13 Select Medical jobs in Mechanicsburg
CX Solutions Sales Executive - Healthcare vertical

Posted 18 days ago
Job Viewed
Job Description
Cloud Applications Sales Representative - Remote
Take your sales career to the next level with a global market leader. Do you have sharp business insights, a talent for selling, and the drive to win? If you want to advance your career in applications software sales, come sell our #1 suite of cloud apps.
Oracle is a technology leader that's transforming how the world does business. We're looking for a talented sales person to join our highly motivated CX Applications Sales team as an Applications Sales Representative. Your enthusiasm, knowledge, and customer-centricity can help us connect to the businesses that need our help to evolve.
As an experienced and dynamic software solutions expert, you'll be confident selling business applications to CEOs and presenting custom solutions to Oracle clients. We need you to unlock up-sell potential in our large base of existing customers and seek out new business opportunities over a large territory. You'll have the world-class resources you need to drive sales and advance your career.
Our mission
Our CX Sales helps companies to improve sales productivity and creates better experiences for your buyers, while CX Service Help customers get answers faster, free your agents to handle more complex tasks, and reduce cost with self-service tools.
Right now, we're broadening our reach, expanding our product range, and committing to sustainable success - so there's never been a more exciting time to join our dynamic sales team.
What you'll do
- Develop an ambitious strategy and sales plan to win new license sales revenue
- Achieve sales targets with a focus on CX applications
- Build strong, long-term relationships with clients, partners, and internal teams
- Sell business applications to CEOs and other C-level executives
- Use business insights to connect with clients and help future-proof their operations
- Translate IT requirements into business driven Oracle solutions that fit our clients' business strategies
- Work with pre-sales, marketing, and consulting services to provide clients with comprehensive custom-fit solutions
- Present custom solutions to clients, unlocking up-sell potential in our existing customer base
- Prospect and win new business opportunities over a wide territory
- Drive success in our open and team-oriented culture
What you'll bring
- 7+ years' experience selling software solutions such as CX (sales, marketing, and service)
- Record of success in Business Software Applications License Sales - experience in cloud sales will be preferred
- Deep understanding of both direct and indirect sales models
- A talent for face-to-face sales, social selling, and other sales techniques
- Experience selling across all lines of business in enterprise organizations
- Ability to develop and execute successful sales strategies
- Experience prospecting for new business over a large territory
- The ambition to take a leading sales role and manage virtual teams
- Proven ability to work well as part of an extended sales team
- Strong communication and presentation skills
- Language required: English
What we'll offer you
- A competitive salary and exciting benefits
- Flexible and remote working
- Opportunities to make an impact in one of the world's leading cloud companies
- Learning and development opportunities to advance your career
- An inclusive culture that champions what makes you unique
**Responsibilities**
Primary job duty is to sell business applications software/solutions and related services to prospective and existing customers. Manage sales through forecasting, account resource allocation, account strategy, and planning. Develop solution proposals encompassing all aspects of the application. Participate in the development, presentation and sales of a value proposition. Negotiate pricing and contractual agreement to close the sale. Identify and develop strategic alignment with key third party influencers.
Disclaimer:
**Certain US customer or client-facing roles may be required to comply with applicable requirements, such as immunization and occupational health mandates.**
**Range and benefit information provided in this posting are specific to the stated locations only**
US: Hiring Range in USD from: $90,000 to $185,100 per annum. May be eligible for equity. Eligible for commission with an estimated pay mix of 45/55 - 50/50.
Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business.
Candidates are typically placed into the range based on the preceding factors as well as internal peer equity.
Oracle US offers a comprehensive benefits package which includes the following:
1. Medical, dental, and vision insurance, including expert medical opinion
2. Short term disability and long term disability
3. Life insurance and AD&D
4. Supplemental life insurance (Employee/Spouse/Child)
5. Health care and dependent care Flexible Spending Accounts
6. Pre-tax commuter and parking benefits
7. 401(k) Savings and Investment Plan with company match
8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.
9. 11 paid holidays
10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.
11. Paid parental leave
12. Adoption assistance
13. Employee Stock Purchase Plan
14. Financial planning and group legal
15. Voluntary benefits including auto, homeowner and pet insurance
The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted.
Career Level - IC4
**About Us**
As a world leader in cloud solutions, Oracle uses tomorrow's technology to tackle today's challenges. We've partnered with industry-leaders in almost every sector-and continue to thrive after 40+ years of change by operating with integrity.
We know that true innovation starts when everyone is empowered to contribute. That's why we're committed to growing an inclusive workforce that promotes opportunities for all.
Oracle careers open the door to global opportunities where work-life balance flourishes. We offer competitive benefits based on parity and consistency and support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs.
We're committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing or by calling +1 in the United States.
Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans' status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.
CX Solutions Sales Executive - Healthcare vertical, East

Posted 18 days ago
Job Viewed
Job Description
Take your sales career to the next level with a global market leader. Do you have sharp business insights, a talent for selling, and the drive to win? If you want to advance your career in applications software sales, come sell our #1 suite of cloud apps.
Oracle is a technology leader that's transforming how the world does business. We're looking for a talented sales person to join our highly motivated CX Applications Sales team as an Applications Sales Representative. Your enthusiasm, knowledge, and customer-centricity can help us connect to the businesses that need our help to evolve.
As an experienced and dynamic software solutions expert, you'll be confident selling business applications to CEOs and presenting custom solutions to Oracle clients. We need you to unlock up-sell potential in our large base of existing customers and seek out new business opportunities over a large territory. You'll have the world-class resources you need to drive sales and advance your career.
Our mission
Our CX Sales helps companies to improve sales productivity and creates better experiences for your buyers, while CX Service Help customers get answers faster, free your agents to handle more complex tasks, and reduce cost with self-service tools.
Right now, we're broadening our reach, expanding our product range, and committing to sustainable success - so there's never been a more exciting time to join our dynamic sales team.
What you'll do
- Develop an ambitious strategy and sales plan to win new license sales revenue
- Achieve sales targets with a focus on CX applications
- Build strong, long-term relationships with clients, partners, and internal teams
- Sell business applications to CEOs and other C-level executives
- Use business insights to connect with clients and help future-proof their operations
- Translate IT requirements into business driven Oracle solutions that fit our clients' business strategies
- Work with pre-sales, marketing, and consulting services to provide clients with comprehensive custom-fit solutions
- Present custom solutions to clients, unlocking up-sell potential in our existing customer base
- Prospect and win new business opportunities over a wide territory
- Drive success in our open and team-oriented culture
What you'll bring
- 7+ years' experience selling software solutions such as CX (sales, marketing, and service)
- Record of success in Business Software Applications License Sales - experience in cloud sales will be preferred
- Deep understanding of both direct and indirect sales models
- A talent for face-to-face sales, social selling, and other sales techniques
- Experience selling across all lines of business in enterprise organizations
- Ability to develop and execute successful sales strategies
- Experience prospecting for new business over a large territory
- The ambition to take a leading sales role and manage virtual teams
- Proven ability to work well as part of an extended sales team
- Strong communication and presentation skills
- Language required: English
What we'll offer you
- A competitive salary and exciting benefits
- Flexible and remote working
- Opportunities to make an impact in one of the world's leading cloud companies
- Learning and development opportunities to advance your career
- An inclusive culture that champions what makes you unique
**Responsibilities**
Primary job duty is to sell business applications software/solutions and related services to prospective and existing customers. Manage sales through forecasting, account resource allocation, account strategy, and planning. Develop solution proposals encompassing all aspects of the application. Participate in the development, presentation and sales of a value proposition. Negotiate pricing and contractual agreement to close the sale. Identify and develop strategic alignment with key third party influencers.
Disclaimer:
**Certain US customer or client-facing roles may be required to comply with applicable requirements, such as immunization and occupational health mandates.**
**Range and benefit information provided in this posting are specific to the stated locations only**
US: Hiring Range in USD from: $90,000 to $185,100 per annum. May be eligible for equity. Eligible for commission with an estimated pay mix of 45/55 - 50/50.
Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business.
Candidates are typically placed into the range based on the preceding factors as well as internal peer equity.
Oracle US offers a comprehensive benefits package which includes the following:
1. Medical, dental, and vision insurance, including expert medical opinion
2. Short term disability and long term disability
3. Life insurance and AD&D
4. Supplemental life insurance (Employee/Spouse/Child)
5. Health care and dependent care Flexible Spending Accounts
6. Pre-tax commuter and parking benefits
7. 401(k) Savings and Investment Plan with company match
8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.
9. 11 paid holidays
10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.
11. Paid parental leave
12. Adoption assistance
13. Employee Stock Purchase Plan
14. Financial planning and group legal
15. Voluntary benefits including auto, homeowner and pet insurance
The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted.
Career Level - IC4
**About Us**
As a world leader in cloud solutions, Oracle uses tomorrow's technology to tackle today's challenges. We've partnered with industry-leaders in almost every sector-and continue to thrive after 40+ years of change by operating with integrity.
We know that true innovation starts when everyone is empowered to contribute. That's why we're committed to growing an inclusive workforce that promotes opportunities for all.
Oracle careers open the door to global opportunities where work-life balance flourishes. We offer competitive benefits based on parity and consistency and support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs.
We're committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing or by calling +1 in the United States.
Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans' status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.
HCM Solutions Sales Executive - Healthcare vertical, East

Posted 18 days ago
Job Viewed
Job Description
Oracle Human Capital Management HCM is a fast-paced, collaborative environment focused on creating customer success. We offer the most comprehensive, cloud based HCM technology. At Oracle, learning is constant. We develop our workforce through training, mentoring and internal mobility opportunities to help everyone succeed and achieve their aspirations.
It is exciting to work with the brightest minds, and industry-leading solutions, to help customers solve the business challenges that stand in the way of their growth and success! As a consistent Leader and Visionary in the HCM space, (Gartner), Oracle is positioned to help our clients become more agile while meeting both current and future business requirements.
Join us and be a part of the exciting HCM transformation!
Our Solutions: Role:
- You will bring your energy and enthusiasm for positioning dynamic HCM cloud solutions to the marketplace.
- You will engage CHROs and connect with key stakeholders to inspire changes that help HR Professionals achieve World-Class results for their organization, workforce and HR function.
- You will understand what motivates customers to buy and know how to tap into those needs and desires in an effective way.
About You:
- You are solutions-oriented
- You are resourceful
- You are results-oriented
- You have a track-record of success selling complex solutions
- You thrive in a team-selling environment
- You are competitive
- You are creative
- You are committed to continuous learning
- You are confident
What you will do:
- Own and analyze your territory; prioritize how to spend your time.
- Master and share the "why Oracle story" that represents the value we provide to customers with our unified, multi-pillar offerings.
- Nurture client relationships by building trust, partnership and an emotional connection to the Oracle brand and team.
- Create and execute key sales and business development initiatives to improve awareness of Oracle HCM and increase sales pipeline.
