Us Medical Management Jobs in Usa
50,719 positions found — Page 2
They are seeking a fellowship-trained and procedural-focused physician to join five other physicians.
Candidates with experience in Epidurals, facets, rhizotomy, joint injections, spinal cord stimulator trials, discograms, and spine surgery assistants are desired.
About the Opportunity Not a primary medication management position Seeking board-certified Pain specialists (Open to Anesthesia or PMR residency training) Position will float between several offices Monday through Friday, 9 AM
- 5 PM 15-20 patients a day (30 minutes for new patients/15 minutes for follow-ups) Occurrence-based Mal Practice provided Generous starting salary with the ability to make an additional 100K in bonuses Offers a full benefits package and will cover the cost of licenses.
Community/Location It is located in a suburb of New York City with a population of 99,876.
The Middlesex County township is just an hour from Manhattan and has easy access to transportation.
DO-3
Enjoy a high-producing, turnkey setting that offers quality of life with a favorable schedule.
About the Opportunity Low medication management Rotate between 3 offices, 10-15 minutes apart Run two rooms in ASC Half day of at home, tele-med per week ASC buy-in option Guaranteed salary, earn MGMA 75th or higher Sign-on plus full, personal, and professional benefits About the Community Look across the banks of the Hudson River into Manhattan.
Hoboken, NJ, is ranked the best place to live by and is highly sought after for its direct access to NYC.
For more information, contact: Kyri Ioannou 1.
KI-46
Enjoy a high-producing, turnkey setting that offers quality of life with a favorable schedule.
About the Opportunity Low medication management Rotate between 3 offices, 10-15 minutes apart Run two rooms in ASC Half day of at home, tele-med per week ASC buy-in option Guaranteed salary, earn MGMA 75th or higher Sign-on plus full, personal, and professional benefits About the Community Look across the banks of the Hudson River into Manhattan.
Hoboken, NJ, is ranked the best place to live by and is highly sought after for its direct access to NYC.
For more information, contact: Kyri Ioannou 1.
KI-45
Tryon Medical Partners | Charlotte, NC
Tryon Medical Partners, a well-established and thriving physician-led, multispecialty practice in Charlotte, North Carolina, is seeking a Board-Certified or Board-Eligible Rheumatologist to join our collaborative team. This is a 100% outpatient position offering an excellent balance of high-quality patient care, advanced diagnostics, and lifestyle flexibility.
Practice Highlights
- Outpatient-only rheumatology practice with no hospital call
- Advanced diagnostic capabilities
- Average patient volume of 15โ20 patients per day
- Experienced nursing and administrative support
- Collegial, team-based environment within a large multispecialty group
As a Rheumatologist at Tryon Medical Partners, you will provide comprehensive outpatient care for patients with a wide range of rheumatologic and autoimmune conditions. You will work closely with primary care providers and specialists in a modern, state-of-the-art clinical setting. This role offers the opportunity to grow your practice while maintaining a strong work-life balance.
Key Responsibilities
- Diagnose and manage rheumatologic and autoimmune conditions, including arthritis, lupus, gout, osteoporosis, and related disorders
- Provide longitudinal patient care, including medication management and follow-up
- Utilize advanced diagnostic tools to support high-quality clinical decision-making
- Collaborate with multidisciplinary care teams to deliver coordinated, patient-centered care
- Participate in clinical research, education, or quality improvement initiatives, if desired
- Maintain accurate and compliant medical documentation in accordance with best practices
- Board-certified or board-eligible in Rheumatology
- Eligible for or licensed to practice in the state of North Carolina
- Strong commitment to patient-centered care and collaboration
- Excellent communication and interpersonal skills
- Competitive compensation with a one-year salary guarantee during ramp-up
- Sign-on bonus and relocation assistance
- Comprehensive benefits package, including:
- Health, dental, and vision insurance
- Retirement plans
- Malpractice coverage
- CME allowance and opportunities for professional growth and development
- Supportive, physician-focused leadership and practice culture
Charlotte, NC is one of the fastest-growing cities in the Southeast, offering excellent schools, diverse neighborhoods, vibrant dining and arts, and easy access to outdoor recreationโfrom the mountains to the coast.
How to Apply
Please submit your CV and cover letter to:
Tryon Medical Partners is an Equal Opportunity Employer and values diversity. We are committed to creating an inclusive environment for all employees.
