89 Hennepin County Medical Center jobs in Champlin
Medical Director, Clinical Services
Posted 13 days ago
Job Viewed
Job Description
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members
**ESSENTIAL RESPONSIBILITIES**
+ Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care.
+ Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise.
+ Participate in protocol and guidelines development to ensure consistency in the review process.
+ Actively manage projects and/or participate on project teams that require a physician subject matter expert.
+ Other duties as assigned.
**EDUCATION**
**Required**
+ Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)
**Substitutions**
+ None
**Preferred**
+ Master's Degree in Business Administration/Management or Public Health
**EXPERIENCE**
**Required**
+ 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice)
**Preferred**
+ 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry
**LICENSES AND CERTIFICATION**
**Required**
+ Medical Doctor or Doctor of Osteopathic Medicine (DO)
+ Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards
+ Active medical state licensure required. Additional specific state licensure(s) may be required based on business need.
**Preferred**
+ None
**SKILLS**
+ Critical Thinking
+ Case Management
+ Customer Service
+ Oral & Written Communication Skills
+ Collaboration
+ Listening
+ Telephone Skills
+ General Computer Skills
+ Clinical Software
+ Managed Care
**Language (Other than English)**
None
**Travel Required**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
Position Type
Office-Based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Rarely
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$170,000.00
**Pay Range Maximum:**
$352,500.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J267780
Clinical Services Manager, Registered Nurse- Minnesota (DaVita IKC)
Posted 4 days ago
Job Viewed
Job Description
Location: Minnesota, requires travel within Minnesota. Required: RN License in Minnesota. The Clinical Services Manager develops and leads clinical resources in delivery of quality cost effective care to patients. This position is the clinical leader for their designated market and is responsible for mentoring and coaching assigned teams of Integrated Care Nurses and Care Coordinators ("CC") to achieve performance and outcome expectations, increase skills, and professional development. This position also supports and leads Integrated Care teammates in existing clinical processes.
Clinical OutcomesOwns, drives and creates clinical outcomes strategy (in collaboration with the ROM/ROS). Identifies metric-driven clinical opportunities and drives process improvement for individuals and teams (in collaboration with the ROM/ROS). Clinical coach on prioritization, critical thinking, and time management of tasks and responsibilities that align with our model of care and program specific requirements.
Clinical Skill Building/MasteryReinforce care delivery, training materials, educational tools, and policies for teammates (in collaboration with the training team). Assesses effectiveness of care delivery and provides necessary coaching and resources (in collaboration with the ROM/ROS). Reviews escalated REM events. Provides necessary investigation and plan of correction. Knows and complies with DaVita policies and procedures in accordance with State and Federal regulations for patient care and services (CMS, HIPAA, OSHA, or other governing agencies); Standards necessary to maintain organizational accreditation (such as NCQA); and, State or Federal regulations of Injury Prevention and Safety Training.
Education and ExperienceCurrent RN license in state of practice (Minnesota) Current driver's license with positive driving record required; ability to meet requirements of insurance coverage, required 4 - 6 years relevant experience Bachelors degree Basic computer skills and proficiency in MS Word, Outlook and Excel Demonstrated experience managing to data driven outcomes and process improvement Experience in healthcare performance coaching Current CRP certification Certified Nephrology Nurse (CNN) or Certified Case Manager (CCM) preferred Travel: Up to 75% depending on market Nights/Weekends: May include overnight travel
DaVita IKC (Integrated Kidney Care) is comprised of an innovative team who is committed to improving patient outcomes and improving quality of life. Come work with a team of passionate professionals to transform kidney care through a value-based, person-centered, comprehensive approach to kidney care. We provide comprehensive care and complex chronic condition management to patients nationwide, whether they are in the early stages of kidney disease, transitioning to dialysis, seeking a kidney transplant or receiving life-sustaining dialysis. 27,000+ patients receiving IKC services every month 20 years of Integrated Kidney Care Experience We're on a mission to revolutionize kidney care, with a vision of making integrated care the standard of care for all renal patients. To help us achieve our vision, we're investing extensively in developing both our model of care and our team. When you join DaVita IKC, you're joining a compassionate team committed to quality patient care. Through our commitment to training, growth and quality we consistently achieve superior clinical outcomes while giving teammates the opportunity to excel in an award-winning environment that enables them to thrive both professionally and personally.
A "community first, company second" culture based on Core Values that really matter. Clinical outcomes consistently ranked above the national average. A award-winning education and training across multiple career paths to help you reach your potential. Performance-based rewards based on stellar individual and team contributions. A comprehensive benefits package designed to enhance your health, your financial well-being and your future. Dedication, above all, to caring for patients suffering from chronic kidney failure across the nation. Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen."
Clinical Services Manager, Registered Nurse- Minnesota (DaVita IKC)
Posted 7 days ago
Job Viewed
Job Description
The Clinical Services Manager develops and leads clinical resources in delivery of quality cost effective care to patients. This position is the clinical leader for their designated market and is responsible for mentoring and coaching assigned teams of Integrated Care Nurses and Care Coordinators ("CC") to achieve performance and outcome expectations, increase skills, and professional development. This position also supports and leads Integrated Care teammates in existing clinical processes.
Clinical Outcomes- Owns, drives and creates clinical outcomes strategy (in collaboration with the ROM/ROS)
- Identifies metric-driven clinical opportunities and drives process improvement for individuals and teams (in collaboration with the ROM/ROS).
- Clinical coach on prioritization, critical thinking, and time management of tasks and responsibilities that align with our model of care and program specific requirements.
- Reinforce care delivery, training materials, educational tools, and policies for teammates (in collaboration with the training team).
- Assesses effectiveness of care delivery and provides necessary coaching and resources (in collaboration with the ROM/ROS).
- Reviews escalated REM events. Provides necessary investigation and plan of correction
- Knows and complies with DaVita policies and procedures in accordance with State and Federal regulations for patient care and services (CMS, HIPAA, OSHA, or other governing agencies); Standards necessary to maintain organizational accreditation (such as NCQA); and, State or Federal regulations of Injury Prevention and Safety Training 10%
- Coordinates and collaborates on patient care across DaVita IKC and DKC
Current RN license in state of practice (Minnesota)
- Current driver's license with positive driving record required; ability to meet requirements of insurance coverage, required
- 4 - 6 years relevant experience
- Bachelors degree
- Basic computer skills and proficiency in MS Word, Outlook and Excel
- Demonstrated experience managing to data driven outcomes and process improvement
- Experience in healthcare performance coaching
- Current CRP certification
- Certified Nephrology Nurse (CNN) or Certified Case Manager (CCM) preferred
DaVita IKC is comprised of an innovative team who is committed to improving patient outcomes and improving quality of life. Come work with a team of passionate professionals to transform kidney care through a value-based, person-centered, comprehensive approach to kidney care.
We provide comprehensive care and complex chronic condition management to patients nationwide, whether they are in the early stages of kidney disease, transitioning to dialysis, seeking a kidney transplant or receiving life-sustaining dialysis.
27,000+ patients receiving IKC services every month
20 years of Integrated Kidney Care Experience
We're on a mission to revolutionize kidney care, with a vision of making integrated care the standard of care for all renal patients. To help us achieve our vision, we're investing extensively in developing both our model of care and our team. When you join DaVita IKC, you're joining a compassionate team committed to quality patient care. Through our commitment to training, growth and quality we consistently achieve superior clinical outcomes while giving teammates the opportunity to excel in an award-winning environment that enables them to thrive both professionally and personally.
Here is what you can expect when you join our Village: A "community first, company second" culture based on Core Values that really matter. Clinical outcomes consistently ranked above the national average. Award-winning education and training across multiple career paths to help you reach your potential. Performance-based rewards based on stellar individual and team contributions. A comprehensive benefits package designed to enhance your health, your financial well-being and your future. Dedication, above all, to caring for patients suffering from chronic kidney failure across the nation.
Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen." Why wait? Explore a career with DaVita today.
More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings:
Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
Support for you and your family: Family resources, EAP counseling sessions, access Headspace, backup child and elder care, maternity/paternity leave and more
Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita's online training platform StarLearning.
At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.
This position will be open for a minimum of three days. The Salary Range for the role is $68,400.00 - $100,400.00 per year.
Pharmacy Technician- Clinical Support Services
Posted 5 days ago
Job Viewed
Job Description
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**
The Pharmacy Technician - Clinical Support Services position is responsible for utilizing their clinical knowledge and excellent customer service skills to provide our patients with the smooth service and delivery of medication to their homes. You will make a difference by bringing your personal touch and clinical experiences that will support our patient's one on one care.
Coram CVS/specialty infusion is a national leader in the home infusion field. As part of the team, you will have an important, uniquely rewarding role putting your Pharmacy Technician skills and experience to work in a closed-door practice setting.
Responsibilities:
· Assist the pharmacist in obtaining authorization for pharmacy services as requested; validate insurance coverage and communication with patients by telephone
· Gather information for the initial admission of new patients and review all new charts to ensure that all necessary nursing paperwork is included
· Manage the schedule for patient deliveries, manage inventory, create and maintain supply templates in the pharmacy computer data base
· Document all supply management activities in the patient medical record
· Participate on call rotation as indicated by staffing and business needs
**Required Qualifications**
Certification/licensed/registered pharmacy technician or as required by state law
· Minimum 1 year of experience
Position is not remote, must be available to work onsite
**Preferred Qualifications**
National Pharmacy Technician certification preferred
2+ years of IV compounding experience
**Education**
Verifiable High School diploma or GED is required
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$17.00 - $31.30
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: 11/07/2025
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.
Pharmacy Technician- Clinical Support Services
Posted 5 days ago
Job Viewed
Job Description
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**
The Pharmacy Technician - Clinical Support Services position is responsible for utilizing their clinical knowledge and excellent customer service skills to provide our patients with the smooth service and delivery of medication to their homes. You will make a difference by bringing your personal touch and clinical experiences that will support our patient's one on one care.
Coram CVS/specialty infusion is a national leader in the home infusion field. As part of the team, you will have an important, uniquely rewarding role putting your Pharmacy Technician skills and experience to work in a closed-door practice setting.
Responsibilities:
· Assist the pharmacist in obtaining authorization for pharmacy services as requested; validate insurance coverage and communication with patients by telephone
· Gather information for the initial admission of new patients and review all new charts to ensure that all necessary nursing paperwork is included
· Manage the schedule for patient deliveries, manage inventory, create and maintain supply templates in the pharmacy computer data base
· Document all supply management activities in the patient medical record
· Participate on call rotation as indicated by staffing and business needs
**Required Qualifications**
Certification/licensed/registered pharmacy technician or as required by state law
· Minimum 1 year of experience
Position is not remote, must be available to work onsite
**Preferred Qualifications**
National Pharmacy Technician certification preferred
2+ years of IV compounding experience
**Education**
Verifiable High School diploma or GED is required
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$17.00 - $31.30
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: 11/07/2025
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.
Pharmacy Technician- Clinical Support Services
Posted 5 days ago
Job Viewed
Job Description
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**
The Pharmacy Technician - Clinical Support Services position is responsible for utilizing their clinical knowledge and excellent customer service skills to provide our patients with the smooth service and delivery of medication to their homes. You will make a difference by bringing your personal touch and clinical experiences that will support our patient's one on one care.
Coram CVS/specialty infusion is a national leader in the home infusion field. As part of the team, you will have an important, uniquely rewarding role putting your Pharmacy Technician skills and experience to work in a closed-door practice setting.
Responsibilities:
· Assist the pharmacist in obtaining authorization for pharmacy services as requested; validate insurance coverage and communication with patients by telephone
· Gather information for the initial admission of new patients and review all new charts to ensure that all necessary nursing paperwork is included
· Manage the schedule for patient deliveries, manage inventory, create and maintain supply templates in the pharmacy computer data base
· Document all supply management activities in the patient medical record
· Participate on call rotation as indicated by staffing and business needs
**Required Qualifications**
Certification/licensed/registered pharmacy technician or as required by state law
· Minimum 1 year of experience
Position is not remote, must be available to work onsite
**Preferred Qualifications**
National Pharmacy Technician certification preferred
2+ years of IV compounding experience
**Education**
Verifiable High School diploma or GED is required
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$17.00 - $31.30
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: 11/07/2025
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.
Patient Care Technician
Posted today
Job Viewed
Job Description
PC - Ts usually work 10-12 hour shifts / 3-4 days a week (including every other Saturday, closed on Sundays!). Our clinics open as early as 3:30 am and close as late as 7 pm. Teammates are required to have availability to work opening, closing, and m Technician, Patient Care, Patient, Training, Healthcare
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