Collecting information
Organizing data
We celebrate our differences, engage in healthy debate, and are inclusive.. Work closely with cross-functional teams, including Scientific Application Support (SAS), Quality Assurance, Regulatory Affairs, Product Development, and manufacturing to investigate and resolve complaints.. Bachelor's degree in Biological Sciences or related field (e.g., Biomedical Engineering, Systems Engineering, Pharmacology, Chemistry). Danaher Corporation and all Danaher Companies are committed to equal opportunity regardless of race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender identity, or other characteristics protected by law.. Please contact us at applyassistance@danaher.com to request accommodation.
Description Job Summary Provides direct and indirect care duties under the guidance and direction of the registered nurse (RN).. Renders care to patients in adherence with written protocols under the supervision of the RN and assists with patient procedures such as venipuncture/phlebotomy, collecting and preparing laboratory specimens & phlebotomy according to health system standards, Point of Care Testing, ensuring EKGs as ordered, Bladder Scanning and other duties as assigned..  Recognizes accepted priorities for care needs and takes direction for re-prioritizing from the RN. Restocks supplies such as gloves, gowns, linen, medical equipment, assists with room preparation and turnover..  Qualifications Minimum Job Requirements Certified Nursing Assistant (CNA) or EMT/Paramedic active licensure in the State of Florida - maintain active and in good standing throughout employment.. Crisis Prevention Institute (CPI) or Safety Care required within 6 months of hire - maintain active and in good standing throughout employment.
Commercial/Product Launch Provide legal advice and guidance on all aspects of the Company’s commercial activities, including product launches, promotional materials, medical education programs, advisory boards, speaker bureaus, research grants, patient assistance programs, patient advocacy groups, foundation grants, sponsorships, charitable contributions, corporate giving, and similar activities.. Advise on interactions with healthcare professionals (HCPs), patient advocacy groups, and payer organizations, including speaker programs, advisory boards, and medical education initiatives.. Work with Compliance team to ensure Company compliance with False Claims Act, Anti-Kickback Statute (AKS), Foreign Corrupt Practices Act (FCPA), and state/federal transparency laws (e.g., Open Payments/Sunshine Act).. Pricing, Market Access & Reimbursement Provide legal guidance on pricing strategies, contracting, and compliance with government price reporting requirements, including Medicaid and Medicare, 340B Drug Pricing Program, and the Inflation Reduction Act (IRA).. Juris Doctorate from an accredited law school, and admitted to a US state bar in good standing.
Job Title: Claims Adjudicator.. This position is primarily responsible for adjudicating all medical and non-medical provider claims and submitting enrollments/disenrollment to Florida Medicaid and CMS. Position is key to PACE’s revenue and expense process, procuring Medicare rate tables, processing provider claims for expenses by service line, ensuring client enrollment for accurate capitation reimbursement from Medicaid and Medicare, generating accruals for Accounting. Completes all medical claims adjudication tasks twice monthly including, tracking all claims in system, verifying referrals/authorizations, entering new providers, working expectations generating remittance notices, file transmissions and mailing checks per established department protocol.. Completes all non-medical claims adjudication (Home health services, ALF, nursing Home) to include verifying claims and incidental charges, flags and researches questionable bills, prints remittance advice and check requests.. Prepares and submits monthly expense accruals to Accounting for physician, outpatient, dental, labs, x-ray, ambulance, DG clinic, hospital, nursing home, home health services, ALF’s, nursing homes and pharmacy
Medical Science Liaison, Oncology - Southern Florida/Puerto Rico. Join to apply for the Medical Science Liaison, Oncology - Southern Florida/Puerto Rico role at Jazz Pharmaceuticals.. The Medical Science Liaison (MSL) is a member of a field-based team of scientists who function as an extension of the US Medical Affairs organization. Participate in medical education for healthcare professionals (HCPs) through on-site presentations at healthcare institutions, investigator meetings, national conferences, advisory boards, or regional meetings.. Interactswith HCPs as a scientific resource to support activities aligned with the Medical Plan including advisory boards, speaker development and clinical trials
Summary:Ambulance Medical Billing Specialist is responsible for billing and collection processes for National Health Transport's ambulance trips.. Ambulance Medical Billing Specialist answers inquiries from insurance companies, patients, and processes claims accordingly.. Identify and separate denials by code and payerFollow through with payers correspondence in a timely manner.. Identify recurring denials and make necessary system changes to resolve them.. Directs patient complaints to the Billing Operations Supervisor for completion and filing.
Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.. About Us About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years.. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about.. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company.. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Competencies:ACCOUNTABILITY, CUSTOMER SERVICE, DEVELOPMENT AND IMPLEMENTATION OF PLAN OF CARE, KNOWLEDGE OF DISEASE PROCESS, ORGANIZATION SKILLS (4), PATIENT AND FAMILY CENTERED CARE, PATIENT SAFETY - NURSING, PROBLEM SOLVING - PATIENT CARE, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR. - Advanced Cardiac Life Support (ACLS) required for ICU, ED, PACU, Endo, Tele, OB, MHN Pre-Op and Specialty Procedural areas.. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.. Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.. Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.
PRIMARY FUNCTIONThe Manager, Healthcare Analytics will lead the development and delivery of analytics related to membership trends, panel management, quality metrics, cost, and utilization.. Develop and implement analytical methodologies to identify trends, patterns, and opportunities for improvement in VBC attribution, quality, cost and utilization management.. QUALIFICATIONSEDUCATION: Bachelor’s Degree in Statistics, Healthcare Economics, Business, Healthcare Administration, or equivalent combination of education and work experience required.. KNOWLEDGE, SKILLS AND ABILITIES Strong analytical and problem-solving skills with expertise in data mining, statistical analysis, and data visualization tools.. Proficiency in data analysis tools (e.g., SQL, SAS, R) and database management systems.
The Legacy at Boca Raton Rehabilitation and Nursing Center - Director of MDS. A nursing home is seeking a Director of MDS.. The Director of MDS is responsible for the overall successful completion of the MDS process from admission to discharge in accordance to company policy and procedure, State and Federal guidelines, and all other appropriate entities.. Initiate and track insurance appeals for admission denials and continued stay. Schedule UAS with Managed Medicaid providers on appropriate residents
The Clinical Research Coordinator assists the Investigators in executing Phase I, II, III, and IV clinical research trials in accordance with Standard Operating Procedures (SOPs), FDA and GCP guidelines, and study protocols while providing an impeccable patient experience in every, single interaction.. RESPONSIBILITIES The Clinical Research Coordinator (CRC) obtains study participant informed consent.. Performs human specimen lab draws and processing, and packages specimen shipments.. Flourish Research represents one of the industry's most progressive and diversified clinical trial companies with robust capabilities in the therapeutic areas of cardiology/metabolic disorders/renal, CNS, pulmonology, and vaccines.. In clinical trials and healthcare, excellence means everyone deserves the best care, regardless of their race, color, gender identity, religion, ethnicity, physical abilities, age, sexual orientation, or veteran status.
Lab Manager - Contract - Fully Remote. Enjoy the freedom of remote work while making an impact within the pharmaceutical industry.. You will act as a subject matter expert, ensuring efficient collaboration and integration across various departments to support clinical trials.. Understanding of the clinical drug development process and clinical trials.. Collaborate cross-departmentally with Vendor Management, Quality Assurance, Procurement, Sample Management, Data Management, and Precision Medicine.
Global Clinix is seeking a dedicated and experienced Principal Investigator (PI) with a background in Internal Medicine, Family Medicine, or any specialty to join our dynamic clinical research team.. The PI will play a pivotal role in ensuring protocol compliance, patient safety, and regulatory adherence while supporting the success and integrity of ongoing and future clinical trials.. Report serious adverse events (SAEs) and safety concerns in a timely and accurate manner to the sponsor and IRB. Preferred experience in clinical trials, either as a Principal Investigator or Sub-Investigator. Strong understanding of Good Clinical Practice (GCP) and applicable FDA regulations
The Analytics Product Manager is a key member of the Analytics organization working to drive the strategy and vision of the products and its features.. The incumbent in this role works very closely with all Analytic Teams, development teams, QA engineers, business analysts, clinical stakeholders, and user experience design leads to create the product vision, roadmap, and ensure the final deliverable meets stakeholder needs.. Collaborates with various teams including engineering, business analysts, clinical stakeholders, and UX/UI to determine the best technical implementation methods.. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve.. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care.
We are seeking a dynamic and experienced Director of Specialty Pharmacy Implementation to lead the strategic planning, coordination, and execution of specialty pharmacy programs across our organization. This role is critical in ensuring seamless integration of specialty pharmacy services, optimizing patient outcomes, and driving operational excellence. Lead end-to-end implementation of specialty pharmacy programs, including Plan design (site visits); buildout and coordination of facility; implementation roll out; execution; and post-launch optimization and customer success. Bachelor's degree in Pharmacy, Healthcare Administration, Business, or related field (PharmD or MBA preferred). Strong knowledge of specialty pharmacy operations, reimbursement models, and regulatory landscape.
Follows established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety, environmental, and/or infection control standards.. Participates in utilization review, quality assessment and improvement programs to improve patient care.. Collaborates with Radiology, Pathology, Surgery, Medical Oncology, and Nursing in the clinical management of patients.. Complies with all applicable JHS policies and procedures, laws and regulations, and accreditation requirements (including HIPPAA and clinical trials protocol).. May also be exposed to needle sticks, airborne infections, medical gases, X-Ray, chemical exposures and other potential hazards.
The Utilization Management (UM) Prior Authorization (PA) Nurse is a full-time role with NeueHealth, dedicated to promoting quality and cost-effective outcomes for the designated population.. o Evaluate and process prior authorization requests for medical procedures, medications, and services based on clinical guidelines such as : Medicare criteria, Medicaid / Medi-Cal criteria, InterQual, MCG, or Health Plan specific guidelines.. o Familiarity with insurance authorization processes, medical billing, and coding (e.g., ICD-10, CPT codes).. o Working knowledge of MCG, InterQual, and NCQA standards.. o Experience with EMR systems and prior authorization platforms.
About the Role Are you a driven, self-motivated sales professional with a passion for healthcare and an entrepreneurial spirit?. Universal Med Solutions (UMS) is seeking experienced or highly motivated medical sales reps to join our growing team as Independent Territory Managers.. In this flexible, remote 1099 role, you will represent high-quality medical devices and testing solutions to hospitals, health systems, private practices, surgical centers, and specialty clinics within your assigned region.. Uncapped earning potential – Your results drive your income Flexibility – Set your own schedule and run your territory like your own business Ongoing support – Sales training, CRM access, marketing tools, and deal coaching provided Purpose-driven – Represent solutions that improve patient care and outcomes Ready to take control of your medical sales career?. Apply now to become a Territory Manager with Universal Med Solutions.
Provides direct and indirect care duties under the guidance and direction of the registered nurse (RN).. Renders care to patients in adherence with written protocols under the supervision of the RN and assists with patient procedures such as venipuncture/phlebotomy, collecting and preparing laboratory specimens & phlebotomy according to health system standards, Point of Care Testing, ensuring EKGs as ordered, Bladder Scanning and other duties as assigned.. Restocks supplies such as gloves, gowns, linen, medical equipment, assists with room preparation and turnover.. Certified Nursing Assistant (CNA) or EMT/Paramedic active licensure in the State of Florida - maintain active and in good standing throughout employment.. Crisis Prevention Institute (CPI) or Safety Care required within 6 months of hire - maintain active and in good standing throughout employment.
The Analyst, Healthcare Analytics is responsible for developing membership, panel management, quality metric, cost and utilization reports.. Analyze attributed membership, patient, quality metric, cost and utilization data at various reporting grains to identify trends, patterns, and areas for improvement in overall panel and contract management.. EDUCATION: Bachelor’s Degree in Statistics, Healthcare Economics, Business, Healthcare Administration, or equivalent combination of education and work experience required.. Analytical and problem-solving skills with expertise in data mining, statistical analysis, and data visualization tools.. Proficiency in data analysis tools (e.g., SQL, SAS, R) and database management systems.