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Home Health Physical Therapist Full Time - Flexible Work Schedule (Hiring Immediately)
Salary not disclosed
Position Overview

As an Aveanna Physical Therapist you will utilize your clinical expertise to assess, teach, and deliver therapy interventions and treatment directed by the Physician as established in the home health plan of care. You will collaborate with interdisciplinary team members, receiving and providing pertinent updates to optimize patient well-being.

Full Time Visits needed Monday - Friday for Brookfield, WI and surrounding communities

Essential Job Functions:

- Perform initial and ongoing assessments to evaluate mobility, coordination, strength and current level of function.
- Responsible for administration, evaluation, and interpretation of tests and measurements to determine functional goals and outcomes.
- Provide a written evaluation and plan of care defining physical therapy needs, goals, progress and expected outcomes.
- Delivery of physical therapy services to comply with prescribed physician orders.
- Maintains plan of care by performing timely documentation of client performance, modifying goals and treatment as needed, and determine discharge care plans as appropriate.
- Responsible for discharge planning, including collaborating and educating the patient and his/her caretakers on home exercise plan to follow discharge.
- Participates in coordination of services with health care team, physicians, parent/guardians, nurses, etc.
- Documents according to policy and procedure and requires minimal supervision or instruction.
- Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers
- Maintain effective communication between staff, healthcare team members and family. Serve as a resource consultant for clinical staff.
- Supervises other personnel (PTA, HHA) as applicable.
- Completes OASIS assessments where allowed by state professional practice and regulation.
- Follow policies and procedures and conforms to all applicable patient care standards, licensure regulations and state laws.

Requirements:

- Degree in Physical Therapy from an accredited university/program.
- Current, unrestricted state license as a Physical Therapist in the state of practice.
- Demonstrated proficiency in clinical assessments, documentation and compliance with policies and procedures.

Preferred:

- Strong organization and communication skills.
- Attention to detail.
- Time management.
- Proven relationship-builder.
- Experience in Home Health Therapy and completion of OASIS documentation.

HHH

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

Notice for Job Applicants Residing in California

Notice for Job Applicants Residing in Florida
Remote working/work at home options are available for this role.
permanent
Home Health Registered Nurse RN Full Time - Flexible schedule with on-call rotation (Hiring Immediately)
🏢 Aveanna Healthcare
Salary not disclosed
Position Overview:

The Registered Nurse – Home Health is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians’ orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times.

Sign-On Bonus: $5,000

Opening: Full Time Mon-Fri flexible schedule with on-call rotation

Territory: Oshkosh, Waupaca, Freemont, Menasha and Neenah

Essential Job Functions:

- Develop a plan of care through physician orders, client input, and nursing assessment to include medical interventions and measurable goals and outcomes.
- Educate clients and their family members based on client’s specific needs.
- Properly orient and train primary caregivers to ensure the most optimal functioning level for each client.
- Coordinate the continuum of hands on client care through documentation and timely communication with the client's physician and other caregivers.
- Provide care in patients home using a variety of skills such as phone triage, patient education, observation/assessment, wound care, infusions, catheter care, PICC line dressing changes etc.

Why Join Our Team?

- Our clinical team is a family of clinicians who work together to meet the needs of each patient
- Nationwide career opportunities where our leaders encourage advancements
- Our clinicians enjoy the flexibility of getting to build rapport with patients to produce the best clinical outcomes
- We know that our clinicians make or break the organization’s success

Benefits Offerings:

- 401(k) with company match
- Health, dental, vision, life, and pet insurance
- Mileage reimbursement and cell phone allowance
- Generous PTO, sick time, and paid holidays
- Inclusion Day to celebrate what matters to you
- Float Day for extra flexibility and balance
- Up to 8 Hours of Paid Volunteer time yearly
- No-Cost Employee Assistance Program (EAP) - unlimited mental health telephonic counseling sessions, support with identity left, Will preparation and travel assistance
- Robust DEI company program because Inclusion is an Aveanna Core Value
- Tuition discounts and reimbursement

