14,244 Priority Health jobs in the United States

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.Job SummaryJob Profile SummaryResponsible for providing care management services and support to an assigned population with the purpose of improving health outcomes via a coordinated approach. The Care Manager II works in collaboration and continuous partnership with patients and their family members, as well as clinic, hospital, post-acute and insurance company partners, along with community resources, to achieve the desired outcomes. Using a defined process to identify patients/members at risk for poor outcomes, the Care Manager II establishes care plans and goals, and coordinates care and services throughout the continuum of care for patients assigned to the care management programs with the goal of enhancing patient health and well-being, improving adherence to health programs, and reducing health care costs. Must be highly collaborative with strong customer service skills and be able to demonstrate the ability to actively engage patients in positive relationships. Must also be able to demonstrate the knowledge and skills necessary to provide care management services appropriate to the patient/member being served.Job DescriptionMinimum QualificationsEducation:Registered Nurse (RN) or Social Worker (LMSW)Licenses/Certifications: Registered Nurse (RN) or Licensed Master Social Worker (LMSW) or Licensed Clinical Social Worker (LCSW) with active license in the state of TexasExperience / Knowledge / Skills:Experience in care/case management, chronic disease management or population health preferredAt least two (2) years of experience in care coordination and planning or other related areaExperience working in interdisciplinary teamsExcellent computer skillsEffective oral and written communication skillsPrincipal AccountabilitiesProvides primary care management interventions to identified members enrolled in the Health Management programs.In conjunction with payers and health care teams across the continuum, identify members at risk for poor outcomes, or experiencing poor coordination of services, who would benefit from more intensive follow-up and care coordination.Coordinates in conjunction with providers and health plans, a comprehensive plan of care for the high-risk, high-utilizing population, and collaborates with clinical staff and the patient/family in the development and execution of the plan of care, and achievement of goals.Provides proactive outreach to members to include telephonic, internet, or face-to-face encounters.Works cohesively with other health management disciplines to assist members in problem-solving potential issues related to financial and psychological barriers, as well as problems with the overall system of care.Increases continuity of care by managing and facilitating relationships with post-acute providers, physicians, and community resources.Manages effective transitions in care by facilitating warm hand-offs and closure of gaps in care.Promotes timely access to appropriate care and promote effective and efficient utilization of clinical resources.Promotes adherence to an established plan of care.Increases utilization of primary care services within an established network.Reduces emergency room utilization and hospital readmissions via a comprehensive approach.Increases patients’ ability for self-management and shared decision-making.Increases comprehension and health literacy through appropriate education.Provides medication management, including comprehensive medication review and make recommendations to primary care provider for medication changes based on evidence-based protocols.Provides chronic disease and self-management education and support.Connects patients to relevant community resources necessary to support health and well-being.Coordinates warm hand-off to member’s primary care provider upon successful completion of the program.Directs and participates in the development and implementation of member care policies and protocols in order to provide advice and guidance in handling special cases or member needs.Makes referrals to other Health Management team members as necessary to promote effective care coordination services.Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.Other duties as assigned.

Join to apply for the Public Health Management Senior Consultant role at Goldbelt Glacier Health Services

Join to apply for the Public Health Management Senior Consultant role at Goldbelt Glacier Health Services

Overview

Please note that this position is contingent upon the successful award of a contract currently under bid.

Overview

Please note that this position is contingent upon the successful award of a contract currently under bid.

Goldbelt Glacier is accelerating healthcare delivery and providing superior force health readiness across the military, federal, and civilian landscapes. Goldbelt Glacier is committed to providing transformative and comprehensive health operational capabilities to support customers across scientific, clinical, technological, and program management areas.

Summary:

The Consultant will have experience performing a wide variety of complex technical activities, in support of contract transition service activities; developing operational concepts, plans, and instructions; identifying alternative courses of action and makes recommendations; and serving as an assistant to senior consulting specialists, technical directors, project managers, the program manager, and program manager alternate.

