field_remote_option

field_job_employment_type

job_industry

field_job_occupational_field_parents_all

field_job_experience

job_organization_name

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.&nbsp; We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. &nbsp;JOB SUMMARY:Coordinator, AppealsESSENTIAL DUTIES AND RESPONSIBILITIES:&nbsp; Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.About this position:Location:&nbsp;Remote (Within US Only), equipment providedRequired Schedule: Monday - Friday, 8:00 AM - 5:00 PM ESTHourly Salary:&nbsp;$18.27 Overview:Our Denial Management department is responsible for managing denied inpatient referrals from our partnered clients, handling a consistently high volume of cases each day. We support approximately 100 facilities, utilizing a structured workflow coordinated through a dedicated queue schedule maintained in SharePoint. Each team member is assigned specific facilities or tasks but remains cross-trained to work across multiple areas to ensure seamless coverage and operational flexibility. The department functions exclusively as an outbound call center, with all incoming communication routed to a centralized mailbox for triage and follow-up.Job Summary<ul><li>Perform denial research and follow-up work with insurance companies via phone to resolve appeals that have been submitted but remain without a determination</li><li>Compile multiple documents into appeal bundles and submit appeal bundles to payers in a timely manner</li><li>Determine and document appeal timeframes and payer process per facility within CorroHealth proprietary system</li><li>Transcribe information from clients’ EMRs and payer portals into required electronic format; check completed work for accuracy</li><li>Monitor and complete tasks within shared inboxes and internal request dashboards</li><li>Receive and document incoming emails, calls, tickets, or voicemails</li><li>Follow up with the client or internal staff via email or phone for additional information as requested</li><li>Export and upload documents within CorroHealth proprietary system</li><li>Cross-trained on various functions within the department to support other teams as needed</li><li>Other responsibilities as requested by management</li></ul>Minimum Qualifications: <ul><li>Must love communicating with others over the phone</li><li>Computer proficient. Must have intermediate skills with Outlook and Excel.</li><li>Must be able to schedule meetings, log onto Teams for meetings.</li><li>Must be able to open a new excel workbook, use formulas such as; adding and subtracting, copying and pasting.</li><li>Must be able to type a minimum of 25wpm</li><li>Detail oriented</li><li>Shows initiative and responsibility in taking the necessary steps towards problem resolution</li><li>Works independently, but is a team player</li><li>Able to work in a fast-paced environment</li><li>Possess good verbal and written communication skills</li><li>Required to keep all client and sensitive information confidential</li><li>Strict adherence to HIPAA/HITECH compliance</li></ul>Education/Experience Required:<ul><li>High School Diploma or equivalent required</li><li>Bachelor’s degree preferred</li><li>Understanding of denials processes for Medicare, Medicaid, and Commercial/Managed Care product lines</li><li>Prior experience of accessing hospital EMR’s and Payer Portals preferred</li><li>Proficient in MS Word and Excel. Needs to be able to open a new excel workbook, copy and paste, do basic formulas such as adding, subtracting and copying and pasting.</li><li>Must have basic skils in Outlook. Should be able to create a meeting invitation, accept a meeting invitation, receive and respond ot email and set up folders.</li><li>Must be able to type a minimum of 25 wpm with a 90% accuracy rate.</li></ul><h4>What we offer:</h4><ul><li>Hourly salary $18.27</li><li>Medical/Dental/Vision Insurance</li><li>Equipment provided</li><li>401k matching (up to 2%)</li><li>PTO: 80 hours accrued, annually</li><li>9 paid holidays</li><li>Tuition reimbursement</li><li>Professional growth and more!</li></ul>PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

CorroHealth

Coordinator, Appeals Management

Join the Clean Energy RevolutionBecome&nbsp;a&nbsp;Distribution/Vegetation Management Asset Strategy Senior Advisorat Southern California Edison (SCE) and build a better tomorrow. In this job, you’ll be responsible for developing and prioritizing company-wide strategic plan concerning SCE’s Distribution assets or vegetation management programs.&nbsp; You will work to advance Distribution grid hardening/infrastructure replacement plans and Maintenance &amp; Inspection activities to ensure better performance and reduce risk for SCE.&nbsp; In addition to developing a long-term plan, you will also be required to work on mitigating immediate asset risk. Additionally, this position will partner with peer organizations to ensure new asset strategies are approved internally as well as developing those concepts into SCE’s regulatory filings, such as the General Rate Case, Wildfire Mitigation Plan, and Risk Assessment Mitigation Phase.As a&nbsp;Distribution/Vegetation Management Asset Strategy Senior Advisor, your work will help power our planet, reduce carbon emissions and create cleaner air for everyone. Are you ready to take on the challenge to help us build the future?<h4>Responsibilities</h4><ul><li>Supports the development of critical regulatory and legislative initiatives to facilitate the execution of the strategic plan</li><li>Identifies system risks and evaluates risk reduction benefits of proposed mitigation strategy projects in the capital investment strategy</li><li>Leads the development and management of Asset strategies for programmatic investment decisions</li><li>Evaluates SCE's enterprise level risks and provides suitable mitigation options to senior management</li><li>Provides strategic and regulatory analysis for the company, specifically including competitive positioning, price forecasting, financial analytics, and regulatory planning scenario evaluations</li><li>Provides analyses, evaluation and management recommendations on key strategic initiatives</li><li>A material job duty of all positions within the Company is ensuring the protection of all its physical, financial and cybersecurity assets, and properly accessing and managing private customer data, proprietary information, confidential medical records, and other types of highly sensitive information and data with the highest standards of conduct and integrity.</li></ul><h4>Minimum Qualifications</h4><ul><li>Ten or more years of experience in strategic planning, setting strategies at the department or organization level.</li></ul>Preferred Qualifications:<ul><li>Master’s degree in applicable profession, business, or technical discipline</li><li>Experience with utility asset management, asset inspections, or vegetation management.</li><li>Experience working with and reviewing large amounts of geospatial and non-spatial data.</li><li>Experience conducting data quality analyses and performing high-level spot checks to ensure accuracy of information.</li><li>Experience evaluating technical solutions, risk analysis and cost benefit variables to make effective business decisions.</li><li>Experience developing communication materials (e.g., power point) and facilitate decision making conversations with senior leadership.</li><li>Experience coordinating or developing components of the General Rate Case and/or WMP.</li></ul>Additional Information<ul><li>This position’s work mode is hybrid. The employee will report to an SCE facility for a set number of days with the option to work remotely on the remaining days.  Unless otherwise noted, employees are required to work and reside in the state of California.  Further details of this work mode will be discussed at the interview stage.The work mode can be changed based on business needs.</li></ul><ul><li>Visit our Candidate Resource page to get meaningful information related to benefits, perks, resources, testing information, hiring process, and more! </li><li>Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.</li></ul><ul><li>Relocation does not apply to this position.</li></ul>About Southern California EdisonThe people at SCE don't just keep the lights on. Our mission is so much bigger. We’re fueling the kind of innovation that’s changing an entire industry, and quite possibly the planet. Join us and create a future with cleaner energy, while providing our customers with the safety and reliability they demand. At SCE, you’ll have a chance to grow personally and professionally, making a real impact in Southern California and around the world.Southern California Edison is a proud Equal Opportunity Employer, including disability and protected veteran status.We are committed to ensuring that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodations at (833) 343-0727.

Southern California Edison

Distribution/Vegetation Management Asset Strategy Senior Advisor

Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&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 Enhanced Care Management (ECM) Clinical Specialist II is responsible for the management and oversight activities associated with L.A. Care's ECM network.&nbsp; The position reports to the Supervisor of ECM and receives clinical supervision as needed from the Medical Director of Care Management. The position is responsible for providing oversight, feedback, and technical assistance to ECM Providers to support effective delivery of ECM services and ensure compliance with local, State, and Federal regulations, statues and guidelines. The position is responsible for conducting regular meetings with providers, reviewing Assessments &amp; Care Plans, providing guidance on clinical best practices, and assisting with escalation of cases that require additional assistance from L.A. Care. The position works directly with Care Management and Provider Network Management staff to inform Provider capacity-building and training activities related to the ECM Program operations.<h4>Duties</h4>Conduct regular monitoring and coaching with Providers to review aggregate progress and individual ECM member cases. May use telephonic, onsite, or written methods and both group and individual Provider activities to monitor performance related to Provider clinical and service requirements. Provide guidance on best practices to ECM providers.Conduct a monthly random sample review of Assessments and Care Plans created by the ECM Provider. Identify any gaps in the Care Plan services or regulatory compliance and provide coaching and feedback to the Provider to improve.&nbsp; Identify any issues that require escalation or more frequent monitoring of the ECM Provider. Organize and perform file review process in accordance with given criteria to include collection &amp; verification of supporting documentation, recording received information in appropriate tracking systems, and communicating end results of requests in writing and/or verbally. Provide training, education and consultation as necessary to Providers. Collaborate with other ECM staff on identifying topics and developing materials for Provider training and capacity building. Assist ECM Providers with escalation of ECM member cases that require additional assistance from L.A. Care. Assist ECM Providers with the coordination of member care with internal L.A. Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and Support (MLTSS), Social Services, Behavioral Health, Community Health, Health Education, as well as external providers such as Participating Physician Groups (PPGs) and Primary Care Physicians (PCPs). Actively identifies and implements efforts to improve the quality, effectiveness and efficiency of ECM.&nbsp; Assist co-workers with special projects or work volume as required. Communicates any barriers to supervisors in an efficient and effective manner. <h4>Perform other duties as assigned.</h4><h4>Duties Continued</h4><h4>Education Required</h4>Associate's Degree in NursingMaster's Degree in Social Work for Licensed Clinical Social Workers<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4>Required:Minimum 3 years of&nbsp; recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments.&nbsp; Previous care management experience to include auditing/oversight/performance management experience.<h4>Skills</h4>Required:Current knowledge of clinical standards of care and disease processes, and community resources.Excellent verbal and written communicating skills; excellent interpersonal skills. Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine the most effective member-centered interventions.Proficiency in Microsoft Office MS Office applications. Maintain confidentiality in compliance with all Health Insurance Portability and Accountability Act (HIPAA) requirements. Ability to solve complex issues and identify creative solutions with external agencies.&nbsp; Excellent project management skills.Working knowledge of Medi-Cal and Medicare regulations.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>Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse (RN); current and unrestrited California License.<h4>Licenses/Certifications Preferred</h4>Certified Professional in Utilization Review (CPUR)Certified Case Manager (CCM)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Preferred:&nbsp; Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or ComplianceSalary 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: Social Worker, Nursing, Registered Nurse, Behavioral Health, Clinic, Service, Healthcare

L.A. Care Health Plan

Enhanced Care Management Clinical Specialist II

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: Senior Director, Executive Talent Management&nbsp;The functionally aligned Precision Talent Lead is responsible for internal and external pipelining, succession planning, and hiring of all enterprise critical roles and functional Vice President and above positions. The Precision Talent Lead also supports the functional HRBP Head in facilitating the development of functional talent solutions with the Integrated Talent expertise areas (Org Effectiveness and Change, Talent Acquisition, People Science. etc.) This role will be supported by an in-house, centralized Executive sourcing and research team, and will be able to leverage the deep knowledge of our integrated talent centers of expertise.Key ResponsibilitiesFunctional Talent Practice Advisor for Enterprise Critical Roles (30%)<ul><li>Drive holistic pipelining strategy for internal and external talent for enterprise critical roles, and review with functional HR Heads as input into Talent Reviews</li><li>Build relationship with and vet talent with high touch candidate experience</li><li>Assess internal and external talent with BMS standards for executive and critical roles and develop/deploy a variety of talent management interventions to support critical roles</li><li>Build strong internal partnerships in support of the business function and ensures that executive talent management is providing the support needed to meet the executive talent needs of the business</li><li>Actively manage, monitor, and report metrics related to enterprise critical roles</li></ul>Functional Leader for Executive Talent Acquisition Practice (40%)<ul><li>Develop a robust professional internal and external network to support engaging with influential talent for proactive talent pipeline development</li><li>Lead executive recruiting for active Vice President and above roles in partnership with functional HR head, and relevant stakeholders</li><li>Understand key markets trends and disseminate external insights with relevant internal parties, especially talent insights, strategic workforce planning &amp; organizational development for executives</li><li>Role models the clear delineations between Executive Talent Management practices and Talent Acquisition</li><li>Manage internal successor identification and development planning for key functional executive positions, and support the deployment of successor identification practices within business function</li><li>Monitor and routinely reports key talent management metrics</li><li>Partner closely with the Executive Total Rewards team</li></ul>Functional Partner for Talent Solutions (30%)<ul><li>Partners with functional HRBP head to translate key business problems into talent solutions</li><li>Facilitates engagements with talent practices to define effective talent solutions to business problems</li><li>Ensure that designed talent solutions have effective handoffs for functional deployment</li></ul>Qualifications &amp; Experience<ul><li>An advanced degree is preferred.</li><li>At least 12 years of experience in executive search, talent pipelining, or executive talent management.</li><li>Proven leadership in executive talent management or executive search, with a strong track record as a matrix partner in a complex global organization.</li><li>Expertise in assessing leadership capabilities.</li><li>Experience with talent-to-value methodologies is preferred.</li><li>Strong communication, collaboration, and influencing skills, with the ability to effectively partner with senior leaders and HR colleagues.</li></ul>The starting compensation for this job is a range from [$226,000-$270,000], plus incentive cash and stock opportunities (based on eligibility). The starting pay rate takes into account characteristics of the job, such as required skills and where the job is performed. Final, individual compensation will be decided based on demonstrated experience. Eligibility for specific benefits listed on our careers site may vary based on the job and location. For more on benefits, please visit our BMS Career Site (<a href="https://careers.bms.com/working-with-us" target="_blank">https://careers.bms.com/working-with-us</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.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.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