Requirements:

- An active RN License in the state of application
- Valid CPR, Drivers License and Proof of automobile insurnace

Preferred:

- Medicare Skilled Nursing experience
- Basic understanding of Oasis
- 1-year RN experience in a health care setting

HHH

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

Notice for Job Applicants Residing in California

Notice for Job Applicants Residing in Florida
Remote working/work at home options are available for this role.
permanent
Home Health Registered Nurse Full Time Weekends - Flexible Schedule for Work-Life Balance (Hiring Immediately)
🏢 Aveanna Healthcare
Salary not disclosed
Similar experience is preferred.

Position Overview

The Registered Nurse Weekends is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians’ orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times.

Schedule: Full-Time Weekend visits Friday through Monday - 27 point produtivity

Territory: Orange, Osceola, and Seminole counties

Essential Job Functions:

- Develop a plan of care through physician orders, client input, and nursing assessment to include medical interventions and measurable goals and outcomes.
- Educate clients and their family members based on client’s specific needs.
- Properly orient and train primary caregivers to ensure the most optimal functioning level for each client.
- Coordinate the continuum of hands on client care through documentation and timely communication with the client's physician and other caregivers.
- Provide care in patients home using a variety of skills such as phone triage, patient education, observation/assessment, wound care, infusions, catheter care, PICC line dressing changes etc.

Aveanna Healthcare Offers:

- 401(k) with match
- Health, Dental and Vision Benefits
- Tuition Discounts and Reimbursement
- PTO, Sick Time, and Paid Holidays

Requirements:

- An active RN License in the state of application
- Valid CPR certification
- Valid Drivers license and auto insurance

Preferred:

- Medicare Skilled Nursing experience
- Basic understanding of Oasis
- 1-year RN experience in a health care setting

HHH

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

Notice for Job Applicants Residing in California

Notice for Job Applicants Residing in Florida
Remote working/work at home options are available for this role.
permanent
Home Health Registered Nurse RN Full Time - Flexible daytime schedule (Hiring Immediately)
🏢 Aveanna Healthcare
Salary not disclosed
Foley, AL, Flexible 4 days ago
Position Overview:

The Registered Nurse – Home Health is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians’ orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times.

Schedule: Full Time visits needed Monday - Friday with on-call rotation

Territory: Baldwin county (Foley, Gulf Shores, Lillian, Elberta, Orange Beach, Summerdale, Robertsdale area)

Essential Job Functions:

- Develop a plan of care through physician orders, client input, and nursing assessment to include medical interventions and measurable goals and outcomes.
- Educate clients and their family members based on client’s specific needs.
- Properly orient and train primary caregivers to ensure the most optimal functioning level for each client.
- Coordinate the continuum of hands on client care through documentation and timely communication with the client's physician and other caregivers.
- Provide care in patients home using a variety of skills such as phone triage, patient education, observation/assessment, wound care, infusions, catheter care, PICC line dressing changes etc.

Why Join Our Team?

- Our clinical team is a family of clinicians who work together to meet the needs of each patient
- Nationwide career opportunities where our leaders encourage advancements
- Our clinicians enjoy the flexibility of getting to build rapport with patients to produce the best clinical outcomes
- We know that our clinicians make or break the organization’s success

Aveanna Healthcare Offers:

- 401(k) with match
- Health, Dental and Vision Benefits
- Tuition Discounts and Reimbursement
- PTO, Sick Time, and Paid Holidays

Requirements:

- An active RN License in the state of application
- Valid CPR and valid Drivers license
- Proof of automobile insurance
- Home Health nursing experience with Oasis experience and HCHB EMR experience highly preferred

HHH

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

Notice for Job Applicants Residing in California

Notice for Job Applicants Residing in Florida
Remote working/work at home options are available for this role.
permanent
Home Health Occupational Therapist OT Full Time - Flexible Work Schedule with Weekday Visits (Hiring Immediately)
🏢 Aveanna Healthcare
Salary not disclosed
Position Overview

We are looking for an Occupational Therapist (OT) to join our team! You will utilize your clinical expertise to assess, teach, and deliver therapy interventions and treatment directed by the Physician as established in the home health plan of care. You will collaborate with interdisciplinary team members, receiving and providing pertinent updates to optimize patient well-being.

