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Job Description: Outpatient Radiology Business Manager Outpatient Radiology Business Manager Location: Fairfield County, CT Salary: $88,000-$117,565 Experience: 4.0 year(s) Job Type: Full-Time Job ID: J136733       About the Opportunity A respected hospital in Fairfield County, CT is actively seeking a driven and highly organized individual for a promising opportunity on their staff as their Outpatient Radiology Business Manager. In this role, the Outpatient Radiology Business Manager will assist in the implementation of projects/programs and play a critical role in any changes designed to promote growth of the radiology department. Apply today! Company Description Hospital Job Description The Outpatient Radiology Business Manager: Utilizes appropriate resources to improve technical/business practices Drafts the operational budget for the radiology department Monitors expenditure trends within the radiology Management Team Drafts fiscal policies and procedures for the radiology Department Works in conjunction with Materials Management to serve as a gatekeeper for all vendors and new product access Participates in cost containment activities Helps radiology managers identify and budget capital equipment needs and track capital purchases Maintains the radiology department repository of utilization, financial other business reports Compiles statistical data on procedure costing, service utilization and productivity analysis to include quality reporting programs Required Skills Bachelor’s Degree in Finance or Business related field 4-5 years of business management experience Ability to multitask Excellent communication skills Ability to meet stringent deadlines Highly organized Ability to communicate effectively with all personnel within department and organization

Job Description: Business Systems Analyst Business Systems Analyst Location: Staten Island, NY Salary: $70,000-$100,000 Experience: 5.0 year(s) Job Type: Full-Time Job ID: J137087       About the Opportunity A growing managed long term care plan headquartered on Staten Island is actively seeking a self-motivated and dynamic individual for promising opportunity on their staff as a Business Systems Analyst. In this role, the Business Systems Analyst will be responsible for application support for the plan's core systems (e.g., Medical Management, Claim, Data Warehouse, etc.). Additionally, the Analyst reviews and resolves staff issues related to applications. Apply today! Company Description Managed Long Term Care Plan Job Description The Business Systems Analyst will: Analyze incoming requests, gather business requirements, create specification documentation and implement systems solutions Provide application support and trouble shoot incoming issues, determine root cause of the issue and participate in the development of the solution Liaison with vendors for application issues Lead other Business/Systems Analyst in the execution of various projects Track and trend issues for effective resolution and to identify underlying systemic causes Participate in standing meetings as necessary, including but not limited to data warehouse, medical management system, claims system and team building Perform other duties and special projects as assigned by manager Required Skills 5+ years of IT experience Proficiency with MS applications, including but not limited to Word, Excel, Outlook, Power Point, Project and Access Strong telephonic and customer service skills Effective presentation skills Excellent verbal and written communication skills Able to participate in meetings with all levels of management within the organization Detail-oriented Excellent follow-up skills Desired Skills Healthcare experience in a Medicaid/Medicare or MLTC environment VB.Net and HTML

Job Description: HR Business Partner HR Business Partner Location: New York, NY Salary: $70,000-$90,000 Experience: 3. year(s) Job Type: Full-Time Job ID: J135426       About the Opportunity A medical facility in New York City is currently seeking an experienced Human Resources professional for a promising Business Partner position with their growing Human Resources Business Partner team. In this role, the HR Business Partner will be responsible for the delivery of all HR services whether delivered personally or in collaboration with colleagues in Human Resources. Apply today! Company Description Medical Facility Job Description The HR Business Partner will: Partner with the HRBP team and business leaders to develop and drive a people agenda Assist in the implementation of new and existing HR programs and initiatives Work with business unit management to analyze complex issues, design effective solutions, and facilitate change Create and maintain effective relationships and develop a strong knowledge of the organization’s structure, roles, goals and challenges to serve as a trusted and valued advisor Provide counsel on a broad spectrum of issues and opportunities, including resolution of complex employee relations issues Clarify, interpret and ensure compliance with HR policies and procedures within assigned client areas Proactively reach out to client department management on a regular basis to ensure up-to-date knowledge of client operations, organizational structure and culture, staffing changes, and potential human resources issues and opportunities Identify or clarify business unit needs as they relate to Human Resources and collaborate with HR Management, Specialists, and Shared Services staff in the development and implementation of programs, policies and initiatives to best meet those needs Required Skills 3+ years of experience as a HR Business Partner or Generalist in a Hospital setting Bachelor's Degree in a related field Human Resources background Solid analytical and research skills Computer savvy Microsoft Office/Suite proficient Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills Master's Degree in a related field

Job Description: Senior Vice President of Business Development Senior Vice President of Business Development Location: Jersey City, NJ Salary:  Experience: 7.0 year(s) Job Type: Full-Time Job ID: J137408       About the Opportunity A hospital in New Jersey is actively seeking an experienced professional to join their growing staff as their new Senior Vice President of Business Development. This is a great opportunity for a diligent and highly motivated professional to gain valuable work experience and further their career at a recognized facility. Apply today! Company Description Hospital Job Description The Senior Vice President of Business Development will be responsible for: Following through from vision to execution with measurable results to the bottom line. Uniting various constituencies to work together harmoniously to achieve high quality patient care. Being inclusive with Physicians on key decisions and meeting frequently with them to ascertain their needs Team building and motivating people Identifying the right people to execute strategic opportunities and motivating people to act. Accumulating a solid understanding of the dynamics and politics of a hospital environment and navigate between disparate entities to successfully unite constituencies toward a common cause Required Skills 7+ years of Healthcare Management level experience in Strategic Planning, Business Development, Market Research or related Executive area Bachelor's Degree in a related field Knowledge of Healthcare Organization and Administration and of standards and laws applicable to managing business development and planning issues with facility operations Sales and/or Marketing experience Strong project management skills Solid analytical and research skills Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Desired Skills MBA

Job Description: Small Group Program Manager Small Group Program Manager Location: Parsippany, NJ Salary: $100,000-$100,000 Experience: 4.0 year(s) Job Type: Full-Time Job ID: J135861       About the Opportunity An established health services company headquartered in Parsippany, NJ is actively seeking a driven and highly organized individual for a rewarding opportunity on their staff as a Small Group Program Manager. In this role, the Small Group Program Manager will be responsible for the facilitation and management of the company's small group business program,  including sales and retention of business in New Jersey. Company Description Health Services Company Job Description The Small Group Business Manager: Identifies, engages, manages, cultivates and develops new and existing brokers, consultants and general agent relationships Oversees a personal sales and retention goal in addition to managing a team of sales and retention associates Participates in performance management and the overall small group production goals Ensures timely and accurate completion of all internal and external business documentation, applications and process Promotes the value, benefits and brand attributes to the marketplace and community to help support the organizations reputation, mission and all sales and retention efforts Manages the relationship and coordinates the exchange of information and communicates the importance of accountability to internal and external business partners Maintains timely and accurate recordings of sales activities and clients interactions in the CRM on a regular and consistent basis Facilitates the initial and ongoing training for general agents that achieve measurable results Seeks, supports and helps facilitate individual and large group sales opportunities where appropriate for the organization Works directly with Operations, and Marketing with support from sales management Oversees resolution of items Attends group sponsored open enrollment, health fairs and broker/GA events Performs miscellaneous duties as assigned Required Skills Bachelor's Degree or equivalent experience 4+ years of sales, marketing, underwriting or related business experience 5+ years of experience in employee benefit programs Insurance license Excellent active listening skills; Solid written communication skills in formal and informal settings Strong presentation skills Ability to interact well with co-workers and outside contacts Ability to respond to multiple tasks and leadership direction while balancing competing demands Exhibits strong leadership by including appropriate people in decision making process Understands group dental healthcare terminology Strong analytical and problem-solving skills to quickly and effectively facilitate customer problem resolution Proven commitment to excellence in customer service. Exhibits strong follow through skills. Familiarity with contracts, Evidence of Coverage and other marketing collateral   Desired Skills Established relationships with brokers and consultants Knowledge of health care marketing and broker channels

