204 Healthcare Provider jobs in Delmont

Location: Anywhere in Country
At EY, we're all in to shape your future with confidence.
We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world.
**Business transformation, Healthcare Provider Operations_Senior**
**#Healthcare**
**About our business**
At EY Consulting, we are building a better working world by transforming businesses through the power of people, technology, and innovation. Our clients are at the heart of what we do. We're focused on solving the key issues of our client buyers, building deeper relationships, and generating lasting value with significant impact.
Our firm sets the standard for consulting services, fostering an environment that encourages career ownership at every stage. As a part of our team, you'll be at the forefront of this dynamic service line, driving change and delivering solutions that revolutionize business operations. You'll help our clients in transformation and innovation efforts: driving growth, reducing costs, and managing risks proactively.
**Healthcare Consulting**
Today's healthcare environment in the post-COVID era is undergoing rapid change and transformation. As healthcare organizations seek to stabilize operations and plan for a financially sustainable future, they are challenged to integrate transformative technology (Artificial intelligence, automation, etc.), adjust to patient-focused operations, and maintain operational discipline to withstand increasing financial pressures. As a manager within our Health consulting practice, you'll work with clients across the healthcare industry, from hospitals and integrated delivery networks to commercial and governmental insurers. You'll use your industry knowledge and relationship skillsets to assist our clients in transforming operations to meet the evolving demands of today's healthcare market.
**The opportunity**
As a Senior Consultant on our Health team, you will play a key role in helping health systems and health insurance companies tackle their financial and operational challenges. You'll contribute to important projects and work closely within teams, using your skills to turn complex data into clear, actionable insights. The health industry is experiencing an unprecedented surge, and our clients depend on us to steer them through transformative changes and pressing challenges. In this pivotal role, you will elevate client outcomes, improve access to care, support quality of care, and streamline the cost of care. If your drive lies in the healthcare sector and you excel in client-facing situations, this position is tailored for you.
**Your key responsibilities**
You'll spend most of your time teaming with our provider team working with a broad spectrum of not-for-profit and for-profit healthcare clients, including hospitals, healthcare systems, physician practices and academic medical centers, to assess and redesign clinical processes.
As a Senior in our Health consulting group, you'll work with clients across the following areas:
+ Operational improvement
+ Benchmarking and financial quantification
+ Cost reduction/revenue enhancement
+ Workflow redesign
**Skills and attributes for success**
+ Effectively manage and motivate client engagement teams with diverse skills and backgrounds Foster an innovative and inclusive team -oriented work environment. Play an active role in counselling and mentoring junior consultants within the organization
+ Foster relationships with client personnel at appropriate levels. Consistently deliver quality client services. Drive high-quality work products within expected timeframes and on budget. Monitor progress, manage risk and ensure key stakeholders are kept informed about progress and expected outcomes
+ Cultivate and manage business development opportunities. Understand EY and its service lines and actively assess/present ways to serve clients. Develop and maintain long-term client relationships and networks
+ Demonstrate in-depth technical capabilities and professional knowledge
**Required qualifications**
+ A bachelor's or master's degree and approximately 3+ years of relevant work experience in healthcare, insurance, business analysis, consulting, or a related field.
+ Approximately 2 years of healthcare consulting experience, preferably with prior experience in a consulting firm
+ Assist in generating revenue within existing healthcare clients and in developing new prospects at the "C" level of large healthcare companies
+ Ability to manage a team of staff/senior consulting professionals
+ Ability to work collaboratively in a team environment (knows when to lead and when to follow)
+ Strong analytical and problem-solving skills, as well as excellent oral and written communication skills
