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The A/R Billing Rep II is responsible for the timely submission of technical or professional medical claims to insurance companies which include claims for physician offices, hospitals, nursing homes, or other healthcare facility
Job ID
2021-153902
Department
Accounts Payable
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The Administrative Assistant is responsible for performing a wide variety of administrative tasks. This position demands an exceptionally high level of organizational skills to balance many projects with varying degrees of priority.
Job ID
2020-129738
Department
Administration
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Scotts Valley
What You’ll be Responsible For in this Role – Your Contribution & Career Journey The Business Intelligence Developer develops reports and data warehouses to monitor Dignity Health Management Services Organization's key performance indicators and meet regulatory reporting requirements by providing the necessary data to business stakeholders. This role is responsible for creating and maintaining computer-based analytics solutions to support the company's financial, clinical, and operational projects.     - The Business Intelligence Developer III Designs, develops, tests, documents, implements and maintains data warehouses and reports. Consults with current and proposed systems users to discuss and document requests for new and/or modified system changes, identifies design alternatives and recommends computer-based solutions. - Performing validation on the warehouse data, populating data cubes for online analytical processing (OLAP) as required by company analysis needs. Writing SQL statements to generate proper data extracts and train end users on 3rd-party OLAP tools. - Writing SQL statements to generate proper data extracts. Monitors and works EDI transaction sets on a daily basis ensuring accurate and timely communication of data. Prepares routine project descriptions and needs assessments for new and/or enhanced system modifications.    
Job ID
2020-147599
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The Case Manager, LVN is an integral part of Dignity Health Management Services Utilization Management team. The Utilization Management team improves the quality of clinical outcomes for members with complex care needs by coordinating care within the health care delivery system using a collaborative partnership approach. The Case Manager, LVN coordinates care and collaborates with multiple disciplinary team members across the continuum of care. The Case Manager, LVN implements the care plan collaborating with the RN and SW to identify patient knowledge gaps concerning disease management, and coordinates appropriate resources or services required to meet an individual's health needs.
Job ID
2021-153176
Department
Family Practice Clinic
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The Case Manager, LVN is an integral part of Dignity Health Management Services Utilization Management team. The Utilization Management team improves the quality of clinical outcomes for members with complex care needs by coordinating care within the health care delivery system using a collaborative partnership approach. The Case Manager, LVN coordinates care and collaborates with multiple disciplinary team members across the continuum of care. The Case Manager, LVN implements the care plan collaborating with the RN and SW to identify patient knowledge gaps concerning disease management, and coordinates appropriate resources or services required to meet an individual's health needs.
Job ID
2021-148011
Department
Family Practice Clinic
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The Case Manager, LVN is an integral part of Dignity Health Management Services Utilization Management team. The Utilization Management team improves the quality of clinical outcomes for members with complex care needs by coordinating care within the health care delivery system using a collaborative partnership approach. The Case Manager, LVN coordinates care and collaborates with multiple disciplinary team members across the continuum of care. The Case Manager, LVN implements the care plan collaborating with the RN and SW to identify patient knowledge gaps concerning disease management, and coordinates appropriate resources or services required to meet an individual's health needs.   The Case Manager, LVN promotes quality cost effective outcomes with the goal of improved care coordination and increased involvement of the individual/family/caregiver in the decision making process to reduce hospitalizations, readmissions and ER utilization. Conducts medical necessity, level of care, and benefit reviews rendered in the inpatient and outpatient setting to ensure the member receives the highest level of care. Coordinates with providers, provider staff, hospital staff, patients and patient family members to establish the appropriate level of care.
Job ID
2021-153968
Department
Case Management
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The Case Management Compliance Coordinator supports management in the daily administrative operations of the assigned area. Provides operational assistance of the Care Coordination and Utilization Management programs across all services areas. Will plan, direct and coordinate administrative functions associated within the assign area including ordering of supplies, equipment, and resources needed. Case Management Compliance Coordinator will leverage project management skills to prioritize and complete all assigned tasks, acting as a subject matter expert (SME) supporting assigned areas, and interacts with all levels of internal and external customers to answer questions and resolve issues as they arise. The incumbent will be expected to assist management with projects and other assignments as required.