Responsibilities

Essential Job Functions:

• Manage/lead multiple work processes from initiation, transition, execution, growth and decrement, and contract close out.
• Develop strong relationships with clients and customers to understand their needs, to anticipate obstacles to success, and to advocate internally on their behalf.
• Regularly track operations and projects, manage operational and project risks and impact of changes, provide mitigation plans, and proactively manage escalation of issues to appropriate stakeholders.
• Review project team deliverables to ensure quality and adherence to internal, contract and government standards.
• Work with recruiters, PM and other program personnel for requisitions development, management and interview coordination and skills verification.
• Oversee staffing process, working with multiple stakeholders to ensure sufficient candidates are identified, vetted, and onboarded efficiently. Track staffing actions for contract, utilizing program-developed tools to provide accurate and timely updates.
• Manage relations with sub-contractors for submission and execution of labor.
• Assist in the management of leadership development projects related to workforce management and program staffing.
• Provide weekly, monthly, quarterly, and annual operational metrics for reporting to senior management and client using MS Excel and other tools.
• Perform tasks requiring the collection, evaluation, and data analysis on official documents, records, forms, reports, plans, policies, and regulations as needed.
• Develop and continuously enhance processes to improve the quality of deliverables, optimize process efficiency and maximize Site Manager throughput.
• Establish and maintain positive relationships with client, partners, vendors, managers, and employees enabling enhanced communication around all staffing activities.
• Other duties as assigned.
  
  

• Strong analytical and problem-solving skills, with the ability to synthesize data and information into actionable recommendations.
• Excellent written and verbal communication skills, with the ability to present complex information clearly and persuasively.
• Demonstrated ability to build and maintain strong client relationships.
• Proficiency in project management software and tools.
• Ability to work independently and as part of a team, managing multiple priorities in a fast-paced environment.
  
  

• Bachelors degree in business management or related field (in lieu of a bachelors degree, minimum ten years experience
• Minimum five (5) years of experience in managing complex projects.
• Experienced in government policies and procedures.
• Possess the ability to pass a NACI background investigation.
• Active Secret clearance.
  
  

• Masters Degree in a related field.
• PMP Certification and/or other equivalent certifications a plus.
  
  

• Seniority level Mid-Senior level

• Employment type Full-time

• Job function Consulting, Information Technology, and Sales
• Industries Health and Human Services

