Supervisor, Healthcare Services Operations Support

83642 Meridian, Idaho Molina Healthcare

Posted 2 days ago

Job Viewed

Tap Again To Close

Job Description

**JOB DESCRIPTION**
**Job Summary**
Leads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
- Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc.
- Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes.
- Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance.
- Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement.
- Assists in the development and implementation of internal desktop processes and procedures.
- Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers.
**Required Qualifications**
- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience.
- Strong analytic and problem-solving abilities.
- Strong organizational and time-management skills.
- Ability to multi-task and meet project deadlines.
- Attention to detail.
- Ability to build relationships and collaborate cross-functionally.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
**Preferred Qualifications**
- Supervisory/leadership experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now

Supervisor, Healthcare Services Operations Support

83756 Boise, Idaho Molina Healthcare

Posted 2 days ago

Job Viewed

Tap Again To Close

Job Description

**JOB DESCRIPTION**
**Job Summary**
Leads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
- Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc.
- Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes.
- Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance.
- Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement.
- Assists in the development and implementation of internal desktop processes and procedures.
- Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers.
**Required Qualifications**
- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience.
- Strong analytic and problem-solving abilities.
- Strong organizational and time-management skills.
- Ability to multi-task and meet project deadlines.
- Attention to detail.
- Ability to build relationships and collaborate cross-functionally.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
**Preferred Qualifications**
- Supervisory/leadership experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now

Supervisor, Healthcare Services Operations Support

83605 Caldwell, Idaho Molina Healthcare

Posted 2 days ago

Job Viewed

Tap Again To Close

Job Description

**JOB DESCRIPTION**
**Job Summary**
Leads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
- Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc.
- Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes.
- Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance.
- Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement.
- Assists in the development and implementation of internal desktop processes and procedures.
- Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers.
**Required Qualifications**
- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience.
- Strong analytic and problem-solving abilities.
- Strong organizational and time-management skills.
- Ability to multi-task and meet project deadlines.
- Attention to detail.
- Ability to build relationships and collaborate cross-functionally.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
**Preferred Qualifications**
- Supervisory/leadership experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now

Supervisor, Healthcare Services Operations Support

83756 Boise, Idaho Molina Healthcare

Posted 2 days ago

Job Viewed

Tap Again To Close

Job Description

**JOB DESCRIPTION**
**Job Summary**
Leads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
- Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc.
- Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes.
- Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance.
- Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement.
- Assists in the development and implementation of internal desktop processes and procedures.
- Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers.
**Required Qualifications**
- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience.
- Strong analytic and problem-solving abilities.
- Strong organizational and time-management skills.
- Ability to multi-task and meet project deadlines.
- Attention to detail.
- Ability to build relationships and collaborate cross-functionally.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
**Preferred Qualifications**
- Supervisory/leadership experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now

Supervisor, Healthcare Services Operations Support

83605 Caldwell, Idaho Molina Healthcare

Posted 2 days ago

Job Viewed

Tap Again To Close

Job Description

**JOB DESCRIPTION**
**Job Summary**
Leads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
- Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc.
- Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes.
- Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance.
- Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement.
- Assists in the development and implementation of internal desktop processes and procedures.
- Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers.
**Required Qualifications**
- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience.
- Strong analytic and problem-solving abilities.
- Strong organizational and time-management skills.
- Ability to multi-task and meet project deadlines.
- Attention to detail.
- Ability to build relationships and collaborate cross-functionally.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
**Preferred Qualifications**
- Supervisory/leadership experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now

Supervisor, Healthcare Services Operations Support

83642 Meridian, Idaho Molina Healthcare

Posted 2 days ago

Job Viewed

Tap Again To Close

Job Description

**JOB DESCRIPTION**
**Job Summary**
Leads and supervises a team supporting non-clinical healthcare services activities for care management, care review, utilization management, transitions of care, behavioral health, long-term services and supports (LTSS), and/or other program specific service support - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
- Supervises healthcare services operations support team members within Molina's clinical/healthcare services function, which may include care review, care management, and/or correspondence processing, etc.
- Researches and analyzes the workflow of the department, and offers suggestions for improvement and/or changes to leadership; assists with the implementation of changes.
- Conducts employee and team productivity/quality assurance checks and documents results for accuracy and time compliance.
- Provides regular verbal and written feedback to staff regarding performance and opportunities for improvement.
- Assists in the development and implementation of internal desktop processes and procedures.
- Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers.
**Required Qualifications**
- At least 5 years of operations or administrative experience in health care, preferably within a managed care setting, or equivalent combination of relevant education and experience.
- Strong analytic and problem-solving abilities.
- Strong organizational and time-management skills.
- Ability to multi-task and meet project deadlines.
- Attention to detail.
- Ability to build relationships and collaborate cross-functionally.
- Excellent verbal and written communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
**Preferred Qualifications**
- Supervisory/leadership experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now

Medical Director, Clinical Services

83756 Boise, Idaho Highmark Health

Posted 12 days ago

Job Viewed

Tap Again To Close

Job Description

**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members
**ESSENTIAL RESPONSIBILITIES**
+ Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care.
+ Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise.
+ Participate in protocol and guidelines development to ensure consistency in the review process.
+ Actively manage projects and/or participate on project teams that require a physician subject matter expert.
+ Other duties as assigned.
**EDUCATION**
**Required**
+ Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)
**Substitutions**
+ None
**Preferred**
+ Master's Degree in Business Administration/Management or Public Health
**EXPERIENCE**
**Required**
+ 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice)
**Preferred**
+ 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry
**LICENSES AND CERTIFICATION**
**Required**
+ Medical Doctor or Doctor of Osteopathic Medicine (DO)
+ Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards
+ Active medical state licensure required. Additional specific state licensure(s) may be required based on business need.
**Preferred**
+ None
**SKILLS**
+ Critical Thinking
+ Case Management
+ Customer Service
+ Oral & Written Communication Skills
+ Collaboration
+ Listening
+ Telephone Skills
+ General Computer Skills
+ Clinical Software
+ Managed Care
**Language (Other than English)**
None
**Travel Required**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
Position Type
Office-Based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Rarely
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$170,000.00
**Pay Range Maximum:**
$352,500.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J
View Now
Be The First To Know

About the latest Healthcare services Jobs in Boise !

