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Complex Claims Consultant (Healthcare)-logo
Complex Claims Consultant (Healthcare)
CNA Financial Corp.Irvine, CA
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. Start the next chapter of your career as a Complex Claims Consultant in Healthcare for CNA Insurance. CNA is a market leader in insuring healthcare providers and facilities, including physicians, nurses, nurse practitioners, dentists, physical therapists, counselors, pharmacists, massage therapists and more than 100 other categories of medical service providers, along with the facilities and practices in which they work. This role will support the Healthcare business and interact with these key customers. You will be responsible for the overall investigation, management and resolution of Healthcare professional liability claims in multiple states. You will be recognized as a technical expert in the interpretation of complex or unusual policy coverages. Under general management direction, you will work within defined authority limits, to manage professional liability healthcare claims with moderate to high complexity and exposure in accordance with company protocols, quality and customer service standards. You will also partner with internal business partners such as Underwriting and Risk Control, to share claim insights that aid in good underwriting and risk management decisions. The individual will work with insureds, attorneys, other insurers and account representatives regarding the handling and/or disposition of complex litigated and non-litigated claims in multi-state jurisdictions. The individual will investigate and resolve claims, coordinate discovery and team with defense counsel on litigation strategy. They should be able to utilize claims policies and guidelines, review coverage, determine liability and damages, set financial reserves, secure information to negotiate and settle claims. 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: Manages an inventory of highly complex healthcare professional liability claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Ensures exceptional customer service by managing all aspects of the claim, interacting professionally and effectively, achieving quality and cycle time standards, providing timely updates and responding promptly to inquiries and requests for information. Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language, estimating potential claim valuation, working with counsel and following the company's claim handling protocols. Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts where necessary, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority. Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner. Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation. Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely. Keeps leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct summaries to senior management. Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business. Mentors, guides, develops and delivers training to less experienced Claim Professionals. May perform additional duties as assigned. Reporting Relationship Typically Director or above Skills, Knowledge & Abilities Thorough knowledge of the professional liability insurance industry, products, policy language, coverage, and claim practices. Strong communication and presentation skills both verbal and written, including the ability to communicate business and technical information clearly. 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. Strong work ethic, with demonstrated time management and organizational skills. Ability to work in a fast-paced environment at high levels of productivity. Demonstrated ability to negotiate complex settlements. Experience interpreting complex insurance policies and coverage. Ability to manage multiple and shifting priorities in a fast-paced and challenging environment. Knowledge of Microsoft Office Suite and ability to learn business-related software. A commitment to collaboration and demonstrated ability to value diverse opinions and ideas. Education & Experience: Bachelor's Degree or equivalent experience. JD a plus. Typically a minimum six years of relevant experience, preferably in claim handling, healthcare/medical malpractice litigation. Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. Professional designations are a plus (e.g. CPCU). #LI-KP1 #LI-Hybrid In Chicago/New York/California, the average base pay range for the Complex Claims Specialist role is $113,000 to $160,000. 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 $72,000 to $141,000 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 1 day ago

Medical Director Opportunity – Southern Illinois Healthcare-logo
Medical Director Opportunity – Southern Illinois Healthcare
In Compass HealthCarbondale, IL
IN Compass Health is searching for qualified, BC/BE Hospitalists to join our team within the Southern Illinois Healthcare System located in and around Carbondale, Illinois! Home to Southern Illinois University, Carbondale is a diverse and vibrant community located just over an hour from St. Louis, MO. Home to numerous beautiful lakes, Carbondale is located on the edge of the Shawnee National Forest and filled with natural beauty. Because of the rich soil ofIN Compass Health is seeking an experienced, Board-Certified Medical Director to lead our dynamic team at Southern Illinois Healthcare, located in the vibrant community of Carbondale, Illinois. This role offers a unique opportunity for professional growth in a leadership capacity, overseeing clinical and administrative aspects of our hospitalist program. Position Highlights: Leadership Role: Guide and mentor a team of medical professionals; oversee clinical operations. Competitive Compensation: Attractive salary with performance incentives. Professional Development: CME allowance and opportunities for growth and advancement. Work/Life Balance: Optimal staffing model for a balanced lifestyle. Comprehensive Benefits: Full health and wellness package, retirement plan with profit sharing, and malpractice coverage with tail. About SIH System: As the region's largest private employer and provider of charity care, SIH offers a not-for-profit health system serving the southernmost counties of Illinois. The system includes four hospitals, a comprehensive cancer center, Level II Trauma Center, and more than 30 outpatient and specialty practices. Carbondale, home to Southern Illinois University, is a diverse and culturally rich community, offering a blend of educational, recreational, and cultural opportunities. The city's proximity to the Shawnee National Forest and beautiful local wineries adds to its appeal. Requirements: Board Certification in Internal Medicine or Family Medicine. Proven leadership experience in a healthcare setting. Excellent communication and team-building skills. For more details and to apply for this leadership opportunity, please contact us at 800-309-2632. southern Illinois, Carbondale is also home to some of the best wineries in the nation with beautiful views and scenic settings. IN Compass Health, Inc. develops and manages hospitalist programs for institutions and physician communities around the country. As one of the premier hospitalist providers in the nation, since our founding in 2001 we have delivered more than 200 programs in 14 states serving over 1,000 patients each day. Our executive leaders have been practicing hospitalists for more than 20 years and know the challenges physicians face today. IN Compass Health is an equal opportunity employer. All aspects of employment including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.

Posted 30+ days ago

Healthcare Medicare Sales & Outreach Manager-logo
Healthcare Medicare Sales & Outreach Manager
myPlace HealthLos Angeles, CA
About myPlace Health myPlace Health was founded in 2021 by mission-aligned healthcare leaders and organizations that are committed to drastically improving health outcomes, quality and experience for vulnerable older adults and frail seniors. We specialize in providing value-based, comprehensive care and coverage for older adults with significant needs so they can thrive in the homes they love and in the communities they cherish. Our mission is simple: to enable older adults to live the independent lives they deserve. We pursue this mission through our myPlace PACE (Program of All-Inclusive Care for the Elderly) model, which provides seamless primary care, integrated health plan coverage, personalized social engagement, and customized services delivered in the participant’s preferred place. myPlace Health is building a mission-driven team that shares our passion for redefining the way older adults experience care as they “age in place” in the community. This is a unique opportunity to take on one of our country’s most challenging healthcare problems and join a fast-growing, dynamic team as we prepare to scale our mission to serve more markets. About This Role Are you passionate about connecting seniors with the care and support they deserve? Do you thrive in building relationships, leading teams, and creating strategies that drive meaningful growth? If so, this is an incredible opportunity to join myPlace Health as an Outreach Manager, where you’ll play a key role in expanding access to our PACE (Program of All-Inclusive Care for the Elderly) services. In this role, you’ll lead and develop a high-performing outreach and enrollment team, forging strong partnerships with community organizations, healthcare providers, and referral sources across the Los Angeles market. You’ll have the unique opportunity to build the outreach and marketing program from the ground up, shaping strategies that will connect underserved frail seniors with the comprehensive care they need to live healthier, more fulfilling lives. We’re looking for an energetic, mission-driven leader who is excited to grow a program that makes a real difference in the community. If you’re ready to take on a rewarding challenge and help seniors access life-changing care, we’d love to hear from you! What Does Success Look Like As our Outreach Manager Shape Outreach & Marketing Strategy – Partner with leadership to develop strategies that drive growth and enhance brand awareness. Grow Our Enrollment Pipeline – Identify and cultivate new referral sources to bring more participants into our PACE program. Stay Ahead of the Market – Keep a pulse on competitors’ positioning to refine and enhance our outreach approach. Lead and Develop a High-Performing Team – Hire, train, mentor, and support outreach staff while ensuring they have the tools to succeed. Ensure Compliance & Best Practices – Oversee outreach and marketing activities to meet DHCS and CMS regulations. Build Meaningful Community Partnerships – Strengthen relationships with hospitals, providers, and community organizations to increase referrals. Enhance Outreach Processes – Evaluate and refine enrollment workflows to improve efficiency and participant experience. Leverage Data & Technology – Monitor and manage our CRM software to maintain accurate documentation and reporting. Collaborate for Success – Work closely with center leadership to meet enrollment goals and pass audits with confidence. Drive Enrollment & Marketing Execution – Implement marketing plans that deliver measurable results. Support Organizational Growth & Mission – Contribute to the organization’s overall success by working cross-functionally with teams, providing insights to improve outreach efforts, and ensuring that our enrollment strategies align with our mission of delivering high-quality care to seniors. What Does An Ideal Candidate Need To Succeed? Experience that Makes an Impact – A proven track record of 5+ years in outreach, sales, business development, or marketing, preferably in healthcare, senior services, or a related field. Leadership & Team Development – 3+ years of experience in hiring, training, and mentoring outreach or sales teams to achieve growth goals. Strategic Thinking & Execution – Ability to develop and impleme nt effective marketing and enrollment strategies that drive results. Community Engagement Expertise – Strong skills in building relationships with referral sources, hospitals, providers, and community organizations to expand outreach. Data-Driven Approach – Proficiency in CRM systems and reporting to track outreach activities and ensure compliance with DHCS and CMS regulations. Regulatory & Compliance Knowledge – Understanding of state and federal regulations governing healthcare marketing and enrollment, particularly within a PACE or managed care setting (preferred). Strong Communication & Collaboration Skills – Ability to effectively present, negotiate, and collaborate with stakeholders at all levels. Adaptability & Problem-Solving – A resourceful approach to challenges with the ability to pivot strategies as needed. Mission-Driven Mindset – A commitment to improving the lives of seniors through compassionate and effective outreach efforts. Education & Experience – A bachelor’s degree in business, marketing, healthcare administration, or a related field is preferred. Equivalent experience will also be considered. What’s in it for you? At myPlace Health, we believe in taking great care of the people who care for our participants. That’s why we offer a comprehensive and rewarding compensation package that supports your well-being—professionally, financially, and personally. Here’s a snapshot of what you can look forward to: Competitive Pay & Total Rewards We offer a strong base salary along with a total rewards package that reflects your experience, education, certifications, and the location of your role. For onsite roles, we adjust pay based on local markets; remote roles are aligned to national pay benchmarks. Performance-Based Incentives Our industry-leading incentive plan recognizes your contributions and rewards your success. Ongoing Growth & Feedback You’ll receive two performance reviews per year (when applicable), giving you the chance to grow, reflect, and celebrate your achievements. Plan for Your Future Take advantage of our 401(k) plan with an employer match—because your future matters. Health Coverage that Fits Your Life Choose from six medical plans, with up to 80% of premiums covered for employees and 75% for dependents. More Than Just Medical We’ve got you covered with dental and vision insurance, FSA/HSA options, short- and long-term disability, basic life insurance, and additional benefits like accident, critical illness, and hospital indemnity coverage. Generous Time Off Recharge with 20 days of PTO to start, 12 paid holidays, and 2 floating holidays each year. Support for Your Learning We prioritize your professional development with a generous CME/CEU budget, dedicated time off for learning, and ongoing growth opportunities. Family Comes First Our family-friendly culture includes paid parental leave and a child care stipend to help support you at home. Ready to Make a Meaningful Impact? At myPlace Health, we’re not just growing a program—we’re building a movement to bring high-quality, compassionate care to the seniors who need it most. As our Outreach Manager, you’ll have the chance to lead with purpose, innovate with heart, and connect our community’s most vulnerable members to life-changing support. If you’re excited to lead a team that’s passionate, mission-driven, and ready to make a difference every day, we can’t wait to meet you. Join us in transforming care for seniors—one connection at a time. Your Application Please submit your resume/CV. Our Commitment to Diversity, Equity and Inclusion At myPlace Health, we value the diversity of our team members, and we are committed to building a culture of inclusion and belonging. We pride ourselves to be an equal opportunity employer. People seeking employment at myPlace Health are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law. COVID-19 Vaccination Policy At myPlace Health, we provide safe and high-quality care to our participants. To achieve this, we have a policy that strongly recommends Covid-19 vaccination to keep both our team members and participants safe. Medical and religious exemptions can be granted based upon review of proper documentation. We adhere to all federal, state, and local regulations by obtaining necessary proof of vaccination prior to employment. Beware of Scams and Fraud Please beware of scams that solicit interviews or promote jobs for opportunities that are not listed on our website or are not directly related to a job you applied for yourself. Please be advised that myPlace Health will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams’ option: https://reportfraud.ftc.gov/#/

Posted 2 weeks ago

VP, Product Management - Healthcare Tech-logo
VP, Product Management - Healthcare Tech
IMO HealthRosemont, IL
Research shows that women and underrepresented groups only apply to jobs only if they think they meet 100% of the qualifications on a job description. IMO Health is committed to considering all candidates even if you don’t think you meet 100% of the qualifications listed. We look forward to receiving your application! IMO Health is a clinical data intelligence business improving how data is used across the healthcare landscape. Combining rich, highly nuanced medical terminology, extensive domain knowledge, and artificial intelligence (AI), we expertly structure and operationalize clinical data to generate sharper insights and inform more intelligent decision-making. I MO Health is seeking a strategic and commercially focused VP, Product Management to lead the growth of our offerings within the healthcare technology segment and the development of IMO Health’s Clinical AI platform. In this role, you will position IMO Health as a trusted partner to healthcare technology vendors by developing tailored solutions for their unique challenges and spearheading IMO Health’s evolution into an AI-first provider. As the healthcare technology solution owner, you will oversee the development and deployment of product bundles that meet the specific needs of digital health companies. You will collaborate closely with other platform teams to shape offerings for the healthcare technology segment in addition to guiding the development of IMO Health’s Clinical AI platform. Success in this role requires a strong business acumen combined with deep healthcare domain expertise. You will act as a commercial product leader, crafting compelling value propositions and go-to-market strategies that drive revenue growth and expand IMO Health’s footprint in this rapidly evolving sector. Your ability to navigate between high-level strategic vision and detailed product intricacies will be essential in delivering impactful solutions and thought leadership in a dynamic environment. IMPACT YOU'LL MAKE: Lead the growth of IMO Health’s offerings within the health tech market by creating tailored solutions that address the unique needs of healthcare technology vendors such as specialty EHRs, data analytics companies, health information exchanges, etc. Drive commercial success by strategically positioning and bundling IMO Health’s products, including Clinical AI and other platform components, to maximize market relevance and revenue. Collaborate cross-functionally to shape the AI platform roadmap, ensuring product development aligns with client demands and advances IMO’s competitive edge. Establish and nurture strong relationships with key stakeholders across the health tech ecosystem, enhancing IMO’s visibility and influence in this critical market segment. WHAT YOU'LL DO: Lead Market Segment Strategy: Develop and execute comprehensive commercial strategies to grow IMO Health’s presence and revenue within the health tech market segment, tailoring solutions to meet the unique needs of healthcare technology vendors. Team Leadership: Lead a small, high-performing team, fostering collaboration and excellence to deliver impactful solutions. Solution Portfolio Management: Curate and bundle IMO’s diverse product offerings to create compelling, market-relevant solutions that address client challenges and drive adoption. Collaborate Cross-Functionally: Work closely with platform owners, product managers, and technical teams to align product development with market demands and ensure seamless delivery of integrated solutions. Client and Stakeholder Engagement: Build and maintain strong relationships with key clients and industry stakeholders, serving as a trusted advisor and thought leader through webinars, presentations, and industry events. Guide AI Platform Development: Provide strategic direction for the IMO Clinical AI platform, shaping its roadmap to support current and future health tech solutions and enhance competitive advantage. Market Insight and Adaptation: Continuously analyze market trends, customer feedback, and competitive landscape to refine solution offerings and pivot strategies as needed to maximize growth opportunities. Visibility and Leadership: Represent the health tech segment at executive and board levels, delivering clear business forecasts, progress reports, and strategic recommendations to senior leadership. Hands-On Product Management: Balance high-level strategic planning with detailed feature-level understanding, ensuring solutions are both visionary and practically executable in a fast-paced, lean environment. WHAT YOU'LL NEED: 10+ years of experience in product management, business development, or commercial leadership within the health technology (health tech) sector, preferably with a strong background in digital health solutions and AI-driven platforms. Demonstrated leadership experience managing and developing high performing teams in a health tech or related environment. Proven ability to develop and execute go-to-market strategies that grow revenue and market presence in complex healthcare technology markets. Deep understanding of the healthcare technology ecosystemand digital health vendors. Strong strategic mindset with experience shaping product roadmaps and guiding AI platform development to meet evolving market needs. Exceptional communication and interpersonal skills, capable of building trusted relationships with clients, internal teams, and executive leadership, including board-level engagement. Demonstrated thought leadership through client-facing activities such as webinars, conference presentations, and industry publications. Ability to navigate between high-level strategic planning and detailed feature-level understanding, with a hands-on approach in a lean, fast-paced environment. Self-motivated, resourceful, and collaborative, with a passion for driving innovation and commercial success in health tech. Proficient in using product management and CRM tools to track performance, manage pipelines, and support data-driven decision-making. Compensation at IMO Health is determined by job level, role requirements, and each candidate’s experience, skills, and location. The listed base pay represents the target for new hires with individual compensation varying accordingly. These figures exclude potential bonuses, equity, or sales incentives, which may also be part of the total compensation package. Our recruiter will provide additional details during the hiring process. IMO Health also offers a comprehensive benefits package. To learn more, please visit IMO Health’s Careers Page . At IMO Health, we celebrate diversity and are committed to creating an inclusive environment for all employees. IMO Health is proud to be an equal opportunity workplace and is an affirmative action employer. IMO Health also provides visa sponsorship opportunities. Please don't hesitate to apply if you meet all the qualifications for this position and require visa sponsorship.

Posted 1 week ago

AI Agent Healthcare Integration Engineer-logo
AI Agent Healthcare Integration Engineer
Health GPT IncPalo Alto, CA
Job Summary: We are seeking a skilled AI Agent Integration Architect to lead the integration of the Hippocratic AI Agents deeply into our healthcare system. Our partners span providers, plans, pharma, and health technology companies that want to incorporate our safety-focused conversational agents. Deep integrations enable us to scale agent use and dramatically improve our ability to create value for our partners. This role is crucial to building the connection between Hippocratic AI's agents and external systems, including Electronic Health Records (EHRs), Health Information Exchanges (HIEs), and third-party healthcare partners. You will work closely with our customers and partners, as well as cross-functional teams including sales, customer support, engineering, and agentic design. We are looking for problem solvers who can work closely with customer IT teams, diagram customer workflows, diagnose technical issues, write complex integration code, and design data pipelines. Key Responsibilities: Integration Management & Development Manage the end-to-end integration lifecycle for a major customer, including requirements gathering, mapping, development, testing, deployment, and ongoing support. Lead the design, development, and implementation of deep integrations between Hippocratic AI and customer systems, including HL7 v2, FHIR, and custom integrations. Oversee the development of APIs and middleware solutions to enable seamless data exchange across healthcare applications and with data exchanges. Liaise between clients and our offshore (India) integration engineering team Ensure compliance with industry regulations (HIPAA, ONC Cures Act, TEFCA, etc.) and data security best practices. Technical Leadership & Strategy Develop integration roadmaps and strategies to enhance interoperability between EHR systems (e.g., Epic, Cerner, Meditech) and third-party vendors. Research and implement emerging technologies and standards in healthcare interoperability. Monitoring & Maintenance Monitor integration health to proactively detect and resolve integration issues. Manage client communication on downtimes, defects and integration errors Maintain system documentation, including interface specifications, data flow diagrams, and integration architecture. Qualifications: Required: Bachelor's degree in Computer Science, Health Informatics, Information Systems, or a related field. 2+ years of experience in healthcare integration, particularly HL7 v2, FHIR, and API-based interoperability. Hands-on experience with integration engines such as Epic Bridges, InterSystems Ensemble, Rhapsody, Mirth Connect, or Corepoint. Strong knowledge of FHIR APIs, SMART on FHIR, and RESTful web services. Experience working with EHRs (Epic, Cerner, Meditech, Allscripts, etc.) and third-party health systems. Proficiency in scripting and development languages such as Python, Java, or JavaScript for integration tasks. Deep understanding of HIPAA, HL7, and healthcare regulatory compliance. Strong problem-solving skills and the ability to troubleshoot complex data exchange issues. Excellent communication skills with the ability to explain technical concepts to non-technical stakeholders. Preferred: Epic Bridges certification or FHIR certification. Experience with cloud-based integration solutions (e.g., AWS, Azure, Google Cloud). Knowledge of HIEs, TEFCA, and data-sharing frameworks. Familiarity with automation tools for EDI and data processing. About Us: Hippocratic AI has developed a safety-focused Large Language Model (LLM) for healthcare. The company believes that a safe LLM can dramatically improve healthcare accessibility and health outcomes in the world by bringing deep healthcare expertise to every human. No other technology has the potential to have this level of global impact on health. Why Join Our Team: Innovative Mission: We are developing a safe, healthcare-focused large language model (LLM) designed to revolutionize health outcomes on a global scale. Visionary Leadership: Hippocratic AI was co-founded by CEO Munjal Shah, alongside a group of physicians, hospital administrators, healthcare professionals, and artificial intelligence researchers from leading institutions, including El Camino Health, Johns Hopkins, Stanford, Microsoft, Google, and NVIDIA. Strategic Investors: We have raised a total of $278 million in funding, backed by top investors such as Andreessen Horowitz, General Catalyst, Kleiner Perkins, NVIDIA's NVentures, Premji Invest, SV Angel, and six health systems. World-Class Team: Our team is composed of leading experts in healthcare and artificial intelligence, ensuring our technology is safe, effective, and capable of delivering meaningful improvements to healthcare delivery and outcomes. For more information, visit www.HippocraticAI.com. Our team values in-person collaboration, with on-site presence expected five days a week in Palo Alto, CA unless otherwise specified.

Posted 2 weeks ago

Patient Account Representative - Customer Service / Call Center - Healthcare-logo
Patient Account Representative - Customer Service / Call Center - Healthcare
GuidehouseSan Antonio, TX
Job Family: Patient Account Representative Travel Required: None Clearance Required: None What You Will Do: The Call Center / Customer Service Representative - Healthcare is an extension of a client's business office staff. Representatives are responsible for taking in-coming and out-going calls to patients and insurance companies to resolve patient accounts. All client policies and procedures are followed. Representatives will perform any and all job-related duties as assigned This position will be based Monday through Friday out of our San Antonio, TX office. Individuals must be able to work an eight hour shift between the hours of 7:30 AM CT - 5:30 PM CT. Inbound calling emphasis Account Review EOB knowledge Assist patients with policy statuses and insurance verifications Customer Service Account Updates Strong Verbal / Written Communication Skills Complete all business-related requests and correspondence from patients. Complete all assigned projects in a timely manner. Assist client and patients in all requested tasks. Communicate to Guidehouse management areas of concern or areas of improvement. Research and respond to all patient inquiries received by telephone and mail. Update patient demographic information and initiate account adjustments. What You Will Need: High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED. 0-2+ years working within the following sectors: healthcare, insurance, business, finance or customer service. Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities. What Would Be Nice to Have: PC skills in a Windows environment. Knowledge and utilization of desktop applications to include Word and Excel. 1+ year experience working in a Healthcare or Customer Service setting. Ability to initiate and follow through on projects and work independently with minimal supervision. Bilingual Spanish a plus but not required #IndeedSponsored What We Offer: Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. Benefits include: Medical, Rx, Dental & Vision Insurance Personal and Family Sick Time & Company Paid Holidays Position may be eligible for a discretionary variable incentive bonus Parental Leave 401(k) Retirement Plan Basic Life & Supplemental Life Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts Short-Term & Long-Term Disability Tuition Reimbursement, Personal Development & Learning Opportunities Skills Development & Certifications Employee Referral Program Corporate Sponsored Events & Community Outreach Emergency Back-Up Childcare Program About Guidehouse Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process. If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant's dealings with unauthorized third parties. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Posted 2 weeks ago

Pharmacy Strategy Advisor - Cigna Healthcare - Hybrid-logo
Pharmacy Strategy Advisor - Cigna Healthcare - Hybrid
CignaNashville, TN
The Cigna Healthcare Pharmacy Management team is seeking a Pharmacy Strategy Advisor who is strategic, has excellent communication skills, extremely organized, and handles ambiguity well. We are looking for the right candidate who can support the overall vision, goals, and objectives of the Cigna Healthcare integrated Pharmacy business. This position will require extensive coordination with cross-functional partners, The Pharmacy Strategy Advisor will be responsible for supporting the department in strategy development and delivery, product roadmap, portfolio funding prioritization, and special projects to support Cigna Pharmacy sales growth, client retention, and enterprise goals. Additionally, this role will be responsible for participating in innovation and ideation activity for new value creation, key initiative tracking and governance, and project management as needed. The position will report to the Director, Pharmacy Strategy within the Pharmacy Strategy team of Cigna Healthcare. A successful individual in this role will have a deep understanding of pharmacy benefits, clinical programs and customer experience as well as strong analytic, communication, and decision-making skills. The position works closely with cross-functional partners across the enterprise including matrix partners within Express Scripts, Evernorth, and Accredo in addition to the Enterprise Strategy team, Finance, Actuary, Sales, and Senior Leadership. Excellent organizational skills, attention to detail and the demonstrated ability to deliver quality, finished work is a must. Advanced experience with Excel, PowerPoint, and Word is essential and experience with Smartsheets or Wrike as a project management tool is necessary. ESSENTIAL FUNCTIONS Provide support across the Senior Leadership team on strategy development, activation and delivery Provide support and coordination on the Pharmacy component within the US Employer strategy memo Partner with cross functional teams and matrix partners on the product roadmap, portfolio funding, and special projects as defined Participate in new value creation activities such as innovation labs and ideation sessions Govern, track, and report out via appropriate communication channels on key initiative progress and action items Provides support for the development, enhancement, and evaluation of the Pharmacy Product portfolio. Other product management responsibilities as assigned QUALIFICATIONS Bachelor's degree required; MBA preferred. 5+ years' experience in insurance or healthcare industry with 3+ years' experience in pharmacy benefit. Excellent written and verbal communication skills, including demonstrated ability to quickly translate ideas and insights into presentation-ready documents Excellent meeting facilitation and organizational skills Strong strategic, financial, and analytical skills A self-starter with advanced problem-solving skills who has the initiative to work cross-functionally to resolve issues and generate results Demonstrated ability to think/act strategically and influence key leaders and matrix partners Ability to prioritize and balance workload accordingly, detail-oriented and proactive Excellent communication skills (verbal, written, and presentation), especially with the ability to work with executives, clients and broad teams; tailoring communication per audience Demonstrated ability to work with remote personnel to achieve agreed upon goals and objectives 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 100,400 - 167,400 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 Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 6 days ago

Product Management Senior Advisor - Cigna Healthcare - Hybrid-logo
Product Management Senior Advisor - Cigna Healthcare - Hybrid
CignaTampa, FL
This is a hybrid position (3 days per week in-office + 2 days work at home). The incumbent candidate can be based out of any US Cigna Healthcare office. This position is a Hybrid role where the Cigna policy requires office alignment but is not restricted to locations that are identified in this posting. Position Summary The Product Management Senior Advisor manages and supports the overall vision, goals, and objectives of programs and products offered to Cigna Healthcare integrated Pharmacy clients and customers. The Product Management Senior Advisor will be responsible for developing new product offerings and managing existing products within the pharmacy benefit and financial product team to support Cigna Pharmacy sales growth, retention and organizational goals. This position requires a strategic thinker with a passion for innovation and a commitment to delivering impactful solutions in the pharmacy and clinical space. The Product Management Senior Advisor will work closely with pharmacy product peers in Networks, Benefits, and Clinical Programs, as well as with Clinical Program Management, Clinical Operations teams, and Express Scripts/Evernorth colleagues. Other key non-pharmacy specific functional areas include Sales, Underwriting, Finance, Legal, Marketing and Communications teams. Product development opportunities will be focused on increasing customer growth, delivering best-in-class customer/client affordability, aligning client, customer, prescriber, pharmacy and health plan incentives, promoting holistic customer health and well-being and providing a best in class, differentiated customer experience. This individual will be adept at working as part of a team in leading work in a complex environment with aggressive timelines and occasional ambiguity. Excellent organizational skills, an orientation to detail and the demonstrated ability to deliver quality, finished work is a must. This role is individual contributor but requires well-developed people management, matrix management and influencing skills. Responsibilities Proactively identifies and assesses new product development opportunities based on market trends, competitive intel, and client/market demand Leads product design and business case development of high potential opportunities and promotes within organization against competing ideas Develops strategy, product requirements document, and other key deliverables needed to communicate concept to business and tech project teams Collaborates with cross-functional partners across the enterprise to successfully build and launch projects on-time, with minimal issues and within budget, utilizing leadership as necessary to overcome barriers Communicates clearly and consistently with all key stakeholders Coordinates with Legal, Compliance and Filing teams to ensure new product offerings are compliant with federal /state regulations; develops plan language and state filing updates as needed Provides education and training to all matrix partners (Sales and Account Management, Product, client support teams, call centers) for new products and existing products Provides support for the development, enhancement, and evaluation of the Pharmacy Product portfolio. Other product management responsibilities as assigned Qualifications Bachelor's degree or equivalent work experience 5+ years' experience in insurance or healthcare industry with 3+ years' experience in pharmacy benefit Demonstrated ability to organize thoughts and vision into presentation ready deliverables Excellent written and verbal communication skills, including demonstrated ability to quickly translate ideas and insights into presentation ready documents Excellent meeting facilitation and organizational skills. Excellent presentation skills to leaders Demonstrated ability to work with remote personnel to achieve agreed upon goals and objectives Strong financial, analytical, quantitative and interpersonal skills Demonstrated decision making capability Comfort with complex systems and processes Demonstrated ability to work independently Demonstrated ability to execute on multiple projects and excel in a results-orientated environment 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 110,700 - 184,500 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 Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 day ago

Government Healthcare Actuarial Manager-logo
Government Healthcare Actuarial Manager
Clark InsuranceMinneapolis, MN
Company: Mercer Description: We are seeking a talented individual to join our Government Human Services Consulting team at Mercer. This role will be based in Phoenix, Atlanta, D.C., or Minneapolis. This is a hybrid role that has a requirement of working at least three days a week in the office. Mercer's Government Human Services Consulting (GHSC) practice has touched more than 60 million lives since our inception in 1985, working with state Medicaid agencies to transform Medicaid programs to better serve our most vulnerable communities. Our nearly 500 specialists provide comprehensive services including actuarial and financial, clinical and behavioral health, pharmacy, policy, and more. We will count on you to: Lead routine client engagements, managing overall service delivery and strategy, financial evaluations, plan design, and more Draft and review client reports and presentations to summarize findings and implications, and recommend strategies and solutions to the client Perform and review complex analyses and cost projects by using or modifying existing tools and pricing models, and review analyses conducted by junior staff to ensure actuarial soundness and correct use of models Handle day-to-day client contact and management, resolving any project-related questions and challenges, and guide junior staff members in client interactions Assist senior team members in the development of the business by identifying potential areas of growth in existing projects, and provide assistance in responding to requests for information or proposals What you need to have: BA/BS degree 5+ years minimum health actuarial experience, with 3+ years of Medicaid actuarial experience Actuarial credentials (ASA, FSA, MAAA) Ability to handle client and project management in a demanding work environment with tight deadlines What makes you stand out? Medicaid actuarial experience spanning multiple states, programs, health insurers, or Federal agencies and actuarial consulting experience Experience leading large teams and/or large, complex projects Experience related to health plan analysis or capitated rate development Why join our team: We help you be your best through professional development opportunities, interesting work, and supportive leaders. We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have impact for colleagues, clients, and communities. Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being. Mercer, a business of Marsh McLennan (NYSE: MMC), is a global leader in helping clients realize their investment objectives, shape the future of work and enhance health and retirement outcomes for their people. Marsh McLennan is a global leader in risk, strategy and people, advising clients in 130 countries across four businesses: Marsh, Guy Carpenter, Mercer and Oliver Wyman. With annual revenue of $24 billion and more than 90,000 colleagues, Marsh McLennan helps build the confidence to thrive through the power of perspective. For more information, visit mercer.com, or follow on LinkedIn and X. Marsh McLennan is committed to embracing a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age background, disability, ethnic origin, family duties, gender orientation or expression, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, veteran status (including protected veterans), or any other characteristic protected by applicable law. If you have a need that requires accommodation, please let us know by contacting reasonableaccommodations@mmc.com. Marsh McLennan is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh McLennan colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one "anchor day" per week on which their full team will be together in person. The applicable base salary range for this role is $117,000 to $234,500. The base pay offered will be determined on factors such as experience, skills, training, location, certifications, education, and any applicable minimum wage requirements. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives. We are excited to offer a competitive total rewards package which includes health and welfare benefits, tuition assistance, 401K savings and other retirement programs as well as employee assistance programs.

Posted 3 weeks ago

Healthcare Retention Specialist - Bilingual English/Spanish Speaking-logo
Healthcare Retention Specialist - Bilingual English/Spanish Speaking
Family Health Centers of San Diego, Inc.San Diego, CA
Impact Lives, Impact Community Family Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care options. Founded by a Latina grandmother/community advocate over 50 years ago in Barrio Logan, FHCSD has grown into one of the largest community health systems in the country. With over 90 sites, over 227,000 patients, and over 1.1 million healthcare visits last year, we provide a wide variety of health care and outreach services to a very diverse patient population. We are proud of our mission, our lasting community impact, and the cultural and individual diversity of our staff. Family Health Centers of San Diego (FHCSD) is looking for a Healthcare Retention Specialist- The Healthcare Retention Specialist is under the supervision of the Coordinator of Access to Care, provides a variety of services to those who have received Insurance Enrollment services, including verification of enrollment, tracking utilization of healthcare services, and encouraging renewal applications. Responsibilities: Answers Insurance Hotline to screen for coverage, and schedules application assistance appointments with an Enrollment Specialist. Completes project-specific logs and collects required project data. Makes timely and accurate submission of monthly reports. Makes telephone and mail contact with individuals receiving FHCSD Enrollment services; verifies enrollment; documents any healthcare utilization; and encourages renewal applications. Meets department retention productivity standards. Performs other duties as assigned. Provides coverage for Healthcare Enrollment Specialists as needed. Participates in community events as needed. Requirements: Ability and means to travel as needed in a timely manner within San Diego County, to locations that may have limited access to public transportation; proof of liability and property damage insurance on vehicle used is required. DRIVER REQUIREMENTS: Licensed for a minimum of 3 years; No more than 2 violations and/or accidents within 3 years; No vehicle related suspensions/reinstatements; No DUI, reckless or felony Driving with 7 years. High school graduate or GED equivalency. Rewards: Job type: Regular Full Time Competitive Salary with Excellent Benefits Retirement Plan with Employer Match Paid Time Off, Extended Sick Leave and Paid Holidays Medical/Dental/Vision/FSA/Life Insurance Employee Discounts and Wellness Programs FHCSD was founded by community activists working towards a common goal: caring, affordable, high-quality medical care for all. We are proud to continue this mission today as we provide accessible services to over 210,000 patients across San Diego County. The successful candidate will have a demonstrated commitment to community medicine and providing culturally competent care to the medically underserved. In the spirit of pay transparency, we are excited to share the base range for this position, exclusive of fringe benefits. $22.00 - $26.27 If you are hired at Family Health Centers of San Diego, your final base salary compensation will be determined based on factors such as geographic location, jurisdictional requirements, skills, education, and/or experience. In addition to these factors - we believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please keep in mind that the range mentioned above is what we reasonably expect to pay for the role. Hiring at the maximum of the range would not be typical in order to allow for future and continued salary growth. We also offer a generous compensation and benefits package (more information on our benefits offerings is available here: FHCSD Wellness- Employee Hub (gobenefits.net)

Posted 30+ days ago

Healthcare Analyst II-logo
Healthcare Analyst II
Network HealthBrookfield, WI
Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. It drives the decisions we make, including the people we choose to join our growing team. The Healthcare Analyst II gathers, validates, maintains, analyzed, and manipulates data used in reporting and decision-making processes, supporting Network Health Plan, plan sponsors, and plan providers affecting decisions, activities, and processes in several departments, including Finance, Group Administration, Claims, IS, Sales, Quality Improvement, and Care Management. This position uses a variety of methods and tools to develop and document reports and processes that support ongoing activity or ad hoc requests. Interpret data, identify trends, establish/utilize benchmark data, and present information to customers in clear, concise, and useful formats, including data visualizations and interpretation of information. Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to for a hybrid work environment (reliable internet in your home is required) Hours: 1.0 FTE, 40 hours per week, 8am-5pm Monday through Friday Check out our 2024 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team. Job Responsibilities: Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies Using a variety of programming languages and query tools, e.g. SAS, SQL, etc., develops and distributes information from integrated databases, e.g. Data Warehouse, Excel, third party purchased data, etc., validates reports to ensure accuracy of reported. Interpret data, identify trends, establish/utilize benchmark data, and present information to customers in clear, concise, and useful formats, including data visualizations and interpretation of information Understands and identifies data elements used in reporting packages and determines impact on management reports needing integrated data. Works with various departments to create new fields in base system or reporting databases to enhance reporting capabilities. Documents process used in transforming raw data to meaningful information. This will provide the customer with a fully defined report, an analysis of the results, and the process used to create the information Job Requirements: Bachelor's degree in a technical, business, actuarial or scientific field Three years of experience in an analytics position, using statistical analysis, report development and analytics Two years of experience in insurance and/or health care related industry Strong oral and written communication skills with the ability to listen mindfully, identify gaps and ask appropriate questions Ability to organize one's work and space to ensure successful completion of assigned tasks within the identified timeframe Ability to adapt to new circumstances, information and challenges in a fast-paced environment Ability to work independently, as well as part of a team Experience with programming languages and query tools. Prefer SAS and/or SQL Ability to communicate with business users and other sources to accurately derive and define project requirements, specifications, and design Ability to work at both a conceptual and detail level with strong analytical, problem solving, and decision-making skills Must be able to analyze and formulate complex design alternatives and recommend appropriate solutions from both a business and technical perspective We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce.

Posted 1 week ago

Government Healthcare Actuarial Lead-logo
Government Healthcare Actuarial Lead
Clark InsuranceSeattle, WA
Company: Mercer Description: We are seeking a talented individual to join our Government Human Services Consulting team at Mercer. This role will be based in Phoenix, Atlanta, D.C., or Minneapolis. This is a hybrid role that has a requirement of working at least three days a week in the office. Mercer's Government Human Services Consulting (GHSC) practice is dedicated to helping publicly funded health and human services clients transform their healthcare programs, impacting the lives of millions in our most vulnerable communities. We believe that each project is an opportunity to build trust between our team and our clients, and we back each project with industry leading experience and multi-disciplinary specialists. We will count on you to: Lead a team that of actuaries, actuarial and data analysts, clinicians and health policy consultants supporting multiple large, complex capitation rate-setting and other actuarial projects In conjunction with other project leaders, work with the client to define and manage the scope of the project, serve as an expert on rate structures and methodologies, and ensure consistency with federal regulations and actuarial standards Oversee the development of rate-setting assumptions that are built into actuarial models and inform client and project teams on the impact of data and assumptions, and provide on-going review and guidance throughout the rate setting process Work directly with clients on emerging and/or unique challenges facing their programs, and leverage the skills and expertise of Mercer actuaries, clinicians, and health policy consultants to design innovative and comprehensive solutions Oversee the drafting of project communications, including rate certification letters and presentations, and act as an actuarial authority that signs rate certification letters and other statements of actuarial opinion Work with project leaders to identify growth and development opportunities for experienced actuaries, junior actuaries, and actuarial students on project teams. Provide guidance, oversight and mentoring for actuarial staff as needed What you need to have: BA/BS degree 10+ years minimum health actuarial experience, with 5+ years of Medicaid actuarial experience Actuarial credentials (ASA, FSA, MAAA) Experience leading large multi-disciplinary teams and large, complex projects What makes you stand out? Medicaid actuarial experience spanning multiple states, programs, health insurers, or Federal agencies and actuarial consulting experience Ability to handle client and project management in a demanding work environment with tight deadlines Experience related to health plan analysis or capitated rate development Why join our team: We help you be your best through professional development opportunities, interesting work, and supportive leaders. We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have impact for colleagues, clients, and communities. Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being. Mercer, a business of Marsh McLennan (NYSE: MMC), is a global leader in helping clients realize their investment objectives, shape the future of work and enhance health and retirement outcomes for their people. Marsh McLennan is a global leader in risk, strategy and people, advising clients in 130 countries across four businesses: Marsh, Guy Carpenter, Mercer and Oliver Wyman. With annual revenue of $24 billion and more than 90,000 colleagues, Marsh McLennan helps build the confidence to thrive through the power of perspective. For more information, visit mercer.com, or follow on LinkedIn and X. Marsh McLennan is committed to embracing a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age background, disability, ethnic origin, family duties, gender orientation or expression, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, veteran status (including protected veterans), or any other characteristic protected by applicable law. If you have a need that requires accommodation, please let us know by contacting reasonableaccommodations@mmc.com. Marsh McLennan is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh McLennan colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one "anchor day" per week on which their full team will be together in person. The applicable base salary range for this role is $150,500 to $301,000. The base pay offered will be determined on factors such as experience, skills, training, location, certifications, education, and any applicable minimum wage requirements. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives. We are excited to offer a competitive total rewards package which includes health and welfare benefits, tuition assistance, 401K savings and other retirement programs as well as employee assistance programs.

Posted 30+ days ago

Sales Ambassador, Healthcare-logo
Sales Ambassador, Healthcare
First Quality Enterprises Incdallas, TX
First Quality was founded in 1989 and has grown to be a global privately held company with over 4,000 employees. Its corporate offices are located in Great Neck, New York, with manufacturing facilities and offices in Pennsylvania, South Carolina, Georgia, and Canada. First Quality is a diversified family of companies manufacturing consumer products ranging from Absorbent Hygiene (adult incontinence, feminine care, and baby care), Tissue (bath and towel), and Industrial (print and packaging materials), serving institutional and retail markets throughout the world. First Quality focuses on private label and branded product lines. We are seeking a Sales Ambassador, Healthcare for our First Quality Products, LLC working remotely from Texas. This position will be responsible for hunting and closing new Healthcare opportunities in assigned territory for First Quality's full range of absorbent and wipe product lines. Also, maintain existing Healthcare business in assigned territory or accounts. Primary responsibilities include: Work closely and effectively with internal teams and distributors to achieve company and customer objectives. Develop, grow, and maintain an active and robust sales pipeline. Identify potential new Healthcare opportunities by researching and uncovering new potential opportunities. Utilize sales reports and data to analyze business to determine customer needs and develop strategic plan. As necessary travel to customers to support closing and maintaining accounts. Represent company to promote our products and programs at trade shows, conferences, and other association meetings Understand the needs and expectations of the customer and provide relevant solutions The ideal candidate should possess the following: 2 years of Sales Experience preferred. Bachelor's degree preferred. Demonstrated sales skills and success at regionally sized accounts. Excellent verbal and written communication skills. Proficient analytical skills. Comfortable and effective presenter digitally and virtually. Standard knowledge of Microsoft Office Suite. Word, PowerPoint, and Excel. Creative thinking, possess ability to resolve critical problems Ability to work independently as well as in a team environment Understanding of Healthcare industry and current with trends. Effectively communicate throughout First Quality their customers/territory and trends Travel within Territory as needed and some travel outside of territory for meetings and industry events. Expect 25-50% overnight travel First Quality is committed to protecting information under the care of First Quality Enterprises commensurate with leading industry standards and applicable regulations. As such, First Quality provides at least annual training regarding data privacy and security to employees who, as a result of their role specifications, may come in to contact with sensitive data. First Quality is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, sexual orientation, gender identification, or protected Veteran status.

Posted 3 weeks ago

Project Architect - Healthcare-logo
Project Architect - Healthcare
Shlemmer Algaze AssociatesCulver City, CA
project architect - healthcare SUMMARY SAA is seeking a passionate and committed Healthcare Project Architect to join a highly collaborative and dynamic Healthcare Team with tremendous opportunities for growth. The ideal individual will have 10+ years of experience and knowledge of healthcare architecture planning and design, with excellent verbal and written communication skills. You are capable of leading a healthcare team and making client presentations across all phases of small to mid-size projects, including strong technical & project knowledge, and delivering exceptional healthcare projects on time and on budget. RESPONSIBILITIES (Include the following, other duties may be assigned) Lead team and client through programming & design through construction administration of ambulatory healthcare facilities, on-campus and skilled nursing facilities. Develop and maintain strong client relationships. Responsible for deploying resources to ensure that the design process flows smoothly, acting as the primary liaison between the team and the client to bring the design, schedule, budget and scope of work to completion. Concurrently implement and manage the design of several small to mid-size projects. Collaborate and consultative in approach, working effectively with internal and external resources. Has a complete understanding of sequencing and coordination of healthcare project-related MEP and structural engineering as well as all vendor contracts. Understands the lease transaction process and SAA's role in the process. Current working relationships within the local Healthcare Real Estate community. Facilitates firm and project goals of excellent customer service, design, & execution with respect & integrity. SUPERVISORY RESPONSIBILITIES Depending on experience and possible concurrent assignment to Project Architect role, may directly supervise up to 8 employees in the department. If so, carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or EXPERIENCE Bachelor's degree (B.A.) or Bachelor's of Architecture (B.Arch) from college or university or 10 years' progressive relevant experience and training or equivalent combination of education and experience 10+ years' of relevant experience Professional Architectural License (CA) preferred Advanced credentials desired (CHID, ACHA, EDAC, LEED, WELL, Fitwel, etc.) Proven experience with HCAI/OSHPD-3/OSHPD-1 construction/design process, and knowledgeable about the different healthcare segments, including institutional, ambulatory, and business occupancy environments, inpatient and outpatient Intimate knowledge and understanding of FGI, IBC and NFPA as applicable to healthcare projects Familiar with current trends of healthcare delivery, emerging technology, various diagnostic modalities, and it's impact on new concepts of patient and staff flow as it relates to medical planning Demonstrates responsiveness to the technical implications of design decisions Excellent management, organizational, negotiation, communications skills, and interpersonal skills, both written and verbal Excellent decision-making and problem-solving skills Excellent administrative, organizational and time management skills Expertise in building relationships, fostering trust, and dealing effectively with a wide range of individuals and work in a team environment Ability to effectively perform in a fast paced, deadline driven environment Working knowledge of REVIT and CAD preferred Intermediate MS Office application skills Lifelong learner eager to share knowledge and mentor team members Knowledge of federal, state and local building administrative codes relating to building projects Extensive knowledge of architectural and interiors principles/practices that include modern architectural methods and background on solving architectural design and construction problems LIFE AT SAA At our heart, we are a creative firm, and we have fun with what we do. We are a tight knit community, supporting each other in and out of the office. We understand work/life integration and encourage our employees to bring their personal experiences and passions into their roles. Innovation is the key to our success and that comes from everyone sharing ideas and exploring ways to make the industry, firm, and your job better. We also believe the best ideas come from those passionate about their company and continually look for ways to bring enjoyment into the workday. We offer full benefits and fun employee perks including: Medical, Dental and Vision Plans (including 2 at no cost to the employee medical options and dependent coverage is available) 14 paid holidays per year Tiered Paid Time Off (PTO) starting at 18 days/year 401(k) Plan with employer match Voluntary Life Insurance Casual work attire, complimentary snacks, drinks and office events. There is also free parking at select office locations. WORK ENVIRONMENT We're team oriented and have fun while designing amazing spaces! The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to success fully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand; sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee must frequently lift and/or move up to 10 pounds and occasionally up to 35 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. POSITION TYPE/EXPECTED HOURS OF WORK This is an Exempt Full-Time position. Typical days and hours of work are Monday through Friday to be discussed with direct supervisor. TRAVEL This position requires up to 25% local travel. Limited travel may include attending meetings and work sessions in other SAA Offices, Client Offices, or Job Site. Mileage will be reimbursed at predetermined market rate. Individual must possess a valid driver's license with a good driving record and have reliable transportation. Travel expenses will be reimbursed and per diem provided when appropriate. AAP/EEO Statement SAA is an equal opportunity employer; applicants are considered without discrimination with regard to race, color, religion, sex, national origin, age, disability, veteran status or other statuses protected by state, local or other applicable laws. Applicants must be authorized to work for ANY employer in the U.S. We are currently unable to sponsor or take over sponsorship of an employment Visa. OTHER DUTIES Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Posted 30+ days ago

Senior Healthcare Project Architect-logo
Senior Healthcare Project Architect
NbbjSan Diego, CA
We are an award-winning design firm, fueled by ideas and a culture of collaboration. Our purpose-driven approach creates healthy places, strong communities and a resilient environment. That's where you come in. With leading clients, diverse colleagues and offices in creative capitals around the globe, a career at NBBJ will inspire you to be extraordinary and help create lasting change. You can learn more about our firm, see what it's like to work here and explore recent projects and ideas at NBBJ.com. Join us to make an impact today! The role at a glance: NBBJ is seeking a Senior Project Architect for our Healthcare Practice to be located in our San Diego office. NBBJ is looking for a project architect with demonstrated experience working on HCAI 1/OSHPD 1 projects in California and who has worked primarily with large-scale, healthcare projects involving client contact and leadership responsibilities. The Senior Project Architect performs architectural design and delivery for a wide variety of projects involving the construction of new buildings and the alteration of existing buildings and facilities. In your new role, you will: Work with clients and team members to identify objectives, develop options, and formulate creative solutions. Interpret design concepts by collaborating with project team and translate them into workable construction systems and detailing, while maintaining design intent and advocating for design excellence. Prepare appropriate documentation and deliverables from schematic design through construction administration in accordance with established firm and industry standards. Maintain appropriate records for project phases in accordance with established firm and industry standards. Lead and coordinate the work of other team members and consultants, providing direction, guidance, and mentoring as appropriate. May participate in marketing efforts, including proposal development, presentations, and client interviews. What you will need to succeed: Minimum 15 years of experience in the architectural field with successful experience in the documentation and delivery of large-scale healthcare projects HCAI 1/OSHPD 1 experience is mandatory for this role Demonstrated experience working on healthcare projects in the state of California Fluency in Revit B Arch or M Arch degree Architectural Licensure; LEED or other sustainability accreditation preferred. Proven ability to work within a highly collaborative team environment Excellent communication skills and strong attention to detail Ability to work with integrity, trust and commitment; setting an example for others Ability to travel as the project(s) requires The annual base pay range for this role is anticipated to be between $115,000 and $140,000. Actual compensation for successful candidates will be carefully determined based on a number of factors, including their skills, qualifications and experience. Why choose NBBJ? We believe that all NBBJ employees should love their work. This means not only loving what you do but having pride in your workplace. We strive to be that irresistible place to work by enhancing your employee experience with customized programs and comprehensive benefits. In addition to 100% covered employee healthcare costs and 401k contributions, we offer unique professional development opportunities, volunteer opportunities and access to leading technology and resources to further help you love your work and advance your career. NBBJ has been named three times by Fast Company as one of the most innovative architecture firms. Founded in 1943, our first office opened over 75 years ago in Seattle, Washington. We now have over 10 office locations around the globe. We are a transdisciplinary, cross-practice focused firm with a deep portfolio of Civic & Cultural, Commercial, Corporate, Healthcare, Higher Education, Science and Technology, Sports, and Urban Environment projects. We also have several areas of service expertise including: Architecture, Environmental Graphic Design, Interior Design, Lighting Design, Workplace Consulting and more. In the past decade, NBBJ has received more than 300 awards from leading global, national and regional award programs across the business, real estate and design communities. We work with 5 of the top global high-tech companies, 14 of the U.S. News and World Report Top Hospitals, and 4 of the top 10 highest-ranked learning institutions. Our clients include institutional leaders such as Cambridge University, Google, Samsung, Cleveland Clinic, Tencent, and Stanford University. NBBJ is an Equal Opportunity Employer. M/F Disabled and Vet EEO/AA Employer. NBBJ does not accept unsolicited resumes or similar submissions from third party recruiters or employment agencies. Any unsolicited materials received by NBBJ from a source other than an individual candidate will be considered NBBJ property and NBBJ reserves the right to pursue and hire candidates referred to us without any financial obligation to the third party in question. If you are interested in becoming an approved NBBJ external recruiter, please contact a member of the NBBJ Talent Acquisition Team.

Posted 30+ days ago

Medical Assistant - Internal Medicine, Crystal Run Healthcare-logo
Medical Assistant - Internal Medicine, Crystal Run Healthcare
UnitedHealth Group Inc.Monroe, NY
Excellent benefits within 30 days, PTO, paid holidays, 401K , tuition reimbursement and more! Opportunities with Optum in the Tri-State region (formerly CareMount Medical, Crystal Run Healthcare, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind Caring. Connecting. Growing together. The role of the Medical Assistant for Internal Medicine is to provide care to patients/significant others via direct and/or telephone contact, following established standards and practices. S/he coordinates with other members of the care team to ensure seamless care delivery, maximal coordination of efforts, and active patient participation in planning and care. Assists physician or other provider with clinical procedures. Primary Responsibilities: Demonstrates clinical competence in the direct care of patients in established area(s) of practice, and assisting MDs with procedures Performs clinical duties within scope of practice complying with the accepted department standards, policies, and protocols Demonstrates a proactive approach to patient care, focusing on addressing each patient's individual and family needs at the time of service; communicates identified needs in a timely manner Directs and/or escorts patients to exam rooms in a timely manner Demonstrated clinical competence when assisting physician/mid-level healthcare professional and/or nurse during exams and office diagnostic procedures/treatments Performs authorized procedures competently (i.e. vital signs, vision screening, selected laboratory tests) as directed by physician or nurse in clinical practice area Seeks validation/guidance from physicians, mid-level healthcare professional and/or nurse when necessary Prepares e-prescriptions for processing to pharmacies when instructed to do so by physician Inspects, cleans/prepares and processes instruments/equipment according to medical guidelines Processes specimens for transport to laboratory, ensuring that specimens are properly labeled and appropriate orders have been placed in Epic 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 Qualification: 1+ years of clinical experience in a medical office, clinic or hospital setting Preferred Qualifications: Graduate of an accredited medical assistant program with 1+ years of recent experience as a medical assistant Current CPR / BLS certification The hourly range for this role is $16.00 to $24.42+ per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group 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). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group 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. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Posted 3 weeks ago

Manager- Healthcare Consulting-logo
Manager- Healthcare Consulting
EisnerAmperAustin, TX
Job Description At EisnerAmper, we look for individuals who welcome new ideas, encourage innovation, and are eager to make an impact. Whether you're starting out in your career or taking your next step as a seasoned professional, the EisnerAmper experience is one-of-a-kind. You can design a career you'll love from top to bottom - we give you the tools you need to succeed and the autonomy to reach your goals. EisnerAmper is seeking a Manager for our Health Care Consulting Group. In this role, you will focus on client service projects pertaining to Hospitals and Medical Centers, Physician Practices and Networks, Government Entities, and Accountable Care Organizations. In addition, you will be responsible for supervising senior staff to execute client engagements while managing multiple client projects. What it Means to Work for EisnerAmper: You will get to be part of one of the largest and fastest growing accounting and advisory firms in the industry You will have the flexibility to manage your days in support of our commitment to work/life balance You will join a culture that has received multiple top "Places to Work" awards We believe that great work is accomplished when cultures, ideas and experiences come together to create new solutions We understand that embracing our differences is what unites us as a team and strengthens our foundation Showing up authentically is how we, both as professionals and a Firm, find inspiration to do our best work What Work You Will be Responsible For: Manages the client engagement team through all phases of a project, including strategic planning, work planning, mobilization, execution, and closeout to meet the scope, schedule, and budget Experience advising healthcare clients on end-to-end revenue cycle operations, including patient access, charge capture, coding, billing, claims management, and collections Proven ability to assess and improve RCM processes to enhance reimbursement, reduce denials, and decrease days in A/R. Lead RCM transformation projects such as workflow redesign, technology implementation or vendor optimization Exhibits excellent client service skills including the identification of opportunities to provide additional services to clients and/or non-clients. Supports business development activities including client relationship development, program-specific positioning activities, teaming arrangements, proposal preparation, presentations, and contract negotiations consistent with established business development processes. Builds and maintains a growth pipeline, gather referrals, and maintain extensive knowledge on the firm's service lines and offerings, as well as market conditions and penetration of services and solutions. Serves as one of the firm's primary contacts with the client and provides timely communication with client leadership as well as the firm's leadership. Strong involvement in client deliverables May be required to occasionally work extended hours, or travel to/work from different firm offices and/or client locations Basic Qualifications: Bachelor's degree in Business, Health Administration, or related field is required 2+ years in a management or supervisory role 5+ years of related and progressive health care management consulting or health care financial and operations experience Revenue Cycle Management experience is required Preferred/Desired Qualifications: Ability to travel up to 30% Master's Degree in Business, Health Administration, or related field is preferred EisnerAmper is proud to be a merit-based employer. We do not discriminate on the basis of veteran or disability status or any protected characteristics under federal, state, or local law. About our Healthcare Sector Services Group: The Health Care Consulting Group provides tailored services to a wide range of clients: hospitals and health systems, academic medical centers, physician and ancillary services practices, entrepreneurs and PE Firms, managed care entities and government agencies. EisnerAmper assists our health care clients in creating and maintaining a value-based network, implementing positive operational improvements and building sustainable plans to meet strategic, financial and growth goals. The Health Care Consulting Group takes a hands-on approach to optimize performance and revenue through improved operations, governance structures and planning processes while leveraging data and analytics. The team has significant experience with deal structure design, valuation, and negotiations, as well as value-based contracting and assessing clinical programs. About EisnerAmper: EisnerAmper is one of the largest accounting, tax, and business advisory firms, with approximately 450 partners and 4,500 employees across the world. We combine responsiveness with a long-range perspective; to help clients meet the pressing issues they face today and position them for success tomorrow. Our clients are enterprises as diverse as sophisticated financial institutions and start-ups, global public firms, and middle-market companies, as well as high net worth individuals, family offices, not-for-profit organizations, and entrepreneurial ventures across a variety of industries. We are also engaged by the attorneys, financial professionals, bankers, and investors who serve these clients. Should you need any accommodations to complete this application please email: talentacquisition@eisneramper.com #LI-LH1 #LI-Hybrid #LI-Remote Preferred Location: New York For NYC and California, the expected salary range for this position is between 85000 and 150000 The range for the position in other geographies may vary based on market differences. The actual compensation will be determined based on experience and other factors permitted by law.

Posted 1 week ago

Senior Software Engineer - Healthcare-logo
Senior Software Engineer - Healthcare
LiveRampSan Francisco, CA
LiveRamp is the data collaboration platform of choice for the world's most innovative companies. A groundbreaking leader in consumer privacy, data ethics, and foundational identity, LiveRamp is setting the new standard for building a connected customer view with unmatched clarity and context while protecting precious brand and consumer trust. LiveRamp offers complete flexibility to collaborate wherever data lives to support the widest range of data collaboration use cases-within organizations, between brands, and across its premier global network of top-quality partners. Hundreds of global innovators, from iconic consumer brands and tech giants to banks, retailers, and healthcare leaders turn to LiveRamp to build enduring brand and business value by deepening customer engagement and loyalty, activating new partnerships, and maximizing the value of their first-party data while staying on the forefront of rapidly evolving compliance and privacy requirements. Your team will: Work with cutting-edge privacy enhancing technologies for safeguarding healthcare data Be responsible for quality and reliability of our systems Be responsible for POC's, including engagement with Product and Customers to determine viability for further scale. Enhance security and privacy controls to maintain HIPAA compliance About you: Minimum 6+ years software engineering experience Have a startup personality and enjoy working as part of a cross-functional team: smart, ethical, friendly, hard-working, and productive. Experience using Java/ Python Have 3+ years of experience writing and deploying object-oriented production code. Have 2+ years of experience using cloud-based platforms such as GCP, AWS, Azure or similar technologies. Have 3+ years of experience with Kubernetes, building services, networking Strong ability to break down complex problems into their essential components, design and implement elegant solutions. Have a passion for building large-scale distributed systems and are comfortable writing maintainable and high-performance code. Comfortable evaluating and adapting to the latest tools and technologies. You love mentoring junior engineers and deploying software that conforms to best practices. Excellent communication and presentation skills. Bachelor of Science in Computer Science or related degrees. Bonus Points: Have worked at a startup or have helped build brand new products Experience with Spark, SQL, Data Lakes like Snowflake, BigQuery, SingleStore Exposure to analytics, machine learning, or data mining The approximate annual base compensation range is $163,000 to $195,500. The actual offer, reflecting the total compensation package and benefits, will be determined by a number of factors including the applicant's experience, knowledge, skills, and abilities, geography, as well as internal equity among our team. Benefits: People: Work with talented, collaborative, and friendly people who love what they do. Fun: We host in-person and virtual events such as game nights, happy hours, camping trips, and sports leagues. Work/Life Harmony: Flexible paid time off, paid holidays, options for working from home, and paid parental leave. Comprehensive Benefits Package: LiveRamp offers a comprehensive benefits package designed to help you be your best self in your personal and professional lives. Our benefits package offers medical, dental, vision, life and disability, an employee assistance program, voluntary benefits as well as perks programs for your healthy lifestyle, career growth and more. Savings: Our 401K matching plan-1:1 match up to 6% of salary-helps you plan ahead. Also Employee Stock Purchase Plan - 15% discount off purchase price of LiveRamp stock (U.S. LiveRampers) RampRemote: A comprehensive office equipment and ergonomics program-we provide you with equipment and tools to be your most productive self, no matter where you're located More about us: LiveRamp's mission is to connect data in ways that matter, and doing so starts with our people. We know that inspired teams enlist people from a blend of backgrounds and experiences. And we know that individuals do their best when they not only bring their full selves to work but feel like they truly belong. Connecting LiveRampers to new ideas and one another is one of our guiding principles-one that informs how we hire, train, and grow our global team across nine countries and four continents. Click here to learn more about Diversity, Inclusion, & Belonging (DIB) at LiveRamp. LiveRamp is an affirmative action and equal opportunity employer (AA/EOE/W/M/Vet/Disabled) and does not discriminate in recruiting, hiring, training, promotion or other employment of associates or the awarding of subcontracts because of a person's race, color, sex, age, religion, national origin, protected veteran, disability, sexual orientation, gender identity, genetics or other protected status. Qualified applicants with arrest and conviction records will be considered for the position in accordance with the San Francisco Fair Chance Ordinance. California residents: Please see our California Personnel Privacy Policy for more information regarding how we collect, use, and disclose the personal information you provide during the job application process. To all recruitment agencies: LiveRamp does not accept agency resumes. Please do not forward resumes to our jobs alias, LiveRamp employees or any other company location. LiveRamp is not responsible for any fees related to unsolicited resumes.

Posted 3 weeks ago

Healthcare Therapeutics Associate Analyst-logo
Healthcare Therapeutics Associate Analyst
T. Rowe PriceBaltimore, MD
At T. Rowe Price, we identify and actively invest in opportunities to help people thrive in an evolving world. As a premier global asset management organization with more than 85 years of experience, we provide investment solutions and a broad range of equity, fixed income, and multi-asset capabilities to individuals, advisors, institutions, and retirement plan sponsors. We take an active, independent approach to investing, offering our dynamic perspective and meaningful partnership so our clients can feel more confident. We believe doing the right thing for our clients and our associates is good business. With a career at the firm, you can expect opportunities to create real impact at work and in your community. You'll enjoy resources to support your career path, as well as compensation, benefits, and flexibility to enrich your life. Here, you'll find a collaborative culture that respects and values differences and colleagues who share a spirit of generosity. Join us for the opportunity to grow and make a difference in ways that matter to you. Role Summary The Associate Analyst provides fundamental equity research support for our therapeutics analyst 3-5 year structured program offering extensive training and mentoring, designed to develop future analysts Exceptional performers have potential to be promoted to Equity Research Analyst Diverse responsibilities including company/industry related research projects, collaboration with portfolio managers, and extensive financial analysis Opportunity to interact with public company CEOs and CFOs both in our offices and on the road Daily opportunity to learn directly from our senior investment professionals Expectation to provide investment insight and impact the investment process, not just number crunching Competitive compensation with significant upside potential for high performers Qualifications Required: Bachelor's Degree required with a strong academic background AND 1-2 years relevant work experience Demonstrated ability to derive meaningful insights from in-depth clinical research and analysis Preferred: Intellectual curiosity and a demonstrated ability to conduct in-depth thematic research across a broad spectrum of topics which can be additive to the investment process Strong Excel and financial modelling skills including previous experience building three-statement models Highly motivated, confident self-starter with ability to work independently and with others Effective communication skills (verbal and written) Completion of at least level 1 of the CFA preferred FINRA Requirements FINRA licenses are not required and will not be supported for this role. Work Flexibility This role is eligible for hybrid work, with up to one day per week from home. Base Salary Ranges Please review the job posting for the location of this specific opportunity. $110,000.00-$140,000.00 for the location of: Maryland, Colorado, Washington and remote workers $110,000.00-$140,000.00 for the location of: Washington, D.C. $110,000.00-$140,000.00 for the location of: New York, California Placement within the range provided above is based on the individual's relevant experience and skills for the role. Base salary is only one component of our total compensation package. Employees may be eligible for a discretionary bonus, which is determined upon company and individual performance. Commitment to Diversity, Equity, and Inclusion At T. Rowe Price, our associates are our greatest asset. We thrive because our company culture is built on inclusion and because we sustain a work environment where associates can bring their best selves to work every day. The backgrounds, talents, and experiences of our global associates allow us to embrace new ideas and perspectives that move our business priorities forward and enable us to deliver strong client outcomes. Here, you can expect equal opportunity and fair and consistent treatment for all. Benefits We value your goals and needs, at work and in life. As an associate, you'll be supported with resources, benefits, and work-life balance so you can thrive in ways that matter to you. Featured employee benefits to enrich your life: Competitive compensation Annual bonus eligibility A generous retirement plan Hybrid work schedule Health and wellness benefits, including online therapy Paid time off for vacation, illness, medical appointments, and volunteering days Family care resources, including fertility and adoption benefits Learn more about our benefits. T. Rowe Price is an equal opportunity employer and values diversity of thought, gender, and race. We believe our continued success depends upon the equal treatment of all associates and applicants for employment without discrimination on the basis of race, religion, creed, color, national origin, sex, gender, age, mental or physical disability, marital status, sexual orientation, gender identity or expression, citizenship status, military or veteran status, pregnancy, or any other classification protected by country, federal, state, or local law.

Posted 2 weeks ago

Healthcare Consulting Associate - CDI Inpatient Pediatrics-logo
Healthcare Consulting Associate - CDI Inpatient Pediatrics
Huron Consulting GroupChicago, IL
Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise. Join our team as the expert you are now and create your future. At Huron, An Associate leads with expertise and collaboration, partnering with Huron and client leaders to create sustainable solutions that drive meaningful results. As an Associate, with our Healthcare CDI team, you will lead one or more project work streams utilizing Huron approaches, methodologies helping clients solve their business challenges to advance their clinical and financial outcomes. You'll work on varied projects, gain valuable, hands-on consulting and change management experience, while positively impacting mission-driven healthcare organizations. Your role will foster a supportive, inclusive environment, empowering team members and creating a workplace where diverse perspectives are valued. You will build critical leadership skills to grow your career and mentor junior Huron staff. This allows you to make an impact and provide you career opportunities both within and beyond your areas of expertise. If you're passionate about driving impactful solutions and believe in the power of collaboration, Huron offers a rewarding path forward. As the Healthcare Consulting Associate in CDI, you will: Partner with project team members and client stakeholders to design and implement effective solutions by leveraging proven methodologies and best practices Leverage critical thinking skills in both data collection and complex analysis identifying data gaps and risks to develop sound conclusions and create implementable, sustainable recommendations for improvement Effectively summarize information and present findings and recommendations to varying levels of Huron and client leadership Provide direct supervision of junior project team members including coaching mentorship, leading teams, and providing feedback through performance management Deliver solutions tailored to each client's unique needs, enhancing both impact and accessibility across healthcare services Requirements: Registered Nurse with BA/BS in Nursing a minimum of 3 years of acute care hospital experience in pediatrics US licensed Physician, Physician Assistant/Associate or Nurse Practitioner may be substituted for RN CCDS or CDIP certification (certification required within 6 months of exam eligibility after date of hire) Relevant experience in a project-based operations performance improvement role within a hospital/clinical setting hospital and/or consulting firm environment focused on healthcare provider operations and/or process re-engineering projects Strong leadership and management skills aligning to Huron's core values and competencies Willingness and ability to travel up to 80% (Monday-Thursday with occasional onsite Fridays) and work extended hours as needed Proficiency in Microsoft Office (Word, PowerPoint, Excel) US Work Authorization required Preferences: A minimum of 3 years in a clinical documentation integrity role Experience in a matrixed organization or cross-functional team environment Proficiency with 3M/Solventum CPRS or similar coding software #LI-CM1 The estimated base salary range for this job is $100,000 - $130,000. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes, and required travel. This job is also eligible to participate in Huron's annual incentive compensation program, which reflects Huron's pay for performance philosophy. Inclusive of annual incentive compensation opportunity, the total estimated compensation range for this job is $112,000 - $153,400. The job is also eligible to participate in Huron's benefit plans which include medical, dental and vision coverage and other wellness programs. The salary range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future. Position Level Associate Country United States of America

Posted 1 week ago

CNA Financial Corp. logo
Complex Claims Consultant (Healthcare)
CNA Financial Corp.Irvine, CA
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Job Description

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.

Start the next chapter of your career as a Complex Claims Consultant in Healthcare for CNA Insurance. CNA is a market leader in insuring healthcare providers and facilities, including physicians, nurses, nurse practitioners, dentists, physical therapists, counselors, pharmacists, massage therapists and more than 100 other categories of medical service providers, along with the facilities and practices in which they work. This role will support the Healthcare business and interact with these key customers.

You will be responsible for the overall investigation, management and resolution of Healthcare professional liability claims in multiple states. You will be recognized as a technical expert in the interpretation of complex or unusual policy coverages. Under general management direction, you will work within defined authority limits, to manage professional liability healthcare claims with moderate to high complexity and exposure in accordance with company protocols, quality and customer service standards. You will also partner with internal business partners such as Underwriting and Risk Control, to share claim insights that aid in good underwriting and risk management decisions.

The individual will work with insureds, attorneys, other insurers and account representatives regarding the handling and/or disposition of complex litigated and non-litigated claims in multi-state jurisdictions. The individual will investigate and resolve claims, coordinate discovery and team with defense counsel on litigation strategy. They should be able to utilize claims policies and guidelines, review coverage, determine liability and damages, set financial reserves, secure information to negotiate and settle claims.

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:

  • Manages an inventory of highly complex healthcare professional liability claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
  • Ensures exceptional customer service by managing all aspects of the claim, interacting professionally and effectively, achieving quality and cycle time standards, providing timely updates and responding promptly to inquiries and requests for information.
  • Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language, estimating potential claim valuation, working with counsel and following the company's claim handling protocols.
  • Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
  • Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts where necessary, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
  • Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner.
  • Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation.
  • Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely.
  • Keeps leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct summaries to senior management.
  • Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
  • Mentors, guides, develops and delivers training to less experienced Claim Professionals.

May perform additional duties as assigned.

Reporting Relationship

Typically Director or above

Skills, Knowledge & Abilities

  • Thorough knowledge of the professional liability insurance industry, products, policy language, coverage, and claim practices.
  • Strong communication and presentation skills both verbal and written, including the ability to communicate business and technical information clearly.
  • 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.
  • Strong work ethic, with demonstrated time management and organizational skills.
  • Ability to work in a fast-paced environment at high levels of productivity.
  • Demonstrated ability to negotiate complex settlements.
  • Experience interpreting complex insurance policies and coverage.
  • Ability to manage multiple and shifting priorities in a fast-paced and challenging environment.
  • Knowledge of Microsoft Office Suite and ability to learn business-related software.
  • A commitment to collaboration and demonstrated ability to value diverse opinions and ideas.

Education & Experience:

  • Bachelor's Degree or equivalent experience. JD a plus.
  • Typically a minimum six years of relevant experience, preferably in claim handling, healthcare/medical malpractice litigation.
  • Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
  • Professional designations are a plus (e.g. CPCU).

#LI-KP1

#LI-Hybrid

In Chicago/New York/California, the average base pay range for the Complex Claims Specialist role is $113,000 to $160,000. 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 $72,000 to $141,000 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.