+ A willingness to travel to meet client needs; travel is required as needed by the client.
+ Strong leadership skills and the ability to work collaboratively in a team environment, demonstrate inclusivity, and embrace diverse perspectives.
+ Excellent presentation skills and the ability to communicate complex concepts effectively to all audiences while leveraging relevant data to generate insights and innovative solutions.
+ Intellectual curiosity, the ability to take initiative and drive execution, and advanced analytical and problem-solving skills within a dynamic and evolving business landscape.
+ Exhibits an agile and growth-oriented mindset.
+ Possesses strong commercial awareness and has a desire to make a positive impact on global companies as well as domestic businesses, contributing to their long-term success.
**Preferred qualifications**
+ Knowledgeable in relevant industry areas such as Health plans, health systems and healthcare specific applications.
+ Exposure to operational improvement, benchmarking and financial quantification, cost reduction/revenue enhancement or workflow redesign within the health industry.
**What we look for**
We're interested in passionate leaders with strong vision and a desire to stay on top of trends in the healthcare industry. If you have a genuine passion for healthcare, this role is for you
**What we offer you**
At EY, we'll develop you with future-focused skills and equip you with world-class experiences. We'll empower you in a flexible environment, and fuel you and your extraordinary talents in a diverse and inclusive culture of globally connected teams. Learn more .
+ We offer a comprehensive compensation and benefits package where you'll be rewarded based on your performance and recognized for the value you bring to the business. The base salary range for this job in all geographic locations in the US is $96,300 to $76,500. The base salary range for New York City Metro Area, Washington State and California (excluding Sacramento) is 115,500 to 200,600. Individual salaries within those ranges are determined through a wide variety of factors including but not limited to education, experience, knowledge, skills and geography. In addition, our Total Rewards package includes medical and dental coverage, pension and 401(k) plans, and a wide range of paid time off options.
+ Join us in our team-led and leader-enabled hybrid model. Our expectation is for most people in external, client serving roles to work together in person 40-60% of the time over the course of an engagement, project or year.
+ Under our flexible vacation policy, you'll decide how much vacation time you need based on your own personal circumstances. You'll also be granted time off for designated EY Paid Holidays, Winter/Summer breaks, Personal/Family Care, and other leaves of absence when needed to support your physical, financial, and emotional well-being.
**Are you ready to shape your future with confidence? Apply today.**
EY accepts applications for this position on an on-going basis.
For those living in California, please click here for additional information.
EY focuses on high-ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities.
**EY | Building a better working world**
EY is building a better working world by creating new value for clients, people, society and the planet, while building trust in capital markets.
Enabled by data, AI and advanced technology, EY teams help clients shape the future with confidence and develop answers for the most pressing issues of today and tomorrow.
EY teams work across a full spectrum of services in assurance, consulting, tax, strategy and transactions. Fueled by sector insights, a globally connected, multi-disciplinary network and diverse ecosystem partners, EY teams can provide services in more than 150 countries and territories.
EY provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, genetic information, national origin, protected veteran status, disability status, or any other legally protected basis, including arrest and conviction records, in accordance with applicable law. 
EY is committed to providing reasonable accommodation to qualified individuals with disabilities including veterans with disabilities. If you have a disability and either need assistance applying online or need to request an accommodation during any part of the application process, please call 1-800-EY-HELP3, select Option 2 for candidate related inquiries, then select Option 1 for candidate queries and finally select Option 2 for candidates with an inquiry which will route you to EY's Talent Shared Services Team (TSS) or email the TSS at .

