Key responsibilities include but not limited to:

• Develop and execute validation protocols for automation systems and processes to ensure they are operating within specifications and are robust against errors
• Design and execute experiments using automated DNA workflows
• Conduct risk assessments and ensure compliance with laboratory safety protocols and regulatory requirements
• Troubleshoot and resolve issues related to automation systems and processes
• Manage project timelines and budgets related to validation of automated processes
• Report writing and presentation of research outcome
• Writing of SOPs and protocols
• Create documentation and training plans for laboratory staff on the use of automated processes
• Contribute to continuous improvement initiatives for automation systems and processes

Job Requirements:

• Background in Biology/ Life Sciences
• Previous experience in automation of lab processes and validation work would be an advantage
• Good understanding of statistical method and experienced in statistical software (e.g SPSS) in Life Sciences setting
• Detail-oriented, organized, and able to manage multiple projects simultaneously
• Meticulous and strong critical thinking skills
• Collaborative team player and able to work independently

Company :

Job Description : 

JOB SUMMARY

*This is a hybrid role requiring 3 days in office at our Fifth Avenue Place location

This job will support both pharmacy and medical cost savings initiatives and rebate strategy. This role will engage with internal and external stakeholders to execute and track low-net cost medication benefit offerings. This role will regularly analyze drug category market share and utilization management trends and make recommendations to internal teams. The incumbent will serve as a key contact with pharmaceutical manufacturers and vendors, including the Pharmacy Benefit Manager. This role may ensure compliance with government drug rebate reporting obligations and may assist in audit responses. This role may support monitoring FDA-approvals, drug manufacturer pipelines, and assess drug utilization reports, in order to develop and execute the Organization's Drug Formulary, and/or recommend codes for pharmaceutical based reporting. The incumbent may review or help craft utilization management edits accounting for rebate compliance (e.g. prior authorization, dose and duration edits, quantity limits, step-care edits). If acting in the capacity as a clinical pharmacist the incumbent may also review UM requests. The incumbent develops and implements physician, pharmacy, account, and member educational initiatives that promote the Organization’s Formularies, utilization management programs, and case/ disease management initiatives; providing clinical review and decisions for physician and member appeals and participates on cross-functional committees to develop and implement clinical and operational initiatives.    

ESSENTIAL RESPONSIBILITIES

• Monitor FDA-approvals, drug manufacturer pipelines,   assess drug utilization reports, and write drug monographs for Committee review to develop the Organization's Drug formulary and/OR provide recommendations for NDC code capture, and monthly identification of high risk members. 
• Gateway - Assist in the development of Gateway’s Drug Formularies by monitoring FDA-approvals and drug manufacturer pipelines, assessing drug utilization reports, and writing drug monographs for Pharmacy & Therapeutics Committee review.
• Assist in the development and implementation of utilization management programs including but not limited to: prior authorization, dose and duration edits, quantity limits, step-care edits, generic sampling  medical policy review and development, member facing outreach initiatives
• Develop and implement physician, pharmacy, account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and disease management initiatives.
• Provide clinical review and decisions including but not limited to:  physician and member appeals, member or provider information/education. 
• Participate on cross-functional committees to develop and implement clinical and operational initiatives within Integrated Clinical Services.  May participate in outreach efforts as needed to effectively reach goals of Medication Therapy Management programs to include, but not limited to Comprehensive Medication Reviews and Targeted Medication Reviews.
• Identify and assist in managing department process improvements to maximize overall efficiencies.
• Manage individual projects for timely review with the Director, Clinical Pharmacy.
• Participate in Medicare Stars performance measures to drive   contribution to excellence (5 Stars).
• Other duties as assigned or requested.

