Contract May 24, 2024 Healthcare Bilingual candidates are encouraged to apply!
Involved in the development, presentation and delivery of community outreach initiatives, activities and market strategies to support the Medicaid business and drive membership retention and growth.
Must be an Indiana resident who resides in or near County, Indiana, willing to travel throughout southern Indiana
Conduct outreach activities for community members that are Aged, Blind, and Disabled
Collaborate with local agencies and medical providers that serve the HCC and PathWays populations
Educate and network with people of diverse backgrounds and cultures
Report feedback from the field to further develop and enhance UHCCP programming
Minimum Qualification, Training, and Experience:
Five or more years of education and/or experience in the health services field, with a preference for a candidate who is a
Certified Community Health Worker preferred
Valid Indiana driver’s license required
Reliable transportation required
Travel up to 75% of the time within assigned territory
Willing to work a flexible 40-hour week, including evenings and weekends
Able to transport, lift, carry and set up promotional materials
Smartphone capable of installing Microsoft Office, Zoom, SalesForce, Google Drive, Slack and others, as necessary
Basic computer skills and knowledge of office programs, with the ability to learn new ones
Experience in outreach and linking the community to local resources
Able to deliver presentations and conduct meetings
Flexible to adjust job responsibilities as the position evolves
No fields configured
Contract May 24, 2024 Healthcare Job Title: Clinical Administrative Coordinator
Location: Indiana (Remote)
Pay: $24hr (Paid Weekly)
Benefits: 8 paid holidays; 80hrs of PTO (after 60 days of employment); Optional Medical, Dental, Vision
Hours: Ability to work any of our 8-hour shift schedules during normal business hours of 8:00am – 8:00pm EST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime
Primary Responsibilities:
• Manage administrative intake of members
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
• Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
• Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
Required Qualifications:
• High School Diploma / GED
• Must be 18 years of age or older
• 2+ years of customer service experience
• Experience with Microsoft Word, Excel (create, edit, save documents and spreadsheets) and Outlook (email and calendar management)
Preferred Qualifications:
• Experience working in a call center
• Clerical or administrative support background
• Bilingual fluency in English/Spanish
• Experience working in a hospital, physician’s office or medical clinic setting
• Experience working within the health care Industry and with health care insurance
Remote Requirements:
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive high-speed internet connection or leverage an existing high-speed internet service.
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Direct Hire May 24, 2024 Other Area(s)
POSITION TITLE:
Director of Admissions & Enrollment
DIVISION:
Strategy, Innovation & Outreach
DEPARTMENT:
Admissions
CLASSIFICATION:
Full-time; Exempt
POSITION DESCRIPTION
OCCUPATIONAL SUMMARY
Reporting to the Associate Vice President of Enrollment Services, the Director of Admissions & Enrollment is responsible for providing effective planning and vision, comprehensive leadership, program development, budget oversight, data analysis, and institutional coordination for Enrollment Management. The Director of Admissions & Enrollment will oversee the admissions team and establish programs for target recruitment and promoting our undergraduate and graduate program to potential students. The Director will work closely and collaboratively with university leadership to achieve a strategic, student-centered approach to student services in support of the University’s mission.
This position does supervise others.
ESSENTIAL JOB FUNCTIONS
Provides leadership, supervision, and direction for personnel assigned to the Department and related programs, including, but not limited to, new student enrollment, student success initiatives including retention, student activities, student records, and related programs.
Develops, implements, and provides support for new student enrollment, oversees new student admissions, student success initiatives, retention, student activities programs, and student records.
Devises innovative strategies, policies and/or programs for goal attainment and process improvements to reach stated objectives.
Oversees the admissions process, including application review, decision-making, and enrollment forecasting.
Analyzing enrollment trends and data to inform decision-making and optimize recruitment efforts.
Developing and maintaining relationships with high schools, community colleges, and other organizations to facilitate recruitment pipelines.
Creates and maintains policies and procedures for programmatic areas.
Works closely with the academic affairs departments to develop and provide student enrollment initiatives, student success initiatives including retention activities, and student activities events.
Participates in program planning in collaboration with the academic affairs departments.
Regularly assesses program functions to assure compliance within operating rules, regulations, policies and procedures; advises supervisor promptly of any programmatic irregularities.
Operates effectively within established budgetary guidelines.
Assures the management and integrity of all Admissions data in compliance with all applicable state and federal laws, rules, and regulations.
Prepares required reports; analyzes data to determine student progress, enrollment trends, labor market information, and related data to draw conclusions and/or make recommendations for process improvement within the department.
Develops relationships and maintains effective communications with diverse groups, internal and external, in support of the institution’s mission.
Collaborates with the institution’s Marketing Department to develop integrated marketing and strategic planning efforts on Admissions initiatives, progress, and outcomes to promote and manage the institution’s image; represents the institution at functions upon request.
ESSENTIAL JOB FUNCTIONS continued:
Serves on administrative committees as assigned.
Directs various personnel functions, including hiring, performance management, employment development, promotions, transfers, leave administration, and the employee relations process in coordination with the Office of Human Resources.
Performs other duties as required.
MINIMUM REQUIREMENTS
Bachelor’s degree from an accredited college or university in business management, marketing, and sales.
Work experience related to student admissions and enrollment, marketing/sales, or similar area.
Knowledge of trends and developments in student testing, admissions and enrollment and demonstrated commitment to higher education.
Proficiency in the use of research, statistical analysis and information technologies.
Ability to relate effectively with multiple constituencies.
Exceptional interpersonal, teambuilding and problem-solving skills.
Working knowledge of Microsoft Office and other standard computer software programs.
Excellent written and oral communication skills.
Ability to deal effectively with a diverse student body.
Collaborate with other departments to support enrollment marketing and retention priorities.
Analyze and use relevant data and trends in planning, decision-making, and management.
The intent of this position description is to provide a representative level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Direct Hire May 24, 2024 Accounting
POSITION TITLE:
Student Accounts Specialist
DIVISION:
Finance & Administration
DEPARTMENT:
Student Accounts
CLASSIFICATION:
Full-time; Exempt
POSITION DESCRIPTION
OCCUPATIONAL SUMMARY
The Student Accounts Specialist reports to the CFO & Executive Vice President of Finance &
Administration. The Student Accounts Specialist is responsible for daily administration of the
University’s accounts receivable, and the accuracy of charges, credits, payments, and refunds entered in the billing system. The Student Accounts Specialist works closely with the Financial Aid Department & the Business office for the reconciliation of the aid applied to students’ accounts. The Student Accounts Specialist works closely and collaboratively with the university leadership to achieve a strategic, studentcentered approach to student accounts management.
This position does not supervise others.
ESSENTIAL JOB FUNCTIONS
Maintains and manages student financial accounts in compliance with federal and state regulations and audit compliance guidelines, including posting and disbursement of funds as appropriate.
Oversees disbursement policies and ensures adherence to the appropriate regulatory requirements associated with the disbursement of financial aid funds.
Oversees upgrades to the institution’s Comprehensive Academic Management Reporting Systems for student accounts.
Oversees financial clearance for students to register.
Prepares payment plans as needed and oversees related payment plans.
Directs invoices and collection of funds for student payment of tuition, books, and fees through government and external funding sources.
Manages the drawdown and reconciliation of financial aid funds.
Create journal entries for recording deposits to the University accounts and monthly reconciliation of both Direct Loan, Pell, and State Aid.
Manages the return of financial aid funds and repayments for student withdrawals from the institution.
