Code Red Diet Plan Pdf Jobs in Usa

20,125 positions found — Page 3

Physician / Family Practice / California / Permanent / Physician needed in Redding, CA - Excellent S
Salary not disclosed
Chicago, Illinois 4 days ago
Hello,My name is Valerie and I work with Private Practice located in Redding, CA.

We are currently looking for Physician who has worked in occupational medicine or workers' comp, to join our team.

This opportunity offers a Monday through Friday schedule, generous benefit package, no call, and more If you are interested in this position, I hope that you call me right away at , and respond to this email with your CV.

I look forward with speaking with you.Have a great day!Warmest Regards,Valerie
permanent
Physician / Internal Medicine / North Dakota / Permanent / At the head of the Red River of the North
Salary not disclosed
Chicago, Illinois 4 days ago
At the head of the Red River of the North
30 miles to Fergus Falls and the lakes
50 miles to Fargo
120 miles to Grand Forks
3 hours to Minneapolis & Sioux Falls

* Outpatient practice - no inpatient/hospitalist coverage required
* Highly-engaged Primary Care team currently consisting of 1 internist, 1 family physician and 1 pediatrician as well as 4 nurse practitioners
* Optometry and surgery also on site with outreach service from many other specialties
* Work schedule: 32-36 patient contact hours per week
* Clinic patients average 16-18/day
* OB is optional
* Certified as HIMSS EMRAM (Electronic Medical Record Adoption Model) Level 7 for both our Inpatient and Ambulatory facilities
permanent
Attorney - Civil Litigation Defense (Red Bank NJ)
Salary not disclosed

Leading firm with a national footprint is seeking an Associate Attorney for their growing Red Bank New Jersey office. Ideal candidate will be admitted in New York and have 3-12+ years of litigation defense experience. This is an excellent opportunity to work with Partners who value collaboration and a collegial work environment.

You will manage your own caseload and work autonomously on a variety of legal matters. Ideal candidate will have experience in one or more of the following areas: General Liability, Premises Liability, Construction Defect, Construction Labor Law, Auto, Product Liability, Toxic Tort, Medical Malpractice, Personal Injury, Transportation, Professional Liability, Insurance Defense, Tort, Civil Defense.

Responsibilities:

  • Manage assigned cases
  • Handle cases from inception to conclusion
  • Take and defend depositions
  • Make court appearances
  • Draft motions, pleadings and respond to discovery

Qualifications:

  • JD from accredited law school
  • Strong research and writing skills
  • 3-12+ years of experience
  • Must be admitted in New York. New Jersey admission is a plus!

Competitive Compensation Range 135k-200k+ Generous Monthly Bonuses + Full Benefits + Hybrid or Remote

Please email resume to

Not Specified
Hematologist/Oncologist Needed for Locum Tenens Coverage at Outpatient Facility in Redding, California
Salary not disclosed
Friant, CA 5 days ago
This Job at a Glance

- Job Reference Id: ORD- -MD-CA
- Title: MD
- Dates Needed: Feb 2-6, Feb 9-13, and 16-20
- Shift Type: Day Shift
- Assignment Type: Outpatient
- Call Required: No
- Board Certification Required: No
- Job Duration: Locums

About the Facility

This regional hospital provides comprehensive emergency and surgical services with Level II trauma capabilities. The facility features approximately 30 emergency department beds and maintains full oncology services. The hospital serves as a key healthcare resource for the Northern California region with modern medical equipment and established clinical protocols.

About the Facility Location

This Northern California region offers diverse outdoor recreation opportunities throughout the year, featuring world-class ski resorts like Mammoth Mountain and scenic mountain landscapes. The area provides access to unique attractions including historic rail experiences, distinctive coastal formations, and numerous wineries alongside well-maintained state parks. Visitors can enjoy year-round activities ranging from winter sports to wine tasting, with the region serving as a gateway to some of California's most scenic natural destinations.

About the Clinician's Workday

The hematologist/oncologist will provide comprehensive outpatient cancer care during day shifts with no call requirements. Responsibilities include evaluating new consults, developing treatment plans, and delivering oncology services in a regional hospital setting. The position offers standard Monday through Friday scheduling with focus on delivering quality patient care in an outpatient environment. Board certification is not required, making this opportunity accessible to qualified clinicians seeking locum tenens coverage.

Additional Job Details

- Case Load/PPD: 15-20
- Support Staff: 1- clinic RN, 2-MAs, 2-front office clerks, 1-quality analyst/billing, and 10 infusions RNs
- Patient Population: Adults
- Location Type: On-Site
- Prescriptive Authority Required: No
- Government: No
- Number of New Consults: 0
- Treatment Types: Comprehensive oncology treatment services

Why choose ?

Our services are 100% free for clinicians and are designed for a seamless experience with every assignment:

- Precision job matching with proprietary algorithm

- Rapid credentialing with Axuall Digital Wallet

- Concierge support with a dedicated clinician deployment specialist

- Digital hub for assignment details
Not Specified
Coder II - Outpatient - Coding & Reimbursement
Salary not disclosed
Lakeland, FL 2 days ago

Position Details

Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.

Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.


Active - Benefit Eligible and Accrues Time Off

Work Hours per Biweekly Pay Period: 80.00

Shift: Flexible Hours and/or Flexible Schedule

Location: 210 South Florida Avenue Lakeland, FL

Pay Rate: Min $19.37 Mid $24.22


Position Summary

Under the direction of the Coding and Clinical Documentation Improvement Manager, reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, Physician Advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract. Participates in ongoing continued education to assure knowledge and compliance with annual changes.

Position Responsibilities

People At The Heart Of All That We Do

  • Fosters an inclusive and engaged environment through teamwork and collaboration.
  • Ensures patients and families have the best possible experiences across the continuum of care.
  • Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

Safety And Performance Improvement

  • Behaves in a mindful manner focused on self, patient, visitor, and team safety.
  • Demonstrates accountability and commitment to quality work.
  • Participates actively in process improvement and adoption of standard work.

Stewardship

  • Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
  • Knows and adheres to organizational and department policies and procedures.

Standard Work Duties: Coder II - Outpatient

  • Assigns and sequences diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding
  • Abstracts and enters coded data as well as correct surgeon, anesthesiologist and procedure date. Assures appropriate information such as pathology and operative reports are present in the medical record prior to final coding for coding accuracy and appropriate APC assignment.
  • Maintains appropriate level of coding and abstracting productivity and quality for outpatient diagnostic, Emergency Department, Family Health Center, ambulatory surgeries, observations, and other recurring services as per established minimum per hour requirement.
  • Demonstrates competence in coding and abstracting requirements by maintaining less than 5% error rate for all ICD-10-CM and/or PCS, CPT, and HCPCS codes and modifiers.
  • Continuously reviews changes in coding rules and regulations including in Coding Clinic, CPT Assistant, CMS, and other payer guidelines.
  • Prioritizes coding functions as directed by the Manager, and organizes job functions and work assignments to efficiently complete tasks within the established time frames.
  • Demonstrates knowledge of all equipment and systems/technology necessary to complete duties and responsibilities.
  • Works collaboratively with the Discharge Not Final Billed (DNFB) clerks to prioritize workload daily.
  • Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.
  • Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.


Competencies & Skills

Essential:

  • Computer Experience, especially with computerized encoder products and computer-assisted coding applications.
  • Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision.
  • Knowledge of anatomy and physiology, pharmacology, and medical terminology.


Qualifications & Experience

Essential:

  • High School or Equivalent

Nonessential:

  • Associate Degree

Essential:

  • High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.


Other information:

Certifications Essential: CCS

Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).


Experience Essential:

2-5 years acute care hospital outpatient coding experience within the past five years, or 5-7 year's experience in a multi-disciplinary clinic including surgeries and/or Emergency Department coding.

Not Specified
Coding II - Inpatient - Coding & Reimbursement
🏢 Lakeland Regional Health-Florida
Salary not disclosed
Lakeland, FL 2 days ago

Position Details

Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.

Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.


Active - Benefit Eligible and Accrues Time Off

Work Hours per Biweekly Pay Period: 80.00

Shift: Flexible Hours and/or Flexible Schedule

Location: 210 South Florida Avenue Lakeland, FL

Pay Rate: Min $24.73 Mid $30.92


Position Summary

Under the direction of the Coding and Clinical Documentation Improvement Manger , reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, physician advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract, Participates in ongoing continued education to assure knowledge and compliance with annual changes.

Position Responsibilities

People At The Heart Of All That We Do

  • Fosters an inclusive and engaged environment through teamwork and collaboration.
  • Ensures patients and families have the best possible experiences across the continuum of care.
  • Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

Safety And Performance Improvement

  • Behaves in a mindful manner focused on self, patient, visitor, and team safety.
  • Demonstrates accountability and commitment to quality work.
  • Participates actively in process improvement and adoption of standard work.

Stewardship

  • Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
  • Knows and adheres to organizational and department policies and procedures.

Standard Work Duties

  • Determines whether the coding assigned was properly assigned based upon clinical indicators and review of the medical documentation and application of coding guidelines.
  • Develop and apply appeal arguments to defend the coding and clinical decisions while being able to address and refute the coding determination made by the carrier/payer.
  • Drafts appeal letters, including the coding argument with clinical and coding references, to support the coding decision. This may include providing additional medical record documentation.
  • Identifies areas for education to improve complete and accurate coding and billing and provide feedback to management regarding trends or patterns noticed in the coding for discussion.
  • Continued follow-up on denials as payers may continue to deny. Collaboration with Physician Advisor as required to continue appeal process.
  • Continuously reviews changes in coding rules and regulations including in Coding Clinic, CMS, and other payer guidelines.
  • Complete denials/appeals reports for leadership.
  • Documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.
  • Assigns and sequence documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.s diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines.
  • Performs special projects and/or other duties as assigned.


Competencies & Skills

Nonessential:

  • Computer Experience, especially with computerized encoder products and computer-assisted coding applications.
  • Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision
  • MS-DRG and APR-DRG methodology expertise required. Strong knowledge of ICD-10-CM, ICD-10-PCS, POAs, HACs, PSIs, SOIs, ROMs and mortality rates as well as physician queries.


Qualifications & Experience

Nonessential:

  • Associate Degree

Essential:

  • High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.


Other information:

Certifications Essential: CCS

Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).

Experience Essential: 2-5 years acute care hospital inpatient coding experience within the past five years.

Not Specified
Supervisor, PB Surgical Coding
Salary not disclosed
Warrenville, IL 3 days ago
Hourly Pay Range:

$32.60 - $48.90 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights

- Position: Supervisor PB Surgical Coding
- Location: Warrenville, IL
- Full Time
- Hours: Monday-Friday, [hours and flexible work schedules]

A Brief Overview:
The Supervisor, Medical Coding, is responsible for overseeing the medical coding team, ensuring accurate code assignments, adherence to coding guidelines, and compliance with regulatory requirements. This position plays a pivotal role in maintaining financial accuracy and integrity within the hospital.

What you will do:

- Supervise and provide leadership to a team of medical coders, offering guidance, training, and support to ensure high-quality code assignments.
- Oversee and review diagnostic (ICD-10-CM) and procedural (CPT) codes assigned to medical records, validating their accuracy and adherence to coding guidelines.
- Conduct internal coding audits to monitor coding accuracy and consistency, providing feedback and guidance to coding staff.
- Collaborate with clinical staff, physicians, and clinical documentation specialists to ensure accurate coding and identify opportunities for documentation improvement.
- Stay current with coding guidelines, conventions, and regulatory changes, and disseminate information to the coding team.
- Ensure coding practices comply with federal, state, and local healthcare regulations and standards, including HIPAA.
- Generate coding reports, analyze coding data, and provide insights into coding accuracy, trends, and process improvement opportunities.
- Provide ongoing training and development opportunities for coding staff, ensuring they stay updated on best practices and regulations.
- Collaborate closely with clinical staff, health information management, and other departments to streamline the flow of coding-related information.
- Maintain strict confidentiality and security of patient data, complying with HIPAA and other privacy regulations.

What you will need:

- Bachelors Degree Health Administration Required or Bachelors Degree Information Technology Required
- 5+ Years of medical coding experience, with at least 2 years in a supervisory or leadership role.
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) Required And
- Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) Required

Benefits:

- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, and Vision options
- Tuition Reimbursement
- Free Parking at designated locations
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off and Holiday Pay
- Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals ? Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) ? all recognized as Magnet hospitals for nursing excellence. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website ( ) to better understand how Endeavor Health delivers on its mission to ?help everyone in our communities be their best?.

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.
Not Specified
Coding Educator
🏢 Endeavor Health
Salary not disclosed
Skokie, IL 3 days ago
Hourly Pay Range:

$24.86 - $37.29 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights:

- Position: Coding Educator
- Location: Skokie, IL
- Full Time
- Hours: Monday-Friday, [hybrid]

What you will do:

- Ongoing growth and development from participation in events such as workshops, in-service programs and departmental meetings.
- Provides care based on physical, psychological, educational and related criteria appropriate to the age and type of the patients/customers served in their area.
- Acts as a coding resource for physicians, charge entry staff, other coders, and clinical staff.
- Participates in continuing education and in-service programs to maintain coding and billing skills.
- Communicates coding changes and updates physicians based on department standards.
- Queries physician and/or staff regarding incomplete or missing documentation.
- Works resolute charge review work queues with the purpose of correcting coding errors, reviewing documentation and applying coding guidelines to ensure the accurate and timely filing of charges.
- Ensure service, procedure and diagnoses codes are accurately reported and linked.
- Assigns CPT, ICD-10 and HCPCS codes based on coding guidelines.
- Queries Physician/Provider when applicable
- Maintains productivity and aging levels based on department standards.
- Identifies trends in coding issues and works with manager to educate and implement solutions.
- Work follow-up work queues with the purpose of reviewing denial codes and remarks and apply coding and billing guidelines for resubmission to obtain final adjudication of claim.
- Use coding resources (NCCI manual, LCD's payor bulletins) to assist with correct resubmission.
- Maintains productivity based on department standards.
- Work account work queues with the purpose of resolving patient disputes by applying coding and billing guidelines.
- Communicates with practice managers and/or physicians if applicable.
- Maintains productivity based on department standards.
- Consistently utilizes coding and billing resources and reference tools.
- Reports identified or potential coding compliance issues to manager and/or Coding Compliance Department in accordance with established policy and procedures.
- Implements findings to improve processes and workflows.

What you will need:

- Education: High School Diploma Required
- Certifications: CCS or CCS-P or CPC or RHIT required
- Experience: 3 years of outpatient coding experience

Benefits:

- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, and Vision options
- Coverage
- Tuition Reimbursement
- Free Parking at designated locations
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off and Holiday Pay
- Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals ? Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) ? all recognized as Magnet hospitals for nursing excellence. Located in Naperville, Linden Oaks Behavioral Health, provides for the mental health needs of area residents. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential. Please explore our website ( ) to better understand how

Endeavor Health delivers on its mission to ?help everyone in our communities be their best?. Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.
Not Specified
Supervisor, Hospital Coding
🏢 Endeavor Health
Salary not disclosed
Warrenville, IL 3 days ago
Hourly Pay Range:

$30.46 - $45.69 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights:

- Position: Supervisor, Hospital Coding
- Location: Warrenville, IL
- Full Time/Part Time: Full Time
- Hours: Monday-Friday, [hours and flexible work schedules]

A Brief Overview:
The Supervisor, Medical Coding, is responsible for overseeing the medical coding team, ensuring accurate code assignments, adherence to coding guidelines, and compliance with regulatory requirements. This position plays a pivotal role in maintaining financial accuracy and integrity within the hospital.

What you will do:

- Supervise and provide leadership to a team of medical coders, offering guidance, training, and support to ensure high-quality code assignments.
- Oversee and review diagnostic (ICD-10-CM) and procedural (CPT) codes assigned to medical records, validating their accuracy and adherence to coding guidelines.
- Conduct internal coding audits to monitor coding accuracy and consistency, providing feedback and guidance to coding staff.
- Collaborate with clinical staff, physicians, and clinical documentation specialists to ensure accurate coding and identify opportunities for documentation improvement.
- Stay current with coding guidelines, conventions, and regulatory changes, and disseminate information to the coding team.
- Ensure coding practices comply with federal, state, and local healthcare regulations and standards, including HIPAA.
- Generate coding reports, analyze coding data, and provide insights into coding accuracy, trends, and process improvement opportunities.
- Provide ongoing training and development opportunities for coding staff, ensuring they stay updated on best practices and regulations.
- Collaborate closely with clinical staff, health information management, and other departments to streamline the flow of coding-related information.
- Maintain strict confidentiality and security of patient data, complying with HIPAA and other privacy regulations.

What you will need:

- RHIA or RHIT American Health Information Management Association (AHIMA) required
- 5+ Years of medical coding experience, with at least 2 years in a supervisory or leadership role.

Benefits:

- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, and Vision options
- Tuition Reimbursement
- Free Parking at designated locations
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off
- Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals ? Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) ? all recognized as Magnet hospitals for nursing excellence. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website ( ) to better understand how Endeavor Health delivers on its mission to ?help everyone in our communities be their best?.

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.

___________________________________________________________

Do not cut and paste below this line-Add only when applicable after posted.
Not Specified
Certified Coding Auditor Primary Care
✦ New
Salary not disclosed
New York, NY 1 day ago

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions.


The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely.


Principal duties and responsibilities:


Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers.


Researching state and payer regulations to identify areas of risk in a variety of healthcare settings and specialties, coordinating with various team members to ensure clear expectations are communicated and deadlines are met.


Qualifications:


CPC/CCS-P with a minimum of 5 years of experience in healthcare coding/auditing (E&M, CPT, HCPCS and ICD-10), with knowledge of professional billing, coding, and documentation practices performed by physicians and other qualified healthcare providers in inpatient and outpatient settings.


Proficiency in evaluating how well clinical documentation supports medical necessity and the E/M, CPT, and HCPCS codes that were billed, across a wide range of services. The focus will be in the primary care sector (fee-for-service and risk-based), though experience in specialties such as dermatology, vascular, podiatry, wound care, home health, and personal care is preferred. Behavioral health experience is also a plus.


Proven ability to identify billing and coding issues including use of modifiers, bundling issues, CCI edits, therapeutic and diagnostic procedures, supplies, materials, injections, drugs, and units of service etc.


Solid understanding of both federal and state coding and documentation laws and regulations, applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity. Identify and access risk of repayment or recoupment in the event of payor scrutiny.


Familiarity with both UB-04 and CMS 1500 claims data, as well as understanding of payor remittances.


Knowledge of anatomy, physiology, and medical terminology necessary to appropriately review assignment and documentation of diagnosis codes.


Solid working knowledge of various EHR/EMR systems; experience accessing these remotely.

Strong organizational skills and task management


Highly organized with a high level of attention to detail


Ability to work in a fast paced and rapidly changing environment.


Skilled at multi-tasking with the ability to handle several different priorities simultaneously.


Strong communication skills with experience in articulating audit findings and interpretation of coding regulations


Experience with HIPAA, data privacy, and/or data security processes.

Experience working with regulators governing (public or private) health insurance carriers.


A minimum of AAPC or AHIMA certification required, that could include:


· Certified Professional Coder (CPC)

· Certified Outpatient Coder (COC™)

· Certified Professional Medical Auditor (CPMA)

· Certified Risk Adjustment Coder (CRC™)

· Certified Coding Specialist (CCS)

· Certified Coding Specialist – Physician based (CCS-P)


For consideration, please email resume and cover letter as attachments with salary expectations to with the subject title “Certified Coding Auditor - Behavioral Health.”


Marwood offers a comprehensive compensation package with full benefits. We offer a competitive wage, a collaborative work environment and an opportunity to participate in a full benefit package, including, Medical, Dental, Vision, Life, AD&D, Voluntary Life and LTD, Spouse and Dependent Life, 401k Retirement plan with a company match, Commuter, FSA/DCFSA. We offer paid days off, and paid holidays. Marwood prides itself on providing employees with a good work-life balance. There is no travel expected with this position.


The position is based in our New York location. Currently working a hybrid schedule. Remote option will be considered.


We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class.

Not Specified
Building Inspector/Plans Examiner III & Building Inspector/Plans Examiner IV(Plan Review Lead)
Salary not disclosed
Corvallis, OR 2 days ago


Position Summary

Lead position that requires multi-certification and disciplines necessary to handle project approvals from start to finish through the plan review and inspection processes in accordance with the Division's mission and performance objectives.

Direct and lead Building Inspector/Plans Examiners and seasonal/casual staff. Assist the Division Manager and Building Official with program planning and personnel direction. Oversee the coordination of the building safety plan review and inspection process. Conduct construction code reviews and inspections for residential, commercial, industrial and multi-family development proposals. Depending on the Division's needs, employees in this position may be assigned to focus primarily on plan review or inspection duties. This program is highly visible and often the first contact made with the City from those outside the community. These tasks are illustrative only and may include other related duties.

This recruitment is accepting applications for
Building Inspector/Plans Examiner III
Building Inspector/Plans Examiner IV (Plan Review Lead)

Full-Time 40 hours per week

AFSCME-represented positions

12-month probationary period


Must meet all qualifications and requirements as listed in the position description below.

Building Inspector/Plans Examiner III $38.25 - 48.66 Hourly

Building Inspector/Plans Examiner IV (Plan Review Lead) $41.27 - $52.51 Hourly

These positions are anticipated to be assigned primarily to commercial and residential plan review.

Essential Duties

Building Inspector/Plans Examiner III
Leads and coordinates members of the development review and inspection teams to ensure a timely, predictable, comprehensive and accurate plan review and inspection process for any development proposal.

