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Job Title Clinician - Pediatric Optometrist Requisition Number FE04605 Working Title Department Name 7H854:OPHTHALMOLOGY &amp; VISUAL SCIENCE Work Location Lexington, KY Type of Position Faculty Position Time Status Full-Time Tenure Track Status Non-Tenure Track Required Education OD Required Related Experience Completion of Pediatric Optometry residency Required License/Registration/Certification Ability to obtain Kentucky Optometric License Job Summary The Department of Ophthalmology &amp; Visual Sciences at the University of Kentucky, College of Medicine, is seeing a Pediatric Optometrist to meet the medical and academic needs of the department. The successful candidate will join a group of providers that are committed to excellence in clinical care, instruction, scholarly activity and professional development in a robust and growing practice across eastern and southeastern Kentucky. The primary responsibility of the individual in this position will be to enhance the clinical practice of the Department of Ophthalmology as part of the Pediatric eye care team. This person will be responsible for providing direct patient care, service as an attending provider, training residents and optometry students assigned to the Ophthalmology Department. The individual in this position is expected to provide, develop and maintain clinical services as well as develop academic pursuits. Please include an updated CV when applying to this position. Applications will be reviewed immediately and continue until the position is filled. Skills / Knowledge / Abilities Does this position have supervisory responsibilities? No Preferred Education/Experience Deadline to Apply Open Until Filled Yes Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Clinician - Pediatric Optometrist

Job Title Physician - Obstetrician / Gynecologist (OB/GYN) Requisition Number FE04611 Working Title Department Name 7H501:OBSTETRICS &amp; GYNECOLOGY - GENERALIST Work Location Lexington, KY Type of Position Faculty Position Time Status Full-Time Tenure Track Status Non-Tenure Track Required Education MD, DO or equivalent Required Related Experience Completion of residency in OB/GYN Required License/Registration/Certification Eligibility for or current medical license in the state of Kentucky Board certified or eligibility in OB/GYN Job Summary The Department of Obstetrics and Gynecology at the University of Kentucky, is seeking a Board Certified/Board Eligible physician to join the General Obstetrics-Gynecology Division for a full-time faculty position in Lexington, KY. Responsibilities of this position include inpatient and outpatient case management, gynecological surgery, labor and delivery coverage, and participation in teaching activities with residents, interns and medical students. Development and participation in research activities and involvement in hospital and university committees is strongly encouraged. Special interest in such as Comprehensive Women’s Health, Maternity Care, midlife health, or pediatric and adolescent gynecology is sought. Experience in teaching and supervising medical students and resident physicians is desirable. Applicants should also have an interest in clinical care and research. A competitive salary and benefits package is being offered. Please include a CV along with application. Applications will be reviewed immediately and continue until the position is filled. Skills / Knowledge / Abilities Does this position have supervisory responsibilities? No Preferred Education/Experience Preferred experience in teaching and supervising medical students preferred Deadline to Apply Open Until Filled Yes Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Physician - Obstetrician / Gynecologist (OB/GYN)

Job Title Vascular Surgeon Requisition Number FE04541 Working Title Assistant, Associate, or Professor of Vascular Surgery Department Name 7H85V:SURGERY-VASCULAR Work Location Lexington, KY Type of Position Faculty Position Time Status Full-Time Tenure Track Status Non-Tenure Track Required Education M.D or equivalent Required Related Experience Completion of residency training in General Surgery, as well as fellowship in Vascular Surgery Required License/Registration/Certification Board Eligible/Board Certified in General Surgery and Vascular Surgery Eligibility for license to practice medicine in the state of Kentucky Job Summary The Department of Surgery at the University of Kentucky HealthCare, located in Lexington, Kentucky, is seeking a vascular surgeon at the Assistant, Associate Professor, Professor level. The allocation of clinical, administrative, and academic time will be determined based on the experience and interests of the selected applicant. UK HealthCare offers an academic career in an environment that promotes professional excellence and work-life balance. To apply, please include a CV along with application. Applications will be reviewed immediately and continue until the position is filled. Skills / Knowledge / Abilities Does this position have supervisory responsibilities? No Preferred Education/Experience Deadline to Apply Open Until Filled Yes Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Vascular Surgeon

