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Specializing in you...serving San Diego’s inland North County communities for more than 50 years, Palomar Pomerado Health is a family of outstanding healthcare facilities that cover an area of more than 800-square miles.

Specializing in you...serving San Diego´s inland North County communities for more than 50 years, Palomar Pomerado Health is a family of outstanding healthcare facilities that cover an area of more than 800-square miles. We are the largest hospital district in Southern California and the first California designated health system to receive ANCC Magnet Recognition. From our state-of-the-art Cardiac Care and Rehabilitation Facilities and busy Trauma Center to Home Healthcare, we deliver a full spectrum of health services to meet the needs of every member in our community. Responsibilities:• The development and execution of the strategic plan for the Construction Audit activities of PPH– as part of the Internal Audit plan for the Healthcare District, as approved by the Board Committee. • Work collaboratively with PPH staff, including management, and various levels of construction personnel, including management, provide technical expertise in identifying, control deficiencies which will result in reduced costs, improved quality and efficiency. • Effective in producing clear and supported audit findings, present accurate and timely reports, and present effective presentations of information to all levels of the organization and governing bodies, including the PPH Board and oversight authorities. • Maintain current knowledge on industry trends and standards, be an active member of professional society, develop and deliver written and oral presentations to internal and external audiences. • Possess a thorough understanding of contract audits relating to internal controls and systems such as accounting system, labor system, purchasing system, estimating system and timekeeping system. • Familiar with construction contract terms and conditions and the different types of contracts e.g. cost plus, time and material, lump sum, guaranteed maximum price. • Ability to audit construction contracts, including costs incurred, and various types of change orders. • Conduct operational reviews of procurement systems and /or the construction management process; review contractors bids and proposals; negotiating contract agreements. • Performs other duties as assigned. • Follows PPH rules, policies, procedures, applicable laws, and standards. • Carries out the mission, vision, values, and quality commitment of PPH. We invite you to join us in our Mission to Heal, Comfort, and Promote Health in the Communities We Serve!Requirements Minimum Education: Bachelor´s Degree Preferred Education: Master´s Degree Minimum Experience: - 5 - 6 years of related audit experience, knowledgeable in current audit processes and technologies. - Experience in conversion of complex information systems & related control environments. - Proficiency expected using ACL, Access, Excel, PowerPoint, P.S. Means Cost Works, Windows, Word, Visio. - Willingness and ability to travel Preferred Experience: - 10+ years of clearly progressive, professional development in the general area of accounting and/or auditing- Experience with analysis of complex engineering and construction projects and disputes.- Knowledge/experience in the construction industry.- Knowledge of construction claims, project management, and experience with a Contractor- Management experience of a large group of professionals of 10 or more Preferred Certification: CPA or CIA Required License: Valid Driver´s License

Located on the Alaska Native Medical Center campus, we are a nonprofit Native healthcare organization that incorporates traditional Native values into western practices. We currently have an opening for an Improvement Advisor. This person will be responsible for working with our senior leadership and management team to develop and redesign systems and processes acts as a coach, mentor and lead trainer for the improvement specialist team. If you are an experienced improvement advisor who welcomes adventure and is looking for a new challenge, join our growing team and kindle your spirit! Masters degree or equivalent experience with two years of improvement specialist II experience required. Salary DOE excellent benefits include a generous 401k retirement savings plan, paid leave, 12 paid holidays, employee health coverage and much more, opportunities to advance, relocation assistance offered for this position.

APS Healthcare has an exciting opportunity for a Program Director to manage a call center of approximately 50+ employees, including Supervisors and Managers, servicing the MO HealthNet Health and Wellness participants.

The Program Director is responsible for: Direct the call center operations by developing and implementing processes to achieve clinical quality and productivity metrics and services which exceed the client´s expectations. Oversee hiring, training and development of call center staff to ensure comprehensive services and supports for DM programs is available and maintained at a high productivity rate both in clinical quality and staff performance. Continuously evaluates staff productivity and quality of performance through available telephony and medical management application data, providing daily reports of operations and metrics and other periodic reports to monitor productivity. Use process and outcome data to identify and address opportunities to improve the delivery of services. Works with the client and other APS leadership to identify and develop program offerings to improve the outcomes of the populations served. Identifies cost-efficient strategies to meet contract deliverables for DM services.EDUCATION:Bachelors Degree in business administration or related field required.REQUIREMENTS: Minimum 5 years demonstrated experience in management of call centers in a healthcare environment, e.g. payer, provider, etc. Public sector, e.g. Medicare / Medicaid experience preferred. Strong written and verbal communication skills. Strong computer skills. Expert knowledge of call center best practices and ability to implement said practices. Ability to interpret data from call center and medical management applications and apply that to an analysis of performance and productivity.

