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Asst Med Ctr Administrator, Quality & Regulatory Svcs

Qualifications: Bachelor�s Degree in Healthcare, Public, or Business Administration, or relatedfield required. Master�s Degree preferred. Five (5)+ years general management experience in acomplex, multi faceted health care setting and in working with a large physician group practicemanaging through influence and collaboration required. Three (3)+ years supervisory experience toinclude but not limited to, disciplinary actions, training, employee development / assessment, andwage and hour regulations. Three (3)+ years experience in financial management, budget development, program development, quality improvement and project management. Strong communication, presentation,leadership, analytical and problem solving skills required. Significant knowledge of applicablefederal and state laws and regulations related to health care (i.e., Knox Keene Act, Federal HMOAct, Public Employees�, JACHO, NCQA) and all applicable Medicare and Medi Cal regulations and NURSEPRACTICE ACT. Consistently demonstrates the knowledge, skills, abilities, and behaviors necessary toprovide superior and culturally sensitive service to each other, to our members, and to customers,contracted providers, and vendors.Preferred Qualifications: Bachelor�s degree in Nursing preferred. Significant knowledge of Title 22in addition to the federal and state laws and regulations related to health care identified above.Knowledgeable in the use of focused performance improvement processes/tools, with the clinicalexpertise necessary to identify, address and improve clinical performance in both inpatient andambulatory settings. Knowledge of Microsoft Project.Duties: Directly and through subordinates, assists Administrator in planning, organizing, directing,and controlling the operation of assigned areas (e.g., general administration, patient care,professional services and/or a combination of these and other services). Contributes toward theoverall development of programs and services to provide for the needs of members, physicians andstaff. Assists Administrator in providing strategic leadership to management to ensure equitabledistribution of resources and delivery of high quality, cost effective health care and efficientmanagement of staff in accordance with goals, objectives, policies, and applicable regulatory agencyrules and regulations. Responsible for the day to day operations by facilitating the development,implementation and monitoring of service, quality and utilization standards; Continually evaluatingand improving the delivery of service by initiating and promoting best practice models. Engagesphysicians and staff in problem solving. Plans, directs, staffs, organizes and evaluates serviceand/or care delivered by staff. Develops, monitors, and controls payroll, non payroll, and capitalbudgets and expenditures for assigned service areas. Hires, fires, performs disciplinary actions,employee training and development, and conducts performance assessments for assigned staff.Contributes to effective and accurate communications, operations, and planning by conducting studiesand reporting findings, and participating in special committees and/or projects. Directly and withsubordinate managers, establishes and maintains operational and performance standards. Monitors andevaluates the overall system of service delivery in terms of ability to meet established targets.Develops short and long term plans to improve service level of department efficiency for each areamanaged. Directly and with Administrator, develops and administers appropriate policies, standards,practices and procedures; With subordinate managers, establishes goals and objectives for eachdepartment; Assures compliance with administrative, legal and regulatory requirements of the HealthPlan Contract and government/ accrediting agencies; Works with management and physicians In Chargeto identify and establish programs and practices which are cost effective and provide qualityservice to members, staff and physicians. Participates in community relations activities to enhancethe image and reputation of the organization in local customer service areas. May represent theorganization in activities involving leaders in business, government, labor, the community at large,Health Plan Members and health care providers in the area. Consistently supports compliance and thePrinciples of Responsibility (Kaiser Permanente�s Code of Conduct) by maintaining the privacy andconfidentiality of information, protecting the assets of the organization, acting with ethics andintegrity, reporting non compliance, and adhering to applicable federal, state and local laws andregulations, accreditation and licenser requirements (if applicable), and Kaiser Permanente�spolicies and procedures. In addition to defined technical requirements, accountable for consistentlydemonstrating service behaviors and principles defined by the Kaiser Permanente Service QualityCredo, the KP Mission as well as specific departmental/organizational initiatives. Also accountablefor consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to providesuperior and culturally sensitive service to each other, to our members, and to purchasers,contracted providers and vendors. Kaiser Permanente is an EEO/AA Employer.

JOB SUMMARY (This is a temporary position that has the possibility to go permanent)The Senior Financial Analyst is primarily responsible for maintaining and analyzing data related to the financial performance of international business ventures. The position is also responsible for compiling and reporting information as requested by the CFO of Methodist International. Must be multi-lingual in order to interface with other top level international client executives Experience - External: DUTIES AND RESPONSIBILITIESConduct market assessments and analysis related to disease states, bed requirements, gender, and age demographics that provide expertise in the type of hospital, clinic, or center that should be established internationally. Preparation of GAP analyses for new international ventures and current clients.Develop various profitability reports including profitability by business, region, and product segments.Complete complex financial analysis including pro-formas and financial components of business plans that evaluate the potential viability of new international ventures.Develop revenue and margin reports comparing actual performance to budget and previous year, and forecast for the different areas of the business supported.Develop forecasting models using market indices, historical trends and other methods. Identify and implement process improvement measures which result in maximizing revenues and/or reducing costs. Must be able to strongly align business goals with measurement indexes.Must be able to travel for customer meetings and assignments on short notice.Design report structures to include financial information specific to new lines of business.Follow all safety rules while on the job. Report accidents promptly and correct minor safety hazards.Demonstrate the components of the I CARE VALUES STATEMENT (Integrity, Compassion, Accountability, Respect, Excellence).Other job duties as assigned -------------------------------------------------------------------------------- Job Title Description - Internal: -- Job Description - Internal: -- Experience - Internal: EDUCATION REQUIREMENTSBachelors degree with a major in Accounting, Finance or Economics required. CPA may be considered as meeting requirement.EXPERIENCE REQUIREMENTSMinimum of 5 years of accounting experience, health care preferred or BIG 4 with global financial services exposure.Must have performed at least 5 business plan response and validations. Previous financial reporting and financial project management experience in healthcare is strongly preferred.SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIREDHigh proficiency in Excel, Access, and PowerPoint. Macros is a must.Excellent verbal and written communication skills.Must have excellent documentation skills.

Become a Cedars-Sinai Employee!

Hours: 8am - 4:30pm Days: Monday - FridayShift Type: DayWeekends: None Job Description: Cedars-Sinai Health System has an opening for a RN, Supervisor Case Review. The Case Review Supervisor will be responsible for the day to day oversight of the Peer Review Process. The supervisor will review correspondence and assist case review coordinators with routine process questions. The Supervisor must demonstrate initiative, resourcefulness and problem-solving skills in applying a detailed knowledge of the responsibilities, functions and underlying management structure of the department and of the larger Health System in organizing and prioritizing work, establishing procedures and systems and ensuring the orderly and timely flow of business. The Supervisor must possess a full understanding of the confidentiality requirements to effectively and legally communicate practitioner related issues. The supervisor will communicate to the Patient Safety Manager all concerns and issues of a non routine nature or potential safety issue. In addition, the supervisor will be responsible for coordinating the Ongoing Professional Practice Evaluation (OPPE) for the medical staff. The Supervisor will have oversight of the Case Review Coordinator who will focus on identifying professional practice trends that impact quality of care and patient safety. The Supervisor will utilize expert clinical knowledge and experience to collaborate with the Case Review Coordinator using the Medical Center and Department specific criteria. Education and Work Experience Preferences: Educational Requirements:Bachelors Degree preferred and course work in healthcare related field preferred.License/Certification/Registration Requirements:Current active licensure as Registered Nurse in California required; Certified Professional in Healthcare Quality preferred

Surgery SchedulerSeeking an experienced individual to coordinate all details involved in scheduling inpatient and outpatient surgeries for various surgical specialties of the Cedars-Sinai Medical Group. Requires 3 years experience as a Surgery Scheduler and strong patient relations and computer skills. Plastic surgery, reconstruction and/or dermatology experience is highly preferred.

Cedars-Sinai Health System, an integrated healthcare delivery system, has the following opening within the Physician Billing Department, located in the Torrance area.

Cedars-Sinai Health System, an integrated healthcare delivery system, has the following opening within the Physician Billing Department, located in the Torrance area. If you are seeking an exciting career opportunity with a world-class organization, take another look at Cedars-Sinai. You will perform professional fee billing and collections activities for Orthopedic specialties. Requires 3 years physician billing experience, CPT & ICD-9 coding, Medicare/MediCal/private insurance experience, excellent customer service skills, as well as excellent verbal & written communication skills.

In the 2009 U.S. News & World Report rankings of Americas Best Hospitals, Cedars-Sinai Medical Center ranked among the top 50 hospitals in America in 11 specialty areas. With precious few hospitals even ranking in one specialty area, that places us in exceptional company. If you consider yourself among the leaders in your filed, we invite you to contribute to a healthcare provider who shares your passion for quality and excellence.In this key assignment, you will leverage your project management and data analysis skills to provide internal and public reporting of hospital quality data on process and outcomes measures. You will work in accordance with the requirements of regulatory, governmental, voluntary agencies and internal entities. Success in this position involves maintaining a knowledge base of measurement definitions/guidelines. In this role, you will adhere to high standards of data integrity and reporting timelines. To qualify, you will have California RN licensure, a Masters degree in Public Health or Health Administration and a background in advanced clinical nursing. You must have at least four years of analytical/statistical experience organizing and synthesizing quantitative and qualitative health care data for clinical and administrative reports and studies. Strong computer and interpersonal skills are essential. We prefer experience with Core Measures or hospital quality reporting.We offer competitive compensation commensurate with qualifications and experience and excellent benefits. Our unique Beverly Hills location is adjacent to downtown Los Angeles, with unlimited access to great shopping, gastronomical delights, cultural diversions and recreational opportunities.Cedars-Sinai welcomes and encourages diversity and is committed to maintaining a drug- and alcohol-free workplace.

In the 2009 U.S. News & World Report rankings of America’s Best Hospitals, Cedars-Sinai Medical Center ranked among the top 50 hospitals in America in 11 specialty areas.

HIPAA Privacy ManagerIn the 2009 U.S. News & World Report rankings of Americas Best Hospitals, Cedars-Sinai Medical Center ranked among the top 50 hospitals in America in 11 specialty areas. With precious few hospitals even ranking in one specialty area, that places us in exceptional company. If you consider yourself among the leaders in your field, we invite you to contribute to a healthcare provider who shares your passion for quality and excellence.We have a management opportunity for a HIPPA Professional to work with the CCO/Privacy Officer in implementing and administering federal and state regulatory requirements on patient privacy and the confidentiality of patient information. Primary customers include physicians and CSHS employees. ESSENTIAL DUTIES: Coordinates HIPAA Privacy rules gap assessment and implementation activities. Serves as in-house consultant on privacy and patient confidentiality issues. Monitors and investigates privacy complaints and violations, to include privacy breaches reportable under federal and/or state law. Participates in implementation of HIPAA privacy standards. Serves as the Compliance Departments principal representative to the IS Security Committee. Provides advice and guidance to the CCO and Privacy Office on HIPAA security issues. Assists with HIPAA security and transactions and code sets gap analyses and implementation activities. Works with a variety of gap analysis tools. Develops and coordinates implementation plan to include an ongoing HIPAA compliance plan. Develops privacy training plan. Serves as a privacy trainer; coordinates all house wide training on HIPAA privacy standards and related state law. Maintains current resources regarding federal and state privacy statutes and regulations. Responsible for assuring compliance with regulatory requirements. Serves as privacy consultant for CS-Link and other system development. Develops and implements auditing plan for HIPAA privacy compliance; assures implementation. Develops and implements record-keeping systems and database tracking systems for HIPAA privacy compliance program, including policies and procedures, training records, logs, and other documentation required for compliance. Co-Chairs the HIPAA Privacy Subcommittee. Serves on and reports to the Corporate Compliance Committee. Performs other duties as assigned or required by the Chief Compliance/Privacy Officer.Educational Requirements: Bachelors degree required. Masters or doctorate degree preferred, especially in the law and/or health information management.Experience: Demonstrated experience in matters relating to patient privacy and the confidentiality of patient health information, project management, systems analysis, and user relations. Demonstrated understanding of health care operations. Competence in software applications for project management, micro-computing including office automation and communications tools. Five to six years of experience in training and education in large organizations, including working with a variety of users (from skilled workers to professional staff). Strong interpersonal skills; able to deal effectively with diverse skill sets and personalities. Excellent oral, written and presentation skills. Ability to effectively interact with patients in resolving privacy complaints. Proven ability to meet deadlines and manage several broad-scope projects at one time. Cedars-Sinai welcomes and encourages diversity and is committed to maintaining a drug- and alcohol-free workplace. EOE.www.cedars-sinai.edu

Known for innovations in patient care, and named a recipient of the Leapfrog Group National Top Hospital Award, Virginia Mason Medical Center is a regional referral, teaching and research center. In addition to our 336-bed hospital, Virginia Mason includes a large downtown clinic complex, neighborhood clinics, an independently funded research center, and Bailey-Boushay House, a skilled nursing facility and day health program for persons with AIDS and other complex nursing needs. Our vision to be the Quality Leader in healthcare is achieved by adopting best practices as standard work and by improving systems via the Virginia Mason Production System (VMPS), which is modeled after the Toyota Production System. At Virginia Mason, we strive to provide the finest health care through an interdisciplinary approach we call Team Medicine, which gives every individual the chance to contribute to the well-being of our patients and the continuing success of our medical center. The Director, Emergency Medicine is responsible for planning and managing patient care which will include oversight of the entire department, including collaboration with providers and ancillary customers. The director will provide vision and leadership to develop and implement strategies and policies to accomplish delivery of services at best possible levels of cost effectiveness and stakeholder satisfaction. This job places strong emphasis on the following outcomes: the achievement of the aggressive development & dissemination of best practices and the cultivation of a highly-effective work unit. This person will need to be a change leader in the department effectively leading physicians and staff incorporating the VMPS system. 1. Manages daily operation of the Emergency Department. Collaboratively establishes priorities to develop short- and long-range plans for changing populations of patients, space management and new programs. This will include progression to a new state of the art Emergency Medicine facility in the new East Wing of the Hospital in late 2010. 2. Provides leadership and direction for all human resources issues within the departments. Recruits, hires, trains, disciplines and supervises staff including completion of performance evaluations and competency assessments. Maintains and updates staff procedure manuals, staff training programs and quality assurance programs. 3. This position will require astute business management of the service line as we move to the new Emergency Department. Develops and manages budget. Ensures cost-effective daily operations and allocation of section resources; develops goals and objectives to correspond with department standards. 4. Acts as a contributing member of the nurse management team. Masters degree in nursing required, Masters in healthcare, or business administration preferred. Licensure as a Registered Nurse in the state of Washington, required. 5 years of increasingly responsible management experience. Extensive clinical and business knowledge of Emergency Medicine is required , which may include appropriate certifications, excellent organization, communication and interpersonal skills, and understanding of budgets and planning. Come join the quality health care leader in Seattle. Be a part of the Virginia Mason team where we offer you not only a competitive salary and comprehensive benefit package, but also a wonderful place to live. Seattle is a vibrant and sophisticated city that offers first-rate restaurants, shopping, theatre and an abundance of outdoor activities. For more information or to apply online visit our website at www.VirginiaMason.org. We are an equal opportunity/affirmative action employer.

This position is responsible for managing all aspects of the departments coding of procedures to ensure correct and compliance processes as well as maximum reimbursement from all carriers.

This position is responsible for managing all aspects of the departments coding of procedures to ensure correct and compliance processes as well as maximum reimbursement from all carriers. The Coding Manager also supervises the coding department in relation to the following: staffing, distribution of work assignments, dissemination of current coding guidelines and modern technology information, reviews and analyzes reimbursement trends in the community for all departments within TMHPO and provides education for physicians and revenue cycle staff. Responsible for managing, tracking and facilitating policies and procedures to maximize reimbursement while maintaining patient and physician satisfaction and adherence to compliance policies.Experience - External:EDUCATION REQUIREMENTS Bachelors degree in a business-related field preferred.Will accept 5 plus years of experience in managing revenue cycle and/or billing operations for a multi-physician clinical practice in lieu of a degree.EXPERIENCE REQUIREMENTSFive years experience with procedural and diagnostic coding, including at least two years of managerial experience. Must have excellent verbal and written communication skills and be able to work independently. Must be able to travel to client sites.Five years of revenue cycle and reimbursement management experience in a healthcare facility.Five years of exposure and involvement with clinic operations and processes.CERTIFICATES, LICENSES AND REGISTRATIONS REQUIREDA nationally recognized coding credential (CPC, CCS-P, CCS or CPC-H) is also required. AAPC or AHIMA is a plus. Experience with facility coding is a plus. SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED1. Must have outstanding Excel and computer skills with experience in scheduling and billing applications.2. A thorough understanding of managed care contracting, CPT/ICD-9 coding, third party and governmental payers, billing and compliance regulations, and computerized billing and collection management systems. 3. Excellent communication skills with the ability to deal effectively with physicians, management, peers, staff, and patients. 4. Must be willing and able to: a) empower, delegate and monitor staff performance, b) encourage the development of innovative and effective solutions by staff, and c) facilitate those solutions to flow through the organization. 5. Motivational and team-building skills important.6. Excellent interpersonal and written communication skills.7. Demonstrated success at independently problem-solving in a high-stress environment.

Research Billing Compliance CoordinatorA full-time opportunity is available for a Research Billing Compliance Coordinator at Lifespan Corporate Services, based in Providence, Rhode Island. Lifespan is a $1 billion not-for-profit health system that includes three teaching hospitals of Brown Medical School: Rhode Island Hospital and its Hasbro Children’s Hospital; The Miriam Hospital; and Bradley Hospital, the nation’s oldest psychiatric hospital for children. Lifespan also includes Newport Hospital, a community-based hospital in Newport, RI. Under general direction of Director Research Administration, incumbent develops and implements policies and procedures to ensure compliant billing of patient care costs to clinical trials and other third party payers. Assesses need for, develops and coordinates training programs related to clinical trials billing practices and regulations. Collaborates with others within and outside research to oversee appropriate billing and collection activities occur for clinical trial contracts. Ensures adherence to hospital policies, sponsor requirements and federal regulations. Requirements:• RI licensed RN or equivalent.• BA in nursing, business administration or related field preferred.• 5 years of related experience, of which 3 years is related to clinical trial and billing within an academic medical center or university. • A thorough knowledge of regulatory, financial and administrative requirements, as well as knowledge of standards of care provided for variety of health issues.