Director, Consult Partner - Digital Workplace Services / Healthcare

83756 Boise, Idaho Kyndryl

Posted 12 days ago

Job Viewed

Tap Again To Close

Job Description

**Who We Are**
At Kyndryl, we design, build, manage and modernize the mission-critical technology systems that the world depends on every day. So why work at Kyndryl? We are always moving forward - always pushing ourselves to go further in our efforts to build a more equitable, inclusive world for our employees, our customers and our communities.
**The Role**
Kyndryl Consult is the fastest growing business within the organization and instrumental to the company's strategic growth objectives. You will play a key leadership role across multi-disciplinary teams, guiding them through complex consulting engagements and be responsible for creating and positioning strategic change agendas within Kyndryl's largest accounts across the C-suite, spanning the intersection between complex Business and IT customer solutions, transformations that impact across the entire customer Eco-system.
As a Consult Partner, you will have a pivotal role in driving profitable growth, leveraging our comprehensive capabilities to build strong client relationships, and leading your team to success. This role demands a strong presence, industry expertise, and the ability to cultivate relationships with CXO-level clients. Your leadership will be critical in fostering talent development and innovation within the organization.
This role will also be leading the overall client engagement and delivering high quality client work alongside senior client stakeholders. Working in a transaction environment which may be pre or post deal, planning post deal implementation, and ultimately supporting execution. Partners will be focused on financial impact, utilization and contribution, client impact and leadership.
**Contribute to Profitable Growth:**
+ Drive significant financial outcomes through signings and revenue targets
+ Ensure sustained growth and profitability, managing margin expectations and backlog growth
+ Support the identification, pursuit and conversion of a pipeline of business development opportunities
+ Undertake scoping and fee negotiation on engagements, while enduring profitability and understanding and containing risk
+ Apply consultative judgment to accurately scope work, negotiate fees, and draft Statements of Work (SOWs) that align with client needs and enable rapid delivery.
+ Leverage a proven track record of consulting and selling digital workplace services, managing large client portfolios and driving revenue growth.
**Client Engagement:**
+ Build and maintain deep relationships with client CXOs and be seen as the 'go to' person and a trusted advisor by senior executives
+ Leading C-level client interactions and consulting initiatives, deliverables and outputs of a deal engagement
+ Demonstrate credibility and experience to advise and deliver on complex consulting engagement
+ Demonstrate a deep understanding of discovery, design, and deployment processes to guide clients through digital workplace transformations.
+ Anticipate and articulate future challenges in digital workplace services, including those driven by Copilot, agentic AI, and evolving office models, to position Kyndryl as a strategic partner.
+ Bring consulting experience-preferably in the Healthcare space-to tailor engagements that resonate with industry-specific needs and priorities.
+ Enhance client satisfaction, as measured by Net Promoter Score (NPS) and new relationship development; Secure client references
**Operational Excellence:**
+ Achieve individual and team utilization targets
+ Lead the design of complex engagements and take responsibility for oversight of delivery, ensuring high performance and customer satisfaction Leadership, Management, People
+ Lead by example; Fostering a culture of continuous personal and professional development and challenging our people to be curious and innovative and supportive for each other. At the same time ensuring that all outcomes are commercially focused, value adding and effectively executed
**Strategic Contribution:**
+ Drive Kyndryl's delivery capability with new and existing clients by leading Digital Workplace-focused transformation programs, services and implementations centered on Collaboration, Virtualization, Contact Center, Employee Experience, and related DWS offerings.
+ Utilize industry and technology expertise to shape and drive the company's strategic initiatives.
+ Align with Kyndryl's strategic vision and contribute to its execution.
+ Drive external eminence and innovation, establishing a strong personal and organizational brand in the industry.
+ Proactively develop thought leadership and intellectual capital
Kyndryl currently does not require employees to be fully vaccinated against COVID-19, however, if you are hired to work at a client, customer, or partner location, you may be required to show proof of vaccination to align with their respective COVID-19 vaccination policies. Those who believe they are eligible may apply for a medical or religious accommodation prior to the start of employment.
**Who You Are**
Who You Are
You're good at what you do and possess the required experience to prove it. However, equally as important - you have a growth mindset; keen to drive your own personal and professional development. You are customer-focused - someone who prioritizes customer success in their work. And finally, you're open and borderless - naturally inclusive in how you work with others.
Required Skills and Experience
+ Candidates with consultative expertise to articulate Digital Workplace challenges and advise on strategies addressing trends like Copilot, Agentic AI, and the future of work are strongly encouraged to apply
+ Experience in discovery, design, and deployment of Digital Workplace solutions using technologies including, but not limited to Microsoft M365, Intune, AVD, Copilot, Viva, ServiceNow ITSM, Amazon Connect, and Google Suite strongly preferred.
+ Extensive experience in client engagement and relationship management at the CXO level
+ Demonstrable ability to build and commercialize relationships with senior executives
+ Proven track record of leading and executing complex projects with multi-disciplinary teams in a consulting, corporate or public sector environment
+ Expertise in mergers and acquisitions (M&A) integration within the Digital Workplace context would be a plus
+ Effective financial acumen with experience in driving revenue growth and managing margins
+ Experience of managing or supporting high-value business development activities with senior stakeholders
+ Deep understanding of industry trends and technology
+ Sound personal brand and presence in the Healthcare industry preferred
+ Demonstrated ability to innovate and drive change
**The compensation range for the position in the U.S. is $159,240 to $86,560 based on a full-time schedule. Your actual compensation may vary depending on your geography, job-related skills and experience. For part time roles, the compensation will be adjusted appropriately. The pay or salary range will not be below any applicable state, city or local minimum wage requirement. There is a different applicable compensation range for the following work locations:**
**California: 175,080 to 343,920**
**Colorado: 159,240 to 286,560**
**New York City: 191,040 to 343,920**
**Washington: 175,080 to 315,240**
**Washington DC: 175,080 to 315,240**
**This position will be eligible for Kyndryl's discretionary annual bonus program, based on performance and subject to the terms of Kyndryl's applicable plans. You may also receive a comprehensive benefits package which includes medical and dental coverage, disability, retirement benefits, paid leave, and paid time off. Note: If this is a sales commission eligible role, you will be eligible to participate in a sales commission plan in lieu of the annual discretionary bonus program. Applications will be accepted on a rolling basis.**
**Being You**
Diversity is a whole lot more than what we look like or where we come from, it's how we think and who we are. We welcome people of all cultures, backgrounds, and experiences. But we're not doing it single-handily: Our Kyndryl Inclusion Networks are only one of many ways we create a workplace where all Kyndryls can find and provide support and advice. This dedication to welcoming everyone into our company means that Kyndryl gives you - and everyone next to you - the ability to bring your whole self to work, individually and collectively, and support the activation of our equitable culture. That's the Kyndryl Way.
**What You Can Expect**
With state-of-the-art resources and Fortune 100 clients, every day is an opportunity to innovate, build new capabilities, new relationships, new processes, and new value. Kyndryl cares about your well-being and prides itself on offering benefits that give you choice, reflect the diversity of our employees and support you and your family through the moments that matter - wherever you are in your life journey. Our employee learning programs give you access to the best learning in the industry to receive certifications, including Microsoft, Google, Amazon, Skillsoft, and many more. Through our company-wide volunteering and giving platform, you can donate, start fundraisers, volunteer, and search over 2 million non-profit organizations. At Kyndryl, we invest heavily in you, we want you to succeed so that together, we will all succeed.
**Get Referred!**
If you know someone that works at Kyndryl, when asked 'How Did You Hear About Us' during the application process, select 'Employee Referral' and enter your contact's Kyndryl email address.
Kyndryl is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. Kyndryl is also committed to compliance with all fair employment practices regarding citizenship and immigration status.
View Now

Clinical Pharmacist Patient Care - Remote

83756 Boise, Idaho UnitedHealth Group

Posted 10 days ago

Job Viewed

Tap Again To Close

Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
The Clinical Excellence Quality (CEQ) Pharmacy Operations team supports Optum's Care Delivery Organizations by delivering patient-centered, clinically collaborative medication consultations to help people live healthier lives. Our team focuses on the design, execution, and delivery of telephonic and digital engagement strategies designed to close Medicare star measure gaps in care. Our interdisciplinary service delivery team is comprised of Pharmacists, Registered Nurses (RNs), Pharmacy Technicians, and Care Coordinators.
Clinical pharmacists perform telephonic, patient-centered clinical consultations focused on the following care opportunities: medication adherence, SUPD/SPC, Care of Older Adults & A1c medication reviews, and polypharmacy measures, including opioids/benzodiazepines and anticholinergic medication use. Clinical pharmacists also consult with providers, pharmacies, internal departments, and/or other external third parties to drive improved patient outcomes. In addition, clinical pharmacists field both clinical and social determinants of health-related needs with members directly or from escalations by other clinical and non-clinical staff.
Clinical pharmacists are required to meet or exceed established productivity and quality metrics, though can work a flexible schedule to support the hours of operation (Monday - Saturday 9:00AM - 6:00PM CT). Clinical pharmacists work a rotating Saturday schedule with approximately 6 shifts per calendar year.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
**Primary Responsibilities:**
+ Conduct telephonic medication consultations that meet/exceed production & quality metrics
+ Complete annual medication review of prescription and non-prescription medications with emphasis on patient assessment and counseling, safe and effective use of medications, identification of potential drug interactions, and other related activities
+ Complete pharmacotherapy assessment of patients' claims, past medical history, and disease states
+ Assess patients for medication adherence barriers and develop a plan to maximize patients' medication success through improving or maintaining adherence to medications
+ Deliver high quality evidence-based therapeutic recommendations to providers
+ Deliver a patient-centered, clinically collaborative medication consultation
+ Develop a post-consultation list of action items for the patient and/or prescriber
+ Document clinical consultations into internal documentation platform
+ Participate in and contribute to staff meetings and other staff development opportunities and interdepartmental work groups
+ Identify areas of improvement where systems modifications could result in operational advancements and efficiencies
+ Maintain a high level of clinical knowledge of chronic disease states and changes in pharmacy practice in adult and geriatric patient populations to serve as an authoritative information source on drugs and their utilization in therapy
+ Assesses and interprets customer needs and requirements
+ Identifies problems and develops solutions to non-standard requests and problems
+ Works with minimal guidance; seeks guidance on only the most complex tasks
+ Provides explanations and information to others on difficult issues
+ Coaches, provides feedback, and guides others
+ Acts as a resource for others with less experience
+ Other duties as assigned
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Must hold active, unrestricted pharmacist license in the state of primary residence and willing to obtain licensure in one or more states as per business requirements
+ 3+ years of pharmacy practice experience to include 1+ years of Clinical Pharmacy Practice experience
+ 1+ years of experience with Medicare STARs & HEDIS Measures to include experience with Medication Therapy Management (MTM) and/or Care for Older Adults (COA) medication review
+ Proficient with Microsoft Word, Excel, Outlook, PowerPoint
+ Ability to manage multiple, concurrent projects
+ Comfortable working in a rapidly changing and highly matrixed environment
**Preferred Qualifications:**
+ Doctor of Pharmacy degree
+ Multi-state licensure, including ID, OR, TN, and/or KY
+ Post Graduate Training (Pharmacy Residency and/or Fellowship)
+ Board certification by the Board of Pharmacy Specialties (BPS)
+ 1+ years Call Center Experience
+ Bilingual - Spanish
+ Excellent written and verbal communication and relationship building skills
+ Planning and organizational skills to demonstrate leadership and initiative
+ Solid interpersonal skills
+ Ability to work independently, as well as a member of a team
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
View Now

Supervisor, Finance Operations - Medical Pricing Services

83756 Hidden Springs, Idaho Cardinal Health

Posted 5 days ago

Job Viewed

Tap Again To Close

Job Description

**_What Finance Operations contributes to Cardinal Health_**

Finance oversees the accounting, tax, financial plans and policies of the organization, establishes and maintains fiscal controls, prepares and interprets financial reports, oversees financial systems and safeguards the organization's assets.

Finance Operations is responsible for the oversight and overall performance of the following core financial processes. This includes pricing administration, rebates, cash application, chargebacks, billing, accounts payable and employee travel & expense.

**_What Customer/Supplier Pricing Services contributes to Cardinal Health_**

Customer/Supplier Pricing Services is responsible for customer and/or supplier contract administration, as well as administering and reviewing specialty pricing initiatives as deemed appropriate. Responsible for researching and problem-solving customer or supplier issues or disputes and acting as a liaison with internal and external key stakeholders. Develops and manages customer relationships within pricing and contract implementation process.

**_Responsibilities_**

+ Lead and support a team of 10+ direct reports with varying levels of experience

+ Set team priorities and delegate effectively across multiple competing demands

+ Create and maintain a strong team culture centered on ownership, accountability, and learning

+ Deliver clear and constructive coaching to individuals to support growth and performance

+ Serve as a point of contact for customer escalations and internal business stakeholders

+ Drive resolution of issues with cross-functional partners while protecting team focus

+ Review operational or transactional data to identify trends, surface gaps, and recommend improvements

+ Present data and strategy in a way that drives leadership decision making

+ Navigate change and ambiguity while keeping the team informed and supported

+ Represent team needs and performance to management with clarity and confidence

**_Qualifications_**

+ Bachelors degree preferred or equivalent working experience

+ 2-4 years experience with people leadership experience preferred

+ Demonstrated ability to lead through change, ambiguity, and shifting business priorities

+ Experience working with internal partners and external customers in cross-functional settings

+ Strong communication skills, including an ability to give and receive feedback, facilitate tough conversations, and influence outcomes

+ An analytical mindset capable of working with large datasets to uncover insights and tell a story

+ Strategic thinker with a proven track record of solving problems

+ Growth mindset with curiosity and an openness to learning new systems, processes, and business logic

+ High emotional intelligence, integrity, and a reputation for being a team builder

**Anticipated salary range:** $66,500 - $99,645

**Bonus eligible:** Yes

**Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

+ Medical, dental and vision coverage

+ Paid time off plan

+ Health savings account (HSA)

+ 401k savings plan

+ Access to wages before pay day with myFlexPay

+ Flexible spending accounts (FSAs)

+ Short- and long-term disability coverage

+ Work-Life resources

+ Paid parental leave

+ Healthy lifestyle programs

**Application window anticipated to close:** 10/20/2025 *if interested in opportunity, please submit application as soon as possible.

The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

_Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._

_Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._

_To read and review this privacy notice click_ here (
View Now
 

Nearby Locations

Other Jobs Near Me

Industry

  1. request_quote Accounting
  2. work Administrative
  3. eco Agriculture Forestry
  4. smart_toy AI & Emerging Technologies
  5. school Apprenticeships & Trainee
  6. apartment Architecture
  7. palette Arts & Entertainment
  8. directions_car Automotive
  9. flight_takeoff Aviation
  10. account_balance Banking & Finance
  11. local_florist Beauty & Wellness
  12. restaurant Catering
  13. volunteer_activism Charity & Voluntary
  14. science Chemical Engineering
  15. child_friendly Childcare
  16. foundation Civil Engineering
  17. clean_hands Cleaning & Sanitation
  18. diversity_3 Community & Social Care
  19. construction Construction
  20. brush Creative & Digital
  21. currency_bitcoin Crypto & Blockchain
  22. support_agent Customer Service & Helpdesk
  23. medical_services Dental
  24. medical_services Driving & Transport
  25. medical_services E Commerce & Social Media
  26. school Education & Teaching
  27. electrical_services Electrical Engineering
  28. bolt Energy
  29. local_mall Fmcg
  30. gavel Government & Non Profit
  31. emoji_events Graduate
  32. health_and_safety Healthcare
  33. beach_access Hospitality & Tourism
  34. groups Human Resources
  35. precision_manufacturing Industrial Engineering
  36. security Information Security
  37. handyman Installation & Maintenance
  38. policy Insurance
  39. code IT & Software
  40. gavel Legal
  41. sports_soccer Leisure & Sports
  42. inventory_2 Logistics & Warehousing
  43. supervisor_account Management
  44. supervisor_account Management Consultancy
  45. supervisor_account Manufacturing & Production
  46. campaign Marketing
  47. build Mechanical Engineering
  48. perm_media Media & PR
  49. local_hospital Medical
  50. local_hospital Military & Public Safety
  51. local_hospital Mining
  52. medical_services Nursing
  53. local_gas_station Oil & Gas
  54. biotech Pharmaceutical
  55. checklist_rtl Project Management
  56. shopping_bag Purchasing
  57. home_work Real Estate
  58. person_search Recruitment Consultancy
  59. store Retail
  60. point_of_sale Sales
  61. science Scientific Research & Development
  62. wifi Telecoms
  63. psychology Therapy
  64. pets Veterinary
View All Healthcare Services Jobs View All Jobs in Boise