Reviews and inspects residential, commercial, industrial, and multi-family development proposals to ensure compliance with State and City codes/ordinances, engineering/architectural, and fire/life safety principles.

Depending on the Division's needs, performs construction plan review and site inspections:

  • Conducts Pre-Development, Plan Intake, and Pre-Construction meetings.
  • Takes the lead in coordinating plan reviews and inspections internally, with customers, and with other departments and agencies.
  • Maintains communication with contractors to anticipate and resolve onsite issues.
  • Performs building safety inspections and plan reviews.
  • Calculates and assesses fees.
  • Monitors permit and project status and follow-up with expired applications and permits.
  • Maintains accurate records and files of construction plan reviews, inspections, and related correspondence. Archives documents as required.
  • Manages phased development and deferred submittal process for assigned projects.
  • Ensures special inspection and structural observation is accomplished where required.
  • Recommends or issues Stop Work Orders, violation notifications, and other building code compliance actions when necessary.
  • Issues final approval of construction permits.
Meets Division expectations, responds to telephone and personal contacts from contractors, architects, engineers and the public on issues related to codes and standards associated with development proposals in a timely manner.

Provides technical interpretations of code issues and requirements.

Leads and coordinates teams to investigate and resolve matters of community concern, public health, building safety and dangerous building situations. Examples include fire scene investigations, flooding, mold growth, post-earthquake inspections, electrical hazards, hazardous materials, boiler explosions, sanitation issues, mechanical failures, and any condition identified in the Dangerous Building Code.

Represents the City at national, state and local boards, meetings, hearings, seminars, classes, and public
outreach events involving construction codes or building safety.

Provides training, support and assistance to cross-trained staff, and participates in cross-training programs.

Conducts compliance verifications for appropriate contractor licensing and registration.

Acts ethically and honestly; applies ethical standards of behavior to daily work activities and interactions. Builds confidence in the City through own actions.

Conforms with all safety rules and performs work is a safe manner.

Operates a motor vehicle safely and legally.

Delivers excellent customer service to diverse audiences.

Maintains effective work relationships.

Adheres to all City and Department policies.

Arrives to work, meetings, and other work-related functions on time and maintains regular job attendance.

Building Inspector/Plans Examiner IV (Plan Review Lead)
Assists with and prepares short and long range work plans, and schedules daily activities for Building Inspector/Plans Examiners.

Directs, trains and assists Building Inspector/Plans Examiners. Participates in recruitment process. Provides input concerning performance evaluations.

Performs Construction Plan Reviews and Inspections on complex residential, commercial, industrial, and multi-family development proposals to ensure compliance with State and City codes/ordinances, engineering/architectural, and fire/life safety principles.

Coordinates scheduling and organization of Pre-Development and Pre-Construction and other related meetings. Coordinates review/inspection approvals with internal/external agencies.

Coordinates Over-the-Counter, Rapid Review, and other processes. Ensures adequate staffing and oversight of a timely, predictable, comprehensive, and accurate plan review and inspection process for any development proposal.

Monitors and inspects work and projects completed by Building Inspector/Plans Examiners and contractors. Makes field decisions on procedures and methods.

Conducts quality control and internal audits for building safety code administration and enforcement.

Assists in budget preparation. Monitors expenses. Maintains staff supplies and resources.

Provides technical expertise and guidance in interpretations of code issues and requirements for development proposals.

Leads, guides, and ensures successful staff resolution of matters of community concern, public health, building safety and dangerous building situations. Examples include fire scene investigations, flooding, mold growth, post-earthquake inspections, electrical hazards, hazardous materials, boiler explosions, sanitation issues, mechanical failures, and any condition identified in the Dangerous Building Code. When necessary, issue notices of violation, notices to vacate, dangerous building declarations and stop work orders.

Represents the City at national, state and local boards, meetings, hearings, seminars, classes, and public outreach events involving development, construction codes or building safety.

Conforms with all safety rules and performs work is a safe manner.

Operates and drives a motor vehicle safely and legally.

Delivers excellent customer service to diverse audiences.

Maintains effective work relationships.

Adheres to all City and Department policies.

Arrives to work, meetings, and other work-related functions on time and maintains regular job attendance.

Qualifications and Skills

Building Inspector/Plans Examiner III

Education and Experience
High school diploma, or equivalent required. Associates degree in Building Inspection Technology, Drafting, Engineering, Fire Prevention, or other related field preferred.

Four years of formal education, training, and/or experience in construction management, architecture, structural engineering, building design, construction inspection, and/or plan review providing the knowledge, skills and abilities necessary to perform the essential functions of the position.

Knowledge, Skills and Abilities
Thorough knowledge of construction practices, engineering concepts, and architectural principles.

Excellent customer service, communication, and public relations skills and the ability to mediate adversarial situations. Ability to proactively anticipate and mitigate problem areas before they become issues.

Prioritize and meet multiple demands by the construction industry, the general public and other City staff.

Organize, coordinate, chair, and effectively facilitate high profile meetings.

Interpret, disseminate, and communicate complex technical information, state and local construction regulations, City review process, and City policies effectively with technicians and non-technicians.

Possess a self-directed commitment to maintain current knowledge of construction standards, methods, technologies, and codes.

Get along well and maintain effective work relationships with coworkers and the public.

Special Requirements

Certifications: Incumbent must be certified in accordance with OAR 918-098. Oregon Inspector Certification is required within 60 days of appointment.

Certifications giving the incumbent the legal ability to perform work described in sets A, B, C, or D:

A: Inspection/Plan Review:
Commercial Inspection (A-Level Building, Mechanical)
Residential Inspection (Building , Mechanical)
Residential Plan Review
Commercial Plan Review (A-Level, Mechanical) must be obtained within the probationary period.
OR
B: Residential Multi-Discipline:
Residential Plan Review
Residential Inspection for 4: Building, Mechanical, Plumbing and Electrical
OR
C: Commercial Plan Review:
Commercial Plan Review (A-level, Mechanical)
Fire and Life Safety
Residential Plan Review and Residential Inspection required within the probationary period
D: Specialty Discipline- Commercial and Residential Inspection and Plan Review to include:

  • Plumbing - Commercial and Residential Plumbing Inspector; obtain a Medical Gas Certification within the probationary period; or
  • Electrical - Commercial and Residential Electrical Inspector; obtain a Fire Investigation Certificate within the probationary period.

Experience in use of permit tracking systems. Excellent ability to use computer hardware, printers, and computer programs to conduct inspections, complete plan reviews, communicate and present information, track progress, schedule projects, and to perform the essential functions of the position. Demonstrable commitment to quality and timely customer service.

Possession or ability to obtain a valid Oregon Drivers License.

Demonstrable commitment to sustainability.

Demonstrable commitment to promoting and enhancing equity, diversity and inclusion.

The individual shall not pose a direct threat to the health or safety of the individual or others in the workplace.

Building Inspector/Plans Examiner IV (Plan Review Lead)

Education and Experience
High school diploma, or equivalent required. Bachelor's degree in Architecture, Engineering, Construction Management, Public Administration or a closely related field preferred. Two years of experience in construction management, architecture, structural engineering, building design, construction inspection, and/or plan review.

Six years of formal education, training and/or experience in construction management, architecture, structural engineering, building design, construction inspection, and/or plan review providing the knowledge, skills and abilities necessary to perform the essential functions of the position.

Knowledge, Skills and Abilities
Thorough knowledge of construction practices, engineering concepts, and architectural principles.

Excellent customer service, communication, and public relations skills and the ability to mediate adversarial situations, and proactively anticipate and mitigate problem areas before they become issues.

Prioritize and meet multiple demands by the construction industry, the general public and other City staff.

Organize, coordinate, chair, and effectively facilitate high profile meetings.

Travel among City worksites, off-site meetings and presentations.

Interpret, disseminate, and communicate complex technical information, state and local construction regulations, City review process, and City policies effectively with technicians and non-technicians.

Experience in use of permit tracking systems. Excellent ability to use computer hardware, printers, and computer programs to conduct inspections, complete plan reviews, communicate and present information, track progress, schedule projects, and to perform the essential functions of the position.

Get along well and maintain effective work relationships with coworkers and the public.

Demonstrable commitment to quality and timely customer service.

Special Requirements
Certifications: Incumbent must be certified in accordance with OAR 918-098. Oregon Inspector Certification is required within 60 days of appointment.

State of Oregon Building Official Certification; or State of Oregon Inspector Certification and International Code Council Certified Building Official Certification, must be obtained within the probationary period.

Certifications giving the incumbent the legal ability to perform work described in sets A, B, or C:
A: Inspection/Plan Review:
Commercial Inspection (A-Level Building, Mechanical)
Commercial Plan Review (A-Level, Mechanical, Fire and Life Safety)
Residential Inspection (Building , Mechanical)
Residential Plan Review
OR
B: Residential Multi-Discipline:
Residential Plan Review
Residential Inspection for 4: Building, Mechanical, Plumbing and Electrical

OR
C: Specialty Discipline - Commercial and Residential Inspection and Plan Review to include:

  • Plumbing - Commercial and Residential Plumbing Inspector plus obtain a Medical Gas Certification within the probationary period; or
  • Electrical - Commercial and Residential Electrical Inspector plus obtain a Fire Investigation Certificate within the probationary period.
Demonstrable understanding and commitment to sustainability; promote commitment, understanding and use of sustainability principles by employees for day to day operations.

Demonstrable commitment to diversity and promote diversity principles with employees in day to day operations.

The individual shall not pose a direct threat to the health or safety of the individual or others in the workplace.

Ability to pass a background check and/or criminal history check

Possession or ability to obtain a valid Oregon Drivers License.

How to Apply

Qualified applicants must submit an online application located on the City of Corvallis website(click on "Apply" above).

Position is open until filled.

First review of applications will occur after 8:00 AM on Friday March 6, 2026.

Resumes will not be accepted in lieu of a completed online application.

Late or incomplete applications will not be accepted/considered.

*Please do not include personal or protected information in attached resumes or cover letters, this includes your birth date, age, dates of education, and graduation dates.*



Not Specified
Commercial Building Code Inspector
Salary not disclosed

NOVA Engineering is currently seeking afully-certified Commercial Building Code Inspector in Panama City Beach FL. Primary duties will include performing building code inspections and/or plans review (building / structural, mechanical, electrical, and plumbing – as licensed) on residential and commercial buildings, as well as managing specific projects related to these types of code inspections. Some travel may be required for inspections and/or managing projects in the assigned area. The inspector positions are predominately located in the field but may occasionally include office assignments.


