Explore numerous healthcare and elder care job opportunities currently available. The demand for skilled professionals in healthcare is consistently high, offering various roles from What Jobs are available for Hiring In Healthcare Or Elder Care in the United States?
Showing 4294 Hiring In Healthcare Or Elder Care jobs in the United States
Nursing Care Manager TDCJ
77551 Galveston, Texas
UTMB Health
Posted 8 days ago
Job Viewed
Job Description
Nursing Care Manager TDCJ
**Galveston, Texas, United States**
**Hot**
Nursing & Care Management
UTMB Health
Requisition #
**Minimum Qualifications:**
RN with Bachelor's degree in Nursing and two years of inpatient experience in a hospital environment. Current license or valid permit to practice professional nursing in Texas.
**Job Summary:**
To support the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. The role integrates and coordinates utilization management, care coordination and discharge planning functions.
**Equal Employment Opportunity**
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.
Compensation
**Galveston, Texas, United States**
**Hot**
Nursing & Care Management
UTMB Health
Requisition #
**Minimum Qualifications:**
RN with Bachelor's degree in Nursing and two years of inpatient experience in a hospital environment. Current license or valid permit to practice professional nursing in Texas.
**Job Summary:**
To support the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. The role integrates and coordinates utilization management, care coordination and discharge planning functions.
**Equal Employment Opportunity**
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.
Compensation
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0
Dietary Manager Nursing Care
Newark, New Jersey
Brimstone Allon Enterprises, LLC.
Posted today
Job Viewed
Job Description
Job Description
Benefits/Perks
We are seeking an experienced Dietary Manager to join our team. In this role, you will be responsible for overseeing all food operations and ensuring an excellent dining experience for a Nursing Home Community. Your goal is to increase sales and revenue and maintain a high level of employee engagement. If you are a strong leader with experience in food and beverage management, we want to hear from you!
Responsibilities
Qualifications
Job Description
Benefits:
- 401(k)
- Bonus based on performance
- Dental insurance
- Health insurance
- Paid time off
Benefits/Perks
- Flexible Scheduling
- Competitive Compensation
- Career Advancement Opportunities
We are seeking an experienced Dietary Manager to join our team. In this role, you will be responsible for overseeing all food operations and ensuring an excellent dining experience for a Nursing Home Community. Your goal is to increase sales and revenue and maintain a high level of employee engagement. If you are a strong leader with experience in food and beverage management, we want to hear from you!
Responsibilities
- Manage Dietary operations for 50 resident and 15 Sisters.
- Maintain a food budget.
- Lead team in providing exceptional customer service
- Create menus while taking into account budget, customer demands, and availability of ingredients
- Hire, train, and manage staff
- Establish goals and standards
- Adhere to all health and safety rules and regulations
Qualifications
- Extensive previous culinary experience
- Certification as a CDM preferred
- ServeSafe or Food Handlers Certification
- Familiarity with Microsoft Office, restaurant management software, and POS software
- Advanced knowledge of culinary techniques and recipes
- Ability to remain calm and thrive under pressure
- Excellent management and leadership skills
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1
Nurse Surveyor - Nursing Care Center
60181 Villa Park, Illinois
The Joint Commission
Posted 1 day ago
Job Viewed
Job Description
**Overview**
**GENERAL SUMMARY**
The Nursing Care Center RN - Field Representative, surveys long term nursing care organizations throughout the United States. Applies systems analysis skills and inductive reasoning skills to determine health care organizations' degree of compliance with applicable standards and functionality of care delivery systems. Engages health care organization staff in interactive dialogues on standards based issues in health care in order to assess compliance and to identify opportunities for improving compliance. Prepares management reports that clearly link individual standards deficiencies with potential systems vulnerabilities and related organization risk points. Effectively communicates this information to health care organization leadership in a constructive and collegial style. Participates in other Joint Commission activities as assigned by supervisor.
**Qualifications**
**KNOWLEDGE, SKILLS, CREDENTIALS AND ABILITIES:** Field Representatives must have the following essential knowledge, credentials, characteristics and abilities:
+ Qualified candidates must be a graduate of approved school of nursing and hold a Master's degree in appropriate discipline.
+ Current professional license in discipline required at time at time of hire and must be maintained throughout the duration of employment.
+ Nursing Home Administration license preferred.
+ Candidates must have five years of experience working in various components of a long term care, including three years direct clinical experience, and two years senior management experience.
+ Ideal candidates will have experience in a culturally diverse work environment; Fluency in Spanish is a plus.
+ The team players we select to take on these highly visible, challenging roles will have strong interpersonal, communication and problem-solving skills, expertise in interviewing, and PC proficiency.
+ Certification requirement: You must hold a CPHQ certification (Certified Professional in Healthcare Quality) through National Association for Healthcare Quality (NAHQ) at time of hire or by December 31, 2028.
**Full-time and part-time positions are currently available** .Candidates interested in part time positions must be available to work two or three weeks per month, and must provide three or four weeks of availability for the purpose of scheduling. All positions require 100% nationwide travel.
**_Physical Abilities:_**
1. Must be able to observe, in real time and without slowing or otherwise interrupting the progress of, all applicable types of ongoing health care treatment (e.g., including emergency treatment, treatment during weather and other extreme situations, etc.).
2. Standing for long periods of time, walking lengthy distances, lifting, climbing, stooping, pulling, and pushing in order to adequately inspect and observe all medical facilities, equipment and procedures, such as emergency exit procedures, remote storage facilities, any areas where cleanliness may affect the possibility of infection, medical equipment, etc., including the following activities:
+ walking up and down stairways (e.g., to test escape routes, assess safety of emergency exits, regulatory compliance, etc.);
+ removing obstructed covers or impediments to equipment or other mechanical areas;
+ examining small and often dirty printed labels and print on equipment;
+ Mustbe able to engage in extensive travel as set forth above, including driving a car to remote locations, flying on small airplanes and into small airports, traveling in all types of weather conditions, etc
+ **We are currently hiring for our orientation class to take place in November 2025 (tentative) and February 2026.**
We offer comprehensive benefits for our employees.For an overview of our benefits package, please visit ourJoint Commission Career Page ( seeking Full-time
_This job description is intended to describe the general nature and level of work performed by an employee assigned to this position. The description is not an exhaustive list of all duties, responsibilities, knowledge, skills and abilities, and working conditions associated with this position. All requirements are subject to possible modification due to business needs and/or reasonable accommodations for individuals with disabilities._
**Min**
USD $115,000.00/year
**Max**
USD $115,000.00/year
**Job Locations** _US-IL-Oakbrook Terrace_
**Job ID** _ _
**# of Openings** _1_
**Category** _Field Representative (Surveyor/Consultant)_
+ Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.
+ Please view Equal Employment Opportunity Posters provided by OFCCP here.
+ The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
+ This Organization Participates in E-Verify. Click here for more information.
**GENERAL SUMMARY**
The Nursing Care Center RN - Field Representative, surveys long term nursing care organizations throughout the United States. Applies systems analysis skills and inductive reasoning skills to determine health care organizations' degree of compliance with applicable standards and functionality of care delivery systems. Engages health care organization staff in interactive dialogues on standards based issues in health care in order to assess compliance and to identify opportunities for improving compliance. Prepares management reports that clearly link individual standards deficiencies with potential systems vulnerabilities and related organization risk points. Effectively communicates this information to health care organization leadership in a constructive and collegial style. Participates in other Joint Commission activities as assigned by supervisor.
**Qualifications**
**KNOWLEDGE, SKILLS, CREDENTIALS AND ABILITIES:** Field Representatives must have the following essential knowledge, credentials, characteristics and abilities:
+ Qualified candidates must be a graduate of approved school of nursing and hold a Master's degree in appropriate discipline.
+ Current professional license in discipline required at time at time of hire and must be maintained throughout the duration of employment.
+ Nursing Home Administration license preferred.
+ Candidates must have five years of experience working in various components of a long term care, including three years direct clinical experience, and two years senior management experience.
+ Ideal candidates will have experience in a culturally diverse work environment; Fluency in Spanish is a plus.
+ The team players we select to take on these highly visible, challenging roles will have strong interpersonal, communication and problem-solving skills, expertise in interviewing, and PC proficiency.
+ Certification requirement: You must hold a CPHQ certification (Certified Professional in Healthcare Quality) through National Association for Healthcare Quality (NAHQ) at time of hire or by December 31, 2028.
**Full-time and part-time positions are currently available** .Candidates interested in part time positions must be available to work two or three weeks per month, and must provide three or four weeks of availability for the purpose of scheduling. All positions require 100% nationwide travel.
**_Physical Abilities:_**
1. Must be able to observe, in real time and without slowing or otherwise interrupting the progress of, all applicable types of ongoing health care treatment (e.g., including emergency treatment, treatment during weather and other extreme situations, etc.).
2. Standing for long periods of time, walking lengthy distances, lifting, climbing, stooping, pulling, and pushing in order to adequately inspect and observe all medical facilities, equipment and procedures, such as emergency exit procedures, remote storage facilities, any areas where cleanliness may affect the possibility of infection, medical equipment, etc., including the following activities:
+ walking up and down stairways (e.g., to test escape routes, assess safety of emergency exits, regulatory compliance, etc.);
+ removing obstructed covers or impediments to equipment or other mechanical areas;
+ examining small and often dirty printed labels and print on equipment;
+ Mustbe able to engage in extensive travel as set forth above, including driving a car to remote locations, flying on small airplanes and into small airports, traveling in all types of weather conditions, etc
+ **We are currently hiring for our orientation class to take place in November 2025 (tentative) and February 2026.**
We offer comprehensive benefits for our employees.For an overview of our benefits package, please visit ourJoint Commission Career Page ( seeking Full-time
_This job description is intended to describe the general nature and level of work performed by an employee assigned to this position. The description is not an exhaustive list of all duties, responsibilities, knowledge, skills and abilities, and working conditions associated with this position. All requirements are subject to possible modification due to business needs and/or reasonable accommodations for individuals with disabilities._
**Min**
USD $115,000.00/year
**Max**
USD $115,000.00/year
**Job Locations** _US-IL-Oakbrook Terrace_
**Job ID** _ _
**# of Openings** _1_
**Category** _Field Representative (Surveyor/Consultant)_
+ Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.
+ Please view Equal Employment Opportunity Posters provided by OFCCP here.
+ The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
+ This Organization Participates in E-Verify. Click here for more information.
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2
Recreation Therapist - Skilled Nursing Care
92108 Mission Valley, California
Rady Children's Hospital San Diego
Posted 1 day ago
Job Viewed
Job Description
JOB SUMMARY:
Evaluates the functional ability of patients through assessment of resident's skills (by clinical observation, interpretation of standardized tests, and patient/family interview). Creates individualized treatment plans, re-evaluates procedures, documents progress and completes written reports for quarterly and annual meetings. Consults with medical team, health professionals, family and school staff to render an individual intervention plan. Trains staff through formal in-services and direct, hands-on training. Coordinates all Recreational activities and the volunteer program, as well as maintains safe transportation services, operation of wheelchair vehicles and working with community groups.
MINIMUM QUALIFICATIONS:
Bachelor's Degree in Area of Study in a Field Related to the Position
1 year of experience
Recreational Therapist Certification
BLS for Healthcare Providers, issued by AHA
CA Driver's License (For Helen Bernardy Recreation Therapist Only)
Auto Insurance (If Driving Personal Vehicle, Helen Bernardy Recreation Therapist Only)
Leadership ability in both professional and interpersonal relationships
PREFERRED QUALIFICATIONS:
2 year of experience
Experience working with people with disabilities (Special Olympics, camp, school)
The current salary range for this position is $29.48 to $40.55
Rady Children's Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.
EOE including disability/vet
Evaluates the functional ability of patients through assessment of resident's skills (by clinical observation, interpretation of standardized tests, and patient/family interview). Creates individualized treatment plans, re-evaluates procedures, documents progress and completes written reports for quarterly and annual meetings. Consults with medical team, health professionals, family and school staff to render an individual intervention plan. Trains staff through formal in-services and direct, hands-on training. Coordinates all Recreational activities and the volunteer program, as well as maintains safe transportation services, operation of wheelchair vehicles and working with community groups.
MINIMUM QUALIFICATIONS:
Bachelor's Degree in Area of Study in a Field Related to the Position
1 year of experience
Recreational Therapist Certification
BLS for Healthcare Providers, issued by AHA
CA Driver's License (For Helen Bernardy Recreation Therapist Only)
Auto Insurance (If Driving Personal Vehicle, Helen Bernardy Recreation Therapist Only)
Leadership ability in both professional and interpersonal relationships
PREFERRED QUALIFICATIONS:
2 year of experience
Experience working with people with disabilities (Special Olympics, camp, school)
The current salary range for this position is $29.48 to $40.55
Rady Children's Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.
EOE including disability/vet
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3
Nursing Care Assistant-Flex unit
Pennsylvania, Pennsylvania
Uniontown Hospital
Posted today
Job Viewed
Job Description
Welcome We're excited you're considering an opportunity with us To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position.
This position performs assigned tasks to aid in the provisions of patient care and daily operation of the Nursing Unit in accordance with established nursing policies and procedures. Provides patient care under the direction of the Registered Nurse.
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
- High school diploma or equivalent (GED)
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
- Pennsylvania Department of Health Nursing Assistant Certification
EXPERIENCE:
- One (1) year recent experience in a clinical setting providing Direct Patient Care or completion of or current enrollment in a health-related program that has provided the ability to perform Nursing Care Assistant skills; i.e. vitals, intake and output, feeding, and bathing.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
Provides and assists with patient care including basic hygiene, comfort, support and safety measures, nutrition and elimination needs, simple treatments and procedures, vital signs, weights, glucose monitoring and mobility utilizing proper tools and body mechanics appropriate to the ages of the patients served.
Receives and communicates patient information accurately; recognizes when to call or report information to the nurse.
Orients patient/significant other to the unit and the patient room upon admission and ongoing.
Answers call lights and performs purposeful rounding timely and appropriately ensuring patient/family needs are being met.
Documents assigned tasks according to policy and procedures of the unit
Cleans all patient equipment as per policy, tags defective equipment and notifies appropriate department for repair.
Performs efficiently in emergency situations i.e. Code 68, Code Yellow
Prepares and/or transports patients and performs courier duties for the department. (i.e. interunit transfers)
Restocks and ensures adequate supplies for patient care such as isolation supplies, linen, etc. per unit.
Monitors and records temperature logs according to unit.
Maintains a neat and orderly nursing unit, hallway and utility room.
Other duties as assigned.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Frequent walking, standing, bending, kneeling, reaching, and twisting
Ability to lift and/or carry up to/over 50 pounds.
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Exposure to bloodborne pathogens, latex, and radiation.
SKILLS AND ABILITIES:
Ability to attend to more than one aspect of a situation simultaneously.
Efficiency in processing of verbal information, either in written or spoken form is a major requirement and prerequisite of the job.
Some independent thought, planning or origination of options and solutions is necessary.
Ability to apply principles of reasoning and problem solving to resolve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Additional Job Description:
Scheduled Weekly Hours:
0
Shift:
Exempt/Non-Exempt:
United States of America (Non-Exempt)
Company:
UNTWN Uniontown Hospital
Cost Center:
93 UNTWN Nursing Nurse Resource and Float Pool
Address:
500 W Berkeley StreetUniontownPennsylvania
Equal Opportunity Employer
West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.