Devises innovative strategies, policies, and/or programs to attain goals and improve processes to reach department objectives.
Regularly assesses program functions to assure compliance with operating rules, regulations, policies, and procedures; advises supervisor promptly of any problematic irregularities.
Assures the management and integrity of all student account data in compliance with all applicable state and federal laws, rules, and regulations.
Oversees and maintains VA external funding, including billing and application to student accounts.
Maintains VA documents under the guidance of US regulations.
Works with external audits to finance, financial aid and VA funds.
ESSENTIAL JOB FUNCTIONS continued:
Assist with other accounting and finance functions within the Business Office.
Operates effectively within established budgetary guidelines and prepares required reports.
Develops relationships and maintains effective communications with diverse groups, internal and external, in support of the institution’s mission.
Represents institution at functions upon request.
Serves on administrative committees as assigned.
Performs other duties as required.
MINIMUM REQUIREMENTS
Bachelor’s degree from an accredited college or university in business, accounting, or related field.
Minimum 3-5 years of experience in financial management roles.
Strong understanding of accounting and financial management principles and practices.
Strong leadership skills and the ability to coordinate with other student offices to support institutional goals.
Demonstrated commitment to higher education.
Impeccable judgment and integrity.
Ability to manage confidential information.
Proficiency in the use of research, statistical analysis and information technologies.
Ability to relate effectively with multiple constituencies.
Exceptional interpersonal and problem-solving.
Exceptional knowledge of budget forecasting, preparation, and administration.
The intent of this position description is to provide a representative level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Direct Hire May 24, 2024 Administrative
POSITION TITLE:
Registrar
DIVISION:
Strategy, Innovation & Outreach
DEPARTMENT:
Registrar’s Office
CLASSIFICATION:
Full-time; Exempt
POSITION DESCRIPTION
OCCUPATIONAL SUMMARY
Reporting to the Associate Vice President of Enrollment Services, the Registrar provides leadership and oversight to all aspects of the Office of the Registrar. The Registrar plays a critical role in the University and Academic operations by effectively managing the maintenance and integrity of all students’ academic records, the approved curriculum, the creation and maintenance of course schedules, all areas of student registration. The registrar functions to achieve a strategic, student-centered approach to registrar activities and student records in support of the University’s mission and to integrate student registrar activities with the academic programs of the University.
This position does not supervise others.
ESSENTIAL JOB FUNCTIONS
Supervises the registration of continuing and incoming undergraduate students, transfer of credits, and degree evaluations;
The Registrar ensures the integrity, accuracy, and security of all academic records of current and former students, and facilitates an effective student registration process.
Partner with Admissions and Academic Advising to facilitate an efficient and timely process to move newly accepted students to register.
Manages an efficient transcript evaluation and processing.
Developing and maintaining degree audit system and certification of students for graduation/graduation clearance.
Maintains up-to-date course schedules, catalogs, final examination schedules.
Manages efficient use of classrooms.
Interprets and enforces academic policies and regulations of the University.
Must keep abreast of operational and reporting trends, regulations, and technology solutions for improving the efficiency and effectiveness of the Registrar's office.
Serves as of the officials responsible for FERPA compliance for the University.
Develop and maintain accurate curriculum management systems and published in the University Catalog.
Interprets and applies college policies and regulations related to Registrar services, including but not limited to explaining, implementing, interpreting, and enforcing academic policies of the University’s undergraduate and graduate faculties.
Maintains all official academic records of the University, and disseminates academic regulations and information to the University community.
Directs plans and coordinates registration procedures and graduation ceremonies, oversees the scheduling of courses, and provides data and reports.
Establishes and enforces registration policies and procedures for all University courses.
Works cooperatively with the Associate Vice President of Enrollment Services to ensure accurate student enrollment reporting to government agencies.
ESSENTIAL JOB FUNCTIONS continued:
Prepares required reports; analyzes date to determine student registration status, and to draw conclusions and/or make recommendations for process improvement.
Develops relationships and maintains effective communications with diverse groups, internal and external, in support of the institution’s mission.
Operates effectively within established budgetary guidelines.
Serves on administrative committees as assigned.
Performs other duties as assigned.
MINIMUM REQUIREMENTS
Master’s degree in student services, educational administration, educational leadership or a related degree, from an accredited college or university preferred.
Must have experience working with Student Information Systems, development of reports and regulations.
Minimum of two years of work experience at the assistant registrar level or higher preferred.
Proficiency in the use of research, statistical analysis and information technologies.
Impeccable judgment and integrity.
Ability to manage confidential information.
Ability to relate effectively with multiple constituencies.
Exceptional interpersonal, teambuilding and problem-solving skills.
Working knowledge of Microsoft Office and other standard computer software programs.
Excellent written and oral communication
The intent of this position description is to provide a representative level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Direct Hire May 24, 2024 Other Area(s)
POSITION TITLE:
Vice President of Advancement
DIVISION:
Office of the President
DEPARTMENT:
Advancement Office
CLASSIFICATION:
Full-time; Exempt
POSITION DESCRIPTION
OCCUPATIONAL SUMMARY
The Vice President for Advancement is responsible directly to the President for developing, managing, and sustaining all campus development functions including fundraising, alumni and donor relations, stewardship, and donor relations systems.
The Vice President will be a member of the President’s cabinet with the purpose of providing leadership that aligns with the University’s vision, mission, and core values. This position will work closely with executive leadership to establish strategies coordinated with institution-wide efforts in key areas of focus that align with the university’s strategic plan and priorities.
Major Responsibilities:
FUNDRAISING
Develops, implements, and evaluates fundraising plans and strategies to increase philanthropic support of Martin University.
Solicits individuals, corporations, foundations and organizations for annual, major, and planned gifts towards annually determined goals to meet the strategic priorities of Martin University.
Plans, coordinates, and executes the advancement of relationships with prospective donors through appropriate stages of the donor cycle (identification, qualification, cultivation, solicitation, and stewardship).
Establishes annual and campaign fundraising goals, budgets and implementation plans, based on the needs of the university.
Collaborates with internal and external partners to identify opportunities to develop and submit funding proposals in support of university initiatives.
Identifies opportunities to involve campus staff in order to enhance fundraising efforts.
STEWARDSHIP AND ALUMNI AND DONOR RELATIONS
Provides stewardship of gifts including the acknowledgement process, coordinating recognition events, dedications, naming opportunities, and endowment reports, in coordination with the Systems Office Foundation staff.
Ensures all donors receive appropriate and timely follow-up after making a gift commitment.
Assists in developing plans to appropriately record, manage and spend contributions in accordance with donor intent.
Develops and implements communication strategies in conjunction with the Marketing and Communications Department to inform internal and external constituencies (including alumni) about the university plans, progress, and overall development.
Plans, hosts and/or attends development-related receptions and events.
Provides reports, data analysis and/or impact stories for donors, board meetings, campaign needs and campus leadership.
DEVELOPMENT PLANNING AND ADMINISTRATION
Supervises the maintenance of database information on donors and prospects, fund balances and fundraising activities.
Ensures effective records maintenance, including recording new proposals and tracking their status and recording action reports in a timely manner, using the Foundation’s prospect management system.
Plans and implements a comprehensive calendar of development events, programs, communications, stewardship, and solicitations to correspond with campus goals and needs, and coordinate with overall statewide Foundation efforts and strategic plan.
Reports regularly on the progress toward annual goals and action plans.
