At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is  invested in your future!

Job Summary

This position is responsible for managing and controlling network strategies, reimbursement contract negotiations, contract drafting, contract administration and issue resolution for 200 hospitals, 65 downstate PPO hospitals, 80 Medicare hospitals and 80 Medicaid hospitals In Illinois. The position is responsible for determining reasonable cost reimbursement (MRC) and for maintaining the integrity of these contracts.

Responsibilities include but not limited to:

• Develops and annually renegotiates reimbursement contracts with hospitals in Illinois and responsible for resolution of disputes and issues arising between HCSC, Med Select, Plan, PPO downstate, and Workers Choice contacts and hospitals.
• Develops network, drafts reimbursement agreements, and negotiates reimbursement contracts for all institutional providers, Plan, and PPO downstate.
• Responsible for completion of all MRC audit settlements and MRC billing budget and related activities.
• Responsible for maintaining the quality and consistency in the MRC audit process among all contracting hospitals.
• Responsible for maintaining the integrity of the Plan Hospital Contract and audit capability.
• Handles inquiries and requests for clarification and interpretation of the Plan Hospital Contract provisions and matters relating to preparation and submission of cost reports from providers.
• Adapts concepts to cost report treatments and settles cost reports taking into consideration changes in current policies, changes in GAAP and GAAS and changes in the Hospital industry’s financial practices.
• Determines when to allow or disallow certain costs on the Blue Cross Cost Report based on Audit Guide/GAAP and/or other intangibles.
• Negotiates new MRC contracts when hospitals change ownership or new hospitals enter the market.
• Assists VP in negotiation of new network products (Medicare Select, Workers Choice, CHP, etc.)
• Negotiates contracts and renewals for downstate PPO, Med Select, and Workers Choice contracts.
• Determines whether or not to bring a provider into certain type of contract situation given a multitude of factors (for MRC, PPO, CHP, etc.)
• Interacts with the Finance Division on monthly MRC accrual calculations
• Works with internal and external auditors to accomplish specific audit of department operations or information requirements.
• Develop and implement overall provider network contracting strategies that provide better value to customers. Within the framework of the overall provider network contracting strategy, develop and implement individual provider strategies.
• Using sophisticated modeling and valuation systems make assessments and set parameters for acceptable payment level targets. Devise strategies to reach agreement with providers within acceptable payment level targets.
• Negotiations individual provider contracts.
• Oversee research on and development of payment methodologies in response to provider requests, new technologies, local and national payment trends, and contracting strategies in order to improve payment value for customers.
• Oversee the creation and maintenance of financial modeling systems to support the development of contracting strategy and individual contract negotiations including but not limited to the following:
o Predictive modeling of the expected effect on payments for contract rate and structure changes as part of individual provider contract rate proposal and overall contract strategy evaluations.
o Cost analysis and contribution to margin analysis on an overall network and individual provider basis.
o Historical payment and utilization trend analysis by provider or by type of service.
o Peer provider comparisons and analysis.
o Medicare Payment comparisons and analysis.
• Through extensive analysis provide analytical, statistical reports to internal departments regarding estimated financial impact of contract strategies and proposals/alternatives.
• Service as liaison in coordinating provider contracting strategies, explanation of contract rates, contract structure, contract language, historical payment performance and predictive modeling results.
• Communicate and interact effectively and professionally with co-workers, management, customers, etc.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
• Maintain complete confidentiality of company business.
• Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

JOB REQUIREMENTS:
 

* Bachelor’s degree and 12 years of experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations or related field OR Master’s degree and 10 years of experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations or related field

* 5 years of leadership/management experience
* Verbal and written communications skills
* 5 years of contract negotiation experience either at a healthcare provider or managed care company
* 10 years of hospital experience or managed care contract/reimbursement experience
* 5 years systems management experience
* Analytical, problem solving, quantitative, communication, prioritization, organization, and training skills
* Trouble shooting experience with solving system problems
* Management skills

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Job Description:

Job Title: Assistant Director, Youth Recovery Services

Location: Springfield, Missouri

Department: Youth Recovery Services

Employment Type: Full-time

Shift: Monday-Friday 8am-5pm

Job Summary:
Are you a motivated and experienced mental health professional interested in supporting youth recovery services in both inpatient and outpatient settings across Preferred Family Healthcare and Burrell Behavioral Health programs? If so, come join our dedicated team as an Assistant Director!

As an Assistant Director, you'll research, implement, and oversee evidence-based programming, provide clinical staff training, monitor for appropriateness of level of care recommendations, complete annual performance evaluations on supervised staff, and perform supervisory duties in the absence of the Director of Recovery Services. Our ideal candidate brings a solid foundation in substance use disorder treatment, along with proven management experience and an understanding of leadership principles.

Springfield, Missouri, offers a vibrant community with a low cost of living, excellent schools, and abundant opportunities for entertainment, culture, and outdoor activities. Don't miss this amazing opportunity to make a difference in young peoples' lives while expanding your horizons professionally!

Position Perks & Benefits:
• Paid time off - 29 days per year including vacation & holiday pay
• Mileage reimbursement - company paid for work functions requiring travel
• Top-notch training - initial, ongoing, comprehensive, and supportive
• Career mobility - advancement opportunities/promoting from within
• Welcoming, warm, supportive - a work culture & environment that promotes your well-being, values you as human being, and encourages your health and happiness

Key Responsibilities:
• Function in accordance with Burrell Behavioral Health Operational Guidelines and within professional codes of ethics.
• Provide practical role modeling, utilizing experience and ability to meet the needs of clients and the goals of treatment.
• Access emergency services as needed.
• Respond to management needs, such as data collection, program evaluation, contract maintenance, and adhere to Quality Assurance procedures.
• Participate in required meetings.
• Regularly evaluate self and assigned staff according to Burrell Operational Guidelines.
• Monitor clinical documentation, time, productivity, and deficiencies of supervised staff.

Education and/or Experience Qualifications:
• Master's degree in counseling, social work, psychology, marriage and family therapy, or a related field.
• Current licensure as an LPC, LCSW, LMFT, or Psy.D in Missouri.
• Minimum five years of progressive experience in substance use disorder treatment, preferably in supervisory roles.
• Proven track record of implementing evidence-based practices.

Brightli is on a Mission:
A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance use care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients.

As a behavioral and community mental health provider, we value diversity, equity, and inclusion in our workforce and encourage applications from individuals from diverse backgrounds and experiences. If you are passionate about empowering your local communities and promoting health equity, we invite you to join our mission-driven organization that is committed to building a diverse, equitable, inclusive and authentic workplace.

We are an Equal Opportunity and Affirmative Action Employer, and encourage applications from all qualified individuals without regard to race, color, religion, sex, gender identity, gender expression, sexual orientation, national origin, age, marital status, disability or veteran status, or to other non-work related factors.

Burrell is a Smoke and Tobacco Free Workplace.

Job Details:

Scheduled hours: Day shift, varies

The Quality Director provides leadership and direction to the quality department.  Facilitates development, implementation, delivery and evaluation of services within the division through collaboration with the organization’s leaders, clinical/medical staff directors, and other management.  Assures achievement of goals and adherence to policies, procedures, and standards set forth by state, federal, and hospital regulatory agencies.  Creates an environment of innovation and creativity through transformational leadership.  This position helps to strategically improve services and develop measurable outcomes throughout all departments and personnel.

Minimum Required Qualifications

• Bachelor’s of Science in Nursing preferred, or Bachelor’s Degree in a related field.
• Advance Degree preferred.
• Maintains current and active status on all required training and education as outlined by corporate policy.
• Maintains valid licensure/certification/registration. 
• Current valid driver’s license.
• Three to five years management experience preferred.
• Five to seven years of experience in clinical practice, hospital operations, and quality roles is preferred.
• Training or education in performance improvement techniques preferred.

Benefits:

We are excited to offer an aggressive compensation and benefits package for qualifying positions, which includes:

• Competitive base pay

• Matching retirement programs

• Health, Dental and Vision plans

• Health Savings and Flexible Spending Accounts

• Employee discounts including car rental, cell-phone plans

• Employer-paid, Long-Term Disability, Life, and AD&D

• Paid time off (PTO)

• Education Assistance Program

• Employee Assistance Program

• Employee Referral Bonus Program

• Discounted cafeteria meals

• Paid Parental Leave

• Employee Service Recognition program  

• Voluntary plans including: Life, AD&D, Short-Term Disability, Critical Illness, Accident, Insurance, and Hospital Indemnity

Great River Health and its affiliates are Equal Opportunity employers.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Position Title:

Director of Digital Health

Department:

Telehealth

Job Description:

General Description:

The Admin Dir Telehealth Program will oversee activities related to the planning, implementation, direction, and performance monitoring of the OU Health Telehealth Services Program. Responsible for supervising the activities of the Telehealth Services Department and will report directly to VP Clinical Strategy and Integration.

Essential Responsibilities:

Responsibilities listed in this section are core to the position.  Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position. 

• Collaborates with OU Health leadership and departmental resources to develop the telehealth program’s strategic plan, objectives, goals, and operating tactics.
• Oversees daily program operations and coordinates program activities and updates the operating officers of each entity on a regular basis regarding the status of new telehealth opportunities.
• Develops the department’s key performance measures
• Monitors program quality and effectiveness, and researches improvement needs
• Collaborates with appropriates physician and administrative leaders to establish program budget
• Monitors department expenditures to ensure budget goals are met
• Acts as liaison with external vendors to ensure proper execution of contracts and oversees related service delivery
• Prepares appropriates reports and financial statements as needed
• Participates in key national leadership meetings related to telehealth
• Coordinates with regional activities related to telehealth services

General Responsibilities:

• Performs other duties as assigned

Minimum Qualifications:

Education: Bachelor’s Degree in a related field (Healthcare Administration, Information Technology, Business, Public Health, etc.)

Experience: Minimum: 3 years of healthcare experience of which 2 years must have been spent in a telemedicine coordination/management capacity.

License(s)/Certification(s)/Registration(s) Required:  None

Knowledge, Skills and Abilities:

• Ability to review processes of care and identify gaps (staffing, process, culture, etc.)
• Solid business acumen and analytical skills
• Experience in the design and implementation of telehealth protocols and processes
• Ensure contract deliverables are met or exceeded and services are provided as efficiently and effectively as possible
• Experience working with and collaborating successfully with senior level leadership; experienced in preparing and presenting information to clinical and executive level leadership
• Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff
• Experience working with telehealth platforms, technology, and/or workflows preferred
• Ability to work independently, handle multiple assignments and prioritize workload

Current OU Health Employees - Please click HERE to login.

OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

1. Lead the development and implementation of quality assured inspection and investigation procedures. Inspect pharmacy premises across the island, providing professional advice on facilities and practices. Make recommendations to the Minister for Health and Social Services regarding the appropriate action to be taken to address unacceptable standards of practice and/or law infringements, including the cancellation of registration of premises and of pharmacists in extreme cases. 2. Investigate complaints or allegations relating to incidents involving dispensed medicines, the sale or supply of medicines, or the advertising and promotion of medicines. This may involve Community Pharmacies, licensed Wholesale Dealers, or any other retailer or supplier. Issue advice and recommendations to enable corrective measures to be taken where necessary, where complaints may have been upheld. 3. Work in collaboration with the Medicines and Healthcare products Regulatory Agency (MHRA) through a memorandum of understanding to regulate pharmaceutical wholesalers and manufacturers. 4. Work with the UK Home Office (UKHO) through a memorandum of understanding to ensure that the United Nations 1961 single convention on narcotic drugs is upheld within Jersey. Conduct inspections of Cannabis Cultivation. 5. Liaise with enforcement agencies and professional bodies, both locally and nationally, to ensure arrangements for the importation, distribution, sale and supply of medicines in the Island comply with all relevant legal, professional and ethical requirements 6. Administer controlled drug importation and exportation licences with delegated authority from the Minister for Health and Social Services, in support of the Chief Pharmacist. Liaise with Law Enforcement and Customs, reviewing import and export queries and legislation. 7. Monitor the production, import/export, possession, supply and administration of controlled drugs and other medicinal products. 8. Support the Chief Pharmacist in ensuring that all pharmacy practice within Jersey is compliant with the most recent Pharmacy Standards as laid out by the Royal Pharmaceutical Society (RPS) and the General Pharmaceutical Council (GPhC) of Great Britain. 9. Ensure the registration of Pharmacists and Pharmacy Technicians in Jersey, in compliance with the Pharmacist and Pharmacy Technicians Registration Law, with delegated authority from the Minister for Health and Social Services. 10. Proactively provide pharmaceutical expertise to regulatory activity with regards to medicines optimisation and the management of the risks associated with the unsafe use of medicines across the island. 11. Lead on collecting, analysing and preparing information to contribute to policy formulation, strategic planning and implementation for medicines optimisation, prescribing and pharmacy practice. Complete impact assessments as required. 12. Undertake themed reviews to identify and share learning with the wider sector, including generating insights and sharing notable practice case examples. 13. Lead on securing funding through Departmental business planning processes to deliver pharmaceutical policy and strategic objectives. 14. Identify opportunities to participate in collaborative research

Are you a strong and experienced leader who is passionate about transforming futures through learning? Are you seeking an exciting new leadership challenge in a forward-thinking Further Education College? Do you embody our College values of ambition, integrity, innovation and respect? An exciting opportunity has arisen to shape the future of our Health & Life Sciences faculty; we are seeking a dynamic, innovative, and supportive Faculty Director to join #teamBCG.

Leading the Health & Life Sciences faculty you will provide challenge and support to the three Curriculum Managers responsible for full and part time provision in Health & Social Care, Education & Childcare, Science, Sport, Uniformed Public Services, HealthTec Thames Valley, Counselling and Access to HE. You will steer the Employer Boards for the areas, ensuring that the curriculum intent, planning, design, and delivery futureproofs our students and the skills needs of the county and beyond. Able to work collaboratively with our well-established partners, such as Bucks Health and Social Care Academy, NHS England, Community Impact Bucks and Buckinghamshire New University, you will drive forwards a careers-focused curriculum delivered through exceptional learning experiences. Our students love to actively learn through real-world settings, such as simulated crime scene investigations, expeditions, cadets, dementia cafes, stay and plays, and you will empower the curriculum teams to further enhance this approach.

This is a really exciting time to join the College. We have recently launched our new 5-year vision and strategy which includes a vibrant new-build in the heart of High Wycombe. The Health & Life Sciences faculty is pivotal to our response to the Buckinghamshire Local Skills Improvement Plan (LSIP) and successfully bid for substantial funding to create an immersive simulation Health Skills suite, develop, and pilot an innovative 'Bucks volunteer skills record' and invest in cutting-edge training resources.

The successful candidate will be a member of the College Leadership Team, report directly to the Vice Principal Curriculum and Quality and will work collaboratively cross-college with a diverse and dedicated team so that our students go 'beyond ambition.'

We are an inclusive and supportive employer and welcome applications from people who may not have a traditional FE background but, for example, may have significant health and social care training and development experience. Want to know more? If you would like to have an informal chat about the role or pop in for a tour, please contact HR directly.

Key knowledge, skills and experience we are looking for:

• Confident leader of people, with a proven track record of innovative curriculum planning, design and delivery, driving continuous quality improvements.
• Strong ability to collaborate with students, colleagues and employers to develop partnerships that enhance learning experiences and progression opportunities for our students.
• Experience of successfully developing and implementing ambitious strategic plans

The successful candidate will be required to:

• To lead on ensuring a consistently high-quality learning experience for students, every day.
• To lead a faculty, providing challenge and support for curriculum staff to continually improve their practice.
• To lead curriculum managers in innovating curriculum planning, design and delivery leading to exceptional student outcomes and progression.
• To lead on developing and implementing the college's strategic vision and goals.
• Work across Aylesbury & Wycombe campuses. 

While working at Buckinghamshire College Group you can also take advantage of a host of employee benefits, further information on these can be found on our website.

Commitment to Safeguarding

BCG is committed to equal opportunities for all, safeguarding and promoting the welfare of students and staff alike; all posts are subject to enhanced DBS checks.

 

We reserve the right to close this vacancy early, if we receive sufficient applications or source a suitable candidate. Therefore, if you are interested, please submit your application as early as possible.

Only completed applications will be considered for this role. All applicants will need to complete an application form via our College Website.

For more information on the role please contact HR directly.

Closing date for applications is Wednesday 17th January 2024, 23:59, with interviews taking place on Friday 2nd February 2024 at the Aylesbury Campus.

Proud member of the Disability Confident employer scheme

• Develop effective marketing campaigns from start to finish and refine campaign messaging for a wide range of pharmaceutical products and medical devices, with a focus on oncology.
• Develop strategic and tactical plans to achieve marketing objectives, including brand planning and strategy development, specifically in the oncology sector.
• Responsible for developing short-term and long-term sales marketing strategy to meet the company's goals and objectives in the oncology market.
• Attend meetings to discuss sales plans for the oncology product portfolio in line with the agreed marketing plan with relevant departments.
• Evaluate the effectiveness of oncology-related promotion and advertising programs and suggest improvements.
• Research and analyze market trends, competitors, and oncology product performance, converting raw data into detailed reports and actionable insights.
• Evaluate and assess the strengths and weaknesses of competitive oncology products and develop comparative statistics and metrics.
• Prepare annual expense budget report for oncology marketing and propose adjustments for budget implementation.
• Develop business relationships with existing and new customers in the oncology field to identify potential opportunities within key territories for sales optimization.
• Perform any other ad-hoc duties as and when assigned by the Company.

Job Specification

• Bachelor's degree in Marketing, Business, or Health Sciences
• Min. 15 years of relevant work experience, preferably with pharmaceutical products, with an emphasis on oncology
• In-depth understanding of healthcare systems, markets, stakeholders, and competitive dynamics within the oncology sector
• Familiarity with the latest trends and best practices in the pharmaceutical field, particularly in oncology
• Oncology-focused project management and prioritization skills
• · Ability to meet deadlines and complete oncology-related projects within budget