Senior Director, Executive Talent Management

The hiring range for this role is: &nbsp;92,787.88 - 139,616.25This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.﻿This role is responsible for monitoring, analyzing, and auditing financial transactions of high complexity, and providing a leadership role. The role also evaluates compliance with regulations, develops corrective action plans, and delivers training to BCBSA and Plans. Additionally, the role involves acting as a resource and consultant on audit activities, developing programs, policies, and procedures to prevent abuse, and leading and supporting projects. The role frequently interacts with staff and management at varying levels within BCBSA, Plans, and a large banking institution.<ul><li>Monitor, Analyze, and Evaluate Financial Transactions: Monitor, analyze, and evaluate assigned financial/accounting transactions and other financial data for accuracy, propriety, and compliance with policy requirements. Document and summarize activities and results in analyses and reports to department management. 25%</li><li>Lead Financial Audits/Reviews: Lead approximately three to five financial audits/reviews per year (via desk or on-site) to determine the accuracy and propriety of Plans recorded financial transactions/reports and assess compliance with pertinent Policies. Supervise and train team members assigned to support these audits. 25%</li><li>Evaluate Compliance and Develop Corrective Action Plans: Evaluate the level of compliance with applicable federal regulations, contractual requirements, and procedures at BCBSA and Plans. Maintain the BCBSA compliance plan and serve as the main point of contact for BCBSA and Plans financial and claims audits. Develop corrective action plans as needed. 20%</li><li>Serve as Subject Matter Expert and Provide Training: Serve as subject matter expert for BCBSA financial policies and procedures regarding the audit process; instruct audit flow facilitation; analyze and assess audit trends, best practices, and risk; and develop an overall and effective audit program. Develop and present training to BCBSA and Plans as it relates to all types of audits. 15%</li><li>Evaluate and Recommend Billing Rates: Evaluate Plan inter-Plan billing rate requests of high complexity levels and recommend rates to be approved to ensure billings/reimbursements between Plans are valid and for proper amounts. 10%</li><li>Perform Complex Contract Administration Activities: Perform more complex activities relating to administration of the contract with a large banking institution and provide guidance to team members on their assignments. Ensure that BCBSA’s transaction billings to Plans are correct and that the various transaction activity reports provided to the Plans meet their internal needs. 5%</li></ul>Job Overview:﻿This role is responsible for monitoring, analyzing, and auditing financial transactions of high complexity, and providing a leadership role. The role also evaluates compliance with regulations, develops corrective action plans, and delivers training to BCBSA and Plans. Additionally, the role involves acting as a resource and consultant on audit activities, developing programs, policies, and procedures to prevent abuse, and leading and supporting projects. The role frequently interacts with staff and management at varying levels within BCBSA, Plans, and a large banking institution. Essential Functions<ul><li>Monitor, Analyze, and Evaluate Financial Transactions: Monitor, analyze, and evaluate assigned financial/accounting transactions and other financial data for accuracy, propriety, and compliance with policy requirements. Document and summarize activities and results in analyses and reports to department management.</li><li>Lead Financial Audits/Reviews: Lead approximately three to five financial audits/reviews per year (via desk or on-site) to determine the accuracy and propriety of Plans recorded financial transactions/reports and assess compliance with pertinent Policies. Supervise and train team members assigned to support these audits.</li><li>Evaluate Compliance and Develop Corrective Action Plans: Evaluate the level of compliance with applicable federal regulations, contractual requirements, and procedures at BCBSA and Plans. Maintain the BCBSA compliance plan and serve as the main point of contact for BCBSA and Plans financial and claims audits. Develop corrective action plans as needed.</li><li>Serve as Subject Matter Expert and Provide Training: Serve as subject matter expert for BCBSA financial policies and procedures regarding the audit process; instruct audit flow facilitation; analyze and assess audit trends, best practices, and risk; and develop an overall and effective audit program. Develop and present training to BCBSA and Plans as it relates to all types of audits.</li><li>Evaluate and Recommend Billing Rates: Evaluate Plan inter-Plan billing rate requests of high complexity levels and recommend rates to be approved to ensure billings/reimbursements between Plans are valid and for proper amounts.</li><li>Perform Complex Contract Administration Activities: Perform more complex activities relating to administration of the contract with a large banking institution and provide guidance to team members on their assignments. Ensure that BCBSA’s transaction billings to Plans are correct and that the various transaction activity reports provided to the Plans meet their internal needs.</li></ul>Qualifications<ul><li>Education </li><li>Preferred Bachelor's Degree in accounting, business, finance, or related field; or equivalent work experience</li><li>Experience </li><li>5+ Years related work experience, including health insurance accounting, internal/financial auditing, general accounting, financial reporting, and project management Required</li><li>Knowledge Skills and Abilities </li><li>Effective written and verbal communication skills. Demonstrated ability to build relationships with key resource people, whether internal or external. Ability to train less experienced staff. Advanced analytical skills and ability to frame issues and develop solutions. Ability to work independently and manage time effectively. Effective presentation skills and ability to adapt to changing priorities. Intermediate knowledge of auditing, finance, and claims operations. Advanced negotiation, analytical, and problem-solving skills. Effective project management, interpersonal, and organizational skills. Ability to develop and maintain business relationships and create strategies that support initiatives.</li><li>Certifications &amp; Licenses </li><li>Preferred: Certified Public Accountant (CPA) - Various</li><li>Extra Posting information: Minimum of five years of related work experience, including health insurance accounting, internal/financial auditing, general accounting, financial reporting, and project management. Experience with BCBS Inter-Plan Programs and proficiency with Microsoft Office Suite.</li></ul>#LI-Remote

Blue Cross Blue Shield Association

Financial Audit Senior Consultant

USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce. We strongly believe in recruiting top talent and creating a diverse and inclusive work climate and culture at all levels of our organization. The Clinical Coordinator is responsible for assisting with management and operation of clinic. This position assumes full responsibility for the dialysis clinic in the absence of the Administrator.Growth:<ul><li> Assist with clinical and operational processes to improve patient health and minimize hospitalizations and missed treatments.</li><li> Assist with planning/coordinating patient scheduling to assure timely acceptance of patients and effective staffing levels.</li><li> Demonstrate effective use of supplies and staff labor hours. </li><li> Responsible for updating all logs and ensuring that dialysis run sheets and logs are sent to billing.</li><li> Perform duties as assigned to meet the patient care or operational needs of the clinic.</li></ul>Outcomes:<ul><li> Coordinate the functions of all departments and develop standards and methods of measuring patient care services, including a chronological record of services provided to patients as required by the ESRD Network Coordinating Council and Medicare.</li><li> Work with Administrator to maintain chronological, thorough, and appropriate documentation in the patient record of all treatments, activities, and communication with the patient, physician, and other healthcare professionals.</li><li> Promote quality management program through education and involvement of staff and patients in outcomes as well as overall responsibility to achieve corporate goals for quality.</li><li> Assist with program's target goals for patient outcomes in accordance with quality patient care and Company goals.</li><li> Review all incident reports; make recommendations and take action relative to incidents as appropriate; report at monthly QAPI meeting as delegated by Administrator or Management.</li></ul>Operational Readiness:<ul><li> Knowledge of and remain current with federal, state, local laws and regulations, including health care professionals practice act requirements. </li><li> Work with Administrator to assure clinic is in compliance with all applicable federal, state, and local laws and regulations.</li><li> Assist Administrator with development, implementation and follow up of Corrective Action Plans required for internal and external surveys. </li><li> May assume Charge Nurse's responsibilities as needed.</li><li> May fulfill responsibility of facility Alternate CEO as delegated by Governing Body. </li><li> Conduct and/or participate in both formal and informal meetings with the governing body, Regional Director, Medical Director and the staff as delegated. Assure that appropriate staff meetings, in-service education meetings, and team patient care planning meetings are held monthly as delegated. Assure that Quality Assessment &amp; Performance Improvement Program is current at all times as delegated.</li><li> Establish, maintain, and submit all required records and reports concerning staff, patients, and the operational affairs of the center if delegated by Administrator.</li><li> Continuously monitor to ensure that a safe and sanitary physical environment is maintained throughout the facility; that all equipment is maintained and functions properly; and that adequate and appropriate inventory levels of all supplies are available and used correctly.</li><li> Oversee the maintenance of equipment and supplies to meet current laws and regulations.</li><li> Responds to all emergencies in clinic. Familiar with emergency equipment and all emergency operational procedures.</li><li> Supervise the maintenance of equipment, building areas occupied by the center and other property belonging to the center.</li></ul>Partnerships:<ul><li> Maintain collaborative working relationship with Medical Director and physicians.</li><li> Establish and maintain a positive relationship with all Administrators, area hospitals, agencies, vendors and the community.</li><li> Actively promote GUEST customer service standards; develop effective relationships at all levels of the organization.</li><li> Respond effectively to inquiries or complaints.</li></ul>Staff Development: <ul><li> Ensure all staff meet required qualifications for position held and perform duties within limitations established by and in accordance with company policy/procedures, health care professionals practice acts, applicable state and federal laws and regulations.</li><li> Serves as a resource/subject matter expert for patient needs and concerns, staff education and in-service sessions as necessary.</li><li> Assists with recruitment, training, development, and supervision of all personnel.</li><li> Assists with maintaining effective personnel management and employee relations, including evaluating the performance of all personnel and counseling employees.</li><li> Uphold management goals of corporation by leading staff in team concepts and promoting a team effort.</li><li> Effectively communicate expectations; accept accountability and hold others accountable for performance.</li></ul>

U.S. Renal Care

Dialysis Clinical Coordinator *Bonus Eligible $12,000*

Company Description By working at Harvard University, you join a vibrant community that advances Harvard's world-changing mission in meaningful ways, inspires innovation and collaboration, and builds skills and expertise. We are dedicated to creating a diverse and welcoming environment where everyone can thrive.Why join Harvard Medical School?Harvard Medical School's mission is to nurture a diverse, inclusive community dedicated to alleviating suffering and improving health and well-being for all through excellence in teaching and learning, discovery and scholarship, and service and leadership.You’ll be at the heart of biomedical discovery, education, and innovation, working alongside world-renowned faculty and a community dedicated to improving human health. This is more than a job - it’s an opportunity to shape the future of medicine. Job Description The Harvard Medical School Departments of Microbiology and Genetics seek an Administrative Coordinator. The Administrative Coordinator provides critical transactional and logistical support to the Genetics and Microbiology departments. This position handles entry-level HR processes, routine financial administration, document collection, and data entry tasks. Under the supervision of the Senior Administrative Manager, the Coordinator ensures timely and accurate execution of administrative functions while maintaining compliance with Harvard policies.Key Responsibilities1. Administrative and HR Support:<ul><li>Processes new hires and terminations in PeopleSoft (PS).</li><li>Collects and uploads required documentation (I-9s, IDS forms, visas, IC certification forms, etc.).</li><li>Initiates online forms (e.g., APEX, Fieldglass) and ensures data entry is complete and accurate.</li><li>Provides back-up to the senior administrative manager as needed.</li><li>Assists the senior administrative manager and both department’s leadership as needed.&nbsp;</li></ul>2. Onboarding and Offboarding Logistics:<ul><li>Tracks checklists for incoming and exiting members.</li><li>Schedules orientations and ensures completion of required training.</li><li>Maintain both departments’ email listservs.</li><li>Coordinates ID cards, system access, and return of university property.&nbsp;</li></ul>3. Reappointments, tracking and document management:<ul><li>Maintains appointment and renewal tracking systems.</li><li>Assists with communication and document collection for annual renewals.</li><li>Maintains organized records for personnel, ICs, students, and departmental activities.&nbsp;</li></ul>4. Timekeeping and Payroll:<ul><li>Approves non-exempt staff time weekly in coordination with unit supervisors.</li><li>Escalates issues to the Senior Administrative Manager for audit and correction.</li><li>Supports compliance efforts by ensuring all required forms are filed and accessible for audit.&nbsp;</li></ul>5. Other Support, as needed:<ul><li>Assists with planning and&nbsp;executing departmental activities.</li><li>Coordinates logistics and communication in collaboration with supervisors and other department staff.</li><li>Serves as department P-Card holder and processes reimbursements (Concur and paper).</li><li>Enters B2P invoices, vendor requests, check requests, and honoraria payments.&nbsp;</li></ul> Qualifications Basic Qualifications:<ul><li>Three or&nbsp;more years of related experience. Education beyond high school may count towards experience.</li></ul> 
Additional Qualifications and Skills:<ul><li>College degree preferred.</li><li>Organizational skills with particular ability to prioritize work in an environment with multiple and conflicting interests.</li><li>Excellent interpersonal and communication skills.</li><li>Self-starter with proven ability to take initiative and be highly productive.</li><li>Willingness to perform tasks outside primary job description as necessary in support of colleagues and departmental researchers.</li><li>Ability to handle complex and confidential information with discretion.</li><li>Competency using a variety of computer software.</li><li>Position requires advanced knowledge of word processing, spreadsheets, and/or databases.</li></ul> Additional Information <ul><li>Standard Hours/Schedule: 35 hrs. per week | Monday - Friday | 9:00 am - 5:00 pm</li><li>Visa Sponsorship Information: Harvard University is unable to provide visa sponsorship for this position</li><li>Pre-Employment Screening: Identity</li></ul>Please note that we are currently conducting a majority of interviews and onboarding remotely and virtually. We appreciate your understanding.Not ready to apply? Join our talent community to keep in touch and learn about future opportunities! <a href="https://www.gem.com/form?formID=16341e35-cbc6-4904-88a3-09b35763307e" target="_blank">https://www.gem.com/form?formID=16341e35-cbc6-4904-88a3-09b35763307e</a>Work Format DetailsThis is a position that is based at a Harvard campus location with some remote work options available. Additional details will be discussed during the interview process. All remote work must be performed within one of the Harvard Registered Payroll States, which currently includes Massachusetts, Connecticut, Maine, New Hampshire, Rhode Island, Vermont, Georgia, Illinois, Maryland, New Jersey, New York, Virginia, Washington, and California (CA for exempt positions only). Certain visa types and funding sources may limit work location. Individuals must meet work location sponsorship requirements prior to employment.&nbsp;
Salary Grade and RangesThis position is salary grade level 054. Please visit &nbsp;<a href="https://hr.harvard.edu/salary-ranges" target="_blank">Harvard's Salary Ranges</a>  to view the corresponding salary range and related information.&nbsp;
BenefitsHarvard offers a comprehensive benefits package that is designed to support a healthy work-life balance and your physical, mental and financial wellbeing. Because here, you are what matters. Our benefits include, but are not limited to:&nbsp;<ul><li>Generous paid time off including parental leave&nbsp;</li><li>Medical, dental, and vision health insurance coverage starting on day one&nbsp;</li><li>Retirement plans with university contributions&nbsp;</li><li>Wellbeing and mental health resources&nbsp;</li><li>Support for families and caregivers&nbsp;</li><li>Professional development opportunities including tuition assistance and reimbursement&nbsp;</li><li>Commuter benefits, discounts and campus perks&nbsp;</li></ul>Learn more about these and additional benefits on our <a href="https://hr.harvard.edu/benefits-wellbeing" target="_blank">Benefits &amp; Wellbeing Page</a>.&nbsp;
EEO/Non-Discrimination Commitment StatementHarvard University is committed to <a href="https://hr.harvard.edu/sites/g/files/omnuum6281/files/2025-04/reaffirmation_statement.pdf" target="_blank">equal opportunity</a> and <a href="https://provost.harvard.edu/files/provost/files/non-discrimination_and_anti-bullying_policies.pdf" target="_blank">non-discrimination</a>. We seek talent from all parts of society and the world, and we strive to ensure everyone at Harvard thrives. Our differences help our community advance Harvard’s academic purposes.&nbsp;Harvard has an <a href="https://hr.harvard.edu/sites/g/files/omnuum6281/files/2025-04/reaffirmation_statement.pdf" target="_blank">equal employment opportunity</a> policy that outlines our commitment to&nbsp;prohibiting discrimination on the basis of race, sex, ethnicity, color, national origin, religion, disability, or any other characteristic protected by law or identified in the university’s <a href="https://provost.harvard.edu/files/provost/files/non-discrimination_and_anti-bullying_policies.pdf" target="_blank">non-discrimination policy</a>. Harvard’s <a href="https://hr.harvard.edu/sites/g/files/omnuum6281/files/2025-04/reaffirmation_statement.pdf" target="_blank">equal employment opportunity</a> policy and <a href="https://provost.harvard.edu/files/provost/files/non-discrimination_and_anti-bullying_policies.pdf" target="_blank">non-discrimination policy</a> help all community members participate fully in work and campus life free from harassment and discrimination.&nbsp;

