Healthcare & Pharma Careers

Title: Director of Nursing LTC/Skilled Care (Interim and Permanent)Location: Sparta, WIAre you looking for a for a company that is interested in patient care?. Would you like to work in an area that offers a quaint, historic town surrounded by some of the most scenic areas in Wisconsin.. Working knowledge of nursing home regulations and the Nurse Practice Act, including MDS procedures and reimbursement guidelines under Medicare and Medicaid and standards of practice relating to the prevention of weight loss, pressure wounds, unnecessary pain, and falls.. Additional Info:The company is a leading provider of short-term post-acute rehabilitation and long-term nursing care.. They help those that need short term rehabilitation, respite care, or long-term assistance.

Additionally, the Director acts as the primary liaison between the company and external agencies, including the county EMS Department, local hospitals, and other provider organizations ESSENTIAL JOB FUNCTIONS Lead the Quality Assurance Department, including supervising QA staff, establishing priorities, and managing departmental resources.. Represent the company in communications and partnerships with the county EMS Department, hospitals, and other relevant provider agencies.. Ensure that sensitive patient care and performance data are securely maintained in compliance with HIPAA and other applicable data privacy regulations.. QUALIFICATIONS Current & valid California State Licensure as EMT-Paramedic or Registered Nurse Ability to obtain Kern County Paramedic Accreditation or Mobile Intensive Care Nurse certification (Within one year of employment) Minimum of five years of clinical experience providing patient care in high-acuity settings, such as an ambulance, emergency room, intensive care unit (ICU), or within a healthcare quality improvement program.. Current & valid Class C California Drivers License Current & valid Health Care Provider CPR Current and valid Advanced Cardiac Life Support; Prehospital Trauma Life Support and Pediatric Advanced Life Support certifications.

Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.. This TPM will work to ensure that the implementation outcomes support requirements and meet targets for quality and UAT, training and user adoption, and for reporting and compliance, particularly in relation to Medicare/DSNP services in California.. Experience with Project Management Information Systems and IT tracking (e.g., Wrike, Azure DevOps, PlanView).. Experience with business and technical solutions in Medicaid and/or Medicare systems, claims, enrollment, provider payments, healthcare analytics, EHR systems, and data management.. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity.

Only when assigned Admin On call, (holding the phone) · How many hours are expected to work per week-40 Role Overview: We are seeking a motivated Director of Nursing with experience in Home Health Care to join our team in Colorado.. Staff Management and Development: Recruit, train, and supervise skilled nursing personnel (RN, LPN & CNA) to ensure high levels of competence, patient satisfaction, and adherence to company policies.. Census Growth and Community Engagement: Develop and implement strategies to grow the census by building relationships with referral sources, healthcare providers, and community organizations.. Experience: Minimum of 5 years of clinical nursing experience, with at least 2 years in home health care or skilled nursing.. Proficiency in electronic health records (EHR) and other healthcare technology systems.

RN Medicare Compliance. Prepares and drafts complex Medicare Set-Asides (MSAs), Medical Cost Projects (MCPs), Submission cases, and related products; completes MCPs in preparation for reserve setting or settlement.. Reviews medical claims and completes complex file review for Medicare Set- Asides (MSA) and future medical cost projections.. Serves as a consultant to Medicare Compliance Nurses on claims.. Utilizes resource data bases for diagnoses, treatment guidelines, and prescription medication pricing, documenting the MSA allocation when applicable and finalizes the MSA allocation including cost projections.

RN Medicare Compliance. Prepares and drafts complex Medicare Set-Asides (MSAs), Medical Cost Projects (MCPs), Submission cases, and related products; completes MCPs in preparation for reserve setting or settlement.. Reviews medical claims and completes complex file review for Medicare Set- Asides (MSA) and future medical cost projections.. Serves as a consultant to Medicare Compliance Nurses on claims.. Utilizes resource data bases for diagnoses, treatment guidelines, and prescription medication pricing, documenting the MSA allocation when applicable and finalizes the MSA allocation including cost projections.

Job Description Job Description Hybrid: San Rafael, CA Duties: The Contract Medical Writer applies advanced documentation preparation and document project management skills to assist in the development, drafting, review, editing, and finalization of documents used in conducting clinical studies and reporting clinical study results for regulatory submissions and publications.. Manages study team participation in the preparation of such documents, including calling/running meetings, developing and managing timelines, and managing the document review and comment adjudication processes.. Contacts: Clinical Medical Writing, Biostatistics, Clinical Data Management, Statistical Programming, Clinical Operations, Medical Affairs, Medical Directors, Regulatory Affairs, Legal, Commercial, Pharmacology/Toxicology, Corporate Compliance, Project management, and Pharmacovigilance.. At least 5 years of experience required Familiar with the drug development process (discovery to market), clinical study protocol design and study conduct, and documentation required for the conduct of clinical studies.. Basic understanding of the concepts of coding dictionaries (MedDRA, WHO Drug).

Licensed Nursing Home Administrator Why Join Us?. The LNHA will be responsible for ensuring that the highest quality of care is delivered to residents while maintaining compliance with all state, federal, and local regulations.. Key Responsibilities:Manage all aspects of the nursing home facility, including staff supervision, budgeting, and care plansEnsure compliance with state and federal regulations related to senior care facilitiesDevelop and implement policies and procedures to enhance resident care and safetyAddress any issues or concerns raised by residents or their families promptly and effectivelyManage and support department heads and staff, ensuring adequate training, staffing, and professional development.. Qualifications:A bachelor’s or master’s degree in healthcare administration field.. Valid Nursing Home Administrator (LNHA) licensePrevious experience in managing assisted living facilities or nursing homesStrong financial acumen with experience in budgeting and financial managementExcellent supervisory skills with the ability to lead and motivate a diverse teamUnderstanding of regulatory requirements governing nursing home facilitiesStrong knowledge of long-term care regulations, Medicare/Medicaid, and healthcare management.

Provide training regarding service documentation to direct care staff.. QUALIFICATIONS: Education, Experience, and CompetenciesEducation: Master’s degree in counseling, psychology, social work or related field.. Experience and Competencies: Position requires knowledge and experience with electronic health records.. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects tools, or controls; reach with hands and arms, climb stairs or steep and/or rough terrain; balance; stoop, kneel, or crouch; talk or hear; taste or smell.. Masters Degree in Human Services i.e. Counseling, Psychology, Social Work or related field.

The Patient Safety Attendant under the supervision of a Registered Nurse, is responsible for providing generalized support services in accordance with the Nursing Plan of Care and Medical/Surgical Standards of Care and Practice.. The PSA may interact with patients and/or families, children, adolescents, adults, and geriatrics.. Receives report from RN and/or off-going patient safety attendant at the start of shift.. Gives report to RN and oncoming patient safety attendant before relinquishing responsibilities.. Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

TNT Healthcare Billing Solutions is seeking a dedicated and detail-oriented Medical Biller to manage full-cycle revenue operations for medical clinics throughout the Twin Cities.. The ideal candidate will possess in-depth knowledge of medical billing, coding, insurance claims processing, and revenue cycle management.. - Review medical documentation and accurately assign appropriate codes using ICD-10, CPT, and HCPCS code sets.. - Ensure compliance with coding and billing regulations, including HIPAA and relevant billing standards.. - Strong knowledge of medical billing procedures, coding systems (ICD-10, CPT, HCPCS), and insurance regulations.

With a track record of global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines, Fred Hutch has earned a reputation as one of the world's leading cancer, infectious disease and biomedical research centers.. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services, and network affiliations with hospitals in five states.. Together, our fully integrated research and clinical care teams seek to discover new cures to the world's deadliest diseases and make life beyond cancer a reality.. These values are grounded in and expressed through the principles of diversity, equity and inclusion.. The Clinical Operations Research Services (CORS) General Oncology / solid tumor Clinical Research Nurse (CRN) will support clinical research patients treated at Fred Hutch in South Lake Union & the University of Washington Medical Center - Montlake.

Publicly Traded Biopharmaceutical company in Watertown, MA is expanding for their high profile clinical development trials.. The Director, Clinical Operations is a leadership role responsible for overseeing and managing all aspects of clinical operations for a high priority immunology program.. This individual possesses clinical operations expertise with a track record of success, working with peers and stakeholders across multiple disciplines to drive programs with multiple studies and indications through all phases of clinical trials (Phase I-III).. The Director will be a leader in the organization who knows how to manage a team internally, at our clinical sites, and with our vendors.

Clinical Research Associate II, Dermatology & Rheumatology ( Oregon, Nevada and/or Arizona ). The clinical research associate (CRA) will monitor the progress of clinical studies at investigative sites or remotely, and ensure clinical trials are conducted, recorded, and reported in accordance with the protocol, standard operating procedures (SOPs), ICH-GCP, and all applicable regulatory requirements.. Focusing on dermatology and developing an expertise in this therapeutic area is interesting to you. 2-5 years experience in conducting on-site clinical monitoring in the biotechnology, pharmaceutical, and/or contract research organization (CRO) industry. This position is home-based with local or regional travel required to clinical research sites

Position Summary: The Patient Safety Coordinator is primarily responsible for analyzing reported incident information, providing feedback to members and assisting them in identifying and addressing areas of improvement.. Reviews and analyzes aggregate data to determine need for patient safety initiatives or recommendations to stakeholders.. Assists with facilitation of RCA and ACA processes.. Provide direct support to the Patient Safety Officer related to data analysis, research, facility communication and/or other support services as requested.. Serves on organization committees as assignedServes on the Patient Safety related committees (such as, Risk/Quality, Hospital Quality, others)Assist with educational programs regarding principles of quality, safety and performance improvement.

Provide Updates: Regularly provide updates to the Clinical Director and Clinical Team on patient care management and progress, Incorporating any notable changes or developments in the patient's condition.. Case Management: Administer integrated case management services, ensuring continuous assessment, planning, implementation, coordination, monitoring, and evaluation of patient care plans.. Leadership Responsibilities: Monitor admission documentation, POT, POC, quality outcomes, and risk management processes, including addressing incident reports in collaboration with the Clinical team.. Reporting: Collect, compile and evaluate data on patient care and outcomes, producing detailed reports for the Clinical Director and organizational leadership as required.. On-Call Availability: Be accessible for on-call duties during evenings, nights, weekends, and holidays as required to respond to emergent patient care needs and assist the Clinical Team. The Profile Registered Nurse (RN) license in good standing.

We are seeking a dynamic and experienced Regional Director of Clinical Reimbursement to lead and oversee multiple nursing home facilities.. Conduct regular audits and reviews to ensure accurate documentation, coding, and billing practices.. Professional development opportunities and continuing education support.. The opportunity to make a meaningful difference in the lives of our residents and their families Qualifications: Bachelor's degree in Healthcare Administration, Finance, or a related field.. Knowledge of electronic health records and billing systems.

A Patient Care Manager at Transitions Care is a member of the leadership team that works collaboratively with the Administrator/Director of Nursing with all patient care activities to ensure the delivery of safe and efficient patient care which adheres to relevant standards of accepted nursing, regulatory, medical practice, and payer source criteria.. The PCM works to offer support and education to team members that is consistent with the identified needs based on a review of the documentation, compliance audits and reported areas of weakness.. Ensures all appropriate external documentation is obtained including but not limited to: History & physicals, diagnostic imaging, lab work (as available), power of attorney (POA) paperwork, and POLST paperwork.. Certification as a Certified Hospice and Palliative Care Nurse (CHPN) preferred. Strong computer skills are required, such as, email, and prior experience working with electronic medical records.

Assist BMS attorneys and the Attorney General’s office in compiling evidence for litigation preparation.. Draft Document Desk Review decisions on behalf of the Commissioner to affirm or reverse denials.. Oversee claims payments, prior authorization processes, reconsideration requests, and denials.. Process Freedom of Information Act (FOIA) requests, gather responsive documents from BMS staff, prepare materials for legal review, and compile final correspondence.. Access and navigate multiple systems—including KEPRO C3, KEPRO C3 Nursing Homes, QNXT, ISIGHT, AD HOC Reports Manager, Health PAS, Health PAS-Rx, and Review Manager (INTERQUAL Criteria)—to analyze and audit claims, prior authorization requests, member hearing requests, and provider denials.

Design, develop, and execute automated test scripts using tools like Selenium and programming languages such as Java, JavaScript, and Python to streamline testing processes.. Participate in SOX compliance and audit activities to support regulatory and organizational requirements.. Proficiency in the following tools is a plus: Agile Accelerator, Postman, MuleSoft, Workbench, and Jira. Proficiency in Selenium and Java/Python-based testing frameworks and tools to create and maintain automated test scripts.. Experience in API testing is required , including the ability to design, execute, and analyze API test cases for functionality, reliability, and performance using tools such as JMeter, Postman, and SOA Test. Experience working within Agile Software Development Life Cycle (SDLC) methodologies is required.. Experience testing Salesforce or other CPQ Tool transformations and/or Data Transformation projects strongly preferred.