104 Dignity Health jobs in Gilbert
Medical Director, Clinical Services

Posted 17 days ago
Job Viewed
Job Description
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members
**ESSENTIAL RESPONSIBILITIES**
+ Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care.
+ Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise.
+ Participate in protocol and guidelines development to ensure consistency in the review process.
+ Actively manage projects and/or participate on project teams that require a physician subject matter expert.
+ Other duties as assigned.
**EDUCATION**
**Required**
+ Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)
**Substitutions**
+ None
**Preferred**
+ Master's Degree in Business Administration/Management or Public Health
**EXPERIENCE**
**Required**
+ 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice)
**Preferred**
+ 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry
**LICENSES AND CERTIFICATION**
**Required**
+ Medical Doctor or Doctor of Osteopathic Medicine (DO)
+ Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards
+ Active medical state licensure required. Additional specific state licensure(s) may be required based on business need.
**Preferred**
+ None
**SKILLS**
+ Critical Thinking
+ Case Management
+ Customer Service
+ Oral & Written Communication Skills
+ Collaboration
+ Listening
+ Telephone Skills
+ General Computer Skills
+ Clinical Software
+ Managed Care
**Language (Other than English)**
None
**Travel Required**
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
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Rarely
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:**
$170,000.00
**Pay Range Maximum:**
$352,500.00
_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 any category protected by applicable federal, state, or local law.
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 the email below.
For accommodation requests, please contact HR Services Online at
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J
Manager Clinical Services
Posted 9 days ago
Job Viewed
Job Description
At Dignity Health at Home, we strive to embody our mission of delivering hope and healing to those we serve. As a Manager, Clinical Services you will contribute to the delivery of high quality care by ensuring the coordination, continuity, and quality of clinical care follows a physician's approved plan of treatment. The Manager, Clinical Services facilitates the completion of documentation to comply with regulatory, operational and financial requirements and acts as a clinical resource to internal and external customers.
+ **Independent Work:** Operate with limited supervision, adhering to organizational guidelines and policies.
+ **Leadership Support:** Promote and support departmental and organizational decisions.
+ **Clinical Education:** Act as a Clinical Educator when needed.
+ **EMR Utilization:** Utilize EMR System to accurately document patient interactions, assessments, and care plans, ensuring compliance with organizational policies and regulatory standards. Train and mentor clinical staff in effective EMR documentation practices to optimize workflow efficiency and enhance patient care.
+ **Team Collaboration:** Participate in case conferences and in-service training.
+ **Quality Care Oversight:** Direct the delivery of accurate and timely client care in compliance with regulations.
+ **Staff Management:** Ensure appropriate staffing, participate in recruitment and retention, and manage employee performance.
+ **Performance Excellence:** Establish goals for staff while fostering continuous improvement through coaching and feedback.
+ **Documentation Compliance:** Ensure clinical documentation meets all standards and requirements.
+ **Referral Management:** Oversee referral intake and ensure timely assessment visits for patients.
+ **Physician Communication:** Contact physicians for service orders and manage documentation reviews.
+ **Patient Visits:** May perform patient visits as requested by management.
**Your benefits include:**
+ Generous annual bonus opportunity based on company performance
+ Excellent holiday and paid time off plans
+ Medical, dental, and vision plans
+ Tuition reimbursement for degree-seeking students
+ Employer contribution to your 401(k)
**Job Requirements**
+ Current RN license (BSN preferred) or Therapist in good standing.
+ CPR or BLS certification (current).
+ Two years of home care or hospice experience; one year in hospital nursing preferred.
+ Strong clinical skills and understanding of home care regulations.
+ Excellent written and verbal communication skills.
+ Ability to work collaboratively within a multidisciplinary team.
+ Demonstrated leadership and supervisory skills, with attention to detail and organizational abilities.
At CommonSpirit Health at Home, we are proud to be an Equal Opportunity Employer, promoting diversity, equity, and inclusion in every aspect of our organization. We value the unique contributions of all individuals, including minorities, protected veterans, and individuals with disabilities.
**Where You'll Work**
Dignity Health at Home is part of an expansive health care network that is committed to providing better patient care, with better outcomes, where it is best received, at home. As a faith-based organization, we are committed to finding new ways to improve the health of our patients and their families and the health of the communities we serve. Rooted in humankindness, our ministry is at the heart of everything we do and can be seen in every patient we touch.
**Pay Range**
$37.59 - $54.50 /hour
We are an equal opportunity/affirmative action employer.
Patient Care Coordinator
Posted today
Job Viewed
Job Description
Optum 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 (40 hours): Monday-Friday, between the hours of 7am-5pm AZ.
Location: 2905 W. Warner Rd. Suite 12, Chandler, AZ
Primary Responsibilities:
• Provide exceptional service to all customers
• Responsible to greet patient and check patient in and out. Ensure demographics including insurance information are correct and update as necessary
• Collect appropriate co-pays and adhere to all cash handling policies
• Schedule appointments as necessary, verifying correct visit type and primary care provider
• Responsible for waiting room management cleanliness, communicating pertinent information to patients, and ensuring all patients have been assisted
• Work with back-office staff to ensure smooth patient flow
• Resolve service issues and complaints, and defer to appropriate management or clinical personnel when necessary
• Assist co-workers and team members with duties when requested, to include but not limited to, floating to other areas
• Perform 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:
You’ll 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)
• 2+ years of medical front desk experience
• 2+ years of electronic medical record experience
• Beginner level of proficiency with MS Office (Word, Excel, Outlook, etc.)
Preferred Qualifications:
• Experience with data analysis software
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
Patient Care Coordinator
Posted today
Job Viewed
Job Description
Optum 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 (40 hours): Monday-Friday, between the hours of 7am-5pm AZ.
Location: 2905 W. Warner Rd. Suite 12, Chandler, AZ
Primary Responsibilities:
• Provide exceptional service to all customers
• Responsible to greet patient and check patient in and out. Ensure demographics including insurance information are correct and update as necessary
• Collect appropriate co-pays and adhere to all cash handling policies
• Schedule appointments as necessary, verifying correct visit type and primary care provider
• Responsible for waiting room management cleanliness, communicating pertinent information to patients, and ensuring all patients have been assisted
• Work with back-office staff to ensure smooth patient flow
• Resolve service issues and complaints, and defer to appropriate management or clinical personnel when necessary
• Assist co-workers and team members with duties when requested, to include but not limited to, floating to other areas
• Perform 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:
You’ll 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)
• 2+ years of medical front desk experience
• 2+ years of electronic medical record experience
• Beginner level of proficiency with MS Office (Word, Excel, Outlook, etc.)
Preferred Qualifications:
• Experience with data analysis software
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
Patient Care Tech
Posted today
Job Viewed
Job Description
Patient Care Tech
Posted 1 day ago
Job Viewed
Job Description
Patient Care Coordinator
Posted 1 day ago
Job Viewed
Job Description
Be The First To Know
About the latest Dignity health Jobs in Gilbert !
Patient Care Coordinator
Posted 2 days ago
Job Viewed
Job Description
Patient Care Tech
Posted 3 days ago
Job Viewed
Job Description
Patient Care Tech
Posted 3 days ago
Job Viewed