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JOB DUTIESClinical SkillsImplements and evaluates all skilled and technical patient care activities designed by the primary RN.Implements the care plan under the direction of the RN.Organizes prescribed medications into medication box for patient/ care givers to administer per plan of care.Performs and documents vital signs each visit.Participates in patient/family teaching activities.DocumentationCompletes required documentation on the day of the visit.Updates the medication sheets on an ongoing basis.Addresses all areas of the plan of care each visit.Updates clinical information on primary assigned patients at each visit.Reports abnormal findings to primary nurse for evaluation.Documents all communications with CCN team via workload.CommunicationReports any changes in the patient's condition to the supervising RN.Interacts with field staff, patients, families, physicians, other health disciplines, agencies, insurance companies, hospitals, labs, employers, government agencies and representatives as necessary.Adheres to all policies set forth in the Nurse Practice Act to maintain safe clinical practice.Maintains confidentiality of patient information.Coordinates physician ordered patient care activities with the Care Coordinator.Professional StandardsProtects patient privacy and confidentiality by being discreet and professional in sharing information on a need to know basis.Adheres to all policies set forth in the Nurse Practice Act and maintains a professional standard of conduct, projecting a positive image of the agency.Complies with infection control and safety policies and procedures.Serves as a role model for all staff.Adheres to all policies and practices.Professional DevelopmentCompletes all assigned continuing education as assigned in Healthstream.Seeks clinical collaboration in new and/or unfamiliar care areas.Participates in staff meetings, care conferences, and education trainings.MINIMUM EDUCATION, KNOWLEDGE, SKILLS, AND ABILITIES REQUIREDCurrent license in the State of Pennsylvania.Minimum of two (2) years' experience in patient care.Reliable, independent means of transportation to make home visits. WORKING CONDITIONSWorks in a variety of patient care environments including the patient's home. Subject to certain patient care activities and exposure to communicable diseases. May be exposed to potential hazards such as chemical wastes, body wastes, fluids and other possible infectious material.DISCLOSUREMMC commits to review, under the intent of this standard, and in coordination with medical professional opinion's and physical demands job analysis performed by certified professionals, an individual's ability to be reasonably accommodated within the role they are responsible and qualified to perform.MMC is committed to complying with the Americans with Disabilities Act ("ADA") and providing equal opportunity employment for qualified persons with disabilities. All employment practices and activities are conducted on a nondiscriminatory basis. Meadville Medical Center will follow any state or local law that provides individuals with disabilities greater protection that the ADA.Every effort has been made to make your job description as complete as possible. However, this in no way states or implies that these are the only duties you will be required to perform. The omission of specific tasks does not exclude them from the position if the task is similar, related, or is a logical assignment to the position, or is imperative for patient care and to meet emergency situations. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Summary:Responsible for maintaining current and high-quality ICD-10-CM/PCS coding for all Inpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting. Inpatient coding is applicable towards all regional Inpatient encounters. Coder will work collaboratively with various CHRISTUS Health HIM and Clinical Documentation Specialists to ensure accurate and complete physician documentation to support accurate billing and reduce denials. Coder will also assist in other areas of the department, as requested by leadership. Coder will report directly to their Regional Coding Manager, with additional leadership from the Director of Coding Operations and System HIM Director.Responsibilities:Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.Assign codes for diagnoses, treatments and procedures according to the ICD-10-CM/PCS Official Guidelines for Coding and Reporting through review of coding critical documentation, to generate appropriate MS/APR DRG.Extracts and abstracts required information from source documentation, to be entered into appropriate CHRISTUS Health electronic medical record system.Validates admit orders and discharge dispositions.Works from assigned coding queue, completing and re-assigning accounts correctly.Manages accounts on ABS Hold or through Epic WQs using account activities, finalizing accounts when corrections have been made, in a timely manner.Meets or exceeds an accuracy rate of 95%.Meets or exceeds the designated CHRISTUS Health Productivity standard per chart type.Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA).Assists in implementing solutions to reduce backend-errors.Identifies and appropriately reports all hospital-acquired conditions (HAC).Expertly queries providers for missing or unclear documentation, by working with the HIM department and Clinical Documentation Improvement Specialists.Participates in both internal and external audit discussions.Strong written and verbal communication skills.Demonstrated proficiency in use of multiple technologies and comfort level with virtual applications and electronic medical record applications such as Epic, Meditech, 3M/360, OneContent, Microsoft Office, Teams, Outlook, OneNote, etc.Able to work independently in a remote setting, with little supervision.All other work duties as assigned by Manager.Job Requirements:Education/Skills High school Diploma or equivalent years of experience required.Completion of Accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred. Experience 3-5 years of Inpatient coding experience in an acute care setting preferred. Licenses, Registrations, or CertificationsAt least one of the following certifications are required: Registered Health Information Administrator (RHIA) (AHIMA)Registered Health Information Technician (RHIT) (AHIMA)Certified Coding Specialist (CCS) (AHIMA)Certified Coding Associate (CCA) (AHIMA)Work Type:Full Time

Join to apply for the Health Information Management Coder Senior-Health Information Management role at TieTalent

1 day ago Be among the first 25 applicants

Join to apply for the Health Information Management Coder Senior-Health Information Management role at TieTalent

Description

Summary:

Responsible for maintaining current and high-quality ICD-10-CM/PCS coding for all Inpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting. Inpatient coding is applicable towards all regional Inpatient encounters.

Coder will work collaboratively with various CHRISTUS Health HIM and Clinical Documentation Specialists to ensure accurate and complete physician documentation to support accurate billing and reduce denials. Coder will also assist in other areas of the department, as requested by leadership. Coder will report directly to their Regional Coding Manager, with additional leadership from the Director of Coding Operations and System HIM Director.

Responsibilities:

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.

Assign codes for diagnoses, treatments and procedures according to the ICD-10-CM/PCS Official Guidelines for Coding and Reporting through review of coding critical documentation, to generate appropriate MS/APR DRG.

Extracts and abstracts required information from source documentation, to be entered into appropriate CHRISTUS Health electronic medical record system.

Validates admit orders and discharge dispositions.

Works from assigned coding queue, completing and re-assigning accounts correctly.

Manages accounts on ABS Hold or through Epic WQs using account activities, finalizing accounts when corrections have been made, in a timely manner.

Meets or exceeds an accuracy rate of 95%.

Meets or exceeds the designated CHRISTUS Health Productivity standard per chart type.

Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA).

Assists in implementing solutions to reduce backend-errors.

Identifies and appropriately reports all hospital-acquired conditions (HAC).

Expertly queries providers for missing or unclear documentation, by working with the HIM department and Clinical Documentation Improvement Specialists.

Participates in both internal and external audit discussions.

Strong written and verbal communication skills.

Demonstrated proficiency in use of multiple technologies and comfort level with virtual applications and electronic medical record applications such as Epic, Meditech, 3M/360, OneContent, Microsoft Office, Teams, Outlook, OneNote, etc.

Able to work independently in a remote setting, with little supervision.

All other work duties as assigned by Manager.

Job Requirements:

Education/Skills

High School Diploma Or Equivalent Years Of Experience Required.

Completion of Accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred.

Experience

3-5 years of Inpatient coding experience in an acute care setting preferred.

Licenses, Registrations, or Certifications

At least one of the following certifications are required:

Registered Health Information Administrator (RHIA) (AHIMA)

Registered Health Information Technician (RHIT) (AHIMA)

Certified Coding Specialist (CCS) (AHIMA)

Certified Coding Associate (CCA) (AHIMA)

Work Type:

Full Time

• Seniority level Mid-Senior level

• Employment type Full-time

• Job function Health Care Provider
• Industries Technology, Information and Internet

Referrals increase your chances of interviewing at TieTalent by 2x

University Park, TX $8.00- 40.00 1 day ago

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Job Description***Must be a current resident of South CarolinaJob DescriptionJob SummaryThe Molina Population Health Management Case Manager uses clinical judgment, knowledge, and direct hands-on member care experience to clinically evaluate the member based on formal assessment and determine the next step(s) for care. Care is then provided directly or referred / escalated. HM CM staff work to ensure that members progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.Job Duties Based on clinical assessment and member reported health care concerns, use clinical judgment to provide care management or refer members to a higher level of care. Identify patient needs, close health care gaps, develop action plan and prioritize goals and educate patients best practice to manage medical needs. Provide condition specific education designed to assist members and their families in better understanding specific chronic health conditions, how to manage symptoms to prevent conditions from progressing and adopting healthy lifestyle behaviors. Provide general member education to assist with self-management goals; disease management or acute condition and provide indicated contingency plan. Assess for barriers to care, provides care coordination and assistance to member to address concerns. Act as an advocate for patients to guide them through the health care system for transition planning and longitudinal care. Reinforce medication adherence and education. Monitor patient reactions to medications and treatments. Engage patient, family, and caregivers telephonically to assure that a well-coordinated action plan is established and continually assess health status. Perform ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. Maintain ongoing member case load for regular outreach and management. Use motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. May facilitate interdisciplinary care team meetings and informal ICT collaboration. Collaborate with RN case managers/supervisors as needed or requiredJob QualificationsREQUIRED EDUCATION:LVN/LPN graduate. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:1-3 years in direct patient care, case management, disease management, managed care in medical or behavioral health settings.REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:LVN/LPN licensure must be current for the state of South Carolina. PREFERRED EXPERIENCE:3-5 years in case management, disease management, managed care or medical or behavioral health settings.PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:Certified Case Manager (CCM)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.