Total 19 Senior Executive level Health / Beauty / Fitness job vacancies in 225 Solar Dr, Imperial PA

Company :

Job Description : 

GENERAL OVERVIEW:

Maintains safety and structure of the milieu, observing and recording patient information pertinent to the treatment plan and reports information to appropriate staff.

ESSENTIAL RESPONSIBILITIES:

• Collaborates with the multi-disciplinary team to provide for an on-going assessment of changes in patient status and gathers pertinent patient care data using all available resources; provides crisis intervention to maintain safety (40%)
• Provides direct patient care and activities, such as activities of daily living, vital signs, specimen collection, assistance with exams, treatments and procedures and patient focused testing; group facilitation, reports any changes in physical, mental, or emotional conditions to nursing staff and documents same; suggests modifications to the master treatment plan (40%)
• Leads or co-leads in social, recreational, and therapeutic activities that enhance patient's social relationships and interpersonal skills (15%)
• Participates in unit activities such as supplies stocking, patient transport, and equipment / appliance cleaning, checks and retrieval. (5%)
• Performs other duties as assigned or required.

QUALIFICATIONS:

Minimum

• Bachelor’s degree or 3 years of relevant experience and/or education as determined by the company in lieu of bachelor's degree.
• Child Abuse Clearance, CPR Certification, Criminal Background Clearance
• Non-violent crisis intervention required within six months of hire
   

Preferred

• None

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

This job will guide the strategy and coach a team in establishing an industry-leading design system for Highmark Health. Building scalable solutions and tools to enable design teams to create experiences that will transform healthcare and help our members live their best lives. This job will focus on developing components, documenting the design system, and supporting its growth and evolution.

ESSENTIAL RESPONSIBILITIES

• Lead cross-disciplinary teams (development, content, research, stakeholders) to solve complex experience needs by implementing an expressive, scalable, and intuitive design system across our platforms.
• Clearly define and document the decisions and design principles utilized while creating the components, including UI states, accessibility guidelines, and interactions.
• Guide and actively contribute to the creation of a scalable and elegant design system to ensure quality, speed, and innovation across the products and experiences we enable. 
• Mentor designers to understand the problems the system will solve, chunk their work into a manageable and clear plan, and properly leverage user research.
• Act as an ambassador for design championing and driving cultural change, unafraid to challenge the status quo and reimagine how we do business to deliver superior customer experiences.
• Foster collaboration by involving others as early as possible to understand their needs and determine how to improve the design process.
• Steward the system's evolution by creating efficient workflows to vet contributions and provide guidance and support to adopting design teams. 
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor's Degree in UX Design, Human-Computer Interaction, or a design related field

Substitutions

• 6 years of related and progressive experience in lieu of Bachelor's degree

Preferred

• None

EXPERIENCE

Required

• 5 years in the Design industry with a proven track record leading designers to deliver successful products. 

To Include

• 1 year of creating and maintaining design systems

Preferred

• 1 year in highly regulated industries such as medical-device/healthcare or financial institutions 
• 1 year collaborating with Front-end engineers to support meeting the needs of a robust library and design system 
• 1 year creating accessible designs with experience working within regulations and guidelines (i.e., WCAG) to advocate for inclusive design for all users
• 1 year utilizing strong facilitation, collaboration, and consensus-building skills, with extensive experience in presenting to large cross-functional teams and Senior/Executive leaders 

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• UX Certification Coursework

SKILLS

• Bring passion and curiosity about design systems, emerging technology, and design trends to help other designers understand potential pitfalls and opportunities of design systems
• Comprehensive understanding of best practices for design systems, user experience standards, and guidelines for building within digital platforms, including web, iOS, and Android
• Demonstrates strong competency of user-centered design process and execution of end-to-end product experiences and scalable design systems for medium – large organizations
• Advanced knowledge of current industry design and prototyping tools (e.g., Figma, Sketch, Principle), with a strong skillset in creating components and shared library functionalities 
• Highly organized, self-starter with the ability to work on multiple projects at once with little oversight and deliver high quality, pixel-perfect work on time in an Agile environment 
• Knack for design thinking exercises and human-centered (HCD) facilitation methods to solve complex challenges 

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

GENERAL OVERVIEW:

As a member of the health care team, assists in coordinating the examination, treatment and health care planning for patients, under the direction of the provider. Also assists with other office functions to support patient care and office operations. Follows all established protocols, policies, procedures and standardized work flows.

ESSENTIAL RESPONSIBILITIES:

• Prepares and rooms patients within the clinical practice setting according to standardized work flows. Accurately obtains patient vital signs. Accurately documents patient information, patient history, and medication screening. Prepares exam room for patient visit. Completes annual wellness visit screenings, pends orders for required age appropriate screenings and may serve as a scribe with additional training.
• Acts as an electronic health record (EHR) superuser. Accurately documents all pertinent details in the  EHR according to established standards and work flows including all pertinent patient interactions at the time of the encounter in the correct EHR note type. Reviews, updates and screens medication list in the EHR. Reviews problem list and social history with patient and updates record. Follows Meaningful Use standards and assists with population health management.
• Assists in the coordination of patient care under supervision of the assigned health care provider. Assists providers with examination and procedures. Assists in administration of depression screening, tobacco screening, chronic disease screening and MU required screenings. Performs in-house testing following established protocols and policies. Assists with patient prescription needs based on established protocols.
• Provides clinical leadership oversight, serving as a department resource for clinical questions.
• Reviews pre-visit planning documentation and patient chart in advance of appointment time to ensure that the provider is prepared to address required screenings and gaps in care.
• In collaboration with the care team nurse, provides follow up with patient at designated intervals via patient preferred method (telephone, electronic, written) in accordance with prescribed provider instructions. Notifies patients of test results under the direction of provider in a timely manner.
• Ensures adequate inventory of medical supplies. Ensures all patient treatment areas are always stocked with the appropriate supplies using established inventory standards. Cleans and sterilizes instruments per established policy and manufacturer's guidelines. Accurately performs lab controls and equipment checks as assigned. Administers and accurately documents medications in accordance with policy and safety practice
• Serves as a peer mentor. Responsibly orients new medical assistants in correct office workflows. Demonstrates proficiency in teaching pre-visit planning, meaningful use standards, appropriate documentation and workflows. Provides meaningful feedback and performance evaluations for orientees. Mentors MA students and externs as assigned.
• Accurately performs clerical office functions and other duties as assigned or required.
• Depending on location, may serve as office safety officer: maintains the office safety log, assures the accuracy and completion of all quality assurance testing for all POCT performed in the office environment. Depending on location, may perform additional duties such as minor wound care, splinting procedures, and 61 capsules procedures.
• May require travel between physician office locations.

QUALIFICATIONS:

Minimum

• One year certificate from college or technical school, or at least three months of related experience and/or training, or equivalent combination of education and experience.
• 1-3 years as a Medical Assistant
• Newly hired medical assistants must complete training and/or attempt testing within 30 days of hire; newly hired medical assistants must obtain certification within 120 days of hire.
• Medical assistants must achieve and maintain certification in accordance with CMS Meaningful Use requirements.
• CPR certification.

Preferred

• Experience with practice management software and electronic health record applications.
• Current valid state driver’s license

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

*This is a hybrid role requiring 3 days in office at our Fifth Avenue Place location

This job will support both pharmacy and medical cost savings initiatives and rebate strategy. This role will engage with internal and external stakeholders to execute and track low-net cost medication benefit offerings. This role will regularly analyze drug category market share and utilization management trends and make recommendations to internal teams. The incumbent will serve as a key contact with pharmaceutical manufacturers and vendors, including the Pharmacy Benefit Manager. This role may ensure compliance with government drug rebate reporting obligations and may assist in audit responses. This role may support monitoring FDA-approvals, drug manufacturer pipelines, and assess drug utilization reports, in order to develop and execute the Organization's Drug Formulary, and/or recommend codes for pharmaceutical based reporting. The incumbent may review or help craft utilization management edits accounting for rebate compliance (e.g. prior authorization, dose and duration edits, quantity limits, step-care edits). If acting in the capacity as a clinical pharmacist the incumbent may also review UM requests. The incumbent develops and implements physician, pharmacy, account, and member educational initiatives that promote the Organization’s Formularies, utilization management programs, and case/ disease management initiatives; providing clinical review and decisions for physician and member appeals and participates on cross-functional committees to develop and implement clinical and operational initiatives.    

ESSENTIAL RESPONSIBILITIES

• Monitor FDA-approvals, drug manufacturer pipelines,   assess drug utilization reports, and write drug monographs for Committee review to develop the Organization's Drug formulary and/OR provide recommendations for NDC code capture, and monthly identification of high risk members. 
• Gateway - Assist in the development of Gateway’s Drug Formularies by monitoring FDA-approvals and drug manufacturer pipelines, assessing drug utilization reports, and writing drug monographs for Pharmacy & Therapeutics Committee review.
• Assist in the development and implementation of utilization management programs including but not limited to: prior authorization, dose and duration edits, quantity limits, step-care edits, generic sampling  medical policy review and development, member facing outreach initiatives
• Develop and implement physician, pharmacy, account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and disease management initiatives.
• Provide clinical review and decisions including but not limited to:  physician and member appeals, member or provider information/education. 
• Participate on cross-functional committees to develop and implement clinical and operational initiatives within Integrated Clinical Services.  May participate in outreach efforts as needed to effectively reach goals of Medication Therapy Management programs to include, but not limited to Comprehensive Medication Reviews and Targeted Medication Reviews.
• Identify and assist in managing department process improvements to maximize overall efficiencies.
• Manage individual projects for timely review with the Director, Clinical Pharmacy.
• Participate in Medicare Stars performance measures to drive   contribution to excellence (5 Stars).
• Other duties as assigned or requested.

QUALIFICATIONS

Required

• Bachelor of Science in Pharmacy with experience in clinical / formulary management or a Doctor of Pharmacy degree with experience in clinical formulary management
• 5 years of related, progressive experience in the area of specialization
• An understanding of managed care principles and practices is essential
• Demonstration of strong verbal and written communication skills, as well as, proficiency in the use of computer-based data processing
• Microsoft Office products, and database applications
• Pharmacy license

Substitutions

• None

Preferred

• Pharmacy Residency or bachelor’s degree in business
• Experience in a Health Plan, Pharmacy Benefit Manager (PBM), or Pharmaceutical Manufacturer environment
• 2 years of experience with pharmacy and/or medical drug cost modeling
• 1 year of experience in a role predominately focused on cost-savings initiatives

SKILLS

• Be able to quickly identify and prioritize essential elements of problem
• Independently or in a team, be able to identify the root issues and formulate potential solutions
• Accurately use logic and reasoning in identifying alternate solutions, conclusions or approaches to problems. Potential solutions should be synthesized into presentation, timetable to resolution and appropriate follow up with measurable outcomes

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

GENERAL OVERVIEW:

Monitors and operates the switchboard including answering and directing incoming calls, placing outgoing calls, overhead paging and emergency response communication. Assists with the efficient operation of the department by providing support to the manager and guidance to the Telephone Operators. Assists in resolving minor problems/issues associated with staffing coverage and interactions with customers. Provides feedback about daily operations to management as appropriate.