Job Title Pediatric Surgeon Requisition Number FE04564 Working Title Department Name 7H857:SURGERY/PEDIATRICS Work Location Lexington, KY Type of Position Faculty Position Time Status Full-Time Tenure Track Status Non-Tenure Track Required Education M.D. or equivalent Required Related Experience Completion of residency training in General Surgery, as well as fellowship in Pediatric Surgery Required License/Registration/Certification Board Eligible/Board Certified in General Surgery and Pediatric Surgery Eligibility for license to practice medicine in the state of Kentucky Job Summary The Division of Pediatric Surgery at the University of Kentucky, College of Medicine seeks a board-certified pediatric surgeon to join our expanding clinical and academic program as an Assistant, Associate, or Professor of Pediatric Surgery. This position offers the opportunity to work alongside seven pediatric general surgeons supported by advance practice professionals and trainees in a mission-driven and supportive environment. Key Responsibilities: · Lead the UK Pediatric Surgery Quality Program by setting the vision and strategy. Develop, monitor, and improve patient-centered quality and safety metrics using evidence-based practices and innovative solutions. Foster a culture of quality and performance improvement. · Provide exceptional clinical care to pediatric patients. · Educate and mentor residents and medical students. · Engage in innovative research and scholarly activities to advance the field of pediatric surgery. About Us: Kentucky Children’s Hospital is a Level 1 Pediatric Trauma Center with an 88-bed Level IV NICU, a 16-bed PICU, and an ELSO Center of Excellence co-located with the UK Hospital System. Serving a catchment area of over 1.6 million people, we offer a comprehensive range of pediatric and surgical care. We are pursuing ACS Pediatric Surgery Level 1 Verification and ACS Quality Verification currently. Why Join Us: · Work at the No. 1 Hospital in Kentucky, as ranked by U.S. News &amp; World Report for nine consecutive years, and ranked in two Pediatric Specialties · Be part of a team at Kentucky Children’s Hospital dedicated to evidence based, high quality care across the full spectrum of pediatric surgery, including minimally invasive surgery, ECMO, fetal care, and trauma. Access to robotic surgery is available. · Benefit from mentorship and support in developing your academic career path with opportunities to lead and innovate · Enjoy living in Lexington, KY, a city known for its rich culture, outdoor activities, and top-rated schools. · Competitive salary and exceptional benefits/retirement package. Applicants should apply via the UK Jobs site and include an up-to-date Curriculum Vitae. This posting will remain open until the appropriate individual is recruited. Skills / Knowledge / Abilities Does this position have supervisory responsibilities? No Preferred Education/Experience Deadline to Apply Open Until Filled Yes Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Pediatric Surgeon

Job Title Cardiology Clinician Scientist Requisition Number FE04317 Working Title Department Name 7H354:INTERNAL MEDICINE &amp; DIVISIONS - CARDIOLO Work Location Lexington, KY Type of Position Faculty Position Time Status Full-Time Tenure Track Status Non-Tenure Track Required Education MD Degree or Equivalent Required Related Experience Completion of residency training in Internal Medicine and Cardiology Medicine; Completion of cardiovascular training or similar establishment of competence Required License/Registration/Certification KY Medical License Board certified in Internal Medicine Board eligible or board certified in subspecialty of Cardiovascular Diseases Board eligible or board certified in subspecialty of Interventional Cardiology Job Summary The Department of Internal Medicine at the University of Kentucky College of Medicine is seeking a clinician scientist to actively contribute to the basic and translational research mission in Cardiology. The successful candidate will be expected to bring and maintain a vigorous, independent, extramurally funded research program. Clinical work will include regular assignments in the faculty rotations to cover inpatient services (CCU, consult, floor) and other procedures including outpatient cardiology clinics. Most all of these activities will include clinical care teaching activities with medical students, residents, and fellows. Professional development activities such as attending continuing education meetings, workshops, lectures, and other activities will be necessary to participate in the various missions of the Department, the College, and the University. Please include an updated CV when applying for position. Applications will be reviewed immediately and continue until the position is filled. Skills / Knowledge / Abilities Does this position have supervisory responsibilities? No Preferred Education/Experience Deadline to Apply Open Until Filled Yes Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Cardiology Clinician Scientist