Job Description: PURPOSE OF POSITION: To direct, coordinate, market, and oversee all aspects of Blood Transfusion Services, Donor collection programs, and autologous donation programs throughout Cape Cod Hospital Laboratory and Cape Cod Healthcare facilities. PRIMARY DUTIES AND RESPONSIBILITIES: Assures the development, coordination, implementation and standardization of all policies, procedures, and practices of all Blood Bank operations at Cape Cod Hospital Laboratory and all C-Lab entities.  Provides services to meet all Cape Cod Healthcare patient needs in accordance with accepted standards and practices. Oversees all related operations of the Blood Donor Center/Program. Continually seeks means of marketing and expanding services.  Continuously increases collections by growing internal database as well as external drives or mobile collections. Explores means of decreasing dependency on purchased blood from outside sources thereby decreasing costs.      Plans, organizes and provides services for assigned sections of the Blood Bank and Donor Center. Prepares work schedules and distributes in a timely fashion. Orders and controls supplies and equipment.  Monitors maintenance and repair of equipment. Coordinates and monitors quality control activities to ensure that standards and procedures are followed and recorded. Evaluates quality of work performed for accuracy and timely reporting of test results. Responsible for all aspects of blood donation, including marketing and donor recruitment. Responsible for oversight, set-up and maintaining fixed off site and mobile collections. Responsible to provide Blood Bank and Serology testing for CCH and C-Lab. Ensures the satisfaction of all users of the departments' services, both internal and external and seeks to continually improve customer service and satisfaction. Works in donor room to maintain technical competency in all areas of responsibility, to fill-in during breaks, short-staffing, excess workload and complex procedures. Obtains health histories and physical exams. Phlebotomizes patient and donors. Prepares and labels blood components and samples for testing. Accurately transcribes test data and other clerical functions. Recruits donors i.e. autologous and homologous. Maintains inventory of supplies. Performs donor related clerical functions. Makes recommendations and implements process improvement measures for quality and/or efficiency. Assists pathologists in maintaining programs including but not limited to: quality control, instrument maintenance, quality assurance and improvement and new methodologies development. Reviews all donor paperwork for accuracy and completeness. Orients and trains staff and evaluates work performance, according to the guidelines established for the department to determine employee competence. Participates in the Laboratory's Quality Assurance program including the development of appropriate area monitors. Provides input to the operating and capital equipment expense budgets on time.  Strives to operate section within allocated budget and submits monthly variance reports on time. Participates in interviews of applicants and make recommendations for hiring. Develops and maintains effective communication with assigned staff, co-workers, physicians and other hospital personnel or others who provide or receive laboratory services. Conducts monthly sectional meetings of staff and records minutes. Maintains professional growth and development through approved seminars workshops, and professional affiliations to keep abreast of latest trends in field of expertise. Maintains a thorough knowledge of the union contract. Maintains section reports and records as required by regulatory agencies. Performs other work related duties and activities as assigned or requested. Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Healthcare’s commitment to CARES: compassion, accountability, respect, excellence and service. EDUCATION/EXPERIENCE/TRAINING    Bachelor (BS, BA) in clinical laboratory sciences area or any related field ASCP, NCA or equivalent. SBB certification preferred. 5 years of related experience, preferably in a blood center. Knowledge of Regulatory and accreditation requirements, prior supervisory experience preferred. Excellent organizational skills, the ability to handle multiple priorities effectively, analyze problems and implement appropriate solutions, and assimilate information quickly. Ability to work independently while developing functioning teams among staff. Excellent interpersonal, verbal and written communication skills to deal with all levels of staff, hospital personnel, physicians, volunteers and donors. May be required to travel to sites throughout the region. Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures or governmental regulations. Ability to write reports, business correspondence and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public. Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios and proportions to practical solutions. Ability to define problems, collect data, establish facts, and draw valid conclusions.

Job Description: Digital Project Manager Digital Project Manager Location: Tampa, FL Salary:  Experience: 3.0 year(s) Job Type: Temporary / Consulting Job ID: U1010748       About the Opportunity A healthcare company in Florida is currently seeking a new Digital Project Manager for a great opportunity with their growing staff. In this role, the Digital Project Manager will be responsible for implementing the strategy for digital marketing and communications initiatives that serve to enhance the company's reputation and providing efficient service to members and providers. Apply today! Company Description Healthcare Company Job Description The Digital Project Manager will: Implement the group of companies' digital communication strategy to various external audiences Collaborate with cross-functional business areas to assess needs, compile requirements and prioritize requests Compose business requirements and ROI documents Manage project management and content development and delivery across multiple websites and other digital channels, working closely with other business areas Conduct quality control and user acceptance testing Accurately scope projects; collect and implement requirements; and, facilitate communication and measure performance to optimize the communication capabilities of the company websites, internet search and mobile Support development of new websites and digital communications vehicles as the company adds new lines of business, subsidiaries, etc., and participate in the integration of web properties for company acquisitions Required Skills 3+ years of experience managing Matrix and Cross-Departmental Projects with a high level of client interactions Bachelor's Degree in Business Administration, Communication, Marketing, or a related field Knowledge of Project Development life cycles, Web Technologies and Web Development processes Solid problem solving and time management skills Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively

Job Description: Corporate Director - Case Management Corporate Director - Case Management Location: Newton, MA Salary: $125,000-$140,000 Experience: 3.0 year(s) Job Type: Full-Time Job ID: J137490       About the Opportunity An established healthcare provider in Massachusetts is actively seeking a self-motivated and compassionate healthcare professional for a promising opportunity as their new Corporate Director of Case Management. In this role, the Corporate Director of Case Management provides oversight for resident care delivery processes (clinical and rehab) in our Post-Acute (HC/SNF) settings. Apply today! Company Description Healthcare Provider Job Description The Corporate Director of Case Management will: Manage systems related to Medicare A, Managed Care, Medicaid, and ACO processes Evaluate current system workflows Identify gaps and create solution plan Deliver a strategic, proactive approach to an effective staff orientation and training program Engage inter-professional team members at all levels of the organization to participate in system design (practice/competency/documentation) Coordinate relevant clinical policy/procedure revisions Identify and manage key quality outcome data measures and methodology Create/implement a regularly scheduled communication plan   Required Skills Bachelor's Degree Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Language Pathologist license 3-5 years of divisional or corporate experience in post-acute care settings Expert knowledge of current state and federal government post-acute care regulations Expert Leadership skills In-depth knowledge of case management and resource utilization review practices Demonstrate ability to work effectively with all levels of the organization Demonstrate expertise in critical thinking and analytical skills Expert clinical skills and ability to provide educational programs to all levels of the organization Strong expertise in Medicare, Managed Care and ACO development Proficient to expert in the use of software systems conducive to developing and presenting system deliverables including, but not limited to Microsoft Office Suite Desired Skills Master's Degree Vendor management / business partnership experience Electronic Health Record experience Proficiency in  QAPI systems

Job Description: Case Management Nurse Manager (RN) Case Management Nurse Manager (RN) Location: New York, NY Salary: $81,000-$86,000 Experience: 0.0 year(s) Job Type: Full-Time Job ID: J130854       About the Opportunity A New York City healthcare organization is currently seeking a licensed Registered Nurse (RN), with a strong Case Management background, for a promising Managerial position with their growing staff. In this role, the Case Management Nurse Manager (RN) will be responsible for effectively managing the daily operations / workflow and supervising clinical and non-clinical staff to provide support for the organization's Care Management programs. Company Description Healthcare Organization Job Description The Case Management Nurse Manager (RN) will be responsible for: Assisting in developing strategic plan by partnering with Assistant Director and Fund management to identify opportunities that have direct impact on clinical and financial outcomes Accessing and analyzing all processes on an ongoing basis to determine their effectiveness, eliminate inefficiencies and make recommendations to senior management to improve workflow, operations, and staff performance Coordinating activities between clinical programs, communication, and report requirements to maintain operational efficiencies and to be in compliance with the Department of Labor (DOL), Summary Plan Description (SPD) departmental protocols and clinical policies and procedures Interacting and collaborating with other departments (e.g. Claims and Provider Relations) in troubleshooting, problem solving, and exchanging information in conjunction with maintaining effective communication with providers and members Staff development, clinical orientation, ongoing education, and training programs to meet the changing needs of the Department Continually assessing clinical staff performance against internal and external departmental and industry standards Required Skills 5+ years of Advanced or Specialized work experience in Care Management programs (Utilization / Case Management / Appeals Programs) within a Managed Care organization; 2+ years of progressive Leadership and Management experience Bachelor’s Degree in Nursing, Business or Health Care Administration or equivalent years of work experience required; plus Current NYS Registered Nurse (RN) license Working knowledge of Milliman / InterQual guidelines or other regulatory protocols (i.e. Medicare), claims processing, medical coding (ICD-9, HCPCS, CPT) and interpreting provider contracts Strong Medical / Clinical background Microsoft Office/Suite proficient Solid critical thinking and analytical skills Patient oriented Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized $ Desired Skills Previous management experience and CCM certification