ESSENTIAL RESPONSIBILITIES:

• Answers and directs all telephone calls and overhead paging inquiries for the efficient and timely operation of hospital communications. Triages and prioritizes calls as to their urgency, and accurately routes accordingly. (65%)
• Immediately responds to all alarms, security calls, and medical emergencies. Pages all persons designated to respond to emergencies. Immediately reports to the supervisor any problems with, or abuses of the alarm system. Logs emergency response information, as appropriate. May reprogram the computerized fire alarm system after it has been activated. (10%)
• Helps manager in resolving minor day-to-day issues/problems, e.g. staff coverage, interactions with customers; assists with rollout of new/revised procedures. (10%)
• Prepares work schedules for the department; prepares daily sheet for physician coverage and contact information. (10%)
• Maintains and cleans all switchboard equipment, identifying and resolving malfunctions to any equipment through defined problem correction procedures. (5%)
• Performs other duties as assigned or required.

QUALIFICATIONS:

Minimum

• High school diploma or GED; or one to three months related experience and/or training; or equivalent combination of education and experience.
• 3-5 years’ telecommunication or similar experience.
• Excellent telephone skills and interpersonal communication skills.

Preferred

• Training as a Telephone Operator, Receptionist, or priority Dispatcher.

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Primary City/State:

Department Name:

Work Shift:

Job Category:

You have a place in the health care industry.  There’s more to health care than IV bags and trauma rooms. We support all staff members as they find the path that is right for them. If you’re looking to leverage your abilities – you belong at Banner Health.  Apply today.

The Senior Acute Patient Access Services Representative will be responsible for insurance verification, patient check in, collections. They will also ensure demographics are obtained and entered accurately into registration platforms, insurance verification has been done and accurately documented, patient financial estimates and responsibility given and accurately relayed to patient and/or responsible parties.  All applicable consent forms obtained and captured in system with accuracy.

Monday - Friday 8:30AM - 5PM

POSITION SUMMARY

This position is the first point of contact at healthcare facilities and assist patients with the administrative aspect of gaining access to medical treatment. This position is in a hospital-based setting which includes Emergency Dept, Inpatient, Obstetrics, Outpatient, etc. Responsible for in person patient intake and registration, providing superior customer service, accurately identifying, and obtaining authorizations patients’ insurance, verifying eligibility and benefits, generating patient estimates for services rendered, financial counseling, and collecting patient liability. Demonstrates the ability to resolve customer issues and provides excellent customer service. This position provides mentoring, training and offers on-going guidance as needed for a Patient Access team. Additionally, Senior Representatives will function as the primary resource/SME for team member workflow questions and concerns.

CORE FUNCTIONS

1. Verifies patient’s demographics and accurately inputs this information into EHR, including documenting the account thoroughly to maximize reimbursement and minimize denials/penalties from the payor(s).

2. Proficiency with multiple services including, but not limited to inpatient, observation, emergency, obstetrics, surgery, imaging. This position may cover services 24/7.

3. Demonstrates a thorough understanding of insurance guidelines for all services. Proficiently verifies, reads, and understands insurance benefits.

4. Demonstrates proficient understanding that this position creates the first impression for our patient's experience with Banner Health. Demonstrates a positive patient experience through interactions and effective communication.

5. Proficient understanding of payer authorization guidelines. Accurately submits timely notification according to insurance guidelines using various systems to reduce/eliminate denials. Consistently meets all registration related key performance indicators as determined by management.

6. Obtains federal/state compliance information, consents and documentation required by the patient’s insurance plan(s). This includes a thorough understanding of accurately completing hospital-based compliance forms required by CMS. Uses multiple computer applications proficiently.

7. Consistently discusses financial liability with the patient(s) and/or families that includes: collection in full of patient liability, assisting patient in applying for Banner Line of Credit, setting up payment plans and/or assisting patient with Banner Financial Assistance policy/application.

8. Provides a variety of patient services and financial services tasks. May be assigned functions such as transporting patients, training new hire employees, recapping daily deposits, posting daily deposits, or conducting other work assignments of the Patient Access Services team.

9. Works independently under regular supervision and follows structured work routines. Works in a high-volume, fast paced, clinical environment which requires to ability to be adaptable, critical thinking, and independent decision making and to prioritize work and ensure appropriateness and timeliness of each patient’s care. Assists in overseeing the workflow for the given shift. Acts as SME for PAS staff including disseminate and communicating education materials and updates. Assists with escalations as needed. Models Banner behaviors and values for the team. Primary external customers include patients and their families, physician office staff and third-party payors.

MINIMUM QUALIFICATIONS

High school diploma/GED is required.

Must have customer service skills or knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over three or more years of work experience.

Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work both independently and collaboratively in a team environment. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences. Strong knowledge in the use of common office software, word processing, spreadsheet, database software, and typing ability are required.

Employees working at Banner Behavioral Health Hospital or the Whole Health Clinic must possess an Arizona Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment. Employees working at Banner MD Anderson on the Banner University Medical Center Phoenix campus must possess a State of Arizona Department of Public Safety Level One Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment. This is a requirement of the Whole Family Counseling Program held at this specific facility.

PREFERRED QUALIFICATIONS

Associate’s degree in Business Management is preferred.

CHAA certification is preferred.

Previous patient access and/or cash collections experience is preferred. Work experience with the Company’s systems and processes is preferred.

Additional related education and/or experience preferred.

EOE/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

Privacy Policy

Primary City/State:

Department Name:

Work Shift:

Job Category:

Voted 4 years in a row by employees as Banner Health’s Best Place to Work and Best Place to Receive Care.

Those who have joined the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, we want to hear from you.

Bring your passion for Behavioral Health to Banner Health! Banner Behavioral Health Hospital in Scottsdale, AZ was remodeled and expanded in 2017, providing new, state-of-the art units for our patients and staff! Banner Behavioral Health Hospital is a voluntary facility for adults and adolescents. We are dedicated to providing safe, confidential, and compassionate treatment with customized treatment plans to meet each patient's needs.

As a Senior Behavioral Health Specialist you will assist in orienting new behavioral health specialist, coordinate breaks for staff on shift, and assist with new training roll outs. you will focus on safety checks, assisting in ADL's, Milieu management, falls prevention measures, and 1 on 1 observations. The hours are 11am-1130pm. You will have 3 shifts per week which will include weekends and holidays on a rotating basis. You will have the opportunity to utilize our self-scheduling tool for shift and weekend coverage. Enjoy a flat rate $1/hour weekend shift differential and an 18%-night shift differential when applicable.

You have a place in the health care industry.  At Banner Health, caring for people is at the core of all we do.  We are committed to diversity, equity and inclusion.  If that sounds like something you want to be a part of - apply today!

Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life

POSITION SUMMARY
This position provides direct health care and therapeutic services to psychiatric patients under the direct supervision of the nurse.

CORE FUNCTIONS
1. Provides oversight in the clinical setting, mentoring and leadership of Behavioral Health Specialists including implementation of behavior management techniques.

2. Guides work of assigned staff to achieve the defined business goals and to ensure smooth work flow in the department. Coordinates team activities and the staff-to-workload ratios to accomplish the most effective use of resources. Helps set work goals for team members and monitors measurable outcomes in accuracy, timeliness, productivity and service quality.

3. In collaboration with RN Manager and/or Senior RN Manager, plans, develops, oversees, implements, and evaluates age-appropriate didactic and social/skills groups that are consistent with treatment plan goals.

4. Reviews and audits Behavioral Health Specialist documentation as appropriate and provide guidance when needed.

5. Documents observations, interventions, and group activities in patient record.

6. Maintains patient safety through observing and reporting to RN patient behaviors, communications, interactions and physical status. Checks for contraband, makes rounds and monitors meals. Participates in restraining and secluding patients.

7. Consistently demonstrates professional, respectful, cooperative, and considerate behavior toward internal and external customers. Documents observations, interventions, and group activities in the patient record. Interacts therapeutically with patient and family.

8. Coordinates and participates in special projects as assigned. May be involved in the interview process. May provide feedback to peers.

9. Works under limited supervision following defined procedures and holds responsibility for the performance of the assigned work group. Interacts with all levels of Banner staff; physicians, patients, families and external providers.

MINIMUM QUALIFICATIONS

Knowledge normally obtained through the completion of a Bachelor’s degree or four years of experience. Demonstrated leadership and adolescent psychiatric milieu management.

Employees working at Banner Behavioral Health Hospital or BTMC Behavioral must possess an Arizona Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment. Employees working in the Banner McKee Senior Behavioral Health Inpatient Unit must possess a Colorado Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment. Employees working in any Banner Staffing (BSS) Behavioral Health role in Arizona must possess a State of Arizona Department of Public Safety Level One Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment.
Certification for BLS is also required.

PREFERRED QUALIFICATIONS

Master's Degree preferred in Social Work, Counseling or Psychology and two years experience in behavioral health service delivery.

Additional related education and/or experience preferred.

EOE/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

Privacy Policy

Company :

Job Description : 

JOB SUMMARY

This job takes the lead in providing technical support to internal and external users of more complex IT Infrastructure (e.g. PC’s, servers, mainframes, etc.).  Takes the lead in answering more complex questions regarding system procedures, online transactions, systems status and downtime. Takes the lead in more complex interactions with various IT areas in order to restore service and/or identify problems.  Takes the lead in maintaining a more complex troubleshooting tracking log ensuring timely resolution of problems. May mentor less experienced team members.

ESSENTIAL RESPONSIBILITIES

• Incident Management.  Take the lead in performing more complex call documentation and determines IT service request type.
• Take the lead in logging and classifying more complex incidents and impacts and provides feedback for potential problem identification.
• Take the lead in resolving more complex initial incident resolutions or dispatches unresolved incidents to appropriate area or vendor. Take the lead on more complex issues to monitor and escalate to ensure appropriate level of response based on severity and urgency.
• Take the lead on more complex verifications and closures to ensure all documentation is correct and accurate.  Take the lead on verifying more complex customer satisfaction and closure.
• Ensure compliance to required standards, procedures, guidelines and processes.
• Other duties as assigned or requested.

EDUCATION

Required

• High School Diploma or equivalent

EXPERIENCE

Required

• 3 - 5 years in Information Technology

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Travel Requirement

0% - 25% - Based out of Forbes Hospital, Monroeville area

Position Type

Office-Based - Based out of Forbes Hospital

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

GENERAL OVERVIEW:

As a member of the health care team, assists in coordinating the examination, treatment and health care planning for patients, under the direction of the provider. Also assists with other office functions to support patient care and office operations. Follows all established protocols, policies, procedures and standardized work flows.

ESSENTIAL RESPONSIBILITIES:

• Prepares and rooms patients within the clinical practice setting according to standardized work flows. Accurately obtains patient vital signs. Accurately documents patient information, patient history, and medication screening. Prepares exam room for patient visit. Completes annual wellness visit screenings, pends orders for required age appropriate screenings and may serve as a scribe with additional training.
• Acts as an electronic health record (EHR) superuser. Accurately documents all pertinent details in the  EHR according to established standards and work flows including all pertinent patient interactions at the time of the encounter in the correct EHR note type. Reviews, updates and screens medication list in the EHR. Reviews problem list and social history with patient and updates record. Follows Meaningful Use standards and assists with population health management.
• Assists in the coordination of patient care under supervision of the assigned health care provider. Assists providers with examination and procedures. Assists in administration of depression screening, tobacco screening, chronic disease screening and MU required screenings. Performs in-house testing following established protocols and policies. Assists with patient prescription needs based on established protocols.
• Provides clinical leadership oversight, serving as a department resource for clinical questions.
• Reviews pre-visit planning documentation and patient chart in advance of appointment time to ensure that the provider is prepared to address required screenings and gaps in care.
• In collaboration with the care team nurse, provides follow up with patient at designated intervals via patient preferred method (telephone, electronic, written) in accordance with prescribed provider instructions. Notifies patients of test results under the direction of provider in a timely manner.
• Ensures adequate inventory of medical supplies. Ensures all patient treatment areas are always stocked with the appropriate supplies using established inventory standards. Cleans and sterilizes instruments per established policy and manufacturer's guidelines. Accurately performs lab controls and equipment checks as assigned. Administers and accurately documents medications in accordance with policy and safety practice
• Serves as a peer mentor. Responsibly orients new medical assistants in correct office workflows. Demonstrates proficiency in teaching pre-visit planning, meaningful use standards, appropriate documentation and workflows. Provides meaningful feedback and performance evaluations for orientees. Mentors MA students and externs as assigned.
• Accurately performs clerical office functions and other duties as assigned or required.
• Depending on location, may serve as office safety officer: maintains the office safety log, assures the accuracy and completion of all quality assurance testing for all POCT performed in the office environment. Depending on location, may perform additional duties such as minor wound care, splinting procedures, and 61 capsules procedures.
• May require travel between physician office locations.

QUALIFICATIONS:

Minimum

• One year certificate from college or technical school, or at least three months of related experience and/or training, or equivalent combination of education and experience.
• 1-3 years as a Medical Assistant
• Newly hired medical assistants must complete training and/or attempt testing within 30 days of hire; newly hired medical assistants must obtain certification within 120 days of hire.
• Medical assistants must achieve and maintain certification in accordance with CMS Meaningful Use requirements.
• CPR certification.

Preferred

• Experience with practice management software and electronic health record applications.
• Current valid state driver’s license

$1,000 Sign-On Bonus

*Sign-On bonus is for External Hires only

Paid out after Probation Period (90 days)

Recipient must stay with the same practice for a minimum of 1 year

Re-Hires may not have worked for AHN within the previous 12 months.

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)***

This job takes the lead in providing more complex application development services typically as part of a project team or in an application support role. Developers analyze, design, code, test and implement more complex systematic solutions to meet customer requirements that adhere to Highmark IT standards and policies.  Developers provide general support to maintain more complex applications that meet the service levels, system availability, performance and quality levels required by their customers. May mentor less experienced team members. Focus is on clinical data exchange between Highmark and providers via cloud-based applications.

ESSENTIAL RESPONSIBILITIES

• Takes a lead role for analyzing, designing, coding, testing and implementing more complex application enhancements, as well as providing general  production support, meeting defined scope, target dates and budgets with minimal or no defects.
• Utilizes and participates in the more complex full system development life cycle, per current Highmark SDLC standards.
• Takes a lead role in collaborating with customers, business analysts, partners, and IT team members to understand business requirements that drive the analysis and design of quality technical solutions. Concentrates on providing innovative solutions to more complex business needs.
• Takes a lead role in providing required technical support, including release implementations, on-call and 24x7 supports when necessary.
• Performs work in compliance with all Highmark and Highmark IT standards, policies and procedures.
• Actively takes a leading role and participates on project teams in various project roles, including, but not limited to, Developer, Technical Lead and Project Manager, based upon level of experience.
• Effectively communicates with team members, customers, partners and management, including assisting with or conducting more complex technical walkthroughs, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor’s degree in Information Technology, Computer Science or closely related field

Substitutions

• None

Preferred

• Master’s degree in Information Technology, Computer Science or closely related field

EXPERIENCE

Required

• 5 years of experience as a developer
• Experience with Project Management tools
• Experience with databases
• Experience with multiple coding languages

Preferred

• Practical experience with Java, FHIR, API development, Angular
• At least 3 years experience as a full-stack developer in the cloud (GCP ideally)
• At least two years development experience using FHIR standards

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• Google Professional Cloud Developer, Google Cloud DevOps Engineer

SKILLS

• Problem solving, root cause analysis, and issue resolution
• Demonstrated leadership skills
• Experience in Healthcare or Health Insurance Industry
• Experience with technology platforms, application development tools, business processes, software development life cycle used by Highmark enterprise

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)***

This job takes the lead in providing complex application development services in Highmark’s Google Cloud Platform environment, typically as part of a project team or in an application support role. Databricks Engineers analyze, design, code, test and implement more complex systematic solutions to meet customer requirements that adhere to Highmark IT standards and policies.  They also provide general support to maintain more complex applications that meet the service levels, system availability, performance and quality levels required by their customers. Able to guide and mentor less experienced team members.

ESSENTIAL RESPONSIBILITIES

• Takes a lead role for analyzing, designing, coding, testing and implementing more complex application enhancements, as well as providing general  production support, meeting defined scope, target dates and budgets with minimal or no defects.
• Utilizes and participates in the more complex full system development life cycle, per current Highmark SDLC standards.
• Takes a lead role in collaborating with customers, business analysts, partners, and IT team members to understand business requirements that drive the analysis and design of quality technical solutions. Concentrates on providing innovative solutions to more complex business needs.
• Takes a lead role in providing required technical support, including release implementations, on-call and 24x7 supports when necessary.
• Performs work in compliance with all Highmark and Highmark IT standards, policies and procedures.
• Actively takes a leading role and participates on project teams in various project roles, including, but not limited to, Developer, Technical Lead and Project Manager, based upon level of experience.
• Effectively communicates with team members, customers, partners and management, including assisting with or conducting more complex technical walkthroughs, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor’s degree in Information Technology, Computer Science or closely related field

Substitutions

• None

Preferred

• Master’s degree in Information Technology, Computer Science or closely related field

EXPERIENCE

Required

• 5 years of experience as a developer
• Experience with Project Management tools
• Experience with databases
• Experience with multiple coding languages

Preferred:

• 5 years of experience as a developer with demonstrated skills in:
  • Databricks
  • Python/Pyspark
  • GCP:  Big Query and PostgreSQL

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• Certifications such as Python, Databricks, GCP

SKILLS

• Problem solving, root cause analysis, and issue resolution
• Demonstrated leadership skills
• Experience in Healthcare or Health Insurance Industry
• Experience with technology platforms, application development tools, business processes, software development life cycle used by Highmark enterprise

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

The Market Executive is responsible for the leading the delivery system-related performance and strategies in their responsible market(s). This includes overseeing provider partnerships and developing and executing on strategic and operational plans related to the provider network, delivery of care, population health management and cost of care, and growth objectives for the market. This role will work in close partnership with the SVP of Markets to establish strategies in the market that support growth and financial objectives for the various insurance segments sold. The Market Executive will work closely with respective Highmark segment (e.g., Government, commercial) leaders to understand the performance and network needs in the market and coordinate the strategy development and building the networks to deliver that performance across key metrics including quality, risk revenue, affordability, access, customer and clinician experience, and equity. The Market Executive is a key driver of transformational change, including the market’s financial and operational performance, as well as organizational culture, talent, and leadership. As such, this role will be a face to the provider community and will need to have experience working in leadership roles inside delivery system entities as well as the ability to influence and work highly collaboratively with both internal and external executives.

ESSENTIAL RESPONSIBILITIES

• Lead the delivery of key financial and operating targets in the responsible market(s), with a dedicated commitment to optimize revenues, maintain cost effective operations, and provide continuous performance improvement. Accountable for meeting targets in areas of Risk Revenue, Quality/stars, affordability, reimbursement/contracting trend, network alignment. 
• Alongside the segment partners, ensure coordination of all market-performance related levers to meet quality, experience, and affordability goals.
• Lead the development and implementation of a holistic market approach which includes market strategy and structure, retention and profitability, partnership growth, and development of accountability frameworks grounded in KPIs.
• Actively lead the transformational strategies with the strategic partners in the market, pulling on the others in the organization for delivery. This includes strategies such as: value-based and alternative payment models, and MLR and risk models to ensure appropriate program results; growth-related levers including care alignment, attributed membership and wallet share; care model improvements where appropriate; solutions to improve member’s health and lower cost of care; new business and legal structures and / or collaboration models to further economic ties; and, provider administration simplification techniques to create efficiency between payor and provider.
• Engage physician and system leadership to create a culture of alignment and further develop and drive an effective clinical integration strategy, which positions Highmark Health and the provider partner systems as the preeminent brand in the market. Work with physician aggregators to ensure appropriate structures and effective physician management of populations resultant in economic returns associated with that management and lower cost of care for members.
• Attract, retain, and develop top talent, focusing on succession planning and the cultivation of a best-in-class team. Cultivate an organizational culture that drives workforce engagement focused on innovation, learning, and continuous improvement.
• Oversee the full relationships with all parts of the delivery system, including guiding contract negotiations and handling operational issues.  Responsible for ensuring that provider relationship goals are set and met every year. Working with data and analytic teams, identify opportunities for improvement in KPIs not meeting expectations as well as trends emerging in the market requiring actions.  Trend may include increases in utilization, total care costs, potential new asset development, or other provider site of care changes.
• Along with Data and Analytics, work in partnership with segment leads and with health plan partners to identify mutual synergies to address profitability resulting from cost reduction strategies in PMPM including its drivers in disease-based management, care management, utilization management, and risk coding opportunities as well as pharmacy strategies.
• Represent Highmark to appropriate market-based constituencies including provider health system C-suites, vendors, and health plan stakeholders. Represent Highmark Health in the industry for our market approach with provider, producers, customers, regulators, and other community stakeholders. 

​

EDUCATION

Required

• Bachelor's degree in business or health

Substitutions

• None

Preferred

• Master's degree in business or health

EXPERIENCE

Required

• 7+ years in healthcare Industry, with some portion of that as part of a delivery system entity
• 7+ years in a management or leadership role
• 5 years in project management, leadership, or strategic planning
• Strong analytic background     ​

Preferred

• Clinical operations experience
• Understanding and managing provider performance, specifically in hospitals, physician practices or health systems. 
• Experience working within a matrixed organization.
• Business process redesign, change management, or program development.
• Experience in complex program management, MSO capability development or operation improvement.
• Management consulting

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Capable of managing provider leadership relationships as a Highmark executive.
• Broad application of principles, theories, and concepts in strategic thinking.
• Strong PC skills (MS Office, PowerPoint, Excel).
• Breadth of knowledge related to Healthcare industry trends.
• Demonstrated executive presence with outstanding communication skills (verbal, written, and presentation) as well as excellent negotiation, networking, and interpersonal operating and finance skills.
• Ability to work effectively across many matrixed functions and with executive leadership teams.
• Presentation skills and a proven ability to communicate detailed information to healthcare executives, provider leaders and physicians.
• Strong project management skills including the ability to manage multiple projects and meet concurrent deadlines.

Language (Other than English)

None

TRAVEL REQUIREMENTS:

25% - 50%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

This job performs financial and business related research and analysis such as the preparation of forecasts and/or analysis of financial reports, records and trends; develops and maintains spreadsheets and databases to facilitate analysis and reporting; and is responsible for conducting and documenting financial analysis projects.

ESSENTIAL RESPONSIBILITIES

• Communicate effectively.  Display effective communication skills.
• Coordinate with other departments, locations, and divisions.
• Communicate with other departments and/or outside agencies to resolve problems.
• Communicate with Management at Highmark, subsidiaries, affiliates, other third parties, etc. as to project status and completion deadlines.
• Advise management of expected outcomes, and recommending ways to improve the outcomes.
• Conduct presentation to all levels of management in order to provide a summary of analysis regarding financial results and trends.
• Communicate with Management as to project status and completion deadlines.
• Perform financial and business related analysis.
• Analyze, evaluate and interpret appropriate financial and statistical data.
• Develop and/or document business policies, conducts special financial and business related studies and cooperate with other departments in the preparation of analyses.
• Conduct financial and business related analyses and research including the preparation of forecasts and/or analysis of trends.
• Analyze financial reports and records.
• Provide reasoning for variances and make recommendations relative to the accounting of reserves, assets, and expenditures.
• Advise management of expected outcomes, and recommend ways to improve the outcomes.
• Independently pursue fundamental problem solving and documents the recommendations to management.
• Facilitate analysis and reporting
• Utilize computer to input, retrieve or display accounting information.
• Develop and maintain spreadsheets and databases.
• Utilize PC and/or mainframe based systems and software, compile and prepare reports, graphs and charts of data developed.
• Serve as a project lead for special projects within the department.
• Lead and document financial analysis projects including the preparation of ad hoc reports; to include but not limited to; gathering of data, analysis, documentation of findings, and calculation of results and generation of reports for distribution. 
• Coordinate activities to ensure the project is advancing properly and to ensure the project is completed within the timeframes established. Included in this process will be communication with Management at Highmark, subsidiaries, affiliates, other third parties, etc. as to project status and completion deadlines.
• Make recommendations based on findings when necessary.
• Other duties as assigned or requested.

QUALIFICATIONS

EDUCATION

Required

• Bachelor's Degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree

Preferred

• None

EXPERIENCE

Required

• 5 - 10 years of relevant, progressive experience in Accounting and/or Finance
• Experience with various computer applications to include MS Excel and/or MS Access

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Strong written and oral communication skills
• Strong relationship building skills
• Client focused with strong business acumen
• Self-starter with the ability to work under pressure independently and as part of a team.
• Ability to think strategically and act proactively to create strong trust and confidence with business units
• Strong innovative problem-solving capabilities

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

This job works closely with customers and design teams in prioritizing data and information requirements.  This job provides analysis in the development and support of projects and data analysis.  Determines how decision support systems will provide information required to make effective business decisions; translates requirements into applications that employ appropriate decision support and reporting tools.   Recommends innovative approaches to analytical investigations.  Performs modeling of data sources and flows, works with data management staff to define an operational framework that will define, develop and implement policies and security frameworks to ensure precise and secure delivery of knowledge and information.

ESSENTIAL RESPONSIBILITIES

• Develop and foster internal relationships across the corporation.  Provide analytic and consultative support to a broad spectrum of internal customer areas and external business partners.
• Mentor colleagues with less experience on both the technical and business aspects of project and consultative work.
• Determine how decision support systems will provide information required to make effective business decisions, translate requirements into applications that employ appropriate decision support and reporting tools.  Use broad experience and technical knowledge to propose solutions to complex business problems.  Take the lead in driving the implementation of the recommended solutions. 
• Take the lead in defining issues and ideas to be studied as well as the approach (methodological and technical) to be used in addressing studies and projects.  Create and/or develop new methods of analysis, database design, and performance measurement or, in some cases, adaptation of existing solutions to new areas. 
• Perform modeling of data sources and flows, work with data management staff to define an operational framework that will define, develop, and implement policies and security frameworks to ensure precise and secure deliver of knowledge and information.
• Provide assistance and, depending on skill and experience, lead with interpretation of raw data, statistical results or otherwise compiled information, identify follow-up action items, and prepare or assist in the preparation of written reports and/or oral presentation of findings to internal and external audiences, customer managers, clinical  staff, compliance agencies, group accounts, providers, agent plans, and brokers.
• Develop and maintain moderate-to extremely-complex computer programs using 4GL programming languages (such as SAS, R, SQL) and other database technology (DB2, Teradata, and Oracle).
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor's Degree in Computer/Information Science, Mathematics/Statistics, Economics, Industrial Engineering or Operations Research, or related field

Substitutions

• None

Preferred

• Master's degree in or related to Computer/Information Science, Mathematics/Statistics, Economics, Industrial Engineering or Operations Research

EXPERIENCE

Required

• 5 years of relevant, progressive experience as a Decision Support Analyst or equivalent training and experience in a business or clinical environment with direct responsibility for applying technology

Preferred

• None

SKILLS

• Strong technical skills in the mainframe, PC and Internet-based technologies to be effective and must be comfortable and proficient using large and complex databases
• Strong skills using various third-party office and report generation products such as Microsoft Office, Business Objects, Cognos, and Enterprise Guide.
• Strong communication skills.  Must be comfortable presenting findings and offering recommendations to senior management

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Never

Travel regularly from the office to various work sites or from site-to-site

Never

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and traini

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

General Overview:

• This position will perform professional accounting work involving compilation, consolidation, and analysis of accounting and finance information. Incumbent will apply accounting techniques and standard practices to the classification and recording of financial transactions.  Incumbent should be knowledgeable of GAAP accounting, Financial Reporting, and Forecasting.   Specific duties may include, but are not limited to, one or more of the following:  Will provide oversight and guidance to properly track and report on Account Receivable transactions relating to Intercompany Invoice processing.   Will jointly support the creation, distribution and preparation of monthly invoices using the Oracle Cloud Fusion ERP System; this could entail generating and preparing approximately 75-100 invoices per month through collaborative effort with other Subbilling staff; Preparation of monthly reconciliations and flux analyses.  Position will be responsible to lead and manage large projects as well as provide reporting to management.   Person will develop and maintain Invoice forecast to be provided to Treasury for their cash forecasts.   The incumbent will support the MAR and Sales tax audit requests as well as handle various ad hoc requests.  Other duties as assigned or requested.

Essential Job Functions:

• Creation, distribution and preparation of monthly invoices using Oracle Cloud Fusion ERP System (Day-4 to Day 5; 50-60 hours)
• Other month end activities; Subdraws/Settlements, account reconciliation, variance/flux analysis (Day 6 to 10; 20-30 hrs)
• Support Oracle Cloud Fusion ERP Implementations (10-20 hrs). 
• Coordinate with other departments, locations, and divisions.
• Communicate with other departments and/or outside agencies to resolve problems.
• Communicate with Management at Highmark, subsidiaries, affiliates, other third parties, etc. as to project status and completion deadlines.
• Advise management of expected outcomes, and recommending ways to improve the outcomes.
• Conduct presentation to all levels of management in order to provide a summary of analysis regarding financial results and trends.
• Communicate with Management as to project status and completion deadlines.
• Perform financial and business related analysis.
• Analyze, evaluate and interpret appropriate financial and statistical data.
• Develop and/or document business policies, conducts special financial and business related studies and cooperate with other departments in the preparation of analyses.
• Conduct financial and business related analyses and research including the preparation of forecasts and/or analysis of trends.
• Analyze financial reports and records.
• Provide reasoning for variances and make recommendations relative to the accounting of reserves, assets, and expenditures.
• Advise management of expected outcomes, and recommend ways to improve the outcomes.
• Independently pursue fundamental problem solving and documents the recommendations to management.
• Facilitate analysis and reporting
• Utilize computer to input, retrieve or display accounting information.
• Develop and maintain spreadsheets and databases.
• Utilize PC and/or mainframe based systems and software, compile and prepare reports, graphs and charts of data developed.
• Serve as a project lead for special projects within the department.
• Lead and document financial analysis projects including the preparation of ad hoc reports; to include but not limited to; gathering of data, analysis, documentation of findings, and calculation of results and generation of reports for distribution. 
• Coordinate activities to ensure the project is advancing properly and to ensure the project is completed within the timeframes established. Included in this process will be communication with Management at Highmark, subsidiaries, affiliates, other third parties, etc. as to project status and completion deadlines.
• Make recommendations based on findings when necessary.

Minimum Qualifications:

• Bachelor’s degree
• 5-10 years of relevant, progressive experience in Accounting and/or Finance.
• Thorough understanding of generally accepted accounting principles (GAAP).
• Strong experience with various computer applications to include MS Excel and/or MS Access

Preferred Qualifications and skills:

• Understanding of Sales and Use Tax rules and impacts to Intercompany Billing
• Excellent organizational skills and attention to detail.
• Strong analytical and problem-solving skills.
• Strong written and oral communication skills.

• Proficient with Microsoft Products
  • Excel, Word, PowerPoint, etc
• Exposure and experience with ERP Financial Systems
  • Exposure to report writing software
  • Understanding and use of query applications, SmartView, etc.

• Strong leadership skills – able to spearhead medium to large projects and work collaboratively with people from different areas.
• Previous experience performing Account Receivable/invoicing process
• Strong relationship building skills.
• Client focused with strong business acumen.
• Self-starter with the ability to work under pressure independently and as part of a team.
• Ability to think strategically and act proactively to create strong trust and confidence with business units.

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice