What Jobs are available for Piedmont Healthcare in Atlanta?

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.
The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.
The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
**Primary Responsibilities:**
+ Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
+ Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
+ Engage with requesting providers as needed in peer-to-peer discussions
+ Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
+ Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
+ Communicate and collaborate with other internal partners
+ Call coverage rotation
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ M.D or D.O.
+ Active unrestricted license to practice medicine
+ Board certification in an ABMS specialty with Internal Medicine, Family Medicine, Hematology - Oncology, General Surgery, ENT, Rheumatology, or PM&R preferred
+ 3+ years of clinical practice experience after completing residency training
+ Demonstrated sound understanding of Evidence Based Medicine (EBM)
+ Proven solid PC skills, specifically using MS Word, Outlook, and Excel
**Preferred Qualifications:**
+ CA, OR, WA or AZ licensure or willing to obtain
+ Experience in utilization and clinical coverage review
+ Proven excellent oral, written, and interpersonal communication skills, facilitation skills
+ Proven data analysis and interpretation aptitude
+ Proven innovative problem-solving skills
+ Proven excellent presentation skills for both clinical and non-clinical audiences
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

**Overview**
**7a-3:30p / Full Time /40 Hours**
**Where you matter as much as the work you** **do**
Join **Emory Healthcare (EHC)** if you're looking for an opportunity with one of the nation's leading Atlanta hospitals in cardiology and heart surgery, cancer, neurology, and more! **EHC** is where those around you are dedicated to the power of teamwork, fostering an environment where you can learn, grow, and innovate with similarly passionate professionals. Work with us to improve the quality of life throughout Georgia through partnerships with the U.S. Centers for Disease Control and Prevention, Georgia Institute of Technology, and other organizations and make a bigger, greater impact than you ever thought possible.
**Description**
JOB DESCRIPTION: The clinical specialist, pharmacy I practices as a clinical expert in specialty practice area(s). In addition to direct patient care activities, this position is responsible for ensuring appropriate medication therapy and clinical outcomes for the institution related to specialty area. Practices as a clinical expert in specialty practice area. Develops and promotes advanced clinical practice based upon recent evidenced based practice. Practices under existing and establishes new collaborative practice agreements to enhance pharmaceutical care. Ensures institution-wide appropriate therapy and institutional outcomes in specialty area. Consistently provides patient-centered, interdisciplinary pharmaceutical care. Proactively reviews and processes orders accurately and efficiently. Prevents and/or resolves drug-related problems to ensure safety, efficacy, and cost-efficiency by consulting with the ordering prescriber and appropriately documents. Performs daily in-depth patient profile review to assess, monitor and recommend appropriate drug therapy as applicable. Consistently evaluates, intervenes, and documents clinical interventions beyond institutional protocols and guidelines. Supports recommendations with critical analysis of literature. Monitors drug therapy regimens and makes recommendations or modifications per protocol. Leads the development of system nomograms and other guidelines. Promotes the documentation of clinical activities and adverse drug events. Attends medical codes as applicable. Develops system policies and processes for proper dosing, storage, handling, dispensing, and/or administration of medications and compounded products. Actively participates in development of system clinical practice initiatives. Serves as a role model for complex clinical and ethical situations and resolves conflict constructively. Develops, uses and promotes effective patient education materials and techniques for drug therapy, adverse effects, compliance, appropriate use, handling and drug administration education. Participates in coordination of transitions of care as appropriate. Responsible for service completion and patient satisfaction. Engages in external professional activities to maintain clinical competency and knowledge of current trends and practices. Develops accredited continuing education activities every 2 years. Precepts pharmacy students and residents as available. Responsible for department training and competency assurance for specialty area. Develops and assists in training and education of pharmacy and other disciplines. Assists pharmacists seeking to advance their clinical skills. Answers drug information questions with in-depth knowledge of research designs, methodologies, and biostatistics. Actively participates in scholarly activities in specialty area; Submits publications or national presentations routinely. Recognizes process failures and actively engages in analysis and improvement efforts. Leads medication use evaluation or quality improvement project annually in specialty area. Oversees the work performed by pharmacy students, technicians and pharmacists to ensure performance standards are maintained and work is in accordance with state, federal and organizational regulations. Documents adverse drug reactions and medication variances per policy. Reviews trends and recommends patient safety solutions in specialty. Promotes new ideas to improve quality or overcome barriers to advance the profession in specialty area. Responsible for overall departmental pharmacy financial stewardship for specialty area. Leads the development and reinforcement of medication use policies and processes to ensure financial medication stewardship. Actively participates in formulary review and medication selection to promote cost savings. Supports and promotes cost-savings initiatives. Engages in review of medication insurance authorization status as applicable. Maintains and promotes understanding of 340b practices as applicable. Responsible for oversight of medication use systems in specialty area. Leads the development and review of protocols, guidelines, or order sets. Participates in multidisciplinary or system Emory Healthcare committee. Performs other duties as assigned or requested.
MINIMUM QUALIFICATIONS: Graduate of an accredited school of pharmacy. ASHP- Accredited Post Graduate Year 1 and 2 Residency or Fellowship or equivalent experience in the specialty area. Relevant Pharmacy Specialty Board Certification is preferred. Active Georgia Pharmacist license. Basic Life Support (BLS) Certification in accordance with the American Heart Association required within 90 days. Advanced Cardiac Life Support required within 6 months, if directly applicable to practice specialty.
PHYSICAL REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
**Additional Details**
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at . Please note that one week's advance notice is preferred.
**Connect With Us!**
Connect with us for general consideration!
**Division** _St. Joseph's Hospital_
**Campus Location** _Atlanta, GA, 30342_
**Campus Location** _US-GA-Atlanta_
**Department** _SJH Pharmaceutical Services_
**Job Type** _Regular Full-Time_
**Job Number** _ _
**Job Category** _Pharmacy_
**Schedule** _7a-3:30p_
**Standard Hours** _40 Hours_
**Hourly Minimum** _USD $65.57/Hr._
**Hourly Midpoint** _USD $77.94/Hr._
Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.
The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.
The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
**Primary Responsibilities:**
+ Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
+ Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements
+ Engage with requesting providers as needed in peer-to-peer discussions
+ Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
+ Participate in daily clinical rounds as requested
+ Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
+ Communicate and collaborate with other internal partners
+ Call coverage rotation
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ M.D or D.O.
+ Active unrestricted license to practice medicine
+ Board certification approved by the American Board of Medical Specialties (ABMS)
+ 5+ years of clinical practice experience after completing residency training
+ Sound understanding of Evidence Based Medicine (EBM)
+ Proven solid PC skills, specifically using MS Word, Outlook, and Excel
**Preferred Qualifications:**
+ Current licensure in New Mexico, Arizona, Texas, or Tennessee
+ Willing to obtain additional licensure if needed
+ Board Certification in Internal Medicine, Family Practice, Surgery, Plastic Surgery but other board certifications considered
+ Experience in utilization and clinical coverage review
+ Proven data analysis and interpretation aptitude
+ Proven innovative problem-solving skills
+ Demonstrated excellent presentation skills for both clinical and non-clinical audiences
+ Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.
The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.
The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
**Primary Responsibilities:**
+ Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
+ Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
+ Engage with requesting providers as needed in peer-to-peer discussions
+ Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
+ Participate in daily clinical rounds as requested
+ Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
+ Communicate and collaborate with other internal partners
+ Call coverage rotation
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ M.D. or D.O.
+ Active unrestricted license to practice medicine
+ Board certification an ABMS or AOA specialty
+ Ability to obtain additional licenses as needed
+ 5+ years of clinical practice experience after completing residency training
+ Proven sound understanding of Evidence Based Medicine (EBM)
+ PC skills, specifically using MS Word, Outlook, and Excel
+ Ability to participate in rotational holiday and call coverage
**Preferred Qualifications:**
+ Experience in utilization and clinical coverage review
+ Demonstrated data analysis and interpretation aptitude
+ Demonstrated innovative problem-solving skills
+ Proven presentation skills for both clinical and non-clinical audiences
+ Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products.
The Supervisor, Clinical Operations provides management and clinical oversight to a team of nurses providing assistance to customers and patients. This role oversees the recruitment and professional development of the clinical patient engagement team to ensure a positive and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides coaching as needed to ensure effective and accurate communication of all clinical information. This job ensures all interactions are within an acceptable standard of telephonic nursing and keeps an eye on the financial management of programs.
**_Responsibilities_**
+ Oversight and management of direct reports including but not limited to nursing staff
+ Oversight of daily clinical operations for patient access support contact center team members and provide daily support ensuring team members can perform job responsibilities.
+ Oversight and implementation of all program compliance activities, product training and adverse event/product quality complaint training.
+ Oversight of clinical training, coach, teach, train, and mentor team members while monitoring individual and team performance.
+ Create and maintain Standard Operating Procedures and work instructions specific to the program.
+ Coordinate and deliver recurring (weekly, monthly, and quarterly) reviews of program metrics / dashboards while proactively sharing results with internal and external senior leaders.
+ Assess / Test / Solution / Approve program changes including those related to Information Technology, platform upgrades, and modifications to program business rules.
+ Report system issues that can impact our client relationship management system (CRM) and/or productivity in a timely manner.
+ Manage employee scheduling/timecards in addition to standard HR responsibilities as a people leader.