Job ID
2021-149860
Department
Utilization Review
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Redlands
The Client Relations Account Manager is responsible for establishing and maintaining positive relationships with various clients building strong, cohesive business partnerships. Works with internal staff, client representatives, and other contracted entities to deliver contractual performance standards and ensure customer service objectives are continually met.
Job ID
2020-136881
Department
Member Services
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The Director of Analytics strategizes for the clinical informatics and quality division and provider network in meeting the goals including but not limited to analysis of population health metrics, network clinical, financial, utilization, and patient satisfaction in support of the optimization of DHMSO's performance relative to value-based contracts. The Director will lead a team to provide and strategize results for hands on data science and analytics functions for DHMSO leadership, day-to-day oversight of the population health analytics team members and collaborate with DHMSO leadership and provider network to achieve organizational goals.
Job ID
2021-149201
Department
Clinical Informatics
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
Job Summary   *Depending on qualifications a candidate may be hired on as an End User Technician I, II, III, or IV.   End User Technician I   Provides desktop hardware setup and basic support for the user community. Works on one or more functional applications and performs work that tends to be entry level technological and business function complexity. Responsible for desktop hardware support to the user community for functional area(s) and ensures reliability of the devices   End User Technician II   The End User Technician II provides desktop hardware support for the user community. Works on multiple functional systems that tend to be of moderate to high complexity. Responsible for desktop hardware support to the user community for functional area(s) and ensure reliability of the devices.   End User Technician III   Provides the desktop hardware deployment and implementation of low to medium complexity and cross functional programs or projects and/or provides support for the user community with high complexity. Responsible for working with customers in the support, maintenance and deployment of desktop hardware as well as the information support processes.   End User Technician IV   The End User Technician IV provides desktop hardware support expertise and direction in the implementation of highly complex / enterprise wide cross functional programs or projects. May lead team to resolution of highly complex problems.   Responsibilities . End User Technician I - Responds to incidents, executes diagnosis, and performs incident resolution for those requiring low to moderate complexity; utilizes knowledge management. Escalates issues when necessary. - Responds to customer requests via the Service Management application. Fulfills request of low to moderate complexity utilizing repeatable documented procedures. Interacts with the customers in a courteous and professional manner. - May handle facility logistics including hardware receiving and maintenance of equipment depot. Enters appropriate data into the device asset management system and the knowledge management system. - Receives necessary information or training to perform basic troubleshooting, installation, upgrades and fixes for new and current devices. Participates in on-call rotation and provides on-call support. - May perform data operations functions, data entry, backup tape changes or other responsibilities as necessary to ensure the successful day-to-day operations. - Maintains awareness of and adheres to Operational Level Agreements (OLAs). - Interacts daily with the user community as it relates to Incident Management and Request fulfillment. - Maintains understanding and adherence to policies and procedures and may provide input to creation or modification of policies. End User Technician II - Provides desktop hardware support for the user community. Works on multiple functional systems that tend to be of moderate to high complexity. - Performs troubleshooting for moderate to high complex hardware, software and system problems. Acts as subject matter expert for at least one device type. - May be assigned to one or more projects as a project team member. - Responds to incidents, performs diagnosis, executes incident resolution for those requiring medium to high complexity. - Utilizes previous experience to reach resolution and will contribute to knowledge management system(s). Escalates issues when necessary. - Responds to customer requests received via the Service Management application. Fulfills requests of moderate to high complexity. Interacts with the customers in a courteous and professional manner. - Assists in the maintenance of and enters appropriate data into the device asset management system and the knowledge management systems to capture knowledge and work processes. - Responds to assigned issues and troubleshoots problems with desktops, laptops, tablets, mobile carts, printers and peripherals, including deployment of new devices. Identifies potential issues that could adversely impact end-user experience and takes corrective action. Participates in low complexity local and enterprise projects. Participates in on-call rotation and provides on-call support. - Performs proactive maintenance on devices. Participates in the 'smart hands program to assist other IT functional areas when needed. - General knowledge of Operational Level Agreements (OLAs) and always works within those metric - Day to day interactions with user community and works collaboratively with Business and IT Stakeholders as it relates to Incident Management, Request Fulfillment and Problem Management. - Understanding and adherence to policies and procedures. Contributes to new or modified policies. - Provides guidance, training and problem solving assistance to other team members. - Performs other duties as assigned.   