Location: Anywhere in Country
At EY, we're all in to shape your future with confidence.
We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world.
**Business Transformation - Sr Manager - Healthcare Provider - Acute Care**
Today's healthcare environment is undergoing rapid change and transformation. The market is being impacted by changing regulations, new payment structures, increasing reliance on technology, and a move towards population health. As a senior manager within our Health consulting practice, you'll work with clients across the healthcare industry, from hospitals and integrated delivery networks to commercial and governmental insurers. You'll use your industry knowledge and relationship skillsets to assist our clients in delivering services efficiently and effectively.
**The opportunity**
As part of EY's Health consulting practice, you will work with these clients across the country in solving complex problems in today's rapidly changing healthcare environment.  We currently are seeking a highly motivated Senior Manager, with a focus on provider operations, to manage client engagement teams, work with a wide variety of clients to deliver professional services and manage business development activities on strategic and global priority accounts.
**Your key responsibilities**
As a Senior Manager in our Health consulting group focused on Clinical Operations, you'll spend most of your time teaming with our provider team working with a broad spectrum of not-for-profit and for-profit healthcare clients, including hospitals, healthcare systems, physician practices and academic medical centers, to assess and redesign clinical processes across the following areas:
+ Operational improvement
+ Benchmarking and financial quantification
+ Cost reduction/revenue enhancement
+ Workflow redesign
Our current hiring priorities are focused on engagements related to acute care. Candidates with experience leading work in the following areas are strongly preferred:
+ Acute care labor/ productivity
+ ED throughput
+ OR optimization
+ Length of stay and patient throughput
+ Care management redesign
+ Acute care organization design/ span of control
**Skills and attributes for success**
+ Effectively manage and motivate client engagement teams with diverse skills and backgrounds
+ Foster an innovative and inclusive team -oriented work environment. Play an active role in counselling and mentoring junior consultants within the organization
+ Foster relationships with client personnel at appropriate levels. Consistently deliver quality client services. Drive high-quality work products within expected timeframes and on budget. Monitor progress, manage risk and ensure key stakeholders are kept informed about progress and expected outcomes
+ Cultivate and manage business development opportunities. Understand EY and its service lines and actively assess/present ways to serve clients. Develop and maintain long-term client relationships and networks
+ Demonstrate in-depth technical capabilities and professional knowledge
**To qualify for the role, you must have**
+ A bachelor's degree and approximately 10 years of related work experience; or a graduate degree and approximately 7 years of related work experience.
+ Approximately 7 years of healthcare consulting experience in provider operations; acute care experience is preferred.
+ Prior experience as a senior manager (or above), in a consulting firm or in a senior management role within industry
+ Ability to read and interpret hospital financial statements and contract terms, utilize complex financial models, experience with operational process mapping and experience with healthcare cost reduction planning and implementation
+ Experience with healthcare organization M&A, physician alignment, or financial margin improvement initiatives
+ Experience in selling and delivering projects that cover the full life cycle of assessment, design and implementation support; demonstrated record of driving revenue within existing healthcare clients and in developing new prospects at the "C" level of large healthcare companies
+ Ability to manage a team of staff/senior/manager consulting professionals
+ Ability to work collaboratively in a team environment
+ Strong analytical and problem-solving skills, as well as excellent oral and written communication skills
+ A willingness to travel to meet client needs; travel is estimated at 80%.
**Ideally, you'll also have**
+ A degree with an emphasis in Finance, Accounting, and/or Business; CPA, MBA, MHA and/or MPH
+ Clinical background is preferred but not required.
**What we look for**
We're interested in passionate leaders with strong vision and a desire to stay on top of trends in the healthcare industry. If you have a genuine passion for healthcare, this role is for you.
**What we offer you**
At EY, we'll develop you with future-focused skills and equip you with world-class experiences. We'll empower you in a flexible environment, and fuel you and your extraordinary talents in a diverse and inclusive culture of globally connected teams. Learn more .
+ We offer a comprehensive compensation and benefits package where you'll be rewarded based on your performance and recognized for the value you bring to the business. The base salary range for this job in all geographic locations in the US is $150,400 to $43,600. The base salary range for New York City Metro Area, Washington State and California (excluding Sacramento) is 180,500 to 390,500. Individual salaries within those ranges are determined through a wide variety of factors including but not limited to education, experience, knowledge, skills and geography. In addition, our Total Rewards package includes medical and dental coverage, pension and 401(k) plans, and a wide range of paid time off options.
+ Join us in our team-led and leader-enabled hybrid model. Our expectation is for most people in external, client serving roles to work together in person 40-60% of the time over the course of an engagement, project or year.
+ Under our flexible vacation policy, you'll decide how much vacation time you need based on your own personal circumstances. You'll also be granted time off for designated EY Paid Holidays, Winter/Summer breaks, Personal/Family Care, and other leaves of absence when needed to support your physical, financial, and emotional well-being.
**Are you ready to shape your future with confidence? Apply today.**
EY accepts applications for this position on an on-going basis.
For those living in California, please click here for additional information.
EY focuses on high-ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities.
**EY | Building a better working world**
EY is building a better working world by creating new value for clients, people, society and the planet, while building trust in capital markets.
Enabled by data, AI and advanced technology, EY teams help clients shape the future with confidence and develop answers for the most pressing issues of today and tomorrow.
EY teams work across a full spectrum of services in assurance, consulting, tax, strategy and transactions. Fueled by sector insights, a globally connected, multi-disciplinary network and diverse ecosystem partners, EY teams can provide services in more than 150 countries and territories.
EY provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, genetic information, national origin, protected veteran status, disability status, or any other legally protected basis, including arrest and conviction records, in accordance with applicable law. 
EY is committed to providing reasonable accommodation to qualified individuals with disabilities including veterans with disabilities. If you have a disability and either need assistance applying online or need to request an accommodation during any part of the application process, please call 1-800-EY-HELP3, select Option 2 for candidate related inquiries, then select Option 1 for candidate queries and finally select Option 2 for candidates with an inquiry which will route you to EY's Talent Shared Services Team (TSS) or email the TSS at .

**WORK LOCATION: Pittsburgh, PA - Western PA/West Virginia market**
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._

WORK LOCATION: Pittsburgh, PA - Western PA/West Virginia market

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.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**Position Summary**
Join our Aetna team as an industry leader in serving Medicaid populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Medicaid members who present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members' health care and social determinant needs.
The Associate Manager, Clinical Health Services will be accountable to lead a team of care managers in the Integrated Care Management NJ department primarily remotely, but with some face to face and field visits required. The Associate Manager is a dynamic leader who inspires and motivates their team by taking initiative, leading by example, and maintaining a positive outlook. This role requires a constant state of readiness, a drive for independent learning, and the ability to navigate and resolve challenging situations with confidence and composure. In this role, organization is paramount- you will be responsible for managing multiple competing priorities and meet deadlines.
The Associate Manager will be responsible to lead their team to ensure enterprise and contractual compliance. The Associate Manager will have a strong leadership skillset to lead a dynamic team of case managers with proven experience in change management. We are seeking a leader who is forward thinking, inspires trust, and champions positive change. This role additionally requires a commitment to integrity, transparency, and accountability, as well as the ability to lead teams through transformation with empathy and vision.
**What will you do/ Fundamental Components** :
+ Proactively identify opportunities for improvement and take initiative to implement solutions.
+ Lead with heart by fostering a supportive, inclusive, and motivating team environment.
+ Maintain a positive attitude, even in the face of adversity, and encourage the same in others.
+ Stay prepared for change and adapt quickly to evolving business needs and priorities.
+ Demonstrate a commitment to continuous learning and self-development, seeking out new knowledge and skills independently.
+ Anticipate and effectively navigate challenging situations, using sound judgment and resilience.
+ Communicate clearly and openly with team members, peers, and leadership.
+ Support organizational goals by aligning team efforts with company values and objectives.
+ Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g., NCQA, URAC, state and federal standards and mandates as applicable)
+ Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking
+ Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care
+ May act as a liaison with other key business areas.
+ Will be responsible to develop/assist in development and/review new training content
+ Will be responsible to collaborate/deliver inter and intra-departmental training sessions
+ Protects the confidentiality of member information and adheres to company policies regarding confidentiality
+ Manages a team of case managers and is responsible for oversight of identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating, and documenting of care with potential of carrying a caseload if needed dependent upon business needs/changes.
+ Evaluate and interpret data, identify areas of improvement, and focus on interventions to improve outcomes
+ Develop, initiate, evaluate, monitor, and communicate performance expectations
+ Ensures the team's understanding and use of information system capability and functionality
+ Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills
+ Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams
+ Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance
+ Consistently demonstrates the ability to serve as a model change agent and lead change efforts
+ Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed
+ Accountable for maintaining compliance with policies and procedures and implements them at the employee level
+ Communicate effectively with Providers, Members, Staff and other Leaders (e.g., may provide support to the sales staff & network staff via onsite customer visits and/or presentations)
+ This position may require up to 50-75% travel to complete Face to Face visits/Observational Audits of Case Managers in the state of NJ in various settings including, but not limited to in homes, hospitals, provider settings, etc. Travel requirements are subject to change based upon business needs.
**Required Qualifications**
+ Field/Remote based position. Prefer residents of NJ but willing to accept Compact Licensed Registered Nures's.
+ Must possess reliable transportation and be willing and able to travel up to 25 % of the time. Mileage is reimbursed per our company expense reimbursement policy
+ 3+ years' experience in clinical area of expertise as a Registered Nurse
+ 3+ years work experience in pediatric, special needs and adult population
+ 3+ years of care management experience
+ 1+ year of discharge planning and/or home health care coordination experience
+ 2+ years of leadership experience managing a team (Clinical Team Lead etc.)
+ RN with current unrestricted state licensure in the State of New Jersey
+ Reliable transportation required to conduct observational face to face audits in the field, assist/mentor case managers in the field as needed face to face. (Mileage is reimbursed per our company expense reimbursement policy)
+ Proficient computer literacy and demonstrated proficiency to navigate internal/external computer systems, MS Office Suite applications, etc.
+ Proficient in data gathering and interpretation to formulate next steps
+ Exceptional organizational skills, flexible, and ability to adapt and embrace change in a fast-paced environment
+ Ability to critically think and navigate challenging situations independently
+ Ability to prioritize competing priorities and meet deadlines independently
+ Self-motivated and dependable
+ Positive, forward-thinking mindset
+ Exceptional communication skills, both verbally and in writing with ability to adapt delivery methods as needed to ensure all parties understand intended message
+ Strong foundational understanding of compliance and independently motivated to learn and acclimate to departmental needs/compliance/SOP's/Contract Review
+ Attention to detail
+ Proficient in independently navigating technological needs, virtual platforms, internet connectivity, etc.
+ Highly motivated and strategic thinker that thinks outside the box
+ Excellent analytical and problem-solving skills
**Preferred Qualifications**
+ 2+ years' leadership case management experience within a managed care organization
+ Behavioral Health Experience
+ Certified Case Manager (CCM)
+ Proficiency with learning and navigating care management systems
+ Excellent analytical and problem-solving skills
**Education**
+ Bachelor's Degree in Nursing (REQUIRED)
**License**
+ Candidate must have an active and unrestricted Registered Nurse (RN) License
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$96,408.00 - $207,648.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit anticipate the application window for this opening will close on: 09/30/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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:

* Able to professionally handle multiple and competing priorities and to thrive in a high volume environment.


* Demonstrated ability to complete work in an efficient and thorough manner.


* Proven record of success and commitment to a people-first culture, including the ability to work well with a global and multicultural student population.


* Excellent communication and interpersonal skills including the ability to manage conflict, clear professional boundaries, and ability to work collegially and collaboratively in an interdisciplinary team process.



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

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:**
+ Able to professionally handle multiple and competing priorities and to thrive in a high volume environment.
+ Demonstrated ability to complete work in an efficient and thorough manner.
+ Proven record of success and commitment to a people-first culture, including the ability to work well with a global and multicultural student population.
+ Excellent communication and interpersonal skills including the ability to manage conflict, clear professional boundaries, and ability to work collegially and collaboratively in an interdisciplinary team process.
**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 ( 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. ( 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 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.