+ Open job requisitions, conduct interviews, and provide personnel recommendations to senior leaders.
+ Coordinate with senior leadership and Advice and Counsel Center to determine appropriate corrective action, not limited to termination when applicable.
+ Continually monitor program adherence, quality, attendance, and address accordingly.
+ Report Non-Conformances in a timely manner.
+ Coordinate with fellow supervisors and collaborate with business partners to provide effective responses and resolutions to complex program related issues.
+ Conduct recurring development-based 1x1s with team members focused on both performance and goal setting.
+ Effectively manage time and independently prioritize work responsibilities to meet key deadlines.
+ Maintain regular contact with client/3rd party partners by leveraging excellent verbal and written communication skills.
+ Contribute to the building and presentation of business reviews to clients (either virtually or in-person).
+ Proactively seek and implement process efficiencies to reduce team manual work.
+ Host recurring (bi-weekly/monthly) team meetings to discuss updates, process changes, team SLAs/KPIs, QA, trends, etc.
+ Work well independently and in a team setting by collaborating across different departments.
+ Travel may be needed to perform your duties up to 25%.
**_Qualifications_**
+ Current, unrestricted Registered Nurse license, required.
+ BA, BS or equivalent experience in related field preferred.
+ 5 years of clinical experience, preferred.
+ Knowledge of program disease state, preferred.
+ Call center or telephonic nursing experience, preferred.
+ Previous leadership experience, preferred.
+ Basic health insurance reimbursement knowledge, preferred.
+ Strong communication, presentation, and time management skills.
+ Experience in conducting web-based meetings, preferred.
+ Commitment to the continued development of oneself and team members.
+ Advanced computer skills and proficiency in Microsoft Office including but not limited to Word (e.g. inserting tables, mail merge, tracking changes, updating headers and footers), Teams, Outlook, PowerPoint (e.g. updating slide layout, adding slides, adding & updating charts, and graphs, and updating themes), and preferred Excel capabilities including pivot tables, graphing, and basic formulas.
**_What is expected of you and others at this level_**
+ Coordinates and supervises the daily activities of operations or business staff
+ Administers and exercises policies and procedures
+ Ensures employees operate within guidelines
+ Decisions have a direct impact to work unit operations and customers
+ Frequently interacts with subordinates, customers, and peer groups at various management levels
+ Interactions normally involve information exchange and basic problem resolution
+ Consistently demonstrate Cardinal Health values (What we value):
+ Integrity - We hold ourselves to the highest ethical standard.
+ Accountable - We bring passion, determination, and grit to deliver on our commitments.
+ Inclusive - We embrace differences to drive the best outcomes.
+ Mission Driven - We serve the greater goal of healthcare.
+ Innovative - We develop new ways of thinking, operating, and serving customers.
+ Regularly practice the Cardinal Heath behaviors (The way we act):
+ Invites curiosity.
+ Builds partnerships.
+ Inspires commitment.
+ Develops self and others.
**_Training and Work Schedules:_**
+ Your new hire training will take place 8:00am-5:00pm CST the first week of employment, mandatory attendance is required.
+ This position is full-time (40 hours/week).
+ Employees are required to have flexibility to work a scheduled shift of Monday-Friday, 8:00am- 5:00pm CST.
**_R_** **_emote Details:_**
All U.S. residents are eligible to apply to this position. You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:
+ Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable.
+ Download speed of 15Mbps (megabyte per second)
+ Upload speed of 5Mbps (megabyte per second)
+ Ping Rate Maximum of 30ms (milliseconds)
+ Hardwired to the router
+ Surge protector with Network Line Protection for CAH issued equipment
**Anticipated salary range:** $80,900-$115,500
**Bonus eligible: No**
**Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being.
+ Medical, dental and vision coverage
+ Paid time off plan
+ Health savings account (HSA)
+ 401k savings plan
+ Access to wages before pay day with myFlexPay
+ Flexible spending accounts (FSAs)
+ Short- and long-term disability coverage
+ Work-Life resources
+ Paid parental leave
+ Healthy lifestyle programs
**Application window anticipated to close:** 12/27/2025 *if interested in opportunity, please submit application as soon as possible.
The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.
_Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._
_Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._
_To read and review this privacy notice click_ here (

**Job Description:**
Sharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change. Driven by our philosophy that we are all together better, at Sharecare, we are committed to supporting each individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit  .
**Job Summary:**
The ROI Support Specialist aids the medical records line of business in triaging flagged requests requiring additional support to adhere to all applicable laws and company standards. This includes scenarios such as data input errors, failure to comply with required laws or company standards, obtaining additional documentation, and expediting delivery of high priority requests.
**Essential Functions: **
+ Review Requests for Records and the documents sent in response to the request.
+ Data Entry of Essential information for release.
+ Evaluate requests utilizing established quality control workflows.
+ Communicate with partnering departments to answer questions and resolve issues with requests.
+ Research and resolve workflow and record issues quickly to ensure timely delivery.
+ Identify and escalate critical and important issues to  leads, managers, or directors in a timely manner.
+ Maintain queue turnaround time of one business day.
+ Meet established individual production and quality goals.
+ Support other queues, primarily in Central Operations, as shifting needs of the business require.
+ Support training of other colleagues as needed.
+ Carry out responsibilities in accordance with policies and procedures, including HIPAA, state/federal regulations related to operations and labor regulations.
**Specific Skills/Attributes: **
+ Ability to work in a fast-paced, production-oriented environment.
+ Ability to work well in a small team environment, work independently and be productive with little supervision.
+ High level of reliability, productivity, and professionalism.
+ Excellent communication skills with a professional and respectful manner.
+ Superior attention to detail skills.
**Qualifications: **
+ Minimum of 2 years' experience in medical records or related experience preferred.
+ Basic computer literacy and previous experience with Microsoft tools such as Outlook, Word, and Excel.
+ Previous training in HIPAA laws and regulations.
+ Minimum typing speed of 40 words per minute.
+ Required to pass an industry related course and exam within six months of hire.
Sharecare, Inc. and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.
Sharecare and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.
Sharecare is an Equal Opportunity Employer and doesn't discriminate on the basis of race, color, sex, national origin, sexual orientation, gender identity, religion, age, disability, genetic information, protected veteran status,or other non-merit factor.

**Job Summary**
Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
+ Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion.
+ Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes.
+ May engage and oversee the work of external vendors.
+ Focuses on process improvement, organizational change management, program management and other processes relative to business needs.
+ Serves as a subject matter expert and leads healthcare services programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate.
+ Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs), user training materials and other related business documents.
**Required Qualifications**
+ At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
+ Strong analytical and problem-solving skills.
+ Strong organizational and time-management skills.
+ Ability to work in a cross-functional, professional environment.
+ Experience working within applicable state, federal, and third-party regulations.
+ Strong verbal and written communication skills.
+ Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
**Preferred Qualifications**
+ Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.
+ Leadership experience.
+ Medicaid/Medicare population experience.
+ Six sigma certification
+ Experience with Agile Methodology
+ Experience with Epic
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**JOB DESCRIPTION**
**Job Summary**
This position will be focused on Clinical Program Design.
Provides subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care.
**Essential Job Duties**
+ Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion.
+ Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes.
+ May engage and oversee the work of external vendors.
+ Focuses on process improvement, organizational change management, program management and other processes relative to business needs.
+ Serves as a subject matter expert and leads healthcare services programs to meet critical needs.
+ Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
+ Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate.
+ Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs), user training materials and other related business documents.
**Required Qualifications**
+ At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
+ Strong analytical and problem-solving skills.
+ Strong organizational and time-management skills.
+ Ability to work in a cross-functional, professional environment.
+ Experience working within applicable state, federal, and third-party regulations.
+ Strong verbal and written communication skills.
+ Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
**Preferred Qualifications**
- Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.
- Leadership experience.
- Medicaid/Medicare population experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $77,969 - $142,549 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

This position will offer remote work flexibility, but the individual selected for the role must reside in Georgia.
JOB DESCRIPTION
Job Summary
Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
+ Assists in implementing health management, care management, utilization management, behavioral health and other program activities in accordance with regulatory, contract standards and accreditation compliance.
+ Functions as a "hands-on" supervisor, assisting with assessing and evaluation of systems, day-to-day operations and efficiency of operations/services.
+ Assists in the coordination of orienting and training staff to ensure maximum efficiency and productivity, program implementation, and service excellence.
+ Trains and supports team members to ensure high-risk, complex members are adequately supported.
+ Assists with staff performance appraisals, ongoing monitoring of performance, and application of protocols and guidelines.
+ Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources, system and program needs.
+ Assists with coordination and reporting of department statistics and ongoing client reports, as assigned.
+ Local travel may be required (based upon state/contractual requirements).
Required Qualifications
+ At least 5 years health care experience, and at least 2 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience. r equivalent combination of relevant education and experience.
+ Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
+ Ability to manage conflict and lead through change.
+ Operational and process improvement experience.
+ Strong written and verbal communication skills.
+ Working knowledge of Microsoft Office suite.
+ Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Preferred Qualifications
+ Registered Nurse (RN). License must be active and unrestricted in state of practice.
+ Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification.
+ Medicaid/Medicare population experience.
+ Clinical experience.
+ Supervisory/leadership experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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Pay Range: $77,969 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.