliver the product to market</li><li>Occasional domestic travel</li></ul><p><strong>Minimum Qualifications:</strong></p><ul><li>Relevant product management experience in a fintech or consumer/small business/commercial bank, preferably managing payment and transfers features (incl. but not limited to ACH, Wires, Bill Pay, Checks, as applicable)</li><li>Experience executing strategies to maximize user engagement and acting as a liaison between business and tech teams to define, prioritize, and deliver projects</li><li>Strategic thought leadership and strong critical thinking and analytical skills</li><li>Ability to provide insight and accurate judgment in addressing and resolving complex business issues and project issues that lead to escalation</li><li>Excellent project management, organization, and prioritization skills and a proven ability to manage cross-functional, large/complex initiatives</li><li>Bachelor's or Master's degree or equivalent work experience in product</li></ul><p>Salary Range: $90,000.00 to $165,000.00 annually + bonus + benefits</p><p>The above represents the expected salary range for this job requisition. Ultimately, in determining your pay, we’ll consider your location, experience, and other job-related factors.</p><p>We back you with benefits that support your holistic well-being so you can be and deliver your best. This means caring for you and your loved ones' physical, financial, and mental health, as well as providing the flexibility you need to thrive personally and professionally:</p><ul><li>Competitive base salaries&nbsp;</li><li>Bonus incentives&nbsp;</li><li>6% Company Match on retirement savings plan&nbsp;</li><li>Free financial coaching and financial well-being support&nbsp;</li><li>Comprehensive medical, dental, vision, life insurance, and disability benefits&nbsp;</li><li>Flexible working model with hybrid, onsite or virtual arrangements depending on role and business need&nbsp;</li><li>20+ weeks paid parental leave for all parents, regardless of gender, offered for pregnancy, adoption or surrogacy&nbsp;</li><li>Free access to global on-site wellness centers staffed with nurses and doctors (depending on location)&nbsp;</li><li>Free and confidential counseling support through our Healthy Minds program&nbsp;</li><li>Career development and training opportunities</li></ul><p>For a full list of Team Amex benefits, visit our Colleague Benefits Site.</p><p>American Express is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law. American Express will consider for employment all qualified applicants, including those with arrest or conviction records, in accordance with the requirements of applicable state and local laws, including, but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance for Employers, and the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. For positions covered by federal and/or state banking regulations, American Express will comply with such regulations as it relates to the consideration of applicants with criminal convictions.</p><p>We back our colleagues with the support they need to thrive, professionally and personally. That's why we have Amex Flex, our enterprise working model that provides greater flexibility to colleagues while ensuring we preserve the important aspects of our unique in-person culture. Depending on role and business needs, colleagues will either work onsite, in a hybrid model (combination of in-office and virtual days) or fully virtually.</p><p>US Job Seekers - Click to view the “Know Your Rights” poster. If the link does not work, you may access the poster by copying and pasting the following URL in a new browser window: <a href="https://www.eeoc.gov/poster" target="_blank">https://www.eeoc.gov/poster</a></p><p>Employment eligibility to work with American Express in the U.S. is required as the company will not pursue visa sponsorship for these positions.</p>

American Express

Sr Manager - Payments/Banking Digital Product Management

<p>At American Express, our culture is built on a 175-year history of innovation, shared values and Leadership Behaviors, and an unwavering commitment to back our customers, communities, and colleagues. As part of Team Amex, you'll experience this powerful backing with comprehensive support for your holistic well-being and many opportunities to learn new skills, develop as a leader, and grow your career.</p><p>Here, your voice and ideas matter, your work makes an impact, and together, you will help us define the future of American Express.</p><p><strong>Position Summary:</strong></p><p>Global Security protects the Company, its customers, and its colleagues against harm and losses by providing a full range of physical security and investigative services. Global Security is responsible for performing investigations related to the possible violation of a criminal law or suspected wrongdoing.&nbsp;</p><p>This first line of defense role provides a unique opportunity to work with a global team and gain a deep understanding of the Global Security Department’s processes, specifically investigations of internal fraud and conduct related matters. This role will focus on supporting the Internal Fraud program with compliance to American Express policy, internal standard adherence, conduct reporting requirements, quality assurance, and procedural control reviews.</p><p><strong>Responsibilities include but are not limited to:</strong></p><ul><li>Working with stakeholders, across all lines of defense, to drive Internal Fraud related operational and compliance risk projects.</li><li>Providing clear and effective communication and visibility of program requirements, metrics, and policy adherence to GS Investigations leadership and business partners.</li><li>Reviewing and updating, where required, the GS Internal Fraud Investigations departmental standards and procedures to align with new or existing compliance and enterprise policy mandates.</li><li>Performing quality assurance reviews of Internal Fraud and Conduct cases to ensure compliance with enterprise policy and department standards.</li><li>Providing accurate and timely reporting of Internal Fraud and Conduct metrics established within policies and standards.</li><li>Managing and supporting the Global Security Internal Fraud program with adherence to the Internal Controls Framework, Enterprise Issue Management, Risk and Control Self-Assessment, and Enterprise Operational Risk Event Policies.</li><li>Supporting, as required, second- and third-line assessments, audits, and inquiries.</li></ul><p><strong>Minimum Qualifications:</strong></p><ul><li>Three to five years relevant experience specializing in risk, audit, compliance, or investigations.</li></ul><ul><li>Strong project management skills with a proven ability to problem solve, prioritize tasks, and maintain a sense of urgency while managing multiple global initiatives.</li></ul><ul><li>Must be detail oriented with strong analytical and critical thinking skills.</li></ul><ul><li>Demonstrated ability to adapt, be flexible, multi-task, work independently, and be self-motivated in a team environment.</li></ul><ul><li>Dynamic, collaborative, and team focused individual with excellent communication skills is a must.</li></ul><ul><li>Logical, consultative, adaptive to change, and an informed risk taker.</li></ul><ul><li>Ability to challenge the status quo, inspire change, influence without direct authority, and deliver results.</li></ul><ul><li>Strong interpersonal skills with a proven ability to develop and maintain relationships with colleagues across multiple business functions.</li></ul><p><strong>Preferred Qualifications:</strong></p><ul><li>Professional certification (e.g., CPP, CISA, CISM, CISSP, etc.)</li></ul><ul><li>Bachelor’s or master’s degree.</li></ul><ul><li>Strong understanding of internal fraud, conduct risk, operational risk management, or regulatory compliance.</li></ul><ul><li>Proven experience in at least one of the following:</li></ul><ul><li><ul><li>Operational Risk</li></ul></li></ul><ul><li><ul><li>Audit</li></ul></li></ul><ul><li><ul><li>Compliance</li></ul></li></ul><ul><li><ul><li>Program / Process Management</li></ul></li></ul><p>Salary Range: $80,000.00 to $155,000.00 annually + bonus + benefits</p><p>The above represents the expected salary range for this job requisition. Ultimately, in determining your pay, we’ll consider your location, experience, and other job-related factors.</p><p>We back you with benefits that support your holistic well-being so you can be and deliver your best. This means caring for you and your loved ones' physical, financial, and mental health, as well as providing the flexibility you need to thrive personally and professionally:</p><ul><li>Competitive base salaries&nbsp;</li><li>Bonus incentives&nbsp;</li><li>6% Company Match on retirement savings plan&nbsp;</li><li>Free financial coaching and financial well-being support&nbsp;</li><li>Comprehensive medical, dental, vision, life insurance, and disability benefits&nbsp;</li><li>Flexible working model with hybrid, onsite or virtual arrangements depending on role and business need&nbsp;</li><li>20+ weeks paid parental leave for all parents, regardless of gender, offered for pregnancy, adoption or surrogacy&nbsp;</li><li>Free access to global on-site wellness centers staffed with nurses and doctors (depending on location)&nbsp;</li><li>Free and confidential counseling support through our Healthy Minds program&nbsp;</li><li>Career development and training opportunities</li></ul><p>For a full list of Team Amex benefits, visit our Colleague Benefits Site.</p><p>American Express is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law. American Express will consider for employment all qualified applicants, including those with arrest or conviction records, in accordance with the requirements of applicable state and local laws, including, but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance for Employers, and the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. For positions covered by federal and/or state banking regulations, American Express will comply with such regulations as it relates to the consideration of applicants with criminal convictions.</p><p>We back our colleagues with the support they need to thrive, professionally and personally. That's why we have Amex Flex, our enterprise working model that provides greater flexibility to colleagues while ensuring we preserve the important aspects of our unique in-person culture. Depending on role and business needs, colleagues will either work onsite, in a hybrid model (combination of in-office and virtual days) or fully virtually.</p><p>US Job Seekers - Click to view the “Know Your Rights” poster. If the link does not work, you may access the poster by copying and pasting the following URL in a new browser window: <a href="https://www.eeoc.gov/poster" target="_blank">https://www.eeoc.gov/poster</a></p><p>Employment eligibility to work with American Express in the United States is required as the company will not pursue visa sponsorship for these positions.&nbsp;</p>

Manager - Security Investigative Service

<p>At American Express, our culture is built on a 175-year history of innovation, shared values and leadership behaviors, and an unwavering commitment to back our customers, communities, and colleagues. As part of Team Amex, you’ll experience this powerful backing with comprehensive support for your holistic well-being and many opportunities to learn new skills, develop as a leader, and grow your career.&nbsp;</p><p>Here, your voice and ideas matter, your work makes an impact, and together, you will help us define the future of American Express.</p><p>Global Servicing (GS) is responsible for the company's customer service, credit, and fraud operations serving consumers, commercial clients, and merchants around the world, as well as global consumer travel and lifestyle servicing. GS provides the world's best customer experience every day by building on Amex's 175-year legacy of service excellence, leveraging new technologies and capabilities to drive innovation, and bringing a human touch to each customer interaction.</p><p>GS Control Management supports our organization in identifying, assessing, &amp; managing operational risk and supporting customer complaints resolution &amp; privacy rights, to maintain a strong &amp; consistent risk &amp; control culture across GS.</p><p>The objective of the GS Control Management Issues, Events &amp; Remediation team is to ensure timely identification, response, and resolution of risk events and issues to minimize impact, as well as to prevent recurrence through effective remediation and lesson learning.</p><p>GS is looking for an Analyst of Issues, Events &amp; Remediation focused on ensuring control management is embedded in the day-to-day operations of our organization. It will involve extensive collaboration with multiple partners across numerous business units, functional areas, and geographies. </p><p>The Analyst, GS Issues, Events &amp; Remediation will:</p><ul><li>Assist in investigation and conduct root cause analysis to address repeated issue types</li><li>Perform quality assurance on documentation of specific issue/ORE type, urgency, severity/impact (e.g., impact analysis)</li><li>Assist portions of the remediation process, these may include:<ul><li>tracking progress</li><li>validating resolution efficacy and</li><li>communicating status updates to stakeholders</li></ul></li><li>Perform quality assurance on documentation and maintenance records of specific issues/OREs and remediations to ensure transparency and accountability in the issue management process</li><li>Identify trends in issues and events associated with a workstream to identify potential systemic risks or control weaknesses within BU processes</li><li>Support review of components of the End-to-End (E2E) BU issue resolution process</li><li>Perform sample testing of specific issues to ensure resolution is complete and effective</li><li>Support sharing insights, better practices, themes, etc. across the enterprise</li></ul><p><b>Required Qualifications: </b></p><ul><li>1-2 Years experience in operational risk management (e.g., within Risk and/or Internal Audit function) Understanding of critical operational risk management lifecycle activities </li><li>Project management, communication, and interpersonal skills</li><li>Experience in process governance, with an understanding of processes that align with policies, regulatory frameworks, and/or operational standards</li><li>Analytical and problem-solving skills, with an ability to analyze data, identify trends, and evaluate risk scenarios effectively</li></ul><p><b>Preferred Qualifications: </b></p><ul><li>Bachelor's Degree in Finance, Business, Risk Mgmt., or related field; advanced degrees (e.g., MBA, MSc) or certifications are advantageous</li><li>Experience in at least one of the following: <ul><li>Scoping, prioritizing, and support remediation of operational issues</li><li>Knowledge of investigating and conducting root cause analysis to address repeated operational risk issue types</li><li>Assisting of quality assurance on documentation of operational risk issues and events</li><li>Recommendation of remediation strategies for operational risk issues and events</li><li>Performing Quality Assurance of documentation and maintaining records of operational risk issues and events to ensure transparency and accountability</li><li>Supporting the BU E2E issue resolution process</li></ul></li></ul><p>Salary Range: $55,000.00 to $110,000.00 annually + bonus + benefits</p><p>The above represents the expected salary range for this job requisition. Ultimately, in determining your pay, we’ll consider your location, experience, and other job-related factors.</p><p>We back you with benefits that support your holistic well-being so you can be and deliver your best. This means caring for you and your loved ones' physical, financial, and mental health, as well as providing the flexibility you need to thrive personally and professionally:</p><ul><li>Competitive base salaries&nbsp;</li><li>Bonus incentives&nbsp;</li><li>6% Company Match on retirement savings plan&nbsp;</li><li>Free financial coaching and financial well-being support&nbsp;</li><li>Comprehensive medical, dental, vision, life insurance, and disability benefits&nbsp;</li><li>Flexible working model with hybrid, onsite or virtual arrangements depending on role and business need&nbsp;</li><li>20+ weeks paid parental leave for all parents, regardless of gender, offered for pregnancy, adoption or surrogacy&nbsp;</li><li>Free access to global on-site wellness centers staffed with nurses and doctors (depending on location)&nbsp;</li><li>Free and confidential counseling support through our Healthy Minds program&nbsp;</li><li>Career development and training opportunities</li></ul><p>For a full list of Team Amex benefits, visit our Colleague Benefits Site.</p><p>American Express is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law. American Express will consider for employment all qualified applicants, including those with arrest or conviction records, in accordance with the requirements of applicable state and local laws, including, but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance for Employers, and the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. For positions covered by federal and/or state banking regulations, American Express will comply with such regulations as it relates to the consideration of applicants with criminal convictions.</p><p>We back our colleagues with the support they need to thrive, professionally and personally. That's why we have Amex Flex, our enterprise working model that provides greater flexibility to colleagues while ensuring we preserve the important aspects of our unique in-person culture. Depending on role and business needs, colleagues will either work onsite, in a hybrid model (combination of in-office and virtual days) or fully virtually.</p><p>US Job Seekers - Click to view the “Know Your Rights” poster. If the link does not work, you may access the poster by copying and pasting the following URL in a new browser window: <a href="https://www.eeoc.gov/poster" target="_blank">https://www.eeoc.gov/poster</a></p><p>Employment eligibility to work with American Express in the U.S. is required as the company will not pursue visa sponsorship for these positions. </p>

Analyst-Control Management

<p><strong>Truckee, CA – Seeking Urgent Care Registered Nurse</strong></p><p><strong>Be The Nurse You Are Meant To Be</strong></p><p>As a Registered Nurse, you play a vital role in our mission to improve lives. Assess, plan, implement, evaluate, and interact with patients to provide and coordinate healthcare services and elevate patient experience. At Vituity we know the impact you can have.</p><p><strong>Join the Vituity Team.</strong> At Vituity we’ve cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call “culture of brilliance.” Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done.</p><p><strong>Vituity Locations:</strong> Vituity has opportunities at 475 sites across the country, serving 9 million patients a year. With Vituity, if you ever need to move, you can take your job with you.</p><p><strong>The Opportunity</strong></p><ul><li>Understanding of the concept of patient-centered care and knowledge of team-based care and evidence-based clinical practice guidelines.</li><li>Independently assess, evaluate, and interpret clinical information and care planning.</li><li>Collaborate with doctors and staff to provide exceptional care; assist during exams, diagnostic testing, and treatments.</li><li>Perform appropriate treatments as ordered by physician in an accurate and timely manner.</li><li>Prepare, administer, and record prescribed medications. Report adverse reactions to medications/treatments in accordance with the policy.</li><li>Document and record all care information concisely, accurately, and completely in a timely manner.</li><li>Maintain accurate and continued nursing documentation including patient histories, conditions, treatments, responses, pain management, and assessment of changes.</li><li>Deliver care with appropriate age and cultural competence to specific patient populations according to individualized needs.</li><li>Serve as the first line of response for patient questions – respond directly to general medical questions and provide screening for questions requiring provider input to ensure that adequate information is gathered to allow providers to respond appropriately.</li><li>Call patients with lab and test results; follow up with patients with abnormal test results.</li><li>Provide Case Management for patients that require referrals or follow up.</li><li>Provide individualized patient/family education customized to the patient and family members.</li><li>Perform drug tests on patients per protocol.</li><li>Has a firm understanding of Occupational Medicine/Workers’ Compensation needs and understand paperwork flow.</li><li>Maintain a clean, sanitary, and organized work environment.</li><li>Maintain established departmental policies and procedures, objectives, performance improvement program, safety, environmental, and infection control standards.</li><li>Work at maximum efficiency without compromising quality of care.</li><li>Abide by all state rules and regulations.</li><li>Conduct self in a composed and professional manner.</li><li>Attend all required training and continuing education events.</li><li>Maintain nursing supply inventory by checking stock to determine inventory levels; anticipate needed supplies; communicate with manager to place supply order.</li><li>Ensure operation of equipment by completing preventive maintenance requirements, following manufacturer’s instructions, troubleshooting malfunctions, calling for repairs.</li><li>Complete required facility and OSHA safety rules and procedures while on assignment.</li><li>Uphold HIPAA regulations.</li><li>Punctual and dependent for assigned shifts.</li></ul><p><strong>Required Experience and Competencies</strong></p><ul><li>Bachelor of Science degree in Nursing (BSN) required.</li><li>Current active Registered Nurse (RN) license in good standing in the state of practice required.</li><li>Current Advanced Cardiac Life Support (ACLS) Certification through the American Heart Association required.</li><li>Current CPR Certification required.</li><li>2-4 years of nursing experience in a fast-paced emergency department or urgent care preferred.</li><li>Experience with electronic health record system; EPIC is preferred.</li><li>Documentation of Procedural Sedation competency.</li><li>Knowledge of nursing services.</li><li>Responsible and compassionate.</li><li>A team player with excellent verbal and written communication skills.</li><li>A flexible approach necessary to prioritize multiple demands to meet deadlines.</li><li>Excellent team building, customer service, and personal development skills.</li><li>Strong organization and interpersonal skills.</li><li>Ability to determine appropriate course of action in more complex situations.</li><li>Ability to work independently, be attentive to detail, and maintain a positive attitude.</li><li>Ability to manage multiple and simultaneous responsibilities and to prioritize.</li><li>Ability to maintain confidentiality of all medical, financial, and legal information.</li><li>Ability to complete work assignments accurately and in a timely manner.</li><li>Ability to handle difficult situations involving patients, physicians, or others in a professional manner.</li><li>Able to stay organized and flexible in a work environment with multiple assignments and changing priorities.</li></ul><p><strong>The Practice</strong></p><p><strong>Northstar Medical Clinic – Truckee, California</strong></p><ul><li>Northstar Medical Clinic is a seasonal urgent care center serving the Vail Northstar ski resorts in Truckee, CA, and is affiliated with the nearby Tahoe Forest Hospital.</li><li>A full-service acute, trauma medical clinic specializing in treating an array of medical conditions, including a wide range of sports injuries.</li><li>New state-of-the-art digital X-ray system.</li></ul><p><strong>The Community</strong></p><ul><li>Truckee, California, nestled in the Sierra Nevada mountains, is a vibrant and picturesque town known for its outdoor recreation, historic charm, and close-knit community.</li><li>Downtown Truckee features beautifully preserved 19th-century architecture, boutique shops, and a lively dining scene.</li><li>The area offers year-round outdoor activities, from skiing and snowboarding at nearby resorts like Northstar and Palisades Tahoe in winter, to hiking, biking, and paddleboarding on Donner Lake during the warmer months.</li><li>Truckee’s seasonal weather includes snowy winters and mild, sunny summers, making it a haven for adventure enthusiasts.</li><li>Its location near Lake Tahoe provides additional opportunities for water sports and alpine beauty.</li><li>Truckee’s mix of small-town charm, outdoor lifestyle, and convenient access to natural wonders make it an exceptional place to live and thrive, offering a balanced blend of relaxation and adventure.</li></ul><p><strong>Benefits &amp; Beyond*</strong></p><p>Vituity cares about the whole you. With our comprehensive compensation and benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future.</p><ul><li>Superior health plan options</li><li>Dental, Vision, HSA/FSA, Life and AD&amp;D coverage, and more</li><li>Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%</li><li>Outstanding Paid Time Off: 3-4 weeks’ vacation, Paid holidays, Sabbatical</li><li>Student Loan Refinancing Discounts</li><li>Professional and Career Development Program</li><li>EAP, travel assistance, and identify theft included</li><li>Wellness program</li><li>Commuter Benefits Program</li><li>Purpose-driven culture focused on improving the lives of our patients, communities, and employees</li></ul><p>Salary rate for this role is $43.81 - $54.76 per hour. Please speak with a recruiter for more information.</p><p>We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. When we work together across sites and specialties as an integrated healthcare team, we exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us.</p><p>Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.</p><p>*Benefits for part-time and per diem vary. Please speak to a recruiter for more information.</p><p><strong>Applicants only. No agencies please.</strong></p>

Vituity

Registered Nurse - Urgent Care - Northstar Medical Clinic

<p><b>Salary Range:&nbsp;</b>&nbsp;$55,245.00&nbsp;(Min.) -&nbsp;$69,045.00&nbsp;(Mid.) -&nbsp;$82,867.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Community Resource Center (CRC) Specialist III builds and maintains meaningful relationships with members of the community, L.A. Care departments, partner health plans, community based agencies, government agencies, and CRC vendors and instructors. The role leads community and provider outreach and engagement initiatives to increase member traffic at a CRC and bridges members of the community to physical and health education programs, classes and resources. Acts as a liaison to the L.A. Care on CRC marketing and promotional initiatives to meet operational needs. Implements processes including coordination of member service support across L.A. Care departments and promote positive health care outcomes. Provides extensive consultation on health care access issues, and identification of resource needs based on social drivers identified through a health assessment process. This position also conducts ongoing member assistance and follow-up in select cases. Collaborates with cross-functional L.A. Care health plan departments The CRCs serve anyone in the community in which they are located; and therefore, this role will provide expertise on referral processes to connect non-member cases to the appropriate external resources.</p><p>Participates in the planning, and development, implementation, and analysis of CRC services, programming, and vendor management. This role may serve as a lead on special projects through the development and implementation of a work plan, technical procedures, and relationship management ensuring successful implementation of CRC initiatives. &nbsp;Acts as a &nbsp;Subject Matter Expert, serves as a resource and mentor for other staff. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</p><h4>Duties</h4><p><b>Outreach and Engagement:</b> (25%) &nbsp;<br>Builds, maintains, and nurtures meaningful relationships with key internal and external stakeholders; and, is an ambassador to grow CRC partnership brand recognition. &nbsp;Identifies key community stakeholders, assesses community needs, and gathers and analyzes data to inform management with an integrated approach to outreach activities and targeted member engagement. &nbsp;Plan, develop, analyze and implement member and community engagement activities to increase member traffic at the CRCs. Makes recommendations for bridging members of the community to physical and health education programs and classes which will enhance health outcomes and member experience. &nbsp;Responsible for communications and marketing efforts through multiple platforms to increase member traffic at assigned CRC; and, engages and educates members of the community on L.A. Care and CRC programs. Responsible for CRC outreach and engagement opportunities relevant to the mission of L.A. Care and the CRCs; recommends to senior management in the development and implementation of &nbsp;work plans. &nbsp;Identifies and recommends what outreach activities to prioritize &nbsp;and implement tactics to attract new L.A. Care and partner health plan members to participate into the CRC services and programs. Responsible for collecting, transporting, and distributing CRC promotional items to community partners with the goal of generating brand awareness across various L.A. Care membership communities and geographical areas in Los Angeles County.</p><p><b>Cross-Collaboration: </b>&nbsp;(25%)<br>Oversees the community initiatives leveraging relationships within L.A. Care, partner health plans, and with community stakeholders to promote access to health care programs, classes, and preventative services offered at the CRC. &nbsp;Educates other L.A. Care departments on the necessary steps to implement relevant services and activities that will resonate with and engage members of the CRC community. &nbsp; &nbsp;</p><p><b>Implementing Strategic Initiatives: </b>&nbsp;(20%) &nbsp;<br>Leads &nbsp;the implementation of special projects and specific tasks that &nbsp;must be &nbsp;completed in order to ensure project, initiatives, and events are successfully implemented within the required timeframe. Proactively monitors risks and provides recommendations and implements mitigation plans to keep initiatives on-track. &nbsp;Maintains consistent documentation of project deliverables, tracks and reports project status. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;</p><h4>Duties Continued</h4><p><b>High-Touch Customer Focus</b>: (15%)&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Performs high quality in-person service and contributes to the extended-hour schedule of the CRC to support members and visitors that may need services outside of regular operating hours and days based on business needs. &nbsp;Provides support in the creating of child creating of activities and programs to support children development while parents and guardians attend a class or service appointment at the CRC.</p><p><b>Day-to-Day Representation: </b>(15%)&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Guides the coordination of member-centric customer service to respond and resolve simple inquiries and complex questions and bridges members to appropriate resources. &nbsp;Creates resource guides and reference materials to identify available CRC, L.A. Care and Plan Partner benefits, resources, and programs to meet the member/visitor needs. &nbsp;Provides guidance and support staff to identify, understand, and master meaningful program and benefit information and resources to inform and educate members, community residents, and other stakeholders. Implements the appropriate approach to identify member or visitor resource needs in complex situations and takes action to link the member/visitor to those services, programs, or resources. &nbsp;Informs L.A. Care and Plan Partner members of health care tailored services including Care Management, Social Services, Health Education, and others. Actively identifies gaps in CRC services, resources, and programs, delivers recommendations for new programs and proposes solutions for the implementation of new services.</p><p>Performs other duties as assigned.&nbsp; (10%)&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;</p><h4>Education Required</h4>Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Bachelor's Degree<h4>Experience</h4><p><b>Required:</b><br>At least 1 year of community work focused on health care, public health, or health education or</p><p>At least 1 year of operations work experience with community events, leading complex projects, and managing relationships with multiple stakeholders or experience related to health plan member services, health plan member benefits and knowledge of any of the following services: Care Management, Social Services, Health Education, or other social service or clinical teams.</p><p>Product experience including knowledge of at least one of the following health care programs: Medicaid/Medi-Cal, Covered California, Medicare, or Medicare Dual Special Needs Plan.&nbsp;</p><p>Minimum of 1 year experience related to marketing, brand awareness tactics, or social media&nbsp;</p><p>Experience with database software, data entry, and reporting process.&nbsp;</p><p><b>Preferred:</b><br>Minimum of 3 years experience with database software, data entry, and reporting processes. Salesforce knowledge.</p><h4>Skills</h4><p><b>Required:</b><br>Strong verbal and written communication skills</p><p>Excellent organizational skills.</p><p>Must be a detail-oriented, collaborative and enthusiastic team player.&nbsp;</p><p>Strong ability to garner consensus on and support for new partnerships and initiatives, particularly when projects rely on participation by multiple internal or external stakeholders.&nbsp;</p><p>Ability to solve complex issues and identify creative solutions to assist members and community stakeholders.</p><p>Must have the ability to troubleshoot problem areas and recommend effective alternative solutions and provide optimal customer service for internal and external customers.</p><p>Demonstrates action oriented leadership to take on new opportunities and rewarding challenges with a sense of urgency, high energy, and enthusiasm.</p><p>Ability to multi-task and meet competing deadlines while maintaining attention to detail and accuracy.</p><p>Must be able to work independently or as part of a diverse team while being business-minded as well as empathetic towards members.</p><p>Must show initiative and act on anticipated business needs without prompting from management.<br><br>Ability to adapt quickly to a fast-changing environment.</p><p>Advanced proficiency in MS Office including Outlook, Word, Excel, and PowerPoint</p><p>Strong interpersonal skills and ability to read non-verbal cues with a high level of situational adaptability.</p><p>Ability to make sound decisions with incomplete information.</p><p><b>Preferred:</b><br>Experience with the Salesforce CRM platform</p><p>Knowledge and understanding of the unique needs of the Medi-Cal beneficiary populations within a social service, healthcare, not-for-profit, or government setting.&nbsp;</p><p>Knowledge of public agencies, organizations, and other resources that support Community Resource Center visitors.</p><p>Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.<br></p><h4>Licenses/Certifications Required</h4>Cardiopulmonary Resuscitation (CPR) Certified within 120 days of hire.<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><p><b>Required:</b></p><p>Within 120 days of hire: Cardiopulmonary resuscitation (CPR) and California Mandated Reporter. </p><p>Management of Aggressive Behavior (MOAB), de-escalation techniques training, safe lifting practices training. Emergency Action Plan (EAP).</p><h4>Physical Requirements</h4>Moderate<h4>Additional Information</h4><p><b>Required:&nbsp;</b><br>Travel to offsite locations for work.</p><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Medicare, Social Services, Data Entry, Relationship Manager, Medicaid, Healthcare, Service, Administrative, Customer Service                                                    </p>

L.A. Care Health Plan

Community Resource Center Specialist III

<p><b>Salary Range:&nbsp;</b>&nbsp;$77,265.00&nbsp;(Min.) -&nbsp;$100,445.00&nbsp;(Mid.) -&nbsp;$123,625.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Customer Solution Center Training Specialist II is responsible for conducting functional training Customer Solution Center (CSC) staff in Customer Service, Health Insurance Portability and Accountability Act (HIPAA) Compliance, Plan Partner agreements, Departmental Policies and Procedures (including product operations), Supervisory/Managerial on boarding, and any additional work processes as needed. In addition, is responsible for developing, up keeping, and facilitating training (new and remedial) on Specialty Lines of Business (e.g., Cal MediConnect, L.A. Care Covered) and technology/system enhancements and updates (QNXT, CRM tools, Share Point, etc.).</p><p>This position is also responsible for coordinating and assisting with facilitating monthly remedial training to CSC staff on identified areas of improvement, such as Appeals and Grievance processes, Claims, etc. Through various delivery methods that meet business needs (web, LMS, PowerPoint, etc.) and coordinating with other units or departments in the development and implementation of technical procedures in triage of phone calls. This position is responsible for training Customer Service Vendors on new Customer Solution Center processes and updated Desk Level Procedures.&nbsp; </p><p>The position intermittently supports other departments within the organization. This position oversees new staff during the first 8 weeks, which includes close support to help assure that they meet the performance goals and department standards and will design and implement a scorecard audit procedure to assess the Customer Service performance of Call Center Reps and other employees within the Customer Solution Center. Coordinate timely implementation of mini-surveys and conduct performance studies within the verticals of CSC which includes working with the Quality Review team to identify points of training needs, and reports results and findings of surveys and performance studies to the training Supervisor, to analyze and identify areas of training needs and improvement.</p><p>The position will also work with Human Resources to ensure specialized training programs are tailored for the Customer Solution Center Department (Call Center Unit, Membership Information Unit and Member Relations Unit).</p><h4>Duties</h4><p>Formulates teaching outlines and determine instructional methods such as individual training, group instruction, lectures, demonstrations, conferences, meetings and workshops. Develops and selects teaching aids such as training handbooks, demonstration models, multimedia visual aids, computer tutorials, and reference workshops. Designs and updates training programs in the Customer Solution Center.</p><p>Creates and conducts timely implementation of mini-surveys and performance studies within the Call Center.&nbsp; Reports results, survey findings and performance studies to the Training Supervisor and provides recommendations in training needs and improvements. </p><h4>Conducts training for Customer Solution Center staff in customer service, product operations, and other work processes. Conducts training sessions covering specified areas such as on-the-job training, use of computers and software, interpersonal skills, quality &amp; process issues, and product knowledge. Ensures Customer Solution Center staff are trained in areas of Customer Service, HIPAA Compliance, Plan Partner Agreements, Departmental Policies and Procedures, and work processes.</h4><h4>Responsible for training Customer Service Vendors on new Customer Solution Center processes and updated Technical Procedures. Responsible for tiered learning modules for advancement training within Customer Solution Center. Oversight of all new staff during the first 8 weeks and ensure that they meet the performance goals and department standards. </h4><h4>Tests trainees to measure progress and to evaluate effectiveness of training. Reports on progress of employees under guidance during training periods. Maintains trainee records. Maintains all supplemental training materials to ensure accuracy and the most current information.</h4><h4>Duties Continued</h4><h4>Works with Human Resources to ensure specialized training programs are tailored for the Customer Solution Center Department. This includes providing supervisory/managerial training to new Management staff (Those in a lead role and above). Confers with management, supervisors and employees to gain knowledge of work situations requiring training and to better understand changes in policies, procedures, regulations, business initiatives and technologies.&nbsp; Intermittently supports other departments within the organization.</h4><h4>Performs other duties as assigned.</h4><h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4><h4>Experience</h4><p><br><b>Required:</b></p><p>At least 3 years of previous experience as a trainer in a call center or customer service with a broad knowledge of training program design and delivery methods.</p><h4>Skills</h4><p><br><b>Required:</b><br>Strong, decision-making and interpersonal skills.</p><p>Excellent verbal land written communication skills. &nbsp;Ability to write routine reports and correspondence.</p><p>Excellent Microsoft Office skills (Excel, PowerPoint, Word).</p><p>Strong analytical and organizational skills.&nbsp;</p><p>Ability to interpret technical data, processes, operating and maintenance instructions and procedure manuals.</p><p>Attention to detail.</p><p>Must be a strong team player willing to work toward achieving team goals.</p><p>Must be flexible to meet the changing training needs.</p><p><b>Preferred:</b></p><p>Bilingual in one of LA Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Call Center, Claims, Customer Service, Insurance                                                    </p>

Customer Solution Center Training Specialist II

<p><b>Salary Range:&nbsp;</b>&nbsp;$47,840.00&nbsp;(Min.) -&nbsp;$57,062.00&nbsp;(Mid.) -&nbsp;$68,474.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative and technical functions of the authorization process including intake, logging, tracking and status follow-up.</p><p>The Authorization Technician II collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time lines by maintaining an accurate database inventory of referral authorizations, retrospective reviews, concurrent reviews and grievance/appeal requests, and prepares UM Activity and Weekly Compliance Reports.</p><p>In addition, the position performs data entry and processing of referrals/authorizations in the system, &nbsp;authorizes request consistent with auto authorization criteria, maintains confidentiality when communicating member information, and assists with the communication of determinations by preparing template letters for members/ providers, with other duties as assigned.</p><h4>Duties</h4><h4>Functional Elements: Technical Support to UM Specialist: Processing of time sensitive authorization and pre-certification requests to meet department timeframes and regulatory requirements; Computer Input: Accurately and completely processing referrals/authorizations and distribute a complete file to UM Specialist within 2 hours of receipt; identify duplicate requests using the claims and verify existing authorization. Independently identifying and appropriately returning to claims or member services any file that is a duplicate to one already processed in the system; appropriately documenting what information was used in making this determination within 4 hours of receipt. Appropriate identification and timely notification of time sensitive requests; appropriately identifying for the staff which you support, request that are priority based on date of receipt and established Turnaround Time criteria for compliance. Accurate filing/maintenance of confidential member information. Creating secure, complete, files. Interface with members, medical personnel and other internal and external agencies; ensure&nbsp; all comply with L.A. Care requirements such as submitting requested information in a timely manner and using the approved Authorization Request form with complete medical information i.e.: ICD 10 codes, CPT, HCPC codes. (35%)</h4><h4>Assist in the preparation of communication for authorization determinations, including, but not limited to preparing template letters for members and providers (authorization approval, denial, deferral, modification and pay/education). (30%)</h4><h4>Assist in the technical aspects of the retrospective review process for authorizations and Member or Provider Appeals, including, but not limited to computer data entry, logging, copying, preparing of template letters for communication of appeal determinations to members, providers and partners (appeal uphold or overturn) and filing: Set up GNA files for review, log and keep track all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all Grievances and Appeals response letters to Grievances Specialist on daily basis. (20%)</h4><h4>Support UM Committee and Audit activity via Department performance reporting. Assure the accuracy of reports concerning inventory and department proficiency in maintaining regulatory standards and time frames. (5%)</h4><p>Perform other duties as assigned. (10%)</p><h4>Duties Continued</h4><h4>Education Required</h4>High School Diploma/or High School Equivalency Certificate<h4>Education Preferred</h4><h4>Experience</h4><p><b>Required:</b></p><p>At least 6 months of health care experience.</p><p>Experience working in a cross functional work environment.</p><p><b>Preferred:</b></p><p>Experience in Medi-Cal managed care.</p><p>1 year of experience in UM/Prior Authorization.</p><h4>Skills</h4><p><b>Required:</b></p><p>Demonstrated proficiency in Medical Terminology required.</p><p>Strong verbal and written office communication skills.</p><p>Proficient with Microsoft Office Suite and Adobe PDF. and </p><p>Excellent organizational, interpersonal and time management skills. </p><p>Must be detail-oriented and an enthusiastic team player.</p><p><b>Preferred:</b></p><p>Knowledge of QNXT computer systems a plus.</p><p>Knowledge of the UM patient referral process.</p><p>Knowledge of member’s health plan eligibility.</p><p>Knowledge of member’s benefits coverage. </p><p>Knowledge of Health Plan regulations.</p><p>Knowledge of HMO/UM functions.</p><p>Knowledge of ICD-10/CPT coding. </p><p>Proficient utilizing electronic medical records and documentation programs.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Medical Coding Certification<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Required:</b></p><p>Weekends and holidays hours may be required, as well as OT based on a business need.</p><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    EMR, Data Entry, Medical Coding, Claims, Healthcare, Administrative, Insurance                                                    </p>

Authorization Technician II

<p><b>Salary Range:&nbsp;</b>&nbsp;$60,778.00&nbsp;(Min.) -&nbsp;$75,950.00&nbsp;(Mid.) -&nbsp;$91,166.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Lead Pharmacy Technician of Pharmacy Benefit Management is responsible for oversight on researching and resolving issues with the Pharmacy Benefit Management company under the direction of the Pharmacy Operations Supervisor, Clinical Pharmacists, Directors/Managers of Pharmacy and Senior Director, Pharmacy Formulary and/or Medical Director in compliance with all federal and state regulatory/contract requirements for all product lines within required Turn-Around-Time standards. Proactively develop and maintain process linkages with internal L.A. Care departments, contracted Pharmacy Benefit Management (PBM), and contracted vendors to increase operational efficiency of pharmacy processes by participating in internal and external workgroups and attending meetings and discussions to ensure best practice. Responsible for the daily workflow and leading the work of assigned staff. &nbsp;This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff. &nbsp;Responsible for producing and analyzing pharmacy reports from the Pharmacy Benefit Management company.</p><h4>Duties</h4><p>Reviews rejected claims and perform outreach for cases where action is required. Applies advanced skills in area of specialization regarding pharmacy daily operations and workflows. &nbsp;Oversees the daily office workflow, develops and recommends enhancements to process and procedures. Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. (25%)</p><p>Collaborates with and act as liaison between Pharmacy staff and PBM representatives to resolve escalated issues. Delegates escalated cases to pharmacy technicians. (15%)</p><p>Takes part in on-call and after hours schedule rotation. (15%)</p><p>Ensures that the pharmacy technician resources, such as the formulary, guidelines, benefit information, and educational materials are updated and distributed. Delegates and assigns projects to Pharmacy Technicians as necessary, including outreach for Stars Adherence Programs. Leads the work of assigned staff; regularly assigns and checks the work of others, providing guidance, training and feedback on performance to department management.&nbsp; (20%)</p><p>Assists in the development of member and provider communication, including writing/editing and distribution. (15%)</p><p>Perform other duties as assigned. (10%)</p><h4>Duties Continued</h4><h4>Education Required</h4>Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Bachelor's Degree<h4>Experience</h4><p><br><b>Required:</b></p><p>At least 3 years of experience as a Pharmacy Technician.</p><p>Minimum of 6 months of lead experience (process, program or staff). </p><p>At least 1 year in an outpatient/home infusion/hospital pharmacy setting.</p><h4>Skills</h4><p><br><b>Required:</b><br>Proficiency with Microsoft Word, Excel and Access.</p><p>Must be customer service oriented.</p><p>Must possess good Communication (verbal) skills.</p><p><b>Preferred:</b><br>Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.</p><h4>Licenses/Certifications Required</h4>Pharmacy Technician - Active, current and unrestricted California License<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Pharmacy Tech, Pharmacy, Claims, Healthcare, Insurance                                                    </p>

Lead Pharmacy Technician

<p><b>Salary Range:&nbsp;</b>&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Manager, Appeals &amp; Grievances (A&amp;G) &amp; General Operations (Clinical) is responsible for the daily oversight of clinical appeals and grievances functions within the Appeals &amp; Grievances Department to ensure clinical grievances, complaints, appeals and complex issues are investigated and resolved using regulatory guidance across all lines of business. Provides direct supervision to the A&amp;G clinical team and the unit that supports them in order to assure operational effectiveness which includes the implementation and adherence to L.A. Care's Policies &amp; Procedures that meet Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), the California Department of Managed Health Care (DMHC), the Managed Risk Medical Insurance Board (MRMIB), National Committee for Quality Assurance (NCQA) and other rules/ regulations/ standards.<br><br>The Manager is responsible for establishing and monitoring processes to oversee and coordinate the identification, documentation, reporting, investigation and resolution of all member appeals and grievances in a timely and culturally-appropriate manner. Coordinates, tracks, and resolves internal and external appeal and grievance complaints for L.A. Care Plan Partners, including identifying opportunities for improvement.</p><p>This position will be a role model for integrity and will establish and maintain effective professional work relationships, working collaboratively with all levels of management and business owners to help guide the discipline of planning, organizing, securing, managing, leading, and controlling resources to achieve specific goals.</p><p>Manages all aspects of running an efficient &nbsp;team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports.&nbsp;</p><h4>Duties</h4><p>Manage and oversee the handling of clinical grievances and appeals, for L.A. Care and Plan Partner members. Establishes and oversees processes and all relevant member correspondence for accuracy, clarity, and cultural appropriateness and sensitivity.<br><br>Review and monitor procedures for identifying quality of care issues and work collaboratively with cross-functional departments to appropriately address and resolve member grievances. Serve as the Key Contact for State Fair Hearings, internal and external audits, DMHC and DHCS inquiries. Review and monitor procedures for identifying quality of care issues and work collaboratively with cross-functional departments to appropriately address and resolve member and provider grievances.</p><p>Responsible for timely daily operations in the A&amp;G Clinical Services Unit and other general operations units. &nbsp;Ensures timely appeal and grievance reporting to regulatory agencies, internal Regulatory Affairs and Compliance Department, internal Quality Oversight Committee, etc. Collaborates with cross-functional departments &nbsp;to ensure the use of appropriate appeal and grievance issue codes, timely resolution, and refers to community partners as appropriate. &nbsp;</p><p>Lead, participate and provide representation of the A&amp;G Team at Internal and External meetings/ workgroups and acts as the point person for A&amp;G Programs especially the Clinical Programs.</p><p>Develop and execute on strategic opportunities to improve the overall appeals &amp; grievance process. Create a best in clinical appeals process that is efficient and effective in managing member appeals.</p><p>Work cross functionally and collaboratively within Appeals and Grievances with key internal partners to build a high functioning, results oriented environment and organization.&nbsp;</p><h4>Duties Continued</h4><p>Partner with internal and external stakeholders to build and maintain collaborative relationships and partnerships. Identify areas of connection to leverage and create added value for L.A. Care.</p><p>Provide input into the development of automation to guide the team to process efficiencies for all lines of business while maintaining compliance and manageable workloads for staff.</p><p>Responsible for maintaining and updating on an annual basis, or as necessary, appeal and grievance policies and procedures, member correspondence, etc., consistent with regulatory changes. &nbsp;Develop and maintain inventory reports for the appeals process ensuring appropriate productivity, compliance, and inventory management. &nbsp;</p><p>Identify and implement continuous business process improvement recommendations to leverage organizational added value to the Appeals and Grievances Department. &nbsp;Develop and implement short and long-term strategies to improve team results, reducing administrative expenses.</p><p>Manage staff , including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others. Supervision of the Clinical Services unit and general operations within Appeals and Grievances. Maintain a team of top talent, providing a culture of teamwork and collaboration.&nbsp;</p><p>Perform other duties as assigned</p><h4>Education Required</h4>Bachelor's Degree in Nursing<h4>Education Preferred</h4><h4>Experience</h4><p><b>Required:</b></p><p>6 years of clinical acute care experience with at least 3 years of experience with health care grievance and/or appeals issues, preferably in a managed care or Medicaid Health Plan environment and/or public services or public benefits programs.</p><p>At least 3 years of management level operations leadership experience.</p><p>Experience working with firm deadlines, regulators, detail oriented with the ability to interpret and apply regulations</p><p>Experience building relationships with organizations and business partners.</p><p><b>Equivalency:</b>&nbsp; Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.</p><p><b>Preferred:&nbsp; </b></p><p>Managed care experience.</p><h4>Skills</h4><p><b>Required:</b><br>Excellent analytical, problem solving, planning and implementation skills.</p><p>Demonstrated strong writing and communication skills.</p><p>Demonstrates excellent leadership, communication, and negotiation skills with the ability to interact and influence all levels of the organization including executive management and key decision -makers.</p><p>Demonstrates professional judgement, and critical thinking, to promote the delivery of quality, cost-effective care.</p><p>Time management and priority setting skills.</p><p>Excellent understanding of NCQA, DMHC, DOI, DHCS, and CMS regulatory requirements.</p><p>Knowledge of Coordination of Care, Medicare and Medi-Cal regulations, prior authorization, level of care and length of stay criteria sets.</p><p>Able to work effectively with various internal departments/service areas, L.A. Care's plan partners, participating provider groups, and other external agencies.</p><p>Able to operate PC-based software programs including proficiency in Word, Excel and PowerPoint presentations.</p><p>Excellent verbal, written communication and presentation skills.</p><h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California License<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>This position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical situations and work on-call.</p><p>This position requires handling various caseloads and flexibility to adapt to changing priorities which may include but not limited to redistributed work assignments, team projects, and other priorities as assigned</p><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Nursing, Registered Nurse, Nurse Management, Medicaid, Medicare, Healthcare                                                    </p>

Registered Nurse (RN) Manager, Appeals and Grievances General Operations (Clinical)

<br><h4>Assistant Director of Academic Programs - Gies College of Business</h4><h4>Gies Undergraduate Programs</h4><br><h4>Job Summary</h4>The Assistant Director of Academic Programs will work closely with the Academic Affairs team to advise, support, and develop programming for all Gies undergraduate students.  They will also supervise our Peer Advisors and create strategic planning around the undergraduate advising series. <h4>Duties &amp; Responsibilities</h4><ul><li>Academic Programming  • Oversee the logistics and planning of New Student Registration • Oversee the logistics of the first semester group advising program for first semester freshman called Spring Semester Planning • Create and develop a Major Course Planning process for Gies undergraduate students including the Gies Majors and Minors Fair • Develop and execute Graduate Planning for Juniors and Seniors preparing to graduate with a Gies undergraduate degree • Manage the Express Advising process for the undergraduate Gies Academic Advisors  • Support Office of Undergraduate Programs initiatives and programs as assigned</li><li>Supervision  • Supervise the student leaders within the Peer Advising Program, including Peer Coordinators, Team Leads, and Peer Advisors • Teach the BUS 199 – Coaching for Success training course for Peer Advisors • Create a Strategic Plan to enhance and develop the Peer Advising Program</li><li>Academic Advising  • Meet with current Gies undergraduate students to create academic plans • Monitor academic progress toward graduation using the appropriate systems; identify and reach out to advisees to support successful academic progress • Serve as an Express Advisor when needed </li></ul><h4>Minimum Qualifications</h4><p>Bachelor's degreeAt least 3 years of Higher Education experience, can include graduate work.</p><h4> Preferred Qualifications</h4><p>• Demonstrated experience with supervision of undergraduate students<br>• Demonstrated experience event programming and assessment<br>• Experience with transition programming<br>• Experience working with a diverse student population</p><h4>Knowledge, Skills and Abilities</h4><ul><li>Exceptional written and verbal communication skills</li><li>Strong organizational skills</li><li>Strong relationship building and collaboration skills</li></ul><h4>Appointment Information</h4><p>This is a 100% full-time Academic Professional position, appointed on a 12-month basis. Sponsorship&nbsp;for&nbsp;work&nbsp;authorization&nbsp;is not available for this position. The expected start date is as soon as possible after 9/22/2025. The budgeted&nbsp;salary&nbsp;range for the position is $60,000 to $63,000 annually.<br></p><p>At Gies, we believe in being a place of inclusion and equity, a place where all can succeed. This position must be attentive to the College’s commitment to diversity, inclusion, and equity and ensure it is being implemented throughout projects and activities. For more information about Gies Business, visit&nbsp;<a href="https://inside.giesbusiness.illinois.edu/work-at-gies" target="_blank">https://inside.giesbusiness.illinois.edu/work-at-gies</a>.<br></p><p>Become an Illinois professional at the University of Illinois Urbana-Champaign (UIUC) and be part of a dynamic and diverse community dedicated to making a positive impact on both local and global scales, advancing knowledge, and fostering creativity. Learn more about why YOU should join us at UIUC </p><h4>Application Procedures &amp; Deadline Information</h4><p>Applications must be received by 6:00 pm (Central Time) on Monday, September 22, 2025. Apply for this position using the Apply Now button at the top or bottom of this posting. Applications not submitted through <a href="https://jobs.illinois.edu" target="_blank">https://jobs.illinois.edu</a> will not be considered. For further information about this specific position, please contact <a href="mailto:porche@illinos.edu" target="_blank">porche@illinos.edu</a>. For questions regarding the application process, please contact 217-333-2137.</p><p>The University of Illinois offers a very competitive benefits portfolio, depending on the position. Click for a complete list of Employee Benefits.</p><p>The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify.</p><p>Applicants with disabilities are encouraged to apply and may request a reasonable accommodation under the Americans with Disabilities Act (2008) to complete the application and/or interview process. Accommodations may also be requested on the basis of pregnancy, childbirth, and related conditions, or religion. Requests may be submitted through the reasonable accommodations portal, or by contacting the Accessibility &amp; Accommodations Division of the Office for Access and Equity at 217-333-0885, or by emailing <a href="mailto:accessibility@illinois.edu" target="_blank">accessibility@illinois.edu</a>.</p><p><strong>Requisition ID</strong>: 1032460<br><strong>Job Category</strong>: Education &amp; Student Services<br><strong>Apply at:</strong> <a href="https://jobs.illinois.edu" target="_blank">https://jobs.illinois.edu</a></p>

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