Schedule: Full-Time Monday - Friday visits

Territory: Lee county

Essential Job Functions:

- Perform initial and ongoing assessments to evaluate mobility, coordination, strength and current level of function.
- Responsible for administration, evaluation, and interpretation of tests and measurements to determine functional goals and outcomes.
- Provide a written evaluation and plan of care defining occupational therapy needs, goals, progress and expected outcomes.
- Delivery of occupational therapy services to comply with prescribed physician orders.
- Maintains plan of care by performing timely documentation of client performance, modifying goals and treatment as needed, and determine discharge care plans as appropriate.
- Responsible for discharge planning, including collaborating and educating the patient and his/her caretakers on home exercise plan to follow discharge.
- Participates in coordination of services with health care team, physicians, parent/guardians, nurses, etc.
- Documents according to policy and procedure and requires minimal supervision or instruction.
- Documents effectively resulting in no technical or clinical denials subsequent to review of documentation by payers
- Maintain effective communication between staff, healthcare team members and family. Serve as a resource consultant for clinical staff.
- Supervises other personnel (OTA, HHA) as applicable.
- Completes OASIS assessments where allowed by state professional practice and regulation.

Aveanna Healthcare Offers:

- 401(k) with match
- Health, Dental and Vision Benefits
- Tuition Discounts and Reimbursement
- PTO, Sick Time, and Paid Holidays

Requirements:

- Degree in Occupational Therapy from an accredited university/program.
- Current, unrestricted state license as an Occupational Therapist in the state of practice
- Valid CPR

Preferred:

- Experience in Home Health Therapy and completion of OASIS documentation

HHH

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

Notice for Job Applicants Residing in California

Notice for Job Applicants Residing in Florida
Remote working/work at home options are available for this role.
permanent
Home Health LPN Licensed Practical Nurse Full time - Flexible Schedule in Home Settings (Hiring Immediately)
🏢 Aveanna Healthcare
Salary not disclosed
Orlando, FL, Flexible 3 days ago
Position Overview

The Licensed Practical Nurse is an essential part of the team responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians’ orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times.

Territory: Osceola County

Schedule: Full-Time visits needed Monday - Friday

Essential Job Functions

- Deliver quality patient care in compliance with physician orders under direction of their Registered Nurse teammate.
- Performs the continuum of hands on client care through documentation and timely communication with the client's physician and other caregivers
- Recognizes changes in patient needs and responses requiring intervention and implements care to prevent risk or reduce risk.
- Educate clients and their family members based on client’s specific needs.
- Provide care in patients home using a variety of skills such as phone triage, patient education, observation/assessment, wound care, infusions, catheter care, PICC line dressing changes etc.

Benefits Offerings:

- 401(k) with company match
- Health, dental, vision, life, and pet insurance
- Mileage reimbursement and cell phone allowance
- Generous PTO, sick time, and paid holidays
- Inclusion Day to celebrate what matters to you
- Float Day for extra flexibility and balance
- Up to 8 Hours of Paid Volunteer time yearly
- No-Cost Employee Assistance Program (EAP) - unlimited mental health telephonic counseling sessions, support with identity left, Will preparation and travel assistance
- Robust DEI company program because Inclusion is an Aveanna Core Value
- Tuition discounts and reimbursement

Requirements:

- An active LPN License in the state of application
- Valid CPR, Proof of Automobile Insurance and Valid Drivers License

Preferred:

- 1-year LPN experience in a home health or health care setting
- Home Care Home Base exp a plus

HHH

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

Notice for Job Applicants Residing in California

Notice for Job Applicants Residing in Florida
Remote working/work at home options are available for this role.
permanent
Home Health Registered Nurse RN Full Time - Flexible Scheduling with On-Call Rotation (Hiring Immediately)
🏢 Aveanna Healthcare
Salary not disclosed
Position Overview:

The Registered Nurse – Home Health is responsible for providing and documenting skilled nursing care in accordance with the developed care plan and physicians’ orders for each individual patient while adhering to confidentiality standards and professional boundaries at all times.