QUALIFICATIONS

Required

• Bachelor of Science in Pharmacy with experience in clinical / formulary management or a Doctor of Pharmacy degree with experience in clinical formulary management
• 5 years of related, progressive experience in the area of specialization
• An understanding of managed care principles and practices is essential
• Demonstration of strong verbal and written communication skills, as well as, proficiency in the use of computer-based data processing
• Microsoft Office products, and database applications
• Pharmacy license

Substitutions

• None

Preferred

• Pharmacy Residency or bachelor’s degree in business
• Experience in a Health Plan, Pharmacy Benefit Manager (PBM), or Pharmaceutical Manufacturer environment
• 2 years of experience with pharmacy and/or medical drug cost modeling
• 1 year of experience in a role predominately focused on cost-savings initiatives

SKILLS

• Be able to quickly identify and prioritize essential elements of problem
• Independently or in a team, be able to identify the root issues and formulate potential solutions
• Accurately use logic and reasoning in identifying alternate solutions, conclusions or approaches to problems. Potential solutions should be synthesized into presentation, timetable to resolution and appropriate follow up with measurable outcomes

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

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

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.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

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 number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

JOB DESCRIPTION:

Abbott is a global healthcare leader, creating breakthrough science to improve people’s health. We’re always looking towards the future, anticipating changes in medical science and technology.

The base pay for this position is

In specific locations, the pay range may vary from the range posted.

JOB FAMILY:

DIVISION:

LOCATION:

ADDITIONAL LOCATIONS:

WORK SHIFT:

TRAVEL:

MEDICAL SURVEILLANCE:

SIGNIFICANT WORK ACTIVITIES:

Located in a historic neighborhood in the nation's capital, Georgetown offers rigorous academic programs, a global perspective, exciting ways to take advantage of Washington, D.C., and a commitment to social justice. Our community is a tight knit group of remarkable individuals interested in intellectual inquiry and making a difference in the world.

Requirements

Senior Bioinformatician – Bioinformatics Science – Georgetown University Medical Center

Job Overview

The Senior Bioinformatician supports two main activities – they participate in bioinformatics activities for research projects using genomics data analysis and management - and provide support with courses in Georgetown’s Master's in Health Informatics & Data Science (HIDS).

Due to the rapidly evolving nature of biomedical informatics, they are expected to stay up to date on bioinformatics tools and electronic data capture technologies for different projects.

And toward conducting research coordination and management activities effectively, they assist the development of research plans, the maintenance of research documents, and the tracking of progress on different tasks for various research projects.

Work Interactions and Work Mode Designation

The Senior Bioinformatician works with the research and education leaders of Georgetown Innovation Center for Biomedical Informatics (ICBI) to provide biomedical data analysis support, perform project related literature and database research, develop project plans, and maintain research documents. They also assist in managing the Master’s HIDS program.

Their work positively impacts ICBI’s mission to drive the Medical Center’s innovation and translational biomedical informatics research; and ensures a strong presence for ICBI in the big data in biomedicine space and is essential for grant application submissions to conduct funded research.

As well, they interact with multiple investigators, data managers, research staff and leaders at ICBI and GUMC on a daily basis.

This position has been designated as On-Campus. Please note that work mode designations are regularly reviewed in order to meet the evolving needs of the University.  Such review may necessitate a change to a position’s mode of work designation. Complete details about Georgetown University’s mode of work designations for staff positions can be found on the Department of Human Resources website: https://hr.georgetown.edu/mode-of-work-designation.

Requirements and Qualifications

• Master’s degree – preference for Computer Science, Molecular Biology, Genetics, Biochemistry, Bioinformatics or other Life Science related field
• 3 to 5 years of experience working in a biomedical environment with experience in analyzing data using statistical package(s)
• Demonstrable knowledge of bioinformatics tools and resources
• Excellent ability to pay attention to detail
• Excellent verbal, written and inter-personal communication skills to work on ICBI’s collaborative team science projects

No additional licenses or certificates are required.

Current Georgetown Employees:

If you currently work at Georgetown University, please exit this website and login to GMS (gms.georgetown.edu) using your Net ID and password. Then select the Career worklet on your GMS Home dashboard to view Jobs at Georgetown.

Submission Guidelines:

Please note that in order to be considered an applicant for any position at Georgetown University you must submit a resume for each position of interest for which you believe you are qualified. Documents are not kept on file for future positions.

Need Assistance:

If you are a qualified individual with a disability and need a reasonable accommodation for any part of the application and hiring process, please click here for more information, or contact the Office of Institutional Diversity, Equity, and Affirmative Action (IDEAA) at 202-687-4798 or ideaa@georgetown.edu.

Need some assistance with the application process? Please call 202-687-2500. For more information about the suite of benefits, professional development and community involvement opportunities that make up Georgetown's commitment to its employees, please visit the Georgetown Works website.