Harvard University FAS Human Resources

Administrative Coordinator

It’s inspiring to work with a company where people truly BELIEVE in what they’re doing! When you become part of the Chapters Health Team, you’ll realize it’s more than a job. It’s a mission. We’re committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success!Role: The Volunteer Coordinator is responsible for coordinating and supervising all patient care volunteer activities. Serves as a member of the Interdisciplinary Group (IDG) and acts as a liaison between staff, community, and volunteers.Qualifications: • Bachelor’s degree (BA/BS) or an equivalent combination of education and experience • Minimum of two (2) years’ experience in volunteer coordination, preferably in a health care setting • One (1) year supervisory experience strongly preferred • Strong demonstrated capabilities in networking with community resources, and strong knowledge of such resources • Strong communication skills (written and verbal) including face-to-face, telephone, and correspondence • Strength in attention to detail and organizational skills • Program development and implementation skills • Must be able to interact successfully with clients, families and other agencies to present a positive and professional image • Bi-lingual preferred • Previous experience in health care and/or social services setting preferred • Excellent telephone and computer skills • Mobile Driver - Valid driver’s license and automobile insurance per Company policy • Ability to travel in community • Ability to take initiative and work independently Competencies: • Satisfactorily complete competency requirements for this position. Responsibilities of all employees: • Represent the Company professionally at all times through care delivered and/or services provided to all clients. • Demonstrates high ethical standards in areas of hospice mission and confidentiality, as well as display sensitivity to family needs. • Complies with all State, federal and local government regulations, maintaining a strong position against fraud and abuse. • Complies with Company policies, procedures and standard practices. • Observes the Company's health, safety and security practices. • Maintains the confidentiality of patients, families, colleagues and other sensitive situations within the Company. • Uses resources in a fiscally responsible manner. • Promotes the Company through participation in community and professional organizations. • Participates proactively in improving performance at the organizational, departmental and individual levels. • Improves own professional knowledge and skill level. • Advances electronic media skills. • Supports Company research and educational activities. • Shares expertise with co-workers both formally and informally. • Participates in Quality Assessment and Performance Improvement activities as appropriate for the position. Job Responsibilities: • Meets standards of practice of the Volunteer Services Department. • Recruits volunteers through community networking activities and marketing efforts. • Screens potential volunteers through intake calls and interviews, and in training. • Trains, assigns, supervises and evaluates patient/family care volunteers as well as volunteers for events, Speakers Bureau, administrative support and various other roles. • Participates in the development and implementation of programs which enhance the morale and effectiveness of volunteers, volunteer newsletter, volunteer in-services, support programs and annual volunteer recognition. • Participates in volunteer-related special events, committees and task force groups. • Maintains records of volunteers, ensuring that all file requirements are met and kept current. • Serves as a liaison between team members and volunteers on the Interdisciplinary Group (IDG). • Performs other duties as assigned.This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.

Chapters Health System

Volunteer Coordinator - Hope PACE

Great opportunity exists for a Residential Rehabilitation Coordinator in our Mental Health Residential Program in&nbsp;Quincy.&nbsp; In this program, adults with mental illness share a home in the community.&nbsp; Our residential staff supports them to reach their goals by teaching them daily living skills to move them toward independence, assist in management of their psychiatric symptoms, ensure their physical health, and improve their quality of life!Join our&nbsp;dedicated team&nbsp;and play an essential role in enabling&nbsp;adults with mental illness&nbsp;to live as actively and independently as possible!!Responsibilities:<ul><li>Advocate for client caseload</li><li>Develop, implement, and monitor treatment plans</li><li>Oversee medication management</li><li>Fiscal management of funds</li><li>Primary liaison for service providers, family, and guardians</li><li>Use of an electronic health record system for client notes</li></ul>&nbsp;&nbsp;We offer a competitive salary and a great benefit package!<ul><li>Tuition remission program - 100% tuition for undergraduate coursework in a&nbsp;Massachusetts State College or University</li><li>Health/dental insurance</li><li>Generous paid time off</li><li>Various opportunities for career advancement</li><li>Commitment to provide quality training to our staff</li><li>Group discounts on cell phones, movie tickets and various club memberships</li><li>Company contributions to retirement plan</li><li>Company paid life insurance</li><li>Opportunities to attend in-service trainings and more…</li></ul> <h4>Required Skills</h4><ul><li>Excellent communication and writing skills</li><li>Time management and ability to organize multiple priorities</li><li>Ability to remain calm and de-escalate stressful situations</li><li>Good judgment and ability to problem solve</li><li>Dependability and flexibility</li><li>Ability to promote a teamwork environment and serve as a role model to other staff</li><li>Ability to form therapeutic relationships with challenging clients</li><li>Computer proficiency and ability to learn to use an electronic health record system</li><li>Must have a valid driver’s license, safe driving record, and access to a personal vehicle</li></ul> <h4>Required Experience</h4><ul><li>Minimum of one year Human Services experience and working knowledge of community based treatment, funding sources, and treatment regulations</li><li>BA/BS in Psychology or related field preferred</li><li>CPR/FA and MAP certifications will be required</li></ul>Aspire Health Alliance is committed to and passionate about diversity, equity, and inclusion. &nbsp;We celebrate, support and promote diversity of thought, culture, and backgrounds.&nbsp; As an employer committed to equal opportunity, we base all employment decisions on each individual’s capabilities and qualifications, without regard to race, color, religious creed, national origin, ancestry, sex, sexual orientation, gender identity, age, physical or mental disability, veteran status, genetics, or any other protected characteristic.&nbsp; Aspire Health Alliance strives to fully reflect the clients and communities we serve and believes that a diversity of interests and cultures leads to a stronger and more innovative organization.

1,093 Project Management / Professional Services Jobs