Current Job Opportunities

 JobTitleCityStateJobType
AR-CT-4142VP. Medical Management | RNLittle Rock, ArkansasAR 
CA-SC-R290812Physical TherapistSanta RosaCA 
CA-ST-154545Contract Registered Nurse | RNFall River MillsCAContract
WA-SC-242594Telemetry RN | DaysSeattleWAFull Time
WI-CT-4132VP, Contracting | Network | Provider Engagement StatewideWI 
WI-CT-4141VP, OperationsMilwaukeeWI 
 
Job ID:AR-CT-4142
Job Title:
VP. Medical Management | RN
Rate:
Primary Skills:
Description:
VP, Health Services | Medical Management | Clinical Operations -  Little Rock
___________________________________________________________


VP will be a part of strong & collaborative leadership team with the opportunity to be a key strategist for Medicaid and all other products in this market.
 
     Incredible growth opportunities and perks for this executive role
                GENEROUS relocation & competitive compensation.
 
 ** We are seeking an experienced leader with a proven background in
       an MCO/health plan/ACO. 
 
Direct and coordinate the medical management, quality improvement and credentialing functions for the for the AR market,  establishing the strategic vision and policies and procedures for the entire  Medicaid medical management team.
 
-Direct and coordinate activities of department and aid the chief officer of the health plan and appropriate corporate staff in formulating and administering organizational and departmental policies.
 
-Review analyses of activities, costs, operations and forecast data to determine department progress toward stated goals and objectives.
 
- Serve as a member of management committees on special studies.
 
-Administer and ensure compliance with National Committee on Quality Assurance (NCQA) and/or Joint Commission on Accreditation of Healthcare Organization (JACHO) standards as determined for accreditation of the health plan.
 
•-Participate in, attend and plan/coordinate staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars.
 
-Participate in provider education and contracting, as necessary.
 
Qualifications:
- Bachelor's degree in Nursing, related field or equivalent experience.
 
-10+ years of clinical nursing, quality improvement, and management experience
 
- Leadership experience in a managed care setting.

-Thorough knowledge of a specialized or technical field such as clinical nursing, managed care, and healthcare administration.

- Thorough skills knowledge of quality improvement practices. Working knowledge of medical information systems, medical claims payment process, medical terminology and coding, case management practices, managed care, and Medicaid programs.
 
-Familiarity of National Committee on Quality Assurance (NCQA) accreditation process and standards.
 
-Strong Leadership skills with succession planning experience.
Ability to lead both in person and remote direct reports.
 
-Current  nursing license REQUIRED.
 
 
 
    
 
Job ID:CA-SC-R290812
Job Title:
Physical Therapist
Rate:
$35 to $59/Hr
Primary Skills:
Description:
Full-time Physical Therapist Opportunity in beautiful Humboldt County! Location: Eureka, CASchedule: Full-timeShift: 8-hour, Day Shift This position affords a balance of team work and autonomy. Opportunity for growth Hard working and positive team environment.National Geographic Traveler calls Humboldt County one of the world's top ten great places while the USDA declares this area to be "America's Most Scenic Rural County." St. Joseph Home Care Network (SJHCN) is a Home Health ministry of St. Joseph Health, serving three Northern California counties; Humboldt County, Napa County and Sonoma County. The Physical Therapist provides assessment and treatment of patients requiring physical therapy services within the home care setting. Provides professional physical therapy visits in the home care setting and directs home health services for caseload of patients and their families in accordance with physician’s orders through direct care, supervision and multidisciplinary team coordination. The Physical Therapist is a resource to the Field Staff in the areas of community rehabilitation and individualized rehabilitation needs of the patient. Participates in the utilization review, performance improvement and interdisciplinary conference of the organization. The Physical Therapist reports to Clinical Manager or Registered Nurse designee. Responsibilities:Maintains patient schedules based on orders and authorizations within the Medicare week; submits caregiver schedules timely and accurately; communicates scheduling changes daily; meets productivity standards demonstrating effective time management skills.Supervises the Home Health Aide and Physical Therapy Assistant on assigned therapy-only cases to ensure plan of care is current and effective in progressing the patient towards achieving patient outcomes. The Physical Therapist provides home health aide staff with individualized personal care plans, updates based on the progress of the patient, and coordinates the care plan with other disciplines to support continuity of care. Accurately and thoroughly documents patient care observations, interventions, supply utilization and evaluations and prepares and submits completed documentation of the home care visit within the established time parameters; submits OASIS data within regulatory timelines and agency policy. Makes ongoing therapy assessments, evaluates patient progress, updates the plan of care based on findings, and reports significant changes in the patient’s condition to the physician, appropriate team members and/or Clinical Manager. Maintains patient caseload for case management; coordinates care activities among all disciplines on the care by participating actively in case conferences, identifying additional services needed and discharge planning with multidisciplinary team and other resources to achieve patient outcomes. Instructs patients and caregivers in the use of assistive devices. Treats patients to relieve pain and/or develops or restores function to maintain maximum performance. Evaluates patients for adaptive equipment needs; obtains physician’s orders; and arranges for necessary adaptive equipment. Teaches the patient/family regarding active and passive exercises and the patient’s total physical therapy program. Confers with the physician in developing and revising the plan of care; reporting patient progress status; obtaining and documenting additional orders based on the initial and ongoing assessment of the patient progress; following regulatory guidelines and policies in writing orders. Provides physical therapy services to the patient in the home setting based on the plan of care, authorizations and physician orders following ordered frequencies within the Medicare week; adheres to agency policies and procedures for nursing, infection control, biohazardous waste management, quality improvement activities, safety and risk management practices. Develops and implements plans of care appropriate to the assessment findings and plans for discharge based on the patient’s needs. Completes accurate and current initial medication profile and maintains ongoing updates of the drug profiles in the medical record and home for assigned therapy-only cases under the supervision of the Clinical Manager. The Physical Therapist performs the initial and ongoing assessment of patient’s physical therapy needs and appropriateness for home care; creates and maintains an individualized goal/outcome based care plan based on the physician’s plan of care. Requirements:Education: Graduated from accredited school of physical therapyExperience: 2 years of current PT experience required, home care experience preferred  
 
    
 
Job ID:CA-ST-154545
Job Title:
Contract Registered Nurse | RN
Rate:
33 to 35/HR
Primary Skills:
Description:
 Job descriptionAdminister medications, provide vaccinations and render treatment to pediatric patientsCommunicate with physicians, LPNs, radiologists and other medical professionalsCollaborate with physicians to create a Plan of Care for each patientConsider the age of the patient and his or her emotional stability when determining appropriate treatmentCreate and contribute to patients’ medical records as neededRespond to inquiries, concerns and complaints from patients and their parents or guardiansTrack and maintain medical supply inventory along with other staff membersCounsel patients and family members before, during and after treatmentRequirements:1. Graduate of an accredited school of nursing.2. Current licensure in good standing in the state of California.3. Maintains current CPR certification. 
 
    
 
Job ID:WA-SC-242594
Job Title:
Telemetry RN | Days
Rate:
Primary Skills:
Description:
The Registered Nurse (RN) provides professional, comprehensive nursing care for patients in an acute care environment. Accountable for the delivery of coordinated, safe, compassionate, therapeutic, evidence-based quality care to patients and families, based on individual physical, emotional, and spiritual needs, and appropriate care strategies throughout the lifespan. . In this position you will:Employs Nursing Professional Practice: Assesses, identifies appropriate nursing diagnoses, plans, implements and evaluates patients’ care.Develops, updates and coordinates the patient’s plan of care to achieve patient goals and to optimize outcomes and transitions across the care continuum. Monitors, records and communicates patient condition as appropriate. Performs and maintains currency of essential competencies as required by specific area of hire and populations served.Advocates: Effectively advocates for ethical and holistic care by partnering in care planning to promote the autonomy, dignity, rights, values and beliefs of those we serve.Facilitates Learning: Fosters a learning environment for patient/families, nursing, and other members of the healthcare team including students; facilitates formal and informal learning for patient/families, nursing, other members of the healthcare team, and community.Aligns Practice with Safety and Quality: Accountable for safety, identifies and corrects problems, and integrates evidence, and best practice into nursing care; uses data and evidence to improve patient outcomes. Aligns patient safety, self-safety and environmental safety as equally important for best outcomes. Qualifications:Required qualifications for this position include:Licensed as Registered Nurse in the State of WashingtonAll Registered Nurses without a minimum of a Bachelor’s degree in Nursing must obtain a Bachelor’s degree in Nursing or higher within 6 years of hireA RN with 20 years of RN experience will not be required to obtain a BSNExceptions will be considered on a case-by-case basis at each facility by the most senior administrative nursing leader in consultation with the Human Resources leaderCurrent Basic Life Support Certification (BLS)Current Advanced Cardiac Life Support Certification (ACLS)12 months acute care experience working with the patient population similar to department of hire or completion of the specialty residency located at that facility
 
    
 
Job ID:WI-CT-4132
Job Title:
VP, Contracting | Network | Provider Engagement
Rate:
Primary Skills:
Description:
VP, Contracting | Network | Provider
Engagement - MILWAUKEE


_____________________________________________________________


 


Join an
exceptional leadership team here in
WISCONSIN.  Working closely with a very accomplished CEO, you will have
excellent opportunity for career development.


         GENEROUS
relocation – strong benefits, bonus and equity.


 


VP will
lead and mentor a team focused on the provider network and contracting
activities. Drive network strategy including, access analysis, network
operations and support decision makers with analysis related to reimbursement
and unit cost management.




Experienced leader will establish the department’s strategic vision,
objectives, and policies and procedures. Develop, implement and maintain
production and quality standards for the Contracting department.




Oversee network development staff and external consultants in the development
of provider networks across expansion markets.




Perform periodic analyses of the provider network from a cost, coverage, and
growth perspective.


Provide
leadership in evaluating opportunities to expand or change the network to meet
Company goals.




Manage budgeting and forecasting initiatives for product lines to networks
costs and provider contracts.




Oversee analysis of claim trend data and/or market information to derive
conclusions to support contract negotiations


.

Conduct periodic review of provider contracting rates to ensure strategic focus
is on target with overall Company strategy.




Support market expansion and M&A activities by leading provider contract
analysis related to due diligence.




Assist health plan CEO and/or COO vendors in key provider relations and
strategy.




Qualifications:




-Bachelor's degree or equivalent experience in Business Administration,
Healthcare Administration or related field.


-MBA or
MHA degree preferred.


-10+
years of experience in managed care network development and provider
relations/contracting management in a health care and/or managed care
environment.


Previous
management experience including responsibilities for hiring, training,
assigning work and managing performance of staff.






NO REMOTE
 
    
 
Job ID:WI-CT-4141
Job Title:
VP, Operations
Rate:
Primary Skills:
Description:
VP, Health Plan
Strategy | Operations- MILWAUKEE


Join this highly successful leadership team in a market that is continuing
to expand and lead change in healthcare.


 

UNLIMITED CAREER POTENTIAL – GENEROUS RELOCATION PACKAGE




VP will partner with multiple stakeholders and senior leadership to establish
and achieve strategic vision and operational objectives.   This will
include oversight for business operations, procurement opportunities, new
product implementations and complex initiatives for business development,
including RFP responses.


-VP will monitor and report achievement of committed action plans to senior
management.


-Direct the development and implementation of operational work processes and
systems with direct oversight for multiple departments.


-Accountable for budget, revenue targets, and Profit & Loss.


-Lead and oversee new business implementation and procurement activities for
all products and complex projects.


-Evaluate program opportunities and recommendations for effectiveness and ROI.


-Serve as a senior liaison between the business unit, corporate, and external
stakeholders.


-Oversee preliminary discovery, due diligence for potential liabilities,
internal control weaknesses, and financial integrity.


Ideal Candidate:


- Bachelor's degree in Business Administration, Finance, Accountancy
or related field.(
Master’s degree preferred)

- 9 + years of operations, management, or administration in the Health Insurance
industry.

-Must have 5+ years in a senior leadership role in broad -based health plan operations

- Experience in business development and/or Request for Proposal (RFP)
experience.

- Extensive knowledge of state legislative and regulatory processes.