Job Title Vascular Surgeon Requisition Number FE04527 Working Title Assistant, Associate, or Professor Department Name 7H85V:SURGERY-VASCULAR Work Location Lexington, KY Type of Position Faculty Position Time Status Full-Time Tenure Track Status Non-Tenure Track Required Education M.D or equivalent Required Related Experience Completion of residency training in General Surgery, as well as fellowship in Vascular Surgery Required License/Registration/Certification Board Eligible/Board Certified in General Surgery and Vascular Surgery Eligibility for license to practice medicine in the state of Kentucky Job Summary The Department of Surgery at the University of Kentucky HealthCare, located in Lexington, Kentucky, is seeking a vascular surgeon at the Assistant, Associate Professor, Professor level. The allocation of clinical, administrative, and academic time will be determined based on the experience and interests of the selected applicant. UK HealthCare offers an academic career in an environment that promotes professional excellence and work-life balance. To apply, please include a CV along with application. Applications will be reviewed immediately and continue until the position is filled. Skills / Knowledge / Abilities Does this position have supervisory responsibilities? No Preferred Education/Experience Deadline to Apply Open Until Filled Yes Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Job Title Pediatric Gastroenterologist Requisition Number FE04556 Working Title Department Name 7H656:PEDIATRICS - GASTROENTEROLOGY Work Location Lexington, KY Type of Position Faculty Position Time Status Full-Time Tenure Track Status Non-Tenure Track Required Education MD, DO, or equivalent Required Related Experience Minimum residency training Required License/Registration/Certification Eligible for or licensed to practice medicine in the state of Kentucky Eligible for certification, or certified by, the American Board of Pediatrics and sub-board of Pediatric GI Job Summary The University of Kentucky College of Medicine, Department of Pediatrics seeks a Division Chief for the Division of Gastroenterology. This is in order to achieve the goals and objectives of the Division, Department, and College in education, service, and research consistent with the mission of the University of Kentucky College of Medicine. As Chief of the Division of Gastroenterology, you will be responsible for developing an expanded program which will include increased clinic availability, expanded faculty and staff, development of Gastroenterology research opportunities, and teaching of medical learners. To apply, please include a CV and cover letter along with application. Rank will be determined based on qualifications for the position. Applications will be reviewed immediately and will continue until filled. Skills / Knowledge / Abilities Does this position have supervisory responsibilities? No Preferred Education/Experience Deadline to Apply Open Until Filled Yes Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Pediatric Gastroenterologist