End User Technician III - Provides the desktop hardware deployment and implementation of low to medium complexity and cross functional programs or projects and/or provides support for the user community with high complexity. - Performs troubleshooting for highly complex hardware, software and system problems for multiple device types. - Works on multiple projects as a project team member. Acts as a subject matter expert in one or more areas. - Responds to incidents, diagnoses and resolves complex problems and provides guidance to other team members. Contributes to knowledge management database for problem reporting and resolution. Escalates issues when necessary. Integrates with problem management and performs root cause analysis when necessary. - Responds to customer requests of high complexity. Interacts with the customers in a courteous and professional manner. - Maintains the device asset management system and the knowledge management systems to capture knowledge and work processes. - Responds to assigned issues and participates in the advanced troubleshooting and deployment of new devices, upgrades, fixes and new installations. Provides feedback on technical process issues to improve overall service delivery. Participates in local and enterprise projects of low to moderate complexity. May coach and advise other team members. Participates in on-call rotation and provides on-call support. - Exhibits knowledge of advanced desktop services skills. Ability to work closely with cross-functional IT teams on complex issues. Continues to build solid understanding of processes, procedures, and Dignity Health standards. - May assist in the development of Operational Level Agreements (OLAs). Monitors deviations and escalates issues to more senior team members. - Day to day interactions with user community and works collaboratively with multiple Business and IT Stakeholders as it relates to Incident Management, Request fulfillment and Problem Management, and Project delivery on small to medium size project. - Understanding and adherence to policies and procedures. Develops new or modifies existing policies. - Demonstrates potential leadership qualities through team motivation, coaching, and mentoring. - Performs other duties as assigned.   End User Technician IV - Provides desktop hardware support expertise and direction in the implementation of highly complex / enterprise wide cross functional programs or projects. May lead team to resolution of highly complex problems. - Leads the team in troubleshooting of highly complex hardware, software and system problems. - Works or coordinates on multiple projects, engaged in enterprise wide projects as a team member, sometimes a team leader. Acts a subject matter expert for multiple areas. - Oversees the End User Services team to ensure customer and production support needs are achieved. - Diagnoses and resolves highly complex issues and provides guidance to other team members. Leads team in problem resolution activities. - Works with leadership to develop strategies for problem reporting and resolution to be used by both the customer and team. - Responds to customer requests of high complexity, typically requiring high-level customer service to facility administration and/or VIPs. Interacts with customers and business stakeholders in a courteous and professional manner. Generates activity and status reports. Oversees the request fulfillment functions of the team. - Ensures the accuracy of information input in the device asset management system. Oversees the team knowledge management contributions and identification of critical knowledge, availability and use. - Leads the team in assigning issues, troubleshooting, and deployment of new devices, upgrades, fixes and new installations. Works with Site Directors and project leaders to staff and execute moderate to highly complex, enterprise solutions. - Serves as an escalation and issue resolution point for team members. Coordinates with facility and IT leadership regarding readiness and delivery issues. - Possesses a deep knowledge of all aspects of desktop services, utilizes advanced principles to deliver End User Services support to their customers and to advice and mentor team members. Extensive understanding of Dignity Health processes, policies, procedures and standards, and ensures team compliance. - Interfaces with customers on Operational Level Agreements (OLAs) and monitors and reports on deviations. Ensures proper monitoring and reporting of OLA deviations. - Day to day interactions with user community and works consistently with all levels of the Business and  IT Stakeholders as it relates to Incident Management, Request fulfillment, Problem Management and Project Delivery of medium to highly complex enterprise scale projects. Seeks opportunities for improvement in adherence to OLA's and Customer Satisfaction. - Understanding and adherence to policies and procedures. Ensures team understanding and adherence to those policies and procedures. - Demonstrates leadership through team motivation, coaching, mentoring, and delegating. - Perform other duties as assigned.  
Job ID
2020-146424
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The role of a Manager, Business Analytics is to analyze, interpret, and report financial and operating data and non-financial performance information, which may include cost analytics, market analytics, profitability analytics, and geographic performance assessments by business unit. This position will play a critical role in linking business activities and strategic initiatives with financial reporting and be an essential part of the day-to-day and long-term operations of the business. You will have the opportunity to collaborate closely with business executives, operational and other finance teams as well. This position will create systems and models and provide the analytics of proposed ventures and work cross-functionally with the executive team, decision support, and operations units to provide comprehensive evaluation of existing, new, and proposed business ventures. This includes forecasting revenue and changes in expense. Evaluate financial reports such as income statements, cash flow statements and balance sheets and determine stability of company’s finances and impact on business operations.