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4
LVN - Private Duty - Skilled Nursing Care
90301 Inglewood, California
Maxim Healthcare
Posted 1 day ago
Job Viewed
Job Description
Salary: $30-$35 / per hour
Maxim Healthcare in Gardena is hiring for a Licensed Vocational Nurse (LVN) to work with Pediatric and/or Adult patients in the home setting. Experience with feeding tubes, tracheostomies, and/or ventilators is preferred but not required. Paid training is provided.
Why Join Maxim:
+ Competitive Pay & Weekly Paychecks
+ Health, Dental, Vision, HSA and Life Insurance
+ Paid Time Off
+ 401(k) Savings Plan
+ Maxcares Awards Program
Responsibilities:
+ Utilize the nursing process to assess, plan, implement, and evaluate patient care.
+ On each assignment, provides skilled nursing care/services in accordance with prescribed orders
+ Assess signs and symptoms indicating physiologic and psychosocial changes in the patient's condition.
+ Collects, analyzes, and interprets data and information from health care members and documents actual and/or potential nursing diagnoses.
Qualifications:
+ Currently licensed as an LPN/LVN in the state in which the LPN will practice.
+ Current TB or Chest X-Ray.
+ Current BLS card.
+ One year prior professional nursing experience preferred
Maxim Benefits:
Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical) and Health Advocate Employee Assistance Program
Retirement and Financial Security: Health Savings Account, 401(k), Short Term Disability, Voluntary Group Life Insurance and Supplemental Accidental Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Home and Auto Insurance discounts, Pet Insurance and Legal Benefits
Lifestyle Benefits: Paid Time Off, Employee Discount Program, Transportation Benefits and College Partnership Program
*Benefit eligibility is dependent on employment status.
About Maxim Healthcare
Maxim Healthcare has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.
Maxim Healthcare, Inc. ("Maxim") is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
Maxim Healthcare in Gardena is hiring for a Licensed Vocational Nurse (LVN) to work with Pediatric and/or Adult patients in the home setting. Experience with feeding tubes, tracheostomies, and/or ventilators is preferred but not required. Paid training is provided.
Why Join Maxim:
+ Competitive Pay & Weekly Paychecks
+ Health, Dental, Vision, HSA and Life Insurance
+ Paid Time Off
+ 401(k) Savings Plan
+ Maxcares Awards Program
Responsibilities:
+ Utilize the nursing process to assess, plan, implement, and evaluate patient care.
+ On each assignment, provides skilled nursing care/services in accordance with prescribed orders
+ Assess signs and symptoms indicating physiologic and psychosocial changes in the patient's condition.
+ Collects, analyzes, and interprets data and information from health care members and documents actual and/or potential nursing diagnoses.
Qualifications:
+ Currently licensed as an LPN/LVN in the state in which the LPN will practice.
+ Current TB or Chest X-Ray.
+ Current BLS card.
+ One year prior professional nursing experience preferred
Maxim Benefits:
Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical) and Health Advocate Employee Assistance Program
Retirement and Financial Security: Health Savings Account, 401(k), Short Term Disability, Voluntary Group Life Insurance and Supplemental Accidental Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Home and Auto Insurance discounts, Pet Insurance and Legal Benefits
Lifestyle Benefits: Paid Time Off, Employee Discount Program, Transportation Benefits and College Partnership Program
*Benefit eligibility is dependent on employment status.
About Maxim Healthcare
Maxim Healthcare has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.
Maxim Healthcare, Inc. ("Maxim") is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
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5
LVN - Private Duty - Skilled Nursing Care
90280 South Gate, California
Maxim Healthcare
Posted 1 day ago
Job Viewed
Job Description
Salary: $30-$35 / per hour
Maxim Healthcare in Gardena is hiring for a Licensed Vocational Nurse (LVN) to work with Pediatric and/or Adult patients in the home setting. Experience with feeding tubes, tracheostomies, and/or ventilators is preferred but not required. Paid training is provided.
Why Join Maxim:
+ Competitive Pay & Weekly Paychecks
+ Health, Dental, Vision, HSA and Life Insurance
+ Paid Time Off
+ 401(k) Savings Plan
+ Maxcares Awards Program
Responsibilities:
+ Utilize the nursing process to assess, plan, implement, and evaluate patient care.
+ On each assignment, provides skilled nursing care/services in accordance with prescribed orders
+ Assess signs and symptoms indicating physiologic and psychosocial changes in the patient's condition.
+ Collects, analyzes, and interprets data and information from health care members and documents actual and/or potential nursing diagnoses.
Qualifications:
+ Currently licensed as an LPN/LVN in the state in which the LPN will practice.
+ Current TB or Chest X-Ray.
+ Current BLS card.
+ One year prior professional nursing experience preferred
Maxim Benefits:
Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical) and Health Advocate Employee Assistance Program
Retirement and Financial Security: Health Savings Account, 401(k), Short Term Disability, Voluntary Group Life Insurance and Supplemental Accidental Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Home and Auto Insurance discounts, Pet Insurance and Legal Benefits
Lifestyle Benefits: Paid Time Off, Employee Discount Program, Transportation Benefits and College Partnership Program
*Benefit eligibility is dependent on employment status.
About Maxim Healthcare
Maxim Healthcare has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.
Maxim Healthcare, Inc. ("Maxim") is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
Maxim Healthcare in Gardena is hiring for a Licensed Vocational Nurse (LVN) to work with Pediatric and/or Adult patients in the home setting. Experience with feeding tubes, tracheostomies, and/or ventilators is preferred but not required. Paid training is provided.
Why Join Maxim:
+ Competitive Pay & Weekly Paychecks
+ Health, Dental, Vision, HSA and Life Insurance
+ Paid Time Off
+ 401(k) Savings Plan
+ Maxcares Awards Program
Responsibilities:
+ Utilize the nursing process to assess, plan, implement, and evaluate patient care.
+ On each assignment, provides skilled nursing care/services in accordance with prescribed orders
+ Assess signs and symptoms indicating physiologic and psychosocial changes in the patient's condition.
+ Collects, analyzes, and interprets data and information from health care members and documents actual and/or potential nursing diagnoses.
Qualifications:
+ Currently licensed as an LPN/LVN in the state in which the LPN will practice.
+ Current TB or Chest X-Ray.
+ Current BLS card.
+ One year prior professional nursing experience preferred
Maxim Benefits:
Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical) and Health Advocate Employee Assistance Program
Retirement and Financial Security: Health Savings Account, 401(k), Short Term Disability, Voluntary Group Life Insurance and Supplemental Accidental Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Home and Auto Insurance discounts, Pet Insurance and Legal Benefits
Lifestyle Benefits: Paid Time Off, Employee Discount Program, Transportation Benefits and College Partnership Program
*Benefit eligibility is dependent on employment status.
About Maxim Healthcare
Maxim Healthcare has been making a difference in the lives of our patients, caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion care, respite care and behavioral care for individuals with chronic and acute illnesses and disabilities. Our commitment to quality customer service, compassionate patient care, and filling critical healthcare needs makes us a trusted partner wherever care is needed.
Maxim Healthcare, Inc. ("Maxim") is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
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6
Provider Contracts Manager (Skilled Nursing & Care Coordination)
48208 Detroit, Michigan
Molina Healthcare
Posted 12 days ago
Job Viewed
Job Description
**_***Remote and must live in Michigan***_**
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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7
Provider Contracts Manager (Skilled Nursing & Care Coordination)
48093 Warren, Michigan
Molina Healthcare
Posted 8 days ago
Job Viewed
Job Description
**_***Remote and must live in Michigan***_**
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Is this job a match or a miss?
View Now
8
Provider Contracts Manager (Skilled Nursing & Care Coordination)
48311 Sterling Heights, Michigan
Molina Healthcare
Posted 8 days ago
Job Viewed
Job Description
**_***Remote and must live in Michigan***_**
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Is this job a match or a miss?
View Now
9