212 Healthcare Providers jobs in Conshohocken

Company DescriptionWHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. Job DescriptionThe Manager, Clinical Care is primarily responsible for the day-to-day operations of an integrated multi-disciplinary clinical and clinical support structure that will effectively monitor, support, and lead Value Based clinical initiatives. This includes but is not limited to case management, transitions of care, care coordination and continuity, provider/staff education on ACO/MA Plan clinical programs, and helping to build and maintain a network of community support. This individual must exhibit strong leadership, management, and interpersonal skills, as well as the ability to utilize both internal and external resources to accomplish the goals and objectives of the organization. WHAT YOU'LL BE DOING Effectively managing day to day Health Plan Clinical Programs to enhance clinical efficiencies Identifying opportunities for increased outpatient vs. inpatient utilization Utilizing data provided to help in managing population health needs and implement population programs for Health Plan beneficiaries Executing case management for patients identified at highest risk for adverse event or exacerbation, having the ability to impact, with the goal of decreasing unnecessary emergency department visits/hospitalizations Overseeing an extended patient care team as assigned including but not limited to: Social Workers, Emergency Department Liaisons, Behavioral Health Liaisons, and Home Health Liaisons. Overseeing smooth Transitional Care Management for all patients discharged from in patient facility (hospital, skilled nursing/rehab, behavioral health) ensuring: Primary Care Provider visit, DME and Home Health Services, Specialist appointments, and community resources/social services are provided as indicated. Ensuring Quality Measures are reviewed and addressed when applicable/appropriate Implementing and directing Health Plan Health Education Activities for beneficiaries, providers, and staff Participating in Care Coordination and Quality Committees, Primary Care Provider Meetings, and other meetings as required Monitoring corporate initiatives and strategies to achieve utilization of business and financial goals Managing the successful integration of ACO Programs into current operations to meet the goals of all stakeholders Maintaining collaborative relationships with business partners both within the company and the community Managing and execute organizational opportunities and implement changes that are in alignment with corporate financial goals and strategic endeavors. Managing departmental expectations: staff hiring, orientation, auditing, and reviews; time management; motivation; and performance improvement Prioritizing of data, tasks, and requirements: Project management with expertise in departmental tasks and processes Representing for health plan audits with development of actions plans for individual clients as needed to ensure compliance and incentive payouts Overseeing all projects, productivity, daily tasks and PHM activities in an organized and efficient manner Ensuring access to EMR systems for department staff Monitoring staff maintenance of HIPPA regulations Communicating with health plan contacts, customer Administrators and Client Business Managers to ensure resolution of any concerns. Identifying and disseminating of Health Plan announcements applicable to Case Management QualificationsWHAT YOU'LL NEED TO HAVE RN/BSN required 5 years of management experience 4 years clinical nursing experience At least 4 years of extensive experience in chronic care case management in outpatient setting Certification in case management preferred Must be able to work remotely and obtain state licensure in Illinois, Georgia, Pennsylvania, and Texas Must feel comfortable and confident leading a team of certified but unlicensed personnel and Registered Nurse case managers Ability to read, analyze, and interpret the most complex documents. Ability to respond effectively to the most sensitive inquiries or complaints. Additional InformationThe salary range for this position is $110,000ALIVE with Purpose: How We Thrive at Guidehealth At Guidehealth, our values come to life in everything we do. We are Driven by Accountability - grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning - staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters - we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive - together - at Guidehealth. BENEFITS:All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.Take Time for Yourself: We offer Flexible Time Off tailored to meet your needs and the needs of the business, helping you achieve work-life balance and meet your personal goals.Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.COMPENSATION:The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT Diversity, inclusion, and belonging are at the core of Guidehealth's values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment. OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATAThis position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth's custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager. REMOTE WORK TECHNICAL REQUIREMENTSGuidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The recommended internet speed is a minimum of 50 mbps download, 10 mbps upload. Please consult with your internet provider or run a speed test here to confirm your internet connection meets these requirements.Videos To Watch

