<![CDATA[A-Line Staffing Solutions LLC: jobboards]]> http://JOBS.ALINESTAFFING.COM/ en-us <![CDATA[Accounts Receivable]]> Description:
  • The AR Representative is charged with maximizing cash flow by ensuring that an accurate and complete accounting of each member's balance due is maintained.
  • This position will also be responsible for documenting and executing account reconciliation through potential adjustments and refunds due on beneficiary's account.
  • The representative will also be monitoring and working payment errors and reversal reports on a weekly basis.

Duties:
  • Reconcile daily cash transactions posted into Facets.
  • Ensure group receipts are properly loaded into Facets based on established SLAs.
  • Update daily cash databases.
  • Validate ACH bank drafts.
  • Analyze monthly suspense report to ensure refunds and adjustments to member accounts occur in a timely manner.
  • Maintain the documentation and process flow for department policies and procedures.
  • Create and generate monthly department metric reports.
  • Create monthly transaction reports for Accounting.
  • Assist with processing beneficiary's requests for account reconciliation in relation to their payments, invoices and adjustments.
  • Assist in ad hoc assignments when needed.

Experience:
  • A minimum of 2 years related work experience required Strong verbal and written communication skills required.
  • Strong data entry (Excel/Access) and typing skills required Must have an understanding of Accounts Receivable.
  • Must be able to work independently as well as the able to work as part of a team Knowledge of Medicare Part D beneficial, but not required.


Education:
  • Verifiable High School Diploma or GED is required.
  • Bachelors degree in finance, accounting or business is preferred.

Hours:
  • M-F 9: 00a-6: 00p.
  • 8 hr shifts.

For more information on this position, please call our office at 877-782-3334.

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Thu, 12 Jul 2018 00:00:00 CDT 0
<![CDATA[Representative]]> Description:
  • Responds to requests received in the Participant Services Area from Participants, Account Managers, internal customers, Clients and Quality Assurance relative to customer service experiences and concerns within the Pharmacy.
  • Assembles comprehensive detail of events, identifies gaps in service and processes.
  • Partners with other business units to facilitate timely response to investigation request and provide gap analysis.
  • Follows through on standard operating procedures, problem solving and troubleshooting with minimal guidance. 


Required Qualifications:
  • Must have strong oral and written communication skills and research, analytical and problem resolution skills.
  • Strong mathematical aptitude and proficient computer skills, with Windows environment experience required.
  • Health insurance background and knowledge of pharmacy terminology desired.

Preferred Qualifications:
  • Minimum one to three years experience in customer services or a related role; including experience in research and problem resolution.


Education:
  • High School education or equivalent.
  • Additional education and/or relevant training preferred.

For more information on this position, please contact our office at 877-782-3334.

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Mon, 09 Jul 2018 00:00:00 CDT 0
<![CDATA[Utilization Management Professional]]> Description:
  • Under general supervision, and in collaboration with Medical Directors and other members of the clinical team, gathers and synthesizes clinical information in order to authorize services.
  • Reviews health care services to determine consistency with contract requirements, coverage policies and evidence-based medical necessity criteria; collects and analyzes utilization information; assists with program processes for transitions across levels of care including discharge planning and ambulatory follow up activity.
  • Serves as an expert resource on coverage policies, covered benefits, and medical necessity criteria.

Essential Functions:
  • Develops and manages new enrollee transitions and those involving a change in provider relationships.
  • Develops and implements transition plans, as indicated, to ensure continuity of care.
  • Negotiates and documents single case agreements according to the company's policies and procedures.
  • Reviews planned, in process, or completed health care services to ensure medical necessity and effectiveness according to evidence-based criteria.
  • Proposes alternatives when the requested services do not meet medical necessity criteria or are outside the contracted network.
  • As assigned and based on credentials, monitors and reviews specialized requests and treatment records such as Treatment Record Forms.
  • In conjunction with providers and facilities, identifies, develops and monitors discharge plans.
  • Collaborates with the Care Coordination Team to implement support for transitions in care.
  • Facilitates timely sharing of enrollees' clinical information (such as previous treatment, medications, and planned care) in order to promote continuity of care.
  • Provides information to enrollees, providers, and internal staff regarding covered and non-covered benefits, community resources, agency programs, and company policies and procedures and criteria.
  • Interacts with Medical Directors and Physician Advisors to provide case information and discuss clinical and authorization questions and concerns regarding specific cases.
  • Assures that case documentation for each decision is complete, including related correspondence.
  • Participates in Care Coordination Team and utilization management activities, including collaboration with other staff on enrollee cases, and performing data collection, tracking, and analysis.
  • Maintains an active work load in accordance with performance standards.
  • Works with community agencies as appropriate.
  • Participates in network development including identification and recruitment of quality providers as needed.
  • Advocates for the enrollee to ensure health care needs are met. Interacts with providers in a professional, respectful manner.
  • Provides coverage of Nurse Line and/or Crisis Line as requested or required for position.

