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Cigna logo
CignaSaint Louis, MO

$91,900 - $153,100 / year

Job Summary The Healthcare Strategy Advisor plays a key role in supporting the development and execution of clinical strategies that drive improved health outcomes, affordability, and business growth across Cigna Healthcare (CHC). This role requires a strong grasp of healthcare dynamics and a growing ability to influence decision-making, contribute to cross-functional initiatives, and translate insights into actionable plans. Success in this role requires a solid foundation in strategic analysis, financial acumen, a collaborative mindset, and experience working in clinical or payor organizations. This role reports to the Principal, Clinical & Provider Strategy. Responsibilities Strategic Support & Planning Support the development of clinical strategy initiatives aligned with CHC and enterprise goals and market needs, including strategic frameworks, business cases, and initiative roadmaps. Conduct robust internal reviews and external market scans to identify emerging trends, capability gaps, and innovation opportunities. Define measures of success for strategic initiatives across financial, clinical, patient experience, and operational drivers. Develop subject-matter expertise in select clinical areas to act as the go-to-resource for clinical leadership. Cross-Functional Collaboration Collaborate with matrix partners across CHC clinical teams, along with other internal teams including product, data and analytics, and finance to ensure strategic alignment. Participate in cross-functional workgroups as a proxy for CHC clinical strategy, contributing to the design of new commercial programs and products. Develop executive-level communications to escalate key issues, opportunities or pain points to CHC leadership, along with recommendations for resolution. Analysis & Insights Analyze clinical and operational data to identify trends, gaps, and opportunities for improvement in patient care delivery. Translate complex data into clear, actionable insights for both clinical and non-clinical stakeholders. Proficiency in using data visualization and analytics tools (e.g., Excel, Tableau, Power BI, SQL, or Python) to develop dashboards, reports, and presentations that inform strategic decisions. Prepare executive-level presentations, memos, and updates on strategic projects. Monitor initiative performance and support continuous improvement efforts. Required Qualifications Bachelor's degree required; advanced degree (e.g., MPH, MBA, MHA) preferred. 5+ years of experience in healthcare strategy, clinical operations, or related roles. Strong analytical and problem-solving skills with the ability to translate data into actionable insights. Excellent written and verbal communication skills. Experience working in a matrixed organization and collaborating across functions. Preferred Qualifications Experience in payer, provider, or integrated delivery system environments. Familiarity with value-based care models, population health strategies, or digital health tools. Exposure to strategic planning, business case development, or healthcare innovation. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 91,900 - 153,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Posted 1 week ago

Berkeley Research Group logo
Berkeley Research GroupWashington DC, District of Columbia

$70,000 - $150,000 / year

We do Consulting Differently The Healthcare Compliance Auditor position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS is currently seeking a Healthcare Compliance Auditor at either the Consultant or Managing Consultant level. HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers and healthcare investors. Compliance audit deliverables include assessment of provider compliance programs and auditing of billing and coding of clinical documents and claims documents. This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization. The work of a Healthcare Compliance Auditor will involve execution of engagement work streams that will primarily involve employing certified coding skills to audit provider claims and provider clinical documentation with a particular focus on government programs such as Medicare and Medicaid. Responsibilities include working with team to develop audit specifications, expert analysis of healthcare claims and supporting documentation, quality control, and development of client deliverables. The work of a Consultant involves execution of engagement work streams that may be either qualitative or quantitative in nature, and responsibilities include: billing and coding audits, compliance program review, quality control, development of client deliverables, and industry research. The work of a Managing Consultant involves both execution and oversight of engagement work streams that may be either qualitative or quantitative in nature, and responsibilities include: management of junior staff, quality control, development and presentation of client deliverables, and industry research. This specific position will require knowledge of medical coding and compliance and potential candidates must have medical auditing expertise. Job title and compensation to be determined based on qualifications and experience. Job Responsibilities: Plan and perform medical record audits to determine coding accuracy and compliant claims submission; Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance; Perform coding and documentation audits, reviewing medical records and charges to ensure compliance with CPT-4/HCPCS and ICD-10-CM coding guidelines and standards, as well as the Centers for Medicare & Medicaid Services (CMS) coverage guidelines; Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement; Serve as a subject matter expert on interpretation and application of coding and documentation guidelines; Monitor relevant resources, publications, and current government compliance and enforcement activity related to high-risk compliance areas; Stay current on coding guidelines. Develop analyses using transactional data and/or financial data; Generate client deliverables and make valuable contributions to expert reports; Manage client relationships and communicate results and work product as appropriate; Manage junior staff and delegate assignments as directed by more senior managers; Demonstrate creativity and efficient use of relevant software tools and analytical methods to develop solutions; Participate in group practice meetings, contribute to business development initiatives and office functions such as staff training and recruiting; Prioritize assignments and responsibilities to meet goals and deadlines. Qualifications: An undergraduate degree (e.g., BS, BA); Active coding certification from either AAPC or AHIMA is required; Preference will be given to candidates that are certified in medical auditing; 2+ years of work experience with a focus on healthcare provider billing and coding; 5-7 years of experience is required for the Managing Consultant level position. Job title to be determined based on relevant qualifications and experience. Preference will be given to candidates that are experienced with physician practice coding (e.g. primary care, dermatology, orthopedics, ophthalmology), ASC coding, and/or post-acute coding (e.g. hospice, home health, SNFs). Comprehensive knowledge of Medicare rules, regulations, and guidelines as they apply to coverage, coding, and provider documentation. Advanced knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems, guidelines, and regulatory requirements. Required skills include: Demonstrated ability to interpret national coding and documentation guidelines and translate them into effective auditing practices and tools; identify issues in coding and documentation practices and recommend corrective action; develop reports, track, and trend audit findings and results. Proficient user in Microsoft Office Suite, specifically Excel, PowerPoint, Access, and Word. A desire to expand those capabilities is required, as is the ability to train others to use such tools. Commitment to producing high quality analysis and attention to detail. Excellent time management, organizational skills, and ability to prioritize work and meet deadlines. Keen interest in healthcare compliance and healthcare policy. Exceptional verbal and written communication skills. Desire to work within a team environment. Candidate must be able to submit verification of their legal right to work in the U.S., without company sponsorship. Consultant Salary Range: $70,000 – $150,000 Managing Consultant Salary Range: $100,000 – $230,000 #ThinkBRG #LI-JQ1| #LI-REMOTE About BRG BRG combines world-leading academic credentials with world-tested business expertise purpose-built for agility and connectivity, which sets us apart—and gets you ahead. At BRG, our top-tier professionals include specialist consultants, industry experts, renowned academics, and leading-edge data scientists. Together, they bring a diversity of proven real-world experience to economics, disputes, and investigations; corporate finance; and performance improvement services that address the most complex challenges for organizations across the globe. Our unique structure nurtures the interdisciplinary relationships that give us the edge, laying the groundwork for more informed insights and more original, incisive thinking from diverse perspectives that, when paired with our global reach and resources, make us uniquely capable to address our clients’ challenges. We get results because we know how to apply our thinking to your world. At BRG, we don’t just show you what’s possible. We’re built to help you make it happen. BRG is proud to be an Equal Opportunity Employer. Our hiring practices provide equal opportunity for employment without regard to race, religion, color, sex, gender, national origin, age, United States military veteran status, ancestry, sexual orientation, marital status, family structure, medical condition including genetic characteristics or information, veteran status, or mental or physical disability so long as the essential functions of the job can be performed with or without reasonable accommodation, or any other protected category under federal, state, or local law.

Posted 1 day ago

Cigna logo
CignaChicago, IL

$91,900 - $153,100 / year

Job Summary The Healthcare Strategy Advisor plays a key role in supporting the development and execution of clinical strategies that drive improved health outcomes, affordability, and business growth across Cigna Healthcare (CHC). This role requires a strong grasp of healthcare dynamics and a growing ability to influence decision-making, contribute to cross-functional initiatives, and translate insights into actionable plans. Success in this role requires a solid foundation in strategic analysis, financial acumen, a collaborative mindset, and experience working in clinical or payor organizations. This role reports to the Principal, Clinical & Provider Strategy. Responsibilities Strategic Support & Planning Support the development of clinical strategy initiatives aligned with CHC and enterprise goals and market needs, including strategic frameworks, business cases, and initiative roadmaps. Conduct robust internal reviews and external market scans to identify emerging trends, capability gaps, and innovation opportunities. Define measures of success for strategic initiatives across financial, clinical, patient experience, and operational drivers. Develop subject-matter expertise in select clinical areas to act as the go-to-resource for clinical leadership. Cross-Functional Collaboration Collaborate with matrix partners across CHC clinical teams, along with other internal teams including product, data and analytics, and finance to ensure strategic alignment. Participate in cross-functional workgroups as a proxy for CHC clinical strategy, contributing to the design of new commercial programs and products. Develop executive-level communications to escalate key issues, opportunities or pain points to CHC leadership, along with recommendations for resolution. Analysis & Insights Analyze clinical and operational data to identify trends, gaps, and opportunities for improvement in patient care delivery. Translate complex data into clear, actionable insights for both clinical and non-clinical stakeholders. Proficiency in using data visualization and analytics tools (e.g., Excel, Tableau, Power BI, SQL, or Python) to develop dashboards, reports, and presentations that inform strategic decisions. Prepare executive-level presentations, memos, and updates on strategic projects. Monitor initiative performance and support continuous improvement efforts. Required Qualifications Bachelor's degree required; advanced degree (e.g., MPH, MBA, MHA) preferred. 5+ years of experience in healthcare strategy, clinical operations, or related roles. Strong analytical and problem-solving skills with the ability to translate data into actionable insights. Excellent written and verbal communication skills. Experience working in a matrixed organization and collaborating across functions. Preferred Qualifications Experience in payer, provider, or integrated delivery system environments. Familiarity with value-based care models, population health strategies, or digital health tools. Exposure to strategic planning, business case development, or healthcare innovation. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 91,900 - 153,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Posted 1 week ago

Cigna logo
CignaIndependence, OH

$91,900 - $153,100 / year

Job Summary The Healthcare Strategy Advisor plays a key role in supporting the development and execution of clinical strategies that drive improved health outcomes, affordability, and business growth across Cigna Healthcare (CHC). This role requires a strong grasp of healthcare dynamics and a growing ability to influence decision-making, contribute to cross-functional initiatives, and translate insights into actionable plans. Success in this role requires a solid foundation in strategic analysis, financial acumen, a collaborative mindset, and experience working in clinical or payor organizations. This role reports to the Principal, Clinical & Provider Strategy. Responsibilities Strategic Support & Planning Support the development of clinical strategy initiatives aligned with CHC and enterprise goals and market needs, including strategic frameworks, business cases, and initiative roadmaps. Conduct robust internal reviews and external market scans to identify emerging trends, capability gaps, and innovation opportunities. Define measures of success for strategic initiatives across financial, clinical, patient experience, and operational drivers. Develop subject-matter expertise in select clinical areas to act as the go-to-resource for clinical leadership. Cross-Functional Collaboration Collaborate with matrix partners across CHC clinical teams, along with other internal teams including product, data and analytics, and finance to ensure strategic alignment. Participate in cross-functional workgroups as a proxy for CHC clinical strategy, contributing to the design of new commercial programs and products. Develop executive-level communications to escalate key issues, opportunities or pain points to CHC leadership, along with recommendations for resolution. Analysis & Insights Analyze clinical and operational data to identify trends, gaps, and opportunities for improvement in patient care delivery. Translate complex data into clear, actionable insights for both clinical and non-clinical stakeholders. Proficiency in using data visualization and analytics tools (e.g., Excel, Tableau, Power BI, SQL, or Python) to develop dashboards, reports, and presentations that inform strategic decisions. Prepare executive-level presentations, memos, and updates on strategic projects. Monitor initiative performance and support continuous improvement efforts. Required Qualifications Bachelor's degree required; advanced degree (e.g., MPH, MBA, MHA) preferred. 5+ years of experience in healthcare strategy, clinical operations, or related roles. Strong analytical and problem-solving skills with the ability to translate data into actionable insights. Excellent written and verbal communication skills. Experience working in a matrixed organization and collaborating across functions. Preferred Qualifications Experience in payer, provider, or integrated delivery system environments. Familiarity with value-based care models, population health strategies, or digital health tools. Exposure to strategic planning, business case development, or healthcare innovation. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 91,900 - 153,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Posted 1 week ago

Q logo
Qualified HealthPalo Alto, California

$170,000 - $240,000 / year

Transform healthcare with us. At Qualified Health, we’re redefining what’s possible with Generative AI in healthcare. Our infrastructure provides the guardrails for safe AI governance, healthcare-specific agent creation, and real-time algorithm monitoring—working alongside leading health systems to drive real change. This is more than just a job. It’s an opportunity to build the future of AI in healthcare, solve complex challenges, and make a lasting impact on patient care. If you’re ambitious, innovative, and ready to move fast, we’d love to have you on board. Join us in shaping the future of healthcare. Job Summary: We're looking for a Staff Healthcare Data Scientist to bridge our robust data infrastructure with high-impact AI applications. You'll analyze downstream use cases, design optimal feature mappings from standardized healthcare data models, and develop sophisticated data transformations that maximize AI application performance. Working at the intersection of clinical knowledge and technical excellence, you'll ensure our platform delivers reliable, actionable insights to healthcare providers. Key Responsibilities: Conduct comprehensive analysis of downstream AI applications to identify optimal data requirements and feature specifications Design and implement featurized data mappings from standardized healthcare data models (FHIR, Epic Clarity, HL7) to application-specific datasets Develop optimized data transformations within Azure Databricks that enhance AI application performance and clinical accuracy Build scalable PySpark workflows that efficiently process large-scale healthcare data while maintaining data integrity Partner with data analysts to develop comprehensive data QC checklists tailored to specific healthcare applications Design and implement automated data quality notebooks and monitoring systems to ensure completeness and clinical validity Collaborate with clinical stakeholders to translate healthcare workflows into optimized data structures and validate feature engineering approaches Establish reusable feature engineering frameworks and data quality metrics aligned with healthcare regulatory requirements Required Qualifications: 6+ years of experience in healthcare data science with demonstrated expertise in clinical data analysis and outcomes research Deep domain knowledge of healthcare data standards (FHIR r4, HL7v2, ICD-10, CPT, SNOMED-CT) and EHR data structures, particularly Epic Clarity Advanced degree in Data Science, Biostatistics, Epidemiology, or related quantitative field Expert-level proficiency in Python data science stack (pandas, scikit-learn, scipy, statsmodels) Extensive hands-on experience with Azure Databricks and PySpark for large-scale healthcare data processing Strong background in statistical modeling, machine learning, feature engineering, and advanced analytics techniques Solid understanding of modern data warehouse architectures and ETL patterns Outstanding communication skills with ability to explain complex analytical findings to both technical and clinical audiences Experience collaborating with cross-functional teams including clinicians, data engineers, and product managers Desirable Skills: PhD in Biostatistics, Epidemiology, Health Informatics, or related field Experience with real-world evidence studies and AI/ML applications in healthcare Background in healthcare regulatory frameworks (HIPAA, HITRUST, FDA guidelines) Experience with clinical decision support systems and quality improvement initiatives Relevant healthcare analytics or data science platform certifications Published research in healthcare informatics or clinical data science Technical Environment: Our data science infrastructure leverages: Azure Databricks + PySpark for large-scale data processing Azure Data Factory for data integration GitHub Actions + Terraform for CI/CD and infrastructure automation Impact & Growth Opportunity: As a Staff Healthcare Data Scientist, you'll play a pivotal role in ensuring our AI platform delivers clinically meaningful insights to healthcare providers. You'll directly influence how cutting-edge AI technologies are applied to real healthcare challenges while working with advanced healthcare datasets. This position offers significant visibility and growth potential as we scale across major health systems. Why Join Qualified Health? This is an opportunity to join a fast-growing company and a world-class team, that is poised to change the healthcare industry. We are a passionate, mission-driven team that is building a category-defining product. We are backed by premier investors and are looking for founding team members who are excited to do the best work of their careers. Our employees are integral to achieving our goals so we are proud to offer competitive salaries with equity packages, robust medical/dental/vision insurance, flexible working hours, hybrid work options and an inclusive environment that fosters creativity and innovation. Our Commitment to Diversity Qualified Health is an equal opportunity employer. We believe that a diverse and inclusive workplace is essential to our success, and we are committed to building a team that reflects the world we live in. We encourage applications from all qualified individuals, regardless of race, color, religion, gender, sexual orientation, gender identity or expression, age, national origin, marital status, disability, or veteran status. Pay & Benefits: The pay range for this role is between $170,000 and $240,000, and will depend on your skills, qualifications, experience, and location. This role is also eligible for equity and benefits. Join our mission to revolutionize healthcare with AI. To apply, please send your resume through the application below.

Posted 30+ days ago

Gresham, Smith and Partners logo
Gresham, Smith and PartnersCharlotte, NC
Our Healthcare team of 150+ architects, engineers, interior designers, and planners helps clients move the needle where it matters most: patient safety, operational efficiency, technology integration, adaptability/resiliency, sustainability, and the human experience. Helping create healthier communities for more than 50 years, we've designed over 8,000 projects for longstanding clients across the United States, and we invite you to join us! Gresham Smith is seeking an Architect to join our Healthcare Studio. In this role, you will collaborate with multi-disciplinary teams to deliver exceptional human experiences in healthcare settings. You should have strong technical skills, the ability to coordinate across multi-disciplines, and strong communication and organization skills. Experience directly with Healthcare projects is a plus. Responsibilities: Lead the delivery of small to medium size healthcare projects. Support project teams on large projects. Direct consultant and technical teams to ensure successful execution of project design and deliverables. Work alongside the Project Executive and Project Manager to create and oversee production timelines, clearly defining and meeting deadlines. Prepare, review, and coordinate deliverables, by managing the work of production staff and consultants, in accordance with our standards and in adherence to our QA/QC processes. Supervise code analysis and verify zoning requirements. Facilitate design discussions, internally and externally, and lead collaborative work sessions with consultants. Develop and present client presentations. Conduct product research and assist the team in selecting appropriate materials and systems. Attend site visits, field reviews, and project meetings and document relevant information. Review submittals, support, and/or lead field observations and agency reviews. Focus on the professional development of staff through mentorship. Promote a positive team atmosphere. Advocate for the firm's principles of design excellence by integrating sustainable practices. Minimum Qualifications: 5-year Bachelor's or Master's degree in Architecture from an NAAB accredited University program. Minimum of 8 years of job-related experience; Healthcare experience is preferred. Architecture License required. Demonstrated proficiency using Revit and AutoCAD is required. Proficiency in Rhino, Photoshop, SketchUp, Lumion, Enscape, and/or other 3D rendering software programs is a plus. Proficient in Microsoft Office applications, particularly in Outlook, Word, and Excel. Excellent knowledge of architectural building systems, accessibility guidelines, building codes, and Quality Control skills. Ability to interact professionally and comfortably with various personalities and communication styles and build and maintain excellent interpersonal relationships. Strong presentation, time management, and organizational skills. Please include a portfolio of work samples along with a resume/CV in your online application. Gresham Smith is an equal opportunity employer and does not discriminate. Everyone is invited to apply! Gresham Smith will not accept unsolicited resumes from recruiters, headhunters, contract recruiters, search firms, or employment agencies. An executed GRESHAM PLACEMENT SERVICES AGREEMENT (PSA) is required prior to any payment obligation for either a referral or recruiter fee. In the event a recruiter or agency submits a resume or candidate without a previously executed PSA, GRESHAM SMITH explicitly reserves the right to recruit and hire those candidate(s) at its discretion, and without any financial obligation whatsoever to the recruiter or agency. Any such unsolicited resume or candidate contact information, including those submitted directly to GRESHAM SMITH'S hiring managers or any other employee, shall become the property of GRESHAM SMITH upon receipt.

Posted 30+ days ago

UnitedHealth Group Inc. logo
UnitedHealth Group Inc.San Antonio, TX

$58,800 - $105,000 / year

WellMed, part of the Optum family of businesses, is seeking a RN Healthcare Manager to join our team in San Antonio, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. Primary Responsibilities: Make outbound calls and receive inbound calls to assess members' current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self-management Make referrals to outside sources Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Strong computer and software navigation skills are critical. You should also be strongly patient-focused and adaptable to changes. In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000+ primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000+ older adults. Together, we're making health care work better for everyone. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current, unrestricted RN license in the state of employment 3+ years of experience in a hospital, acute care or direct care setting Proven ability to type and have the ability to navigate a Windows based environment Preferred Qualifications: BSN Certified Case Manager (CCM) Proven background in managed care Case management experience Experience or exposure to discharge planning Experience in utilization review, concurrent review or risk management Experience in a telephonic role Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Posted 3 weeks ago

GolinHarris logo
GolinHarrisNew York, NY

$50,000 - $75,000 / year

We have recently become aware that individuals not associated with Golin have fraudulently used our name - to solicit applications for fake jobs, to conduct fake job interviews and to make fake job offers. Any request to schedule an interview and any bona fide offer of employment will only come from an authorised representative of Golin with an email address [email protected]. We urge you to be careful when sharing your personal information and to be aware of scams involving fake job postings and job offers. View All Jobs Senior Associate, Public Relations (Healthcare) New York, New York, United States Senior Associate Catalyst, Healthcare Golin is a progressive public relations agency with expertise ranging from brand-building and cutting- edge digital content, to corporate reputation, healthcare advocacy and measurement. Golin aligns earned-first, data-driven creative with the customer journey, to deliver maximum impact for clients and reach a profoundly diverse global market. "Go All In" is the agency's ethos and commitment to bravery over mediocrity. We Go All In, in everything we do. We're especially committed to Go All In for our people. We challenge our employees to be Courageously Happy and have empowered them to do so by offering our LifeTime benefits program. Lifetime offers unlimited time off, enhanced family care, ridiculously good health and wellness benefits, and a monthly LifeTime stipend for the gym or hobbies. We really do want you to play as hard as you work! Ready to go all in with us? What You'll Do: Opportunity to work on one of our largest pharmaceutical clients with a diverse mix of scientific communications, stakeholder engagement and a robust educational initiative Develop trusted advisor relationships with our clients by providing strategic counsel and a mastery of all aspects of client management Help to further develop our healthcare offering, capabilities, and growth trajectory Own the brainstorm process; see the need, lead the brainstorm, and begin to identify other team members who have the potential of becoming good brainstorm facilitators Flesh out ideas as they relate to client objectives and learn how to bring them to life in presentations and written proposals Showcase a command of both digital and traditional communication practices and strategies Be engaged in thought leadership/speaking opportunities What You Have: Ability to motivate a team Skilled at fostering growth and development Collaborative, but knows how to mobilize others to achieve a common goal Problem-solver, resourceful, goal-oriented Not afraid to challenge clients and team members, but knows how to resolve, gain consensus and move forward Experience managing all financial aspects of client business and managing/achieving revenue goals internally at an agency is critical Minimum of 1-2 years of relevant experience Healthcare / Pharma experience a must Salary range: $50,000 - $75,000 Golin has included the base salary range or hourly rate for this role. Actual compensation offered within the range will depend upon, among other factors: a candidate's skills, qualifications, and experience; actual ranges for current or former employees in the role; and market considerations. Golin is proud to be an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability or protected veteran status. Any request to schedule an interview and any legitimate offer of employment will only come from an authorized representative of Golin. We will never require an applicant to provide sensitive personally identifiable information in order to conduct an interview. We make our careers website accessible to any and all users. If you need an accommodation to participate in the application process, please contact us at [email protected]. This email address is not for general employment inquiries or vendors; rather it is strictly for applicants who require special assistance accessing our employment website. Due to volume, messages sent to this email address that are not related to an accommodation cannot be answered.

Posted 30+ days ago

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RYAN COS. US INCChicago, IL

$87,300 - $109,100 / year

Job Description: We're seeking an experienced Project Architect, Healthcare to join our team in Minneapolis and help lead the design of impactful healthcare environments. In this role, you'll guide and support architects through the full design process on small to mid-sized projects-providing direction, supervision, and mentorship to ensure the delivery of complete, accurate, and timely design documents. The ideal candidate brings at least eight years of relevant experience, a bachelor's or master's degree in architecture, active architectural licensure, and strong expertise in Revit, building codes, documentation, and constructability, along with solid proficiency in the Microsoft Office Suite. To be successful in this role, you must have at least 8 years of relevant work experience. A bachelor's (or master's) degree in architecture and Architectural licensure is required. You need strong knowledge of Revit, Building Codes, Documentation, and Constructability. Proficiency with Microsoft Office Suite is expected. Some things you can expect to do: Works in tandem with Client, Architects, Design Project Manager, Designers, Development, Construction and Consultants. Supports and leads team of Architects and Designers through the design process of small to mid-size projects. Creates complete and thorough set of design documents to meet project goals, milestones and schedules. Leads detailing effort for a complete set of construction documents and construction phase. Leads design meetings, consultant meetings and project team meetings. Coordinates project design schedules. Resolves unusual or complex technical issues. Research and lead code reviews and regulatory approval process. Manages and coordinates Ryan's QA/QC process and project specifications. Identifies and communicates deviations in project Performs tasks with a high level of collaboration and sets an example for others to Establishes and pursues annual goals based on personal, professional and company growth in the Ensures project goals of design excellence, execution and sustainability. Direct, supervise and mentor junior staff. You will really stand out if you have: Bluebeam knowledge. Leadership in Energy and Environmental Design Accredited Professional (LEED AP) and/or WELL Accredited Professional (WELL AP) Certification(s). Eligibility: Positions require verification of employment eligibility to work in the U.S. Compensation: The base salary is $87,300 - 109,100 Annually. The base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills and abilities. Benefits: Competitive Salary Medical, Dental and Vision Benefits Retirement and Savings Benefits Flexible Spending Accounts Life Insurance Educational Assistance Paid Time Off (PTO) Parenting Benefits Long-term Disability Ryan Foundation - charitable matching funds Paid Time for Volunteer Events Ryan Companies is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Non-Solicitation Notice to Recruitment Agencies: Ryan Companies kindly requests that recruitment agencies and third-party recruiters do not submit unsolicited resumes or candidate information to any Ryan Companies employee or office. Ryan Companies will not be responsible for any fees or expenses associated with unsolicited submissions. If recruitment services are required, we will reach out directly to agencies on our approved vendor list. We appreciate your understanding and cooperation.

Posted 30+ days ago

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CNA Financial Corp.New York, NY

$97,000 - $205,000 / year

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential. CNA is one of the premier providers of professional liability insurance. We currently have an opening for a Complex Claims Consulting Director focused on Healthcare Professional Liability for CNA Insurance. CNA is a market leader in insuring healthcare providers and facilities. This individual contributor role will work on the largest exposure claims across all Healthcare segments. This individual must have the ability to step into a claim at various points, evaluate next steps and proactively move the claim toward resolution. The claim professional will handle approximately 65 high exposure claims. 25% travel. This position enjoys a flexible, hybrid work schedule and is available in any location near a CNA office. JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Oversees the most complex investigations of claims, liability and damages and determines claim strategy, including if a claim should be settled or litigated. Develops and directs the execution of the litigation management strategy. Counsels management on legal risks, claim and litigation strategy and obligations in complex matters. Manages litigation by staff, coverage or outside counsel. Monitors trials, tracks legal and regulatory developments. Advises management and claim professionals regarding issues, approaches and impact of changes. Directs the negotiation of the most complex settlement packages, ensuring adequate reserves and cost effective settlements. Provides research, legal analysis, counsel and guidance on legal or claim handling questions or issues. May participate with senior management in the development and implementation of claims policy and business strategy. Mentors, guides, develops and delivers training to less experienced Claim Professionals. May perform additional duties as assigned. Reporting Relationship Director or above Skills, Knowledge & Abilities Expert knowledge of commercial insurance industry, products, policy language, coverage, and claim practices. Excellent verbal and written communication skills with the ability to develop collaborative working relationships, articulate very complex claim facts, analysis and recommendations in a concise manner to senior management, as well as with external business partners and customers. Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions, and to effectively evaluate and resolve ambiguous, complex and challenging business problems. Extensive experience in leading complex negotiations, as well as developing and implementing resolution strategies. Strong work ethic, with demonstrated time management, organizational skills, and an ability to work independently in a fast-paced environment. Ability to drive results by taking a proactive long-term view of business goals and objectives. Extensive experience interpreting commercial insurance policies and coverage. Ability to partner with internal resources, oversee/manage outside counsel, and collaborate with other carriers. Ability to lead multiple and shifting priorities in a fast-paced and challenging environment. Knowledge of Microsoft Office Suite and ability to learn business-related software. Demonstrated ability to value diverse opinions and ideas. Education & Experience: Bachelor's degree with JD preferred in a related discipline or equivalent. Typically a minimum ten years of relevant experience. Medical malpractice experience preferred. Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. Advanced negotiation experience Professional designations are highly encouraged (e.g. CPCU) #LI-KP1 #LI-Hybrid In Chicago/New York/California, the average base pay range for the Complex Claims Consulting Director role is $144,500 to $205,000. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $97,000 to $189,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact leaveadministration@cna.com.

Posted 2 weeks ago

Cigna logo
CignaPhiladelphia, PA
The Chief Medical Officer will be responsible for the following key areas of focus: Implements Clinical Strategy, Solution and Program Design- Implements and advances the overall clinical strategy in support of the transformation of the health plan offerings to deliver value through exceptional patient and provider experience, high quality outcomes, more affordable care, and with the use of modernized digital, technology, and data capabilities. Oversees Medical Management- Provides strategic leadership and oversight for all medical management functions, including case management (CM), utilization management (UM), and escalated case review. Ensures policies, procedures, and governance frameworks are in place to deliver a high-functioning, compliant health plan that meets regulatory requirements and internal standards. Drives excellence in clinical quality and consistency across programs while maintaining a seamless, positive experience for members and providers. Partners with internal teams to monitor performance, resolve complex cases, and continuously improve processes that safeguard patient outcomes and operational integrity. Serves as the External Clinical Face of Health Plan to the Market- Acts as the primary clinical ambassador for Cigna Healthcare, engaging with clients of all sizes across employer groups, as well as consultants and brokers. Plays a critical role in the sales process, account management, and ongoing performance oversight by providing clinical insight and executive sponsorship. Builds and nurtures strategic relationships with key stakeholders to strengthen trust and partnership. Represents Cigna in the provider community to foster collaboration, influence clinical policy, and advance value-based care initiatives. Ensures that every external interaction reflects Cigna's commitment to quality, affordability, and an exceptional member experience. Drives Clinical Product Strategy and Design- Leads the development and execution of Cigna Healthcare's clinical product strategy to ensure a market-leading clinical value proposition and compelling external narrative. Shapes and oversees the design of differentiated programs, including best-in-class case management and innovative solutions in high-impact areas such as GLP-1 therapies, gene therapy, women's health, and other core and emerging clinical domains. Partners with product, technology, operations, and business teams to create solutions that deliver measurable outcomes, supported by robust proof points and performance metrics. Ensures that Cigna's clinical programs stand out in the marketplace through demonstrated results, scalability, and alignment with client needs, while reinforcing our commitment to quality, affordability, and innovation. Implements and Advances Value-Based Care Strategy- Leads the next chapter of Cigna Healthcare's value-based care (VBC) journey, including oversight of our ACO model and development of innovative approaches to strengthen plan-provider alignment. Drives adoption of VBC enablers such as data integration, performance measurement, and incentive structures that improve quality and affordability. Pilots novel care models and partnerships to accelerate transformation while ensuring alignment with the broader enterprise network strategy. Positions Cigna as a market leader in value-based care through measurable outcomes, proof points, and a compelling external narrative. Collaboration Across Clinical Leadership- Ability to work seamlessly with other clinical leaders across the enterprise, serving as a key member of the clinical leadership bench. Thought partner to the enterprise CMO and peers to ensure integration of clinical strategy with each business's objectives, fostering alignment and shared accountability. Advances Clinical Data and AI Strategy- Champions a data-first mindset to transform CHC's clinical strategy through advanced analytics and AI. Leads efforts to harness data and AI for superior member experience, personalized care, improved outcomes, and operational efficiency. Partners closely with data, technology, and business teams to identify and execute clinical use cases that drive measurable impact. Ensures all AI applications adhere to rigorous clinical standards and governance guardrails to maintain trust and safety. Positions Cigna Healthcare at the forefront of digital innovation by embedding AI into clinical workflows while maintaining transparency, compliance, and a commitment to quality. Drives Health Equity Strategy- Leads the design and implementation of the next phase of Cigna Healthcare's health equity strategy, ensuring measurable business impact and alignment with our mission. Embeds a health equity lens across clinical programs to drive better outcomes for all patients, reduce disparities, and improve access to high-quality care. Establishes clear proof points and performance metrics to demonstrate progress and accountability, while partnering across the enterprise to integrate equity principles into product design, policy, and care delivery. Builds and Inspires our New Age Clinical Workforce- Sets the sourcing, recruitment, and onboarding strategy for building the team of clinicians who can support and drive the business strategy. Ensures our clinical teams are supported, engaged, and inspired to deliver exceptional outcomes. Leads and executes strategies to make Cigna an employer of choice for clinical talent through a differentiated employee value proposition that ensures the sustainability and well-being of our teams. The CMO will be the major clinical voice for Cigna Healthcare's US market president and senior leadership team. Partners with Enterprise Clinical Leadership - Collaborates and engages Clinical leaders/peers across the enterprise to support the enterprise clinical strategy and build out clinical community. The successful candidate will be a forward-thinking, flexible physician executive with a broad understanding of the healthcare industry, its challenges and opportunities, and deep experience within health plans. This leader will know how to navigate the complexities of a health plan environment to deliver results that align clinical priorities with business strategy. They will demonstrate genuine intellectual curiosity and a collaborative mindset, working effectively across a complex, matrixed organization with a servant leadership disposition. The individual will be an innovative thinker and problem-solver with a proven ability to lead transformative change while fostering trust, engagement, and retention of top clinical talent. The ideal candidate will combine clinical expertise, digital and technology depth, and strong business acumen with a results-oriented focus-driving measurable impact on both clinical outcomes and enterprise growth objectives. Experience & Expertise: Clinical Execution: Ability to deliver a clinical vision for the business. The skills to shape and implement the development of forward-looking strategies that align with overarching enterprise objectives. Can identify opportunities for improvement that balance profitable business and clinical outcomes (e.g., patient outcomes, cost containment, and quality of healthcare services). Enterprise Value Creation and Scaling Commercial Solutions: Ability to align clinical metrics/outcomes with a direct linkage to enterprise value creation and member health to create a clear mandate and accountability that prioritizes high-value areas. Experience overseeing the end-to-end development and scaling of healthcare solutions. Can drive innovation through the implementation of technologies and care models. Strong understanding of finance, technology, and the levers to pull in business development and sales. Thought Leadership and Clinical Face-To-Market: Track record of engaging with diverse external stakeholders in the community to stay informed and shape the latest clinical and policy developments. Experience serving as the clinical face outside the organization to help inform and validate decision-making processes and provide insight supporting the business development lifecycle. Fosters collaborations to enhance care delivery and contribute to discussions in the public policy arena. Plays a crucial role in market-facing change and crisis management communications related to the Cigna health plan, ensuring effective and clear messaging to all stakeholders. Clinical Leadership: Gravitas to serve as the highest point of clinical leadership in Cigna Healthcare. Skills and experience to effectively have end-to-end oversight of the clinical model (including P&L) for all programs and care delivery businesses while creating a high-quality patient care culture. Can balance clinical choices with business outcomes to gain market traction and deliver financial results. Health Plan and Medical Management Expertise: Deep experience operating within health plan environments, including fluency in medical management functions such as utilization management (UM), case management (CM), policy development, and governance. Proven ability to navigate complex plan structures and deliver compliant, high-performing operations that enhance member experience and clinical quality. Transformation & Change: Leads masterfully and empathetically through change in a complex matrixed environment (e.g., transformation of ways of working/processes, vision/priorities/culture and technology application). Manages transformation through practices such as creating a vision and purpose, frequent and timely communication, leadership alignment, stakeholder engagement, educating/training the organization, and overcoming resistance. Builds strong working relationships rooted in collaboration and trust. Value-Based Care: Deep experience transitioning healthcare delivery models toward value-based care, emphasizing outcomes and cost-effectiveness. Building Next Generation Clinical Talent: Has direct people management responsibility for a team through the full talent lifecycle: attracting, hiring, onboarding, developing, managing performance, and promoting talent, as well as existing team members when necessary. Compliance, Safety and Quality Care: Cultivates a culture and fosters practice across the care delivery teams that prioritizes high quality, safe, and compliant operations within the Healthcare Sector. REQUIRED SKILLS: MD/DO degree required; MBA and/or relevant business experience (10+ years) preferred. 10+ years of experience in healthcare leadership. Excellent leadership skills including the ability to think strategically, develop vision, and execute for results. Proven thought leader of innovative, effective clinical solutions; must have end-to-end experience in deriving clinical and business value from clinical interventions, programs, and solutions. Experience demonstrating iterative and synergistic solutions with near-term value delivery in service of longer-term pivots. Experience with Commercial health plan product constructs, design, and innovative benefit structures. Demonstrated ability to deliver creative solutions to complex challenges. Experience working in a highly matrixed organization, with proven ability to develop internal enterprise relationships and influence partners. Strong communication skills, particularly the ability to translate complex topics into consumable formats. Willingness to travel as needed to support provider and regional team engagement. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Posted 2 weeks ago

JLL logo
JLLSan Francisco, CA

$180,000 - $220,000 / year

JLL empowers you to shape a brighter way. Our people at JLL and JLL Technologies are shaping the future of real estate for a better world by combining world class services, advisory and technology for our clients. We are committed to hiring the best, most talented people and empowering them to thrive, grow meaningful careers and to find a place where they belong. Whether you've got deep experience in commercial real estate, skilled trades or technology, or you're looking to apply your relevant experience to a new industry, join our team as we help shape a brighter way forward. Consulting Portfolio Lead We are seeking an experienced Consulting Portfolio Lead to join our team in a full-time, long-term role with one of JLL's premier healthcare clients in the Bay Area. In this role, you will serve as a Consulting Portfolio Lead, overseeing strategic real estate portfolio consulting and acting as a trusted thought partner to senior leadership on critical portfolio decisions. This position requires building and maintaining strong relationships with senior management and stakeholders across the organization, driving collaborative participation to deliver effective portfolio strategy that achieves key strategic objectives. The Consulting Portfolio Lead is highly integrated within the client team, working within a matrixed organization, to deliver a complex set of projects within a healthcare real estate portfolio. Key Responsibilities: Develop and execute comprehensive healthcare real estate portfolio strategies and plans, including market assessments to measure location performance, demographic analytics, and strategic positioning goals Work directly with the client's Geospatial Analytics Leader to support initiatives, maintaining clear and proactive communication throughout all collaborative efforts Support major healthcare portfolio strategic initiatives including site selection and market analysis Collaborate with leadership teams to deliver cohesive portfolio strategies before, during, and after strategic decisions Service as a strategic advisor for senior leaders in helping them achieve portfolio growth and optimization objectives Manage strategic planning communications and executive presentations Provide ongoing portfolio performance analysis and recommendations Drive utilization and future enhancements of GIS systems and market analytics for healthcare portfolio strategic initiatives Monitor implementation timelines and activities, escalating market risks and preparing mitigation tactics Qualifications: Bachelor's degree required; MBA, advanced degree, or relevant certifications preferred 12-15 years of experience in healthcare real estate strategy, portfolio strategy, and hospital operations Proven track record in healthcare operations and supporting relationships at the senior executive level within healthcare organizations Experience with large-scale, multi-market healthcare strategic initiatives Strong collaboration skills and ability to manage complex, cross-functional, stakeholder alignment and issue resolution using executive influence skills Strong knowledge of healthcare real estate market processes, strategic methods, and regulatory requirements Entrepreneurial mindset with excellent time management and prioritization abilities Healthcare portfolio consulting experience, working with cross-functional teams GIS systems knowledge and spatial analytics experience is required Outstanding presentation, facilitation, and communication skills (both written and verbal) Solid project management capabilities Key Competencies: Executive presence: Ability to command respect and build credibility with senior healthcare stakeholders. Strategic thinking: Capacity to develop innovative solutions for complex healthcare real estate challenges. Data-driven decision making: Proficiency in analyzing complex datasets, GIS mapping, deriving actionable insights, and using data to inform strategy and drive results. Adaptability: Flexibility to work in a dynamic healthcare environment and adjust to changing client needs. Leadership: Ability to guide teams, mentor colleagues, and drive projects to successful completion. Business acumen: Strong understanding of healthcare real estate portfolio strategy principles and their application in the healthcare sector, specifically hospital operations. Location: Bay Area / hybrid Estimated compensation for this position: 180,000.00 - 220,000.00 USD per year This range is an estimate and actual compensation may differ. Final compensation packages are determined by various considerations including but not limited to candidate qualifications, location, market conditions, and internal considerations. Location: On-site -San Francisco, CA If this job description resonates with you, we encourage you to apply, even if you don't meet all the requirements. We're interested in getting to know you and what you bring to the table! Personalized benefits that support personal well-being and growth: JLL recognizes the impact that the workplace can have on your wellness, so we offer a supportive culture and comprehensive benefits package that prioritizes mental, physical and emotional health. Some of these benefits may include: 401(k) plan with matching company contributions Comprehensive Medical, Dental & Vision Care Paid parental leave at 100% of salary Paid Time Off and Company Holidays Early access to earned wages through Daily Pay JLL Privacy Notice Jones Lang LaSalle (JLL), together with its subsidiaries and affiliates, is a leading global provider of real estate and investment management services. We take our responsibility to protect the personal information provided to us seriously. Generally the personal information we collect from you are for the purposes of processing in connection with JLL's recruitment process. We endeavour to keep your personal information secure with appropriate level of security and keep for as long as we need it for legitimate business or legal reasons. We will then delete it safely and securely. For more information about how JLL processes your personal data, please view our Candidate Privacy Statement. For additional details please see our career site pages for each country. For candidates in the United States, please see a full copy of our Equal Employment Opportunity policy here. Jones Lang LaSalle ("JLL") is an Equal Opportunity Employer and is committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation because of a disability for any part of the employment process - including the online application and/or overall selection process - you may email us at HRSCLeaves@jll.com. This email is only to request an accommodation. Please direct any other general recruiting inquiries to our Contact Us page > I want to work for JLL. Pursuant to the Arizona Civil Rights Act, criminal convictions are not an absolute bar to employment. Pursuant to Illinois Law, applicants are not obligated to disclose sealed or expunged records of conviction or arrest. Pursuant to Columbia, SC ordinance, this position is subject to a background check for any convictions directly related to its duties and responsibilities. Only job-related convictions will be considered and will not automatically disqualify the candidate. California Residents only If you are a California resident as defined in the California Consumer Privacy Act (CCPA) please view our Supplemental Privacy Statement which describes your rights and disclosures about your personal information. If you are viewing this on a mobile device you may want to view the CCPA version on a larger device. Pursuant to the Los Angeles Fair Chance Initiative for Hiring Ordinance, JLL will consider for employment all qualified Applicants, including those with Criminal Histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Accepting applications on an ongoing basis until candidate identified.

Posted 30+ days ago

CareBridge logo
CareBridgeNashville, TN

$19 - $28 / hour

A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug therapies through our specialty pharmacies, our infusion centers, and the home setting. Administrative Clerk II - Paragon Healthcare Schedule: Monday- Friday; 9:00am- 6:00pm Central Hybrid 1: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Administrative Clerk II is responsible for performing routine but varied clerical duties following standard procedures. How you will make an impact: Makes and receives phone calls to exchange information to accomplish tasks. Contacts customers, suppliers and/or company associates to exchange information. Receives, sorts, and distributes incoming mail and email communication. Sets up and maintains records, logs, and files. Receives, classifies, reconciles, consolidates, and summarizes documents and information, as well as processing and coding them. Compiles regular and special reports using established formats and procedures. Scans claims, correspondence, and other related documents, and may maintain equipment. Flags quality issues as they arise while completing and maintaining production logs. It is an expectation of the role to use basic office equipment. Minimum Requirements: Requires a H.S. diploma or equivalent and a minimum of 2 years of related work experience; or any combination of education and experience which would provide an equivalent background. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $18.66 to $27.98 Locations: Chicago, Illinois In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits 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. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Posted 30+ days ago

P3 Health Partners logo
P3 Health PartnersHenderson, NV
Overall Purpose: The Provider Data Management Specialist is responsible for overseeing the accuracy, integrity, and maintenance of provider data within P3 internal systems. The Provider Data Management Specialist ensures data integrity across systems to support claims processing, provider directories, regulatory compliance, and operational efficiency. This role acts as a liaison between internal contracting, health plans, and credentialing to ensure successful maintenance of data through all stages of provider enrollment. Essential Functions Supports contracting and credentialing with obtaining accurate provider data. Responsible for building positive relationships between the health plan, providers and practice managers. Manage processes for provider data integration and system enhancements, working with systems to develop reporting. This includes supporting the development and publication of provider directories for various internal stakeholders. Serve as the primary point of contact for provider data-related inquiries and issue resolution. Maintains, audits, and updates notice of change documentation for all providers. Identifying gaps in network composition and services to assist the department. Identifying operational short-falls, researching and remediating issues. Handles confidential and non-routine information. Delivers assigned projects on time and compliant to applicable state and federal regulations. Organizes and prioritizes large volumes of information. General administrative duties. Knowledge, Skills, and Abilities Must have a high level of interpersonal skills to handle sensitive and confidential situations. Position continually requires demonstrated poise, tact and diplomacy. Must have excellent verbal and written skills. Must be able to interact and communicate with individuals at all levels of the organization and external parties. Must have knowledge of variety of computer software applications in word processing, spreadsheets, database and presentation software (Word, Excel, Access, PowerPoint) Work requires continual attention to detail in composing, typing and auditing large amounts of data. contracts. Must be able to work in a fast-paced environment with demonstrated ability to juggle multiple competing tasks and demands. Excellent organization and coordinating skills. Experience Must have a minimum of five years of work experience in managed care and strong relationship building skills. Education Associates Degree preferred or in process of completion or equivalent experience.

Posted 3 weeks ago

Gensler logo
GenslerNew York, NY

$110,000 - $140,000 / year

Your Role As a Gensler Design Manager, you will leverage your experience on healthcare projects, your attention to detail, and interpersonal skills to deliver exceptional client projects on time and under/on budget. You will manage and deploy resources to ensure that the design phases flow smoothly and act as the primary liaison between the team and client. This is a great opportunity to join a highly creative, collaborative team while working on trendsetting architectural projects across a variety of industries. What You Will Do Be a trusted advisor for your clients and build relationships. Work with strategy and design leaders to prepare presentations, workshops, and related research and client interactions. Support communication between project team, clients, vendors, contractors, consultants, and building and permitting officials. Prepare project proposals, negotiate contracts and fees, coordinate bidding process. Manage all phases of a Healthcare projects, including scheduling, budgets, project set-up, design, and construction administration and coordination with consultants. Take ownership of financial performance of projects. Provide mentorship and guidance for your teams and other staff. Understand key aspects of studio business and proactively develop ways to create better client engagements, people-centric approaches, and project efficiencies. Your Qualifications 10+ years of related experience, 4+ managing healthcare projects and teams. Bachelor's degree in Architecture, Interior Design or design-related field. Experience leading, managing and mentoring multiple project teams and projects through the entire project lifecycle including post-occupancy. Strong leadership, organization, communication and relationship management skills. Must have the ability to maintain existing client relationships and build new client relationship. Experience negotiating healthcare project scope and fees. Knowledge of building codes, standards, building construction, and building structure. Strong understanding of, and ability to oversee, architectural and interior design package deliverables consistent with industry standards. Flexibility to focus on concurrent projects in various stages of development. Experience with MS Office is required, additional experience with Bluebeam Revu, Adobe Creative Suite and Revit is a plus. Demonstrated commitment to sustainability and sustainable building practices required. All applications must include a portfolio for full consideration. The base salary range will be estimated between $110-140k plus bonuses and benefits and contingent on relevant experience. Life at Gensler At Gensler, we are as committed to enjoying life as we are to delivering best-in-class design. From curated art exhibits to internal design competitions to "Well-being Awareness Week," our offices reflect our people's diverse interests. We encourage every person at Gensler to lead a healthy and balanced life. Our comprehensive benefits include medical, dental, vision, disability, wellness programs, flex spending, paid holidays, and paid time off. We also offer a 401k, profit sharing, employee stock ownership, and twice annual bonus opportunities. Our annual base salary range has been established based on local markets. As part of the firm's commitment to licensure and professional development, Gensler offers reimbursement for certain professional licenses and associated renewals and exam fees. In addition, we reimburse tuition for certain eligible programs or classes. We view our professional development programs as strategic investments in our future.

Posted 30+ days ago

Lumeris logo
Lumerisdubberly, LA

$98,400 - $132,225 / year

Your Future is our Future At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. Position: Program Manager & Trainer - AI Healthcare Solutions Position Summary: The Program Manager & Trainer is responsible for designing, coordinating, and delivering training programs that help physicians, clinical staff, and administrative teams adopt our AI-powered primary care solution. This role blends program management with hands-on training creation and delivery, ensuring large health systems are equipped to use the technology effectively and realize its value. You will work directly with health system stakeholders to design training strategies, coordinate rollout programs, and ensure continuous learning opportunities. Internally, you'll partner with Customer Success Managers, Clinical Success Managers, and Product teams to align training with client needs and product updates. Job Description: Key Responsibilities Program Management Develop and manage comprehensive training rollout plans for large health systems (300+ physicians). Coordinate training schedules, resources, and communications with client leadership. Monitor adoption and provide program-level reporting to clients and internal stakeholders. Standardize training methodologies to ensure consistency across clients. Training Design & Delivery Create training materials (guides, presentations, e-learning modules, quick reference sheets). Deliver in-person and virtual training sessions to physicians, nurses, and office staff. Train-the-trainer: enable client "super users" and physician champions to scale training within their organizations. Adjust training strategies based on client workflows and adoption data. Change Management & Adoption Act as a change management leader, helping staff understand the "why" behind adoption. Identify barriers to adoption and develop interventions with client champions. Serve as feedback loop for product improvements, capturing frontline staff input. Qualifications 5+ years experience in program management, healthcare training, or learning & development (L&D). Strong background in healthcare operations, digital health, or clinical systems (Epic, Cerner, Athena preferred). Experience training clinicians and staff in new technologies or process changes. Exceptional communication and facilitation skills (comfortable with both large groups and one-on-one coaching). Familiarity with adult learning principles and instructional design. PMP, Prosci, or training certifications (e.g., ATD) a plus. Ability to travel 30-40% to health system sites. Working Conditions While performing the duties of this job, the employee works in normal office working conditions. Pay Transparency: Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements. The hiring range for this position is: $98,400.00-$132,225.00 Benefits of working at Lumeris Medical, Vision and Dental Plans Tax-Advantage Savings Accounts (FSA & HSA) Life Insurance and Disability Insurance Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days) Employee Assistance Program 401k with company match Employee Resource Groups Employee Discount Program Learning and Development Opportunities And much more... Be part of a team that is changing healthcare! Member Facing Position: No- Not Member or Patient Facing Position Location: Louisiana Time Type: Full time Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment. Disclaimer: The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities. Lumeris is an EEO/AA employer M/F/V/D.

Posted 3 weeks ago

Adams Brown logo
Adams BrownJonesboro, AR
Description Position Summary A Tax Manager is a professional who has the technical ability to prepare and review tax returns, standard accounting work papers and statements, and other financial reports while guiding and mentoring other staff. This role demonstrates the ability to work well with others especially in the capacity to earn the confidence and respect of clients, principals, staff, and administrative support personnel. The Tax Manager is familiar with tax and audit standard concepts, practices, and procedures, and relies on extensive experience and judgment to accomplish goals. A wide degree of creativity and latitude is expected. This individual will work on the Healthcare Focus Area team. FLSA Status: Exempt Requirements Required Experience and Education A current and valid CPA license is required. Must be a member in good standing with the American Institute of CPAs and respective state societies. 5-7 years' experience in public accounting or relevant position, demonstrating a progression in complexity, scope, and number of projects. Special consideration will be made to waive the requirement of the CPA license in lieu of comparable experience and demonstrated expertise. Major Duties and Responsibilities Responsible for maintaining tax records and preparing tax returns, related schedules, and related reports Responsible for supervising and reviewing the work of others Maintains in depth knowledge of accounting and tax matters, and specialized industries or functional/technical areas Ensures top quality client service through a cadence of in-person and virtual communications Consistently applies effective project management skills in order to plan and coordinate multiple engagements Participates in mentoring, training, recruiting, retention, and team-building activities Complies with all firm policies and procedures Recognizes complex technical issues, reaches appropriate conclusions, and applies authority to support conclusions Maintains accurate time and expense records to ensure proper billing of clients Anticipates problem areas and questions that will arise during the course of a project Uses established network of business relationships to generate new sales opportunities for continued development of client base Demonstrates knowledge of all technical aspects of the job, including related knowledge of necessary systems and procedures Demonstrates advanced technical knowledge effectively through written and verbal communication; seeks to continuously develop communication skills Increasingly builds knowledge base on the firm's industry lines and service offerings Performs other duties as assigned Desired Skills, Abilities and Characteristics Leads by example exhibiting integrity, energy, enthusiasm, dedication, and commitment to excellent client service, firm reputation, and the one team concept Professional and forward-looking mindset Ability to maintain confidentiality of firm and client information Effectively communicates verbally as well as short-form, and long-form writing Client service oriented Effectively manage people with poise and professionalism Promotes the vision, missions, and core values of the firm and supports the one-firm concept Demonstrates the ability to properly delegate and manage workload and train others on the proper delegation and management of work Continually strives to improve effectiveness through a mindset of lifelong learning Ability to apply principles of accounting to analyze and prepare financial information Excellent organizational skills Ability to demonstrate confidence and good judgment when interacting with colleagues, supervisors, and clients Strong presentation skills Ability to work well with others Working Environment Adams Brown, LLC promotes a flexible work environment with a deep commitment to technology and modern work arrangements. Our offices are open from 8:00 a.m. - 5:00 p.m. Monday through Friday through tax season and close at noon on Fridays outside of tax season. We are closed on major holidays, offer substantial paid-time-off, a comprehensive benefit package, competitive pay structure, and a culture of growth, clarity, and respect. Click here to learn more about our benefits. AdamsBrown, LLC. is an Equal Opportunity Employer.

Posted 30+ days ago

CONTACT GOVERNMENT SERVICES logo
CONTACT GOVERNMENT SERVICESSan Francisco, CA

$85,000 - $105,000 / year

Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client. CGS brings motivated, highly skilled, and creative people together to solve the government's most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Responsibilities will Include: Review, sort, and analyze data using computer software programs such as Microsoft Excel. Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.). Develop HCF case referrals including, but not limited to: Ensure that HCF referrals meet agency and USAO standards for litigation. Analyze data for evidence of fraud, waste and abuse. Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence. Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings. Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc. Assist conducting witness interviews and preparing written summaries. Qualifications: Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field. Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work. Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc. Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data). Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy. U.S. Citizenship and ability to obtain adjudication for the requisite background investigation. Experience and expertise in performing the requisite services in Section 3. Must be a US Citizen. Must be able to obtain a favorably adjudicated Public Trust Clearance. Preferred qualifications: Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3. Relevant experience working with a federal or state legal or law enforcement entity. #CJ $85,000 - $105,000 a year We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Posted 30+ days ago

C logo
Cambia HealthLewiston, ID

$92,000 - $124,000 / year

SYSTEMS ANALYST III (HEALTHCARE) Hybrid (In office 3 days/week) within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's Software Engineering Team is living our mission to make health care easier and lives better. The Systems Analyst participates in a team environment for the development, maintenance, and delivery of product/application (s) and data integrations as an integral part of a multi-functional team. This position is generally responsible for business, data and product/application analysis. This position requires business, analytical, design, interpersonal, technical and administrative skills in performing day to day work. - all in service of making our members' health journeys easier. If you're a motivated and experienced Systems Analyst looking to make a difference in the healthcare industry, apply for this exciting opportunity today! What You Bring to Cambia: Preferred Key Experience (MUST HAVE): Healthcare Experience Facets Experience API - Not development Qualifications and Certifications: Bachelor's degree in Computer Science, Mathematics, Business Administration, or a related field and minimum 5 years business or system experience developing requirements for projects where computer software is created The equivalent combination of education and/or experience including experience with methodologies and structured analytical approach Skills and Attributes (Not limited to): Ability to work with teammates and with business partners to participate in sessions to gather, translate and document and system requirements to support transforming requirements into effective technology solutions. Ability to create simple story cards and understand simple acceptance criteria enough to verify results; develop simple technical documentation and understand technical documentation and concepts. Ability to coordinate and facilitate one to one and small groups (3-5) of customers or other analysts for small work efforts. Ability to develop positive relationships among business partners, teammates and management. Ability to follow direction, collaborate effectively with peers to provide results, and relay status to management and peers in a timely manner. Additional Minimum Requirements for level II Understands moderately complex acceptance criteria enough to verify results; develops technical documentation and can understand moderately complex technical documentation. Ability to facilitate and lead small teams (1-3) for moderate work efforts which includes estimating, coordinating, tracking progress, inspiring others to complete tasks on time, assisting with resolving issues. Able to participate in requirements sessions/interviews and document clear requirements for moderate work efforts. Mastering knowledge and skills of common software development methodologies. Additional Minimum Requirements for level III Ability to lead small teams (3-5) for complex work efforts which includes estimating, coordinating, tracking progress, inspiring others to complete tasks on time, assisting with resolving issues and creating status reports. Ability to present and effectively communicate with leadership. Ability to participate in the definition of a QA plan. Ability to use and coach more junior team members and business partners on development methodologies. What You Will Do at Cambia (Not limited to): Read and create simple structured specifications such as use cases, story cards. Read and understand design and business models including basic technical understanding. Writes SQL queries, reads simple data models. Understands and participates in the creation of deliverables by acting as a liaison between the development team and the end users. Contributes to deliverables including analysis, development that may include writing SQL/scripting, quality and validation. Additional General Functions and Outcomes for level II Reads and creates moderately complex and structured specifications such as use cases, story cards and requirements. Provides support for applications and products during releases and warranty which may include quality and validation. Actively acquires basic understanding of API concepts as applicable to the products and teams. Reads most data models and has the ability to participate in logical data model creation. Writes moderately complex SQL queries. Additional General Functions and Outcomes for level III Applies in depth knowledge on health insurance terminology and concepts as needed by the product/application (s) the teams support. Reads and creates complex structured specifications such as use cases, story cards. Reads complex and creates moderately complex business models. Writes well designed complex SQL queries and trains the more junior analysts. Participate/ Actively develop automated validation techniques (QA automation) as applicable to the product and team. Understands basic API concepts, such as API structures, JSON, collections and how to document in a technical design as applicable to the product and team. Reads complex data models and creates basic logical data models. Provide estimates for complex size work efforts increasing accuracy of the estimate as work effort progresses. Trains and coaches less experienced and peer analysts. May participate in the research, evaluation and selection of vendor products, methodologies and processes. Lead medium size groups including multiple departments with a structured approach (i.e. JRP or grooming sessions). Manages own tasks on moderate size enterprise-wide work efforts. The expected target hiring range for the Systems Analyst III is $92k - $124k is depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15% . The current full salary range for the Product Manager is $86k / $141k. About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: Work alongside diverse teams building cutting-edge solutions to transform health care. Earn a competitive salary and enjoy generous benefits while doing work that changes lives. Grow your career with a company committed to helping you succeed. Give back to your community by participating in Cambia-supported outreach programs. Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. Annual employer contribution to a health savings account. Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). Award-winning wellness programs that reward you for participation. Employee Assistance Fund for those in need. Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.

Posted 30+ days ago

Whoop logo
WhoopBoston, MA

$120,000 - $155,000 / year

At WHOOP, we're on a mission to unlock human performance and healthspan. WHOOP empowers users to perform at a higher level through a deeper understanding of their bodies and daily lives. We are hiring a Senior Analyst to partner closely with our Healthcare Product team, work on future-focused health initiatives, and support the broader digital health and clinical teams in their efforts to utilize data and insights to make informed decisions on their roadmap and continuously improve the member experience. We are looking for an individual who can be fluent in data, driven by product thinking and is looking to deeply understand and tackle complex analytics challenges. This person should feel empowered to foster their own curiosity and raise support for ideas that meaningfully impact the WHOOP member experience. This role is based in the WHOOP office located in Boston, MA. The successful candidate must be prepared to relocate if necessary to work out of the Boston, MA office. RESPONSIBILITIES: Collaborate closely with Product, Digital & Connected Health, Software, UX, Data Science, Marketing, and Strategic Finance teams to break down and prioritize the product strategy and roadmap. Develop a deep understanding of WHOOP's database and tools to effectively drive data-driven proposals to internal stakeholders on necessary changes. Help build and refine health-specific KPIs, including engagement with relevant features, adoption of recommended behaviors, and member-reported value. Uncover insights about key member segments - including those managing hormonal health, cardiometabolic health, or looking for more personalized wellness support. Create repeatable tools and processes for analytics across new health features and algorithms- from data pipelines to dashboards and weekly health performance reviews. Collaborate with a high-performance team in a fast-paced environment, providing thought leadership to identify the most impactful ways to drive decisions and improve retention. QUALIFICATIONS: 4+ years of experience in a deeply strategic/analytical role, including partnership with clinical, product, data science, or engineering teams. Able to take broad questions, wrangle appropriate data, quickly isolate and model key insights, visualize results and communicate actionable recommendations. Strong storytelling skills - able to create compelling and concise presentations that convey actionable solutions to complex, ambiguous problems. Demonstrated success in influencing senior stakeholders and leadership on strategic direction based on analytical recommendations. Experience working with data engineering and development teams on complex datasets Advanced skills in SQL and general understanding of ELT (dbt) and data warehousing (Snowflake) structures, as well as data visualization (eg. Amplitude, Sigma, Hex). Python is a plus. Strong commitment to embracing and leveraging AI tools in day-to-day tasks, ensuring AI-assisted work aligns with the same high-quality standards as personal contributions. Interested in the role, but don't meet every qualification? We encourage you to still apply! At WHOOP, we believe there is much more to a candidate than what is written on paper, and we value character as much as experience. As we continue to build a diverse and inclusive environment, we encourage anyone who is interested in this role to apply. WHOOP is an Equal Opportunity Employer and participates in E-verify to determine employment eligibility. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. The WHOOP compensation philosophy is designed to attract, motivate, and retain exceptional talent by offering competitive base salaries, meaningful equity, and consistent pay practices that reflect our mission and core values. At WHOOP, we view total compensation as the combination of base salary, equity, and benefits, with equity serving as a key differentiator that aligns our employees with the long-term success of the company and allows every member of our corporate team to own part of WHOOP and share in the company's long-term growth and success. The U.S. base salary range for this full-time position is $120,000 - $155,000. Salary ranges are determined by role, level, and location. Within each range, individual pay is based on factors such as job-related skills, experience, performance, and relevant education or training. In addition to the base salary, the successful candidate will also receive benefits and a generous equity package. These ranges may be modified in the future to reflect evolving market conditions and organizational needs. While most offers will typically fall toward the starting point of the range, total compensation will depend on the candidate's specific qualifications, expertise, and alignment with the role's requirements.

Posted 1 week ago

Cigna logo

Healthcare Strategy Advisor - Cigna Healthcare - Hybrid

CignaSaint Louis, MO

$91,900 - $153,100 / year

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Job Description

Job Summary

The Healthcare Strategy Advisor plays a key role in supporting the development and execution of clinical strategies that drive improved health outcomes, affordability, and business growth across Cigna Healthcare (CHC). This role requires a strong grasp of healthcare dynamics and a growing ability to influence decision-making, contribute to cross-functional initiatives, and translate insights into actionable plans. Success in this role requires a solid foundation in strategic analysis, financial acumen, a collaborative mindset, and experience working in clinical or payor organizations. This role reports to the Principal, Clinical & Provider Strategy.

Responsibilities

Strategic Support & Planning

  • Support the development of clinical strategy initiatives aligned with CHC and enterprise goals and market needs, including strategic frameworks, business cases, and initiative roadmaps.
  • Conduct robust internal reviews and external market scans to identify emerging trends, capability gaps, and innovation opportunities.
  • Define measures of success for strategic initiatives across financial, clinical, patient experience, and operational drivers.
  • Develop subject-matter expertise in select clinical areas to act as the go-to-resource for clinical leadership.

Cross-Functional Collaboration

  • Collaborate with matrix partners across CHC clinical teams, along with other internal teams including product, data and analytics, and finance to ensure strategic alignment.
  • Participate in cross-functional workgroups as a proxy for CHC clinical strategy, contributing to the design of new commercial programs and products.
  • Develop executive-level communications to escalate key issues, opportunities or pain points to CHC leadership, along with recommendations for resolution.

Analysis & Insights

  • Analyze clinical and operational data to identify trends, gaps, and opportunities for improvement in patient care delivery.
  • Translate complex data into clear, actionable insights for both clinical and non-clinical stakeholders.
  • Proficiency in using data visualization and analytics tools (e.g., Excel, Tableau, Power BI, SQL, or Python) to develop dashboards, reports, and presentations that inform strategic decisions.
  • Prepare executive-level presentations, memos, and updates on strategic projects.
  • Monitor initiative performance and support continuous improvement efforts.

Required Qualifications

  • Bachelor's degree required; advanced degree (e.g., MPH, MBA, MHA) preferred.
  • 5+ years of experience in healthcare strategy, clinical operations, or related roles.
  • Strong analytical and problem-solving skills with the ability to translate data into actionable insights.
  • Excellent written and verbal communication skills.
  • Experience working in a matrixed organization and collaborating across functions.

Preferred Qualifications

  • Experience in payer, provider, or integrated delivery system environments.
  • Familiarity with value-based care models, population health strategies, or digital health tools.
  • Exposure to strategic planning, business case development, or healthcare innovation.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 91,900 - 153,100 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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