Assists in the development of coordinated fundraising materials, campaigns, themes and projects with campus and Systems Office staff.
Represents the University at community events and through community organizations in order to identify new avenues of philanthropic support.
GENERAL
As a member of the President’s cabinet:
Assures assessment of functional area needs, investigates and develops alternative strategies, establishes priorities and goals, recommends implementation activities, and evaluates progress.
Oversees the development and administration of budgets and determines priorities for expenditures.
Serving as a model for strong leadership by being student- and employee-centered.
Builds and sustains a process-managed organization and culture that delivers measurable value for the organization targeting efficiency and cost optimization in functional areas.
Collaborates with other cabinet members to implement the university’s strategic plan. Executes strategic initiatives and resource allocation at a local level to achieve university-wide metrics.
Continually improves professional competency through participation and/or leadership in professional and other not-for-profit organizations.
Minimum Qualifications:
Bachelor’s degree required. Master’s degree preferred.
CFRE or equivalent professional credential is preferred (commitment to attainment of CFRE or other appropriate credentials expected).
Five years of progressive development or similar experience, preferably in higher education or with a not-for-profit organization.
Working knowledge of principles of philanthropy and fundraising, including annual and major gift campaigns, special events, and planned giving.
Capability to build partnerships with internal and external groups for the overall success of the university.
Excellent planning, supervisory and evaluation skills.
Results-oriented and proven track record of accomplishing goals.
Self-starter and team player.
High ethical standards for fundraising and donor relations.
Demonstrated ability to exercise confidentiality with information and financial transactions.
Willingness and ability to perform some evening and weekend work.
Must have excellent written and oral communication skills.
Proven ability to identify key issues and to carry forward an idea or project from conception to execution.
Good judgment, discretion, tact and the ability to work easily with senior leaders within the higher education, charitable, government, and business sectors.
The intent of this position description is to provide a representative level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Direct Hire May 24, 2024 Other Area(s)
POSITION TITLE:
Financial Aid Counselor
DIVISION:
Strategy, Innovation, and Outreach Division
DEPARTMENT:
Financial Aid
CLASSIFICATION:
Full-time; Exempt
POSITION DESCRIPTION
OCCUPATIONAL SUMMARY
Reporting to the Associate Vice President of Enrollment Services, the Financial Aid Counselor is responsible for evaluating the financial needs of students from a variety of sources including documentation of financial status and personal interviews. Assist with coordination and supports activities for Financial Aid, to achieve a strategic, student-centered approach to financial aid activities in support of the University’s mission and to integrate student financial accounts with the academic programs of the University.
This position does not supervise others.
ESSENTIAL JOB FUNCTIONS
Counsels and advises students about financial aid eligibility, application procedures, aid programs, costs, indebtedness, money and management and financial planning; individualizes information to their specific need and situation of the student.
Adheres to quality compliance auditing.
Interprets and applies federal laws and regulations, college policies and regulations and state regulations relating to the disbursement of student financial aid funds and disbursement checks.
Coordinates Federal Work Study Program with the Assistant Financial Aid Director.
Directs Students in completing the FAFSA application, FSAID, Entrance/Exit Counseling, MPN (Master Promissory Note) & completing the Default Management Form.
Processes State Grants, Freedom of Choice and 21st Century awards.
Regularly assesses program functions to assure compliance within operating rules, regulations, policies and procedures; advises supervisor promptly of any programmatic irregularities.
Assures the integrity of all student accounts data in compliance with all applicable state and federal laws, rules, and regulations.
Assists with exploring program options and devising innovative strategies, policies and/or programs for goal attainment and process improvements to reach Financial Aid goals and objectives.
Answers questions, inquiries, or requests from students, parents, or guardians in person or writing regarding financial aid programs and eligibility.
Prepares required reports.
Develops relationships and maintains effective communications with diverse groups, internal and external, in support of the institution’s mission.
Implements or assists in the implementation of new projects related to system conversions and federal, state regulations or institutional policy and other Financial Aid functions.
Verifies student and parent’s data to assure compliance and eligibility of students receiving aid under federal and institutional guidelines; notifies students of changes in eligibility of awards and alternatives to amend the situation.
ESSENTIAL JOB FUNCTIONS continued:
Assists with students, employers, outside agencies and/or staff to resolve financial aid issues.
Responsible for assisting Quality Control monitoring of financial aid files.
Operates effectively within established budgetary guidelines.
Represents institution at functions upon request.
Serves on administrative committees as assigned.
Performs other duties as required.
MINIMUM REQUIREMENTS
Bachelor’s degree in Business, Public Administration, Humanities or related field from an accredited college or university.
Minimum one-year experience in a financial aid office with working knowledge of processing student aid packages.
In-depth knowledge of Title IV and ICHE (State) regulations.
Prior exposure and/or experience to government regulatory policy and procedure, post-secondary higher education funds and operations and working with financial aid reporting systems.
Ability to work under pressure to meet timelines and objectives.
Working knowledge of Microsoft Office (experience in Excel is a must).
Excellent written and oral communication skills.
Ability to deal effectively with a diverse student body.
Exceptional customer service and organizational skills.
The intent of this position description is to provide a representative level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Direct Hire May 24, 2024 Other Area(s)
POSITION TITLE:
Business Technology Faculty
DIVISION:
Academic Affairs
DEPARTMENT:
College of Business & Technology
CLASSIFICATION:
Full-time; Exempt
POSITION DESCRIPTION
OCCUPATIONAL SUMMARY
Reporting to the Dean of the College of Business & Technology, the Faculty member is responsible for providing classroom instruction to students in a variety of Business Technology courses. The faculty works closely and collaboratively with College and University leadership to achieve a strategic, student centered approach to academics in support of the University’s mission and to integrate the student learning experience with the academic programs of the University. This position does not formally supervise others but may at times oversee the work of adjunct faculty and/or Work Study students.
ESSENTIAL JOB FUNCTIONS
Facilitates Business Technology classes and provides assignments to be completed outside the classroom.
Advises students for the purpose of obtaining positive progression in the academic curriculum on a semester basis.
Mentors students toward professional and vocational goals.
Demonstrates knowledge of and experience in assessing student learning outcomes.
Assigns grades for academic performance.
Participates in the student evaluation process.
Leads and participates in curriculum review and curriculum and program development to ensure program and course outcomes meet student and marketplace needs.
Participates in dialogue with colleagues to keep abreast of new developments and research within the discipline.
Maintains posted office hours for availability to students and colleagues.
Conducts research as required.
Identifies and submits proposals for grants and participates in fundraising activities.
Regularly assesses teaching strategies to assure compliance within operating rules, regulations, policies, and procedures; advises supervisor promptly of any programmatic irregularities.
Operates effectively within established budgetary guidelines.
Assures the management and integrity of all student data in compliance with all applicable state and federal laws, rules, and regulations.
Prepares required reports.
Develops relationships and maintains effective communications with diverse groups, internal and external, in support of the institution’s mission.
Participate in peer review process.
Represents institution at functions upon request.
Serves on administrative committees as assigned.
Performs other duties as required
MINIMUM REQUIREMENTS
Doctoral degree from an accredited college or university required. Holders of Masters degrees who commit to pursuing a terminal degree may be considered.
Instructional classroom experience at the college or university level required.
Appreciation and understanding of nontraditional students.
Significant knowledge of current business practices in the marketplace.
Ability to deliver curriculum through in-person, hybrid, and online methodologies.
Awareness of Higher Learning Commission accreditation process.
Must demonstrate strong analytical and high communication skills.