Full Time hours needed with on-call rotation in Mobile and Washington Areas

Essential Job Functions:

- Develop a plan of care through physician orders, client input, and nursing assessment to include medical interventions and measurable goals and outcomes.
- Educate clients and their family members based on client’s specific needs.
- Properly orient and train primary caregivers to ensure the most optimal functioning level for each client.
- Coordinate the continuum of hands on client care through documentation and timely communication with the client's physician and other caregivers.
- Provide care in patients home using a variety of skills such as phone triage, patient education, observation/assessment, wound care, infusions, catheter care, PICC line dressing changes etc.

Why Join Our Team?

- Our clinical team is a family of clinicians who work together to meet the needs of each patient
- Nationwide career opportunities where our leaders encourage advancements
- Our clinicians enjoy the flexibility of getting to build rapport with patients to produce the best clinical outcomes
- We know that our clinicians make or break the organization’s success

Aveanna Healthcare Offers:

- 401(k) with match
- Health, Dental and Vision Benefits for employees at 30+ hours
- Tuition Discounts and Reimbursement
- PTO, Sick Time, and Paid Holidays

Requirements:

- An active RN License in the state of application
- Valid CPR

Preferred:

- Medicare Skilled Nursing experience
- Basic understanding of Oasis
- 1-year RN experience in a health care setting

HHH

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

Notice for Job Applicants Residing in California

Notice for Job Applicants Residing in Florida
Remote working/work at home options are available for this role.
permanent
Respiratory Therapist Full-Time Weekend Track- St. Peter's Hospital - Flexible Work-Life Balance (Hiring Immediately)
✦ New
Salary not disclosed
Employment Type:Part timeShift:Day ShiftDescription:

Respiratory Therapist – St. Peter's Hospital

Full-Time Weekend Track

12 Hour Day Shift

If you are looking for a full-time weekend track Respiratory Therapist position to meet your schedule, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places.

Position Highlights:

  • Quality of Life: Where career opportunities and quality of life converge
  • Advancement: Strong orientation program, generous tuition allowance and career development
  • Work/Life: Positions and shifts to accommodate all schedules

What you will do:

As an RT you will work at assessing, treating and caring for patients of all ages who suffer from pulmonary (breathing) disorders. In addition to analyzing and performing diagnostic testing, respiratory therapists perform relevant exams as well as set up and utilize cardiopulmonary equipment and machines needed to assist or monitor the patients breathing

Responsibilities:

  • Gather data to be able to accurately assess a patient's current health status
  • Assess the patient according to the patient's physical or age related needs
  • Observe, record and report symptoms, reactions and progress of patients
  • Administer and record prescribed medications, treatments and diagnostic procedures
  • Responsible for airway management including performing endotracheal intubations and extubations, pulmonary hygiene, and tracheostomy care and emergency life support procedures
  • Provides extensive health education to patients and to the general population through community services

What you will need:

  • Associates Degree in Respiratory Therapy
  • Current NY State RT License

Night Weekend Track Rate: $43.90

Pay Range: $36.33 - $47.65

Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.


Remote working/work at home options are available for this role.
temporary
Registered Nurse OB Float Pool Full-Time - Flexible self-scheduling shifts (Hiring Immediately)
✦ New
Salary not disclosed
Employment Type:Full timeShift:Rotating ShiftDescription:

We are looking to hire a Full-Time Registered Nurse for our Clinical Support Team as part of our newly formed OB Float Pool! This position will support Saint Alphonsus Health System at our Boise, Nampa, and Ontario Oregon hospitals. Hours for this position are 12 hours shifts and colleagues self-schedule their working days.