EEO Statement:

Georgetown University is an Equal Opportunity/Affirmative Action Employer fully dedicated to achieving a diverse faculty and staff.  All qualified applicants are encouraged to apply and will receive consideration for employment without regard to race, color, religion, national origin, age, sex (including pregnancy, gender identity and expression, and sexual orientation), disability status, protected veteran status, or any other characteristic protected by law.

Benefits:

Georgetown University offers a comprehensive and competitive benefit package that includes medical, dental, vision, disability and life insurance, retirement savings, tuition assistance, work-life balance benefits, employee discounts and an array of voluntary insurance options. You can learn more about benefits and eligibility on the Department of Human Resources website.

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

Required Job Qualifications:

• Bachelor’s degree in design strategy, design planning, or service design
• 5 years of project work experience in the design strategy, design research or service design space
• Experience planning and conducting research programs (including secondary and primary research), analyzing and synthesizing qualitative data and co-facilitating concept/design workshops
• Systems thinking
• Service design understanding
• Experience collaborating and working with multi-disciplinary teams
• Experience with user-centered design practices, methods and tools
• Experience generating user-friendly reports with strategic thinking and visuals
• Verbal and written communication skills

Preferred Job Qualifications:

• Advanced degree preferred
• Understanding of and ability to engage in the entire design process (planning, research, concept development, prototype and pilot)
• Comfort and experience in collaborating with, as well as presenting to, stakeholders (internal and external)

#LI-HYBRID

#LI-EL1

INJLF

NOTE: This is a Hybrid workstyle - working in the Dallas C1 Innovation Lab three days per week and working remotely two days per week.

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.

• Conduct forensic examination of exhibits submitted to the laboratory, under the supervision of senior officers.
• Operate and maintain laboratory equipment / instruments.
• Assist in the quality assurance program in the laboratory.
• Assist in general adminstrative duties such as procurement activities to ensure continual operation of laboratory activities.

Job Requirements

• Background in Chemistry or a relevant field.
• Understand the underlying theories and principles of IRMS and other common analytical techniqes such as FT-IR spectroscopy, Raman spectroscopy and SEM. Experience in the operation and maintanence these instruments would be advantageous.
• Good critical-thinking and problem-solving skills, with attention to details.
• Excellent written and spoken English.
• Experience with programming languages such as Excel VBA, R and Python is a plus.
• Ability to work independently and also collaborate with others.Assist in the instrument validation and method development of isotope-ratio mass spectrometry (IRMS) for the enhancement of the laboratory's forensic capabilities.

• Provide quality and efficient forensic science services for casework in the area of Forensic Patterns (eg. firearms, toolmarks, manufacturing marks, impressions and questioned documents).
• Conduct forensic examination of exhibits submitted to the laboratory by law enforcement agencies
• Prepare forensic reports and provide expert testimony in Court for the administration of Justice.
• Assist in/Lead research projects to develop and improve in the methodology, technology and quality aspects of Forensic Patterns.
• Attend crime scenes when required.

Job Requirements

• Background in Chemistry / Physics / Forensic Science / Materials Science Engineering or a relevant field.
• Good critical-thinking and problem-solving skills, with attention to details.
• Excellent written and spoken English and good oral presentation skills, with the ability to explain technical concepts to non-technical audiences.
• Experience with programming languages such as MATLAB, R and Python is a plus.
• Highly motivated with a strong desire to serve the administration of justice.
• Ability to work independently and also collaborate withothers.

• Assist in the implementation and enhancement of the lot release framework/programme.
• Review submissions, manage technology transfers, and oversee test method setup and equipment qualifications for biologics testing.
• Perform testing, interpret and compile results, provide expert comments to clients, and support policy compliance.
• Conduct investigations, evaluate training programmes, and undertake projects for laboratory operations and/or publications.
• Develop new or improved test methods for accreditation, assess clients' needs, and participate in relevant professional development activities.
• Participate in local and oversea attachments, learning courses and seminars/conferences (with posters or oral presentation) relevant to the area of work.

Job Requirements

• Postgraduate qualifications in relevant disciplines.
• Minimum 5 years' experience in assay development, bioanalytics, or biotherapeutic development/manufacturing.
• Proficiency in method transfer, validation, and verification of bioanalytical assays.
• Proficiency in common biostatistics and analysis software preferred.
• Familiarity with government regulations for public health protection and relevant international guidelines and standards, such as ICH, USP, Ph.Eur. and ISO17025.
• Strong communication and interpersonal skills, ability to work independently and in a team, deliver results in a timely manner and a strong commitment to public health and safety.

#CorewellHealthCareers

Primary Location

Department Name

Employment Type

Shift

Weekly Scheduled Hours

Hours of Work

Days Worked

Weekend Frequency

CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.

Primary Location

Department Name

Employment Type

Shift

Weekly Scheduled Hours

Hours of Work

Days Worked

Weekend Frequency

CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.

Company :

Job Description : 

GENERAL OVERVIEW:

As a member of the health care team, assists in coordinating the examination, treatment and health care planning for patients, under the direction of the provider. Also assists with other office functions to support patient care and office operations. Follows all established protocols, policies, procedures and standardized work flows.

ESSENTIAL RESPONSIBILITIES:

• Prepares and rooms patients within the clinical practice setting according to standardized work flows. Accurately obtains patient vital signs. Accurately documents patient information, patient history, and medication screening. Prepares exam room for patient visit. Completes annual wellness visit screenings, pends orders for required age appropriate screenings and may serve as a scribe with additional training.
• Acts as an electronic health record (EHR) superuser. Accurately documents all pertinent details in the  EHR according to established standards and work flows including all pertinent patient interactions at the time of the encounter in the correct EHR note type. Reviews, updates and screens medication list in the EHR. Reviews problem list and social history with patient and updates record. Follows Meaningful Use standards and assists with population health management.
• Assists in the coordination of patient care under supervision of the assigned health care provider. Assists providers with examination and procedures. Assists in administration of depression screening, tobacco screening, chronic disease screening and MU required screenings. Performs in-house testing following established protocols and policies. Assists with patient prescription needs based on established protocols.
• Provides clinical leadership oversight, serving as a department resource for clinical questions.
• Reviews pre-visit planning documentation and patient chart in advance of appointment time to ensure that the provider is prepared to address required screenings and gaps in care.
• In collaboration with the care team nurse, provides follow up with patient at designated intervals via patient preferred method (telephone, electronic, written) in accordance with prescribed provider instructions. Notifies patients of test results under the direction of provider in a timely manner.
• Ensures adequate inventory of medical supplies. Ensures all patient treatment areas are always stocked with the appropriate supplies using established inventory standards. Cleans and sterilizes instruments per established policy and manufacturer's guidelines. Accurately performs lab controls and equipment checks as assigned. Administers and accurately documents medications in accordance with policy and safety practice
• Serves as a peer mentor. Responsibly orients new medical assistants in correct office workflows. Demonstrates proficiency in teaching pre-visit planning, meaningful use standards, appropriate documentation and workflows. Provides meaningful feedback and performance evaluations for orientees. Mentors MA students and externs as assigned.
• Accurately performs clerical office functions and other duties as assigned or required.
• Depending on location, may serve as office safety officer: maintains the office safety log, assures the accuracy and completion of all quality assurance testing for all POCT performed in the office environment. Depending on location, may perform additional duties such as minor wound care, splinting procedures, and 61 capsules procedures.
• May require travel between physician office locations.

QUALIFICATIONS:

Minimum

• One year certificate from college or technical school, or at least three months of related experience and/or training, or equivalent combination of education and experience.
• 1-3 years as a Medical Assistant
• Newly hired medical assistants must complete training and/or attempt testing within 30 days of hire; newly hired medical assistants must obtain certification within 120 days of hire.
• Medical assistants must achieve and maintain certification in accordance with CMS Meaningful Use requirements.
• CPR certification.

Preferred

• Experience with practice management software and electronic health record applications.
• Current valid state driver’s license

$1,000 Sign-On Bonus

*Sign-On bonus is for External Hires only

Paid out after Probation Period (90 days)

Recipient must stay with the same practice for a minimum of 1 year

Re-Hires may not have worked for AHN within the previous 12 months.

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.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

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 number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Job Category:

Work Shift/Schedule:

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Job Summary

This position shall contribute to the value-based contracting team responsible to support an enterprise wide portfolio of value-based programs that span government and commercial payers. This position shall collaborate with and engage executives and physician leadership in assessing and executing value-based strategy through a wide range of value-based contractual arrangements including pay for performance and various levels of risk.  

