Benchmark Human Services Jobs in Usa

Full-time, exempt position located at Corona Regional Medical Center in Corona, CA. Under the direction of the Chief Executive Officer and the Chief Medical Officer, the Director of Medical Staff Services oversees all internal and external activities of the Medical Staff and is responsible for all operational aspects of the department, including organizing and conducting programs and establishing procedures for medical staff functions. Responsible for maintaining federal, state and other licensing regulatory standards. Coordinates meeting agendas, minutes and follow-up. Acts as liaison between administration and hospital medical staff. Supervises Medical Staff personnel.

The tradition of caring that culminated in the establishment of Corona Regional Medical Center began in 1965, with the founding of Corona Community Hospital. Since that time the hospital has changed to meet the needs of the rapidly growing community. Corona Community Hospital merged with Circle City Medical Center in 1992 and the resulting entity became Corona Regional Medical Center. The merged hospitals are now a 238-bed community hospital network comprised of a 160-bed acute care hospital and a 78-bed rehabilitation campus. It is certified by The Joint Commission, employs more than 1,250 trained healthcare workers and has a medical staff of approximately 347 physicians representing more than 40 specialties.

About Universal Health Services: One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

Qualifications

Education/Training/Experience: Bachelor's degree from an accredited College or University in related field required. Master's degree from an accredited College or University in related field preferred. Five (5) to Seven (7) years of experience in Medical Staff Services required. Minimum 3 years leadership experience in Medical Staff Services required, acute care experience preferred. Regulatory and Accreditation knowledge, critical thinking, attention to details, organization and time management skills are essential.

Certifications/Licenses: Certified Professional in Medical Services Management (CPMSM) Certified Provider Credentialing Specialist (CPCS) preferred.

EEO Statement: All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams: At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Weaver is a full-service national accounting, advisory, and consulting firm with opportunities for professionals in many different fields. We seek to bring a human element to the world of accounting, which includes creating a diverse, collaborative, and entrepreneurial workplace culture. Our leaders truly care about the well-being of all our employees and encourage them to pursue their ambitions.

While our business is based in numbers, our success is truly based on people. It's why we commit to supporting our people not just in their professional growth, but also in their ability to lead balanced, integrated lives. At the foundation of that commitment are our core values. Weaver's core values were created specifically to empower our people to deliver extraordinary service and be their best selves. Our goal is to balance high development with high performance in order to meet the long-term goals of each individual, team, and our firm.

Weaver is looking for a Transaction Advisory Services Manager to join our growing firm. Weaver's Transaction Advisory Services team is a high-performing team widely recognized for delivering exceptional attention to detail and a personal level of service. Our size enables us to be more nimble and responsive while servicing clients with transaction sizes ranging from $1 million to over $500 million.

A Transaction Advisory Services Manager at Weaver assists in the strategic development and execution of an appropriate transaction structure, including the execution of financial due diligence. The Manager works to understand profit drivers and trends, assists with purchase agreements and post-closing transaction matters. A Manager is responsible for identifying issues for purchase price reductions, deal structuring or deal termination, and post-acquisition action steps to achieve anticipated earnings/cash flow improvements. The Manager is responsible for the overall engagement quality and timeline. They will assist in the review of databook and reports prepared by Associates and Senior Associates. The Manager will prepare client ready deliverables. A Weaver Manager is an excellent communicator and team leader, and is able to manage and develop staff.

To be successful in this role, the following qualifications are required:

• Bachelor's degree in Accounting
• CPA required
• 5+ years of experience in transaction advisory services/financial due diligence, or mergers and acquisitions transactions
• Demonstrate an advanced understanding of technical accounting literature with GAAP
• Possess experience with due diligence engagements related to acquisitions by private equity investor groups and strategic corporate buyers, analyzing financial/operational results of targets through reviewing accounting records and conducting interviews with management, and preparing pro forma financial information
• Demonstrates independent thinking and strong decision-making skills

Additionally, the following qualifications are preferred:

• Master's degree in Accounting or related field
• Proven ability to manage, mentor and develop staff
• Strong relationship management and practice development skills
• Ability to attract and service new clients and expand services to existing clients

Annual Base Pay Range in California and New York: $110,000 to $160,000. Exact compensation may vary based on skills, experience, and location.

Weaver Benefits: At Weaver, our most valuable resource is our people. We take the time to evaluate our employees' wants and needs and invest our resources accordingly. Weaver offers competitive health benefits, such as medical, dental, vision, disability, life insurance, and a 401(k) plan. Further, we support our employees by offering flexible scheduled time off (STO), minimum of 56 hours of sick and safe leave, 11 holidays, and 2 scheduled recharge days! Learn more here.

We also offer in-house CPE and learning opportunities through our internal Learning & Development department. Our multi-faceted internal learning program including technical improvement, practice development, management/leadership training, and whole-life growth. Our goal is to balance both high development with high performance to meet the long-term goals of each individual, team, and our firm.

We are committed to investing in the strength of our team. That is why we have created an internal leadership coaching program to train leaders to support other leaders at every level of the organization. The goal of WeaverLEAD is to inspire the growth and development of our leaders by:

• Leaning into the experience of exploring new ideas for each individual's growth as a leader.
• Engaging the coaching mindset at work with new ways of thinking about challenges and opportunities.
• Adapting to the transformation that takes place as a result of participating in the program.
• Developing yourself and others with coaching competencies to create a firm-wide culture of coaching.

People are our formula! At Weaver, we recognize that everyone brings different strengths, backgrounds, and working styles to our team. We cultivate a safe and inclusive work environment that celebrates each individual's unique qualities through visibility, progression, advocacy, and support. We are proudly an equal opportunity employer.

Interested applicants should apply directly to the job posting. You may apply to multiple roles. Be sure to upload your most recent resume and ensure that it is attached to your application. By registering, you are only activating an account and creating a presence. Please apply directly to a position of interest. You will receive a confirmation email after completing an application for a role. After reviewing your application, a friendly Weaver Recruiter will contact you soon and walk you through the hiring process. Thank you for exploring a career with us. We look forward to meeting you!

Currently, we are not accepting resume submissions from third-party staffing agencies for this role. This role is Employee Referral Program eligible.

Hybrid: Applicants must be a California resident as of their first day of employment.

PRINCIPAL RESPONSIBILITIES:

Member Services Representatives (MSR) are the first point of contact for our members' primary contact with the Alliance for both routine and complex member issues with the goal of delivering excellent customer service to our customers. The position is responsible for answering a high volume of inbound and outbound calls in a timely manner. Respond to all communications coming into Member Services in the form of email, fax, letters, chat and phone calls. Timely responses to all member communication are essential. Must effectively prioritize and flex the workload as new communication and tasks are submitted. Identify the caller's needs, clarify information, research issues, and provide solutions and/or alternatives whenever possible. Accurately and consistently document all conversations in the electronic database. This position is a liaison between the plan, the provider network, and other community agencies. The MSR positions are flexibly staffed classification and work is expected to be performed minimally at the MRS II level. However, the initial selection will be made at the entry level MSR I. Our more advanced level position of the series is the MSR III who will be required to perform a variety of complex matters.

Member Services Representatives are under the direction of a Member Services Supervisor, Manager and Director, and service our members through our call center as well assisting other departments with responses to member issues by initiating communication between departments to ensure action, cooperation, and compliance of managed care operations.

Member Services Representative I

This position which requires the ability to work as a team player within the Alliance and with external contacts, make sound judgments based on analysis of information, be an effective communicator, active listener and balance advocacy for the member with the policy provisions such as plan policies, EOC, regulatory guidelines, and DMHC/DHCS rules and regulations. The MSR provides courteous, professional, and accurate responses to incoming inquiries regarding network, plan benefits, eligibility, authorizations, plan services and guidelines, as well make decisions with the goal of ensuring member satisfaction and retention. The MSR performs a variety of complex functions and is also responsible for maintaining accurate and complete inquiry/grievance records in the electronic database. Maintains compliance with DMHC regulatory requirements and DHCS contractual obligations. MSR I staff who demonstrate proficiency in meeting, maintaining and exceeding principal performance objectives and metrics may be eligible to be promoted to a Member Services II or III role. Member Services Representative I staff may be eligible for promotion to Member Services Representative II or III positions once they have worked as a MSR I for a minimum of 12 months to be proficient with program and system knowledge in addition to meeting performance matrix requirements.

Principle duties and responsibilities

* Serve as the primary contact for members, providers and others for questions related to claims, benefits, authorizations, pharmacy, member eligibility and other questions related to Alameda Alliance and provide accurate, satisfactory answers to their inquiries or concerns.

* Respond to and resolve member service inquiries and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility, claims, behavioral health, and care coordination.

* Answer incoming calls, emails, chats, and other requests for assistance in a timely manner in accordance with departmental performance targets and provide excellent customer service while doing so. May include assisting members in person.

* Recognize and understand the difference between calls that require quick resolutions and calls which will require follow-up and handle each appropriately.

* De-escalate situations involving dissatisfied customers, offering patient assistance and support.

* Accurately document all contacts per department standards/guidelines in the Customer Relationship Management (CRM) system.

* Accurately and consistently document (electronic database) and resolve Exempt Grievances (any expression of dissatisfaction that are not coverage disputes, disputed health care services involving medical necessity, or experimental or investigational treatment and that are resolved by the next business day following receipt).

* Interface with Grievance and Appeals, Claims, Enrollment, IT, Network Management, Pharmacy, Authorizations, and other internal departments to provide Service Excellence to our members.

* Help guide and educate members about the fundamentals and benefits of managed health care topics, to include managing their health and well-being by selecting the best benefit plan service options, maximizing the value of their health plan benefits, and choosing a quality care provider.

* Intercede with care providers (doctor's offices) on behalf of the member, assisting with appointment scheduling; connect members with internal Case Management Department for assistance as needed.

* Assist members in navigating , the Member Portal, and other health care partner online resources and websites to encourage/reassure them to use self- service tools that are available.

* Manage any issues through to resolution on behalf of the member, either on a single call or through comprehensive and timely follow-up.

* Research complex issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issues.

* Provide education and status on previously submitted pre-authorizations or pre- determination requests for both medical and pharmaceutical benefits.

* Meet the performance goals established for the position in the areas of compliance, efficiency, call quality, member satisfaction, first call resolution, punctuality, and attendance.

* Always maintain a professional level of service to members.

* Always maintain confidentiality of information.

* Consistently support the Alliance's approach to Service Excellence by adhering to established department and company standards for all work-related functions.

* Interact positively with all Alliance Departments.

* Accurately and consistently document (electronic database) and resolve Exempt Grievances (any expression of dissatisfaction that are not coverage disputes, disputed health care services involving medical necessity, or experimental or investigational treatment and that are resolved by the next business day following receipt).

* Process MS Dept projects

* Serve as a back-up to manage the escalated calls.

* Perform other duties as assigned.

ESSENTIAL FUNCTIONS OF THE JOB

* Contacts: Receive, manage, and document telephone calls, emails, and other sources of contacts from members, potential members, and providers, and explain health plan benefits and plan rules. Describe the types of services the Alliance offers to the Member within the managed care system. Provide clarification about issues regarding patient and physician rights and how the plan operates.

* Conflict resolution: Resolve member problems/conflicts by convening with other departmental staff as needed.

* Member communications: Create and/or mail appropriate member materials and communications as needed.

* Computer: Perform ongoing data entry which assists in the maintenance of the Member Services department database to ensure data integrity.

* Comply with the organization's Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.

PHYSICAL REQUIREMENTS

* Constant and close visual work at desk or computer.

* Constant sitting and working at desk.

* Constant data entry using keyboard and/or mouse.

* Constant use of multi-monitor setup

* Frequent use of telephone and headset.

* Frequent verbal and written communication with staff and other business associates by telephone, correspondence, or in person.

* Frequent lifting of folders, files, binders, and other objects weighing between 0 and 30 lbs.

* Frequent walking and Standing

Number of Employees Supervised: 0

MINIMUM QUALIFICATIONS:

* Bachelor's degree or equivalent experience preferred.

* High school diploma, GED required.

* The ability to speak and understand-bilingual: Spanish/English, Cantonese/English, Vietnamese/English, Tagalog/English are required as designated.

* A bilingual proficiency exam will be administered to ensure the candidate possesses the appropriate skill level to meet requirements. The successful candidate must score 90% or higher.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

* Minimum one year of direct customer service experience. Call center experience and managed care experience a plus

* Experience determining eligibility for financial assistance, insurance benefits, unemployment and/or other social services programs.

* Demonstrated knowledge expert of AAH Member Services policies and procedures

* Consistent record of meeting, maintaining, or exceeding monthly Departmental performance metrics.

* Consistent track record of documenting Service Requests accurately and clearly and monitoring open Service Requests to ensure responses and closure.

* Consistent record of high quality of work as demonstrated through call and documentation auditing, appropriate Call Disposition coding, as well as an overall acceptable monthly Member Satisfaction Survey result as assessed by Member Services Quality Specialist, MS Trainer and Member Services Supervisor.

* Demonstrated proficiency in current Customer Relationship Management (CRM) tool, phone system software Quality Management Solution, Pharmacy Benefits Management applications (PBM), Interpreter vendor scheduling software, delegate portal solutions and the Alliance's Member portal.

* Demonstrated ability to effectively handle the department's key special projects: Member Portal Request Processing, Kaiser PTE Requests, PCP retroactive and same month requests.

* Demonstrated ability to help members face-to-face in the field and/or at the Alliance offices (walk-ins). Also highly skilled at handling issues related to member bills, transportation set-up and benefit coordination with providers and pharmacy needs.

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

* Ability to prioritize and adapt to changing situations in a calm and professional manner.

* Ability to maintain composure in stressful situations.

* Excellent problem-solving skills

* Ability to exhibit cooperation, flexibility, and provide assistance when talking to members, providers, and staff.

* Skill in basic data entry

* Ability to type 40 net words per minute: multi-task

* Manual dexterity to operate telephone, computer keyboard equipment.

* Speak English proficiently, clearly, and audibly.

* Memorize and retain information quickly; meet physical requirements

* Spell correctly

* Learn the policies, regulations, and rules applicable to business operations.

* Follow instructions, reason clearly, analyze solutions accurately, act quickly and effectively in emergency situations; operate office equipment including computers and supporting word processing, spreadsheet, and database applications.

* Excellent phone etiquette and ability to communicate clearly and concisely, both orally and in writing.

* Excellent interpersonal skills with the ability to interact with diverse individuals and flexibility to customize approach to meet all types of member communication styles and personalities.

* Strong verbal and written communication skills.

* Demonstrated ability to quickly build rapport and respond to members in a compassionate manner by identifying and exceeding member expectations (responding in respectful, timely manner, consistently meeting commitments).

* Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member.

* Must be self-motivated and able to work with minimal supervision

* Must be team-oriented and focused on achieving organizational goals.

* Proficient problem-solving approach to quickly assess current state and formulate recommendations.

* Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions which members can understand and act upon.

* Proficient conflict management skills to include ability to resolve issues during stressful situations and demonstrating personal resilience.

* Ability to work regularly scheduled shifts within the Alliance's hours of operation including the training period, with scheduled lunches and breaks, flexibility to adjust daily schedules; and to work over-time and/or weekends as needed.

* Medical terminology knowledge preferred

* Ability to work within a broad systems perspective

* Experience in use of various computer systems software as well as Microsoft Windows, and Microsoft Suite, especially Outlook, Word, Excel.

* Must have reliable and stable internet connection for remote work (50-100 Mbps download speeds).

Employees who interact with members of the public may be required to be tested for Tuberculosis and fully vaccinated against COVID-19 and influenza. Successful candidates for those positions/ classifications may be required to submit proof of vaccination against influenza and/or COVID-19, a negative Tuberculosis test, or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates should not present proof of vaccination until instructed to do so by the Human Resources department.

SALARY RANGE $22.88-$34.33 HOURLY

The Alliance is an equal opportunity employer and makes all employment decisions on the basis of merit and business necessity. We strive to have the best-qualified person in every job. The Alliance prohibits unlawful discrimination against any employee or applicant for employment based on race, color, religious creed, sex, gender, transgender status, age, sexual orientation, national origin, ethnicity, citizenship, ancestry, religion, marital status, familial status, status as a victim of domestic violence, assault or stalking, military service/veteran status, physical or mental disability, genetic information, medical condition, employees requesting accommodation of a disability or religious belief, political affiliation or activities, or any other status protected by federal, state, or local laws.

Who We Are

As the nation's largest producer of clean, carbon-free energy, Constellation is focused on our purpose: accelerating the transition to a carbon-free future. We have been the leader in clean energy production for more than a decade, and we are cultivating a workplace where our employees can grow, thrive, and contribute.

Our culture and employee experience make it clear: We are powered by passion and purpose. Together, we're creating healthier communities and a cleaner planet, and our people are the driving force behind our success. At Constellation, you can build a fulfilling career with opportunities to learn, grow and make an impact. By doing our best work and meeting new challenges, we can accomplish great things and help fight climate change. Join us to lead the clean energy future.

Total Rewards

Constellation offers a wide range of benefits and rewards to help our employees thrive professionally and personally. We provide competitive compensation and benefits that support both employees and their families, helping them prepare for the future. In addition to highly competitive salaries, we offer a bonus program, 401(k) with company match, employee stock purchase program comprehensive medical, dental and vision benefits, including a robust wellness program paid time off for vacation, holidays, and sick days and much more.

Expected salary range of $162,000 to $180,000, varies based on experience, along with comprehensive benefits package that includes bonus and 401(k).

Primary Purpose of Position

Manage and monitor the work activities of the assigned regional valve services organization to ensure a productive workforce that supports all divisional, departmental, Clean Energy Center (CEC) and corporate goals while in accordance with all company policies and local, state, and federal regulations.

Primary Duties and Accountabilities

• Provide guidance and oversight to regional Valve Services group during online and outage activities execution functions through routine performance monitoring, audits, self-assessment, and lessons learned for continuous improvement.
• Collaborate and interface with CECs to plan, schedule, and execute work activities.
• Manage and monitor department resources and budgets to ensure optimum performance and equipment reliability.
• Hire, develop, retain and mentoring of talent required to support the organization.
• All other job assignments and/or duties pursuant to company policy or as directed by management to include but not limited to: (Emergency Response duties and/or coverage, Department duty coverage and/or call out, and positions outside of department in support of outage activities etc.)

Minimum Qualifications

• Bachelor's degree with 8 years of related experience OR
• Current or previous Senior Reactor Operator (SRO) license with 8 years of related experience OR
• Associate's degree with 10 years of related experience OR
• High school diploma/GED with 12 years of related experience
• Supervisory and/or managerial experience
• Maintain minimum access requirements or unescorted access requirements, as applicable, and favorable medical examination and/or testing in accordance with position duties

Preferred Qualifications

• Experience in nuclear power plant operations
• Electrical experience within the realm of Motor Operated Valve planning
• Valve / outage planning experience
• P6 / scheduling experience