Superior presentation and interpersonal skills.
Strong organization and management skills, with follow-through.
Excellent inductive and deductive reasoning skills
Ability to form collegial partnerships with fellow faculty members and to work both independently and collegially.
The intent of this position description is to provide a representative level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Contract May 24, 2024 Healthcare Job Title: (Social Worker) Well Care Coordination Manager
Location: Remote (Indiana) **Must be an Indiana Resident
Hours: Monday - Friday 8am-5pm
Pay: $38hr weekly pay
Travel Requirement: 25%-50%
Job Summary:
The Community Well Care Coordination Manager must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordination Manager must, at a minimum, be a registered nurse or similar medical professional with extensive experience in providing care coordination to members 60 years and older. This individual will work directly under the Health Services Directors to maintain the care coordination program. The individual will be responsible for overseeing care coordination teams, care plan development and care plan implementation. The Care Coordination Manager will be responsible for directing the activities of the care coordinators. These responsibilities extend to physical and behavioral health care services. This individual will work with the Heath Services Director, Service Coordinator Administrator, Medical Director, Provider and Member Services Managers, and with State staff as necessary, to communicate to providers and members. The Care Coordination Manager will provide input, as requested by the State, at State-level meetings.
Primary Responsibilities:
• Selects, manages, develops, mentors and supports staff in designated department or region
• Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results
• In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements
• Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements
• Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence
• Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care
• Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
• Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team
• Participates in training and coaching of direct reports as needed
• Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship
• Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders
Required Qualifications:
• Resident of Indiana
• BSW with equivalent experience
• Experience working within the community health setting in a health care role
• Experience or knowledge of Indiana Medicaid, Medicare, Long term care
• Experience coaching or mentoring staff
• Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment
Preferred Qualifications:
• 3+ year of case management leadership experience within a healthcare industry
• Background in managed care
• Case Management experience
• Certified Case Manager (CCM)
• Experience / exposure with members receiving long term social supports
• Experience in utilization review, concurrent review and/or risk management
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract May 23, 2024 Healthcare Provide resources who are trusted members of the communities served and/or have an unusually close understanding of the communities to facilitate access to health care services, improve the quality and cultural competency of those services, and improve member health outcomes. Outreach Coordinator Resources work to increase health literacy, reduce costs of services, and improve care.
The overall approach for outreach workers is fluid and flexible based on identified quality and member outcome needs. The primary focus of the Outreach resources will be as follows:
Understand Member history and the physical, behavioral, and social factors that may be leading to less-than-ideal health outcomes or persistent gaps in care.
Utilize a whole health approach when interacting with Members and caregivers.
Working with Case Management to place outreach resources at point of care facilities to better facilitate member engagement and action.
Facilitate real time gap closure initiatives including but not limited to immunizations, telehealth visits, A1c tests, lead tests, and blood pressure readings.
Pivot priorities as necessary month to month based on HEDIS performance.
Engage member in care coordination and case management as necessary.
Educate member on health care benefits and services and monitor for over and/or underutilization.
Requirements:
Community Outreach Experience preferred
CHW Certification and/or CNA/HHA preferred
Home Visits
Driver’s License required
High School Diploma/GED required
Contract May 23, 2024 Healthcare The Community Well Care Coordination Manager must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordination Manager must, at a minimum, be a registered nurse or similar medical professional with extensive experience in providing care coordination to members 60 years and older. This individual will work directly under the Health Services Directors to maintain the care coordination program. The individual will be responsible for overseeing care coordination teams, care plan development and care plan implementation. The Care Coordination Manager will be responsible for directing the activities of the care coordinators. These responsibilities extend to physical and behavioral health care services. This individual will work with the Heath Services Director, Service Coordinator Administrator, Medical Director, Provider and Member Services Managers, and with State staff as necessary, to communicate to providers and members. The Care Coordination Manager will provide input, as requested by the State, at State-level meetings.
Primary Responsibilities:
• Selects, manages, develops, mentors and supports staff in designated department or region
• Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results
• In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements
• Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements
• Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence
• Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care
• Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
• Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team
• Participates in training and coaching of direct reports as needed
• Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship
• Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders
Required Qualifications:
• Resident of Indiana
• BSN or BSW with equivalent experience
• Registered Nurse with an unrestricted License in Indiana
• Experience working within the community health setting in a health care role
• Experience or knowledge of Indiana Medicaid, Medicare, Long term care
• Experience coaching or mentoring staff
• Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment
Preferred Qualifications:
• 3+ year of case management leadership experience within a healthcare industry
• Background in managed care
• Case Management experience
• Certified Case Manager (CCM)
• Experience / exposure with members receiving long term social supports
• Experience in utilization review, concurrent review and/or risk management
Contract May 23, 2024 Healthcare Job Title: (RN) Well Care Coordination Manager
Location: Remote (Indiana) **Must be an Indiana Resident
Hours: Monday - Friday 8am-5pm
Pay: $48hr weekly pay
Travel Requirement: 25% - 50%
Job Summary:
The Community Well Care Coordination Manager must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordination Manager must, at a minimum, be a registered nurse or similar medical professional with extensive experience in providing care coordination to members 60 years and older. This individual will work directly under the Health Services Directors to maintain the care coordination program. The individual will be responsible for overseeing care coordination teams, care plan development and care plan implementation. The Care Coordination Manager will be responsible for directing the activities of the care coordinators. These responsibilities extend to physical and behavioral health care services. This individual will work with the Heath Services Director, Service Coordinator Administrator, Medical Director, Provider and Member Services Managers, and with State staff as necessary, to communicate to providers and members. The Care Coordination Manager will provide input, as requested by the State, at State-level meetings.
Primary Responsibilities:
• Selects, manages, develops, mentors and supports staff in designated department or region
• Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results
• In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements
• Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements
• Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence
• Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care
• Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
• Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team
• Participates in training and coaching of direct reports as needed
• Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship
• Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders
Required Qualifications:
• Resident of Indiana
• BSN with equivalent experience
• Registered Nurse with an unrestricted License in Indiana
• Experience working within the community health setting in a health care role
• Experience or knowledge of Indiana Medicaid, Medicare, Long term care
• Experience coaching or mentoring staff
• Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment
Preferred Qualifications:
• 3+ year of case management leadership experience within a healthcare industry
• Background in managed care
• Case Management experience
• Certified Case Manager (CCM)
• Experience / exposure with members receiving long term social supports
• Experience in utilization review, concurrent review and/or risk management
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract May 23, 2024 Other Area(s) Program Specialist (Social Worker) to conduct screening and risk assessment interventions per program guidelines. Assist with non-medical aspects of the member’s care, including referrals to community resources. Work schedule is M-F 8:00am-5:00pm. This position is remote, but MUST reside in INDIANA.
Job Responsibilities: Identify special needs members through the completion of health screens and other resources Work with community outreach/member advocates to coordinate member care Educate providers and community resources on program components and available support services Educate members with special needs to foster compliance with program and positively impact outcomes Conduct site visits as appropriate for programs and provide support to other special programs Develop and modify care plans in conjunction with member, member’s family and managing physician Development of plan specific literature and education materials in conjunction with medical director and corporate oversight.
Education/Experience: Bachelor’s degree in Social Work, Nursing, Health, Behavioral Science or Equivalent Experience. Experience in a managed care environment preferred. 0-2 years of experience
Contract May 23, 2024 Clerical PME is looking for a part time (20 hours/week) data entry clerk for a 2-month contract assignment. The work schedule will be Tuesday, Wednesday, and Thursday from 7 am to 1:30 pm.
Responsibilities:
Gather and input data in database, and verify accuracy of valuable company information
Review data for errors or redundancies, make corrections, and check outputs
Research information needed for completing documents with minimal oversight
Analyze and use data from automated information aggregators to update database
Create systems and processes to efficiently capture information, and coach team members on usage
Generate reports, store outputs in database, and perform backups
Scan and print files when requested
Requirements:
Previous Data entry experience
Well-organized, with sharp attention to detail
Ability to work under pressure
Good communication and literacy skill
Contract To Hire May 23, 2024 Healthcare Job Title: Program Specialist 1
Location: Remote (Indiana)
Pay: $20hr (Paid Weekly)
Hours: Monday - Friday 8am-5pm Eastern
Summary: Conduct screening and risk assessment interventions per program guidelines. Assist with non medical aspects of the member’s care, including referrals to community resources.
Job Responsibilities:
Identify special needs members through the completion of health screens and other resources
Work with community outreach/member advocates to coordinate member care
Educate providers and community resources on program components and available support services
Educate members with special needs to foster compliance with program and positively impact outcomes
Conduct site visits as appropriate for programs and provide support to other special programs
Develop and modify care plans in conjunction with member, member’s family and managing physician
Development of plan specific literature and education materials in conjunction with medical director and corporate oversight.
Education/Experience: Bachelor’s degree in Social Work, Nursing, Health, Behavioral Science or Equivalent Experience. Experience in a managed care environment preferred. 0-2 years of experience
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Direct Hire May 23, 2024 Industrial Job Title: Janitor
Pay: $16hr (Paid Weekly)
Location: Indianapolis, Indiana
Position Overview:
We are seeking a dedicated and detail-oriented individual to join our team as a Janitor. The primary responsibility of this role is to ensure that vacated apartments are thoroughly cleaned and prepared for new occupants. The ideal candidate will have a keen eye for cleanliness, excellent time management skills, and the ability to work independently.
Responsibilities:
Clean vacant apartments thoroughly according to established standards, including but not limited to:
Sweeping, mopping, and vacuuming floors
Dusting surfaces and fixtures
Cleaning windows, mirrors, and glass surfaces
Sanitizing kitchen and bathroom fixtures
Removing trash and debris
Cleaning appliances such as stoves, refrigerators, and microwaves
Inspect apartments after cleaning to ensure they meet company standards and are ready for new occupants.
Report any maintenance issues or damages found during the cleaning process to the appropriate supervisor.
Maintain cleaning equipment and supplies, ensuring they are properly stored and in good working condition.
Follow all safety protocols and procedures to ensure a safe working environment.
Complete any additional cleaning tasks or special projects as assigned by management.
Qualifications:
Previous experience in janitorial or housekeeping roles preferred.
Ability to work efficiently and independently with minimal supervision.
Strong attention to detail and commitment to delivering high-quality work.
Excellent time management skills with the ability to prioritize tasks effectively.
Physical stamina and the ability to lift and move heavy objects.
Knowledge of cleaning techniques, equipment, and chemicals preferred.
Good communication skills and the ability to follow instructions.
Willingness to work flexible hours, including evenings and weekends, as needed.
Note: This job description is intended to convey information essential to understanding the scope of the position and is not an exhaustive list of skills, efforts, duties, responsibilities, or working conditions associated with it. Management may assign or reassign duties and responsibilities to this job at any time.
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract May 23, 2024 Administrative Responsibility:
-- Provide a wide range of administrative assistance to two programs within the Food Protection Division.
-- Act as a liaison between program or department administration, state agencies, and other stakeholders.
-- Provide routine policy interpretation and related decisions to stakeholders.
-- Research and prepare various reports for manager.
-- Prepare and processes correspondence and verbally communicates with the public or other agency representatives. Directs incoming correspondence to the appropriate individual.
-- Reviews and inspects incoming documents for accuracy, completeness, and to ensure dompliance with applicable federal, state, and local rules and regulations. Obtains necessary approvals if needed.
-- Provides technical guidance and composes manuals for agency personnel.
-- Coordinates clerical and administrative functions.
-- Other duties as assigned.
Job Requirements:
-- High School Diploma or equivalent.
-- 3 years full time experience performing administrative support, bookkeeping, office management, or related experience.
-- General knowledge of office administrative functions, theories, and principles.
-- Working knowledge of research techniques and report composition.
-- Working knowledge of functions of other departments and agencies and their impact on the department.
-- Effective written and verbal communication skills.
-- Attention to detail and proofreading skills.
-- Organizational skills with the ability to prioritize tasks effectively and multitask
-- Ability to use Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
-- Ability to analyze procedures and policies and writes procedural manuals to recommend improvements.
-- Ability to coordinate the work of the RRT and Produce Safety Teams.
-- Ability to maintain cooperative work relationships.
Contract May 23, 2024 Healthcare The Community Well Care Coordination Manager must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordination Manager must, at a minimum, be a registered nurse or similar medical professional with extensive experience in providing care coordination to members 60 years and older. This individual will work directly under the Health Services Directors to maintain the care coordination program. The individual will be responsible for overseeing care coordination teams, care plan development and care plan implementation. The Care Coordination Manager will be responsible for directing the activities of the care coordinators. These responsibilities extend to physical and behavioral health care services. This individual will work with the Heath Services Director, Service Coordinator Administrator, Medical Director, Provider and Member Services Managers, and with State staff as necessary, to communicate to providers and members. The Care Coordination Manager will provide input, as requested by the State, at State-level meetings.
Primary Responsibilities:
• Selects, manages, develops, mentors and supports staff in designated department or region
• Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results
• In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements
• Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements
• Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence
• Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care
• Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
• Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team
• Participates in training and coaching of direct reports as needed
• Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship
• Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders
Required Qualifications:
• Resident of Indiana
• BSN or BSW with equivalent experience
• Registered Nurse with an unrestricted License in Indiana
• Experience working within the community health setting in a health care role
• Experience or knowledge of Indiana Medicaid, Medicare, Long term care
• Experience coaching or mentoring staff
• Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment
Preferred Qualifications:
• 3+ year of case management leadership experience within a healthcare industry
• Background in managed care
• Case Management experience
• Certified Case Manager (CCM)
• Experience / exposure with members receiving long term social supports
• Experience in utilization review, concurrent review and/or risk management
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract May 22, 2024 Information Technology
Description:
Responsible for programming on specific application subsets of the company's application portfolio, participating in all phases of the development and maintenance life cycle, typically for an assigned business unit, client program, or corporate department and utilizing various customer technology platforms.
Primary duties may include, but are not limited to:
Maintains active relationships with customers to determine business requirements and leads requirements gathering meetings. Owns the change request process and may coordinate with other teams as necessary. Develops and owns list of final enhancements. Develops and defines application scope and objectives and prepares technical and/or functional specifications from with programs will be written. Performs technical design reviews and code reviews. Ensures unit test is completed and meets the test plan requirements, system testing is completed and system is implemented according to plan. Assesses current status and supports data information planning. Coordinates on-call support and ensures effective monitoring of system. Maintains technical development environment. Mentors others and may lead multiple or small to medium sized projects. Facilitates group sessions to elicit complex information on requirements clarification, design sessions, code reviews and troubleshooting issues. Supports vendor evaluation.
Requires BA/BS degree in related field or technical institute training; 5 or more years related experience; multi platform experience; , expert level experience with business and technical applications, or any combination of education and experience, which would provide an equivalent background. Incumbent should also have the ability to mentor others, lead multiple small projects and provide troubleshooting support. Multi dimensional required. Multi database and/or multi language preferred.
allowed to work from home?
Yes
required skill sets, experiences, or methodologies
UiPath test automation engineer:
- Extensive knowledge and skills in orchestrating and automating the end-to-end testing workflow using UiPath Test Manager, UiPath Studio, and UiPath Orchestrator.
- Develop configurable, maintainable, reusable and dependable test automation framework using UiPath automation tools.
- Experience with RPA tools and cognitive platforms such as UiPath
work schedule
8 AM to 5 PM, Monday to Friday. No weekend support needed - position is 100% remote - flexible with time zones
Additional Job Description Details
- The Test Automation Engineer is responsible for acting as the technical expert on automated testing for the development teams in support of Robotic Process Automation platforms
- This role conducts requirements analysis, defines test strategies, designs, and leads execution of test cases and automated testing to guarantee superior outcomes
- The Test Automation Engineer ensures our validated systems are protected by verifying documentation for releases and collaborating with our software development teams to deliver high quality software on a regular cadence
- Design and develop UiPath solutions to create reusable components, frameworks and libraries
- Deploy RPA components including bots, robots, development tools, code repositories, and logging tools
- Supports development teams with technical expertise and assistance in both integrating and debugging systems used by and associated with Low/No Code tools that are automating manual testing
Contract May 21, 2024 Other Area(s) Care Engagement Specialist to be responsible for supporting the organization’s goals of obtaining health needs screenings, scheduling preventive service appointments, and educating members on plan benefits and services. Provide members with educational materials and carry out strategies to increase health care adherence and reduce barriers to care. MUST reside in Indiana. Schedule: Mon-Fri 9am-6pm Remote
Job Responsibilities:
Make outbound or receive inbound calls from members to schedule doctor appointments, assist members that need to complete Health Needs Screenings or make payments to become eligible for enhanced benefits.
Influence members to take advantage of additional benefits.
Educate members on utilization of Emergency Departments in non-emergent conditions.
Identify and overcome barriers for members to complete needed health screenings, obtain needed services or make payments to secure enhanced benefits.
Review each member profile prior to outreach to identify areas of opportunity.
Participate in continuous quality improvement initiatives to ensure department and company goals are met.
Review and analyze data for call reports to make adjustments as needed.
Act as a secondary resource for the Member Services or Provider Services call centers.
Education/Experience: High School diploma or equivalent and 0-2 years of sales experience in a call center or other high-pressure sales environment. Bilingual in Spanish and English preferred.
Contract May 20, 2024 Administrative The CRC Communications Coordinator position will provide coordination and support to the following state cultural commissions located with the Indiana Civil Rights Commission:
Position duties include the following:
1. Social media: content creation; graphics; social listening
2. Website content management
3. Meeting minutes and notices
4. Event coordination: administrative; photography; Black Barbershop Health Initiative
5. Outreach assistance and event coordination
6. Meeting setup/coordination: Subcommittee meetings-coordination and note-taking
7. Indiana Commission for Women – Torchbearer Awards
8. Other tasks as assigned
Project-based duties:
1. Partnership databases for: Indiana Commission on Hispanic/Latino Affairs partner organizations; license plate recipient database for Indiana Native American Indian Affairs Commission; Indiana Commission for Women – women’s organizations and programs
2. Grant program coordination for the Indiana Commission on Hispanic/Latino Affairs grants
3. Organization of shared drive
4. Web projects for the Indiana Commission on Hispanic/Latino Affairs – resources page
5. Indiana Native American Indian Affairs Commission – License plate marketing campaign
Contract May 15, 2024 Other Area(s) Researches the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in compliance with applicable regulations or standards. Performs appeal and retrospective reviews demonstrating ability to define and determine precedence of pertinent issues in application of policies and procedures to clinical information and or application to benefit or policy provisions.
Required Skills and Abilities: Working knowledge of word processing software. Working knowledge of managed care and various forms of health care delivery systems. Strong clinical experience to include home health, rehabilitation, and/or broad medical surgical experience. Analytical or critical thinking skills.
Required Software and Tools: Microsoft Office.
Preferred Skills and Abilities: Administrative Law Judge (ALJ) process. Knowledge of statistical principles. Knowledge of National Committee for Quality Assurance (NCAG). Knowledge of Utilization Review Accreditation Commission (URAC). Knowledge of South Carolina Department of Insurance (SCDOI). Knowledge of US DOL and Health Insurance Portability/Accountability Act (HIPAA) standards/regulations. Excellent organizational and time management skills. Knowledge of claims systems. Presentation skills.
Required Education: Associate Degree - Nursing or Graduate of Accredited School of Nursing. Required Work Experience: 2 years clinical experience plus 1 year utilization/medical review, quality assurance, or home health, OR, 3 years clinical.
Required License and Certificate: An active, unrestricted RN license from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC).
Preferred Education: Bachelor's degree- Nursing. Preferred Work Experience: 3 years-utilization/medical review, quality assurance, or home health, plus 5 years clinical.
Contract To Hire May 13, 2024 Other Area(s) Performs routine facility maintenance tasks to ensure company employees have a safe and properly conditioned work environment. Assemble, relocate, and repair free standing or modular office furniture and equipment. Perform general maintenance tasks. Clean equipment, mechanical rooms, and work sites as directed. Perform preventative inspections. Respond to emergency calls after normal working hours.
Schedule: Monday-Friday 8-4:30pm
Location: I-20 and Alpine Road Columbia, South Carolina 29219
Required Skills and Abilities:
Ability to lift 50 pounds frequently. Good judgment. Customer service skills. Ability to care for tools and material of the electric trade. Ability to follow verbal and written instruction. Required Software and Tools: Ability to use various hand tools. Ability to use or learn to use key cutting machine.
Contract May 7, 2024 Healthcare The Clinical Appeals Nurse is responsible for the completion of clinical appeals and state hearings from all states.
Essential Functions:
• Responsible for the completion of clinical appeals and state hearings from all states
• Review and complete all provider clinical appeals within required timeframes.
• Review and complete member clinical appeals within required timeframes.
• Review all information necessary to prepare State Hearing packets.
• Communicate with state agencies and internal departments to prepare for State Hearings
• Attend assigned State Hearing and completed all required compliances.
• Complete required compliances for Administrative Hearing decisions
• Apply CareSource Medical Policy and Milliman guidelines when processing clinical appeals.
• Issue notification letters to providers and members.
• Issue administrative denials appropriately.
• Refer denials based on medical necessity to medical director.
• Maintain hardcopy documentation, Facets documentation and appeals database documentation at 90-95% accuracy rates.
• Conduct monthly, quarterly, and ad hoc appeals reporting.
• Collaborate with the Quality Improvement and Clinical Operations Team Lead to prepare all requests for Independent External Review
• Ensure compliance with regulatory and accrediting requirements.
• Perform any other job duties as requested.
Education and Experience:
• RN License required.
• Associate degree or equivalent years of relevant experience required.
• Managed care, appeals, and Medicaid experience preferred.
• Utilization review experience is strongly preferred.
•
Competencies, Knowledge, and Skills:
• Intermediate proficiency with Microsoft Office products and Facets
• Knowledge of NCQA, URAC, OAC, and MDCH regulations
• Strong written and oral communication skills
• Ability to work independently and within a team environment.