Minimum Job Qualifications

• Licensure or other certifications:

• Educational Requirements: Bachelor's Degree in healthcare administration, finance, mathematics or other related discipline required.

• Minimum Experience: 7 or more years of successful experience organizing and negotiating value based payment terms with Medicare Advantage and Medicaid plans; Advanced knowledge of and ample experience in value-based care and risk based contracting with a broad range of providers; Proficient in excel and managing key contractual inputs that drive the proforma

• Other:

Preferred Job Qualifications

• Preferred Licensure or other certifications:

• Preferred Educational Requirements:

• Preferred Experience: Experience working in a CIN or ACO

• Other:

Job Specific and Unique Knowledge, Skills and Abilities

• Strong communication and negotiation skills 

• Demonstrates solid value-based contracting expertise in developing and negotiating value-based contractual terms with payers

• Detail oriented. Questions the unusual

• Highly organized with ability to multi-task and prioritize duties and responsibilities

• Ability to think independently and problem solve with both internal and external constituents

• Proficient in Microsoft Office applications (Work, Excel, Outlook, PowerPoint)

• Ability to develop strong, trusting relationships with co-workers, managers, directors, and payers

• Must be self-motivated, dependable, and maintain a high-level of confidentiality

Essential Tasks and Responsibilities

• Lead payer negotiations for Health Partners and HP2 in dyad with executive leadership

• Evaluate and make recommendations on new and changing value-based contracting proposals and opportunities working in concert with the analytics and quality teams including finance and contracting committee members

• Manage on-going obligations of executed contracts to ensure both HP2 and the payer are meeting performance expectations elevating critical and recurring issues to leadership

• Collaborate with payers and manage and/or lead the required Joint Operating Committee meetings and/or finance meetings as assigned. Ability to take the lead as well as contribute as a participant in committee meetings and work sessions

• Resolve complex contractual problems that require judgment and independent thinking

• Act with a fluent and comprehensive knowledge of value-based contract language and terms

• Apply a deep understanding of provider reimbursement methodologies for physicians, ancillaries, and hospitals in all transactions.

• Conduct analysis of complex financial models using assumptions and scenario planning

• Shall manage the inputs that support the proforma

• Draft, edit and prepare counter proposals to include complex contract documents and reimbursement attachments

• Draft content for presentations and agendas for HP2 committee meetings and payer meetings, maintain notes and/or minutes as deemed necessary

• Conduct research and analysis to support filing appeals with the payers working in partnership with other members of the HP2 team

• Compiles, maintains and reviews value-based contracts and risk contracts portfolio for the purpose of identifying opportunities to improve contract terms and structures

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time

• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time

• Vision: Heavy, Constantly 66-100% of time

• Kneeling/Stooping/Bending: Occasionally 0-30% of time

• Standing/Walking: Occasionally 0-30% of time

• Pushing/Pulling: Occasionally 0-30% of time

• Intensity of Work: Occasionally 0-30% of time

• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding,

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. 

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.

Company :

Job Description : 

JOB SUMMARY

***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)***

This job takes the lead in providing complex application development services in Highmark’s Google Cloud Platform environment, typically as part of a project team or in an application support role. Databricks Engineers analyze, design, code, test and implement more complex systematic solutions to meet customer requirements that adhere to Highmark IT standards and policies.  They also provide general support to maintain more complex applications that meet the service levels, system availability, performance and quality levels required by their customers. Able to guide and mentor less experienced team members.

ESSENTIAL RESPONSIBILITIES

• Takes a lead role for analyzing, designing, coding, testing and implementing more complex application enhancements, as well as providing general  production support, meeting defined scope, target dates and budgets with minimal or no defects.
• Utilizes and participates in the more complex full system development life cycle, per current Highmark SDLC standards.
• Takes a lead role in collaborating with customers, business analysts, partners, and IT team members to understand business requirements that drive the analysis and design of quality technical solutions. Concentrates on providing innovative solutions to more complex business needs.
• Takes a lead role in providing required technical support, including release implementations, on-call and 24x7 supports when necessary.
• Performs work in compliance with all Highmark and Highmark IT standards, policies and procedures.
• Actively takes a leading role and participates on project teams in various project roles, including, but not limited to, Developer, Technical Lead and Project Manager, based upon level of experience.
• Effectively communicates with team members, customers, partners and management, including assisting with or conducting more complex technical walkthroughs, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor’s degree in Information Technology, Computer Science or closely related field