- Successfully prospect into your assigned accounts to discover, and develop viable selling opportunities.
- Gain access and build relationships with key executives and decision makers.
- Initiate and manage complex sales cycles, leveraging the support and strengths of key internal partners (Pre-Sales, Product Management, HCM Transformation and the Value Team to name a few).
- Consistently achieve your sales target.
- Travel as required, as this role may be a virtual position.
About your background and qualifications:
- You demonstrate sound independent judgment, initiative, collaboration and leadership
- You exhibit exceptional written, verbal, presentation and negotiation skills
- Your sales experience has a proven record of accomplishment of selling to large, complex accounts, working with C-level executives, qualifying prospects, solving problems and generating positive customer outcomes.
At Oracle, we don't just value differences-we celebrate them. We're committed to creating a workplace where all kinds of people work together. We believe innovation starts with diversity and inclusion.
you are a Colorado resident, Please Contact us or Email us at to receive compensation and benefits information for this role. Please include this Job ID: 108222 in the subject line of the email.
**Responsibilities**
Primary job duty is to sell business applications software/solutions and related services to prospective and existing customers. Manage sales through forecasting, account resource allocation, account strategy, and planning. Develop solution proposals encompassing all aspects of the application. Participate in the development, presentation and sales of a value proposition. Negotiate pricing and contractual agreement to close the sale. Identify and develop strategic alignment with key third party influencers.
Disclaimer:
**Certain US customer or client-facing roles may be required to comply with applicable requirements, such as immunization and occupational health mandates.**
**Range and benefit information provided in this posting are specific to the stated locations only**
US: Hiring Range in USD from: $90,000 to $185,100 per annum. May be eligible for equity. Eligible for commission with an estimated pay mix of 45/55 - 50/50.
Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business.
Candidates are typically placed into the range based on the preceding factors as well as internal peer equity.
Oracle US offers a comprehensive benefits package which includes the following:
1. Medical, dental, and vision insurance, including expert medical opinion
2. Short term disability and long term disability
3. Life insurance and AD&D
4. Supplemental life insurance (Employee/Spouse/Child)
5. Health care and dependent care Flexible Spending Accounts
6. Pre-tax commuter and parking benefits
7. 401(k) Savings and Investment Plan with company match
8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.
9. 11 paid holidays
10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.
11. Paid parental leave
12. Adoption assistance
13. Employee Stock Purchase Plan
14. Financial planning and group legal
15. Voluntary benefits including auto, homeowner and pet insurance
The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted.
Career Level - IC4
**About Us**
As a world leader in cloud solutions, Oracle uses tomorrow's technology to tackle today's challenges. We've partnered with industry-leaders in almost every sector-and continue to thrive after 40+ years of change by operating with integrity.
We know that true innovation starts when everyone is empowered to contribute. That's why we're committed to growing an inclusive workforce that promotes opportunities for all.
Oracle careers open the door to global opportunities where work-life balance flourishes. We offer competitive benefits based on parity and consistency and support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs.
We're committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing or by calling +1 in the United States.
Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans' status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.
RN Registered Nurse Medical Surgical Float - Contingency Staffing
Posted 4 days ago
Job Viewed
Job Description
**Location:** US:PA: Hershey
**Work Type:** Part Time
**FTE:** 0.50
**Shift:** Day
**Hours:** 3:00a - 3:00p
**Recruiter Contact:** Jose V. Ceballos at (MAILTO:// )
**SUMMARY OF POSITION:**
Float pool staff are instrumental in carrying out our organizational mission by supporting a variety of clinical units as part of daily operations. They are deployed in response to unpredictable absences, vacancies, and/or fluctuating acuity. In return, float pool staff is compensated for their expertise and flexibility to meet these ongoing demands.
Adult Acute Care float RNs are trained to staff-
+ Trauma Surgical Unit
+ Medical Oncology Unit
+ Orthopedics Neurology Unit
+ Surgical Specialties Unit
+ Medical Specialties Unit
+ Penn State Cancer Institute Unit
+ Emergency Observation Unit
** All units are telemetry capable and require telemetry monitoring skills
Orientation is completed in partnership with the Nursing Education and Professional Development specialist who will evaluate and monitor your growing clinical skills while guiding your unique associated education.
Self-scheduling occurs in conjunction with the organizational timeline and simultaneously with core units.
This role is perfectly suited for RNs with solid experience looking for variety, autonomous practice, and a challenging landscape. We hope you will join us!
**MINIMUM QUALIFICATION(S):**
+ Currently licensed to practice as a Registered Nurse by state of employment or holds a multistate RN license through the interstate Nurse Licensure Compact.
+ Associate's degree in Nursing.
+ AHA BLS prior to end of orientation period.
**PREFERRED QUALIFICATION(S):**
+ Professional certification in field of specialty, ie. CCRN
+ Minimum three (3) years experience: RN position in adult acute care setting, inpatient hospital setting
**WHY PENN STATE HEALTH?**
Penn State Health offers exceptional opportunities to learn and grow, exposure to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in the community.
**Penn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below:**
+ **_Be Well_** with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton).
+ **_Be Balanced_** with Generous Paid Time Off, Personal Time, and Paid Parental Leave.
+ **_Be Secured_** with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection.
+ **_Be Rewarded_** with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program.
+ **_Be Supported_** by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling.
**WHY PENN STATE HEALTH MILTON HERSHEY MEDICAL CENTER?**
Penn State Hershey Medical Center is Central Pennsylvania's only Academic Medical Center, Level 1 Regional Adult and Pediatric Trauma Center, and Tertiary Care Provider. As a four-time Magnet-designated hospital, Hershey Medical Center values the hard work and dedication that our employees exhibit every day. Through our core values of Respect, Integrity, Teamwork, and Excellence, our employees are a team committed to compassionate care for our diverse patient population, our community and each other. As a valued team member, we promote continued professional development, specialty certification, continuing education, and career growth.
**YOU TAKE CARE OF THEM. WE'LL TAKE CARE OF YOU. State-of-the-art equipment, endless learning, and a culture of excellence - that's Penn State Health. But what makes our healthcare award-winning? That's all you.**
_This job posting is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. Eligibility for shift differential pay based on the terms outlined in company policy or union contract._ _All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities._
_Penn State Health is fundamentally committed to the diversity of our faculty and staff. We believe diversity is unapologetically expressing itself through every person's perspectives and lived experiences. We are an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information._
**Union:** SEIU Healthcare Pennsylvania
**Position** RN Registered Nurse Medical Surgical Float - Contingency Staffing
**Location** US:PA: Hershey | Nursing | Part Time
**Req ID** 80927
Business transformation, Healthcare Provider Operations -Senior
Posted today
Job Viewed
Job Description
Location: Anywhere in Country
At EY, we're all in to shape your future with confidence.
We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world.
Business transformation, Healthcare Provider Operations_Senior
#Healthcare
About our business
At EY Consulting, we are building a better working world by transforming businesses through the power of people, technology, and innovation. Our clients are at the heart of what we do. We're focused on solving the key issues of our client buyers, building deeper relationships, and generating lasting value with significant impact.
Our firm sets the standard for consulting services, fostering an environment that encourages career ownership at every stage. As a part of our team, you'll be at the forefront of this dynamic service line, driving change and delivering solutions that revolutionize business operations. You'll help our clients in transformation and innovation efforts: driving growth, reducing costs, and managing risks proactively.
Healthcare Consulting
Today's healthcare environment in the post-COVID era is undergoing rapid change and transformation. As healthcare organizations seek to stabilize operations and plan for a financially sustainable future, they are challenged to integrate transformative technology (Artificial intelligence, automation, etc.), adjust to patient-focused operations, and maintain operational discipline to withstand increasing financial pressures. As a manager within our Health consulting practice, you'll work with clients across the healthcare industry, from hospitals and integrated delivery networks to commercial and governmental insurers. You'll use your industry knowledge and relationship skillsets to assist our clients in transforming operations to meet the evolving demands of today's healthcare market.
The opportunity
As a Senior Consultant on our Health team, you will play a key role in helping health systems and health insurance companies tackle their financial and operational challenges. You'll contribute to important projects and work closely within teams, using your skills to turn complex data into clear, actionable insights. The health industry is experiencing an unprecedented surge, and our clients depend on us to steer them through transformative changes and pressing challenges. In this pivotal role, you will elevate client outcomes, improve access to care, support quality of care, and streamline the cost of care. If your drive lies in the healthcare sector and you excel in client-facing situations, this position is tailored for you.
Your key responsibilities
You'll spend most of your time teaming with our provider team working with a broad spectrum of not-for-profit and for-profit healthcare clients, including hospitals, healthcare systems, physician practices and academic medical centers, to assess and redesign clinical processes.
As a Senior in our Health consulting group, you'll work with clients across the following areas:
-
Operational improvement
-
Benchmarking and financial quantification
-
Cost reduction/revenue enhancement
-
Workflow redesign
Skills and attributes for success
-
Effectively manage and motivate client engagement teams with diverse skills and backgrounds Foster an innovative and inclusive team -oriented work environment. Play an active role in counselling and mentoring junior consultants within the organization
-
Foster relationships with client personnel at appropriate levels. Consistently deliver quality client services. Drive high-quality work products within expected timeframes and on budget. Monitor progress, manage risk and ensure key stakeholders are kept informed about progress and expected outcomes
-
Cultivate and manage business development opportunities. Understand EY and its service lines and actively assess/present ways to serve clients. Develop and maintain long-term client relationships and networks
-
Demonstrate in-depth technical capabilities and professional knowledge
Required qualifications
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A bachelor's or master's degree and approximately 3+ years of relevant work experience in healthcare, insurance, business analysis, consulting, or a related field.
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Approximately 2 years of healthcare consulting experience, preferably with prior experience in a consulting firm
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Assist in generating revenue within existing healthcare clients and in developing new prospects at the "C" level of large healthcare companies
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Ability to manage a team of staff/senior consulting professionals
-
Ability to work collaboratively in a team environment (knows when to lead and when to follow)
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Strong analytical and problem-solving skills, as well as excellent oral and written communication skills
-
A willingness to travel to meet client needs; travel is required as needed by the client.
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Strong leadership skills and the ability to work collaboratively in a team environment, demonstrate inclusivity, and embrace diverse perspectives.
-
Excellent presentation skills and the ability to communicate complex concepts effectively to all audiences while leveraging relevant data to generate insights and innovative solutions.
-
Intellectual curiosity, the ability to take initiative and drive execution, and advanced analytical and problem-solving skills within a dynamic and evolving business landscape.
-
Exhibits an agile and growth-oriented mindset.
-
Possesses strong commercial awareness and has a desire to make a positive impact on global companies as well as domestic businesses, contributing to their long-term success.
Preferred qualifications
-
Knowledgeable in relevant industry areas such as Health plans, health systems and healthcare specific applications.
-
Exposure to operational improvement, benchmarking and financial quantification, cost reduction/revenue enhancement or workflow redesign within the health industry.
What we look for
We're interested in passionate leaders with strong vision and a desire to stay on top of trends in the healthcare industry. If you have a genuine passion for healthcare, this role is for you
What we offer you
At EY, we'll develop you with future-focused skills and equip you with world-class experiences. We'll empower you in a flexible environment, and fuel you and your extraordinary talents in a diverse and inclusive culture of globally connected teams. Learn more .
-
We offer a comprehensive compensation and benefits package where you'll be rewarded based on your performance and recognized for the value you bring to the business. The base salary range for this job in all geographic locations in the US is $96,300 to $76,500. The base salary range for New York City Metro Area, Washington State and California (excluding Sacramento) is 115,500 to 200,600. Individual salaries within those ranges are determined through a wide variety of factors including but not limited to education, experience, knowledge, skills and geography. In addition, our Total Rewards package includes medical and dental coverage, pension and 401(k) plans, and a wide range of paid time off options.
-
Join us in our team-led and leader-enabled hybrid model. Our expectation is for most people in external, client serving roles to work together in person 40-60% of the time over the course of an engagement, project or year.
-
Under our flexible vacation policy, you'll decide how much vacation time you need based on your own personal circumstances. You'll also be granted time off for designated EY Paid Holidays, Winter/Summer breaks, Personal/Family Care, and other leaves of absence when needed to support your physical, financial, and emotional well-being.
Are you ready to shape your future with confidence? Apply today.
EY accepts applications for this position on an on-going basis.
For those living in California, please click here for additional information.
EY focuses on high-ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities.
EY | Building a better working world
EY is building a better working world by creating new value for clients, people, society and the planet, while building trust in capital markets.
Enabled by data, AI and advanced technology, EY teams help clients shape the future with confidence and develop answers for the most pressing issues of today and tomorrow.
EY teams work across a full spectrum of services in assurance, consulting, tax, strategy and transactions. Fueled by sector insights, a globally connected, multi-disciplinary network and diverse ecosystem partners, EY teams can provide services in more than 150 countries and territories.
EY provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, genetic information, national origin, protected veteran status, disability status, or any other legally protected basis, including arrest and conviction records, in accordance with applicable law?
EY is committed to providing reasonable accommodation to qualified individuals with disabilities including veterans with disabilities. If you have a disability and either need assistance applying online or need to request an accommodation during any part of the application process, please call 1-800-EY-HELP3, select Option 2 for candidate related inquiries, then select Option 1 for candidate queries and finally select Option 2 for candidates with an inquiry which will route you to EY's Talent Shared Services Team (TSS) or email the TSS at .
Business transformation, Healthcare Provider Operations -Senior
Posted 9 days ago
Job Viewed
Job Description
At EY, we're all in to shape your future with confidence.
We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world.
**Business transformation, Healthcare Provider Operations_Senior**
**#Healthcare**
**About our business**
At EY Consulting, we are building a better working world by transforming businesses through the power of people, technology, and innovation. Our clients are at the heart of what we do. We're focused on solving the key issues of our client buyers, building deeper relationships, and generating lasting value with significant impact.
Our firm sets the standard for consulting services, fostering an environment that encourages career ownership at every stage. As a part of our team, you'll be at the forefront of this dynamic service line, driving change and delivering solutions that revolutionize business operations. You'll help our clients in transformation and innovation efforts: driving growth, reducing costs, and managing risks proactively.
**Healthcare Consulting**
Today's healthcare environment in the post-COVID era is undergoing rapid change and transformation. As healthcare organizations seek to stabilize operations and plan for a financially sustainable future, they are challenged to integrate transformative technology (Artificial intelligence, automation, etc.), adjust to patient-focused operations, and maintain operational discipline to withstand increasing financial pressures. As a manager within our Health consulting practice, you'll work with clients across the healthcare industry, from hospitals and integrated delivery networks to commercial and governmental insurers. You'll use your industry knowledge and relationship skillsets to assist our clients in transforming operations to meet the evolving demands of today's healthcare market.
**The opportunity**
As a Senior Consultant on our Health team, you will play a key role in helping health systems and health insurance companies tackle their financial and operational challenges. You'll contribute to important projects and work closely within teams, using your skills to turn complex data into clear, actionable insights. The health industry is experiencing an unprecedented surge, and our clients depend on us to steer them through transformative changes and pressing challenges. In this pivotal role, you will elevate client outcomes, improve access to care, support quality of care, and streamline the cost of care. If your drive lies in the healthcare sector and you excel in client-facing situations, this position is tailored for you.
**Your key responsibilities**
You'll spend most of your time teaming with our provider team working with a broad spectrum of not-for-profit and for-profit healthcare clients, including hospitals, healthcare systems, physician practices and academic medical centers, to assess and redesign clinical processes.
As a Senior in our Health consulting group, you'll work with clients across the following areas:
+ Operational improvement
+ Benchmarking and financial quantification
+ Cost reduction/revenue enhancement
+ Workflow redesign
**Skills and attributes for success**
+ Effectively manage and motivate client engagement teams with diverse skills and backgrounds Foster an innovative and inclusive team -oriented work environment. Play an active role in counselling and mentoring junior consultants within the organization
+ Foster relationships with client personnel at appropriate levels. Consistently deliver quality client services. Drive high-quality work products within expected timeframes and on budget. Monitor progress, manage risk and ensure key stakeholders are kept informed about progress and expected outcomes
+ Cultivate and manage business development opportunities. Understand EY and its service lines and actively assess/present ways to serve clients. Develop and maintain long-term client relationships and networks
+ Demonstrate in-depth technical capabilities and professional knowledge
**Required qualifications**
+ A bachelor's or master's degree and approximately 3+ years of relevant work experience in healthcare, insurance, business analysis, consulting, or a related field.
+ Approximately 2 years of healthcare consulting experience, preferably with prior experience in a consulting firm
+ Assist in generating revenue within existing healthcare clients and in developing new prospects at the "C" level of large healthcare companies
+ Ability to manage a team of staff/senior consulting professionals
+ Ability to work collaboratively in a team environment (knows when to lead and when to follow)
+ Strong analytical and problem-solving skills, as well as excellent oral and written communication skills
+ A willingness to travel to meet client needs; travel is required as needed by the client.
+ Strong leadership skills and the ability to work collaboratively in a team environment, demonstrate inclusivity, and embrace diverse perspectives.
+ Excellent presentation skills and the ability to communicate complex concepts effectively to all audiences while leveraging relevant data to generate insights and innovative solutions.
+ Intellectual curiosity, the ability to take initiative and drive execution, and advanced analytical and problem-solving skills within a dynamic and evolving business landscape.
+ Exhibits an agile and growth-oriented mindset.
+ Possesses strong commercial awareness and has a desire to make a positive impact on global companies as well as domestic businesses, contributing to their long-term success.
**Preferred qualifications**
+ Knowledgeable in relevant industry areas such as Health plans, health systems and healthcare specific applications.
+ Exposure to operational improvement, benchmarking and financial quantification, cost reduction/revenue enhancement or workflow redesign within the health industry.
**What we look for**
We're interested in passionate leaders with strong vision and a desire to stay on top of trends in the healthcare industry. If you have a genuine passion for healthcare, this role is for you
**What we offer you**
At EY, we'll develop you with future-focused skills and equip you with world-class experiences. We'll empower you in a flexible environment, and fuel you and your extraordinary talents in a diverse and inclusive culture of globally connected teams. Learn more .
+ We offer a comprehensive compensation and benefits package where you'll be rewarded based on your performance and recognized for the value you bring to the business. The base salary range for this job in all geographic locations in the US is $96,300 to $76,500. The base salary range for New York City Metro Area, Washington State and California (excluding Sacramento) is 115,500 to 200,600. Individual salaries within those ranges are determined through a wide variety of factors including but not limited to education, experience, knowledge, skills and geography. In addition, our Total Rewards package includes medical and dental coverage, pension and 401(k) plans, and a wide range of paid time off options.
+ Join us in our team-led and leader-enabled hybrid model. Our expectation is for most people in external, client serving roles to work together in person 40-60% of the time over the course of an engagement, project or year.
+ Under our flexible vacation policy, you'll decide how much vacation time you need based on your own personal circumstances. You'll also be granted time off for designated EY Paid Holidays, Winter/Summer breaks, Personal/Family Care, and other leaves of absence when needed to support your physical, financial, and emotional well-being.
**Are you ready to shape your future with confidence? Apply today.**
EY accepts applications for this position on an on-going basis.
For those living in California, please click here for additional information.
EY focuses on high-ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities.
**EY | Building a better working world**
EY is building a better working world by creating new value for clients, people, society and the planet, while building trust in capital markets.
Enabled by data, AI and advanced technology, EY teams help clients shape the future with confidence and develop answers for the most pressing issues of today and tomorrow.
EY teams work across a full spectrum of services in assurance, consulting, tax, strategy and transactions. Fueled by sector insights, a globally connected, multi-disciplinary network and diverse ecosystem partners, EY teams can provide services in more than 150 countries and territories.
EY provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, genetic information, national origin, protected veteran status, disability status, or any other legally protected basis, including arrest and conviction records, in accordance with applicable law?
EY is committed to providing reasonable accommodation to qualified individuals with disabilities including veterans with disabilities. If you have a disability and either need assistance applying online or need to request an accommodation during any part of the application process, please call 1-800-EY-HELP3, select Option 2 for candidate related inquiries, then select Option 1 for candidate queries and finally select Option 2 for candidates with an inquiry which will route you to EY's Talent Shared Services Team (TSS) or email the TSS at .
Business Transformation - Sr Manager - Healthcare Provider - Acute Care

Posted 18 days ago
Job Viewed
Job Description
At EY, we're all in to shape your future with confidence.
We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world.
? **Business Transformation - Sr Manager - Healthcare Provider - Acute Care**
Today's healthcare environment is undergoing rapid change and transformation. The market is being impacted by changing regulations, new payment structures, increasing reliance on technology, and a move towards population health. As a senior manager within our Health consulting practice, you'll work with clients across the healthcare industry, from hospitals and integrated delivery networks to commercial and governmental insurers. You'll use your industry knowledge and relationship skillsets to assist our clients in delivering services efficiently and effectively.
**The opportunity**
As part of EY's Health consulting practice, you will work with these clients across the country in solving complex problems in today's rapidly changing healthcare environment? We currently are seeking a highly motivated Senior Manager, with a focus on provider operations, to manage client engagement teams, work with a wide variety of clients to deliver professional services and manage business development activities on strategic and global priority accounts.
**Your key responsibilities**
As a Senior Manager in our Health consulting group focused on Clinical Operations, you'll spend most of your time teaming with our provider team working with a broad spectrum of not-for-profit and for-profit healthcare clients, including hospitals, healthcare systems, physician practices and academic medical centers, to assess and redesign clinical processes across the following areas:
+ Operational improvement
+ Benchmarking and financial quantification
+ Cost reduction/revenue enhancement
+ Workflow redesign
Our current hiring priorities are focused on engagements related to acute care. Candidates with experience leading work in the following areas are strongly preferred:
+ Acute care labor/ productivity
+ ED throughput
+ OR optimization
+ Length of stay and patient throughput
+ Care management redesign
+ Acute care organization design/ span of control
**Skills and attributes for success**
+ Effectively manage and motivate client engagement teams with diverse skills and backgrounds
+ Foster an innovative and inclusive team -oriented work environment. Play an active role in counselling and mentoring junior consultants within the organization
+ Foster relationships with client personnel at appropriate levels. Consistently deliver quality client services. Drive high-quality work products within expected timeframes and on budget. Monitor progress, manage risk and ensure key stakeholders are kept informed about progress and expected outcomes
+ Cultivate and manage business development opportunities. Understand EY and its service lines and actively assess/present ways to serve clients. Develop and maintain long-term client relationships and networks
+ Demonstrate in-depth technical capabilities and professional knowledge
**To qualify for the role, you must have**
+ A bachelor's degree and approximately 10 years of related work experience; or a graduate degree and approximately 7 years of related work experience.
+ Approximately 7 years of healthcare consulting experience in provider operations; acute care experience is preferred.
+ Prior experience as a senior manager (or above), in a consulting firm or in a senior management role within industry
+ Ability to read and interpret hospital financial statements and contract terms, utilize complex financial models, experience with operational process mapping and experience with healthcare cost reduction planning and implementation
+ Experience with healthcare organization M&A, physician alignment, or financial margin improvement initiatives
+ Experience in selling and delivering projects that cover the full life cycle of assessment, design and implementation support; demonstrated record of driving revenue within existing healthcare clients and in developing new prospects at the "C" level of large healthcare companies
+ Ability to manage a team of staff/senior/manager consulting professionals
+ Ability to work collaboratively in a team environment
+ Strong analytical and problem-solving skills, as well as excellent oral and written communication skills
+ A willingness to travel to meet client needs; travel is estimated at 80%.
**Ideally, you'll also have**
+ A degree with an emphasis in Finance, Accounting, and/or Business; CPA, MBA, MHA and/or MPH
+ Clinical background is preferred but not required.
**What we look for**
We're interested in passionate leaders with strong vision and a desire to stay on top of trends in the healthcare industry. If you have a genuine passion for healthcare, this role is for you.
**What we offer you**
At EY, we'll develop you with future-focused skills and equip you with world-class experiences. We'll empower you in a flexible environment, and fuel you and your extraordinary talents in a diverse and inclusive culture of globally connected teams. Learn more .
+ We offer a comprehensive compensation and benefits package where you'll be rewarded based on your performance and recognized for the value you bring to the business. The base salary range for this job in all geographic locations in the US is $150,400 to $43,600. The base salary range for New York City Metro Area, Washington State and California (excluding Sacramento) is 180,500 to 390,500. Individual salaries within those ranges are determined through a wide variety of factors including but not limited to education, experience, knowledge, skills and geography. In addition, our Total Rewards package includes medical and dental coverage, pension and 401(k) plans, and a wide range of paid time off options.
+ Join us in our team-led and leader-enabled hybrid model. Our expectation is for most people in external, client serving roles to work together in person 40-60% of the time over the course of an engagement, project or year.
+ Under our flexible vacation policy, you'll decide how much vacation time you need based on your own personal circumstances. You'll also be granted time off for designated EY Paid Holidays, Winter/Summer breaks, Personal/Family Care, and other leaves of absence when needed to support your physical, financial, and emotional well-being.
**Are you ready to shape your future with confidence? Apply today.**
EY accepts applications for this position on an on-going basis.
For those living in California, please click here for additional information.
EY focuses on high-ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities.
**EY | Building a better working world**
EY is building a better working world by creating new value for clients, people, society and the planet, while building trust in capital markets.
Enabled by data, AI and advanced technology, EY teams help clients shape the future with confidence and develop answers for the most pressing issues of today and tomorrow.
EY teams work across a full spectrum of services in assurance, consulting, tax, strategy and transactions. Fueled by sector insights, a globally connected, multi-disciplinary network and diverse ecosystem partners, EY teams can provide services in more than 150 countries and territories.
EY provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, genetic information, national origin, protected veteran status, disability status, or any other legally protected basis, including arrest and conviction records, in accordance with applicable law?
EY is committed to providing reasonable accommodation to qualified individuals with disabilities including veterans with disabilities. If you have a disability and either need assistance applying online or need to request an accommodation during any part of the application process, please call 1-800-EY-HELP3, select Option 2 for candidate related inquiries, then select Option 1 for candidate queries and finally select Option 2 for candidates with an inquiry which will route you to EY's Talent Shared Services Team (TSS) or email the TSS at .
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RN Registered Nurse Medical Surgical Float - NIGHT SHIFT - Contingency Staffing

Posted 18 days ago
Job Viewed
Job Description
**Location:** US:PA: Hershey
**Work Type:** Part Time
**FTE:** 0.50
**Shift:** Night
**Night Shift Differential:** $4.50/hour
**Hours:** 7:00p - 7:30a, 11:00p - 7:00a
**Recruiter Contact:** Jose Ceballos at
**SUMMARY OF POSITION:**
Float pool staff are instrumental in carrying out our organizational mission by supporting a variety of clinical units as part of daily operations. They are deployed in response to unpredictable absences, vacancies, and/or fluctuating acuity. In return, float pool staff is compensated for their expertise and flexibility to meet these ongoing demands.