DescriptionAt ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.Job Summary<ul><li>Responsible for directing and coordinating all nursing care based on established clinical nursing practice standards</li><li>Collaborates with other professional disciplines to ensure effective and efficient patient care delivery and the achievement of desired patient outcomes</li></ul>Essential Functions<ul><li>Ability to practice nursing as described by the following definition: “The diagnosis and treatment of human responses to actual or potential health alterations.” Ability to utilize the nursing process in the provision of nursing care including but not limited to administering treatments and medications, interpreting diagnostic tests, formulating a plan of care, collaborating with other health care providers, and providing education to patients and/or significant others. The successful candidate will be required to pass competencies for this position. Involves discretion and independent action within prescribed limits.</li><li>Collects patient health data</li></ul><ul><li><ul><li>Determines the priority of data collection based on the patient’s immediate condition or needs.</li><li>Collects pertinent data using appropriate assessment techniques.</li><li>Involves the patient, significant others, and health care providers in data collection when appropriate.</li><li>Ensures that the data collection process is systematic and ongoing.</li><li>Documents relevant data in the medial record according to hospital standards.</li></ul></li></ul><ul><li>Analyzes the assessment data in determining diagnoses/patient problems.</li></ul><ul><li><ul><li>Derives diagnoses/patient problems from the assessment data.</li><li>Validates diagnoses/patient problems with the patient, significant other, and health care providers, when possible.&nbsp;</li><li>Documents diagnoses/patient problems in a manner that facilitates the determination of expected outcomes and plan.</li></ul></li></ul><ul><li>Identifies expected outcomes individualized to the patient.</li></ul><ul><li><ul><li>Derives outcomes from the diagnoses/patient problems.</li><li>Documents outcomes as measurable goals.</li><li>Formulates outcomes mutually with the patient and health care providers, when possible.</li><li>Ensures outcomes are realistic in relation to the patient’s present and potential capabilities.&nbsp;</li><li>Ensures outcomes are attainable in relation to resources available to the patient.</li><li>Ensures outcomes include a time estimate for attainment.</li><li>Ensures outcomes provide direction for continuity of care. Anticipates potential problems situations and intervenes to offset any adverse impact.</li></ul></li></ul><ul><li>Develops a plan of care that prescribes interventions to attain expected outcomes.</li></ul><ul><li><ul><li>Individualizes the plan to the patient’s condition or need.</li><li>Develops the plan with the patient, significant others, and health care providers, when appropriate.&nbsp;</li><li>Ensures the plan reflects current nursing practice.</li><li>Documents the plan.</li><li>Provides continuity of care in the plan.</li></ul></li></ul><ul><li>Implements the interventions identified in the plan of care.</li></ul><ul><li><ul><li>Establishes interventions that are consistent with the plan of care.</li><li>Implements interventions in a safe and appropriate manner.</li><li>Documents interventions.</li></ul></li></ul><ul><li>Evaluates the patient’s progress toward attainment of outcomes.</li></ul><ul><li><ul><li>Ensures evaluation is systematic and ongoing.</li><li>Documents patient’s responses to interventions.</li><li>Evaluates the effectiveness of interventions in relation to outcomes.</li><li>Utilizes ongoing assessment data to revise diagnoses/patient problems, outcomes, and the plan of care, as needed.&nbsp;</li><li>Documents revisions in diagnoses/patient problems, outcomes, and the plan of care.</li><li>Involves the patient, significant others, and health care providers in the evaluation process, when appropriate.</li></ul></li></ul><ul><li>Participates in quality-of-care activities as appropriate to include but not limited to:&nbsp;</li></ul><ul><li><ul><li>Identification of aspects of care important for quality monitoring.</li><li>Identification of indicators used to monitor quality and effectiveness of nursing care.</li><li>Collection of data to monitor quality and effectiveness of nursing care.</li><li>Analysis of quality data to identify opportunities for improving care.&nbsp;</li><li>Formulation of recommendations to improve nursing care or patient outcomes.</li><li>Implementation of activities to enhance the quality of nursing practice.</li><li>Utilizes the results of quality-of-care activities to initiate changes in practice.</li></ul></li></ul><ul><li>Other duties as assigned.</li></ul> QualificationsEducation<ul><li>Bachelor’s Degree preferred</li><li>Graduate of an accredited school of professional nursing</li></ul>Licenses/Certifications<ul><li>Licensure as a Registered Professional Nurse (RN)</li></ul>Experience<ul><li>Minimum of one year of hospital clinical experience preferred</li></ul>

St. Francis-Emory Healthcare

Registered Nurse Crisis Stabilization Unit, PRN

Job Title Interventional Gastroenterologist with Digestive Diseases and Nutrition Requisition Number FE03571 Working Title Interventional Gastroenterologist Department Name 7H358:INTERNAL MEDICINE &amp; DIVISIONS - GASTROEN Work Location Lexington, KY Type of Position Faculty Position Time Status Full-Time Tenure Track Status Tenure Track Required Education MD Degree or Equivalent Required Related Experience Completion of residency training in Internal Medicine and Gastroenterology Fellowship Clinical gastroenterology experience is required. Required License/Registration/Certification Ky Medical License; Board certified in Internal Medicine; Board eligible or board certified in subspecialty of Gastroenterology Job Summary The Department of Internal Medicine is seeking an Interventional Gastroenterologist at the Assistant Professor or higher level, candidate pending, for digestive diseases. Duties include, but are not limited to: Participation in the Interventional Gastroenterology Programs within the Division of Digestive Diseases and Nutrition at the University of Kentucky. Serve as an Attending and/or Consulting Physician at the UK HealthCare Hospitals and/or the Veterans Administration Hospital for no less than three months per year. Patient care responsibilities will include interventional gastroenterology services at the UK HealthCare outpatient clinics and possibly other outreach clinics. Provide teaching and supervision of residents and medical students in all clinical settings (inpatient, outpatient, and clinical research subjects). Will be an active participant in postgraduate education/ CME efforts. Candidate will be expected to develop and serve as director of the clinical pancreas program at UK. Candidate will be involved in establishing the annotated clinical database needed to follow patients in the clinic and coordinate with other faculty across multiple departments. They will accumulate data according to the National Pancreas Foundation. Candidate will be responsible for supervising the clinic’s nursing staff along with midlevel providers involved in the care of pancreatic disease patient populations in the University of Kentucky outpatient network. Candidate will be expected to work with multiple faculty across multiple departments to develop pancreas research projects. They will supervise research coordinators involved in of tissue and blood samples from these patients. These samples will be stored in the GI division biorepository. Candidate will begin to produce clinical and translational observations with this patient subset. It is expected that the team will produce multiple abstracts at both the national pancreas foundation meetings as well as American College of Gastroenterology and possibly Digestive Disease Week. It is projected that these interactions will result in the production of manuscripts within the second year and expectations are that grant submissions would be achieved in years 3 or 4. Serve on appropriate Division, Department, University, Hospital and College committees. Participation in Continuing Education Programs at the College of Medicine. Please include a CV along with application. Applications will be reviewed immediately and continue until the position is filled. Skills / Knowledge / Abilities Does this position have supervisory responsibilities? No Preferred Education/Experience Deadline to Apply Open Until Filled Yes Our University Community We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco &amp; Drug Free campus. The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status. Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Interventional Gastroenterologist with Digestive Diseases and Nutrition

Salary Range:&nbsp;&nbsp;$102,183.00&nbsp;(Min.) -&nbsp;$132,838.00&nbsp;(Mid.) -&nbsp;$163,492.00&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 Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance related to Payment Integrity initiatives to include concept and cost avoidance development. This position trains and mentors Payment Integrity Nurse Coder, RN staff. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.<h4>Duties</h4>Performs Quality Audits to include validation of accuracy and completeness of ICD, Rev Code, CPT, HCPCs, APR, DRG, POA, and all relevant coding elements. Audits can include inpatient, outpatient, and professional claims.Serves cross functionally with Utilization Management, Medical Directors, and other internal teams to assist in identification of overpayments as well as other projects.Serves as SME for all Payment Integrity functions to include both Retrospective Data Mining as well as Pre-Payment Cost Avoidance. Identifies trends and patterns with overall program and individual provider coding practices.Responsible for training and mentoring Payment Integrity Nurse Coder, RN staff.Supports the creation and execution of strategies that determine impact of opportunity and recover overpayments as well as prospective internal controls preventing future overpayments of each applicable pipeline opportunity. Works with both internal and external groups to define and develop cost avoidance measures to ensure continued success.Identifies and defines Payment Integrity issues and reviews and analyzes evidence, utilizes data for the purpose of verifying errors and identifying systemic errors, works as an active team member during scheduled engagements and work collaboratively to achieve the goals of the team, and provides feedback to the team lead on any issues identified during research or claims review.Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.Performs other duties as assigned.<h4>Duties Continued</h4><h4>Education Required</h4>Associate's Degree in Nursing<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4>Required:At least 8 years of clinical RN experience.At least 3 years of experience in utilization management or clinical coding.Investigation and/or auditing experience.<h4>Skills</h4>Required:Knowledge in CPT, HCPCS, ICD-9, ICD-10, Medicare, and Medicaid rules and regulations.Knowledge of healthcare reimbursement concepts, health insurance business, industry terminology, and regulatory guidelines.Working knowledge of claims coding and medical terminology.Solid understanding of standard claims processing systems and claims data analysis.Strong project leadership and management skills required; ability to prioritize, plan, and handle multiple tasks/demands simultaneously.Excellent interpersonal, verbal, and written communication skills required with excellent analytical and problem-solving skills. Detail oriented and ability to thrive in fast-paced work environment.Must be collaborative and have the ability to establish credibility quickly with all levels of management across multiple functional areas and be able to present findings across all departments.Must be familiar with coordinating benefits between health plan payers.Advanced knowledge of Microsoft Office suite, including Word, Excel and PowerPoint.<h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California LicenseCertified Professional Coder (CPC) designation by the American Academy of Professional Codersand/orCertified Coding Specialist (CCS) designation by the American Health Information Management Association (AHIMA).<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: Nursing, Medical Coding, Registered Nurse, Claims, Medicare, Healthcare, Insurance

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