About the department:  RNs working in the Clinical Support Team (OB Float Pool) care for mother/baby within our labor delivery, postpartum, and NICU teams.

About our ideal candidate: Our ideal candidate embraces daily change, is a team player, appreciates independence, is a self-driven learner and has a passion for mother/baby care.

General Requirements:

  • Minimum of 1 year of experience as an inpatient RN, experience in LD/OB/NICU preferred.
  • RN license in the state of Idaho required prior to start. If multistate required to notify Idaho Board of Nursing in 60 days of residency.
  • RN license in the state of Oregon required within 90 days of start date.
  • American Heart Association Basic Life Support for HealthCare Provider (BLS/HCP) certification
  • ACLS and NRP required or obtained within six months of hire date
  • PALS, STABLE and NCC-EFM certifications required or obtained within one year of hire date

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.


Remote working/work at home options are available for this role.
permanent
Medical Director - Sharp Health Plan - Hybrid / Remote - Day Shift - Full Time
Salary not disclosed
Hours:

Shift Start Time:

Variable

Shift End Time:

Variable

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:

As Needed

On-Call Required:

Yes

Hourly Pay Range (Minimum - Midpoint - Maximum):

$124.640 - $160.830 - $197.020

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do
Working with the Chief Medical Officer, oversees medical care for Sharp Health Plan (SHP) products and services and oversees the health care needs of the membership. Serves as a medical manager and policy advisor to SHP and its Chief Medical Officer. Is accountable for and provides professional leadership and direction to the utilization/cost management and clinical quality management functions. Works collaboratively with other plan functions that interface with medical management such as provider relations, member services, benefits and claims management, etc. Assists (as determined by the plan Chief Medical Officer) in short and long range program planning, total quality management (quality improvement), and external relationships. Works with all departments of Health Services to support, provide assistance and direction in overall medical management effectiveness. Reports all issues of clinical quality management to the health plan Chief Medical Officer. To ensure that policies and systems are followed until agreed upon change is implemented. Works toward SHP strategic goals and objectives of ensuring a high quality of medical care for Plan members, staff empowerment, customer satisfaction, cost-effectiveness, and market competitiveness. As a member of the management team, assists in identifying and establishing strategic goals and objectives for the Plan.

Required Qualifications

- Doctor of Medicine (MD)
- Previous experience in the clinical practice of medicine.
- Previous experience as a physician executive in a managed care environment, preferably as an HMO Medical Director.
- California Physicians and Surgeons License - Medical Board of CA -REQUIRED

Other Qualification Requirements

- Board certified in a medical discipline (internal medicine or family practice preferred).

Essential Functions

- Responsible and accountable to the Chief Medical Officer for helping to manage health plan medical costs and assuring appropriate health care delivery for SHP's products and services. Reports organizationally to the Chief Medical Officer.
- Plans, organizes, and directs the professional medical services program, consisting of all primary and Specialty services for in-patient, out-patient, preventive and wellness programs.
- Implements health plan medical policies, goals and objectives.
- Provides professional leadership and direction to the functions within the Medical Management
- Department (Utilization/Cost Management and Quality Management)
- Responsible for and assists with the development of staffing plans and assuring the adequate allocation of resources to the medical management functions.
- Responsible and accountable for implementing the Utilization/Cost Management Program and Quality Improvement Program, in conjunction with the Manager Medical Management and Quality Improvement Manager.
- Assists the Chief Medical Officer with activities to promote positive community relations.
- Assures plan conformance with legal and regulatory requirements
- Assists the Chief Medical Officer and the Quality Improvement Manager in creating and maintaining a system that gives feedback to providers individually and collectively regarding managed care effectiveness of individual providers and networks.
- Assists the Chief Medical Officer in designing and implementing corrective action plans to address issues and improve plan and network managed care performance.
- Collaborates with Chief Medical Officer in creating and maintaining programs that incentivize providers to achieve selected utilization/cost and quality outcomes.
- Participates in policy review, performs analysis and makes recommendations.
- Participates in the retrospective review and analysis of Plan performance from summary data of paid claims, encounters, authorization logs, complaint and grievance logs and other sources.
- Achieves and maintains benchmarked utilization and cost management (UM) goals and clinical quality improvement (QI) objectives, in conjunction with the Manager Medical Management and Quality Improvement Manager.
- Provides periodic written and verbal reports and updates as required in program descriptions, Annual Work Plans and policy and procedures to various plan committees, and the SHP Chief Medical Officer.
- Supports NCQA qualification activities. Prepares for site visits and responds to accrediting and regulatory agency feedback.
- Supports pre-admission review, utilization management, and concurrent and retrospective rev1ew process.
- Participates in risk management, pharmacy utilization management, catastrophic case review, outreach programs, HEDIS reporting, site visit review coordination, triage, provider orientation, credentialing, profiling, etc.
- Conducts quality improvement and outcomes studies as directed by the Quality Management Committee, Peer Review Committee and Chief Medical Officer and reports findings in conjunction with the Quality Improvement Manager.
- Participates in the grievance process with the Chief Medical Officer, insuring a fair outcome for all members.
- Monitors member and provider satisfaction survey results and implements changes as needed to increase satisfaction and assure that satisfactory relationships are maintained between network and plan participants.
- Participates in SHP Advisory Committees which include (but are not limited to) the Peer Review Committee and the Quality Management Committee.
- Participates in key marketing activities and presentations, as requested.
- Promotes wellness and ensures programs of prevention, education and outreach to members and providers are consistent with SHP's mission, vision and values.
- Maintains up-to-date knowledge of new information and technologies m medicine and their application to SHP.
- Performs and oversees in-service staff training and education of professional staff.
- Represents SHP at medical group meetings, conferences, etc.
- Participates in the development of strategic planning for existing and expanding business. Recommends changes in program content in concurrence with changing markets and technologies.
- Participates in key marketing activities and presentations, as necessary, to assist the marketing effort, as requested.
- Ensures that the Utilization Management staff is available on a 24 hour basis to respond to authorization requests for emergency and urgent services and is available, at a minimum, during normal working hours for inquiries and authorization requests for non-urgent health care services..
- Performs other duties as requested or assigned.
- Collaborates with the Manager, Medical Management to guide and direct staff in relation to medical issues and departmental responsibilities. Assists in monitoring, reviewing, and evaluating the quality of health care services provided and the appropriateness of health care resources utilized, and communicates with PMGs and Plan providers as needed. Addresses physicians' issues and educates providers with regard to Plan policy as needed.
- Completes and/or supervises the completion of all clinical appeals and grievances. Collaborates with Customer Care Manager to identify trends in grievances. Supervises the process for identifying Potential Quality Issues.
- Supervises Physician Reviewer(s)
- Shares after-hours coverage responsibilities with other physicians
- Assists the CMO, as needed, to oversee the credentialing process.
- Assists in the development and interpretation of the covered benefit provisions of member materials and Plan contracts. Assists in the development and implementation of new benefits packages.
- Maintains appropriate contacts with membership in community and professional organizations.

Knowledge, Skills, and Abilities

- Strong clinical background and skills.
- Solid understanding of utilization management and quality assurance activities and concepts.
- Excellent communication skills, both verbal and written.
- Strong interpersonal skills, including the ability to interface effectively with employees, members, physicians, senior management, and the public at large.
- Management skills to meet the organizational goals.
- Knowledge of regulatory and accreditation agencies and requirements.
- Able to manage multiple priorities and deadlines in an expedient and decisive manner.
- Able to manage difficult peer situations arising from medical care review.
- Appreciation of cultural diversity and sensitivity towards target population.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class

California Physicians and Surgeons License - Medical Board of CA; Doctor of Medicine (MD)

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Remote working/work at home options are available for this role.
permanent
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