Requirements/Certifications:
  • ** Must have 2 years Utilization post degree clinical experience.
  • License: RN (State and/or Compact State License) Care Management, or LPN, or LCSW or LPC.

For more infomation on this position, please contact our office at 877-782-3334.

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Mon, 09 Jul 2018 00:00:00 CDT 0
<![CDATA[Psych Nurse Practitioner]]>
Responsibilities:
  • Perform Medication Review on a quarterly basis or more often as necessary by the needs of the consumer.
  • Perform Medication Review utilizing contract agency forms and complete forms thoroughly and legibly (or is willing to dictate when necessary).
  • Through discussion with consumer of history and present concerns, evaluate efficacy of current treatment plan as outlined in the psychiatric evaluation.
  • Monitors patient progress by carrying out patient-care services; maintain patient records.
  • Consulting with supervising physician when patient progress does not meet anticipated and/or predetermined criteria; arranging consultations.
  • Must be able to prescribe or adjust medications to assist in controlling symptoms and educate consumers on the effects of the medications, possible side effects, and desired results.
  • Have working knowledge of prescription insurance coverage and, when possible, prescribe medications covered by the consumer's insurance plan.
  • Plan possible medication treatment is not covered, refer to nurse for assistance with prescription coverage.
  • Consult with psychiatrist, case managers, therapists, other treatment providers, and family when appropriate to determine best possible treatment plan.
  • Consult with psychiatrist on a regular basis and provide consumer chart notes for his/her review and signature.
  • Maintain credentials and certifications as required by contract agency and State of Michigan.
  • Improve patient care quality results by studying, evaluating and re-designing processes; implementing changes.
  • Perform Peer Review.

Qualifications:
  • Knowledge of principles and processes for providing customer and personal services.
  • This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
  • Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
  • Knowledge of the structure and content of the English language.
  • Knowledge of principles and procedures for personnel recruitment, selection, training, compensation and benefits, labor relations and negotiation, and personnel information systems.
  • Knowledge of group behavior and dynamics, societal trends and influences, human migrations, ethnicity, cultures and their history and origins.
  • Knowledge of administrative and clerical procedures and systems.
  • Knowledge of relevant equipment, policies, procedures, and strategies to promote effective security operations for the protection of people, data, property, and institutions.

Knowledge of electronic equipment, and computer hardware and software, including applications:
  • Microsoft Office
  • Electronic Medical Record
  • Human Resource E-File
  • Human Resource Management System (HRMS)
  • Ml Bridges (DHS)
  • SOS System

Skills:
  • Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • Talking to others to convey information effectively.
  • Managing one s own time and the time of others.
  • Adjusting actions in relation to others' actions.
  • Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  • Considering the relative costs and benefits of potential actions to choose the most appropriate one.
  • Being aware of others' reactions and understanding why they react as they do.
  • Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.
  • Understanding written sentences and paragraphs in work related documents.
  • Actively looking for ways to help people.
  • Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
  • Determining how a system should work and how changes in conditions, operations, and the environment will affect outcomes.
  • Communicating effectively in writing as appropriate for the needs of the audience.
  • Understanding the implications of new information for both current and future problem-solving and decision-making.

For more information on this position,  please contact  us at 877-782-3334.

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Thu, 28 Jun 2018 00:00:00 CDT 0
<![CDATA[Utilization Management Professional]]> Description:
  • Under general supervision, and in collaboration with Medical Directors and other members of the clinical team, gathers and synthesizes clinical information in order to authorize services.
  • Reviews health care services to determine consistency with contract requirements, coverage policies and evidence-based medical necessity criteria; collects and analyzes utilization information; assists with program processes for transitions across levels of care including discharge planning and ambulatory follow up activity.
  • Serves as an expert resource on coverage policies, covered benefits, and medical necessity criteria.

Essential Functions:
  • Develops and manages new enrollee transitions and those involving a change in provider relationships.
  • Develops and implements transition plans, as indicated, to ensure continuity of care.
  • Reviews planned, in process, or completed health care services to ensure medical necessity and effectiveness according to evidence-based criteria.
  • Proposes alternatives when the requested services do not meet medical necessity criteria or are outside the contracted network.
  • As assigned and based on credentials, monitors and reviews specialized requests and treatment records such as Treatment Record Forms.
  • In conjunction with providers and facilities, identifies, develops and monitors discharge plans. Collaborates with the Care Coordination Team to implement support for transitions in care.
  • Facilitates timely sharing of enrollees, clinical information (such as previous treatment, medications, and planned care) in order to promote continuity of care.
  • Provides information to enrollees, providers, and internal staff regarding covered and non-covered benefits, community resources, agency programs, and company policies and procedures and criteria. Interacts with Medical Directors and Physician Advisors to provide case information and discuss clinical and authorization questions and concerns regarding specific cases.
  • Assures that case documentation for each decision is complete, including related correspondence.
  • Participates in Care Coordination Team and utilization management activities, including collaboration with other staff on enrollee cases, and performing data collection, tracking, and analysis.
  • Maintains an active work load in accordance with performance standards. Works with community agencies as appropriate.
  • Participates in network development including identification and recruitment of quality providers as needed. Advocates for the enrollee to ensure health care needs are met.
  • Interacts with providers in a professional, respectful manner.
  • Provides coverage of Nurse Line and/or Crisis Line as requested or required for position.

Requirements/Certifications:
  • 3 years experience post degree in a clinical setting.
  • Also requires minimum of 3 years of experience conducting utilization management according to medical necessity criteria.
  • Must haves: Utilization Review.
  • Preferred: Managed Long Term Care.
  • *Not Behavioral Health.
  • Able to demonstrate the ability to quickly develop an alliance with providers via telephone. On call coverage of Nurse Line as requested or required of position.
  • Ability to use computer systems.
  • Good organization, time management and verbal and written communication skills. Knowledge of utilization management procedures, Managed long term care.
  • Medicare and Medicaid benefits, community resources and providers. Knowledge and experience in diverse patient care settings including inpatient care.
  • Ability to function independently and as a team member.
  • Additional skills: Knowledge of ICD and DSM IV coding or most current edition.
  • Ability to analyze specific utilization problems and creatively plan and implement solutions.
  • Licensing: RN with New York state license.
  • Degree: Associates.

For more information on this position, please call our office at 877-782-3334.

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Wed, 27 Jun 2018 00:00:00 CDT 0
<![CDATA[Manager, Case Management]]> Description:
  • Perform duties to conduct and manage the day to day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions.
  • Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes.
  • Promote compliance with federal and state regulations and contractual agreements.
  • Develop, implement and maintain compliance with policies and procedures regarding medical case management.
  • Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure.
  • Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries.
  • Develop staff skills and competencies through training and experience.

Education/Experience:
  • Bachelor s degree in Nursing or equivalent experience. 3+ years case management experience and recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics and management experience.
  • Thorough knowledge of case and/or utilization management and clinical nursing. Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP.
  • Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

License/Certification:
  • Unrestricted RN license in applicable state(s) and valid driver's license and automobile insurance.
  • Case Management Certification (CCM) preferred.

For more information on this position, please contact our office at 877-782-3334.

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Wed, 20 Jun 2018 00:00:00 CDT 0
<![CDATA[Nurse Practitioner]]> Description:
  • Nurse Practitioner delivers defined patient care services in a retail clinic environment.
  • You will work in collaboration with a dedicated team of professionals as you independently provide holistic, evidenced based care inclusive of accurate assessment, diagnosis, treatment, management of health problems, health counseling, and disposition planning for our patients ranging in age 18 months and above.
  • Care is documented via computerized electronic health record.
  • This position reports directly to the Senior Practice Manager. 

Duties:
  • Provide patient-centered quality and safety.
  • Accurately, evaluate, treat, provide health counseling, and disposition planning for our patients ranging in age 18 months and above.
  • Educate patients on maintaining proper health.
  • Evaluate, make recommendations, co-manage and treat patients' medical needs for safe and high quality treatment.
  • Document all patient care within an electronic health record according to policies and procedures.
  • Participate in an interdisciplinary team providing care and coordination of our patients with internal and external colleagues including the broader patient centered medical home ensuring the highest level of care is provided for all patients and at all times.
  • Faciliates the development of effective patient centered practice teams.
  • Responds to patient care inquiries throughout the day.
  • Deliver excellent customer service.
  • Seek to increase patient engagement and satisfaction through integration of feedback from patients, management, and professional colleagues.
  • Focus consistently on the patient.
  • Create a warm and welcoming environment.
  • Communicate effectively and adjust communication style to effectively influence quality outcomes and patient needs.
  • Cultivate and maintain all levels of communication.
  • Maintain patient confidentiality at all times.
  • Resolve conflict using appropriate management techiques.
  • Cultivate and maintain positive relationships among practice employees and retail store colleagues.
  • Re-prioritorizes continually throughout the day to fulfill patient and business needs.
  • Manage clinical and non-clinical duties efficiently.
  • Manage multiple demands and needs of clinic operations, patients in the waiting room, and incoming phone calls while maintaining focus and high quality care on the patient in the exam room.
  • Adapt quickly to new models of patient care for clinic efficiency.
  • Assist with hiring, development and evaluation of Practice employees.
  • Enhance operational effectiveness, emphasizing cost containment without jeopardizing important innovation or quality of care.
  • Remain accountable to managing the business including, but not limited to, budget, payroll, inventory, billing insurance, and payment collection.
  • Drive business results through connecting day to day activity achievement to overall business goals.
  • Validate insurance coverage and incorporates knowledge into care plan.
  • Review and supervise internal systems for handling cash, daily reconciliation, deposits, clinic cleanliness and organization.
  • Work independently by being self- motivated, prioritize and solve problems, take initiative, and advocate for their patients and their practice.
  • Actively participate in professional development thru professional groups, committees within the organization and/or additional external experiences.
  • Maintain self awareness and professionalism of individual actions and how they impact the clinic, practice, and healthcare industry.


Experience:
  • Minimum of two years of medically-relevant experience or equivilant.
  • Completed accredited DOT certificate training program prior to start date.
  • Effective verbal, written, and electronic communication skills.
  • Outstanding organizational skills and ability to multi-task.
  • Initiative, problem solving ability, adaptability and flexibility.
  • Ability to work without direct supervision and practice autonomously.


Education:
  • Completion of a: Master's Degree level Family Nurse Practitioner program with current National Board Certification and State of Employment license to practice in the Advanced Practice Nurse role required.
  • Or, in select states, Master's of Science in Physician Assistant Studies (or other health-related Master's Degree in conjunction with Bachelor s of Science in Physician Assistant Studies) with current National Board Certification and State of Employment license to practice in the role required.

For more information on  this position, please call us at 877-782-3334.

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Mon, 04 Jun 2018 00:00:00 CDT 0
<![CDATA[UAS Assessor - RN]]> Description:
  • Responsible for the completion of UAS Initial Assessments and Reassessments based on NY State requirements and guidelines and training provided by client and/or outside resources.
  • Enrollment paperwork materials required to appropriately process consumer s application for enrollment.
  • UAS Tasking Tool based on guidelines and training provider by client and/or outside resources.
  • Responsible for correction and revision of UAS, paperwork, and tasking tool documentation based on review and feedback provided through quality and associated review processes.


Essential Functions:
  • Complete UAS Initial and/or Reassessment documentation, enrollment paperwork, and tasking tool in the consumer s home.
  • Attend training and continuing education sessions and lessons focused on the proper completion of UAS documentation, enrollment paperwork, and tasking tool.
  • Focus on continuous improvement and quality excellence in the completion of all material associated with the initial enrollment/continued enrollment of consumers as members in the plan.
  • Supports initiatives of the Quality Assessment and Performance Improvement Committee.
  • All other duties as assigned.

Requirements/Certifications:
  • Bilingual preferred (Spanish or Chinese languages) but not required.
  • Minimum 3 years clinical experience with focus in UAS Assessment.
  • UAS Assessor experience is required.


Hours:
  • The position is M-F with the typical hours of 9am - 5pm; however there is some flexibility with the hours.

Education:
  • Degree: Associates Nursing.
  • Licensing: RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt.
  • CCM - Certified Case Manager - Care Mgmt (preferred).
  • CCP - Chronic Care Professional - Care Mgmt (preferred).

Additional skills/experience:
  • Understands and is able to apply principals of Care Management and Person Centered Service Planning.
  • Is able to understand and apply coverage guidelines and benefit limitations.
  • Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses (depression, challenging behaviors, Alzheimer s disease and other disease-related dementias).
  • Understands and adapts appropriately to issues related to communication, cognitive or other barriers.

For more information about this position, please contact us at 877-782-3334.

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Thu, 31 May 2018 00:00:00 CDT 0
<![CDATA[Recruiting Assistant]]> A-Line Staffing Solutions is a recruiting and staffing company that specializes in placing Healthcare, IT and Professional/Administrative candidates.

We are hiring internally due to our growing client base and brand-new facility in downtown Utica!

Currently seeking Recruiting Assistants to join our team!

Pay: $13 per hour

Hours:
8: 00am - 5: 00pm Monday - Friday

Job Description:
  • Entry-Level Position! Room for Growth!
  • The position is designed for high-energy, motivated individuals with little to no recruiting experience!
  • Learn to perform Full-Cycle Recruiting for our Healthcare Clients.
  • Post Job Postings to various job boards
  • Outbound calls to prospective candidates on the job boards
  • Communicate with candidates regarding job details / screening
  • Scheduling interviews and preparing candidate for success prior to interview
  • Maintain good relationship with all candidates, employees and corporate clients
  • Assist candidate and HR with on-boarding of new employees to ensure that all documents are completed
  • Performs other duties as assigned

Requirements:
  • Must be dependable, flexible, and exhibit outstanding customer service and interpersonal communication skills
  • Ability to handle sensitive and confidential personnel matters
  • Excellent at multi-tasking and quickly switching gears (required)
  • Typing speed of at least 40 wpm
  • Working knowledge of MS Office applications (Windows 7, Word, Excel, PowerPoint, Outlook)
  • High School Diploma/GED required

Additional Great Benefits to A-Line Staffing Solutions:
  • Health, Dental, Vision, and Life Insurance available on day 91
  • 401K with company match available
  • Paid Holidays
  • Competitive PTO

Interested? Apply to this job posting right away for immediate consideration or call our office at  877-782-3334.

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Fri, 18 May 2018 00:00:00 CDT 0
<![CDATA[LTSS Provider Network Performance Manager]]> Position Purpose:
  • Develop, manage and support high performing provider network performance for Medicaid Long Term Services and Supports (LTSS) including metrics, improvements, including analytics, reporting, training and education.
  • Leverage various tools and solutions to support effective provider engagement activities.
  • Collaborate with health plan leaders and LTSS product leaders to review LTSS network performance, including quality, cost, care gaps, and risk adjustment gaps, and develop improvement plans.
  • Determine analytic reporting needs and provide training and support on network performance applications and reporting tools.
  • Lead provider profiling and network performance analytic support functions and provide support to health plans and other stakeholders.
  • Monitor and measure provider Health Benefits Ratio (HBR), quality, unit cost and utilization trends and identify and implement network improvement opportunities.
  • Support existing application tools and solutions, identify and recommend technical enhancements to improve outcomes and functionality.

Qualifications:
  • Bachelor s degree in Business, Economics, Finance, Healthcare or related field or equivalent experience.
  • 4+ years of contracting, health care reimbursement, provider contract modeling or quality measurement experience.
  • Prior experience building and managing relationships with health care providers preferred.


For more information about this position, please contact us at 877-782-3334.

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Mon, 07 May 2018 00:00:00 CDT 0
<![CDATA[Pharmacy Technician]]> Description:
  • Seeking  a full-time Pharmacy Technician Lead to support our clients local pharmacy.
  • The lead pharmacy technician holds a leadership position in which they must provide guidance and instructions to other pharmacy technicians.
  • The schedule for this position is 9: 00 am to 6: 00 pm M-F (Saturday hours are optional).

Duties & Responsibilities:
  • Create bills and medicine labels.
  • Maintain inventory and track restocking.
  • Whenever discrepancies are noted, the pharmacy technician must notify the pharmacist immediately.
  • Under direct supervision of the registered pharmacist fills compounds and prescription orders and makes them available for verification by the Pharmacist.
  • Once verified by the pharmacist, dispenses the prescriptions.
  • Order, receive and store incoming pharmacy supplies.
  • Receive and process wholesaler medication orders.
  • Verify medication stock and enter data in computer to maintain inventory records.
  • Help maintain a clean organized work environment.
  • Perform various clerical duties as needed.
  • Work with the pharmacist to assist in the pharmacy functions and keeping the pharmacy in compliance with all federal and state requirements.
  • Occasional medication delivery to consumers.
  • Provide exceptional customer service.
  • Other Duties as assigned.

Qualifications:
  • Must be a  Michigan licensed/registered Pharmacy Technician (CPhT).
  • Two years of retail Pharmacy Technician experience is highly preferred.
  • Candidates for the position will be subject to a standard reference, background check and drug screening.
  • Knowledge of Microsoft Office and telephone protocol.
  • Professional verbal and written communication skills.

For more information, please contact us at 877-782-3334.

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Fri, 04 May 2018 00:00:00 CDT 0
<![CDATA[Risk Adjustment Analyst]]>
Position Purpose:
  • Responsible for advanced and predictive data analytics using big data and data science technology for healthcare innovation and outcomes.
  • Perform analysis using data science techniques on structured and unstructured data sets, and develop algorithms for Risk Adjustment.


Position Responsibilities:
  • Design, develop and maintain risk adjustment data models.
  • Prepare risk score projections to estimate future payments.
  • Researches and reports on relevant regulatory and process changes impacting risk adjustment and financial performance.
  • Tracks and monitors encounter data submissions and supplemental information to state and federal systems.
  • Manage relationship and oversight of various risk adjustment vendors.
  • Design and construct analysis tools that extract, and analyze data and store analytical results in an appropriate format for business needs.
  • Conduct exploratory data analysis from complex data sources and build key data sets to support company's mission.
  • Evaluate and design experiments to monitor key metrics and identify improvement opportunities.
  • Develop mathematical and statistical models to distinguish relevant content or events and recognize patterns.
  • Participate in presentations and communicate results of analysis and findings.
  • Participate in the design of automated, operational analytics processes to achieve scale and durability of analysis processes.
  • Validate and measure the outcomes of health management programs using SAS, R and other tools, to include provider data, claims data, membership data.
  • Manage multiple projects as assigned.
  • Assist with training Data Analysts.

 

Qualifications:
  • Master's degree in Statistics, Mathematics, Computer Science, Informatics, Econometrics, Engineering, Experimental Science with 3+ years of experience or Bachelor s degree and 5+ years of quantitative analysis experience in data science capabilities including data mining, predictive modeling, machine learning, statistical modeling, large scale data acquisition, transformation, and structured and unstructured data analysis.
  • Experience with database technologies, including Oracle, SAP, DB2, Teradata, MS SQL Server, SAP HANA, MySQL.
  • Healthcare & Risk Adjustment experience strongly preferred.
  • SAS and Micro Strategy experience preferred.

For more information on this position, please call 877-782-3334.

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Wed, 02 May 2018 00:00:00 CDT 0
<![CDATA[Business Analyst]]> Duties:
  • Support existing PMO solutions.
  • Work with Senior leadership to understand portfolio and reporting needs within Enterprise Analytics.
  • Partner with teams to understand pain points of current intake system and help optimize new system to meet demands of end users and provide value to the business.
  • Develop and build out new structure for Enterprise Analytics PMO intake system.
  • Develop and maintain project reporting (ex: KPIs, executive reporting, etc).
  • Create and implement trainings with colleagues across the department to gain better understanding on newly built tools.


Experience:
  • A minimum of 3 years of strong technical experience in SharePoint 2013 or SharePoint 2016, SharePoint Developer, and familiarity with Nintex.
  • 1+ years of experience with Tableau (both user and developer).
  • Outstanding process and project management skills, including coordinating activities across diverse departments and ensure that contributions across different teams are lined and integrated as part of overall delivery.
  • 1+ years experience in building and supporting complex applications.
  • 1+ years experience in software design guidance including architecture, performance, re-usability and maintenance considerations.

 

Preferred Qualifications:
  • Ability to communicate and facilitate discussion with business leaders within the organization.
  • Ability to work with a high degree of accuracy and attention to detail.
  • Ability to work in a fast paced environment both independently and in a team setting.
  • Strong organizational skills and ability to work on multiple projects.
  • Understanding of data management and reporting tools and applications.
  • Excellent written and oral communication skills, ability to interact with and influence decision-making by non-analytical business audiences.
  • Creative problem solver, flexible, proactive and ability to work in a fast paced, ever changing environment.
  • Experience with programming concepts, procedures and practices.
  • Excellent analytical ability.

Education:
  • Bachelor's degree in Computer Science or equivalent work experience required.

Hours:
  •   Mon- Fri 8: 30- 5: 00.

For more information, please contact us at 877-782-3334.

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Wed, 02 May 2018 00:00:00 CDT 0
<![CDATA[Pharmacy Technician]]>
SUMMARY:

Under the direction of a pharmacist, a pharmacy technician's primary job is to receive and fill prescription requests for patients. These prescription requests can come from hospitals, physicians, nurses, directly from the patient or internal referral.


DUTIES AND RESPONSIBILITIES 
  • Retrieving prescription orders.
  • Counting, pouring, measuring and weighing tablets and medications.
  • Selecting the proper prescription container.
  • Creating prescription labels.
  • Making outbound refill notification calls or text messages.
  • Handling pre-authorizations as necessary.
  • Maintaining patient profiles.
  • Handling patient co-pay.
  • Answering phones in a professional manner.
  • Taking inventory.
  • Being aware of the latest medicines and their availability.
  • All other duties as assigned by supervisor.

    QUALIFICATIONS:
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
  • The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Must be able to use good and sound judgment.
  • Must be able to document accurately and appropriately.
  • Must follow up as needed and appropriately with doctor s office, HLMS customer service    and  management staff pertaining to any concerns regarding patient care.
  • Demonstrates patience, flexibility and a cooperative attitude.
  • Able to provide excellent customer service.
  • Able to effectively manage concurrent demands and multi-task.
  • Detail orientated.
  • Proficient in Microsoft Office suite.

    EDUCATION and/or EXPERIENCE:
  • High school diploma or equivalent.
  • Minimum of one (1) year of experience in a retail pharmacy setting.
  • Minimum of one (1) three (3) years of experience in a customer service capacity.
  • Experience with QS1 software programs is preferred.

CERTIFICATES, LICENSES, REGISTRATIONS:
  • Must have and maintain in good standing a full, valid professional license and certification as required by the state of Michigan. Should have a valid Michigan Driver s License.

PHYSICAL DEMANDS:
  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
  • The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

For more information, call 877-782-3334

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Fri, 06 Apr 2018 00:00:00 CDT 0
<![CDATA[Hardware Controls Designer]]> Job Description

Client is seeking an experienced hardware controls designer. This position will be responsible for industrial controls systems design; under the supervision of the assigned Controls Engineer. Must have proven experience in PLC and / or Servo system design with any of the following hardware systems: Bosch Rexroth, Rockwell, Modicon, GE Fanuc, Siemens, Mitsubishi, Omron, etc.

Responsibilities
  • Panel design and layout, bill of materials, and wiring schematic capabilities are expected with this position.
  • This designer must be able to work with minimal supervision and perform all required normal engineering calculations associated with this type of hardware design.
  • All designs will normally be done using AutoCAD.

Skills/Experience
  • E-Plan experience would be an added benefit
  • The ideal candidate will have a proven track record in engineering design as well as the ability to implement standard engineering practices, and provide detailed documentation upon project completion.
  • A minimum of 3 years experience in a similar position is required.
  • Experience in Automotive, Food Processing, or Water/Wastewater industries is a plus.

Attractive compensation package including:
  • Health insurance
  • Dental insurance
  • Vision insurance
  • Life insurance
  • Short and Long Term disability insurance
  • 401k
  • Paid holidays
  • Paid PTO

For more information, contact us at 877-782-3334.

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Thu, 05 Apr 2018 00:00:00 CDT 0
<![CDATA[RN Home Health]]>

Job Description:
  • RN will be providing skilled visits to patients in their homes.
  • RN will be expected to provide 5-6 visits daily.

Responsibilities:
  • RN will be responsible for setting up schedule with patients.
  • RN will be responsible for obtaining documentation.
  • RN will conduct assessments, resumptions, wound care visits etc.

Qualifications:
  • Must have an active RN license in the state of Michigan.
  • Must have Home Health experience.
  • Must be willing to travel.
  • Must have reliable transportation.
  • Must have Auto Insurance.

For more information, please contact  our office  at 877-782-3334.

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Wed, 21 Feb 2018 00:00:00 CST 0
<![CDATA[Psychiatrist]]> Job Description:
  • Doctor will see patients, review charts & sign off at  1-2 nursing homes per day (all near one another)
  • Psych evals, Med Reviews and History of Illness
  • Psychiatrist will be provided a scribe or transcription service and a Clinical Assistant for charting & all paperwork.

Requirements:
  • BE / BC (Board Eligible or Board Certified)
  • Psychiatrist to travel to Nursing Homes in Grand Rapids, Hudsonville, Kalamazoo and surrounding cities.

For more information, please contact our office at 877-782-3334.

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Thu, 01 Feb 2018 00:00:00 CST 0
<![CDATA[Case Manager]]> Top Skills:
  • 2-4 years of clinical experience in a hospital or other acute care setting.
  • Knowledge/experience with case management and disease management principles, discharge planning & chronic diseases
  • Strong knowledge/experience with computers, typing and Microsoft Office programs (Word, Excel, Outlook)

Job Details:
  • Utilizing a collaborative process, the case manager will assess, plan, implement, coordinate, monitor, evaluate and advocate the options and services required to meet an individual s health needs, using communication and available resources to promote quality, cost effective outcomes. The case manager helps identify appropriate providers and facilities throughout the continuum of services while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source.
  • Assessment - The case manager will collect in-depth information about a person s situation and functioning to identify individual needs in order to develop a comprehensive case management plan that will address those needs.
  • Planning - The case manager will determine specific objectives, goals and actions as identified through the assessment process. The treatment plan is developed in collaboration with the member/authorized representative, treating physician, medical consultant, and, if appropriate, the social worker and keeping all parties informed of the treatment plan progress. The treatment plan should be action oriented and time specific.
  • Implementation - The case manager will execute specific intervention that will lead to accomplishing the goals established in the case management plan.
  • Coordination - The case manager will organize, integrate and modify the resources necessary to accomplish the goals established in the case management plan. Identify and coordinate services so that the member s health care needs are met across the continuum of care using the most effective means available.
  • Monitoring - The case manager will gather sufficient information from all relevant sources in order to determine the effectiveness of the case management plan.
  • The case manager will act as the liaison between the member/authorized representative and the facility, provider, and/or client management team through regular contact and collaboration with the member and provider(s) contacting the member/authorized representative on a regular basis
  • Evaluation - At appropriate and repeated intervals, the case manager will determine the plan s effectiveness in reaching desired outcomes and goals. This process might lead to a modification or change in the case management plan in its entirety or in any of its component parts.
  • Advocate - The case manager will advocate on behalf of the member/authorized representative.
  • Conducting a thorough and objective evaluation of the patient s current status including physical, psychological, environmental, financial, and health status expectation.
  • As a patient advocate, seek authorization for case management from the recipient of services (or designer)
  • Assessing resource utilization and cost management; the diagnosis, past and present treatment; prognosis, goals (short and long term).
  • Identifying opportunities for intervention.
  • Assisting members in meeting and managing both health care and quality needs
  • Setting goals and time frames for goals appropriate to the individual.
  • Identifying quality of care and savings opportunities, negotiating with providers when needed, facilitating the use of appropriate extra-and-contractual benefits, and providing the member with information or links to community, state, and/or federal resources.
  • Maintaining communications and collaborating with patient, family, physicians and health team members and payer representatives.
  • Comparing the patient s disease course to established pathways to determine variances and then intervene as indicated.
  • Introducing, assessing, opening, managing, closing assigned cases with guidance from the POD leader and physician consultant.
  • Routinely assessing patient s status and progress; if progress is static or regressive, determines reason and proactively encourages appropriate adjustments in the care plan, providers and/or services to promote better outcomes.
  • The case manager will document patient profile updates, discuss cases with POD leaders, and schedule case reviews with the physician consultants on a routine basis.
  • Establishing measurable goals which promotes evaluation of the cost and quality outcomes of the care provider.

  • Reporting quantifiable impact, quality of care and/or quality of life improvements as measured against the case management goals.

Education and/or Experience:
  • Registered Nurse with current Michigan License required
  • Nursing Diploma or Associates Degree in Nursing
  • Bachelor s degree in Nursing or related fields (preferred)
  • CCM certification (preferred). If not certified upon hire, encouraged to become CCM certified within four (4) years of functioning in a case management role
  • Certification in Chronic Care Professional (preferred)
  • Two (2) years full time equivalent of direct clinical care to the consumer
  • Two (2) to four (4) years of clinical experience preferably in Case Management or Home Health Care with a Medical/Surgical background
  • One (1) to three (3) years experience with client (preferred)
  • Working knowledge of Case Management principles and procedures based on nationally recognized standards of Case Management

For more information, please call our office at 877-782-3334.
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Mon, 22 Jan 2018 00:00:00 CST 0