Substitutions

• None

Preferred

• Master’s degree in Information Technology, Computer Science or closely related field

EXPERIENCE

Required

• 5 years of experience as a developer
• Experience with Project Management tools
• Experience with databases
• Experience with multiple coding languages

Preferred:

• 5 years of experience as a developer with demonstrated skills in:
  • Databricks
  • Python/Pyspark
  • GCP:  Big Query and PostgreSQL

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• Certifications such as Python, Databricks, GCP

SKILLS

• Problem solving, root cause analysis, and issue resolution
• Demonstrated leadership skills
• Experience in Healthcare or Health Insurance Industry
• Experience with technology platforms, application development tools, business processes, software development life cycle used by Highmark enterprise

Language (Other than English):

None

Travel Requirement:

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

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

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.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

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 number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

The Market Executive is responsible for the leading the delivery system-related performance and strategies in their responsible market(s). This includes overseeing provider partnerships and developing and executing on strategic and operational plans related to the provider network, delivery of care, population health management and cost of care, and growth objectives for the market. This role will work in close partnership with the SVP of Markets to establish strategies in the market that support growth and financial objectives for the various insurance segments sold. The Market Executive will work closely with respective Highmark segment (e.g., Government, commercial) leaders to understand the performance and network needs in the market and coordinate the strategy development and building the networks to deliver that performance across key metrics including quality, risk revenue, affordability, access, customer and clinician experience, and equity. The Market Executive is a key driver of transformational change, including the market’s financial and operational performance, as well as organizational culture, talent, and leadership. As such, this role will be a face to the provider community and will need to have experience working in leadership roles inside delivery system entities as well as the ability to influence and work highly collaboratively with both internal and external executives.

ESSENTIAL RESPONSIBILITIES

• Lead the delivery of key financial and operating targets in the responsible market(s), with a dedicated commitment to optimize revenues, maintain cost effective operations, and provide continuous performance improvement. Accountable for meeting targets in areas of Risk Revenue, Quality/stars, affordability, reimbursement/contracting trend, network alignment. 
• Alongside the segment partners, ensure coordination of all market-performance related levers to meet quality, experience, and affordability goals.
• Lead the development and implementation of a holistic market approach which includes market strategy and structure, retention and profitability, partnership growth, and development of accountability frameworks grounded in KPIs.
• Actively lead the transformational strategies with the strategic partners in the market, pulling on the others in the organization for delivery. This includes strategies such as: value-based and alternative payment models, and MLR and risk models to ensure appropriate program results; growth-related levers including care alignment, attributed membership and wallet share; care model improvements where appropriate; solutions to improve member’s health and lower cost of care; new business and legal structures and / or collaboration models to further economic ties; and, provider administration simplification techniques to create efficiency between payor and provider.
• Engage physician and system leadership to create a culture of alignment and further develop and drive an effective clinical integration strategy, which positions Highmark Health and the provider partner systems as the preeminent brand in the market. Work with physician aggregators to ensure appropriate structures and effective physician management of populations resultant in economic returns associated with that management and lower cost of care for members.
• Attract, retain, and develop top talent, focusing on succession planning and the cultivation of a best-in-class team. Cultivate an organizational culture that drives workforce engagement focused on innovation, learning, and continuous improvement.
• Oversee the full relationships with all parts of the delivery system, including guiding contract negotiations and handling operational issues.  Responsible for ensuring that provider relationship goals are set and met every year. Working with data and analytic teams, identify opportunities for improvement in KPIs not meeting expectations as well as trends emerging in the market requiring actions.  Trend may include increases in utilization, total care costs, potential new asset development, or other provider site of care changes.
• Along with Data and Analytics, work in partnership with segment leads and with health plan partners to identify mutual synergies to address profitability resulting from cost reduction strategies in PMPM including its drivers in disease-based management, care management, utilization management, and risk coding opportunities as well as pharmacy strategies.
• Represent Highmark to appropriate market-based constituencies including provider health system C-suites, vendors, and health plan stakeholders. Represent Highmark Health in the industry for our market approach with provider, producers, customers, regulators, and other community stakeholders. 

​

EDUCATION

Required

• Bachelor's degree in business or health

Substitutions

• None

Preferred

• Master's degree in business or health

EXPERIENCE

Required

• 7+ years in healthcare Industry, with some portion of that as part of a delivery system entity
• 7+ years in a management or leadership role
• 5 years in project management, leadership, or strategic planning
• Strong analytic background     ​

Preferred

• Clinical operations experience
• Understanding and managing provider performance, specifically in hospitals, physician practices or health systems. 
• Experience working within a matrixed organization.
• Business process redesign, change management, or program development.
• Experience in complex program management, MSO capability development or operation improvement.
• Management consulting

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Capable of managing provider leadership relationships as a Highmark executive.
• Broad application of principles, theories, and concepts in strategic thinking.
• Strong PC skills (MS Office, PowerPoint, Excel).
• Breadth of knowledge related to Healthcare industry trends.
• Demonstrated executive presence with outstanding communication skills (verbal, written, and presentation) as well as excellent negotiation, networking, and interpersonal operating and finance skills.
• Ability to work effectively across many matrixed functions and with executive leadership teams.
• Presentation skills and a proven ability to communicate detailed information to healthcare executives, provider leaders and physicians.
• Strong project management skills including the ability to manage multiple projects and meet concurrent deadlines.

Language (Other than English)

None

TRAVEL REQUIREMENTS:

25% - 50%

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

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

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.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

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 number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :

Job Description : 

JOB SUMMARY

This job performs financial and business related research and analysis such as the preparation of forecasts and/or analysis of financial reports, records and trends; develops and maintains spreadsheets and databases to facilitate analysis and reporting; and is responsible for conducting and documenting financial analysis projects.

ESSENTIAL RESPONSIBILITIES

• Communicate effectively.  Display effective communication skills.
• Coordinate with other departments, locations, and divisions.
• Communicate with other departments and/or outside agencies to resolve problems.
• Communicate with Management at Highmark, subsidiaries, affiliates, other third parties, etc. as to project status and completion deadlines.
• Advise management of expected outcomes, and recommending ways to improve the outcomes.
• Conduct presentation to all levels of management in order to provide a summary of analysis regarding financial results and trends.
• Communicate with Management as to project status and completion deadlines.
• Perform financial and business related analysis.
• Analyze, evaluate and interpret appropriate financial and statistical data.
• Develop and/or document business policies, conducts special financial and business related studies and cooperate with other departments in the preparation of analyses.
• Conduct financial and business related analyses and research including the preparation of forecasts and/or analysis of trends.
• Analyze financial reports and records.
• Provide reasoning for variances and make recommendations relative to the accounting of reserves, assets, and expenditures.
• Advise management of expected outcomes, and recommend ways to improve the outcomes.
• Independently pursue fundamental problem solving and documents the recommendations to management.
• Facilitate analysis and reporting
• Utilize computer to input, retrieve or display accounting information.
• Develop and maintain spreadsheets and databases.
• Utilize PC and/or mainframe based systems and software, compile and prepare reports, graphs and charts of data developed.
• Serve as a project lead for special projects within the department.
• Lead and document financial analysis projects including the preparation of ad hoc reports; to include but not limited to; gathering of data, analysis, documentation of findings, and calculation of results and generation of reports for distribution. 
• Coordinate activities to ensure the project is advancing properly and to ensure the project is completed within the timeframes established. Included in this process will be communication with Management at Highmark, subsidiaries, affiliates, other third parties, etc. as to project status and completion deadlines.
• Make recommendations based on findings when necessary.
• Other duties as assigned or requested.

QUALIFICATIONS

EDUCATION

Required

• Bachelor's Degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree

Preferred

• None

EXPERIENCE

Required

• 5 - 10 years of relevant, progressive experience in Accounting and/or Finance
• Experience with various computer applications to include MS Excel and/or MS Access

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Strong written and oral communication skills
• Strong relationship building skills
• Client focused with strong business acumen
• Self-starter with the ability to work under pressure independently and as part of a team.
• Ability to think strategically and act proactively to create strong trust and confidence with business units
• Strong innovative problem-solving capabilities

Language (Other than English):

None

Travel Requirement:

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

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Never

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.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

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 number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice