Supervisor - NY Elite Dispensary

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. We’re Hiring: Full time Medical Directors Centene Corporation is a leading provider of government-sponsored healthcare coverage, providing access to affordable, high-quality services to Medicaid and Medicare members, as well as to individuals and families served by the Health Insurance Marketplace. Looking for a compelling opportunity to move beyond patient encounters and drive meaningful change in the community? Qualifications for this role include: • MD or DO without restrictions, • Must be licensed in New York, • Board certified in Internal Medicine or Family Medicine, • Utilization Management experience and knowledge of quality accreditation standards., • 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, ensuring timely and quality decision making., • 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., • Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes., • Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals., • Participates in provider network development and new market expansion as appropriate., • Asssts 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., • As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues., • Represents the business unit at appropriate state committees and other ad hoc committees. License/Certifications: Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services. (Certification in Psychiatry specialty Is required.) Current New York state license as a MD or DO without restrictions, limitations, or sanctions from government programs. Pay Range: $231,900.00 - $440,500.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. 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 other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Overview Coordinates/oversees a designated group of patients being treated by assigned Physical Therapy Assistants (PTA) and any related clinical supervision of such PTAs and provides appropriate therapy evaluations, treatments and modalities in accordance with established VNS health policies and procedures. Works under general supervision. Licenses and Certifications: License and current registration to practice, as a Physical Therapist in the State of New York Required Education: Bachelor's Degree or Master’s Degree in Physical Therapy from a program registered by the Department of Education or accredited by a national accreditation agency Required Work Experience: Minimum of two years experience as a Physical Therapist Required Minimum of one year supervisory experience Preferred Pay Range USD $85,000.00 - USD $106,300.00 /Yr. About Us VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us — we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.

P&G PRO is a leading manufacturer and marketer of away from home products. P&G PRO Account Executives manage our business with Jan/San and Foodservice distributors, hospitality, healthcare, restaurants and other independent businesses. They develop business building ideas and sell these ideas to our accounts, as well as manage their implementation. They market products which will enable customers to meet their consumers' needs. P&G PRO Account Executives are part of a multi-functional Customer Team which includes experts in Finance, Logistics, Marketing, and Information Systems to provide the resources needed to develop a new and successful way of doing business. We are looking for individuals who are leaders and have a history of making things happen. We are seeking candidates who are analytical thinkers and problem solvers, as well as excellent communicators. We are looking for someone who can set priorities and follow through on commitments, as well as demonstrate creativity, innovation, and initiative. Previous experience in Jan/San sales area is a plus, but not required. Account Executives are expected to influence the customer's marketing, finance, logistics, and other critical business decisions. Our selling begins with developing a concept - a new way of looking at events or business - then pulling together the information to explain the concept and finally persuading our account to accept the recommendation for one or more specific courses of action. Account Executives are expected to become knowledgeable in advertising, promotions, finance, and merchandising, as well as develop expertise in areas such as product knowledge and technical support. THE ROLE: As a Sales Account Executive you will: * * Sell Healthcare, Hospitality and other Jan San customers * Develop collaborative partnerships with our distributor partners * Leverage product and technical service knowledge to partner with customers on program execution, compliance and finding solutions to grow the joint business * Use analytical tools and integrate various data systems to drive superior execution, compliance and find creative ways to improve partnership with a customer. * Develop customer specific solutions to meet or exceed our financial objectives * Developing and cultivating critical professional and personal relationships across all functions of key customers, partner distributors and industry influencers. * Work with Multifunctional Team to create and retain customer contracts.

Please note that any position posted in Canada is for Capital One Canada, any position posted in the United Kingdom is for Capital One Europe and any position posted in the Philippines is for Capital One Philippines Service Corp. Capital One is one of the fastest growing organizations in the world t

Please note that any position posted in Canada is for Capital One Canada, any position posted in the United Kingdom is for Capital One Europe and any position posted in the Philippines is for Capital One Philippines Service Corp. Please note that this salary information is solely for candidates hire

Please note that any position posted in Canada is for Capital One Canada, any position posted in the United Kingdom is for Capital One Europe and any position posted in the Philippines is for Capital One Philippines Service Corp. Please note that this salary information is solely for candidates hire

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We are looking for a SIU Investigator (mid-level). This is a desk position. Within defined guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures. This role is remote eligible. However, you need to live in the New York City metropolitan areas. There may be occasional business travel. What you'll do: * Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims. * Participates in the development of fraud prevention strategies. * Applies knowledge of P&C insurance industry products, services, and processes in investigating claims to include P&C insurance policy contracts, coverages and internal claims handling process and procedures. * Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims. * Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools. * Makes recommendations within defined authority guidelines. * Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome. * Develops and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention. * May serve as a resource team member on specific matters through demonstrated skill or training. * Assists with the delivery of fraud awareness training initiatives in a defined environment. * Handles CAT duty responsibilities as business requires. * Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures. * High School Diploma or General Equivalency Diploma (GED). * 2+ years claims adjusting experience, or P&C SIU/Fraud Investigation experience OR 4+ years prior investigative law enforcement (to include military) or relevant fraud industry investigation experience. * Proven investigatory skills. * Experience obtaining statements from various parties to incidents, witnesses, and suspects. * Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud. * Demonstrated ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems. * Familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems. * Knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology. * SIU experience conducting low to complex PNC fraud investigations OR a combination of Claims and Law Enforcement Investigations OR Military Investigative experience. * Designations such as CFE, CIFI, SCLA, ACLS, FCLS, LPCS, AIC, CPCU, CCLS, or other. * US military experience through military service or a military spouse/domestic partner Compensation range: The salary range for this position is: $77,120 - $147,390 Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors. The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. For more details on our outstanding benefits, visit our benefits page on USAAjobs.com Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting. USAA is 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, or status as a protected veteran.