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Salary Range:&nbsp;&nbsp;$55,245.00&nbsp;(Min.) -&nbsp;$69,045.00&nbsp;(Mid.) -&nbsp;$82,867.00&nbsp;(Max.)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. 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. <h4>Job Summary</h4>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.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;<h4>Duties</h4>Outreach and Engagement: (25%) &nbsp; 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.Cross-Collaboration: &nbsp;(25%) 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;Implementing Strategic Initiatives: &nbsp;(20%) &nbsp; 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;<h4>Duties Continued</h4>High-Touch Customer Focus: (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.Day-to-Day Representation: (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.Performs other duties as assigned.&nbsp; (10%)&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;<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>Required: At least 1 year of community work focused on health care, public health, or health education orAt 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.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;Minimum of 1 year experience related to marketing, brand awareness tactics, or social media&nbsp;Experience with database software, data entry, and reporting process.&nbsp;Preferred: Minimum of 3 years experience with database software, data entry, and reporting processes. Salesforce knowledge.<h4>Skills</h4>Required: Strong verbal and written communication skillsExcellent organizational skills.Must be a detail-oriented, collaborative and enthusiastic team player.&nbsp;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;Ability to solve complex issues and identify creative solutions to assist members and community stakeholders.Must have the ability to troubleshoot problem areas and recommend effective alternative solutions and provide optimal customer service for internal and external customers.Demonstrates action oriented leadership to take on new opportunities and rewarding challenges with a sense of urgency, high energy, and enthusiasm.Ability to multi-task and meet competing deadlines while maintaining attention to detail and accuracy.Must be able to work independently or as part of a diverse team while being business-minded as well as empathetic towards members.Must show initiative and act on anticipated business needs without prompting from management. Ability to adapt quickly to a fast-changing environment.Advanced proficiency in MS Office including Outlook, Word, Excel, and PowerPointStrong interpersonal skills and ability to read non-verbal cues with a high level of situational adaptability.Ability to make sound decisions with incomplete information.Preferred: Experience with the Salesforce CRM platformKnowledge and understanding of the unique needs of the Medi-Cal beneficiary populations within a social service, healthcare, not-for-profit, or government setting.&nbsp;Knowledge of public agencies, organizations, and other resources that support Community Resource Center visitors.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. <h4>Licenses/Certifications Required</h4>Cardiopulmonary Resuscitation (CPR) Certified within 120 days of hire.<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4>Required:Within 120 days of hire: Cardiopulmonary resuscitation (CPR) and California Mandated Reporter. Management of Aggressive Behavior (MOAB), de-escalation techniques training, safe lifting practices training. Emergency Action Plan (EAP).<h4>Physical Requirements</h4>Moderate<h4>Additional Information</h4>Required:&nbsp; Travel to offsite locations for work.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<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> Nearest Major Market: Los Angeles Job Segment: Medicare, Social Services, Data Entry, Relationship Manager, Medicaid, Healthcare, Service, Administrative, Customer Service

L.A. Care Health Plan

Community Resource Center Specialist III

Salary Range:&nbsp;&nbsp;$77,265.00&nbsp;(Min.) -&nbsp;$100,445.00&nbsp;(Mid.) -&nbsp;$123,625.00&nbsp;(Max.)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. 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. <h4>Job Summary</h4>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.).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; 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.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).<h4>Duties</h4>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.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. <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> Required: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.<h4>Skills</h4> Required: Strong, decision-making and interpersonal skills.Excellent verbal land written communication skills. &nbsp;Ability to write routine reports and correspondence.Excellent Microsoft Office skills (Excel, PowerPoint, Word).Strong analytical and organizational skills.&nbsp;Ability to interpret technical data, processes, operating and maintenance instructions and procedure manuals.Attention to detail.Must be a strong team player willing to work toward achieving team goals.Must be flexible to meet the changing training needs.Preferred: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.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<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> Nearest Major Market: Los Angeles Job Segment: Call Center, Claims, Customer Service, Insurance

Customer Solution Center Training Specialist II

Salary Range:&nbsp;&nbsp;$47,840.00&nbsp;(Min.) -&nbsp;$57,062.00&nbsp;(Mid.) -&nbsp;$68,474.00&nbsp;(Max.)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. 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. <h4>Job Summary</h4>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.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.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.<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>Perform other duties as assigned. (10%)<h4>Duties Continued</h4><h4>Education Required</h4>High School Diploma/or High School Equivalency Certificate<h4>Education Preferred</h4><h4>Experience</h4>Required:At least 6 months of health care experience.Experience working in a cross functional work environment.Preferred:Experience in Medi-Cal managed care.1 year of experience in UM/Prior Authorization.<h4>Skills</h4>Required:Demonstrated proficiency in Medical Terminology required.Strong verbal and written office communication skills.Proficient with Microsoft Office Suite and Adobe PDF. and Excellent organizational, interpersonal and time management skills. Must be detail-oriented and an enthusiastic team player.Preferred:Knowledge of QNXT computer systems a plus.Knowledge of the UM patient referral process.Knowledge of member’s health plan eligibility.Knowledge of member’s benefits coverage. Knowledge of Health Plan regulations.Knowledge of HMO/UM functions.Knowledge of ICD-10/CPT coding. Proficient utilizing electronic medical records and documentation programs.<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>Required:Weekends and holidays hours may be required, as well as OT based on a business need.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<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> Nearest Major Market: Los Angeles Job Segment: EMR, Data Entry, Medical Coding, Claims, Healthcare, Administrative, Insurance

Authorization Technician II

Salary Range:&nbsp;&nbsp;$60,778.00&nbsp;(Min.) -&nbsp;$75,950.00&nbsp;(Mid.) -&nbsp;$91,166.00&nbsp;(Max.)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. 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. <h4>Job Summary</h4>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.<h4>Duties</h4>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%)Collaborates with and act as liaison between Pharmacy staff and PBM representatives to resolve escalated issues. Delegates escalated cases to pharmacy technicians. (15%)Takes part in on-call and after hours schedule rotation. (15%)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%)Assists in the development of member and provider communication, including writing/editing and distribution. (15%)Perform other duties as assigned. (10%)<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> Required:At least 3 years of experience as a Pharmacy Technician.Minimum of 6 months of lead experience (process, program or staff). At least 1 year in an outpatient/home infusion/hospital pharmacy setting.<h4>Skills</h4> Required: Proficiency with Microsoft Word, Excel and Access.Must be customer service oriented.Must possess good Communication (verbal) skills.Preferred: 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.<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>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<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> Nearest Major Market: Los Angeles Job Segment: Pharmacy Tech, Pharmacy, Claims, Healthcare, Insurance

Lead Pharmacy Technician

Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)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. 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. <h4>Job Summary</h4>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. 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.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.Manages all aspects of running an efficient &nbsp;team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports.&nbsp;<h4>Duties</h4>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. 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.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;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.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.Work cross functionally and collaboratively within Appeals and Grievances with key internal partners to build a high functioning, results oriented environment and organization.&nbsp;<h4>Duties Continued</h4>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.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.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;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.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;Perform other duties as assigned<h4>Education Required</h4>Bachelor's Degree in Nursing<h4>Education Preferred</h4><h4>Experience</h4>Required: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.At least 3 years of management level operations leadership experience.Experience working with firm deadlines, regulators, detail oriented with the ability to interpret and apply regulationsExperience building relationships with organizations and business partners.Equivalency:&nbsp; Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.Preferred:&nbsp; Managed care experience.<h4>Skills</h4>Required: Excellent analytical, problem solving, planning and implementation skills.Demonstrated strong writing and communication skills.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.Demonstrates professional judgement, and critical thinking, to promote the delivery of quality, cost-effective care.Time management and priority setting skills.Excellent understanding of NCQA, DMHC, DOI, DHCS, and CMS regulatory requirements.Knowledge of Coordination of Care, Medicare and Medi-Cal regulations, prior authorization, level of care and length of stay criteria sets.Able to work effectively with various internal departments/service areas, L.A. Care's plan partners, participating provider groups, and other external agencies.Able to operate PC-based software programs including proficiency in Word, Excel and PowerPoint presentations.Excellent verbal, written communication and presentation skills.<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>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.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 assignedSalary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<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> Nearest Major Market: Los Angeles Job Segment: Nursing, Registered Nurse, Nurse Management, Medicaid, Medicare, Healthcare

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

<h4>Assistant Director of Academic Programs - Gies College of Business</h4><h4>Gies Undergraduate Programs</h4> <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>Bachelor's degreeAt least 3 years of Higher Education experience, can include graduate work.<h4> Preferred Qualifications</h4>• Demonstrated experience with supervision of undergraduate students • Demonstrated experience event programming and assessment • Experience with transition programming • Experience working with a diverse student population<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>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. 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>. 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 <h4>Application Procedures &amp; Deadline Information</h4>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.The University of Illinois offers a very competitive benefits portfolio, depending on the position. Click for a complete list of Employee Benefits.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.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>.Requisition ID: 1032460 Job Category: Education &amp; Student Services Apply at: <a href="https://jobs.illinois.edu" target="_blank">https://jobs.illinois.edu</a>

University of Illinois Urbana-Champaign

Assistant Director of Academic Programs - Gies College of Business

Working with Us Challenging. Meaningful. Life-changing. Those aren’t words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every day, in every department. From optimizing a production line to the latest breakthroughs in cell therapy, this is work that transforms the lives of patients, and the careers of those who do it. You’ll get the chance to grow and thrive through opportunities uncommon in scale and scope, alongside high-achieving teams. Take your career farther than you thought possible.Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives. Read more: careers.bms.com/working-with-us.Position SummaryThe Data Scientist Co-Op Student will play a crucial role in supporting analytics utilized by GPS’ Cell Therapy Development and Operations (CTDO) organization.&nbsp; This role will contribute to our team’s mission to establish and advance our process monitoring, analytics, and modeling ecosystem to support improved process design, risk management, continuous improvement, and investigations.&nbsp; The Data Scientist Co-Op Student will help ensure that our analytics meet business requirements and function in a robust, and operationally resilient manner.&nbsp; This role will have opportunities to build new or enhance existing analytics and/or help advance new/existing capabilities in predictive modelling (e.g. continue drivers analysis for existing Critical-to-Quality Attributes (CQAs), expand model to new CQAs, etc) and statistical process control (SPC). The Data Scientist Co-Op Student should have a strong interest in solving business problems, and an eagerness to work on all parts of the analytics value chain, from partnering with IT on data pipelines to operationalizing predictive models in the service of our patients around the world.&nbsp;The full-time co-op will take place January - June 2026. Key Responsibilities<ul><li>Collaborate with stakeholders to identify business problems, goals, and KPIs to design, establish and maintain data products, predictive models, and business facing reports and dashboards.</li><li>Contribute to testing, documentation of testing artifacts, and validation of Cell Therapy Data Products (e.g. Process Control and Product Quality etc.)</li><li>Create or Update data flow diagrams and end-user training documentation</li><li>Identify and implement enhancement and automation of high-value analytics while ensuring they continue to function efficiently.</li><li>Prepare reports, dashboards, and presentations to communicate analyses to stakeholders at various levels of the organization.</li><li>Gather and prepare data using a combination of Python, SQL, or R from GPS source systems</li><li>Follow technical best practices in building, maintaining, and enhancing analytics output with scalable solutions, including code version control, pipeline management, deployment, and documentation.</li></ul> Qualifications &amp; Experience<ul><li>Currently pursuing or completed a Bachelor's or Master's degree in data analytics, engineering, mathematics, statistics, or life sciences discipline (e.g. Biology, Microbiology, Chemistry, Biochemistry etc.)</li><li>Experience working with large datasets, data visualization tools, statistical software packages and platforms (specifically R, Python, SQL, Domino, AWS, GitHub, PowerBI, Tableau)</li><li>Prior experience in a data and analytics role, including direct development experience a plus</li><li>Experience with platforms or applications such as SAP, Benchling, LIMS, Veeva Quality Vault, MES is a plus</li><li>Experience with biotech product development, manufacturing operations, supply chain, and quality control is a plus</li><li>All candidates must be authorized to work in the US both at the time of hire and for the duration of their employment.&nbsp; Please note that immigration or visa sponsorship is not available for this position.</li></ul>This is a temporary, time-bound position intended for the duration of the internship or co-op program. Employment in this role does not imply or guarantee ongoing or permanent employment with BMS.The starting hourly compensation for this assignment is within the range of $23.00 to $42.00/hr. Please note that the final individual compensation and any applicable benefits will be determined by your employer of record (and not BMS). Factors influencing this decision may include the characteristics of the assignment, such as demonstrated experience, required skill, and the geographic location of the job. Compensation details are subject to change.If you come across a role that intrigues you but doesn’t perfectly line up with your resume, we encourage you to apply anyway. You could be one step away from work that will transform your life and career.Compensation Overview:The starting compensation range(s) for this role are listed above for a full-time employee (FTE) basis. Additional incentive cash and stock opportunities (based on eligibility) may be available. The starting pay rate takes into account characteristics of the job, such as required skills, where the job is performed, the employee’s work schedule, job-related knowledge, and experience. Final, individual compensation will be decided based on demonstrated experience.&nbsp; Eligibility for specific benefits listed on our careers site may vary based on the job and location. For more on benefits, please visit <a href="https://careers.bms.com/life-at-bms/" target="_blank">https://careers.bms.com/life-at-bms/</a>. Benefit offerings are subject to the terms and conditions of the applicable plans then in effect and may include the following: Medical, pharmacy, dental and vision care. Wellbeing support such as the BMS Living Life Better program and employee assistance programs (EAP). Financial well-being resources and a 401(K). Financial protection benefits such as short- and long-term disability, life insurance, supplemental health insurance, business travel protection and survivor support. Work-life programs include paid national holidays and optional holidays, Global Shutdown Days between Christmas and New Year’s holiday, up to 120 hours of paid vacation, up to two (2) paid days to volunteer, sick time off, and summer hours flexibility. Parental, caregiver, bereavement, and military leave. Family care services such as adoption and surrogacy reimbursement, fertility/infertility benefits, support for traveling mothers, and child, elder and pet care resources. Other perks like tuition reimbursement and a recognition program.Uniquely Interesting Work, Life-changing Careers With a single vision as inspiring as “Transforming patients’ lives through science™ ”, every BMS employee plays an integral role in work that goes far beyond ordinary. Each of us is empowered to apply our individual talents and unique perspectives in a supportive culture, promoting global participation in clinical trials, while our shared values of passion, innovation, urgency, accountability, inclusion and integrity bring out the highest potential of each of our colleagues.On-site ProtocolBMS has an occupancy structure that determines where an employee is required to conduct their work. This structure includes site-essential, site-by-design, field-based and remote-by-design jobs. The occupancy type that you are assigned is determined by the nature and responsibilities of your role:Site-essential roles require 100% of shifts onsite at your assigned facility. Site-by-design roles may be eligible for a hybrid work model with at least 50% onsite at your assigned facility. For these roles, onsite presence is considered an essential job function and is critical to collaboration, innovation, productivity, and a positive Company culture. For field-based and remote-by-design roles the ability to physically travel to visit customers, patients or business partners and to attend meetings on behalf of BMS as directed is an essential job function.BMS is dedicated to ensuring that people with disabilities can excel through a transparent recruitment process, reasonable workplace accommodations/adjustments and ongoing support in their roles. Applicants can request a reasonable workplace accommodation/adjustment prior to accepting a job offer. If you require reasonable accommodations/adjustments in completing this application, or in any part of the recruitment process, direct your inquiries to <a href="mailto:adastaffingsupport@bms.com" target="_blank">adastaffingsupport@bms.com</a>. Visit careers.bms.com/eeo-accessibility to access our complete Equal Employment Opportunity statement.BMS cares about your well-being and the well-being of our staff, customers, patients, and communities. As a result, the Company strongly recommends that all employees be fully vaccinated for Covid-19 and keep up to date with Covid-19 boosters.BMS will consider for employment qualified applicants with arrest and conviction records, pursuant to applicable laws in your area.If you live in or expect to work from Los Angeles County if hired for this position, please visit this page for important additional information:&nbsp;<a href="https://careers.bms.com/california-residents/" target="_blank">https://careers.bms.com/california-residents/</a>Any data processed in connection with role applications will be treated in accordance with applicable data privacy policies and regulations.

Bristol Myers Squibb

Data Scientist Co-Op

Working with Us Challenging. Meaningful. Life-changing. Those aren’t words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every day, in every department. From optimizing a production line to the latest breakthroughs in cell therapy, this is work that transforms the lives of patients, and the careers of those who do it. You’ll get the chance to grow and thrive through opportunities uncommon in scale and scope, alongside high-achieving teams. Take your career farther than you thought possible.Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives. Read more: careers.bms.com/working-with-us.The Oncology Thematic Research Center at BMS is a key research and early development engine, responsible for the discovery and development of novel oncology therapeutics for patients.&nbsp;Centered at our state-of-the-art research sites in Cambridge and Seattle, scientists focus on novel targets and pathways for tumors that are refractory to current therapies.&nbsp;With a deep understanding of the causal human biology, we are able to leverage our multiple modality platforms to best match the modality to the mechanism and desired outcome.&nbsp;We are a fully integrated drug discovery through translational and early clinical development organization which exploits state-of-the-art in vitro, in vivo and ex-vivo models of Cancer biology and Immuno-oncology to identify and validate targets.&nbsp; &nbsp;We partner closely with colleagues in Translational Medicine, Informatics and Predictive Sciences and Early Clinical Development to generate biomarker and patient enrichment hypotheses to enable efficient decision making in early clinical trials. We are&nbsp;optimally positioned to complement the world-class translational expertise, biology and leading academic research centers in the area.Our Bristol Myers Squibb research site in Cambridge Crossing will help us continue to deliver on our mission, positioning the company and our scientists in the heart of a vibrant ecosystem of world-class science, innovation, and business opportunities.Position Overview:We are seeking a highly motivated, experienced and talented Scientist to join our Discovery Biosciences team. This individual will play a key role in advancing our oncology drug discovery programs, with a focus on cancer immunology and next-generation biotherapeutic target identification, validation, mechanism of action and optimization studies. This position is heavily focused on wet lab work, contributing to cutting-edge research projects aimed at understanding cancer biology, identifying novel drug targets, and developing new therapeutic approaches. The successful candidate will bring deep scientific expertise, creative problem-solving skills and a collaborative mindset to drive impactful research.&nbsp; &nbsp;Position Responsibilities: In the role as a Scientist within the Discovery Biosciences team, the ideal candidate will:<ul><li>Conduct full time laboratory-based research supporting target identification, oncology drug discovery and development</li><li>Strong biology skills with experience using a wide range of cellular and molecular biology techniques, 2D and 3D cell culture and manipulation of complex cellular model systems (organoid, immune and stromal cell co-culture, and cancer cells), flow cytometry, qPCR, cell proliferation assays, generating reporter assays, molecular cloning, western blotting, immunoprecipitation, ELISA, and MSD</li><li>Experience with in vivo oncology and/or immunology models. Animal handling is not a requirement, but the candidate should understand the strengths and weaknesses of commonly used cancer immunology models, and have experience with downstream tissue processing (dissociation, flow cytometry, IHC)</li><li>Strong experience developing and applying state-of-the-art gene perturbation methods (siRNA/shRNA knockdown, nucleofection, and CRISPR-mediated genome editing)</li><li>Design, optimize, and troubleshoot complex cell-based and in vivo assays to evaluate therapeutic candidates and understand cancer signaling pathways</li><li>Collaborate with cross-functional teams, including medicinal chemistry, bioinformatics, and in vivo pharmacology, to advance project goals</li><li>Analyze and interpret experimental data, maintain accurate and detailed lab records, and present findings in team meetings</li><li>Contribute to the preparation of technical reports, publications, and presentations</li></ul>Experience = Basic Qualifications: <ul><li>Bachelor’s Degree<ul><li>5+ years of academic and / or industry experience</li></ul></li></ul>Or<ul><li>Master’s Degree<ul><li>3+ years of academic and / or industry experience</li></ul></li></ul>Or<ul><li>Ph.D. or equivalent advanced degree in the Life Sciences<ul><li>No experience necessary</li></ul></li></ul>Preferred Qualifications: <ul><li>PhD and 0-4+ years of academic and / or industry experience preferred</li><li>Extensive experience in oncology research, with background in cancer immunology and/or biotherapeutics (e.g. ADCs, multi-specifics, and TCEs) is strongly preferred</li><li>Proven track record with designing and developing a variety of molecular biology and cellular assays</li><li>Hands on experience with functional genomics, CRISPR screens, high content imaging, flow cytometry, RNA-seq and proteomics is highly desirable</li><li>Proficiency in data analysis software (e.g., GraphPad Prism, FlowJo) and familiarity with bioinformatics tools</li><li>Familiarity with querying large-scale oncology datasets (DepMap, cBioPortal, TCGA) to generate and test hypotheses</li><li>Effective troubleshooting skills when optimizing assays and when developing innovative methodologies</li></ul>#LI-OnsiteIf you come across a role that intrigues you but doesn’t perfectly line up with your resume, we encourage you to apply anyway. You could be one step away from work that will transform your life and career.Compensation Overview:Cambridge Crossing: $129,640 - $157,096 &amp;#xa;The starting compensation range(s) for this role are listed above for a full-time employee (FTE) basis. Additional incentive cash and stock opportunities (based on eligibility) may be available. The starting pay rate takes into account characteristics of the job, such as required skills, where the job is performed, the employee’s work schedule, job-related knowledge, and experience. Final, individual compensation will be decided based on demonstrated experience.&nbsp; Eligibility for specific benefits listed on our careers site may vary based on the job and location. For more on benefits, please visit <a href="https://careers.bms.com/life-at-bms/" target="_blank">https://careers.bms.com/life-at-bms/</a>. Benefit offerings are subject to the terms and conditions of the applicable plans then in effect and may include the following: Medical, pharmacy, dental and vision care. Wellbeing support such as the BMS Living Life Better program and employee assistance programs (EAP). Financial well-being resources and a 401(K). Financial protection benefits such as short- and long-term disability, life insurance, supplemental health insurance, business travel protection and survivor support. Work-life programs include paid national holidays and optional holidays, Global Shutdown Days between Christmas and New Year’s holiday, up to 120 hours of paid vacation, up to two (2) paid days to volunteer, sick time off, and summer hours flexibility. Parental, caregiver, bereavement, and military leave. Family care services such as adoption and surrogacy reimbursement, fertility/infertility benefits, support for traveling mothers, and child, elder and pet care resources. Other perks like tuition reimbursement and a recognition program.Uniquely Interesting Work, Life-changing Careers With a single vision as inspiring as “Transforming patients’ lives through science™ ”, every BMS employee plays an integral role in work that goes far beyond ordinary. Each of us is empowered to apply our individual talents and unique perspectives in a supportive culture, promoting global participation in clinical trials, while our shared values of passion, innovation, urgency, accountability, inclusion and integrity bring out the highest potential of each of our colleagues.On-site ProtocolBMS has an occupancy structure that determines where an employee is required to conduct their work. This structure includes site-essential, site-by-design, field-based and remote-by-design jobs. The occupancy type that you are assigned is determined by the nature and responsibilities of your role:Site-essential roles require 100% of shifts onsite at your assigned facility. Site-by-design roles may be eligible for a hybrid work model with at least 50% onsite at your assigned facility. For these roles, onsite presence is considered an essential job function and is critical to collaboration, innovation, productivity, and a positive Company culture. For field-based and remote-by-design roles the ability to physically travel to visit customers, patients or business partners and to attend meetings on behalf of BMS as directed is an essential job function.BMS is dedicated to ensuring that people with disabilities can excel through a transparent recruitment process, reasonable workplace accommodations/adjustments and ongoing support in their roles. Applicants can request a reasonable workplace accommodation/adjustment prior to accepting a job offer. If you require reasonable accommodations/adjustments in completing this application, or in any part of the recruitment process, direct your inquiries to <a href="mailto:adastaffingsupport@bms.com" target="_blank">adastaffingsupport@bms.com</a>. Visit careers.bms.com/eeo-accessibility to access our complete Equal Employment Opportunity statement.BMS cares about your well-being and the well-being of our staff, customers, patients, and communities. As a result, the Company strongly recommends that all employees be fully vaccinated for Covid-19 and keep up to date with Covid-19 boosters.BMS will consider for employment qualified applicants with arrest and conviction records, pursuant to applicable laws in your area.If you live in or expect to work from Los Angeles County if hired for this position, please visit this page for important additional information:&nbsp;<a href="https://careers.bms.com/california-residents/" target="_blank">https://careers.bms.com/california-residents/</a>Any data processed in connection with role applications will be treated in accordance with applicable data privacy policies and regulations.

Scientist, Discovery BioSciences Oncology

Working with Us Challenging. Meaningful. Life-changing. Those aren’t words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every day, in every department. From optimizing a production line to the latest breakthroughs in cell therapy, this is work that transforms the lives of patients, and the careers of those who do it. You’ll get the chance to grow and thrive through opportunities uncommon in scale and scope, alongside high-achieving teams. Take your career farther than you thought possible.Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives. Read more: careers.bms.com/working-with-us.Summary:The position is part of the U.S. Government Price Reporting team and supports the monthly and quarterly government pricing calculation submission deliverables. The role requires attention to details, accuracy, time management skills, and adherence to evolving regulations.Responsibilities:<ul><li>Provide reporting and analytical support as part of the U.S. Government Price Reporting team to ensure BMS compliance with government program regulations.</li><li>Timely and accurate preparation, review, and analysis of information required for government pricing calculations.</li><li>Active participation in monthly and/or quarterly pricing review process.</li><li>Develop an understanding of the regulations, methodology and processes that drive the respective government programs to ensure BMS compliance with program requirements.</li><li>Drive digital transformation by identifying opportunities to automate pricing processes and implement scalable digital tools.</li><li>Champion process innovation by evaluating current pricing practices and recommending digital enhancements to improve efficiency and accuracy.</li><li>Assist with implementation and testing of government pricing system.</li><li>Assist with special projects as required.</li></ul>Qualifications:<ul><li>Bachelor’s degree in an analytical, financial, or business-related program preferred.</li><li>A minimum of 5 to 7 years of progressive responsibility in business operations, finance, planning and analysis or other similar roles.</li><li>Experience with government pricing and/or financial processes, SAP/BI/AO and Model N is a plus.</li><li>Demonstrated ability to communicate and explain analysis effectively with all levels within the organization.</li><li>Strong analytical, written, and problem-solving skills.</li><li>Organizational skills with attention to detail and ability to work under tight deadlines.</li><li>Work comfortably within a team environment.</li><li>Proficiency in spreadsheet analysis, database management and data delivery are required.</li><li>Solid technology background with knowledge of Excel (Pivot Tables, VLOOKUP, Macros, Index Match, Conditional Formatting, Flash Fill, etc.), Word (Formatting, Tables, Footnotes, Creating Templates, etc.), and PowerPoint.</li><li>Demonstrated experience leveraging and/or implementing, AI-driven insights and digital tools to enhance customer engagement strategies, optimize HCP/patient experience, and drive data-informed commercial decision-making.</li><li>Experience with process automation technologies (e.g., RPA, workflow automation tools, or scripting) is highly desirable.</li></ul>#LI-HybridIf you come across a role that intrigues you but doesn’t perfectly line up with your resume, we encourage you to apply anyway. You could be one step away from work that will transform your life and career.Compensation Overview:Madison - Giralda - NJ - US: $101,940 - $123,528&amp;#xa;Princeton - NJ - US: $101,940 - $123,528 &amp;#xa;Tampa - FL - US: $101,940 - $123,528&amp;#xa;The starting compensation range(s) for this role are listed above for a full-time employee (FTE) basis. Additional incentive cash and stock opportunities (based on eligibility) may be available. The starting pay rate takes into account characteristics of the job, such as required skills, where the job is performed, the employee’s work schedule, job-related knowledge, and experience. Final, individual compensation will be decided based on demonstrated experience.&nbsp; Eligibility for specific benefits listed on our careers site may vary based on the job and location. For more on benefits, please visit <a href="https://careers.bms.com/life-at-bms/" target="_blank">https://careers.bms.com/life-at-bms/</a>. Benefit offerings are subject to the terms and conditions of the applicable plans then in effect and may include the following: Medical, pharmacy, dental and vision care. Wellbeing support such as the BMS Living Life Better program and employee assistance programs (EAP). Financial well-being resources and a 401(K). Financial protection benefits such as short- and long-term disability, life insurance, supplemental health insurance, business travel protection and survivor support. Work-life programs include paid national holidays and optional holidays, Global Shutdown Days between Christmas and New Year’s holiday, up to 120 hours of paid vacation, up to two (2) paid days to volunteer, sick time off, and summer hours flexibility. Parental, caregiver, bereavement, and military leave. Family care services such as adoption and surrogacy reimbursement, fertility/infertility benefits, support for traveling mothers, and child, elder and pet care resources. Other perks like tuition reimbursement and a recognition program.Uniquely Interesting Work, Life-changing Careers With a single vision as inspiring as “Transforming patients’ lives through science™ ”, every BMS employee plays an integral role in work that goes far beyond ordinary. Each of us is empowered to apply our individual talents and unique perspectives in a supportive culture, promoting global participation in clinical trials, while our shared values of passion, innovation, urgency, accountability, inclusion and integrity bring out the highest potential of each of our colleagues.On-site ProtocolBMS has an occupancy structure that determines where an employee is required to conduct their work. This structure includes site-essential, site-by-design, field-based and remote-by-design jobs. The occupancy type that you are assigned is determined by the nature and responsibilities of your role:Site-essential roles require 100% of shifts onsite at your assigned facility. Site-by-design roles may be eligible for a hybrid work model with at least 50% onsite at your assigned facility. For these roles, onsite presence is considered an essential job function and is critical to collaboration, innovation, productivity, and a positive Company culture. For field-based and remote-by-design roles the ability to physically travel to visit customers, patients or business partners and to attend meetings on behalf of BMS as directed is an essential job function.BMS is dedicated to ensuring that people with disabilities can excel through a transparent recruitment process, reasonable workplace accommodations/adjustments and ongoing support in their roles. Applicants can request a reasonable workplace accommodation/adjustment prior to accepting a job offer. If you require reasonable accommodations/adjustments in completing this application, or in any part of the recruitment process, direct your inquiries to <a href="mailto:adastaffingsupport@bms.com" target="_blank">adastaffingsupport@bms.com</a>. Visit careers.bms.com/eeo-accessibility to access our complete Equal Employment Opportunity statement.BMS cares about your well-being and the well-being of our staff, customers, patients, and communities. As a result, the Company strongly recommends that all employees be fully vaccinated for Covid-19 and keep up to date with Covid-19 boosters.BMS will consider for employment qualified applicants with arrest and conviction records, pursuant to applicable laws in your area.If you live in or expect to work from Los Angeles County if hired for this position, please visit this page for important additional information:&nbsp;<a href="https://careers.bms.com/california-residents/" target="_blank">https://careers.bms.com/california-residents/</a>Any data processed in connection with role applications will be treated in accordance with applicable data privacy policies and regulations.

Manager, Government Pricing

Working with Us Challenging. Meaningful. Life-changing. Those aren’t words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every day, in every department. From optimizing a production line to the latest breakthroughs in cell therapy, this is work that transforms the lives of patients, and the careers of those who do it. You’ll get the chance to grow and thrive through opportunities uncommon in scale and scope, alongside high-achieving teams. Take your career farther than you thought possible.Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives. Read more: careers.bms.com/working-with-us.The SVP, Global Business Unit Head Oncology will be responsible for the global &nbsp;market access strategy for all BMS assets (in-line and pipeline in oncology. He/she will provide input to the Development and Commercial Strategy organization on access approaches in global markets. He/she will also be responsible for the US Access strategy across the oncology portfolio and be accountable for all LTFP, budget and GTN decisions.&nbsp; This role will also be responsible for global oncology HEOR and across oncology portfolio above brand responsibilities for modeling and policy work. &nbsp;The Head of HEOR Oncology will report to this role. Additionally, he/she will be responsible for representing integrated MAx input on above-brand oncology portfolio strategy and portfolio prioritization decisions. It also critical that this role integrates &nbsp;market access strategy across oncology indications that overlap with Cell therapy and radiopharmaceuticals.He/she will ensure the Global long term product forecast pricing, and access assumptions are accurate and updated for the Oncology portfolio including launched and pipeline assets. In addition, he/she will be responsible for indication expansions of launched assets and transitioning numerous products at earlier stages of development into full commercial development. In this role, the SVP will need to maintain the relevant corporate relationships with multiple customers eg GPO, Oncology Advocacy. This will involve chairing market access committees.He or she will oversee a team of senior leaders who in turn have multiple pipeline Pricing and Access Strategy Leads (PASLs) each sitting on multiple Global Product Teams (GPTs), providing input into the development and commercialization strategy from a pricing, access, and HEOR perspective, and assisting the markets through product launch through their teams of (PASLs). He or she will also oversee US access strategy across brands and be responsible for the value propositions and PIE and FDAMA decks and training of FHEOR and AEs across the oncology portfolio. The leader will also oversee overall GPO, Advocacy, Community oncology market access strategies across products.The position is cross functional in nature and is part of a highly matrixed organization. The SVP, Global Business Unit Head Oncology Head of Cardiovascular, Immunology and Neurology will partner with senior leaders of Commercial, Medical, and Clinical Development, as well as the Heads of Access in the markets across the world to optimally and position BMS products for success in an increasingly challenging and evolving WW access landscape. He/She will chair the Oncology DEX meetings,&nbsp; Commercialisation Strategy &amp; Resource Endorsement (CSR-E) with the Senior Vice Presidents of Commercial and Medical. He/She will also Chair the Cross Functional Leadership Teams (CFLT) with the Senior Vice Presidents of Commercial, Medical, Regulatory and Clinical Development. He/she will be an important advisor of the &nbsp;Commercial Development Operating Committee (CDOC) and Asset &amp; Portfolio Oversight Committee (APOC) as permanent member.The role will have relationships and interactions with stakeholders in field based functional market roles, up to senior worldwide management (CCO for governance decisions). A motivated, inclusive, and decisive disposition is essential for success.It is critical that the successful candidate be highly informed on Global Access strategy, have a track record of making complex strategic decisions, and can communicate strategy effectively to senior leaders across functions.Key ResponsibilitiesTo develop worldwide market access strategies and access advice for Oncolofy products through: evaluating payer insights/perspectives;&nbsp; assessing payer appropriateness of clinical development programs, and recommending modifications to these programs if appropriate; influencing brand strategies based on access, pricing, and HEOR insights; due diligence on business development opportunities (when existing disease area knowledge is required); and leading cross functional teams in a matrixed organization, by both participation, and by leading a teams of Senior Directors, who in turn have teams of PASLs.Development of strong payer value propositions articulating bold and differentiated messages on clinical, humanistic and economic benefits, and that those propositions are supported by strong evidence coming from registrational trials, non-registrational trials, and real-world evidence in appropriate timelines for the worldwide brand / indication launch. Working with BMS HEOR and regulatory teams to seek optimal PRO claims in the product label as appropriate, and maximize the economic value of assets.Monitor competitive environment in partnership with the Business Insights team, and update cross functional teams on important access developments. Qualifications &amp; Experience<ul><li>Demonstrated ability to lead and leverage high performing, highly experienced cross-functional teams through complex decisions to deliver results, and develop talent</li><li>Understanding of the current and evolving global market access, pricing, and HEOR environment for Oncology products</li><li>Solid understanding of competitors in the Oncology space; familiarity with top KOLs and their clinical beliefs in the core disease areas a plus</li><li>Previous leadership experience in launch / commercialization required, with demonstrable results in achieving positive HTA results across WW markets</li><li>Proven ability to translate scientific/clinical value into economic value</li><li>Strong financial acumen, and ability to navigate corporate annual reports and finance documents</li><li>Ability to efficiently craft and accurately articulate access strategy to senior, cross functional, stakeholders with potentially limited understanding of the access environment in a particular disease area</li><li>Solid understanding of clinical trial design, health economic models and cost effectiveness, formal certification in HEOR a plus</li><li>Minimum of 15 to 20 years experience with a strong track record in Market Access, Pricing or HEOR in a Global/WW or large country market. Prior in-market access experience is essential</li><li>Demonstrated ability to establish unmet needs and drive value perception</li><li>Knowledge of the product development and commercialization process</li><li>Ability to travel to international congresses and BMS internal meetings</li><li>Demonstration of all BMS Behaviors, including Accountability, Innovation, Passion &amp; Speed</li><li>Undergraduate degree required, an advanced degree (MBA and/or PhD) degree highly desired</li><li>Demonstrated ability to lead and leverage high performing, highly experienced cross-functional teams through complex decisions to deliver results, and develop talent</li><li>Understanding of the current and evolving global market access, pricing, and HEOR environment for Oncology products</li><li>Solid understanding of competitors in the Oncology space; familiarity with top KOLs and their clinical beliefs in the core disease areas a plus</li><li>Previous leadership experience in launch / commercialization required, with demonstrable results in achieving positive HTA results across WW markets</li><li>Proven ability to translate scientific/clinical value into economic value</li><li>Strong financial acumen, and ability to navigate corporate annual reports and finance documents</li><li>Ability to efficiently craft and accurately articulate access strategy to senior, cross functional, stakeholders with potentially limited understanding of the access environment in a particular disease area</li><li>Solid understanding of clinical trial design, health economic models and cost effectiveness, formal certification in HEOR a plus</li><li>Minimum of 15 to 20 years experience with a strong track record in Market Access, Pricing or HEOR in a Global/WW or large country market. Prior in-market access experience is essential</li><li>Demonstrated ability to establish unmet needs and drive value perception</li><li>Knowledge of the product development and commercialization process</li><li>Ability to travel to international congresses and BMS internal meetings</li><li>Demonstration of all BMS Behaviors, including Accountability, Innovation, Passion &amp; Speed</li><li>Undergraduate degree required, an advanced degree (MBA and/or PhD) degree highly desired</li><li>Proven experience leveraging and/or implementing, AI-driven insights and digital tools to enhance customer engagement strategies, optimize HCP/patient experience, and drive data-informed commercial decision-making.</li></ul>The starting compensation for this job&nbsp;is a range from $385,070.00 USD- $466,700.00 USD, plus incentive cash and stock opportunities (based on eligibility).&nbsp;The starting pay rate takes into account characteristics of the job, such as required skills and where the job is performed.&nbsp;Final, individual compensation will be decided&nbsp;based on demonstrated&nbsp;experience.&nbsp;Eligibility for specific benefits listed on our careers site may vary based on the job and location. For more on benefits, please visit <a href="https://careers.bms.com/life-at-bms/" target="_blank">https://careers.bms.com/life-at-bms/</a>.&nbsp;Benefit&nbsp;offerings&nbsp;are subject to the terms and conditions of the applicable plans then in effect&nbsp;and may include the following: Medical, pharmacy, dental and vision care. Wellbeing support&nbsp;such as&nbsp;the BMS Living Life Better program and employee assistance programs (EAP). Financial well-being resources and a 401(K). Financial protection benefits such as short- and long-term disability, life insurance, supplemental health insurance, business travel protection and survivor support.&nbsp;Work-life programs include paid national holidays and optional holidays, Global Shutdown Days between Christmas and New Year’s holiday, up to 120 hours of paid vacation, up to two (2) paid days to volunteer, sick time off, and summer hours flexibility.&nbsp;Parental, caregiver, bereavement, and military leave. Family care services such as adoption and surrogacy reimbursement, fertility/infertility benefits, support for traveling mothers, and child, elder and pet care resources. Other perks like tuition reimbursement and a recognition program.Why You Should ApplyAround the world, we are passionate about making an impact on the lives of patients with serious diseases. Empowered to apply our individual talents and diverse perspectives in an inclusive culture, our shared values of passion, innovation, urgency, accountability, inclusion and integrity bring out the highest potential of each of our colleagues.Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives.If you come across a role that intrigues you but doesn’t perfectly line up with your resume, we encourage you to apply anyway. You could be one step away from work that will transform your life and career.Compensation Overview:$326,430 - $395,551The starting compensation range(s) for this role are listed above for a full-time employee (FTE) basis. Additional incentive cash and stock opportunities (based on eligibility) may be available. The starting pay rate takes into account characteristics of the job, such as required skills, where the job is performed, the employee’s work schedule, job-related knowledge, and experience. Final, individual compensation will be decided based on demonstrated experience.&nbsp; Eligibility for specific benefits listed on our careers site may vary based on the job and location. For more on benefits, please visit <a href="https://careers.bms.com/life-at-bms/" target="_blank">https://careers.bms.com/life-at-bms/</a>. Benefit offerings are subject to the terms and conditions of the applicable plans then in effect and may include the following: Medical, pharmacy, dental and vision care. Wellbeing support such as the BMS Living Life Better program and employee assistance programs (EAP). Financial well-being resources and a 401(K). Financial protection benefits such as short- and long-term disability, life insurance, supplemental health insurance, business travel protection and survivor support. Work-life programs include paid national holidays and optional holidays, Global Shutdown Days between Christmas and New Year’s holiday, up to 120 hours of paid vacation, up to two (2) paid days to volunteer, sick time off, and summer hours flexibility. Parental, caregiver, bereavement, and military leave. Family care services such as adoption and surrogacy reimbursement, fertility/infertility benefits, support for traveling mothers, and child, elder and pet care resources. Other perks like tuition reimbursement and a recognition program.Uniquely Interesting Work, Life-changing Careers With a single vision as inspiring as “Transforming patients’ lives through science™ ”, every BMS employee plays an integral role in work that goes far beyond ordinary. Each of us is empowered to apply our individual talents and unique perspectives in a supportive culture, promoting global participation in clinical trials, while our shared values of passion, innovation, urgency, accountability, inclusion and integrity bring out the highest potential of each of our colleagues.On-site ProtocolBMS has an occupancy structure that determines where an employee is required to conduct their work. This structure includes site-essential, site-by-design, field-based and remote-by-design jobs. The occupancy type that you are assigned is determined by the nature and responsibilities of your role:Site-essential roles require 100% of shifts onsite at your assigned facility. Site-by-design roles may be eligible for a hybrid work model with at least 50% onsite at your assigned facility. For these roles, onsite presence is considered an essential job function and is critical to collaboration, innovation, productivity, and a positive Company culture. For field-based and remote-by-design roles the ability to physically travel to visit customers, patients or business partners and to attend meetings on behalf of BMS as directed is an essential job function.BMS is dedicated to ensuring that people with disabilities can excel through a transparent recruitment process, reasonable workplace accommodations/adjustments and ongoing support in their roles. Applicants can request a reasonable workplace accommodation/adjustment prior to accepting a job offer. If you require reasonable accommodations/adjustments in completing this application, or in any part of the recruitment process, direct your inquiries to <a href="mailto:adastaffingsupport@bms.com" target="_blank">adastaffingsupport@bms.com</a>. Visit careers.bms.com/eeo-accessibility to access our complete Equal Employment Opportunity statement.BMS cares about your well-being and the well-being of our staff, customers, patients, and communities. As a result, the Company strongly recommends that all employees be fully vaccinated for Covid-19 and keep up to date with Covid-19 boosters.BMS will consider for employment qualified applicants with arrest and conviction records, pursuant to applicable laws in your area.If you live in or expect to work from Los Angeles County if hired for this position, please visit this page for important additional information:&nbsp;<a href="https://careers.bms.com/california-residents/" target="_blank">https://careers.bms.com/california-residents/</a>Any data processed in connection with role applications will be treated in accordance with applicable data privacy policies and regulations.

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