LI-SM3
Summary:
The System Chief Medical Officer will be a leader in the creation of the โideal patient experience,โ by developing, implementing and monitoring systems and processes that ensure the highest quality of care, patient safety and evidence based medical standards are practiced at the Bon Secours Charity Health System; moreover, the VPMA will ensure that all programs are in compliance with JCAHO, HIPPA, and other accreditation bodies.
The CMO will also serve as one of the leaders of Clinical Transformation; a comprehensive inter-disciplinary approach to achieve care delivery excellence throughout the patient care continuum that measurably improves quality, creates holistic, patient centered care experiences, and reduces healthcare costs by reducing waste and optimizing the value proposition. This is done through the effective alignment of people, process and technology that enables and supports rapid cycle tests of innovation leading to creative, effective solutions.
Responsibilities:
- Develop objective measures for core competencies for physiciansโ as required by JCAHO and implement procedures for ongoing measurement and reporting. Lead and support the development of an innovative multi-specialty peer review and create process for ongoing evaluation and reporting.
- Assume leadership for facilitating action plans for continually improving patient satisfaction & physician satisfaction scores.
- Create and drive the vision for high quality care; in partnership with, Charity CEO, Good Samaritan EVP, CNE, and members of the Administrative team to lead โClinical Transformationโ initiatives in partnership with the BSHSI- HSO Chief Medical Officer and Chief Nursing Executive.
- Develop physician champions prepared to implement EMR. Led the initiative to implement Connect Care order sets and clinical pathways.
- Improve โphysician to physicianโ communication and improve lines of communication between medical staff and administration.
- In partnership with Chief Nurse Executive, create nurse/physician collaborative relationships.
- Focus on physician governance issues: define role and responsibilities of Department Chairs and Medical Directors.
- Take a leadership role in managing hospital based physician groups: (e.g. anesthesia, radiology, pathology, emergency department and hospitalist).
Qualifications/Requirements:
Experience: A minimum of 10 years of clinical practice with demonstrated achievement; a minimum of three (3) years in hospital medical staff leadership in the role(s) of Director of Patient Safety or Quality (for complex and multiple departments/units) or VPMA/ CMO experience in a similar sized hospital or system.
Experience monitoring and managing physician practice productivity and the peer review process.
Experience with Joint Commission and other regulatory bodies. Experience and/or training in medical administration; advanced degree/certification in business, medical management or similar field (MBA, MMM, MHA, etc.).
Education: A degree of Doctor of Medicine (Doctor of Osteopathic Medicine may receive consideration) from an accredited and approved school of medicine, Board certified physician, with current state license or unencumbered eligibility (not excluded by the OIG) for license issued by the New York Board of Medicine
Licenses / Certifications: License to practice medicine in the State of New York.
About Us:
Good Samaritan Hospital in Suffern, NY, is a 286-bed hospital providing emergency, medical, surgical, obstetrical/gynecological and acute-care services to residents of Rockland and southern Orange counties in New York; and northern Bergen County, NJ. The hospital is home to a recognized cardiovascular program, comprehensive cancer-treatment services, the areaโs leading Wound and Hyperbaric Institute and outstanding maternal/child services that includes a Childrenโs Diagnostic Center. Good Samaritan Hospital also provides social, psychiatric and substance-abuse services and its certified home-care agency supports residents of the Hudson Valley and beyond.
Benefits:
We offer a comprehensive compensation and benefits package that includes:
- Health Insurance
- Dental
- Vision
- Retirement Savings Plan
- Flexible Savings Account
- Paid Time Off
- Holidays
- Tuition Reimbursement
A multidisciplinary provider of mental health services forover 16 years with Outpatient Offices located in Southern Pines & Fayetteville.
This position will provide direct clinical and administrative services.
Outpatient services focused on evaluation and medication management with psychotherapy provided by psychologists, licensed social workers, and licensed professional counselors.Preferred: Board Eligible in child psychiatry/Minimum: Board Eligible in general psychiatry.
Compensation: Based upon experience.
Facility has been awarded CARF Three Year Accreditation for Outpatient Therapy, Intensive In-Home & Community Support Services, and Treatment Foster Care Services with currently over 100 foster care parents servicing the community.
Call me today for more information! Contact Jay Eblen Ext.
1005 or E-mail
Our facilities include 22 medical offices, with 13 urgent cares and retail clinics, two lifestyle centers catering to seniors and two outpatient surgery centers.
The practice is fully integrated and includes home health, complex disease management, pharmacy services, medical management and palliative care.
SMA is actively engaged in population health management, with an emphasis on outcomes, and offers patients compassionate, innovative and high-quality care throughout Nevada.
SMA is headquartered in Las Vegas, Nevada.
Our On-Demand Care Department is the largest, most-comprehensive in Nevada for outpatient episodic care, with a quarter million visits annually.
The department includes six urgent cares and seven retail clinics, offering a full-spectrum of services, with on-site laboratory, radiology (which includes CT and ultrasound), observation unit and infusion center.
Our practice is nearly paperless, with electronic health records, digital radiology, electronic prescriptions and e-visits.
The practice encompasses the full scope of urgent care and is evidence-based and protocol driven.
Our department also includes a robust telemedicine practice, with nearly 15,000 virtual consultations since 2014.
The Associate Medical Director, OnDemand Medicine , is a member of the leadership team and responsible for the quality, cost and service levels of health care provided by the OnDemand Division.
This position works closely with the Medical Director to direct, manage and evaluate OnDemand practice operations.
This position is also responsible for planning, implementing and monitoring of activities in direct support of patient satisfaction, quality improvement, utilization and quality management.
This position is 70 percent clinical outpatient and 30 percent administrative.
Primary Responsibilities: Provide leadership and communication for OnDemand physician leaders, physicians and clinical staff Responsible for effective interviewing, selection, orientation, development and retention of OnDemand Medicine providers.
Partner with medical management staff to promote clinical process improvement and access enhancement; work with operations team to improve operations at clinic level including door to door time and patient experience.
Ensure effective quality assurance and risk management processes; ensure appropriate utilization of resources and provider education Ensure customer satisfaction and compliance with regulatory standards Ensure cost effective delivery of health care within the OnDemand practice management operations Ensure that all NCQA and other accreditation standards are met; ensure compliance with accurate coding and documentation standards, HEDIS measures.
Ensure ongoing professional medical management development programs Establish direct relationship with key departments including pharmacy, underwriting, medical adjudication, claims and provider relations, and assist with issues and/or concerns
Location Detail: 45 Salem Turnpike Norwich (10583)
Shift Detail: Mon-Fri
Get MORE from your career with Hartford HealthCare
Hartford HealthCare has an exciting opportunity for an Advanced Practice Registered Nurse (APRN) to join our Norwich-based hospital outpatient department within Pain Management team. This role plays a key part in delivering comprehensive, patient-centered pain care through a blend of medication management, clinical assessment, and postโprocedure follow-up, working in close collaboration with our pain physicians.
This APRN will serve as a clinical cornerstone within a busy pain management practice, supporting patients across the spine and chronic pain continuum and ensuring seamless care coordination.
Someย highlights of this opportunity include:
The Pain Management Nurse Practitioner (APRN) will work in an outpatient setting.ย
ยทย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย Full Time, 5/8s, or 4/10s
ยทย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย This position will be helping to support a busy pain office by providing both consultations and follow-up care for patients struggling with managing pain.
ยทย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย Responsibilities include seeing new patients, follow-ups
ยทย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย A holistic patient care model that encompasses the entire spine care continuum including pain management, surgical interventions, and medication management.
ADVANCED PRACTITIONERS ENJOY
ยทย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย A culture that fosters continual growth and development for providers.ย
ยทย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย Competitive compensation, matching 401k, tiered medical, and CME reimbursement.
We support your development and wellbeing through the respected Hartford HealthCareโs Office of Advanced Practice - an internal organization committed to the growth and development of our Advanced Practitioners, and the groundbreaking Office of Provider Wellness.
ย
Qualifications
ยทย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย Eligibility to be licensed Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), or Adult Gerontology Primary Care Nurse Practitioner (AGPCNP) is required.
ยทย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย Experience practicing as a Physician Assistant or Nurse Practitioner (APRN) is highly preferred.
ยทย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย ย Pain management, injection, orthopedics, neurosurgery, rheumatology, or primary care experience is highly preferred.
