246 Healthcare Provider jobs in Delmont

The Manager, Provider Contracting Network Management serves as an integral member of the Provider Contracting Team and reports to the AVP, Provider Contracting. This role assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory.

DUTIES AND RESPONSIBILITIES

• Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups).
• Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
• Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.
• Contributes to the development of alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
• Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
• Creates and manages initiatives that improve total medical cost and quality.
• Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives.
• Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms.
• Creates healthcare provider agreements that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners.
• Assists in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues.
• Manages key provider relationships and is accountable for critical interface with providers and business staff.
• Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.
• Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.
• May provide guidance or expertise to less experienced specialists.

POSITION REQUIREMENTS

• Should possess a bachelor's degree; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a bachelor's degree. MBA or MHA preferred.
• 3+ years Managed Care contracting and negotiating experience involving complex delivery systems and organizations required.
• Experience in developing and managing key provider relationships
• Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
• Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
• Intimate understanding and experience with hospital, managed care, and provider business models.
• Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
• The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations.
• Customer centric and interpersonal skills are required.
• Demonstrates an ability to maneuver effectively in a changing environment.
• Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
• Knowledge and use of Microsoft Office tools.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Carnegie Mellon University invites applications for the position of Registered Nurse (RN) with University Health Services (UHS) within the Community Health and Well-Being Unit of the Division of Student Affairs. The Registered Nurse is a salaried full-time, 12-month, benefits eligible position, with a start date as soon as possible. The Registered Nurse is a vital member of a multidisciplinary team of highly skilled practitioners, health promotion and administrative professionals. We are hiring 2 positions.

The full-time RN is responsible for providing quality nursing care and related services to a diverse population of undergraduate and graduate students in a medical practice setting. This person should share in the vision of providing quality clinical services to the Carnegie Mellon University Community. UHS performs over 30,000 patient contact visits annually and is a dynamic and collaborative work environment that respects and supports the professional development of its staff.

Core responsibilities include:

• Assist the physicians and advanced practice clinicians in the provision of care.

• Deliver in-person and telehealth screening and treatment of students per nursing standing orders including: Triage of healthcare needs, minor illnesses/injuries, STI testing, administering medications and immunizations, performing phlebotomies, CLIA- waived testing, and IV infusions.

• Educate students regarding health promotion and illness treatment.

• Serve as an advocate for patient care and a liaison between students, parents, families, and clinicians.

• Maintain complete and accurate electronic medical documentation of medical care.

• Follow confidentiality requirements as set by HIPAA, FERPA, federal, state, and local regulations.

• Scheduling patient/student appointments through an electronic medical record.

• Opportunities to innovate processes to expand and improve clinical care at UHS.

• Opportunities to participate in quality improvement efforts and AAAHC accreditation.

• Share responsibility with UHS staff for evening and weekend hours.

• Participate in department, divisional, and other University committees as assigned.

• Attend and participate in regular UHS staff meetings, case conferences, and in- service/professional development training.

Adaptability, excellence, and passion are vital qualities within Carnegie Mellon University. We are in search of a team member who can effectively interact with a varied population of internal and external partners at a high level of integrity. We are looking for someone who shares our values and who will support the mission of the university through their work.

You should demonstrate:

• ?The ability to professionally handle multiple and competing priorities and to thrive in a high-volume environment.

• A demonstrated ability to complete work efficiently and thoroughly.

• A proven record of success and commitment to a people-first culture, including the ability to work effectively with a global and multicultural student population.

• Excellent communication and interpersonal skills, including the ability to manage conflict, maintain clear professional boundaries, and work collegially and collaboratively within an interdisciplinary team.

Qualifications:

• Nursing degree from an accredited university required.

• 5-8 years of experience in Nursing and/or Medical-Surgical careCertified in the State of Pennsylvania to practice nursing.

• A combination of education and relevant experience from which comparable knowledge is demonstrated may be considered.

Preferred Qualifications:

• Experience in treating young adult populations, emergency room or urgent healthcare, college health, reproductive health, or LGBTQIA+ health.

Requirements:

• Successful completion of a pre-employment background check

• Child Protection Clearances

Additional Information:

• Sponsorship : Applicants for this position must be currently legally authorized to work for CMU in the United States. CMU will not sponsor or take over the sponsorship of an employment visa for this opportunity. Carnegie Mellon is not a qualifying employer for the STEM OPT benefit: only the 12-month OPT may be used to work at Carnegie Mellon.

Joining the CMU team opens the door to an array of exceptional benefits.

Benefits eligible ( employees enjoy a wide array of benefits including comprehensive medical, prescription, dental, and vision insurance ( as well as a generous retirement savings program ( with employer contributions. Unlock your potential with tuition benefits ( , take well-deserved breaks with ample paid time off ( and observed holidays ( , and rest easy with life and accidental death and disability insurance.

Additional perks include a free Pittsburgh Regional Transit bus pass, access to our Family Concierge Team ( to help navigate childcare needs, fitness center access ( , and much more!

For a comprehensive overview of the benefits available, explore our Benefits page ( .

At Carnegie Mellon, we value the whole package when extending offers of employment. Beyond credentials, we evaluate the role and responsibilities, your valuable work experience, and the knowledge gained through education and training. We appreciate your unique skills and the perspective you bring. Your journey with us is about more than just a job; it's about finding the perfect fit for your professional growth and personal aspirations.

Are you interested in an exciting opportunity with an exceptional organization! Apply today!

Location

Pittsburgh, PA

Job Function

Providers

Position Type

Staff - Regular

Full Time/Part time

Full time

Pay Basis

Salary

More Information:

• Please visit "Why Carnegie Mellon ( " to learn more about becoming part of an institution inspiring innovations that change the world.

• Click here ( to view a listing of employee benefits

• Carnegie Mellon University is an Equal Opportunity Employer/Disability/Veteran .

• Statement of Assurance (

Interested in a career with Carnegie Mellon University but not finding anything that currently aligns with your interests, background, or experience? Learn how to sign up for Job Alerts ( through your candidate profile.

If your heart is in your work, come work with us. Carnegie Mellon University isn't just one of the world's most renowned educational institutions - it's also a hotspot for some of the most talented doers, dreamers, and difference-makers on the planet. When you join our staff, you'll become an important part of our mission to create a healthier, safer, and more just life for all. No matter what your role or location, you'll connect and collaborate with dedicated, passionate colleagues - and you'll have the satisfaction of delivering work that truly matters.

We cultivate a vibrant, welcoming environment where everyone is valued and encouraged to contribute and achieve. In addition to competitive benefits and a robust support network, you'll have access to many tools and resources to sharpen your abilities and professional skills, as well as opportunities to engage and share perspectives with a dynamic and inspiring community of uniquely talented staff, faculty, students, and alumni.

The future is awaiting your expertise and intellect. Come join the architects of what's next. Apply now.

Learn more about Student Employment ( .

Please see Faculty Careers. (

For technical assistance, email HR Services ( ) or call .

If you are an individual with a disability and you require assistance with the job application process, please email Equal Opportunity Services ( ) or call .

Prospective Employee Disclosures (

The U.S. Services East Business Growth Director is responsible for driving standardization, best practices, and innovation across the portfolio to enhance business development efforts within state and local government health and human services. This role ensures strategic solutioning, market intelligence, and leadership engagement to optimize bid strategies and improve win probabilities.

Essential Duties and Responsibilities:
- Responsible for capture, pursuit, and solutioning architecture for multiple lines of business.
- Provide strategic guidance to executives including solution shaping and strategy responses.
- Develop strong business relationships with internal stakeholders.
- Provide guidance to executives for decision making.
- Work to maintain a win/loss ratio.

- Drive standardization, best practices, and innovation across the portfolio to enhance competitive positioning

- Provide leadership with status updates on opportunities, risks, trends, and key decisions required for bid success

- Lead key discussions in key solutioning, pricing, and proposal meetings in collaboration with Operations, Business Solutions Group, Technical Architects, Capture, and Proposals

- Utilize recent opportunities and competitive landscape insights to drive strategic solutioning and tailor bids to government agency needs

- Evaluate existing or proposed technology stacks, identify innovations, assess staffing approaches, evaluate MBE/WBE or other vendor partners, and proposal and pricing strategy

- Provide recommendations on key decisions to leadership to ensure alignment with company goals and client expectations

- Identify emerging industry trends, share best practices, and lessons learned across the portfolio to enhance organizational strategy

Minimum Requirements

- Bachelor's degree in related field.

- 10 years relevant professional experience.

- At least 7-10 years of experience in Capture, Business Development, or related position

- At least 7-10 years of experience in state & local government, with strong knowledge of health and human services programs

- Experience managing P&L or Operations, preferred

- Demonstrated experience leading bid efforts and ability to effectively inspire and influence teams and partners to meet business needs and strategic goals

- Demonstrated experience in a matrixed environment with ability to manage multiple projects simultaneously

- Strong leadership, collaboration, negotiation, and communication skills

- Strong familiarity with government procurement processes and compliance requirements, operational policies & procedures, and innovative technology solutions

- Bachelor's degree in Business Administration, Public Policy, or a related field (Master's preferred) or equivalent years working experience.

#TrendingJobs #c0rejobs #HotJobs0916LI #HotJobs0916FB #HotJobs0916X #HotJobs0916TH #maxcorp #LI-LT2 #HotJobs0930LI #HotJobs0930FB #HotJobs0930X #HotJobs0930TH

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

$

138,380.00

Maximum Salary

$

165,000.00

The Bradley Center is excited to announce that our Outpatient Program is growing. 

We provide therapy as well as psychiatric and med management services to children, adults, and families.  School-Based Mental Health Services are provided to students in several school districts in Allegheny and surrounding counties.

We are looking for confident licensed clinicians who have the ability to assess, plan, and provide compassionate therapy to those we serve. Therapists manage their caseloads and function independently, while also collaborating with others in a team-based approach to treatment. All activities are in accordance with outpatient regulations, The Joint Commission standards, and trauma-informed treatment.

Requirements

• A valid PA counseling license, inclusive of LCSW, LMFT, LPC, or psychologist
• Master’s degree in a generally recognized clinical discipline, with a degree program that includes clinical practicum
• NCC or LSW preferred
• Experience diagnosing and providing therapy is preferred
• Must be at least 21 years of age
• Valid PA driver’s license or ability to obtain such license, with proof of auto insurance coverage

Qualifications best suited for the position:

• Strong interpersonal skills
• Excellent verbal and written communication and listening skills
• Ability to communicate with compassion and empathy
• Ability to build rapport quickly
• Effective listening, interpersonal, critical thinking, and problem-solving skills.
• Professional demeanor, sound judgment, dependability, and a strong work ethic
• Detail oriented with a strong ability to manage time and prioritize tasks
• Initiative

Primary Responsibilities:

• Establish a positive, trusting rapport with clients
• Diagnose and treat mental health disorders
• Create individualized treatment plans according to client needs
• Conduct ongoing assessments of client progress
• Maintain thorough records and completes documentation in a timely manner

Benefits

• Student loan repayment program (We contribute directly to employee's student loan lenders monthly)
• $1500 sign on bonus
• $2000 relocation assistance
• Referral bonuses
• Generous Paid Time Off in the first year of employment
• Health, dental and vision Coverage
• 401(k)
• Life insurance
• Advanced training opportunities and continuing education credits

We are committed to advocacy for children with special needs, care and compassion, and focus on the inherent strengths of children, youth and families without regard to race, religion, sexual orientation, national origin, age, or gender. The Bradley Center is an Equal Opportunity Employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Job description:

Job Title: Patient Care Coordinator

Supervisor: Regional Director

Candidate must be able to commute between Pittsburg, Pa 3 days a week and McKees Rocks, Pa 2 days a week

Position Summary

The Patient Care Coordinator (PCC) is the first point of contact and demonstrates professionalism by using a patient centered approach of building trust, meeting needs, and delivering solutions through recognizing the needs and opportunities that exists while coordinating all clinic and patient support services within their specific clinic location(s). The PCC screens the patient to determine how we can best help them.

Essential Duties and Responsibilities:

• Provide the first contact for patients who call or come in to schedule an appointment or inquire about our services.
• Screen calls, identify better hearing candidates and facilitate excellent service by providing the information necessary to secure an appointment.
• Schedule and confirm appointments and conduct outbound retention calls to patients.
• Coordinate provider’s schedule and ensure the smooth and efficient flow of patient care while in the office.
• Check patients in and out, collect and record payments, track revenue and accounting activities to include: petty cash reconciliation, end of day close, bank deposits, posting of charges, entering invoices, payments and insurance claim processing.

Education and Experience Requirements :

• High school diploma; Associates degree in administrative, accounting, sales or customer-oriented field or equivalent work experience.
• A minimum of 2 years office management experience in a customer driven industry.

Required Skills:

• Strong computer skills
• Experience with word processing and database software.
• Excellent interpersonal skills that allow effective working relationships with a diverse, patient, colleague, and vendor population. This includes listening, sales and problem-solving skills.
• Excellent oral and written communication skills.
• Basic understanding of accounting procedures and good math aptitude.
• Strong customer service orientation.
• Excellent organizational skills.
• Ability to manage multiple tasks within strict deadlines.
• Ability to input and track sales revenues and balance accounts daily and monthly.
• Detail oriented.
• Front desk medical/sales field experience and/or knowledge of procedures desirable.

Physical Demands:

• Ability to handle a busy office with interruptions, calls, walk-ins and direct the flow of the office with efficiency and grace.
• Must be able to pick up after an interruption to complete tasks that require focus.
• Must be able to lift boxes up to 20 pounds.

Job Type :

Full-time

Benefits :

• 401(k)
• Dental insurance
• Health insurance
• Paid time off

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person / Candidate must be able to commute between Pittsburg, Pa 3 days a week and McKees Rocks, Pa 2 days a week