WVMC is a multi-specialty medical center with over 250 providers, located in North Central WA State. We are seeking an Asst Dir of Revenue Cycle Mgmt for the daily administrative duties associated with charge capture, management and collection of insurance and patient revenue in the Business Office and the branch campuses. This position has a strong focus on hospital business operations and serves as a key member of the hospital management team. Candidates will have strong working knowledge of front and back office operations as they relate to the revenue cycle. Manages a staff of 80 employees. Requires BA degree or significant relevant exp. Coding cert is pref. Min of 5 yrs previous mgmt exp in a hospital business office reqd. Exp managing in a large healthcare business dept strongly desired.

Radiology practice searching for Assistant Business Office Manager

Washington Radiology Associates, P.C. is a private physician-owned medical practice with full-service imaging centers located throughout DC,VA, MD. We offer the latest technology supported by a staff dedicated to quality patient care. We offer a generous benefits package and competitive compensation. Under the direction of the Business Office Manager, the incumbent assists with the administration of the scheduling, billing, and collections functions of a dynamic diagnostic radiology practice. Additionally responsible for maintaining the radiology information and patient accounting systems that support these functions. Position requires extensive knowledge of the patient revenue cycle and a proven record of success with:- Prioritizing and overseeing accounts receivable- Collecting, posting, and reconciling cash - Minimizing bad debts - Monitoring manage care contract performance - Analyzing and reporting complex billing and reimbursement issues - Understanding rules and laws concerning insurance reimbursement and ability to contend with multiple payer requirements - Effectively communicating, both orally and in writing, with staff members, department managers, and outside agencies *Bachelor´s degree required*Previous supervisory experience required*Minimum 5 years medical billing and collections experience*General experience with outpatient radiology practice preferred*PC proficiency required including the use of word processors, spreadsheets, databases, presentation software, and queries*Familiarity with HL7 and DICOM concepts required*Previous experience maintaining a RIS or patient accounting system preferred

The Association of Womens Health, Obstetric and Neonatal Nurses (AWHONN) is currently recruiting for an experienced sales professional to aggressively sell and market specific association offerings to institutions. Specific duties include: - Manage the sales and marketing of consulting services to hospitals, health systems and other health care settings- Sale offerings to institutional customers, primarily through product-membership bundling. - Collaborate with product marketing staff to establish volume pricing for institutional customers. - Identify opportunities to cross-sell clients to enhance customer penetration - Conduct periodic competitive assessments, integrating market research and analysis in strategic planning and program development. - Work with the marketing team to establish offerings/product-membership bundles for institutions. manage field consultants including recruiting, training and conducting performance evaluations; assign consulting teams for engagements to deliver services based upon client needs- Develop and negotiate contract terms for engagements; develop and implement sales strategy to meet projected revenues and profit objectives. - Collaborate with VP, Marketing to identify and monitor industry trends, identify business opportunities, develop strategic alliances and competitive strategies that will advance the mission of the organization and result in new business opportunities. - In conjunction with VP, marketing monitor budget and adjust forecasts based on identified changes in market. Ideal individual will have a Bachelors degree in Business Administration or Marketing. Masters degree in health care administration, marketing or business administration preferred. Must have demonstrated complex problem solving skills, including interdisciplinary approaches and demonstrated history of working independently and creatively. Must have experience supporting clients in a highly professional manner and demonstrated understanding of customer relations management. Proven track record of health care business development with at least 5 to 7-years of previous management experience including budgetary development, performance accountability and responsibility for multiple business units. Clinical or equivalent hospital experience a plus. Excellent writing skills including technical writing and demonstrated proficiency using Microsoft Office software applications a must. Demonstrated skill with learning needs assessment and staff development. Must be able to develop and negotiate contract terms and conditions. Excellent presentation skills are required. This is a 3 month contract position with possibility of extension or full-time employment. Position located at AWHONN headquarters in Washington, D.C. Limited telecommuting arrangement may be considered.

We provide opportunities for career growth and advancement to employees at all levels.

South Fulton Medical Center, a 338-bed facility located in East Point, GA, has been among those at the forefront in meeting the medical and health care needs of residents of South Fulton, Coweta, Fayette, Clayton and Douglas counties since 1963. South Fulton Medical Center is a JCAHO accredited, community-based hospital known for its friendly and team-oriented work environment. We provide opportunities for career growth and advancement to employees at all levels.We are seeking a Director of Medical Staff Services to join the South Fulton Medical Center team. The Director of Medical Staff Services will manage and supervise the credentialing process, medical staff services functions, graduate medical education compliance and on-call emergency schedule in a hospital setting. The Director will also maintain accreditation knowledge, develop departmental policies, hire and train staff and be proficient in a credentialing focused database, such as ECHO. This individual works closely with administrative and medical staff leadership. Qualified candidates must have designation of CPMSM or CPCS. Candidates with a college degree are preferred. For more than 45 years, South Fulton Medical Center has been providing quality health care services for the families of South Fulton County and surrounding areas. Our competitive benefits package includes a 401(k) savings plan, income replacement, medical/vision/dental/life insurance after 31 days of employment, paid time-off program, online educational program, tuition reimbursement, student loan repayment program and an employee stock purchase plan.

Purpose: Responsible for the education and servicing of providers regarding all aspects of MHP and its subsidiaries. Responsible for assisting in the development of policy, procedures, and educational materials for use with all Provider Programs and for the development of benchmarks to measure performance against MHPs goals. Establishes and maintains effective relationships with key administrative executive staff of contracted medical delivery entities (i.e. physician organizations, physician hospital organizations, faculty groups, large independent groups, hospitals, etc.). Responsible to develop and maintain routine communications with such groups, performing presentations, education, and other activities to support MHPs provider servicing goals. Responsible for contracting of PCPs, Specialists, and Ancillary providers in their defined servicing area. Responsible for claims research and resolution. All duties are to be carried out in collaboration with the contracting staff and other key senior staff as appropriate. Essential Functions and Responsibilities:1.Establishes and maintains effective relationships with key administrative executive staff of contracted medical delivery entities (i.e. physician organizations, physician hospital organizations, faculty groups, large independent groups, hospitals, etc.). 2.Acts as the primary resource and liaison for the medical delivery entities to facilitate effective communication, problem solving, and provide information and data necessary for optimal working relationships with MHP and its subsidiaries.3.Develop and maintain positive relationships with contracted medical delivery entities, including significant time spent out of the office meeting with providers and their office staffs.4.Collaboratively develops and implements strategic plans in collaboration with the contracting staff for provider development.5.Develops and maintains a monitoring system for the business aspects of network services and development.6.Resolves provider related problems related to servicing issues.7.Represents MHP on related internal and external committees and task forces as appropriate.8.Works with MHP designated staff in profiling the quality and financial effectiveness of providers, optimal size of the network, etc. and carries out corrective action plans as appropriate.9.Coordinates network activities with other MHP departments to support membership growth.10.Interfaces with other MHP departments to assist in developing and refining the operational systems to meet the changing needs of the providers, facilities, customers, and MHP corporate objectives. Works collegially with these departments to solve problems.11.Assists in the development of provider training manuals, seminars, etc.12.Make recommendations to senior personnel regarding network expansion, provider compliance issues, etc.13.Responsible for contracting PCPs, Specialists, and Ancillary providers in a defined servicing area.14.Responsible for claims research and resolution.15.Communications: communicates verbally and in writing in a positive, consistent, enthusiastic, and open mannered approach with all internal and external customers. 16.Works independently in a self directed, non-confrontational, collaborative manner.17.Constantly seeks opportunities to improve processes to support more efficient and effective work outcomes.18.Customer Focus: promotes positive internal and external relations by actively seeking and being responsive to customer feedback. Ability to support and participate in continuous quality improvement projects.19.Translates the Vision, Mission, and Leadership traits in to daily interactions with internal and external clients. Exhibit at all times a high level of character that exemplifies the core leadership traits developed by MHP. Demonstrates drive, initiative, and ownership in all endeavors undertaken for the benefit of the Plan.20.Displays high ethical standards.21.Other duties as assigned or when necessary to maintain efficient operations of the department and the Company as a whole.Knowledge and Skills Requirements:Required:1.Associates Degree in business, health care, or related field. An equivalent combination of relevant education and experience may be substituted for the educational requirement.2.Two (2) years experience and knowledge of HMO, PPO, TPA, PHO, and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting, and risk arrangements and actuarial precepts).3.Extensive knowledge of clinical, operational, and regulatory functions of a managed care organization.4.Experience in servicing hospitals, providers, and their office staff5.In-depth understanding of claims administration as it pertains to provider payments, including CPT-4 codes, revenue codes, HCPCS codes, DRGs, etc.6.Ability to handle multiple projects simultaneous and work well in stressful situations.7.Available to work a flexible schedule to meet organizational needs.8.Excellent analytical skills and independent decision making ability.9.Excellent communication, consultancy, facilitation, and conflict resolution skills.10.Strong relationship building skills and the ability to influence others positively. 11.Proficient computer skills including command of Word, Excel, Access, Power Point, and email required.12.Possess ability to interact with all customers, internal and external in professional manner.13.Must have use of a personal vehicle for travel.PREFERRED:-Five years experience in provider contracting and servicing.-Established relationships with providers in MHPs service areas.

McLaren Health Care Corporation is one of the top 25 integrated health care systems in the United States.

Responsible for generating new provider contracting activities within assigned market segments for McLaren Health Plan and its subsidiaries. Professionally and effectively markets the advantages of being a McLaren Health Plan network provider to prospective providers. Generates new contracting opportunities through telemarketing, written communications, and other distribution channels. Responsible for meeting established provider contracting targets. Develops and implement processes to monitor contractual obligations and ensure MHPs compliance with such. Supports all contracting activities of the Network Development Coordinators, including required follow up with such groups to facilitate obtaining provider demographic information required by MHP, ensuring documentation is accurately completed for entry onto the MHP claim system, issuing contract reminders, ensuring contracts are returned and filed, etc. Assists in preparing contracting activity reports and other ad hoc reports as necessary. Responsible for research and resolution of provider claims issues. Identifies process improvement opportunities and develops plans to address opportunities. Essential Functions and Responsibilities:1.Responsible for generating new provider contracting activities within assigned market segments for McLaren Health Plan and its subsidiaries.2.Research and recommend best practices for network development processes. Assist in development and implementation of policies and procedures relative to contracting. 3.Develop and implement processes to monitor contractual obligations and ensure MHPs compliance with such (i.e. annual performance benchmarks, open panels, payment rate changes, etc.).4.Assist in ensuring the Plan meets or exceeds all of the accrediting body, and States regulatory requirements pertaining to provider servicing, contracting, and quality standards.5.Achieves new contracting opportunities through telemarketing, written communications and other distribution channels. 6.Responsible for meeting established provider contracting targets. 7.Supports all contracting activities of the Network Development Coordinators, including obtaining provider demographic information required by MHP, ensuring documentation is accurately completed for entry onto the MHP claim system, issuing contract reminders, ensuring contracts are returned, properly executed and filed, etc.8.Maintains provider prospect databases and spreadsheets.9.Identify and communicate process improvements to the contracting process and data requirements.10.Assists in preparing contracting activity reports and other ad hoc reports as necessary. 11.Responsible for the provider error report, identify areas for improvement, work with servicing staff to educate providers and make corrections, as appropriate.12.Maintains and updates provider directories, weekly or as needed.13.Responsible for claims research and resolution of provider claims issues.14.Identifies process improvement opportunities and develops plans to address opportunities.15.Promotes positive internal and external relations by actively seeking and being responsive to customer feedback. Ability to support and participate in continuous quality improvement projects.16.Research identified issues, develop work plans, including implementation to resolve issues. 17.Communications: communicates verbally and in writing in a positive, consistent, enthusiastic, and open mannered approach with all internal and external customers.18.Works independently in a self directed, non-confrontational, collaborative manner.19.Customer Focus: promotes positive internal and external relations by actively seeking and being responsive to customer feedback. Ability to support and participate in continuous quality improvement projects.20.Translates the Vision, Mission and Leadership traits in to daily interactions with internal and external clients. Demonstrates drive, initiative and ownership in all endeavors undertaken for the benefit of the Plan.21.Displays high ethical standards.22.Other duties as assigned or when necessary to maintain efficient operations of the department and the Company as a whole.Knowledge and Skills Requirements:Required:1.Associates Degree in business, health care or related field. An equivalent combination of relevant education and experience may be substituted for the educational requirement.2.Excellent analytical and problem solving skills.3.Proven computer skills including command of Access, Word, Excel, and email required.4.Excellent organizational skills and ability to handle multiple projects simultaneously.5.Proven sound judgment and diplomacy skills.6.Excellent communication, consultancy, facilitation and conflict resolution skills.7.Strong relationship building skills and the ability to influence others positively. 8.Must have use of a personal vehicle for travel.9.Available to work a flexible schedule to meet organizational needs.Preferred:1.Bachelors degree in business, health care or related field.2.Three (3) years experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting and risk arrangements and actuarial precepts).3.Two (2) years healthcare claims and/or billing experience with basic understanding of payment methodology and medical terminology.4.Demonstrated sales and negotiating experience with successful outcomes.5.Established relationships with providers in MHPs primary service areas.

Qualifications / Requirements include:- A graduate degree in Healthcare Administration (MHA), Business Management (e.g. MBA) or equivalent is required. - Lean Six Sigma (L6S) Master Black Belt certification required plus at least two years experience leading formal improvement projects. - Ten years of relevant industry specific business or operations experience demonstrating strong leadership skills and a proven ability to facilitate cross functional teams. Relevant experience should include the following: - Project management, - Lean Six Sigma (L6S) Black Belt or Green Belt experience, process engineering or industrial engineering; quality, and change management experience. - Minimum five years direct and/or matrix manager experience is required. - Must be able to demonstrate clinical and financial measurement ability.- Applicant must be able to demonstrate ability to influence and persuade senior leaders and have high analytical skills.- Must have experience with Minitab or other process analysis software; teaching the software is a plus. - Must have experience with Microsoft Project and Microsoft Office Suite (specifically Excel, Word, and Powerpoint). - Lean methodologies experience requiredHealthcare industry and clinical experience highly desired.