Job ID
2021-149777
Department
Financial Operations
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The purpose of this position is to negotiate physician and ancillary provider agreements, oversee the implementation of all contracts including health plan agreements, and provide support to Administration in evaluating contract terms and preparing contract proposals. The position supervises the contracting team and is responsible for organizing contract information and ensuring that timely information is provided to all DHMSO staff and all partnering stakeholders involved in implementing contract changes.
Job ID
2021-149773
Department
Managed Care Contract & Administration
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
What You’ll be Responsible For in this Role – Your Contribution & Career Journey Conducts medical reviews for necessity, level of care, and benefit reviews rendered in the inpatient and outpatient setting to ensure the patient receives the highest level of care.  Coordinates with providers, provider staff, and hospital staff, patients and patient family members to establish an appropriate level of care. What We’re Looking For - Responsible for meeting all of the DHMSO Job Standards described below. - Plans for and ensures that all post discharge care is coordinated appropriately according to the needs of the patient and ensures continuity of care. - Conducts prior authorization review on all services that require nurse review. - Travels to various hospital within established areas to conduct patient visits. - Analyzes inpatient clinical data and conducts skill nursing facility level of care review on a concurrent basis. Refers cases that do not meet the criteria to the Medical Director and UM committee and assists in coordinating the review process. - Refers known or suspected problems of under-utilization or over-utilization or inappropriate scheduling of services to the attention of the Medical Director, UM Committee and Quality Management Department. Examples include avoidable bed days, inappropriate admissions and delayed procedures. - Provides technical support and serves as resource to PCP and specialists offices, providers, and members regarding healthcare needs and authorization process. - Ensures identification of patients and maintenance of information regarding high risk/high cost utilizers such as ESRD patients, long-term care patients, third party liability patients and transplant candidates. Identifies ways in which UM process impacts other departments internally as well as external customers and works to facilitate effective interactions. - Collects in-depth information about a patient’s situation and function. Identifies individual needs and develops comprehensive case management plan to address patient needs.  Creates plans that are action-oriented and time-specific.  Monitors care to ensure plan is achieving desired outcome, and makes revisions as needed to affect outcome.  Utilizes all relevant sources of information to ascertain the efficiency to the plan. - Coordinates all discharges from inpatient and skilled nursing facilities. - Makes outbound calls to patients according to care management queue assignment and care management policies and procedures. - Tracks barriers to appropriate inpatient and SNF utilization according to policy and procedure. - Attends Utilization Management and/or Quality Management meetings as needed. - Other duties as directed by supervisor or administration.
Job ID
2021-149339
Department
Utilization Review
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The Medical Director is responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent responsive medical care. Provides technical expertise in medical management by direct decision making in the areas of:  preauthorization, concurrent review of hospitalized patients, discharge planning, complex case and chronic care management.  This position is responsible for all UM and QM activities including, but not limited to developing clinical guidelines, measuring adherence to guidelines, and communicating utilization and quality concerns on specific cases to the provider network. 
Job ID
2020-146909
Department
Medical Director
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The Quality Data Abstractor supports the Clinical Performance Department by locating specified clinical data for abstraction from various forms of medical records through intensive medical record review. The Quality Data Abstractor abstracts clinical information from paper or electronic medical record and populates data collection tool to support compliance with quality measures. 
Job ID
2021-155483
Department
Quality Management
Shift
Day
Employment Type
Full Time
Location
AZ-Phoenix
The Quality Management Coordinator will be a part of the Quality Management department.  The department works to measure and improve clinical quality functions across the enterprise.  This consists of monitoring and analyzing electronically submitted digital representations of clinical services, and auditing to assure accuracy in reporting.   JOB KNOWLEDGE, SKILLS & ABILITIES - Knowledge of current CPT, ICD-9 and ICD-10 coding procedures and practices. - Awareness of coding guidelines and understanding of CMS HCC Risk Adjustment coding and data validation. - Awareness of clinical HEDIS measures. - Experience in HCC coding preferred. - Experience working with physicians’ offices in regards to coding, documentation or quality measures. - Must be attentive to detail, accurate, thorough, and persistent in following through to completion all activities, demonstrating initiative for completing work assignments. - Ability to communicate effectively in verbal and written form. - A self-motivator with the ability to function independently in Corporate and Provider offices. - Extensive knowledge of Microsoft Office applications; Excel, Word, Outlook, PowerPoint. - Ability to learn and use other software such as, QNXT, NextGen, and other electronic medical records.    
Job ID
2021-152095
Department
Quality Management
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Scotts Valley
The Quality Management Nurse provides direct local service area support to the Clinical Integration (CI) program.  The QM Nurse reports to the SCQCN Executive Director and is an employee of Dignity Health Managed Services Organization. The QM Nurse provides local support to the CI Program through continuous interaction and education with the participating physicians and mid-level providers, as well as hospital QM staff.   PRINCIPLE DUTIES AND RESPONSIBILITIES: - Serve as a key interface and liaison for the local participating physicians through collaboration with the Executive Director, physician practice liaison, and other key members of the SCQCN leadership team. - Responsible for physician education and training on processes and workflow related to clinical initiatives undertaken as a part of the CI Program, including CPTII and HCPCS coding, documenting quality data in paper and electronic charts, and reporting via the dashboard. This requires travel to provide on-site training in physician offices. - Working closely with Physician Practice Liaison to provide physician office staff education regarding support for physician in implementing clinical initiatives undertaken within the physician’s area of specialty. - Collaborate with Physician Practice Liaison by developing proficiency in understanding quality data extracts and reporting. - Collaborate with the Physician Practice Liaison in analysis, monitoring and interpretation of ambulatory clinical quality data, using dashboard reports. - Provide one-on-one education on use of dashboard reports and other communications as appropriate to identify potential improvements and assist physicians in understanding methods and processes required to achieve measurable results. - Collaborate with the Executive Director and SCQCN Chief Medical Officer (CMO)/Medical Director in preparing analyses, as well as monitoring, interpreting, and educating on results of clinical (ambulatory and hospital) quality, cost and utilization data. - Responsible for monitoring and evaluating physician compliance and performance with quality standards, as identified in weekly, monthly and quarterly reports and provide feedback to the Executive Director. - Perform patient chart review to reconcile quality reporting results with chart documentation, using a sampling methodology approved by the Board of Managers. - Provide Executive Director with support on performance improvement and development of remediation plans at the local service area level. - Support marketing and communications with materials relating to disease management programs. - Attend local quality management committee meetings, if requested by the Executive Director. - Assists the Executive Director with other duties as assigned.     #MISSIONCRITICAL
Job ID
2020-118073
Department
Quality Management
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Scotts Valley
The System Engineer II will provide operational support in addition to evaluation and implementation services for new products, technologies and solutions to address corporate business requirements. Works beyond the routine utilizing specialized knowledge and analysis of multiple variables. Has a comprehensive understanding and skillsets for supported platforms/products and environments.
Job ID
2020-143348
Department
Information Technology
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
The utilization review LVN uses clinical judgement in providing utilization management services. The focus is to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary.
Job ID
2020-142640
Department
Utilization Review
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Bakersfield
As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team. The goal of care coordination is to assist in managing care, cost, and outcomes across the continuum of patient care as it relates to acute inpatient stay and post-acute facility stay. The Utilization Review RN Coordinates continuing care/outside services for value based risk members (HMO members) in collaboration with the hospital and primary care physician. The Utilization Review RN is responsible to repatriate stable members from nonmember facilities in the emergency department and inpatient setting. This role monitors the patients in Skilled Nursing Facilities and out of network admissions using InterQual and makes assessments regarding appropriate lengths of stay. The process also involves screening for appropriateness of care and talking to the outside physicians to establish stability to and appropriateness of transfer. The Utilization Review RN coordinates and promotes an appropriate post-hospitalization treatment plan and evaluates effectiveness. The position possesses proficient knowledge of evidenced based criteria such as Interqual to review for appropriate care. The implementation of sound clinical, fiscal, and operational strategies is critical to the continued delivery of quality services. Care coordination principles provide an opportunity to balance care with cost. The Utilization Review RN interacts with multiple disciplines to assure high quality, cost efficient care utilizing available resources for Dignity Health members.
Job ID
2020-126308
Department
Utilization Review
Facility
Dignity Health Management Services Organization
Shift
Day
Employment Type
Full Time
Location
CA-Redlands

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