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

• Supports Penn Presbyterian Medical Center and those parts of the Clinical Practices of the University of Pennsylvania (CPUP) which practice at or in conjunction with PPMC, operating under the license of said hospital, its leaders and staff to ensure full compliance with federal conditions of participation, state regulations, and accreditation standards. Actively participates in and leads the organization's efforts to prepare for, take part in, and respond to any necessary follow-up of both announced and unannounced regulatory body site visits. Responsibilities also include educating staff to hospital accreditation, disease specific, and licensure standards and regulations. Researches and completes certain applications, as needed by the organization such as Department of Health and other applications / surveys; and The Joint Commission (TJC) e-application survey. Actively works with policy owners to support current and develop new administrative & clinical hospital polices. Supports committee/team projects, and brings groups to consensus on strategies and/or actions necessary to improve compliance to include regulatory, clinical performance, and/or safety outcomes. Develops, maintains, and documents in requisite databases in order to track regulatory activities to ensure continuous process improvement and efficiency within the organization and department. Participates in the regulatory aspects of occupancy surveys. Active in promoting the organization's tracer program.Demonstrates understanding of concepts, methods, techniques and principles needed to accomplish job responsibilities to include but not limited to the Pennsylvania, and New Jersey Department of Health (DOH), The Joint Commission (TJC) and Center for Medicare and Medicaid Services (CMS) regulations.•Effective oral and written communicator.•High level of initiative and strong business judgment. •Comfortable as a team member and informational leader.•Works well under pressure while completing tasks quickly and accurately.•Complex, abstract problem solving capabilities to maintain system-wide functions. •Demonstrates ability to manage, develop, plan and deliver projects with minimal direction.•Ability to apply creative thinking to service line themes, content and strategic solutions in a fast-paced environment.•Strong analytical abilities, organization and project/process management skill; ability to manage multiple projects simultaneously to achieve goals.•Personal Computer, audio/visual equipment, Internet, & various office technologies.•Proficiency with computers, spreadsheets, tracer and other databases recommended.Focus on the following regulatory coaching assignments:•Assigned provider-based ambulatory sites focused on procedural areas and High Level Disinfection, such as all Central Processing Departments and procedural settings•Assigned as lead to PA ASF surveys (Surgery Center and Penn Digestive Liver Health)•Assigned complementary inpatient locations for ongoing survey readiness and coaching. Focus on procedures, HLD locations to align with ambulatory assignment•Spearhead Disease-Specific Survey: Hip/Knee; VAD; participate in Bariatric Survey•Committee/Workgroup Participation based on expertise to include but not limited to the following•Perioperative Services•Pt. Safety•Critical Care•Enterprise IT/EPIC optimization•Sedation•Infection Control Committee•Nursing leadership (PRN)•Major Lower Joint (CET)•Surgery Center Quality, Pt Safety and IC•PDLH Quality, Pt. Safety and IC•Code Committee/Airway•Radiation SafetyPerform regulatory functions for assigned areas; attend other meetings as needed

• Supports vision of PPMC CMO and Regulatory Department
  
  Maintains a solid working knowledge of regulatory body regulations, including but not limited to, TJC, CMS, state regulations
  
  Acts as liaison with state and other accrediting bodies as needed
  
  Researches and completes surveys which describe institutional demographics, volumes of services, and other activities
  
  Assesses educational needs, provides information and instructional materials to services/departments
  
  Ensure internal clients are aware of services offered
  
  Educates staff on key policies & procedures & regulatory requirements
  
  Develops, documents in, and maintains regulatory related databases necessary to track compliance activities and outcomes.
  
  Coordinates and participates in regulatory survey readiness activities to include environment of care rounds and tracers
  
  Ensures that all initiatives are in compliance with accrediting, regulatory, & institutional standards
  
  Develop relationships within the organization to ensure effective communication & partnership / cooperation in all facets of the licensure & accreditation process
  promote use of tracer program.
  
  Collaborate with leaders & staff to evaluate proposed rules / regulations & assess, develop, or participate in, as appropriate, regulatory advocacy approaches
  
  Coordinate with others, as appropriate, to resolve highly complex or unusual business problems impacted by proposed or finalregulatory action or inaction affecting major functions or disciplines
  
  Develop effective approaches to assess regulatory readiness, collaborating with entity operations in the development of standard processes and procedures.
  
  Provide strategic consultation and coordination in the prioritization of major areas of opportunity incorporating both internal best practices as well as external regulatory developments.
  
  Convene regulatory workgroups/teams to seek feedback and maximizing transparent sharing of efforts and findings.
  
  Support clinical integration across the system by standardizing the writing, review, updating and management of regulatory related policies.
  
  Collaborate with entity operations and other departments to develop standard processes and procedures related to regulatory readiness.
  
  Facilitates identification of future regulatory-related improvement initiatives and organizes appropriate team members.
  
  Coordinates team projects and brings groups to consensus on methods necessary to improve clinical outcomes
  
  With extensive input from and collaboration with entity regulatory directors, prepare routine reports on the state of regulatory readiness at Penn, including major risks and opportunities.
  
  Works with individual clinicians & teams to identify methods to improve compliance with clinical performance indicators required By regulators
  
  Maintains a working knowledge of outcome related publicly reported data and identifies areas where compliance is Problematic
  Monitors consistency, validity, & reliability of data. Edits as appropriate
  
  Primary liaison with state agency, including but not limited to PA DOH
  
  Serves as a liaison with departments such as Pharmacy, Clinical Effectiveness and Quality Improvement (CEQI), Case Management, Infection Control and Prevention, the Medical Staff Departments to identify & solve patient care issues with PPMC managers & staff

• Bachelor of Arts or Science (Required)
• Education Specialization: Equivalent Experience: • And 5+ years Clinical experience in a healthcare setting is preferred. Minimum 3-5 years of experience in healthcare management or healthcare education required. Must be highly organized with the ability to work well with people. Must have ability to work with highly sensitive & confidential information.
• Master of Arts or Science
• Education Specialization: Healthcare, Business Administration Equivalent Experience: