Director - Clinical Services Operations

07101 Newark, New Jersey Maximus

Posted 7 days ago

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Job Description

Permanent
Description & Requirements

We are currently seeking qualified and motivated professionals interested in joining our team in support of an upcoming federal contract (pending award). This position will play a key role in delivering high-quality services to our government client and will be contingent upon contract award.

As part of this project, you will support a federally funded initiative that provides essential medical readiness services-such as exams, screenings, dental care and preventive care-to individuals in remote or underserved areas. Services are delivered through a network of providers and mobile teams, with remote coordination and scheduling. The program ensures consistent access to care across dispersed populations and contributes to broader public service goals.

The Director, Clinical Services Operations will lead the operational and clinical execution of program services, ensuring alignment with contract requirements and clinical standards. This role will collaborate closely with internal teams to coordinate scheduling, logistics, and service delivery. The Director will monitor key performance metrics, drive process improvements, and serve as primary point of contact for client communications and reporting.

***Please note that this position is contingent upon bid award***

Essential Duties and Responsibilities:

- Lead the day-to-day operations to ensure compliance with the prime contract, all subsequent amendments, program business rules, as well as state and federal regulations.

- Develop and implement innovative methodologies, process improvements and corrective action plans to continually streamline and improve project operations, outcomes and quality.

- Develop clinical protocols based on regulations and best practices.

- Develop policies and procedures related to care, in accordance with state and federal requirements.

- Participate in the training and education of staff, and review assessments with clinicians to improve assessment outcomes.

- Provide direction and guidance to staff, individually and in teams, to achieve quality assurance goals.

- Manage multiple teams led by managers and/or supervisors including creating workforce and staffing plans and making hiring, firing, promotion and rewards decisions in accordance with guidelines.

Minimum Requirements

- Bachelor's degree in relevant field of study and 10+ years of relevant professional experience required.

- At least eight (8 years) of experience managing large, complex, healthcare or human services programs with government contracting required.

- Minimum of eight (8) years of clinical experience.

- Proven leadership in operational environments; multi-site experience preferred.

- Call center-style workflow experience preferred.

- Military service or occupational health background preferred.

- Travel expectations up to 10%.

- Per contact requirements, this position is open only to U.S. citizens.

EEO Statement

Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.

Pay Transparency

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.

Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at .

Minimum Salary

$

142,800.00

Maximum Salary

$

182,800.00

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Program Manager, Healthcare Services - Clinical Systems

10701 Yonkers, New York Molina Healthcare

Posted 12 days ago

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Job Description

**Job Summary**
Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
+ Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion.
+ Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes.
+ May engage and oversee the work of external vendors.
+ Focuses on process improvement, organizational change management, program management and other processes relative to business needs.
+ Serves as a subject matter expert and leads healthcare services programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate.
+ Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs), user training materials and other related business documents.
**Required Qualifications**
+ At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
+ Strong analytical and problem-solving skills.
+ Strong organizational and time-management skills.
+ Ability to work in a cross-functional, professional environment.
+ Experience working within applicable state, federal, and third-party regulations.
+ Strong verbal and written communication skills.
+ Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
**Preferred Qualifications**
+ Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.
+ Leadership experience.
+ Medicaid/Medicare population experience.
+ Six sigma certification
+ Experience with Agile Methodology
+ Experience with Epic
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Clinical Pharmacist, Pharmaceutical Services Consultant

07932 Florham Park, New Jersey Conduent

Posted 2 days ago

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Job Description

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
The **Clinical Pharmacist, Pharmaceutical Services Consultant,** will analyze new-to-market medications and propose use criteria to MOHealthNet for utilization by Missouri Medicaid participants.
**Responsibilities**
+ Providing ad-hoc query results to the client, MOHealthNet, to support clinical program recommendations.
+ Proactively bringing new drug criteria and analyses to the department with recommendations on coverage, clinical criteria, Pharmacoeconomics, and pharmacy practice guidelines.
+ Providing ad-hoc query results to the client to support clinical program recommendations.
+ Leading weekly and quarterly scheduled client clinical meetings. Being available during business hours to respond to client requests and questions.
+ Authoring medication reviews for use by MOHealthNet and the Missouri Rare Disease Advisory Committee.
+ Researching to implement new interventions, creating ad hoc reports, and answering client, provider, and staff inquiries.
+ Working with the account team to maintain current interventions based on updates to clinical guidelines and treatment recommendations.
**Requirements**
+ Have a PharmD degree.
+ Possess a current Missouri Pharmacist license in good standing or be able to obtain a Missouri Pharmacist license within 6 months of hire.
+ Demonstrate experience with Pharmacy Benefit Management, Prior Authorization, and knowledge of pharmacy point-of-sale and adjudication rules.
**Preferred**
+ Display understanding of Prior Authorization applications, Pro DUR, and Retro DUR.
+ Medicaid experience.
**Flexible Working**
At Conduent, we want you to be yourself. We recognize that everyone is different and that how people want to work and deliver at their best is different for everyone too.
In this role, you can expect the following working conditions:
+ **Remote work** : Enjoy the convenience of working from home and maximize your time by unplugging at the end of your workday.
**Working For You**
Perks and rewards designed for you:
+ Health and Welfare Benefits: Our health and welfare benefits can be tailored to fit you and your family's needs and start on the first day of employment.
+ Retirement Savings: We will support you as you save for your future.
+ Employee Discounts: We offer you access to a vast selection of global, national, and local discounts on merchandise, services, travel, and more.
+ Career Growth Opportunities: We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
+ Paid Training: Earn while you learn and continue to grow with access to award-winning learning platforms throughout your Conduent career.
+ Paid time off: We provide attractive paid time off packages designed for you to enjoy your life away from work.
+ Great Work Environment: We are proud of our award-winning culture and the recognition we've received for our diversity efforts.
**Join Us**
At Conduent, we are one team, one mission. We understand that our success is directly related to the success of our associates. We strive to create a culture where you can:
Bring your authentic self to work.
Grow and thrive, both personally and professionally.
Make a difference with our clients, in our communities, and with the millions of people we support.
When you join Conduent, you are engaged in creating the future - both our company's and your own. With more than 60,000 associates across 24 countries, we will provide you the opportunity to grow with a team of people who will challenge and inspire you to be the best!
Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $95,000-$123,500.
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form ( . Complete the form and then email it as an attachment to . You may also click here to access Conduent's ADAAA Accommodation Policy ( .
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Patient Care Coordinator

07070 Rutherford, New Jersey UnitedHealth Group

Posted today

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Job Description

**Opportunities with Optum in the Tri-State region** (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind **Caring. Connecting. Growing together.**  
**Rutherford Cardiology** has an immediate opening for a friendly, patient focused and detailed oriented **Patient Care Coordinator** to join our team. The **Patient Care Coordinator** is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals.
**Working Hours:** Monday through Friday a 40-hour work week between the hours of 8:00 am to 4:00 pm, 7:00 am to 3:00 pm or 9:00am to 5:00pm, rotating Saturdays from 8:00 am to 1:00 pm. Scheduleshift to be determined by manager upon hire.
**Location:** 201 Route 17 North, Eleventh Floor, Suite 1101 Rutherford, NJ 07070
**Primary Responsibilities:**
+ Obtain accurate and updated patient information, such as name, address and insurance information
+ Perform insurance verification on the date of service
+ Obtain patient signatures for required documents
+ Upload a valid Government issued state ID of patient and patient insurance cards
+ Accurate and complete occupational medicine registration workflow
+ File and maintain medical records
+ Consistently correct registration work queue errors
+ Confirms and schedule appointments
+ Answer telephone calls promptly and courteously
+ Perform referral documentation promptly
+ Working daily in the claims edit work queue to correct registration errors for submission to insurance companies
+ Performs certain follow-up services for patients in a prompt and courteous manner, such as scheduling specialist appointments, scheduling follow-up appointments and obtaining copies of lab results or specialist reports
+ Adhere to the standards identified via Sparq regarding Optum Employee Policies
+ Work cohesively with fellow employees to achieve specific team goals
+ Comfortable working in high pace environment
+ Participate in planning, coordinating, and implementing care in conjunction with the multidisciplinary team in accordance with the Plan of Care
+ Assure the continuity of care through scheduling and tracking systems
+ Provide effective communication to patient / family team members and other health care professionals as evidenced by documentation, case conferences, communication notes, and evaluations
+ Notify clinical staff of schedule changes as they occur
+ Comply with administrative policies to ensure quality of care
+ Demonstrate precision and efficiency in scanning documents and monitoring the fax server, retrieving and / or scanning documents and assigning to the appropriate electronic chart
+ Participate in orientation (scheduling segment) of new field employees and distribute updates and changes as needed
+ Perform other related duties and assignments as required
+ Organize and maintain medical records
+ All employees are expected to keep abreast of current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPPA and OSHA requirements
+ Complete new clinical competencies rolled out by the Educational Committee
+ Performs other duties as assigned
**What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:**
+ Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
+ Medical Plan options along with participation in a Health Spending Account or a Health Saving account
+ Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
+ 401(k) Savings Plan, Employee Stock Purchase Plan
+ Education Reimbursement
+ Employee Discounts
+ Employee Assistance Program
+ Employee Referral Bonus Program
+ Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
+ More information can be downloaded at: be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ High School Diploma/GED (or higher)
+ 1+ years of experience working in medical office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays, and maintaining medical records
+ Intermediate level of computer proficiency including MS Word, Excel and Outlook and the ability to use multiple web applications
+ Ability to travel 10% of the time to cover other offices as needed and have reliable transportation
**Preferred Qualifications:**
+ Knowledge of Epic EMR software
+ Bilingual in Spanish and English
**Soft Skills:**
+ Ability to work independently and maintain good judgment and accountability
+ Demonstrated ability to work well with health care providers
+ Strong organizational and time management skills
+ Ability to multi-task and prioritize tasks to meet all deadlines
+ Ability to work well under pressure in a fast-paced environment
+ Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
#RPO #RED
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Patient Care Coordinator

07020 Edgewater, New Jersey UnitedHealth Group

Posted 10 days ago

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Job Description

**Opportunities with Optum in the Tri-State region** (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind **Caring. Connecting. Growing together.**  
**Optum Edgewater** has an immediate opening for a friendly, patient focused and detailed oriented Patient Care Coordinator to join our team. The **Patient Care Coordinator** is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals.
**Hours:** Monday through Friday a 40-hour work week between the hours of 8:00 am to 6:00 pm. Rotating Saturdays from 8:00 am to 2:00 pm. Schedule to be determined by manager upon hire.
**Location:** 935 River ROAD, Suite 301 Edgewater, NJ 07020.
**Primary Responsibilities:**
+ Obtain accurate and updated patient information, such as name, address, insurance information
+ Perform insurance verification on the date of service
+ Obtain patient signatures for required documents
+ Upload a valid Government issued state ID of patient and patient insurance cards
+ Accurate and complete occupational medicine registration workflow
+ File and maintain medical records
+ Consistently correct registration work queue errors
+ Confirms and schedule appointments
+ Answer telephone calls promptly and courteously
+ Perform referral documentation promptly
+ Working daily in the claims edit work queue to correct registration errors for submission to insurance companies
+ Performs certain follow-up services for patients in a prompt and courteous manner, such as scheduling specialist appointments, scheduling follow-up appointments and obtaining copies lab results or specialist reports
+ Adhere to the standards identified via Sparq regarding Optum Employee Policies
+ Work cohesively with fellow employees to achieve specific team goals
+ Keep abreast on current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPAA and OSHA requirements
+ Comfortable working in high pace environment
+ Participate in planning, coordinating, and implementing care in conjunction with the multidisciplinary team in accordance with the Plan of Care
+ Assure the continuity of care through scheduling and tracking systems
+ Provide effective communication to patient / family team members and other health care professionals as evidenced by documentation, case conferences, communication notes, and evaluations
+ Notify clinical staff of schedule changes as they occur
+ Comply with administrative policies to ensure quality of care
+ Demonstrate precision and efficiency in scanning documents and monitoring the fax server, retrieving and / or scanning documents and assigning to the appropriate electronic chart
+ Participate in orientation (scheduling segment) of new field employees and distribute updates and changes as needed
+ Perform other related duties and assignments as required
+ Organize and maintains medical records
+ All employees are expected to keep abreast on current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPPA and OSHA requirements
+ Complete new clinical competencies rolled out by the Educational Committee
+ Performs other duties as assigned
**What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:**
+ Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
+ Medical Plan options along with participation in a Health Spending Account or a Health Saving account
+ Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
+ 401(k) Savings Plan, Employee Stock Purchase Plan
+ Education Reimbursement
+ Employee Discounts
+ Employee Assistance Program
+ Employee Referral Bonus Program
+ Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
+ More information can be downloaded at: be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ High School Diploma/GED (or higher)
+ 1+ years of experience working in a medical office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays, and maintaining medical records
+ Intermediate level of computer proficiency including MS Word, Excel and Outlook be able to use multiple web applications
+ Ability to travel 10 % of the time within territory assigned, and have reliable transportation
**Preferred Qualifications:**
+ Knowledge of Epic EMR software
+ Bilingual in Spanish and English
**Soft Skills:**
+ Ability to work independently and maintain good judgment and accountability
+ Demonstrated ability to work well with health care providers
+ Strong organizational and time management skills
+ Ability to multi-task and prioritize tasks to meet all deadlines
+ Ability to work well under pressure in a fast-paced environment
+ Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
#RPO, #RED
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Patient Care Coordinator

07002 Bayonne, New Jersey UnitedHealth Group

Posted 14 days ago

Job Viewed

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Job Description

**Opportunities with Optum in the Tri-State region** (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind **Caring. Connecting. Growing together.**  
**Bayonne Rheumatology** has an immediate opening for a friendly, patient focused and detailed oriented **Patient Care Coordinator** to join our team. The **Patient Care Coordinator** is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals.
**Schedule:** A 40-hour work week, Monday through Thursday from 8:00 am to 5:00 pm, Friday 8 am to noon. The schedule will be determined by the supervisor upon hire.
**Location** : 191 Lefante Way, Suite 1-C, Bayonne, NJ 07002
**Primary Responsibilities:**
+ Obtain accurate and updated patient information, such as name, address and insurance information
+ Perform insurance verification on the date of service
+ Obtain patient signatures for required documents
+ Upload a valid Government issued state ID of patient and patient insurance cards
+ Accurate and complete occupational medicine registration workflow
+ File and maintain medical records
+ Consistently correct registration work queue errors
+ Confirms and schedule appointments
+ Answer telephone calls promptly and courteously
+ Perform referral documentation promptly
+ Working daily in the claims edit work queue to correct registration errors for submission to insurance companies
+ Performs certain follow-up services for patients in a prompt and courteous manner, such as scheduling specialist appointments, scheduling follow-up appointments and obtaining copies of lab results or specialist reports
+ Adhere to the standards identified via Sparq regarding Optum Employee Policies
+ Work cohesively with fellow employees to achieve specific team goals
+ Comfortable working in high pace environment
+ Participate in planning, coordinating, and implementing care in conjunction with the multidisciplinary team in accordance with the Plan of Care
+ Assure the continuity of care through scheduling and tracking systems
+ Provide effective communication to patient / family team members and other health care professionals as evidenced by documentation, case conferences, communication notes, and evaluations
+ Notify clinical staff of schedule changes as they occur
+ Comply with administrative policies to ensure quality of care
+ Demonstrate precision and efficiency in scanning documents and monitoring the fax server, retrieving and / or scanning documents and assigning to the appropriate electronic chart
+ Participate in orientation (scheduling segment) of new field employees and distribute updates and changes as needed
+ Perform other related duties and assignments as required
+ Organize and maintain medical records
+ All employees are expected to keep abreast of current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPPA and OSHA requirements
+ Complete new clinical competencies rolled out by the Educational Committee
+ Performs other duties as assigned
**What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:**
+ Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
+ Medical Plan options along with participation in a Health Spending Account or a Health Saving account
+ Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
+ 401(k) Savings Plan, Employee Stock Purchase Plan
+ Education Reimbursement
+ Employee Discounts
+ Employee Assistance Program
+ Employee Referral Bonus Program
+ Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
+ More information can be downloaded at: be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ High School Diploma/GED (or higher)
+ 1+ years of experience working in medical office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays, and maintaining medical records
+ Intermediate level of computer proficiency including MS Word, Excel and Outlook be able to use multiple web applications
+ Ability to travel 10% of the time to cover other offices as needed and have reliable transportation
**Preferred Qualifications:**
+ Knowledge of Epic EMR software
+ Bilingual in Spanish and English
**Soft Skills:**
+ Ability to work independently and maintain good judgment and accountability
+ Demonstrated ability to work well with health care providers
+ Strong organizational and time management skills
+ Ability to multi-task and prioritize tasks to meet all deadlines
+ Ability to work well under pressure in a fast-paced environment
+ Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
#RPO #RED
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Patient Care Coordinator

07110 Nutley, New Jersey Adecco US, Inc.

Posted 20 days ago

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Job Description

Adecco Healthcare & Life Sciences is hiring a Patient Care Coordinator in Nutley, New Jersey. This role is in person / onsite. Please read below and reply with an updated resume for consideration:
**Type:** Three-month contract, with opportunity for full-time offer
**Schedule:** Monday through Friday, 40 hours between 8am and 7pm, with rotating Saturdays
**Pay:** $20.00 to $3.00 an hour
**Responsibilities of the Patient Care Coordinator:**
· Welcome patients as they enter the site with a friendly greeting.
· Assist patients with locating items or answering general questions.
· Maintain a clean and organized entrance area.
· Attention to detail and ability to manage multiple tasks efficiently
· Familiarity with medical terminology and HIPAA compliance
· Answering incoming calls
· Chart prep, including Insurance verification
· End of day reconciliation
· Collect patient payments
· Make patient follow up calls (e.g., after procedures, admissions, or ER visits) to identify/close gaps in care
· Ask patients for and/or assist patients with completing required paperwork (e.g., health history, insurance documentation, etc.)
· Manage/respond constructively to challenging patient interactions
**Qualifications of the** **Patient Care Coordinator:**
· High School Graduate or GED
· Prior experience in a front-facing role ideally in healthcare
· Clear, compassionate, and professional verbal communication
· Bilingual with English + Spanish is a plus
**Why work for Adecco?**
· Weekly Pay
· 401(k) Plan
· Skills Training
· Excellent medical, dental, and vision benefits
**IMPORTANT:** This **Patient Care Coordinator** job is being recruited for by Adecco Healthcare & Life Sciences division, not your local Adecco Branch Office.
For opportunities available at Adecco Healthcare & Life Sciences go to Details:** $20.00 to $23.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
+ The California Fair Chance Act
+ Los Angeles City Fair Chance Ordinance
+ Los Angeles County Fair Chance Ordinance for Employers
+ San Francisco Fair Chance Ordinance
**Massachusetts Candidates Only:** It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
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Patient Care Coordinator

07663 Saddle Brook, New Jersey UnitedHealth Group

Posted 22 days ago

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Job Description

**Opportunities with Optum in the Tri-State region** (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind **Caring. Connecting. Growing together.**  
Optum is seeking a **Patient Care Coordinator** to join our growing team. At Optum, we are transforming healthcare nationally while providing physician-led care locally. Work with the largest care delivery organization in the world and start doing **your life's best work.**
**Optum Saddle Brook Adult Medicine** has an immediate opening for a friendly, patient focused and detailed oriented **Patient Care Coordinator** to join our team. The **Patient Care Coordinator** is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals.
**Working Hours:** Monday through Friday between the hours of 8:00 am to 8:00 pm, (must work late (closing) shift 2 nights per week) Rotating Saturdays from 8:00 am to 2:00 pm. This is a 40-hour work week, and the shifts are to be determined by the practice manager upon hire. May be asked to float to other clinics as needed
**Location** : 299 Market Street, Suite 110, Saddle Brook, NJ 07663
**Primary Responsibilities:**
+ Obtain accurate and updated patient information, such as name, address, insurance information
+ Perform insurance verification on the date of service
+ Obtain patient signatures for required documents
+ Upload a valid Government issued state ID of patient and patient insurance cards
+ Accurate and complete occupational medicine registration workflow
+ File and maintain medical records
+ Consistently correct registration work queue errors
+ Confirms and schedule appointments
+ Answer telephone calls promptly and courteously
+ Perform referral documentation promptly
+ Working daily in the claims edit work queue and referrals work queue to correct registration errors for submission to insurance companies
+ Performs certain follow-up services for patients in a prompt and courteous manner, such as scheduling specialist appointments, scheduling follow-up appointments and obtaining copies of lab results or specialist reports
+ Adhere to the standards identified via Sparq regarding Optum Employee Policies
+ Work cohesively with fellow employees to achieve specific team goals
+ Keep abreast of current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPAA and OSHA requirements
+ Comfortable working in a high pace environment
+ Participate in planning, coordinating, and implementing care in conjunction with the multidisciplinary team in accordance with the Plan of Care
+ Assure the continuity of care through scheduling and tracking systems
+ Provide effective communication to patient / family team members and other health care professionals as evidenced by documentation, case conferences, communication notes, and evaluations
+ Notify clinical staff of schedule changes as they occur
+ Comply with administrative policies to ensure quality of care
+ Demonstrate precision and efficiency in scanning documents and monitoring the fax server, retrieving and / or scanning documents and assigning to the appropriate electronic chart
+ Participate in orientation (scheduling segment) of new field employees and distribute updates and changes as needed
+ Perform other related duties and assignments as required
+ Organize and maintain medical records
+ All employees are expected to keep abreast of current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPAA and OSHA requirements
+ Complete new clinical competencies rolled out by the Educational Committee
+ Work Independently and assist with clinical duties on a limited basis
+ Performs other duties as assigned
**What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:**
+ Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
+ Medical Plan options along with participation in a Health Spending Account or a Health Saving account
+ Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
+ 401(k) Savings Plan, Employee Stock Purchase Plan
+ Education Reimbursement
+ Employee Discounts
+ Employee Assistance Program
+ Employee Referral Bonus Program
+ Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
+ More information can be downloaded at: be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ High School Diploma/GED (or higher)
+ 1+ years of experience working in a medical office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays and maintaining medical records
+ Intermediate level of computer proficiency including MS Word, Excel and Outlook and the ability to use multiple web applications
+ Access to reliable transportation and the ability to travel 10% of the time to cover other offices as needed
**Preferred Qualifications:**
+ Knowledge of Epic EMR software
+ Bilingual Spanish and English
**Soft Skills:**
+ Ability to work independently and maintain good judgment and accountability
+ Demonstrated ability to work well with health care providers
+ Strong organizational and time management skills
+ Ability to multi-task and prioritize tasks to meet all deadlines
+ Ability to work well under pressure in a fast-paced environment
+ Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
#RPO #RED
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Patient Care Coordinator

07011 Clifton, New Jersey UnitedHealth Group

Posted 2 days ago

Job Viewed

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Job Description

**Opportunities with Optum in the Tri-State region** (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind **Caring. Connecting. Growing together.**  
Optum is seeking a **Patient Care Coordinator** to join our growing team. At Optum, we are transforming healthcare nationally while providing physician-led care locally. Work with the largest care delivery organization in the world and start doing **your life's best work.**
**Optum Medical** has an immediate opening for a friendly, patient focused and detailed oriented **Patient Care Coordinator** to join our team. The **Patient Care Coordinator** is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals.
**Working Hours:** Monday through Friday from 8:00 am to 7:00 pm, and Saturdays between the hours of 8:00 am to 2:00 pm. This is a 40-hour work week, and the shifts are to be determine by the practice manager upon hire.
**Location:** 930 CLIFTON AVENUE, First floor Clifton, NJ 07013
**Primary Responsibilities:**
+ Obtain accurate and updated patient information, such as name, address, insurance information
+ Perform insurance verification on the date of service
+ Obtain patient signatures for required documents
+ Upload a valid Government issued state ID of patient and patient insurance cards
+ Accurate and complete occupational medicine registration workflow
+ Consistently correct registration work queue errors
+ Confirms and schedule appointments
+ Answer telephone calls promptly and courteously
+ Perform referral documentation promptly
+ Working daily in the claims edit work queue to correct registration errors for submission to insurance companies
+ Performs certain follow-up services for patients in a prompt and courteous manner, such as scheduling specialist appointments, scheduling follow-up appointments and obtaining copies lab results or specialist reports
+ Adhere to the standards identified via Sparq regarding Optum Employee Policies
+ Work cohesively with fellow employees to achieve specific team goals
+ Keep abreast on current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPAA and OSHA requirements
+ Comfortable working in high pace environment
+ Participate in planning, coordinating, and implementing care in conjunction with the multidisciplinary team in accordance with the Plan of Care
+ Assure the continuity of care through scheduling and tracking systems
+ Provide effective communication to patient / family team members and other health care professionals as evidenced by documentation, case conferences, communication notes, and evaluations
+ Notify clinical staff of schedule changes as they occur
+ Comply with administrative policies to ensure quality of care
+ Demonstrate precision and efficiency in scanning documents and monitoring the fax server, retrieving and / or scanning documents and assigning to the appropriate electronic chart
+ Participate in orientation (scheduling segment) of new field employees and distribute updates and changes as needed
+ Perform other related duties and assignments as required
+ Organize and maintains medical records
+ Complete new clinical competencies rolled out by the Educational Committee
+ Work Independently, and Assist with Clinical duties on a limited basis
+ Performs other duties as assigned
**What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:**
+ Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
+ Medical Plan options along with participation in a Health Spending Account or a Health Saving account
+ Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
+ 401(k) Savings Plan, Employee Stock Purchase Plan
+ Education Reimbursement
+ Employee Discounts
+ Employee Assistance Program
+ Employee Referral Bonus Program
+ Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
+ More information can be downloaded at: be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ High School Diploma/GED (or higher)
+ 1+ years of experience working in medical office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays and maintaining medical records
+ Intermediate level of computer proficiency including MS Word, Excel and Outlook and the ability to use multiple web applications
+ Ability to travel to other offices if needed
+ Ability to work a 40-hour week schedule
+ Monday through Friday from 8:00 am to 7:00 pm
+ Saturdays from 8:00 am to 2:00 pm
+ Bilingual in Spanish and English
**Preferred Qualifications:**
+ Knowledge of Epic EMR software
**Soft Skills:**
+ Ability to work independently and maintain good judgment and accountability
+ Demonstrated ability to work well with health care providers
+ Strong organizational and time management skills
+ Ability to multi-task and prioritize tasks to meet all deadlines
+ Ability to work well under pressure in a fast-paced environment
+ Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
#RPO #RED
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Patient Care Associate (PCA)

11375 Forest Hills, New York Northwell Health

Posted 9 days ago

Job Viewed

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Job Description

**Req Number**
Job Description
Provides direct care as assigned for a designated group of patients. Performs functions requiring skill and competence such as, but not limited to phlebotomy, EKG, obtaining specimens and cultures, activities of daily living, simple wound dressings and vital signs. Shares accountability for quality patient outcomes.
Job Responsibility
+ * Assists with the unit's admission and discharge processes.
+ * Establishes good interpersonal relationships with families/visitors and hospital staff.
+ Reports vital information to all levels of the healthcare team, as needed.
+ Conveys needed information to patients and visitors.
+ Maintains good communication with co-workers for proper team functioning.
+ Communicates pertinent patient observations to members of the health care team.
+ * Performs direct patient care as assigned for designated group of patients.
+ Obtains and documents patient vital signs (temperature, blood pressure, respirations, pulse, weight, and height) using appropriate equipment.
+ Apprises the Registered Nurse and health care team of any observed significant changes in the patient's condition.
+ Communicates written and verbal information.
+ Responds to patient requests and/or call light.
+ Maintains a safe, comfortable and therapeutic environment for patients and families in accordance with hospital standards.
+ Functions in an emergency situation as a team member with guidance from supervisory personnel.
+ Assists with restrained patients according to established policy.
+ * Performs grade I and II decubitus care, as directed.
+ * Performs activities of daily living appropriate to patient's condition.
+ Uses proper body mechanics, obtains help and/or uses appropriate equipment when lifting, moving or transferring patients from bed to chair, putting them on stretchers and assisting them into wheelchairs.
+ * Performs delegated patient care procedures.
+ * Obtains and labels specimens, and performs certain diagnostic tests consistent with established procedures, as directed.
+ * Performs phlebotomy procedures.Performs telemetry and electrocardiograms, as directed.
+ * Uses clinical knowledge in the care and management of patients based on diagnoses and the unit assigned.
+ Performs related duties, as required.
*ADA Essential Functions
Job Qualification
High School graduate or equivalency diploma, required.
Nursing Assistant Certificate with proficiency in performing EKG and Phlebotomy, preferred.
Minimum two (2) years of direct patient care experience, required.
*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
The salary range for this position is $29.32-$29.89/hour
It is Northwell Health's policy to provide equal employment opportunity and treat all applicants and employees equally regardless of their age, race, creed/religion, color, national origin, immigration status or citizenship status, sexual orientation, military or veteran status, sex/gender, gender identity, gender expression, disability, pregnancy, genetic information or genetic predisposition or carrier status, marital or familial status, partnership status, victim of domestic violence, sexual or other reproductive health decisions, or other characteristics protected by applicable law.
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