There are no limits to what you can achieve when you join theย Pain Management Team at Hartford HealthCare.ย The extensive capabilities of the most integrated healthcare system in CT offersย Physician Assistants and Nurse Practitioners MORE OPPORTUNITYย as you practice with nationally respected colleagues in a progressive, physician-led environment.ย ย ย
Our broad network includes seven acute care hospitals including one of the largest academic and surgical hospitals in the northeast, thriving community teaching hospitals, and one of the largest multi-specialty medical groups in New England with more than 1,000 providers.
This meansย MORE OPTIONSย to propel your career to new heights and all within a deeply embedded culture of inclusion, innovation, and focus on the highest quality of care. We are teachers, researchers, innovators, leaders and, most of all, caregivers.
Location Detail: St Vincents Medical Center (10427)
Shift Detail: Mon-Fri
Get MORE from your career with Hartford HealthCare
Hartford Healthcare has a new opportunity available for a Pain Management Physician Assistant or Nurse Practitioner (APRN) to join our talented Pain Management team.
Someย highlights of this opportunity include:
ยทย ย ย ย ย ย ย ย ย ย ย ย The Pain Management Physician Assistant or Nurse Practitioner (APRN) will work in an inpatient and outpatient setting. Flexibility to work within satellite locations as well.
ยทย ย ย ย ย ย ย ย ย ย ย ย Shift โ 40 hours Monday- Friday
ยทย ย ย ย ย ย ย ย ย ย ย ย This position will be helping to support a busy pain office by providing both consultations and follow-up care for patients struggling with managing pain.
ยทย ย ย ย ย ย ย ย ย ย ย ย Responsibilities include seeing new patients, follow-ups, and assisting with injections as determined by the attending.ย
ยทย ย ย ย ย ย ย ย ย ย ย ย A holistic patient care model that encompasses the entire spine care continuum including pain management, surgical interventions, and medication management.
ADVANCED PRACTITIONERS ENJOY
ยทย ย ย ย ย ย ย ย ย ย ย ย A culture that fosters continual growth and development for providers.ย
ยทย ย ย ย ย ย ย ย ย ย ย ย Competitive compensation, matching 401k, tiered medical, and CME reimbursement.
We support your development and wellbeing through the respected Hartford HealthCareโs Office of Advanced Practice - an internal organization committed to the growth and development of our Advanced Practitioners, and the groundbreaking Office of Provider Wellness.
ย
Qualifications
ยทย ย ย ย ย ย ย ย ย ย ย ย Eligibility to be licensed as a Physician Assistant (PA), Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), or Adult Gerontology Primary Care Nurse Practitioner (AGPCNP) is required.
ยทย ย ย ย ย ย ย ย ย ย ย ย Experience practicing as a Physician Assistant or Nurse Practitioner (APRN) is highly preferred.
ยทย ย ย ย ย ย ย ย ย ย ย ย Pain management, injection, orthopedics, neurosurgery, rheumatology, or primary care experience is highly preferred.
There are no limits to what you can achieve when you join theย Pain Management Team at Hartford HealthCare.ย The extensive capabilities of the most integrated healthcare system in CT offersย Physician Assistants and Nurse Practitioners MORE OPPORTUNITYย as you practice with nationally respected colleagues in a progressive, physician-led environment.ย ย ย
Our broad network includes seven acute care hospitals including one of the largest academic and surgical hospitals in the northeast, thriving community teaching hospitals, and one of the largest multi-specialty medical groups in New England with more than 1,000 providers.
This meansย MORE OPTIONSย to propel your career to new heights and all within a deeply embedded culture of inclusion, innovation, and focus on the highest quality of care. We are teachers, researchers, innovators, leaders and, most of all, caregivers.
ย
We are the career home for Providers who are eager to bring compassion and passion, energy and focus to their work every day.
Join us and you'll discover a chance to build meaningful relationships with the patients, their families and the health care providers who are responsible for their care.
At OptumCare Breast Care, we strive to create a home for breast health, offering comprehensive, coordinated, and multi-disciplinary care.
We tailor treatments to suit each patients unique needs.
The Breast Care program has been recognized as a Certified Quality Breast Center of Excellence, which is the highest level of recognition available from the National Quality Measure for Breast Centers.
We are committed to providing high-quality, comprehensive breast care in a patient-centered setting.
The Medical Director, Breast Care Program is a member of the leadership team and responsible for the quality, cost and service levels of health care for the overall Breast Care Program.
This position works closely with the senior leaders to direct, manage and evaluate all surgical and breast care practice operations.
This position is also responsible for planning, implementing and monitoring the activities in direct support of patient satisfaction, quality improvement, utilization, clinical intervention, and quality management.
Primary Responsibilities: Provide leadership and communication for physician leaders, physicians and clinical staff as well as leadership for our expanding Breast Care Program Responsible for effective interviewing, selection, orientation, development and retention of Breast Care Program Providers Partner with medical management staff to promote clinical process improvement Ensure effective quality assurance and risk management processes Ensure customer satisfaction and compliance with regulatory standards Ensure ongoing professional medical management development programs Establish direct relationship with key departments including pharmacy, underwriting, medical adjudication, claims and provider relations, and assist with issues and/or concerns
Be part of changing the way health care is delivered while working with a Fortune 6 industry leader.
We are looking for a Market Medical Director to join our WellMed medical team in the Ft.
Worth office.
The market medical director is a key member of the market leadership team who shares responsibility for the contracted clinic outcomes with other members of the team.
You will work to drive measurable and meaningful improvement in the use of evidence-based medicine to improve affordability.
You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare Advantage, Medicare, Medicaid and commercial members and plan sponsors.
We are looking for a market medical director who understands the value based approach to medical care and is comfortable working in a Medicare Advantage setting as well as a Fee for Service setting.
You will be responsible for conducting Patient Care Coordination meetings weekly with your care management team and you should be able to understand risk adjustment initiatives.
In addition, you should have the ability to understand the metrics that drive clinical quality initiatives in the primary care medical home and joint commission arenas.
You will be expected to work collaboratively with operations and matrix partners.
You will also be required to become competent in Tableau and other informatics/reports required to achieve market metrics/objectives.
The market medical director is responsible for improving the quality and efficiency of medical care in his/her clinics of responsibility.
Primary Responsibilities: Work to improve quality and promote evidence-based medicine Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement Support initiatives that enhance quality throughout our national network Ensure the right service is provided at the right time for each member Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review Success in this technology-heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production-driven setting.
Careers with WellMed.
Our focus is simple.
We're innovators in preventative health care, striving to change the face of health care for seniors.
We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services.
We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness.
Our providers and staff are selected for their dedication and focus on preventative, proactive care.
For you, that means one incredible team and a singular opportunity to do your life's best work.
SM WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors.
Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them.
We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
This is a role where you are directing and coordinating the medical management, quality improvement and credentialing functions.
You should be willing to practice clinically ONE day a week.
Salary plus 20% bonus or higher We can only consider those who are Board certified by the American Board of Psychiatry and Neurology.
Current state medical license without restrictions.
Board certification in general psychiatry or child psychiatry.
5+ years of experience working in behavioral health managed care or behavioral health clinical settings, with at least 2 years in a clinical setting.
Certification in addiction medicine or in the sub-specialty of addiction psychiatry preferred.
Our client may consider candidates requiring Visa Sponsorship.
Here is what a typical day would look like for you: Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
Supports effective implementation of performance improvement initiatives for capitated providers.
Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.
Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.
Oversees the activities of physician advisors.
Utilizes the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
Participates in provider network development and new market expansion as appropriate.
Assists in the development and implementation of physician education with respect to clinical issues and policies.
Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.
Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.
Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.
Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
Develops alliances with the provider community through the development and implementation of the medical management programs.
This is NOT a remote opportunity.
To be considered you should not currently have a non-compete clause in your current contract.
This position reports to the Senior Director.
Our client is located in the Little Rock, Arkansas region Interested? Please email your resume to us and we will promptly follow up with you should you meet the qualifications of this role.
Overview: Our client, a US Fortune 50 organization and a leading provider of Healthcare and Health Insurance services, seeks an accomplished Medical Claims/ Appeals Specialist
Position: Medical Claims/ Appeals Specialist
Location: Tampa, FL
Duration: 6-12 months+ temp-to-hire!!!
Pay rate: $24/hr on W2
Note:
- REMOTE role with possibility
- The schedule for the training period will be a set schedule: 8:00am to 4:30pm EST time.
- Training will be 5-6 weeks. After training, the candidates may choose to flex start time of 6:00 AM EST to 10:00 AM EST.
- Candidates can work from 50 miles (or 1 hour) from any NGS or PulsePoint locations (EXCEPT the state of CA). These are not HYBRID requirements while working temp. However, if/when they convert temp-hire, they must be willing to work onsite depending on what the HYBRID requirements for FTE associates are at the time of conversion (usually 1-3 days per week).
JOB DESCRIPTION:
This is an entry level position in the Appeals Department that reviews, analyzes and processes non-complex pre-service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (Part A & B) related to clinical and non-clinical services, quality of service, and quality of care issues to include executive and regulatory grievances.
- The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments.
- Requires a High school diploma or GED; up to 2 yearsโ experience working in grievances and appeals, claims, or customer service or any combination of education and/or experience which would provide an equivalent background.
- Familiarity with medical coding and medical terminology, demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, all of the company's internal business processes, and internal local technology strongly preferred.
- Preferred Skills: Medical Terminology, Letter Writing, Claims Experience, Appeals Experience
Primary duties may include, but are not limited to:
- Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language.
- Utilizes guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing and/or medical staff for review.
- The grievance and appeal work is subject to applicable accreditation and regulatory standards and requirements.
- As such, the analyst will strictly follow department guidelines and tools to conduct their reviews. Analyzes and renders determinations on assigned non-complex grievance and appeal issues and completion of the respective written communication documents to convey the determination.
- Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of clinical information.
Recruiter Contact Info
Gurjant Singh
Phone: 925-297-5994
Email:
'd love to talk to you if you think this position is right up your alley, and assure prompt communication, whichever direction. If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you.
Company Overview:
Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally: as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. We create value by bringing together the right people to achieve results. Our clients and employees say they choose to work with Amerit because of how we work with them - with a service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clientsโ businesses forward.
Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Applicants with criminal histories are considered in a manner that is consistent with local, state and federal laws.
Are you an experienced nurse practitioner looking to make a difference in the lives of patients? We are seeking a full-time nurse practitioner to join our outpatient team, focusing on pain evaluation and medication management. If you have a passion for providing high-quality care and supporting physicians, we want to hear from you!
Responsibilities:
* Assist and support physicians in an outpatient setting
* Focus on pain evaluation and medication management
* Provide compassionate care to patients
Qualifications:
* Certification as a Nurse Practitioner
* 2+ years of experience in a pain management setting
* Advanced education and training in the diagnosis and management of common medical conditions
Benefits:
* Full-time position, Monday-Friday 8-5pm
* Opportunity to work in a level III trauma center
* Access to Mayo Clinic expertise and resources
* Join a diverse and compassionate team of healthcare providers
For more jobs like this, check out .
- New Britain Salary Range : 0.00
- 0.00 per year (USD Permanent) Job Type : Permanent Recruiter Email : Looking for a Physician Assistant to join our growing Pain Management team.
Full time opportunity in our progressive Pain Management office.
Primary responsibilities to include performing office exams, medication management, ordering and interpreting diagnostic tests and studies, diagnosing medical conditions, treating acute and chronic illnesses and performing office based procedures and tests.
Must be licensed and registered in the state of CT.
Previous experience preferred in Pain Management, Neurology or Orthopedics.
If you enjoy independence and being part of something new, our Medical Director role is unique.
Our Home Health agency is an integral part of the Optum Nevada healthcare delivery system with a focus on improving patient outcomes.
The agency is a multi-disciplinary service that includes nursing, physical therapy, social work, dietary, speech and occupational therapy, and home health aides.
Our goal is to improve our patients health when visiting them in their residence, typically following a hospital admission.
Were looking for someone with the motivation and heart to provide experienced, compassionate, innovative and high-quality care to patients throughout Southern Nevada.
The Home Health Medical Director, is a member of the Post-Acute senior leadership team helping to improve the quality, cost and service levels of health care provided by the home health agency.
This position works closely with other senior leaders to direct, manage and evaluate all home health practice operations.
This position is 30 percent clinical patient care in the home and 70 percent administrative.
Primary Responsibilities: Provide leadership for and communication to home health clinical and operational staff Develop and implement methods to decrease acute and SNF readmission rates Develop disease specific critical pathways in collaboration with cardiology, COPD physicians, medical specialties, and home health clinicians.
Provide education and training to staff related to critical pathway disease management See patients in the home and/or consult with clinical staff at their patient visits Be the home health Ambassador in the community to improve communication and awareness of home health services by providing education and training to physicians and referral sources Ensure that home health policies are maintained and followed.
Establish new policies and procedures related to patient care, medical management/education, and disaster procedures as needed Attend leadership and staff meetings, IDTs, case conferences, clinical rounds, committee meetings, and maintain designated admin office hours Partner with medical management and ACE staff to promote process improvements, cost saving initiatives, and service enhancements Ensure that CMS Conditions of Participation and Nevada Department of Health regulatory standards are met Work with finance to develop Key metrics/dashboards to drive affordability Assist with complaints, issues and other duties as they arise Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Hoag Health, the top-ranked health system in Orange County, CA is seeking a full-time Nurse Practitioner or Physician Assistant to join our growing pain management program! This is a great opportunity to join an established and reputable organization and contribute to providing high-quality care to the Orange County community! Our multidisciplinary Team of pain specialists put patients first with pain care that begins with non-invasive therapies and, when needed, includes targeted procedures like injections or ablations to reduce pain, restore function, and enhance quality of life. We are accepting applications for both Nurse Practitioners and Physician Assistants who possess pain management experience.
Position Details:
- Schedule: Full-Time Position, Monday โ Friday, Clinic Hours 8am โ 5pm.
- Setting: Outpatient, Clinic setting
- Location: Newport Beach, CA
- Team: 3 Pain Medicine Physicians, 3 Pain Management APPโs, 1 Nurse Navigator
- EMR: Epic
- Conditions Treated: Arthritis, Autoimmune, Cancer Pain, Chronic Pain, IBD, Lumbar Disc, Migraines, Sciatica, Shoulder Pain
- Modalities: Medication management and procedures
Compensation and Benefits:
- Competitive compensation package
- Base guaranteed salary
- Comprehensive benefit package: medical, dental vision, life insurance
- Malpractice coverage provided
- Retirement plan: 401k plan with employer matching contribution
- Generous Paid time off policy
- CME Stipend
Requirements:
- Graduate of a Nurse Practitioner or Physician Assistant Program
- Adult Pain Management experience working as a Nurse Practitioner Physician Assistant or equivalent combination of relevant education and/or experience.
- Minimum 1 to 3 years of experience within Pain/PMR or Neurology/ Neurosurgery focus is required for consideration
- Previous experience with join injections, trigger point injections and suturing preferred
- Furnishing license issued by the State of California and personal DEA number.
- Current ACLS and BLS
Contact:
Steven Yi
Physician Consultant
This position is full time, and permanent, offering health insurance benefits, 11 holiday paid days, 1 day off in your birthday month, vacation pay, sick pay, 403(b) plan with employer matching up to 4%, up to 5 jury duty days, CME days and more.As the CMO you can expect to oversee and manage all clinical functions of the clinic, monitor the standards of medical care, oversee all employees who provide direct patient care, create, review and approve all medical protocols, policies and procedures in the clinic and coordinate, evaluate and oversee all physician specialty panels as they relate to primary care and continuum of care referrals.
Other duties include attending clinic staff meetings and committee meetings, provide consultant services as needed to the staff physicians and nurse practitioners, conduct chart audits as required by funding agencies, conduct monthly clinician in-service trainings and provide leadership and management for all health clinic clinicians, employees, contractors or volunteers.Requirements:Board Certified or Board EligibleValid, unrestricted license to practice medicine in CaliforniaMust obtain hospital privileges at an accredited local hospitalMinimum of 3 years clinical practice in direct patient careMinimum of 3 years medical management experience in managed care setting, plus knowledge of managed care operations processes and managed care contracting.Completed residency trainingExperience and demonstrated success in leading matrix teamsExperience in developing relationships with networks of individuals from various internal and/or external departmentsExperience interacting with key academic investigators and/or thought leadersKnowledge of medical staff organization and structure, medical credentialing and privileging, outcome based quality of care, clinical effectiveness and performance improvement.
The focus is on providing the highest level of quality patient care and the staff is very friendly and team oriented to work with.
A great mentoring environment is provided and there is plenty of room for professional growth and advancement.
You will be doing epidurals, blocks, ablations, PRP, implants and other appropriate interventional procedures.
The goal is to minimize opioid usage and medical management as much as possible.
The focus is on procedures and ongoing follow up that is designed to address the patients condition and improve their quality of life.
?THE DETAILS Excellent compensation Full benefits package Relocation assistance is available Sign on bonus is offered 100% outpatient Interventional Pain Management No nights or weekends PA/NP support is provided you focus on patient care Procedure oriented practice with outstanding compliance and solid vetting process QUALIFICATIONS MD or DO license (or eligible) in Florida is required Board certification / board eligibility is required Pain Management Fellowship is preferred
Weโre building a world of health around every individual โ shaping a more connected, convenient and compassionate health experience. At CVS Healthยฎ, youโll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesย accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger โ helping to simplify health care one person, one family and one community at a time.
Medical Scribe Monday - Friday, 8a-5p
For applicants in Illinois, the estimated range would be $18.88 per hour. The total compensation package for this position includes bonus and benefits such as health care, 401(k) plan, Employee Stock Purchase Plan (ESPP), life insurance, disability insurance, and more.The purpose of an Oak Street Health Medical Scribe is to be the personal data assistant to the primary care provider. This means handling clinical data responsibilities for providers during patient visits in our centers. Medical Scribes are trained to be experts in structured clinical assessments, accurate and specific documentation, population health workflows, and team-based healthcare. A major goal will be to also facilitate efficient and effective medical care for our patients. Oak Street Health is hiring Medical Scribes at over 100 centers in 20 states. Apply today!ย
Responsibilities:
- Observing and recording patient encounters/examinations
- Documenting patient information, history, and diagnoses
- Assisting in medical management
- Documenting medical decision making
- Consultation with the care team and other providers on patient needs
- Other duties as assignedย
What we're looking for
- Applicants committed to ongoing learning that are interested in full-time short-term (1 year) or longer-term opportunities. We are especially interested in recent graduate/gap year/deferred acceptance premedical students looking to gain practical, paid experience in a patient care setting prior to applying to medical, dental, nursing, or physician assistant school.
- Advanced communication skills.
- Ability to type 70+ words per minute.
- Basic level of medical knowledge and/or a willingness to learn quickly.
- Ability and willingness to take direction and be a member of a team providing patient care.
- Excellent job attendance. (Our providers count on you.)
- Ability to work approximately 40-45 hours per week (full-time position) with predictable hours and protected break times.
- Compliance with hospital and Oak Street Health policies, including HIPAA.
- Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve (where necessary)
- US work authorization
- Someone who embodies being โOakyโ.
What it means to be OAKY:
- Creating an unmatched patient experience
- Driving clinical excellence
- Taking ownership and driving for results
- Being relentlessly determined
- Radiating positive energy
- Assuming good intentions
Why Oak Street Health?
Oak Street Health is a rapidly growing, innovative company of community-based healthcare centers that provides higher quality health and wellness care that improves outcomes, manages medical costs, and provides an unmatched experience for adults on Medicare in medically underserved communities.ย By providing holistic, comprehensive, and integrated care right in our patientโs communities, we can keep our patients healthy and then reinvest cost savings in further care for those same communities and others.ย Since 2013, Oak Street Health has brought its singular approach to tens of thousands of people in Illinois, Indiana, Michigan, Pennsylvania, and Ohio.ย With an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody Oak Street values and are passionate about the mission to rebuild healthcare as it should be.
For more information, visitย Street Health offers our coworkers advantages that canโt be found in other clinical workplaces, including:
- The opportunity to be part of a hyper-growth company focused on changing the future of healthcare.ย
- Paid vacation/sick time, retirement options, as well as health, vision, and dental benefits
- Brand new, beautiful working environment
- Supportive and fun culture
- High levels of responsibility and rapid advancement
- Opportunity to be at the forefront of a revolution in healthcare
Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to learn more here:ย Diversity, Equity, and Inclusion | Oak Street Health
For applicants in Illinois, the estimated range would be $18.88 per hour. The total compensation package for this position includes bonus and benefits such as health care, 401(k) plan, Employee Stock Purchase Plan (ESPP), life insurance, disability insurance, and more.
ย
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$17.00 - $28.46This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. ย The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. ย This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.ย
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Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits โ investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visitย anticipate the application window for this opening will close on: 09/25/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.