Essential Functions:

  • Building Code Review and/or Quality Control Inspections on commercial construction projects (Building, Mechanical, Electrical, and Plumbing)
  • Prepare written and electronic reports, and issue notices of correction
  • Explain and interpret code and/or quality control regulations or requirements
  • Recognize, evaluate and properly resolve unique problems or situations
  • Maintain effective customer service relationship with clients and the public
  • Assist the inspection management team with business development
  • Perform other related duties as assigned by the Manager


Qualifications:

  • Required state of Florida commercial building inspection license (BN#) in two or more of the following disciplines: Building (Structural), Mechanical, Electrical, and Plumbing.
  • 3+ years’ experience performing plan review and/or inspections


Check out our Perks:

In addition to our welcoming company culture and competitive compensation packages, our employees enjoy the below benefits:


  • Use of take-home Company Vehicle and gas card for daily travel to work sites
  • Comprehensive group medical insurance, including health, dental and vision
  • Opportunity for professional growth and advancement
  • Certification reimbursement
  • Paid time off
  • Company–observed paid holidays
  • Company paid life insurance for employee, spouse and children
  • Company paid short term disability coverage
  • Other supplemental benefit offerings including long-term disability, critical illness, accident and identity theft protection
  • 401K retirement with company matching of 50% on the first 6% of employee contributions
  • Wellness program with incentives
  • Employee Assistance Program


NOVA is an Equal Opportunity Employer. All qualified candidates are encouraged to apply. NOVA does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, disability, national origin, ancestry, marital status, veteran status or any other characteristic protected by law.

Not Specified
Engineering Plans Examiner
✦ New
Salary not disclosed
Columbus, OH 1 day ago
E.P. Ferris and Associates is seeking a detail-oriented and knowledgeable *Engineering Plans Examiner* to review engineering plans and technical documents for compliance with applicable codes, standards, and regulations. This role plays a critical part in supporting public agencies and private clients by ensuring projects are safe, compliant, and constructible.

The ideal candidate has strong technical expertise, excellent communication skills, and the ability to interpret complex engineering documents across multiple disciplines.

*Key Responsibilities*

* Review and evaluate engineering plans, calculations, and specifications for compliance with applicable local, state, and federal codes, ordinances, and standards
* Examine plans related to civil, structural, transportation, drainage, grading, utilities, and related engineering disciplines (scope may vary by assignment)
* Identify deficiencies, inconsistencies, and code violations; prepare clear and concise correction comments and reports
* Coordinate with engineers, architects, contractors, and agency staff to resolve plan review comments
* Provide technical guidance and interpretations of engineering codes and standards
* Maintain accurate records of plan reviews, approvals, and revisions
* Meet established turnaround times and service level agreements for plan review
* Stay current with changes in engineering codes, standards, and best practices
* Support permitting and entitlement processes as required by client agencies

*Required Qualifications*

* Bachelor’s degree in Civil Engineering or a related engineering discipline
* Minimum 4 years of experience in engineering plan review, design, or construction
* Strong knowledge of engineering codes, standards, and regulations
* Ability to read and interpret complex engineering plans, calculations, and technical reports
* Excellent written and verbal communication skills
* Strong organizational skills with the ability to manage multiple projects simultaneously
* Proficiency with standard engineering and plan review software (e.g., Bluebeam, AutoCAD, Civil 3D, or similar)

*Preferred Qualifications*

* Professional Engineer (PE) license or Engineer-in-Training (EIT) certification
* Previous experience working with or for public agencies
* Familiarity with electronic plan review systems
* Experience in consulting or third-party plan review services

*Work Environment & Benefits*

* Collaborative consulting environment supporting a variety of public and private sector clients
* Competitive compensation commensurate with experience
* Benefits package includes health insurance, retirement plan, paid time off, and professional development opportunities

*About EP Ferris and Associates*

E.P. Ferris and Associates is a professional consulting firm providing specialized plan review and engineering support services to public agencies. The firm is committed to technical excellence, responsiveness, and delivering high-quality service to its clients.

Job Type: Full-time

Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Employee assistance program
* Health insurance
* Life insurance
* Paid time off
* Referral program
* Retirement plan
* Vision insurance

Application Question(s):
* What is your proficiency with standard engineering and plan review software (Bluebeam, AutoCAD, Civil 3D, or similar)?

Experience:
* engineering plan review, design, or construction: 4 years (Required)

License/Certification:
* Professional Engineer (PE) or Engineer-in-Training (EIT) (Preferred)

Work Location: In person
permanent
Modular Construction Plans Examiner - ICC B3
✦ New
Salary not disclosed
Cottage Grove, WI 1 day ago

PFS TECO is seeking an experienced MOD Plans Examiner to join our Manufactured Structures Division in Cottage Grove, WI.


In this role, you will review modular construction plans and engineering documentation to ensure compliance with ICC building codes and modular construction standards.

We are looking for a professional who enjoys applying building code expertise to real-world construction projects and collaborating with manufacturers and engineers across the country.


Responsibilities

• Review modular residential and commercial construction plans

• Prepare plan review reports and identify compliance issues

• Provide code interpretation to manufacturers and engineers

• Coordinate with internal inspection teams to ensure consistent code application


Qualifications

ICC B3 – Building Plans Examiner certification required

2–3 years experience in modular construction, plan review, or building inspection

• Strong ability to interpret construction drawings and engineering documents

• Strong analytical and communication skills


Why Join PFS TECO

• Work with modular manufacturers nationwide

• Apply your ICC expertise to specialized construction projects

• Opportunities for additional ICC certifications and professional development

• Part of NFPA Global Solutions, a global organization advancing safety in the built environment


Apply Now: PFS TECO Career Page


Location: In-person – Cottage Grove, WI

Not Specified
Modular Construction Plans Examiner
✦ New
Salary not disclosed
Bloomsburg, PA 1 day ago

Are you interested in engineering, construction, or building design and looking to grow into a technical career?


PFS TECO is hiring an Entry-Level MOD Plan Reviewer to join our Manufactured Structures Division in Bloomsburg, PA. In this role, you will learn how to review modular building construction plans and ensure they meet national building code requirements.


This position is ideal for someone who enjoys solving technical problems, working with construction drawings, and building specialized expertise in the modular construction industry.


What You’ll Do

• Review modular residential and commercial construction plans

• Learn to apply building codes

• Identify code compliance issues and assist with plan review reports

• Work with engineers, inspectors, and manufacturers across the country

• Develop technical expertise and pursue ICC certifications


What We’re Looking For

• Interest in construction, engineering, architecture, or building design

• Strong attention to detail and analytical thinking

• Ability to review technical drawings and documents

• Desire to learn and grow in a technical field


Why Join PFS TECO

• Training and mentorship from experienced code professionals

• Career growth through International Code Council certifications

• Work with a nationally recognized certification organization

• Be part of NFPA Global Solutions, advancing safety in the built environment


Apply Now! Modular Plan Reviewer


Location: In-person – Bloomsburg, PA

Not Specified
Inventory Planning Supervisor
✦ New
Salary not disclosed
Miami, FL 1 day ago

Our client is seeking an Inventory Planning Supervisor. This role will oversee procurement and supply chain for parts and accessories in LATAM/Caribbean, ensures stock availability and supplier performance, collaborates with internal teams, and reports on key supply metrics.


Title: Inventory Planning Supervisor

Industry: Automotive Parts Distribution

Type: Full-Time, Direct Hire

Location: Miami, FL

Pay: $73-76K/(DOE)


Key Responsibilities :

  • Manage procurement of parts and accessories for LATAM and Caribbean regions.
  • Execute SCM tasks following standard procedures and resolve issues with other departments.
  • Collaborate with internal teams to ensure timely, high-quality customer service.
  • Prepare and present regular performance reports; track key metrics and suggest improvements.
  • Monitor supplier performance and implement strategies to meet departmental KPIs.
  • Maintain adequate stock levels, anticipate shortages, and ensure supplier compliance with policies.


Qualifications

  • Bachelor’s degree in supply chain, business, or related field, or equivalent experience.
  • 5+ years in operations, procurement, supply chain, or logistics; LATAM/Caribbean experience a plus.
  • Basic knowledge of import process and application of harmonized codes.
  • Strong customer service, communication, and presentation skills (English/Spanish bilingual preferred).
  • Proficient in MS Office; knowledge of import processes and harmonized codes.
  • Strong analytical, decision-making, and time management skills.
  • Able to work independently, collaborate in teams, manage projects, and travel internationally.


**Please submit your application with a 1-2 page resume. Only qualified candidates will be contacted**

Not Specified
Health Plan IT Director
Salary not disclosed
Dallas, TX 6 days ago

Health Plan IT Director

Onsite | Dallas, Texas


We are seeking an experienced IT Applications Manager to lead health plan-focused application development and support within our payer organization in Dallas, TX.

This role oversees mission-critical insurance systems supporting eligibility, utilization management, care management, pharmacy, and related payer operations. This is not a hospital IT role — we are seeking a leader with direct health plan / insurance-side experience. The ideal candidate brings strong payer application knowledge, a data-driven mindset, and proven success leading teams in delivering projects on time and within scope.


What You’ll Do

  • Lead and manage a team of IT professionals supporting health plan applications
  • Oversee application development, integration, enhancement, and production support
  • Partner closely with business stakeholders to translate operational needs into technical solutions
  • Provide architectural input and solution design guidance (non-coding leadership role)
  • Manage vendor relationships, including third-party system implementations (e.g., pharmacy platforms)
  • Ensure strong process control, documentation, and system governance
  • Drive project execution with strong focus on timelines, accountability, and quality
  • Collaborate with enterprise IT teams to ensure cohesive system integration
  • Maintain compliance with HIPAA and healthcare data privacy standards


What We’re Looking For

  • 5+ years of IT leadership experience within a health plan / payer organization
  • Direct experience supporting insurance-side systems (eligibility, UM, care management, pharmacy)
  • Strong background in data-driven application environments
  • Experience overseeing vendor implementations and system integrations
  • Demonstrated ability to lead cross-functional projects and meet deadlines
  • Strong documentation, process management, and operational discipline
  • Experience managing teams of 10+ FTEs
  • Working knowledge of SQL and application environments (technical fluency required; coding not required)
  • Bachelor’s degree in Computer Science or related field
Not Specified
Health Plan Nurse Navigator (PLEASANTON)
Salary not disclosed
PLEASANTON, Texas 4 days ago
POSITION SUMMARY/RESPONSIBILITIES

Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.

EDUCATION/EXPERIENCE

Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.

LICENSURE/CERTIFICATION

Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
permanent
Health Plan Care Coordinator - PRN (SEGUIN)
🏢 University Health
Salary not disclosed
SEGUIN, Texas 4 days ago
POSITION SUMMARY/RESPONSIBILITIES

Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.

EDUCATION/EXPERIENCE

Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.

LICENSURE/CERTIFICATION

Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
temporary
Health Plan Utilization Specialist (HONDO)
🏢 University Health
Salary not disclosed
HONDO, Texas 4 days ago
POSITION SUMMARY/RESPONSIBILITIES

Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.

EDUCATION/EXPERIENCE

Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.

LICENSURE/CERTIFICATION

Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
temporary
jobs by JobLookup