Job Description: Senior Account Manager Senior Account Manager Location: New York, NY Salary: $90,000-$110,000 Experience: 5.0 year(s) Job Type: Full-Time Job ID: J137189       About the Opportunity A premier regional health information organization (RHIO) is actively seeking a self-motivated and dynamic individual for a promising opportunity on their staff as a Senior Account Manager. In this role, the Senior Account Manager will be responsible for all participant account activities including activity management, outreach and training, selling new services, and consent management. Apply today! Company Description Regional Health Information Organization Job Description The Senior Account Manager will be responsible for: Utilization of the organization's platform Developing areas of consent acquisition and strategies to drive consent Oversight of user management and training Acting as a central point of contact for all corporate information Required Skills Bachelor's Degree 5 years of total professional experience 2+ years of related experience including account management of hospitals, nursing homes, and/or large providers Knowledge of MS Office and Salesforce.com Understand and capitalize on the uniqueness of a C-level meeting, a technology meeting, and a business level meeting Able to provide software demonstrations while focusing on the value and benefits to the member organization Able to manage account management and sales meetings with mid-sized audiences Strong analytical and interpersonal communication skills including process, writing, problem solving, customer relationship, organizational and conflict resolution

Job Description: Managed Care Coordinator Managed Care Coordinator Location: Trenton, NJ Salary:  Experience: 1. year(s) Job Type: Temporary / Consulting Job ID: U1012012       About the Opportunity A New Jersey-based healthcare organization is actively seeking a new Managed Care Coordinator for a promising position with their growing staff. In this role, the Managed Care Coordinator will be responsible for supporting the Health Services and Utilization Management functions and acting as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators. Apply today! Company Description Healthcare Organization Job Description The Managed Care Coordinator will: Perform review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients Handle initial screening for pre-certification requests from Physicians / members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff Prepare, document and route cases in appropriate system for clinical review Initiate call backs and correspondence to members and providers to coordinate and clarify benefits Review professional medical / claim policy related issues or claims in pending status Required Skills 1+ year of related work experience High School Diploma Knowledge of Medical terminology Computer savvy Solid problem solving and time management skills Exceptional phone etiquette Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively Desired Skills 1+ year of experience in a Customer Service or Medical Support related position College Degree Knowledge of Managed Care principles Knowledge of contracts, enrollment, billing & claims coding/processing

Job Description: Managed Care Coordinator Managed Care Coordinator Location: Mount Laurel, NJ Salary:  Experience: 1.0 year(s) Job Type: Temporary / Consulting Job ID: U1011159       About the Opportunity A healthcare organization in New Jersey is looking to fill an immediate need with the addition of a new Managed Care Coordinator to their growing staff. In this role, the Managed Care Coordinator will be responsible for supporting the Health Services and Utilization Management functions and acting as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators. Apply today! Company Description Healthcare Organization Job Description The Managed Care Coordinator will be responsible for: Performing review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients Handling initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff Preparing, documenting and routing cases in appropriate system for clinical review Initiating call backs and correspondence to members and providers to coordinate and clarify benefits Reviewing professional medical/claim policy related issues or claims in pending status Required Skills 1+ year of related work experience High School Diploma Knowledge of Medical terminology Computer savvy Solid problem solving and time management skills Exceptional phone etiquette Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively Desired Skills 1+ year of experience in a Customer Service or Medical Support related position College Degree Knowledge of Managed Care principles Knowledge of contracts, enrollment, billing & claims coding/processing

Job Description: Network Management Representative Network Management Representative Location: Tampa, FL Salary:  Experience: 1.0 year(s) Job Type: Temporary / Consulting Job ID: U1008101       About the Opportunity A Florida-based healthcare company is actively seeking a personable professional to join their staff as a Network Management Representative.  In this role, the Network Management Representative will be responsible for providing quality, accessible and comprehensive services to the company's provider community. Company Description Healthcare Company Job Description The Network Management Representative will: Coordinates communications process on such issues as administrative and medical policy, reimbursement and provider utilization patterns Develops, maintains, and enhances relations with providers to foster cooperative business relationships Coordinates prompt claims resolution through direct contact with providers and claims department Provides assistance with policy interpretation Researches, analyzes and recommends resolution for provider disputes as well as issues with billing and other practices Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery Tracks customer service patterns/trends and identifies training when appropriate Drafts training documents and conduct provider refresher training at onsite provider locations or by telephone Researches issues that may impact future provider negotiations or jeopardize network retention Required Skills 1+ year of Customer Service experience High School Diploma Computer savvy Microsoft Office/Suite proficient Solid time management and problem solving skills Exceptional phone etiquette Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively

Job Description: Managed Care Coordinator Managed Care Coordinator Location: Trenton, NJ Salary:  Experience: 0.0 year(s) Job Type: Temporary / Consulting Job ID: U1007150       About the Opportunity A recognized healthcare facility located in Trenton, NJ is actively seeking a self-motivated and diligent Managed Care professional for a rewarding Coordinator role on their staff. As a Managed Care Coordinator, the qualified candidate supports the Health Services and Utilization Management functions, and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators. Company Description Healthcare Facility Job Description The Managed Care Coordinator: Performs review of service requests Handles initial screening for pre-certification requests from physicians/members Prepares, documents, and routes cases in appropriate system for clinical review Initiates call backs and correspondence to members and providers to coordinate and clarify benefits Reviews professional medical/claim policy-related issues or claims in pending status Performs other relevant tasks as assigned by Management Required Skills High School Diploma Knowledge of medical terminology Polished and professional demeanor Excellent written and verbal communication skills Strong decision-making skills Team-oriented Demonstrates initiative and discretion Highly organized Desired Skills Bachelor's Degree 1-2 years of customer service or medical support-related experience Knowledge of Managed Care principles Ability to analyze and resolve problems with minimal supervision Ability to use a personal computer and applicable software and systems

Job Description: Managed Care Coordinator Managed Care Coordinator Location: Ewing, NJ Salary:  Experience: 0.0 year(s) Job Type: Temporary / Consulting Job ID: U1005418       About the Opportunity A widely recognized healthcare organization located in Ewing, NJ is actively seeking a self-motivated and dynamic professional for a promising opportunity on their staff as a Managed Care Coordinator. In this role, the Managed Care Coordinator supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators. Company Description Healthcare Organization Job Description The Managed Care Coordinator: Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients Handles initial screening for pre-certification requests from physicians/members Prepare, document and route cases in appropriate system for clinical review Initiates call backs and correspondence to members and providers to coordinate and clarify benefits Upon completion of inquiries initiate call back or correspondence to Physicians/Members to coordinate/clarify case completion Reviews professional medical/claim policy related issues or claims in pending status Upon collection of clinical and non-clinical information, authorize services based upon scripts or algorithms used for pre-review screening Perform other relevant tasks as assigned by Management Required Skills High School Diploma Strong medical skills and knowledge Proficient in Microsoft Office Excellent written and verbal communication skills Ability to make sound decisions under the direction of Supervisor Strong analytical skills Demonstrated interpersonal skills Team-oriented Desired Skills 1-2 years of experience in a customer service or medical support-related position Knowledge of contracts, enrollment, billing and claims coding/processing Knowledge of Managed Care principles Ability to analyze and resolve problems with minimal supervision Ability to use a personal computer and applicable software and systems

Job Description: Managed Care Coordinator Managed Care Coordinator Location: Trenton, NJ Salary:  Experience: 0.0 year(s) Job Type: Temporary / Consulting Job ID: U1005564       About the Opportunity A widely recognized healthcare organization in Trenton, NJ is actively seeking a driven and patient-oriented healthcare professional for a promising opportunity on their staff as a Managed Care Coordinator. In this role, the Managed Care Coordinator supports the Health Services and Utilization Management functions and acts as a liaison between Members, Physicians, Delegates, Operational Business members and Member Service Coordinators. Company Description Healthcare Organization Job Description The Managed Care Coordinator: Performs review of service requests Handles initial screening for pre-certification requests from physicians/members  Prepares, documents and routes cases in appropriate system for clinical review Initiates call backs and correspondence to members and providers to coordinate and clarify benefits Initiates call back or correspondence to Physicians/Members  Reviews professional medical/claim policy related issues or claims in pending status Required Skills High School Diploma Polished and professional demeanor Ability to multitask Proficient in Microsoft Office Knowledge of medical terminology Strong verbal and written communication skills Demonstrated analytical skills Highly organized Desired Skills Bachelor's Degree 1-2 years of customer service or medical support-related experience Knowledge of contracts, enrollment, billing and claims coding/processing Knowledge of Managed Care principles Ability to analyze and resolve problems with minimal supervision Ability to use a personal computer and applicable software and systems

Job Description: Regional Nurse Manager (RN) Regional Nurse Manager (RN) Location: New York, NY Salary:  Experience: 2.0 year(s) Job Type: Temporary / Consulting Job ID: U1010846       About the Opportunity A skilled nursing facility in New York City is currently seeking a licensed Registered Nurse (RN) to join their growing staff as a Regional Nurse Manager. Reporting to the Director of CHHA, the Regional Nurse Manager (RN) will be responsible for implementation and supervision of clinical programs and objectives of the CHHA's regional business operations. This is a great opportunity for a diligent and dedicated Regional Nurse Manager (RN) to gain valuable work experience and further their career at one of the facilities in Manhattan or the Bronx. Apply today! Company Description Skilled Nursing Facility Job Description The Regional Nurse Manager (RN) will: Manage and coordinate patient services Coordinate orientation and participate in the development of all levels of staff Identify needs and/or participate in formal and informal in-service activities for all levels of staff Utilize reports and other management tools to manage staff and build accountability Appraise job performance of nursing staff and team liaison in according to their job descriptions Maintain professional competency through participation in independent intra or extra-agency learning experiences Assist Business Development staff and facility discharge planners, Physicians, patients' family members, and other agencies to determine patient's eligibility to receive home health care services Manage clinical staff's daily productivity to ensure staff meets targets Manage workflows successfully by ensuring all clinical documentation and appropriate processes are followed to meet claims and billing requirements to meet accounts receivable goals Required Skills 2+ years of experience as a Public Health Nurse BSN NYS Registered Nurse (RN) license Previous Management experience Solid assessment, clinical, and documentation skills Patient oriented Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively Desired Skills MSN

Job Description: IVF Care Manager (RN) IVF Care Manager (RN) Location: White Plains, NY Salary: $80,000-$92,000 Experience: 2.0 year(s) Job Type: Full-Time Job ID: J137268       About the Opportunity A healthcare organization in Westchester County is actively seeking a licensed Registered Nurse, with a strong IVF background, for a promising Care Manager position with their growing staff. Under the guidance of the Vice President of Clinical Services and Consulting Chief Medical Officer, the IVF Care Manager (RN) will be responsible for managing treatment plan utilization and care, reviewing clinical outcomes to determine appropriateness of care, and ensure the organization and contract obligations are met. Apply today! Company Description Healthcare Organization Job Description The IVF Care Manager (RN) will: Review medical treatments and approve care based on the organization’s medical and contract guidelines Review non-standard service outcomes and enter outcomes into the Authorization Tracking System (ATS) ensuring entry of all required information Review data entered into ATS by Customer Service Agents (CSA) to ensure accuracy and completeness Call patients to discuss care, clarify, augment and/or confirm accuracy of information received from providers to ensure appropriate care, as necessary Ensure providers are informed of patient needs, treatment modification, and/or progress when necessary or requested Handle complex clinical issues or questions and troubleshoot clinical problems for the CSA team Track ART trends, quality of care, protocols and pathways, denial and appeal service reviews, and state mandates to ensure organization’s protocols are continually improving to meet or exceed ASRM guidelines Utilize knowledge of ATS, contract obligations, infertility, and best business practices to provide superior service to clients Review benefit status based on customer plans and eligibility file information prior to authorization of services or administrative/benefit denials Required Skills 2+ years of experience in Assisted Reproductive Technology, including: General Infertility; IVF or Infertility Care Management; and/or, Women’s Health Associate's Degree in Nursing NYS Registered Nurse (RN) license Microsoft Office/Suite proficient Solid assessment, clinical, and documentation skills Patient oriented Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively Desired Skills Bachelor's Degree in Nursing Bilingual (English and Spanish)

Job Description: Regulatory and Compliance Project Manager Regulatory and Compliance Project Manager Location: Bronx, NY Salary: $80,000-$100,000 Experience: 3.0 year(s) Job Type: Full-Time Job ID: J136365       About the Opportunity A healthcare facility in New York City is actively seeking an experienced Project Manager to focus on Regulatory and Compliance functions for the the facility. In this role, the Regulatory and Compliance Project Manager will be responsible for managing all aspects of regulatory reporting and data submission for various lines of business, including MLTC, FIDA, SNP and MAP. Apply today! Company Description Healthcare Facility Job Description The Regulatory and Compliance Project Manager will: Keep abreast of regulatory reporting, rules and changes; keep departments (including administrative, clinical and operations management) current and informed of issues Read, analyze and anticipate potential impact of proposed CMS/NYSDOH legislation, regulations and other guidance Identify and manage risk areas; present risk issues and items to senior management for review Support data collection, analyses, preparation and coordination of responses for regulatory audits, corrective action plans, quality/performance improvement plans Support compliance program activities Prepare and or update, for senior management approval, policies and procedures to comply with state and federal law and regulations; Prepare and handle the submission of marketing and participant materials for government approval; coordinate translations of marketing materials Organize and attend meetings related to programs and operations Required Skills 3+ years of related work experience Bachelor’s Degree in a related field Previous Compliance background Knowledgeable in Operations of MLTC, Medicare Advantage, FIDA and MAP programs Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized

Job Description: Director of Utilization Management (RN) Director of Utilization Management (RN) Location: Brooklyn, NY Salary: $110,000-$135,000 Experience: 5. year(s) Job Type: Full-Time Job ID: J137164       About the Opportunity A healthcare organization in New York City is actively seeking a licensed Registered Nurse (RN), with a strong Utilization Management background, for a promising Director-level position with their growing medical staff. Reporting directly to the Vice President of Care Management, the Director of Utilization Management (RN) will be responsible for the development, implementation and coordination of quality driven programs, including evaluation of the Utilization Management Program. Apply today! Company Description Healthcare Organization Job Description The Director of Utilization Management (RN) will be responsible for: Providing leadership emphasizing utilization management program development, process improvement, implementation and measurement of quality metrics Interpreting and implementing utilization management criteria and clinical standards Creating, developing and implementing policies and procedures in accordance with regulations and contract compliance with the State of NY Department of Health Contract, regulatory and accreditation requirements Reviewing quality assurance standards; studying existing policies and procedures; and, interviewing personnel and customers to evaluate effectiveness of utilization management program Leading and/or participating in quality initiatives and activities as designated by Continuous Quality Improvement Committee Acting as a key contact source in accreditation processes Improving the quality of care and services, work performance and department processes Performing quality-assurance functions to accomplish business coordination, monitoring, and reporting of quality-assurance studies according to the CM/QA plan Compiling statistical data and writes narrative reports summarizing quality assurance findings Assuring timely identification of problems and correction of deficiencies Assisting departments with the coordination of audit information, and recommends appropriate data-gathering mechanisms, procedures, etc. Required Skills 5+ years of Utilization Management experience Bachelor's Degree in Nursing, Business, and/or Healthcare Management NYS Registered Nurse (RN) license Strong Management background Knowledge of current Care / Case / Disease Management methodologies and Program Development Working knowledge of Interqual or Milliman Knowledge of the Healthcare delivery system Solid assessment, clinical, and documentation skills Patient oriented Great interpersonal skills Excellent communication skills (written and verbal) Strong attention to detail Highly organized Able to multitask efficiently and effectively

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Business manager positions can be found in all industries. Managers may be in charge of a specific department or group of people, and in some cases they run the entire company. Duties vary depending on both industry and facility; however, all business managers have a few things in common.

By analyzing the businesses, managers are able to make business plans to increase profitability. If business plans are not unfolding in a profitable way, business managers are responsible for adjusting plans or implementing new ones.

In most cases, business managers oversee staff members and are responsible for ensuring employees complete their work efficiently. Their goal is to reach maximum output and increase the company’s finances. They can do this in a variety of ways, including implementing new business models and offering incentives and rewards.

To qualify for business manager jobs, candidates usually need an MBA. In healthcare, a master’s degree in healthcare administration can be an acceptable substitute. Because business managers work in all industries, employers may prefer candidates with a background in their particular field.

If you’re looking for business manager jobs in healthcare, start your search here at ADVANCE Healthcare Jobs. Use our Resume Builder to upload your current resume, edit the information or create a brand-new resume. Plus, you can save up to five versions of your resume, so customizing your application is easier than ever!