Adult Acute Care float RNs are trained to staff-
+ Trauma Surgical Unit
+ Medical Oncology Unit
+ Orthopedics Neurology Unit
+ Surgical Specialties Unit
+ Medical Specialties Unit
+ Penn State Cancer Institute Unit
+ Emergency Observation Unit
** All units are telemetry capable and require telemetry monitoring skills
Orientation is completed in partnership with the Nursing Education and Professional Development specialist who will evaluate and monitor your growing clinical skills while guiding your unique associated education.
Self-scheduling occurs in conjunction with the organizational timeline and simultaneously with core units.
This role is perfectly suited for RNs with solid experience looking for variety, autonomous practice, and a challenging landscape. We hope you will join us!
**MINIMUM QUALIFICATION(S):**
+ Currently licensed to practice as a Registered Nurse by state of employment or holds a multistate RN license through the interstate Nurse Licensure Compact.
+ Associate's degree in Nursing.
+ AHA BLS prior to end of orientation period.
**PREFERRED QUALIFICATION(S):**
+ Professional certification in field of specialty, ie. CCRN
+ Minimum three (3) years experience: RN position in adult acute care setting, inpatient hospital setting
**WHY PENN STATE HEALTH?**
Penn State Health offers exceptional opportunities to learn and grow, exposure to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in the community.
**Penn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below:**
+ **_Be Well_** with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton).
+ **_Be Balanced_** with Generous Paid Time Off, Personal Time, and Paid Parental Leave.
+ **_Be Secured_** with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection.
+ **_Be Rewarded_** with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program.
+ **_Be Supported_** by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling.
**WHY PENN STATE HEALTH MILTON HERSHEY MEDICAL CENTER?**
Penn State Hershey Medical Center is Central Pennsylvania's only Academic Medical Center, Level 1 Regional Adult and Pediatric Trauma Center, and Tertiary Care Provider. As a four-time Magnet-designated hospital, Hershey Medical Center values the hard work and dedication that our employees exhibit every day. Through our core values of Respect, Integrity, Teamwork, and Excellence, our employees are a team committed to compassionate care for our diverse patient population, our community and each other. As a valued team member, we promote continued professional development, specialty certification, continuing education, and career growth.
**YOU TAKE CARE OF THEM. WE'LL TAKE CARE OF YOU. State-of-the-art equipment, endless learning, and a culture of excellence - that's Penn State Health. But what makes our healthcare award-winning? That's all you.**
_This job posting is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. Eligibility for shift differential pay based on the terms outlined in company policy or union contract._ _All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities._
_Penn State Health is fundamentally committed to the diversity of our faculty and staff. We believe diversity is unapologetically expressing itself through every person's perspectives and lived experiences. We are an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information._
**Union:** SEIU Healthcare Pennsylvania
**Position** RN Registered Nurse Medical Surgical Float - NIGHT SHIFT - Contingency Staffing
**Location** US:PA: Hershey | Nursing | Part Time
**Req ID** 71308
Medical Director, Clinical Services
Posted 8 days ago
Job Viewed
Job Description
Company :
Highmark Inc.
Job Description :
JOB SUMMARY
This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members
ESSENTIAL RESPONSIBILITIES
-
Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care.
-
Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise.
-
Participate in protocol and guidelines development to ensure consistency in the review process.
-
Actively manage projects and/or participate on project teams that require a physician subject matter expert.
-
Other duties as assigned.
EDUCATION
Required
- Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)
Substitutions
- None
Preferred
- Master's Degree in Business Administration/Management or Public Health
EXPERIENCE
Required
- 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice)
Preferred
- 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry
LICENSES AND CERTIFICATION
Required
-
Medical Doctor or Doctor of Osteopathic Medicine (DO)
-
Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards
-
Active medical state licensure required. Additional specific state licensure(s) may be required based on business need.
Preferred
- None
SKILLS
-
Critical Thinking
-
Case Management
-
Customer Service
-
Oral & Written Communication Skills
-
Collaboration
-
Listening
-
Telephone Skills
-
General Computer Skills
-
Clinical Software
-
Managed Care
Language (Other than English)
None
Travel Required
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-Based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Rarely
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$170,000.00
Pay Range Maximum:
$352,500.00
Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J267780
Medical Director, Clinical Services
Posted 13 days ago
Job Viewed
Job Description
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members
**ESSENTIAL RESPONSIBILITIES**
+ Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care.
+ Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise.
+ Participate in protocol and guidelines development to ensure consistency in the review process.
+ Actively manage projects and/or participate on project teams that require a physician subject matter expert.
+ Other duties as assigned.
**EDUCATION**
**Required**
+ Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)
**Substitutions**
+ None
**Preferred**
+ Master's Degree in Business Administration/Management or Public Health
**EXPERIENCE**
**Required**
+ 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice)
**Preferred**
+ 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry
**LICENSES AND CERTIFICATION**
**Required**
+ Medical Doctor or Doctor of Osteopathic Medicine (DO)
+ Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards
+ Active medical state licensure required. Additional specific state licensure(s) may be required based on business need.
**Preferred**
+ None
**SKILLS**
+ Critical Thinking
+ Case Management
+ Customer Service
+ Oral & Written Communication Skills
+ Collaboration
+ Listening
+ Telephone Skills
+ General Computer Skills
+ Clinical Software
+ Managed Care
**Language (Other than English)**
None
**Travel Required**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
Position Type
Office-Based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Rarely
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$170,000.00
**Pay Range Maximum:**
$352,500.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J267780