• Critical listening and thinking skills.
• Proper grammar usage
• Time management skills
• Proper phone etiquette
• Customer Service oriented
• Decision making/problem solving skills.
• Familiarity of healthcare field
• Knowledge of Medicaid
• Flexibility
• Change resiliency.
Licensure and Certification:
• Current, unrestricted license as a Registered Nurse (RN) is required.
• MCG Certification is required or must be obtained within six (6) months of hire.
Working Conditions:
• General office environment; may be required to sit or stand for extended periods of time.
Contract May 2, 2024 Other Area(s) PME is looking for a Healthcare Case Manager I (RN, LCSW, LMSW) experienced in Case Management working with complex medical and mental illness cases. The position will require field visits 3 days a week and the rest will be from home. Schedule M-F 8:30am-5:00pm CST.
MUST live in within 30 minutes of ARLINGTON HEIGHTS, BARTLETT, HANOVER PARK, BARRINGTON, ELGIN, MOUNT PROSPECT, HOFFMAN ESTATES, PALATINE, ROLLING MEADOWS, ROSELLE, SCHAUMBURG, STREAMWOOD, WHEELING
Responsible for health care management and coordination of healthcare members
Works with members to create and implement an integrated collaborative plan of care.
Coordinates and monitors Healthcare members’ progress and services.
Provides case management services to members with chronic or complex conditions.
Proactively identifies members that may qualify for potential case management services.
Conducts assessment of member needs by collecting in-depth information from healthcare information system, the member, member’s family/caregiver, hospital staff, physicians, and other providers.
Identifies, assesses, and manages members per established criteria.
Develops and implements a case management plan in collaboration with the member, care team.
Performs ongoing monitoring of the plan of care to evaluate effectiveness.
Documents care plan progress in healthcare information system.
Requirements
Healthcare Case Management experience
RN, LPN or bachelors in social service or related field.
0-2 years of clinical experience with case management experience
Active, unrestricted State RN or LPN license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing
Familiarity with NCQA standards, state/federal regulations, and measurement techniques. In depth knowledge of CCA and/or other Case Management tools.
Required Experience
0-2 years of clinical experience with case management experience.
Required Licensure/Certification: Active, unrestricted State Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing.
Must have a valid driver’s license with a good driving record and be able to drive locally if required.
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract May 2, 2024 Other Area(s) Seeking an RN Care Manager II to provide Care Management duties to include telephonic outreach to members, assess members for complex medical needs, develop and update care plans, assess members current health , resource utilization , assess progress to goals , assist member with coordinating services and appointments , provide member education, assist with access to community based services, participate in care management rounds, This position is fully remote. The work schedule is M-F 8:00am-5:00pm. You MUST be a Licensed RN that is good standing and residing in the state of Indiana.
Education/Experience:
Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.
Licenses/Certifications:
Current state’s RN license.
Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care, or community setting. 2+ years’ experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.
Licenses/Certifications: Indiana state’s RN license in good standing.
Contract Apr 30, 2024 Administrative Job Summary
Data Capture Specialist is responsible for the accurate capture of the alphabetic, numeric, or symbolic data from electronic images and/or source documents according to the custom developed software application including repair of incorrect data resulting from OCR process (optical character recognition results).
Pay Rate: $14.85hr (Weekly Pay)
Work Schedule
Monday (9:00 am – 6:00 pm)
Tuesday (9:30 am – 5:30 pm)
Wednesday – Friday (9:00 am – 5:30 pm)
Duties and Responsibilities
The responsibilities of the Data Capture Specialist are outlined as follows and no intended to be all inclusive:
Enters alphabetic, numeric, or symbolic data from electronic images utilizing the Captiva Input Accel software application to capture the appropriate data including repairing any rejected characters as a result of the OCR function.
Routes electronic data to next work flow process when completed or in the case of undefined documents or documents that are not able to be indexed, may need to route electronic image to next work flow process.
Responds to inquiries regarding the status of data capture, rejected character repair, or quality assurance phases of the data capture process.
Follows proper procedures, rules, and processes for data capture and quality assurance of the data as outlined in the procedures manual.
Utilizes appropriate and compliant safeguards to reasonably prevent the use or disclosure of confidential and protected information including Protected Health Information (PHI) and Personally Identifiable Information (PII) and reports any concerns to the Document Center Operations Manager.
Data Capture Specialist must be a team player and required to assist the entire team in meeting the Key Performance Indicators (KPI) requirements.
90% of documents are scanned, indexed and entered into the database on the same business day of receipt by Doc Center if received prior to 7:15 pm.
90% of documents are scanned, indexed and entered into the database by Noon of the following business day if received after 7:15 pm.
100% of documents are scanned within two business days of receipt by Doc Center.
Competencies
To perform the job successfully, an individual should demonstrate the following competencies:
Quality: Demonstrates accuracy and thoroughness; looks for ways to improve and promote quality; applies feedback to improve performance; monitors own work to ensure quality. Must meet standards of quality that are required to meet the service levels and performance standards outlined in the SLA/KPI’s.
Quantity: Meets productivity standards; completes work in timely manner; strives to increase productivity; works accurately and efficiently.
Dependability: Follows instructions; responds to management direction; takes responsibility for own actions; maintains the production schedule requirements; commits to extended hours of work when necessary to reach daily production schedules and meets the daily service levels and performance standards; completes tasks on time or notifies supervisor of any potential delays or inabilities to meet the daily service levels and performance standards (SLA/KPI) requirements.
Adaptability: Adapts to changes in the work environment; manages competing demands; changes approach or method as directed by supervisor; exhibits ability to deal with change or unexpected events.
Job Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily, with or without accommodations. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Education/Experience
Previous work experience helpful.
High School Diploma or equivalent required.
Essential Functions: Knowledge, Skills, Abilities
Proficient computer skills
Ability to track work and document routinely
Manual dexterity with proficient hand-eye coordination
Excellent verbal communication skills
Regular and timely attendance on the job
Physical Demands and Work Environment
The physical demands and work environment characteristics 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 frequently required to sit, talk, hear, and use hands to write, type, handle, or feel. Specific vision abilities required by this job include close vision. Specific lifting requirements include ability to lift and move trays weighing up to 20 pounds.
The noise level in the work environment is usually moderate and the work environment includes proximity to many individuals like a public environment.
Direct Hire Apr 29, 2024 Administrative Professional Management Enterprises, inc. is looking for an entry-level Technical Writer. Their role is to employ their technical knowledge to research, document, and present detailed information in easy-to-interpret guides, help manuals, white papers, templates, web pages, videos, journal articles, etc.
The Technical Writer will transform complex information into concise and precise documentation. Able to utilize various advanced domains, including medicine, engineering, computer science, information technology, etc., and create content around topics specific to their expertise.
Duties/Responsibilities:
Carry out extensive research to craft high-quality software documentation that communicates clear and appropriate terminologies. Define and explain niche-related jargon where necessary.
Carefully analyze the target audience, create, design, and present technical content in the best possible way. Tailor the document’s knowledge level and specificity according to the target audience’s familiarity with the subject.
Choose an appropriate medium to deliver content to the audience. Analyze the audience’s behavior and identify its engagement on various platforms and content types. Create content that bodes well for the audience.
Use visual components such as charts, graphs, lists, etc., to highlight and amplify valuable information. Ensure to include credible and authentic content with proper citation–if using external sources to back up data.
Coordinate with product managers and technical team, and frequently examine mockups, product samples, and Software Requirement Specifications documents to integrate production sequences.
Update and edit every document to introduce new components added to the associated product, technology, or technique.
Edit and update material produced by software development teams/technical staff and comprehend it for the end-users.
Create documents that reflect the organization’s goals and culture.
Collect user feedback to update and improve documentation.
Skills Required:
An entry-level technical writer should possess editing and proofreading skills to deliver documents free of grammatical and style errors.
They should be tech-savvy, have a keen eye for detail, and quickly grasp technical knowledge.
They should comprehend complex methods in straightforward step-by-step processes to defy the reader’s ambiguities.
They should be exceptional at problem-solving and must possess a mind that exhibits patience and persistence.
they should display outstanding communication skills.
They should be able to correlate their ideas and communicate them logically.
They should use proper layouts and indentation rules in their documents to make them scannable and easily readable.
Be able to strategically highlight high-value information in their content.
They should have the ability to craft easily searchable content by labeling indexes, tables of content, roadmaps, etc.
They must be well-coordinated, agile, highly responsive, and bound to deliver results the way customers and stakeholders want.
They should be able to meet deadlines and handle the stress that comes with them.
An entry-level technical writer you will need to be proficient in tools such as; Grammarly, MS Word, Hemingway app, Evernote, Freemind, etc.
Education:
Bachelor’s degree preferred.
Minimum three (2) years of cumulative experience
Work Environment:
Hybrid (3 days in office)
Monday - Friday 8am-5pm
Contract Apr 25, 2024 Other Area(s) Job Summary:
The trainer is responsible for facilitation of a range of training content, primarily for Indiana early childhood education professionals and program leaders, SPARK IN staff/partners, and for broader external audiences.
**This position is remote in Indiana, with travel to provide training coverage.**
Essential Duties & Responsibilities:
Supports the implementation of technical assistance initiatives, including online and in-person learning opportunities, learning management system administration, and content development processing and cataloging.
Provides virtual and in-person learning opportunities
Completes responsibilities on the learning management system
Completes all aspects of the training process, including identification of training needs; provides input in the design and development of learning solutions (content/materials); direct facilitation of training sessions; and learning transfer and evaluation.
Evaluates data to inform and improve training opportunities
Participates in assigned meetings, events, training and conferences as required.
Non-Essential Duties:
Contributes to other Professional Development projects as needed.
Performs any and all other duties as assigned.
Job Specifications:
To perform this job successfully, an individual must be able to carry out each essential duty in a satisfactory manner. The job specifications listed are representative of the education and experience, the physical requirements, as well as the knowledge, skill and/or ability (KSAs) that are generally necessary for the role. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Job Requirements:
Master’s degree preferred.
Minimum three (3) years of cumulative experience in related fields, which may include Head Start or other early childhood education, family/community engagement, or program design & management
Experience with in-person and virtual training/facilitation (in an educational setting a plus)
Physical exam and background checks are required for this position.
Travel required locally or long-distance up to 20% of the time for work-related meetings and functions.
Must have a valid driver’s license and/or reliable transportation.
Knowledge, Skills, & Abilities:
Bilingual (Spanish) desirable
Extraordinary facilitation, presentation and general interpersonal skills.
Knowledge of Shine Early Learning offerings/partners a plus; or, ability to get up-to-speed quickly.
Ability to navigate a complex organizational structure, assess and balance priorities, and facilitate inclusive input and decision-making processes.
Ability to multitask, work independently, and organize efficiently.
Ability to synthesize information and communicate effectively in written or verbal format with off-site colleagues, partners, groups of all sizes and individuals.
Demonstrated computer literacy skills, using MS Office applications and other basic data systems including internet navigation.
Ability to interact effectively with people from diverse backgrounds.
Must be honest, dependable and able to meet deadlines.
Self-motivated and able to work independently.
Physical Requirements:
Ability to sit most of the time with some bending and reaching.
Ability to stand, walk, and bend periodically.
Ability to engage in repetitive movement of wrists, hands, and fingers – typing and/or writing.
Ability to work frequently at close visual range (i.e. preparing and analyzing data and figures, accounting, transcription, computer terminal, extensive reading).
Ability to receive and respond to oral communication.
Ability to exert up to 10 pounds of force to lift, carry, push, pull, or otherwise move objects.
Work Environment:
Work is generally performed remotely, typically in a home office environment; occasionally, work occurs in a business office environment where:
Noise level is moderate to occasionally loud (examples: business office with computers and printers, light to moderate traffic, human voices).
Standard equipment generally used includes:
Smartphone/Telephone
Personal Computer (monitor, keyboard, and mouse), Laptop, or Tablet
Printer/Photocopy Machine
Calculator
Fax Machine
May be required to operate a motor vehicle during the course of duties.
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Contract Apr 24, 2024 Other Area(s) Seeking a RN to function as a Medical Affairs Coordinator. This position if fully remote. The schedule is M-F, 9am-5pm.
DUTIES:
Ensures that the Local Coverage Determination (LCD) process adheres to contract instructions. Creates, implements, and maintains educational tools to help providers reduce the submission of claims for non-covered services and reduce the claims payment error rate. Provides clinical expertise, research, and judgment to develop Local Coverage Determinations (LCDS). Provides clinical input for internal requests. Serves as reviewer to determine inter-rater reliability.
Required Skills and Abilities:
Knowledge of managed care or medical claims payment policy issues. Excellent verbal and written communication skills. Excellent customer service, organizational, presentation, analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion.
Required Software and Tools:
Microsoft Office. Working knowledge of database software. Knowledge of government/healthcare programs and contracts laws, regulations, coding, and approval practices. Knowledge of corporate administrative/medical policy for all lines of business. Knowledge of guidelines, benefits, and coverage for all lines of business.
Preferred Software and Tools: Working knowledge of Microsoft Access or other database software, DB2 and Easytrieve.
EDUCATION/REQUIREMENTS:
Bachelor's degree - Nursing or other health related field. OR, Associate's degree in Nursing with an active unrestricted RN license from the United States and in the state of hire.
Required Work Experience:
5 years clinical experience in medical insurance, managed care, case management, or claims management, or a combination of these areas.
Required License and Certificate:
An active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC).
DUTIES:
Ensures that the Local Coverage Determination (LCD) process adheres to contract instructions. Creates, implements, and maintains educational tools to help providers reduce the submission of claims for non-covered services and reduce the claims payment error rate. Provides clinical expertise, research, and judgment to develop Local Coverage Determinations (LCDS). Provides clinical input for internal requests. Serves as reviewer to determine inter-rater reliability.
Required Skills and Abilities:
Knowledge of managed care or medical claims payment policy issues. Excellent verbal and written communication skills. Excellent customer service, organizational, presentation, analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion.
Required Software and Tools:
Microsoft Office. Working knowledge of database software. Knowledge of government/healthcare programs and contracts laws, regulations, coding, and approval practices. Knowledge of corporate administrative/medical policy for all lines of business. Knowledge of guidelines, benefits, and coverage for all lines of business.
Preferred Software and Tools: Working knowledge of Microsoft Access or other database software, DB2 and Easytrieve.
EDUCATION/REQUIREMENTS:
Bachelor's degree - Nursing or other health related field. OR, Associate's degree in Nursing with an active unrestricted RN license from the United States and in the state of hire.
Required Work Experience:
5 years clinical experience in medical insurance, managed care, case management, or claims management, or a combination of these areas.
Required License and Certificate:
An active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC).
