Region Director Care Coordination Job at CommonSpirit Health (Tacoma)

Director - Managed Care

Corporate-level leader responsible for executing enterprise-wide strategic and t...

Location

United States , Hollywood

Salary:

Not provided

Memorial Healthcare System

Expiration Date

Until further notice

Requirements

Bachelors (Required)
7 years managed care contracting experience with emphasis on facility contracting, preferably with local market knowledge
Payer and provider experience preferred
Requires critical thinking skills, effective communication skills, decisive judgment and the ability to work with minimal supervision
Must be able to work in a stressful environment and take appropriate action
Strong technical, financial and negotiation skills
Extensive managed care insurance and hospital industry knowledge

Job Responsibility

Enhance, estimate and preserve net revenues
Assures financial viability of contracts through financial analysis and forecasting in conjunction with Financial Analyst(s), contract negotiations and issue resolution
Execute strategies and guides operations to protect and build market share
Plan and monitor activities of staff and/or team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching & disciplinary actions, as applicable
Execute and manage complex legal, financial and operational contract language negotiations
Execute contracting strategy for all service lines in Memorial hospitals, Atlantic Coast Health Network (clinically integrated network), Memorial Health Network (clinically integrated network), MHS employed physicians, transplant programs (including subcontracting hospital-based groups), and ancillary services (ambulatory surgical centers, skilled nursing facility, rehabilitation facility, home health, home infusion, urgent care centers, sleep labs and other components) of the fully integrated healthcare delivery system, and its jointly-owned or joint-ventured entities for fee-for-service and value based agreements (capitation, bundled payments, pay for performance, shared savings, shared risk and full risk agreements)
Direct and analyze financial performance, reports and models, quality metrics and cost savings for negotiations with major national and regional payors
Monitor department operations, activities, resources to meet budget and goals
Respond to insurance industry activities, healthcare reform, payer strategies, emerging market demands, and legislative considerations and changes to the managed care industry to maintain a competitive position
Initiate and research new business opportunities (relationships, pricing, services, structures, operations, quality)

Fulltime

Regional Director of Resident Care

The Regional Director of Resident Care is responsible for activities related to ...

Location

United States , Milwaukee

Salary:

110000.00 - 120000.00 USD / Year

Dewolfe Place

Expiration Date

Until further notice

Requirements

Bachelor of Science in Nursing required
Master of Science in Nursing preferred
Maintains knowledge of regulatory compliance in all states of responsibility
Experience in assisted living, home health or long-term care industries
Ten (10) years' nursing experience
Licensed Registered Nurse in good standing
Five (5) year nursing management experience

Job Responsibility

Monitors the implementation of current policies and procedures, which reflect adherence to corporate and external regulatory guidelines
Reviews new regulatory directives and implements changes as needed
Reviews and investigates resident complaints/Hotline Complaints as directed
Ensures compliance with resident rights policies and works to resolve resident grievances
Conducts compliance surveys at communities
Assist in coordinating actions plans to minimize liability and risks as a result of compliance surveys
Participates in State and Federal surveys and compliance investigations
Supports and follows up with communities in identifying trends and assists in the development of corrective action plans and troubleshooting resolutions
Reports findings of State and Federal surveys to the Regional Operations Leader
Gathers performance improvements indicators and survey data to identify trends

What we offer

Medical
Dental
Vision
Life and disability insurances
Paid time off
Paid holidays
401(k) plan with company match
Employee Assistance Program
Accident insurance policies

Fulltime

Regional Director of Resident Care

The Regional Director of Resident Care is responsible for activities related to ...

Location

United States

Salary:

110000.00 - 120000.00 USD / Year

Rittenhouse Village At Michigan City

Expiration Date

Until further notice

Requirements

Bachelor of Science in Nursing required, Master of Science in Nursing preferred
Maintains knowledge of regulatory compliance in all states of responsibility
Experience in assisted living, home health or long-term care industries
Ten (10) years' nursing experience
Licensed Registered Nurse in good standing
Five (5) year nursing management experience

Job Responsibility

Monitors the implementation of current policies and procedures which reflect adherence to corporate and external regulatory guidelines
Reviews new regulatory directives and implements changes as needed
Reviews and investigates resident complaints/Hotline Complaints as directed
Ensures compliance with resident rights policies and works to resolve resident grievances
Conducts compliance surveys at communities
Assists in coordinating actions plans to minimize liability and risks as a result of compliance surveys
Participates in State and Federal surveys and compliance investigations
Supports and follows up with communities in identifying trends and assists in the development of corrective action plans and troubleshooting resolutions
Reports findings of State and Federal surveys to the Regional Operations Leader
Gathers performance improvements indicators and survey data to identify trends

What we offer

Medical insurance
Dental insurance
Vision insurance
Life insurance
Disability insurances
Paid time off
Paid holidays
401(k) plan with company match
Employee Assistance Program
Accident insurance policies

Fulltime

Regional Director of Resident Care

The Regional Director of Resident Care is responsible for activities related to ...

Location

United States

Salary:

105000.00 - 115000.00 USD / Year

Dewolfe Place

Expiration Date

Until further notice

Requirements

Bachelor of Science in Nursing required
Master of Science in Nursing preferred
Maintains knowledge of regulatory compliance in all states of responsibility
Experience in assisted living, home health or long-term care industries
Ten (10) years’ nursing experience
Licensed Registered Nurse in good standing
Five (5) year nursing management experience

Job Responsibility

Monitors the implementation of current policies and procedures, which reflect adherence to corporate and external regulatory guidelines
Reviews new regulatory directives and implements changes as needed
Reviews and investigates resident complaints/Hotline Complaints as directed
Ensures compliance with resident rights policies and works to resolve resident grievances
Conducts compliance surveys at communities
Assist in coordinating actions plans to minimize liability and risks as a result of compliance surveys
Participates in State and Federal surveys and compliance investigations
Supports and follows up with communities in identifying trends and assists in the development of corrective action plans and troubleshooting resolutions
Reports findings of State and Federal surveys to the Regional Operations Leader
Gathers performance improvements indicators and survey data to identify trends

What we offer

medical
dental
vision
life and disability insurances
paid time off
paid holidays
401(k) plan with company match
Employee Assistance Program
accident insurance policies

Fulltime

Care Management Coordinator OhioRISE - Field - Central and SE Region of Ohio

This is a full-time field-based telework position, in Ohio. This position requir...

Location

United States , Columbus

Salary:

21.10 - 40.90 USD / Hour

CVS Health

Expiration Date

Until further notice

Requirements

2+ years of experience in behavioral health, social services, or human services
2+ years of experience with personal computers, keyboard and multi-system navigation, and MS Office Suite applications (Outlook, Word, Excel, SharePoint)
2+ years of experience in children's mental health, child welfare, developmental disabilities, juvenile justice, or a public sector human services or behavioral health care field, providing community-based services to children and youth, and their family/caregivers
2+ years experience in one or more of the following areas of expertise: family systems, community systems and resources, case management, child and family counseling/therapy, child protection, or child development
2+ year of experience with Ohio delivery systems, including local community networks and resources
Willing and able to travel within the assigned region up to 50% of the time
Some travel to the New Albany office may be required for trainings/meetings
Reliable transportation required
Willing and able to work beyond core business hours of Monday-Friday, 8am-5pm, as needed
Bachelor's degree or non-licensed master level clinician required

Job Responsibility

Utilizes critical thinking and judgment to collaborate and inform the case management process
Facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members
Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution
Coordinates and implements assigned care plan activities and monitors care plan progress
Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health/behavioral health programs to overcome barriers
Works collaboratively with the members' Child and Family Teams
Identifies and escalates quality of care issues through established channels
Utilizes negotiation skills to secure appropriate options and services
Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement
Provides coaching, information, and support to empower the member

What we offer

Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs
Bonus, commission or short-term incentive program

Fulltime

Human Resources Manager

As a member of the property Human Resources support staff, he/she works with Hum...

Location

Indonesia , Nusa Lembongan

Salary:

Not provided

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

High school diploma or GED
3 years experience in the human resources, management operations, or related professional area
2-year degree from an accredited university in Human Resources, Business Administration, or related major
1 year experience in the human resources, management operations, or related professional area

Job Responsibility

Assists in the interviewing and hiring of Human Resource employee team members with the appropriate skills, as needed
Establishes and maintains contact with external recruitment sources
Attends job fairs and ensures documentation of outreach efforts in accordance with Human Resource Standard Operating Procedures
Networks with local organizations (e.g., Hotel Association and peers) to source candidates for current or future openings
Oversees/monitors candidate identification and selection process
Provides subject matter expertise to property managers regarding selection procedures
Partners with vendor partners to ensure effective advertisement efforts are being utilized for open positions in appropriate venues to attract a diverse candidate pool
Performs quality control on candidate identification/selection
Works with the unemployment services provider to respond to unemployment claims
reviews provider reports for accuracy and corrects errors

Fulltime

Sr. Human Resources Manager - Collegiate Hospitality

The HR Generalist Manager will provide vital support to the Senior Managers and ...

Location

United States , Morrisville

Salary:

Not provided

Aramark

Expiration Date

Until further notice

Requirements

Previous human resources experience crucial - preferably multi-site operation
Operational management experience preferable
Team building skills to plan, lead and empower all staff
Ability to collaborate closely with management
Previous experience of a HRIS system
Good written and verbal communication skills, able to communicate and co-ordinate effectively at all levels in the organization
Is eloquent and a completer finisher
Motivation - to work alone with no supervision - handling unstructured and diverse workload
Action based and a natural Problem solver, results focused
Influencing skills and flexible and adaptable

Job Responsibility

Act as company representative at management appeal interviews
Act as company representative at management grievance appeal interviews
Represent the company at all employment tribunals
Assist in company training programs
Ensure employee presentations are carried out where contract has been won
Prepare reports as needed
Review employee relations queries that the HR Advisors are unsure of
Take care of any regional team management employee relations query that may lead to disciplinary action
Prepare material for employment tribunal claims
Ensure that all managers in the region are kept up to date with any legal changes, with any HR company changes as coordinated by the company HR Director

Fulltime

Clinical Research Coordinator II

Must be comfortable with 50% travel. Highly prefer someone who lives in the Nort...

Location

United States

Salary:

Not provided

Fresenius Kidney Care Eupora

Expiration Date

Until further notice

Requirements

2 to 4 years of clinical research experience, or has successfully performed in the role of Clinical Research Coordinator I for a minimum of 3 years and demonstrated outstanding performance through performance evaluations, certification and other job performance measures
Critical care, nephrology and/ or cardiac experience desirable
Willing to pursue CCRC or CCRP certification when eligible
Current state licensure, if applicable
Good computer skills: Microsoft Office minimally
Excellent communication and organizational skills
Ability to work independently, and exhibit diplomacy and problem solving skills in the performance of this role

Job Responsibility

Assists with the determination of the guidelines for the collection of clinical data and coordinates and implements procedures and processes for data collection
Coordinates all aspects of study subject care from pre-screening through study completion as defined by the protocol and Principal Investigator (PI) delegation
Protect the rights and the well-being of subjects enrolled in studies
Ensures thorough, individualized, protocol-based study subject education on all study process requirements including but not limited to: informed consent, study participation obligations, appropriate use of investigational product, safety, privacy, rights and responsibilities
Develops processes for methodically monitoring the status of study subjects as they progress through the study’s timeline of activities
Regularly evaluates the study subjects’ condition and communicates/documents concerns to PI to ensure subject safety
Accurately documents study subject activities as outlined by the protocol
Maintains documents according to applicable HIPAA and regulatory requirements
Implements study-specific quality goals and practices
Acts as the point of contact or lead person in a facility/practice to oversee protocol compliance

Select Country

Region Director Care Coordination

Job Description

Job Responsibility

Requirements

What we offer

Looking for more opportunities?