Contract Dec 9, 2024 Information Technology Responsible for the full range of database development, support activities and detailed analysis.
Responsibilities:
Develops database designs based on business requirements.
Reviews and revises database designs and ensures that all technical and business requirements are met.
Builds database structures based on detailed design.
Performs database testing to ensure performance is met and compare with expected results.
Provides support during the system implementation and production. Suggests new features, coding techniques and reference material.
Identifies gaps in scripts and procedures. suggests options for implementation of features.
Provides 24x7 production and non-production DBA on-call support.
Requirements:
BA/BS in Computer Science or Information Systems or related field.
5 or more of industry experience required in information systems and 5 or more years of experience in database administration or related disciplines; or any combination of education and experience, which would provide an equivalent background.
Requires detailed business knowledge, detailed technical design knowledge, knowledge of database administration techniques and database administration tools.
Excellent written, oral and interpersonal communication skills required. Leadership and interpersonal skills with the ability to influence others.
Experience with DBMS performance management and monitoring tools. Proficiency in utilizing DBMS system management tools and implementation of new features and functionality preferred.
Contract Dec 6, 2024 Administrative Job Summary
Data Capture Specialist is responsible for the accurate keying of information and scanning various documents.
Pay: 14.85/hour
Onsite Position - Marion, IN
Duties and Responsibilities
The responsibilities of the Data Capture Operator are outlined as follows and no intended to be all inclusive:
Accurately entering alphabetic and numeric data from electronic images with speed and accuracy utilizing software application to capture the appropriate data.
Reading, analyzing, and classifying documents based on certain assigned criteria.
Operating and maintaining scanning equipment, including processing documents through scanner and making appropriate adjustments to improve image capture.
Reviewing completed work and administering the company’s quality control procedures to ensure work is at or above required accuracy rates.
Assisting entire team in meeting daily and monthly KPIs and SLAs.
Following proper procedures, rules, and processes for data capture and quality assurance of data.
Utilizing appropriate and compliant safeguards to reasonably prevent the improper use or disclosure of confidential and protected information which may include Protected Health Information (PHI) and/or Personally Identifiable Information (PII) and reporting any concerns to manager.
Knowledge, Skills, and Abilities
High School Diploma or equivalent required.
Proficiency is MS Office (Word, Outlook, Teams, Sharepoint).
Excellent typing skills—touch, 10 key, 45 wpm
Ability to pass reference checks, drug screen, and background checks.
Work Schedule
Monday (9:00 am - 6:00 pm)
Wednesday (9:00 am - 5:30pm
Friday (9:00 am - 5:30 pm)
Contract Dec 6, 2024 Healthcare Care Review Clinician I works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. This position is remote, but candidates MUST be local to NEVADA. The work schedule will be 8am-5pm. Prefer Saturday worker with Wednesday or Monday being the preferred day off during the week.
KNOWLEDGE/SKILLS/ABILITIES
Must have experience in UM, experience with turnaround timeframes, good with computer systems and be able to learn a new system. MUST have experience with conducting clinical reviews and processed denials and partial denial determinations. MCG criteria knowledge is a plus, case presentation for medical reviews. MUST have experience with reviewing for Medicaid/ MLTC members. MUST know Medicaid/ Medicare guidelines. May also perform prior authorization reviews and/or related duties as needed.
Required Education
Graduate from an Accredited School of Nursing.
Required Experience
3+ years hospital acute care/medical experience.
Required License, Certification, Association
Active, unrestricted State Registered Nursing (RN) license in good standing in the state of Nevada.
Contract Dec 5, 2024 Healthcare Summary:
The main function of an Office/Mail Clerk may include sorting checks, keeping payroll records, taking inventory, and distributing mail. Acts as an information and communication distributor for the office. This is a remote position with an occasional need to work onsite.
Job Responsibilities:
Communicate with customers, employees, and other individuals to answer questions, disseminate or explain information, and address complaints. Answer telephones, direct calls and take messages. Compile, copy, sort, and file records of office activities, business transactions and other activities. Compute, record and proofread data and other information, such as records or reports. Maintain and update filing, inventory, mailing, and database systems.
Skills:
Verbal and written communication skills, multi-tasking, customer service skills and interpersonal skills. Ability to work independently and manage one’s time. Ability to keep information organized and confidential. Previous experience with computer applications, such as Microsoft Word, Excel and PowerPoint.
Education/Experience:
High school diploma or GED is typically required. 0-2 years administrative/customer service-related experience required.
Contract Dec 5, 2024 Healthcare Seeking an RN Care Manager with experience working with high-risk OB members to perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members. 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.
Provide Care Management duties to include telephonic outreach to high-risk OB 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 and assist with access to community based services.
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: Indiana state’s RN license in good standing.
Contract Dec 3, 2024 Other Area(s) Job Title: Clinical Case Manager
Location: (Evansville, Indiana) **Must be an Indiana Resident
Hours: Monday - Friday 8am-5pm
Job Summary:
The Community Well Care Coordinator 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). This position is remote, but field visits will be required.
Primary Responsibilities:
• 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
• 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
• 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 Nov 18, 2024 Healthcare The Community Well Care Coordinator 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 Coordinator 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 Coordinator 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 Coordinator will provide input, as requested by the State, at State-level meetings.
Primary Responsibilities:
• Selects,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 Nov 18, 2024 Healthcare The Community Well Care Coordinator 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 Coordinator 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 Coordinator 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 Coordinator will provide input, as requested by the State, at State-level meetings.
Primary Responsibilities:
• Selects,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.
Direct Hire Nov 12, 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.
Contract Nov 12, 2024 Healthcare The Community Well Care Coordinator 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 Coordinator 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 Coordinator 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 Coordinator 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 Oct 21, 2024 Call Center Job Description:
Intermediate knowledge of training processes, such as adult learning theories and instructional design principles.
Effective facilitation skills, such as ability to facilitate open discussion in a less structured environment.
Effective class preparation skills.
Ability to coordinate cross state tasks and to interact with employees in all areas of the project.
Ability to analyze effectiveness of training and to independently implement, with guidance from the training supervisor, appropriate solutions without compromising instructional design and adult learning theory.
Ability to coach others and provide performance feedback (e.g. trainees, agents, etc.)
Travel within the State of Indiana
REQUIREMENTS:
Education: Some college with 1 plus years experience in facilitation/trainer role or HS diploma or GED and 2 plus years experience with Indiana Eligibility Public Assistance Programs.
Must be able to travel 20% - 40% within the State of Indiana
Extensive knowledge of Policy and Guidelines in relation to Indiana Eligibility Public Assistance Programs (TANF, Medicaid, SNAP
Preferred
Experience working in IEDSS
Bachelor’s Degree
Coaching or training experience
Training Certification
Excellent communication & presentation skills
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 Sep 26, 2024 Healthcare PME is actively seeking a CNA FT/PRN to assists with nursing programs as assigned. Performs a variety of tasks associated with the daily care and treatment of patients.
Job Responsibilities:
Administers and documents authorized medications and treatments per hospital policies and procedures.
Carries out or assists with physical care of patients including bathing, feeding, taking vital signs, heights, weights, and other activities of daily living as indicated.
Maintains current CPR and Bridge Building certifications.
Escorts patients to and from therapies, and other areas of the hospital for treatment and programming.
Escorts and/or drives patients to off-ground appointments and activities.
Observes patients’ physical condition and reports changes to the RN.
Appropriately and accurately reports pertinent information, both verbal and written.
Appropriately applies skills in psychosocial care of patients: Encourages patients and interacts with them to socialize and participate in activities and programming.
Job Requirements:
High school diploma or GED Equivalent
Successful completion of a Certified Nursing Assistant program
Basic computer skills are required.
Maintain current CPR.
Bridge Building certification.
