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The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. Provides quality, cost-effective care to all members through the direct supervision of staff responsible for the management and coordination of the member's care through the incorporation of interdisciplinary strategies, medicare regulations, and medically accepted standards of care. Supervises the assessment of all acute and sub-acute inpatient care for appropriateness of setting and services, according to pre-established criteria and guidelines and ensure a 95% compliance or greater. Supervises the assessment and coordination of the members physical, psychosocial and discharge planning needs through communication with appropriate hospital staff including treating physician, PCP, utilization managers, social workers, discharge planners. Assures appropriate staffing to support departmental/agency services. Ensures all employees are oriented to their department/agency and job and provided with appropriate training, development and continuing education. Correctly interprets and applies all Human Resources policies and procedures relative to discipline, recruitment and selection, performance appraisals, salary reviews and staffing.Bachelor's Degree in Nursing. Minimum one to three years previous management experience preferred. Previous managed care experience in the areas of utilization management and/or case management required. Working knowledge of Windows, Word, Excel. Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies.

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. The Assistant Director of Medicaid and Integrated Products is primarily responsible for guiding the planning, execution, and administration of Medicaid Managed Care, as well as supporting the MLTC & Integrated Products lines of business. Core responsibilities include assisting in the direction of product ideation, development, implementation, and continuous improvement; competitive landscape analyses and market trend monitoring in New York and regional areas; supporting the identification & development of member growth & retention strategies; leading high-visibility, cross-functional product initiatives and regulatory implementations, and overseeing the development of regulatory Medicaid member materials. The successful candidate will also co-lead Federal and State policy and regulatory analysis impacting Medicaid products, and leverage analytics to support ongoing advocacy and/or product performance monitoring. Product Strategy and Innovation • Serves as Medicaid Product SME to internal operational, technical, regulatory, clinical, and other cross-functional teams to support the exploration, coordination, and implementation of new Medicaid products, service area changes, and/or benefit designs, DOH and/or CMS required regulations, and/or strategic improvement initiatives., • Evaluates, develops, and builds new offerings within Medicaid and integrated benefits program including liaising with cross-functional stakeholders and government agencies on regulatory submissions, regulatory communications, readiness reviews, and overall product build & ongoing implementation., • Develops and leads systematic competitive intelligence monitoring and tracking such as benefit design and vendor utilization, product/plan offerings, membership and enrollment trends, service area modifications, mergers and acquisitions, and marketing and promotion efforts., • Conduct in-depth research on business and market trends, product analyses, and competitive intelligence to leadership teams for strategy development. Federal and State Regulatory and Policy Analysis & Oversight • Monitor and track Federal and State policies & regulations that impact Medicaid and integrated benefit products across contractual obligations, eligibility, enrollment, marketing, benefits offering, utilization management, and other areas., • Analyze and interpret CMS and State contractual requirements and updates across all products (e.g., model contracts, state Medicaid agency contract), • Assess and evaluate Federal and State regulatory and policy impacts on products' growth and operations, and summarize risks or opportunities with business stakeholders in plan-wide forums., • Support internal leadership and external audiences (e.g., government agencies, association groups) in defining advocacy points, recommendations or suggestions in response to proposed regulations or policies, and coordinate responses to the State on behalf of the organization, • Lead and/or support Medicaid, Managed Long-Term Care, and Integrated Product regulatory reporting, • Reviews member communications and coordinate with internal teams to ensure regulatory compliance and implementation according to Medicaid managed care requirements. Product Analytics and Optimization • Partners with internal departments to ideate and evaluate product metrics (enrollment, disenrollment, Medicaid recertification, member experience and interaction, benefit utilization, demographics, risk scores, and others) to support ongoing product performance and identify areas of opportunity., • Identifies member and provider abrasion points based on product offerings, and proactively initiates cross-functional projects to improve member and provider experience, workflows, or marketing awareness., • Proactively initiates and leads projects to support member growth and retention including developing business case and scope, defining project parameters, implementation requirements (operational and technical), and evaluation metrics to evaluate success. Support Organization and Departmental goals • Tracks overall Product Initiatives Dashboard to monitor team capacity, resource tracking, and overall progress towards company and departmental goals., • Collaborates with Director to support product changes, strategic performance improvement initiatives, regulatory compliance and auditing, policy & procedure development, and ongoing management of product operations., • Coordinates all phases of a project lifecycle including but not limited to initiation, project plan development and management, execution, control and quality assurance management, post-implementation monitoring, overall project documentation, and project close out and hand-off., • Represent Elderplan/HomeFirst and Medicaid & Integrated Products team in government agency meetings, or external meetings with providers and advocates., • Completes adhoc tasks and assignments as requested., • Utilizes corporate services resources such as Human Resources, Compliance, Legal, Finance, Information Services, Marketing, etc., as appropriate., • Interviews and participates in the selection process for qualified staff in collaboration with Human Resources and department management., • Bachelor's degree required. Graduate degree in business, health administration, public policy or related area preferred., • Minimum of five years of heath plan experience is required, with core experience in Medicaid Managed Care and in any of the following disciplines: Product development & management, Quality, Clinical Strategy & Operations (UM/CM), Health Economics, Finance, Health Plan Operations, or health care industry/healthcare consulting., • Minimum of 2-3 years of managerial experience., • Requires in-depth knowledge of Medicaid Managed Care program, preferably in the New York market, and CMS/State regulations across key areas such as benefit offerings, eligibility and enrollment, quality, utilization management, care management, regulatory and compliance, finance and health economics., • Demonstrated ability to initiate, plan, implement, and project manage high-visibility, cross-functional initiatives to successful completion., • Requires ability to read complex statutes and regulations and interpretation to identify operational, financial, or regulatory risk., • Strong and proactive work ethic, attention to detail, effective time management, and commitment to developing quality work quickly., • Can critically interpret and synthesize key data for leadership and business stakeholders to inform and influence decision-making., • Strong public speaking and oral and written communication skills., • Advanced Microsoft Word, PowerPoint, Excel skills.

Job Title: Corporate Compliance Assistant – healthcare Location: New York, NY 10004 Initial Duration: 3 months with possible extension Shift Time: 9:00 AM-5:00 PM, Hybrid M- F Pay Range: $30-$32/h on w2 Job Description: Client is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. The Corporate Compliance Assistant reports to the Senior Manager of Corporate Compliance and provides critical administrative and operational support to ensure the smooth functioning of compliance activities. This role is responsible for maintaining timely and accurate tracking tools, coordinating communications, assisting with documentation needs, and supporting compliance processes across the department. The Corporate Compliance Admin works closely with internal business units to gather information, support investigations, and ensure compliance requirements are met. Product of Role & Responsibilities: Provide general administrative support to the Corporate Compliance team, including scheduling, document preparation, and communication follow ups. Assist with data collection and requests from internal departments and external stakeholders. Support audit preparation activities and maintain organized, secure documentation. Process mail merges for biannual Service Verification mailings. Coordinates mailing activities for Corporate Compliance, including preparing and sending request letters, conducting weekly office visits to support incoming mail, and distributing mail to appropriate parties. Maintain and regularly update the various Corporate Compliance Trackers, ensuring all information is current and accurate. Supports Corporate Compliance Investigators by tracking due dates for key investigatory activities, monitoring case timeliness, and sending reminders to promote timely completion of case-related tasks. Assist the Senior Manager of Corporate Compliance with populating data in presentations for committee meetings. Input all Medicare compliance activities onto the Compliance Oversight Activities table and ensure all entries are current and complete. Assists with Corporate Compliance Work Plan activities, which may include but are not limited to, conducting outbound calls for the provider directory audit and compiling supporting documents. Monitors the exclusion screening vendor dashboard to ensure internal departments are completing required reviews in a timely manner; maintains user access by adding, removing and updating users as needed. Other duties as assigned or requested. Education, Training & Professional Experience: High school diploma. College degree preferred. 1–3 years of administrative support experience in compliance and/or health plan operations. Experience working in a regulated industry (healthcare, insurance, government). Familiarity with medical terminology or claim billing concepts is a plus. Ability to manage multiple tasks, track deadlines, and maintain organized documentation. Experience working with confidential or sensitive information is preferred. Strong proficiency with Microsoft Office tools. Professional Competencies: Proficient skills in Microsoft products, including Excel, Word, Outlook, PowerPoint, Vizio, and SharePoint. Excellent ability to manage multiple tasks and work independently. Excellent oral, written skills, and organization skills. Proficiency in Microsoft Work mail merge functions for large-volume correspondence. The utmost integrity in the discreet and confidential handling of confidential materials is necessary.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Company: Oak Street Health Title: Medical Scribe - Bilingual Spanish Required (Full-time in Primary Care Setting) Location: 4405 Broadway, New York, NY 10040 This is a full time position, M-F from 8am to 5pm The minimum and maximum base hourly wage for this position is $19.88. This base pay does not include additional forms of compensation including bonuses, overtime, etc. Role Description The purpose of a Medical Scribe at Oak Street Health is to support our primary care providers with clinical documentation so that they can focus on providing exceptional care to our patients. Scribes assist providers throughout the patient care journey - huddling each morning to plan for the day's visits, joining them in the exam room to observe and document, and touching base after the visit to assist with next steps. Beyond the typical Scribe role, these important care team members serve as clinical documentation assistants to their paired provider. Internally, we call them CISs (Clinic Informatics Specialists) in recognition of their important role in supporting accurate, specific, and timely clinical documentation. In addition to observing and documenting all patient encounters in real time, our Scribes become experts in our value-based care model and the documentation and care of chronic conditions, including ICD-10 and CPT coding. Scribes use this expertise to help providers identify and help close care gaps. Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. Because our patients and providers rely on our Scribes, the ideal candidate should commit at least 1-2 years to this role. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields. Check out this ___ for a sneak peek into the life of an Oak Street Medical Scribe! Responsibilities: * Documenting Patient Encounters ~ 80% * Joining the provider in the exam room to observe patient visits * Documenting patient encounters in a structured note, including the history of the present illness, assessment, plan, and physical exam * Assigning appropriate CPT and ICD-10 codes * Preparing After Visit Summaries * Consulting with provider to ensure accurate and specific documentation * Clinical Documentation Improvement ~ 10% * Requesting and reviewing medical records * Leveraging Oak Street's population health tools to support clinical documentation improvement * Preparing for and supporting Daily Huddles and Clinical Documentation Reviews * Consulting with provider on clinical documentation opportunities * Administrative support for your provider and care team ~ 10% * Placing orders orders and referrals * Addressing tasks * Supporting the care team with additional responsibilities related to clinical documentation * Other duties as assigned What we're looking for Knowledge * Knowledge of medical terminology and common medications, either from a pre-medical degree or prior clinical experience * Prior clinical experience, including shadowing and/or volunteering * Prior scribe or transcription experience Skills * Advanced listening and communication skills * Strong computer literacy and ability to learn new technical workflows * Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Abilities * Ability to adapt to new workflows and to quickly learn new concepts and skills [required] * Ability to type 70+ words per minute * Ability and willingness to take direction and be a member of a team providing patient care, including adapting to the provider's working style * Ability to be a self-starter within your role scope * Excellent job attendance including ability to work in-person in our clinics (Our providers count on you.) * Ability to commit to at least 1 year in role (2+ is ideal) * Ability to work approximately 40-45 hours per week during clinic hours (full time position) with predictable hours and break times * Compliance with hospital and Oak Street Health policies, including HIPAA * US work authorization Behaviors We strive for team members who represent our service standards and are: * Competent * Dependable * Inclusive * Seamless * Someone who embodies being 'Oaky' What does being 'Oaky' look like? * Radiating positive energy * Assuming good intentions * Creating an unmatched patient experience * Driving clinical excellence * Taking ownership and delivering results * Being relentlessly determined Why Oak Street Health? Oak Street Health is on a mission to 'Rebuild healthcare as it should be'', providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient's communities, and focused on the quality of care over volume of services. We're an organization on the move! With over 150 locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody 'Oaky' values and passion for our mission. Oak Street Health Benefits: * Mission-focused career impacting change and measurably improving health outcomes for medicare patients * Paid vacation, sick time, and investment/retirement 401K match options * Health insurance, vision, and dental benefits * Opportunities for leadership development and continuing education stipends * New centers and flexible work environments * Opportunities for high levels of responsibility and rapid advancement Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply. Learn more at ___ Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $34.15 This 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. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 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 – 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, visit ___ We anticipate the application window for this opening will close on: 05/22/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Company: Oak Street Health Title: Medical Scribe (Full-time in Primary Care Setting) Location: 4405 Broadway, New York, NY 10040 This position is full time, M-F from 8am to 5pm The minimum and maximum base hourly wage for this position is $19.88. This base pay does not include additional forms of compensation including bonuses, overtime, etc. Role Description The purpose of a Medical Scribe at Oak Street Health is to support our primary care providers with clinical documentation so that they can focus on providing exceptional care to our patients. Scribes assist providers throughout the patient care journey - huddling each morning to plan for the day's visits, joining them in the exam room to observe and document, and touching base after the visit to assist with next steps. Beyond the typical Scribe role, these important care team members serve as clinical documentation assistants to their paired provider. Internally, we call them CISs (Clinic Informatics Specialists) in recognition of their important role in supporting accurate, specific, and timely clinical documentation. In addition to observing and documenting all patient encounters in real time, our Scribes become experts in our value-based care model and the documentation and care of chronic conditions, including ICD-10 and CPT coding. Scribes use this expertise to help providers identify and help close care gaps. Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. Because our patients and providers rely on our Scribes, the ideal candidate should commit at least 1-2 years to this role. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields. Check out this ___ for a sneak peek into the life of an Oak Street Medical Scribe! Responsibilities: * Documenting Patient Encounters ~ 80% * Joining the provider in the exam room to observe patient visits * Documenting patient encounters in a structured note, including the history of the present illness, assessment, plan, and physical exam * Assigning appropriate CPT and ICD-10 codes * Preparing After Visit Summaries * Consulting with provider to ensure accurate and specific documentation * Clinical Documentation Improvement ~ 10% * Requesting and reviewing medical records * Leveraging Oak Street's population health tools to support clinical documentation improvement * Preparing for and supporting Daily Huddles and Clinical Documentation Reviews * Consulting with provider on clinical documentation opportunities * Administrative support for your provider and care team ~ 10% * Placing orders orders and referrals * Addressing tasks * Supporting the care team with additional responsibilities related to clinical documentation * Other duties as assigned What we're looking for Knowledge * Knowledge of medical terminology and common medications, either from a pre-medical degree or prior clinical experience * Prior clinical experience, including shadowing and/or volunteering * Prior scribe or transcription experience Skills * Advanced listening and communication skills * Strong computer literacy and ability to learn new technical workflows * Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Abilities * Ability to adapt to new workflows and to quickly learn new concepts and skills [required] * Ability to type 70+ words per minute * Ability and willingness to take direction and be a member of a team providing patient care, including adapting to the provider's working style * Ability to be a self-starter within your role scope * Excellent job attendance including ability to work in-person in our clinics (Our providers count on you.) * Ability to commit to at least 1 year in role (2+ is ideal) * Ability to work approximately 40-45 hours per week during clinic hours (full time position) with predictable hours and break times * Compliance with hospital and Oak Street Health policies, including HIPAA * US work authorization Behaviors We strive for team members who represent our service standards and are: * Competent * Dependable * Inclusive * Seamless * Someone who embodies being 'Oaky' What does being 'Oaky' look like? * Radiating positive energy * Assuming good intentions * Creating an unmatched patient experience * Driving clinical excellence * Taking ownership and delivering results * Being relentlessly determined Why Oak Street Health? Oak Street Health is on a mission to 'Rebuild healthcare as it should be'', providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient's communities, and focused on the quality of care over volume of services. We're an organization on the move! With over 150 locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody 'Oaky' values and passion for our mission. Oak Street Health Benefits: * Mission-focused career impacting change and measurably improving health outcomes for medicare patients * Paid vacation, sick time, and investment/retirement 401K match options * Health insurance, vision, and dental benefits * Opportunities for leadership development and continuing education stipends * New centers and flexible work environments * Opportunities for high levels of responsibility and rapid advancement Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply. Learn more at ___ Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $34.15 This 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. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 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 – 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, visit ___ We anticipate the application window for this opening will close on: 05/25/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Job Description Provider Services Representative VillageCareMAX 112 Charles Street, New York, NY 10014 MUST LIVE IN NJ/NY/CT VillageCareMAX is looking for a motivated individual for this Full Time role as the Provider Services Representative. This role is the primary point of contact between VillageCareMAX and contracted and/or non-contracted providers for our MLTC and Medicare lines of business for submitting Organization Determination requests. Some of your daily activities will include: • Supporting our Utilization Management team and Member Experience team by maintaining incoming service requests to the department., • Adhere to call center KPI requirements and Quality Assurance guidelines., • Handle incoming requests from providers via ACD Calls and Faxes for compliance timeframes as well as performing outbound calls as needed to provide a first call resolution., • Initiates Organization Determination requests upon requests from providers. Must reside within the New York Tri-State Area - NY, NJ, or CT. There are many benefits to working for VillageCare. If you are someone who likes being part of a team, enjoys a highly competitive benefits package from world leading carriers and competitive compensation, than we would love to speak with you! • PTO package, • 10 Paid Holidays, • Personal and Sick time, • Medical/Dental/Vision, • HRA/FSA, • Education Reimbursement, • Retirement Savings 403(b), • Life & Disability, • Commuter Benefits, • Paid Family Leave, • Additional Employee Discounts VillageCare offers a wide range of at-home and community-based services, as well as managed long-term care options that seek to match each individual's needs to help them attain and maintain the greatest level of independent living possible. We are committed to superior outcomes in quality health care. VillageCare is an Equal Opportunity Employer. Job Posted by ApplicantPro

Job DescriptionPharmacist in Charge About PersonalRx 🌐 PersonalRx is a patient-first, service-driven pharmacy dedicated to improving lives through personalized medication management and reliable home delivery. By combining technology, clinical expertise, and regulatory excellence, we ensure every prescription is filled accurately and on time. Join our growing team and help shape the future of pharmacy care. Position Overview PersonalRx is seeking an experienced and motivated Pharmacist in Charge to lead our East Rutherford, New Jersey pharmacy operations. This role carries full accountability for regulatory compliance, pharmacy operations, and team performance while maintaining a strong focus on patient-centered care. The ideal candidate brings deep pharmacy operations experience, strong leadership skills, and a proactive approach to quality, compliance, and continuous improvement. Key Responsibilities * Serve as the designated Pharmacist-in-Charge (PIC)/ with full accountability for pharmacy operations * Ensure compliance with all New Jersey Board of Pharmacy, state, and federal regulations, including DEA, Medicare, and Medicaid requirements * Lead, mentor, and support a team of 5–10 pharmacists and pharmacy technicians * Partner with the Operations Manager to streamline workflows, improve productivity, and maintain exceptional service levels * Collaborate with executive leadership on strategic initiatives, service expansion, and operational improvements * Manage pharmacy inventory, including procurement, storage, and controlled substance accountability * Oversee quality assurance programs, audit readiness, and continuous process improvement initiatives * Serve as the primary contact for regulatory inspections, audits, and third-party payer reviews * Evaluate, implement, and oversee pharmacy technology systems; ensure staff training and compliance * Resolve escalated patient issues while maintaining a high standard of patient-centered care Qualifications * Doctor of Pharmacy (PharmD) or equivalent degree from an accredited institution * Active, unrestricted New Jersey pharmacist license (required) * Minimum 5–7 years of pharmacy operations experience, including 2+ years in a PIC or leadership role * Strong knowledge of USP, DEA, FDA, and NJ State Board of Pharmacy regulations * Proven experience managing teams and workflows in a complex pharmacy environment * Proficiency with pharmacy management systems and related software * Excellent communication, organizational, and leadership skills * Demonstrated commitment to patient safety, quality, and service excellence Preferred Qualifications * Experience in specialty, long-term care, or mail-order pharmacy * Familiarity with Medicare Part D and third-party payer processes * Strong analytical, reporting, and process-improvement skills Compensation & Benefits * Competitive salary: $135,000 – $150,000 (commensurate with experience) * Paid time off and paid holidays * Professional development support and continuing education reimbursement * Collaborative, mission-driven work culture Why Join PersonalRx? At PersonalRx, you’ll have the opportunity to make a meaningful impact every day—enhancing medication safety, improving patient outcomes, and leading a talented pharmacy team in a supportive, growth-oriented environment. Apply today! A member of our leadership team will review your application promptly. PersonalRx is an EOE Powered by JazzHR 5L1wi41I2r

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: • Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,, • Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Location: Remote or Hybrid (NYC, Denver) Position Summary: We are seeking a highly motivated and talented Data Engineering Intern to join our team and play a critical role in shaping the future of healthcare data management. This individual will be involved in supporting building robust, scalable, and accurate data systems that empower operational and analytics teams to make informed decisions and drive positive outcomes. Position Responsibilities: • Partner closely with operational and analytics teams to translate business needs into effective data solutions, • Architect and implement ETL workflows leveragingCapitalRxplatforms and technologies such as Python,dbt,SQLAlchemy, Terraform, Airflow, Snowflake, and Redshift, • Conduct testing to ensure the flawless execution of data pipelines before production deployment, • Proactivelyidentifyand resolve data-related issues, ensuring system reliability and data integrity, • Provide ongoing maintenance and support for data infrastructure, • Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. Required Qualifications: • Pursuing a Masters degree in Computer Science, Information Technology, or a related field, • Knowledge of Python (or Java), SQL, JSON, and XML, • Knowledge of data warehousing architecture techniques and familiarity with Kimballmethodology, • A strong interest in data engineering, displaying the ability to design, implement, andmaintaincomplex data pipelines, • Capacity to analyze the company's broader data landscape and architect scalable data solutions that support growth, • Excellent communication skills to collaborate effectively with both technical and non-technical stakeholders, • Experience as a Data Engineer, ideally in the healthcare or PBM sector, • Knowledge of Airflow,dbt, Snowflake, and SQL development and Python experience This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. About Capital Rx Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi, the company's cloud-native enterprise health platform. Judi connects every aspect of the healthcare ecosysteminone efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of benefits and rebuilding trust in healthcare. Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Salary Range$35—$40 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at___.

Consultant, Payment Intelligence AArete is one-of-a-kind when it comes to consulting firm culture. We're a global, innovative management and technology consulting firm, with offices in the U.S., India, and the U.K. Our name comes from the Greek word for excellence: "Arete." And excellence is exactly what we strive for. Our success starts with enriching and empowering our people. From robust career development planning to competitive life and wellness benefits, AArete's "Culture of Care" takes a holistic approach to the employee experience. AAretians (our team members) are leaders at every level. You are encouraged to unlock your full potential by directly contributing to our mission and prioritizing space for personal development and fulfillment. The Role Health plans face continued challenges in reimbursing claims on-time and accurately. AArete's consulting service line, Payment Intelligence, goes beyond typical payment integrity to ensure erroneous and inefficient payments are identified, rectified, and recouped to prevent them in the future. Our Payment Intelligence team addresses issues with payment policies, provider contracts, provider data, covered benefits, member eligibility and prior authorizations. In this role, the individual will be responsible for client delivery of Payment Intelligence. The position will reporttoa Payment IntelligenceManager. The individual will be the subject matter expert on strategies to help our clients ensure proper claims paymentthrough the use of(1) claims analytics, (2) process improvements, (3) integration of automation/technology, and (4) configurations setups. This role will also support the internal development of Payment Intelligence initiatives. Work You'll Do • Support the development, identification and analysisof payment accuracy opportunities through remediation with clientcounterparts, • Utilize analytics to identify claims payment opportunities through your knowledge of standard payment methodologies including Prospective Payment Systems (IPPS/OPPS), fee for service, Groupers, RUG, etc., • Support process improvements and automation initiatives for clients, • Conduct research on current events, changes in regulatory requirements and market trends impacting health plan reimbursement, • Contribute to the preparation of client ready deliverables with clear and actionable insight, • Exercise sound judgement and clear and direct communication in all aspects of your work, • Other duties as assigned Requirements • 2+ years of experience in a role within consulting, provider revenue cycle, a payment integrity vendor, and/or a payer organization, • Foundational knowledge of claims processing across multiple lines of business, including Medicare, Medicaid, ACA/Marketplace, Commercial, and Duals, • Experience across various spend areas, including professional, ancillary, outpatient, and inpatient services, • Ability to identify and analyze mispaid claims to ensure accuracy and compliance, • Knowledge of industry vendors and tools related to claims processing, provider data, and contract management, • Understanding of end-to-end claims processes, including claims management, provider lifecycle, and network optimization, • Strong professional communication skills, including written, verbal, interpersonal, and in-person presentation expertise, • Experience coaching and mentoring team members, • Advanced proficiency utilizing Microsoft Excel and basic/intermediate SQL for data analysis, • Strong analytical, data interpretation, and problem-solving skills, • Ability to identify client savings opportunities and develop actionable business cases, • Bachelor's degree or equivalent, • Direct client interaction with possible travel to client locations, • Policy & Claims Editing Expertise, • Research and interpretation of healthcare policies and regulations, • Experience in reimbursement policy writing and claims editing, • Proficiency in data mining to detect errors and inconsistencies, • Ability to crosswalk and compare edits and policies, • Knowledge of claims editing processes, including Prepay/Post-Pay, COB, Subrogation, Fraud Detection, and Medical Record Reviews, • Contract Configuration & Provider Data Expertise, • Interpretation of provider contract terms and pricing methodologies, including fee schedules, per diem, DRGs, cost-plus, and outlier payments, • Understanding of contract carve-outs, including bundled services, readmissions, and reductions, • Experience in contract pricing and claims reimbursement analysis, • Ability to price and reprice claims based on contractual agreements, • Understanding of provider TIN and NPI relationships, • Knowledge of the provider lifecycle, including Credentialing, Data Management, Contracting, and Configuration, • Familiarity with network processes, including Optimization, Adequacy, and Pricing, • Familiarity with claims adjudication systems (e.g., Facets, QNXT, Amisys, etc.), • Based in Chicago, IL, and flexible to work from our Chicago office as needed Compensation & Benefits • Flexible PTO, monthly half-day refuels, volunteer time off, 10 paid holidays, • Own Your Day flexible work policy, • Competitive majority employer-paid benefits: Medical, Dental, Vision, 401K Match, • Generous paid parental leave options, • Employer paid Life Insurance, STD, LTD, • Charitable contribution matching program, • New client commission opportunities and referral bonus program AArete will accept applications until the position is filled. The job posting will be removed once the role is no longer available. We put humans at the center of our work We're a global management and technology consulting firm specializing in strategic profitability improvement, digital transformation, and strategy & change for clients. Our cross-industry solutions are powered by a digital-first mindset, market intelligence, and data-driven approach to deliver purposeful change, actionable insights, and guaranteed results. But what sets us apart is our people. We are guided by our deeply embedded guiding principles: Excellence, Passion, Loyalty to Clients, Stewardship, Family, Community, Sustainability, and Inclusion. And we've been recognized as a top firm to work for by companies like Forbes, Top Workplaces Chicago Tribune, and Consulting Magazine. We've earned a Great Place to Work Certification and been named a World's Best Management Consulting Firm by Forbes, Vault's Top 50 Firms to Work For, Crain's Chicago Business Fast 50, Inc 5000's Fastest Growing Firms, and Consulting Magazine's Fastest Growing Firms. We are an Equal Employment 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. #LI-DNI

• Job Type: Officer of Administration, • Bargaining Unit:, • Regular/Temporary: Regular, • End Date if Temporary:, • Hours Per Week: 35, • Standard Work Schedule:, • Building: Reporting directly to the Associate Director of Contracts (the "Director") of the Clinical Trials Office (the "CTO") of Columbia University's Vagelos College of Physicians & Surgeons ("VP&S"). The Senior Contract Specialist will administer agreements (such as clinical trials, research services, and confidentiality agreements) from inception through termination, which includes, but is not limited to, negotiation, providing consultation & advice, which will best meet the needs of the research community at VP&S. One of the main objectives of this position is to have the necessary skill set to support the contracting processes. The CTO assists investigators and academic/research staff in developing clinical trials at VP&S and provides administrative resources and infrastructure to build and sustain clinical trials and clinical research at VP&S. The successful candidate will work with Sponsors in negotiating contracts for clinical trials in accordance with all applicable regulatory and legal requirements and institutional policies and procedures. Responsibilities Responsibilities include, but not limited to the following: • Collaborate with the Director, the Executive Director of the CTO, General Counsel, VP&S faculty and administration, and New York-Presbyterian Hospital ("NYPH") administration to meet the institutional needs regarding clinical trial negotiations and execution. The role of the Contract Specialist includes being skilled and qualified to negotiate and develop contracts using knowledge of applicable Institutional policies and procedures, as well as various laws, statutes, guidelines and requirements., • Liaise with internal departments such as Sponsored Projects Administration, Columbia Technology Ventures, Institutional Review Boards (IRB), Procurement, and the Office of Research Compliance and Training., • Negotiate Clinical Trial Agreements (CTAs) with sponsors, ensuring alignment with budgetary considerations and institutional policies and procedures., • Assist the Director in the development and implementation of policies and procedures that ensure Clinical Trial Agreements comply with applicable federal and state regulations, including those promulgated from the U.S. Food and Drug Administration, the U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services, and the Joint Commission., • Draft, negotiate, and distribute subcontracts on behalf of the research community., • Prepare agreements for execution in accordance with institutional policies and procedures., • Maintain and update activity databases and workflow trackers., • Collaborate with pre-award, post-award, and regulatory colleagues within the CTO to provide seamless support to the research community., • Serve as the primary point of contact for Principal Investigators and study teams regarding the status of contract negotiations., • 3+ years of experience in contract negotiation and administration, with a solid understanding of contracting principles, risk management, and their application to clinical research and clinical research lifecycle., • Demonstrated ability to work independently, with prior project management experience., • Strong verbal and written communication skills., • Excellent interpersonal and presentation skills. Columbia University is committed to the hiring of qualified local residents.

Summary of Job As part of the overall clinical audit process, assess and audit medical record charts to ensure compliance with internal (EmblemHealth) and external regulatory and accreditation requirements. Compare collected data against Healthcare Effectiveness Data and Information Set (HEDIS) and Quality Assurance Reporting Requirements (QARR) audit standards. The information abstracted from completed chart review will directly impact EmblemHealth's Quality award programs, including Medicare Stars and Quality Incentive Awards. Identify and report significant and/or patterns of variances from established standards that can negatively impact scores. May provide process improvement recommendations to safeguard a high quality of clinical care for patients. Responsibilities • Support EmblemHealth's Quality program by conducting targeted chart review to enhance quality scores during the annual Medical Record Review project as well as throughout the year for Supplemental data collection., • Review each chart to determine if the patient meets the selection criteria., • Complete one audit tool (paper form or row in the electronic spreadsheet) for each patient that meets the criteria., • Ensure that patient confidentiality is protected., • Utilize appropriate tools, processes, standards, and techniques to perform audits., • Identify variations from established standards in audit results., • Ensure that these variations are reported accurately and timely., • May provide assistance in the compilation/interpretation of data and results., • Conduct telephonic outreach calls to EmblemHealth Members in support of various HEDIS/QARR measures, to complete health assessments, and collect historical information that directly impacts Quality results., • Ensure that relevant areas of patient care are covered so that a complete picture can be reported on (i.e., accessibility of care, communication with providers, care coordination, interactions with staff)., • Provide recommendations on process improvements based on audit results., • Bachelors' Degree. Current licensed NP, LPN or RN with 3 - 5years of clinical experience in critical care or med-surgical experienced (Required) • 3 - 5 years of relevant, professional work experience (Required), • 2 - 3 years' experience in a managed care environment (Preferred), • Knowledge of HEDIS/QARR/Star specifications (Required), • Proven track record of accurately performing audits within specified parameters of quality and timeliness (Required), • Advanced clinical assessment skills and the ability to apply clinical criteria and guidelines (Required), • Attention to detail, and the ability to proficiently read and interpret medical records (Required), • Experience with EPIC (Preferred), • Knowledge of ICD-10 codes (Required), • Excellent communication skills - verbal, written, interpersonal (Required), • Must have ability to physically travel between sites (Required) Additional Information, • Requisition ID: 1000002946, • Hiring Range: $56,160-$99,360

Description: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Billing Coordinator / Coder is responsible for coordinating the day-to-day billing operations of the department and the hospital outpatient billing service utilizing a centralized medical information system. This position is responsible for accurately abstracting data following the Official International Classification of Diseases (ICD)-10-Clinical Modification (CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Guidelines for Coding and Centers for Medicare and Medicaid Services (CMS) directives across the Hackensack Meridian Health (HMH) network. Performs data entry of required abstracted patient information into the electronic medical record system. Queries physicians when appropriate. Responsibilties: A day in the life of a Billing Coordinator / Coder at Hackensack Meridian Health includes: * Coordinates pertinent information of a patient's medical record for submission to the physician billing service. * Verifies patient's insurance and acts as a liaison with patients regarding charges, answers billing inquiries and assists with outstanding bills. * Ensures proper receipt of authorization / referral and completion of all forms. * Analyzes medical records and identifies documentation deficiencies. * Daily monitoring of all WQ's for coding and billing corrections. * Assigns codes to clinical services performed for use in reimbursement and data collection. * Assign CPT, HCPCS and ICD-10-CM codes. * Assesses clinical documentation and communicates with physicians and advanced practice providers for additional information when documentation for proper coding is missing or incomplete. * Knowledge of and ability to address National Correct Coding Initiative (NCCI) and National Coverage Determinations (NCD) / Local coverage determinations (LCD) edits. * Maintains required productivity and quality requirements * Complies with HMH Organizational policies, procedures, and standards of behavior; maintains patient record Reports unusual circumstances, possible risk factors, errors, and discrepancies to management. * Other duties and/or projects as assigned. Qualifications: Education, Knowledge, Skills and Abilities Required: * High School diploma, general equivalency diploma (GED), and/or GED equivalent programs. * Minimum of 1 year of coding for professional services * Strong understanding of physiology, medical terms and anatomy. * Proficiency in computer skills including typing speed and accuracy. * Excellent written and verbal communication skills. * Proficient computer skills including but not limited to Microsoft Office and Google Suite platforms. * Must be able to achieve and maintain appropriate coding quality and productivity as established by HMH Compliance Education, Knowledge, Skills and Abilities Preferred: * Prior working experience with outpatient hospital ICD10 diagnosis, CPT procedural and E&M coding experience is desired Licenses and Certifications Required: * Certified Coding Specialist or Certified Outpatient Coder. Licenses and Certifications Preferred: * An approved American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) coding credential. If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!

• Job Type: Support Staff - Union, • Bargaining Unit: SSA, • Regular/Temporary: Regular, • End Date if Temporary:, • Hours Per Week: 35, • Standard Work Schedule:, • Building: The Senior Secretary is responsible for handling and resolving incoming phone calls from patients, insurance carriers and or physician offices. Responsibilities will include collections of outstanding patient balances, establishing payment arrangements, and updating patient and guarantor accounts with new demographic and insurance coverage information. The Senior Secretary must exhibit professional and courteous behavior at all times during patient and/or client interaction. Additionally, the Senior Secretary is responsible for handling billing/coding edits, and charge review by analyzing and resolving encounters in multiple workqueues. Responsibilities • Analyze multiple Epic workqueues require review, including but not limited to Charge Review, Return Mail, Accounts, Denials, and Registration edits. Execute charge and coding edits within charge review to achieve account resolution., • Responsible for managing and reviewing self-pay accounts. Attempt to collect full payments from the patient or guarantor in a professional and courteous manner. Provide itemized statements upon request and monthly for self-pay accounts., • Establishes payment arrangements per FPO guidelines. Document terms in the billing system. Develop solutions to help address patient financial needs in accordance with FPO policies and procedures., • Handle a high volume of calls and perform work in a timely manner. customer inquiries, disputes, and complaints in a professional and courteous manner. Escalate contentious complaints to a supervisor or higher management., • Obtain all insurance, demographic, and guarantor information, update patient demographics, and bill third-party payers as appropriate., • Clearly documents in the system summary of work and follow-up steps after each call., • Conforms to all applicable HIPAA, Billing Compliance, and safety policies and guidelines. Bachelor's degree. * A minimum of 2-year experience in a physician billing or third-party payer environment. * Patient financial and practice management system experience in Epic and or other of electronic billing systems. * Knowledge of medical terminology and previous experience in an academic healthcare setting. * Ability to multi-task, prioritize, and manage time effectively; and ability to work independently. * Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.). * Ideal candidate is a motivated individual with a positive attitude and exceptional work ethic. Other Requirements • Typing 60-65 WPM., • Must successfully complete all online systems training requirements. Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions, and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid, and compliance program regulations. * Candidate must demonstrate the ability to understand and navigate the payer adjudication process. * Candidate must demonstrate a strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner. * Must demonstrate effective communication skills both verbally and written. Equal Opportunity Employer / Disability / Veteran Columbia University is committed to the hiring of qualified local residents.

• Job Type: Officer of Administration, • Regular/Temporary: Regular, • Hours Per Week: 35, • Standard Work Schedule: Core business hours Monday-Friday, schedules vary, • Building: 3 Columbus Circle, New York, NY 10019 The Revenue Cycle Manager (Outsourcing) is responsible for direct oversight of the outstanding receivables that have been referred to an outside vendor and the FPO outsourcing team. The Manager is responsible for units and vendor performance, work quality, efficiency, and compliance with policies and regulations. Responsibilities Operations • Manages the outsourcing unit for CUIMC, including the College of Dental Medicine (CDM), and leads a team of four Outsourcing Coordinators. Oversees and monitors daily operational workflows, work queues, and related programs to ensure optimal efficiency and effective resource utilization. Continuously evaluates the need for new tasks, functions, or process improvements. Ensures adherence to established workpriority matrices and monitors workqueue inventory to confirm timely followup on accounts. Proactively identifies potential backlogs and advises Directors on appropriate mitigation strategies., • The role involves supervising and assisting outsourcing coordinators in managing vendor performance, productivity, and quality, as well as monitoring staff performance within the outsourcing unit. It includes developing guidelines for prioritizing work activities and optimizing work queues. The position also entails evaluating the effectiveness of workflows and implementing quality control measures and audits to ensure compliance and operational efficiency., • Supports vendor negotiation activities and coordinates the purchase order process. Reviews, audits, and prepare vendor invoices for approval and payment., • Manages vendor system access and training, ensuring appropriate onboarding, ongoing education, and compliance with institutional standards., • Conducts analysis and provides reporting to Directors on referrals, contingency fees, receivables aging, and other operational metrics to identify efficiencies, trends, and opportunities for improvement., • Maintains and updates policies and procedures, ensuring they are clearly communicated, understood, and consistently followed by both internal staff and external vendor partners., • Serves as the primary liaison between departmental leadership and the billing vendor on all revenue cycle and accounts receivable-related matters., • Oversees special projects and escalated issues, providing resolution for highercomplexity items raised by vendor(s) or internal staff., • Regularly evaluates workqueues to ensure they accurately capture required activities, analyzes inflow for issues and trends, and collaborates with management and departments such as IT to resolve systemic issues. Reviews, understands, and communicates payer industry standards, policies, and other changes. Stays apprised of payer process changes., • Serves as the subject matter expert responsible for troubleshooting, analyzing, and performing resolution management for accounts receivables., • Implement approved quality and audit control measures to achieve compliance and optimum efficiency., • Reviews denial reports for trends and research denials. Identifies root cause and prepares issues for escalation., • Works collaboratively with clinical departments and vendor(s) to establish effective communications to further the efficiency of the revenue cycle process., • Serves as an individual or team contributor towards achieving established organizational goals across all Revenue Cycle units., • Collects and evaluates data to identify trends and gaps across Revenue Cycle processes. Uses analysis to make recommendations for improvements and optimization. Participates in improvement/optimization initiatives., • Direct oversight of assigned personnel and vendors. Manages and mentors vendors to onboard and train staff., • Promotes staff and vendor professionalism and performance with training and feedback. Promotes a culture of collaboration, facilitating continuous process improvement and professional development., • Oversee team performance, ensuring productivity and quality benchmarks are consistently achieved., • Evaluates staff performance and takes corrective action in accordance with departmental HR guidelines. Review staff productivity and quality measures. Administer improvement plans as required., • Lead regular team meetings to discuss updates, address challenges, and reinforce best practices., • As a member of the management team, performs other tasks, assumes additional management or supervisory responsibilities within the Revenue Cycle Department as assigned., • Represents the FPO on committees, task forces, and work groups as assigned. Please note: While this position is primarily remote, candidates must be in a Columbia University-approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the responsibility of the employee and will not be reimbursed by the company. Minimum Qualifications • Requires a bachelor's degree or equivalent in education and experience., • Minimum of 4 years' related experience in a physician billing or third-party payor environment., • An equivalent combination of education and experience may be considered., • Demonstrated intermediate skills in problem assessment, resolution, and collaborative problem solving in complex and interdisciplinary settings, including strong proficiency in healthcare and payer guidelines as it pertains to insurance verification., • Ability to work collaboratively with a culturally diverse staff and patient/family population, strong customer service skills, demonstrating tact and sensitivity in stressful situations., • Ability to work independently and follow-through and handle multiple tasks simultaneously., • Excellent verbal and written communication skills., • Intermediate to advanced level proficiency of Microsoft Office (Word & Excel) or similar software is required, and an ability and willingness to learn new systems and programs., • Must be a motivated individual with a positive and exceptional work ethic., • Demonstrated intermediate proficiency in health insurance eligibility as it pertains to Medicare and Medicaid regulations, insurance, and managed care reimbursement concepts and overall operational impact., • At least 2 years of direct supervisory experience is preferred. Patient Facing Competencies Minimum Proficiency Level Accountability & Self-Management Level 3 - Intermediate Adaptability to Change & Learning Agility Level 3 - Intermediate Communication Level 3 - Intermediate Customer Service & Patient Centered Level 3 - Intermediate Emotional Intelligence Level 3 - Intermediate Problem Solving & Decision Making Level 3 - Intermediate Productivity & Time Management Level 3 - Intermediate Teamwork & Collaboration Level 3 - Intermediate Quality, Patient & Workplace Safety Level 3 - Intermediate Leadership Competencies Minimum Proficiency Level Business Acumen & Vision Driver Level 1 - Introductory Performance Management Level 2 - Basic Innovation & Organizational Development Level 1 - Introductory Equal Opportunity Employer / Disability / Veteran Columbia University is committed to the hiring of qualified local residents.

• Job Type: Officer of Administration, • Bargaining Unit:, • Regular/Temporary: Regular, • End Date if Temporary:, • Hours Per Week: 35, • Standard Work Schedule:, • Building: Reporting directly to the Associate Director of Regulatory Science (the "Associate Director") of the Clinical Trials Office (the "CTO") of Columbia University's Vagelos College of Physicians & Surgeons ("P&S") at Columbia University Irving Medical Center ("CUIMC"), the Regulatory Science Specialist assists the Associate Director in overseeing the CTO's regulatory compliance and providing assistance to the research community in the development and conduct of clinical trials. The CTO, which is operated jointly with the New York-Presbyterian Hospital ("NYPH") assists investigators and academic/research staff in developing clinical trials at CUIMC and provides administrative resources and infrastructure to build and sustain clinical trials research. Responsibilities The Regulatory Science Specialist is responsible for the following: • Collaborates with the Associate Director, the Executive Director of the CTO (the "Director"), the Medical Director of the CTO, CUIMC faculty and administration and NYPH administration in meeting the institutional needs regarding clinical trial compliance, quality assurance, training and process-improvement goals., • Assists the Associate Director in developing and implementing policies and procedures designed to assure that clinical trials are carried out in compliance with applicable federal and state regulations, including those promulgated in the U.S. Food and Drug Administration, the U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services and the rules of the Joint Commission., • Assists the Medical Director and Associate Director of Regulatory Science in implementing the IND/IDE Assistance Program, which provides regulatory guidance in connection with investigator initiated clinical trials., • Assists in the implementation of a training program for research personnel, including research newsletters, workshops, and didactic training sessions upon request., • Provides guidance regarding regulatory and institutional requirements to investigators and research personnel, • Participates in the Clinical Trials Monitoring Assistance Program (CTMAP) that includes oversight and monitoring of investigator/coordinator compliance with standard operating procedures as they pertain to the conduct of FDA regulated clinical trials., • Collaborates with the CTSA and the HRPO/IRB in developing programs such as programs to increase patient recruitment and to address regulatory and compliance needs., • Provides support of RecruitMe Platform for the CUIMC research community including:, • Coordinating with investigators and research teams in RecruitMe entry., • Developing training and process improvement projects, and other project management duties with RecruitMe., • Collaborating with the Director and Associate Director to implement objectives and workflow strategies for content maintenance on RecruitMe and other CTO websites., • Fulfilling reporting requirements for management, including metrics from Google Analytics data., • Monitoring external communications for social media websites., • Liaising with RecruitMe contacts, information technology ("IT") groups, CTSA leadership, outside vendors and/or internal partners in research for needs related to RecruitMe and other CTO websites., • Represents the Manager and Director in his/her absence and all other duties as assigned. Minimum Qualifications • Bachelor's degree, • In depth knowledge of federal, state and local laws and regulations and industry requirements and practices regarding the proper conduct of clinical trials:, • Particular knowledge and experience in FDA matters, including regulations relating to INDs and IDEs, • Expert working knowledge in GCP, patient safety standards and IRB regulations pertinent to clinical research, • Demonstrable ability to collaborate with partners in research, investigators and coordinators, • Excellent verbal and written communication skills, • Excellent interpersonal and presentation skills, • Strong computer skills required, including proficiency with content management systems, social media websites, Microsoft Office, • Ability to manage/handle multiple tasks, teams, and teamwork simultaneously. Equal Opportunity Employer / Disability / Veteran Columbia University is committed to the hiring of qualified local residents.

Licensed Mental Health Counselor (LMHC) Wage: Between $120-$131 an hour Licensed Mental Health Counselor — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required. About you ? You're a fully-licensed Mental Health Counselor at a Master's level or above with LMHC, LPCMH, or LIMHP licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. ? You're ready to launch a private practice, or grow your existing business by taking insurance. About Headway Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need. How Headway supports providers Start taking insurance, stress-free: Get credentialed for free in multiple states in as little as 30 days and start seeing covered clients sooner. Built-in compliance Stay compliant from day one with audit support and ongoing resources. Expansive coverage: Work with the plans that most clients use, including Medicare Advantage and Medicaid. Increase your earnings: Secure higher rates with top insurance plans through access to our nationwide insurance network. Dependable payments: Build stability in your practice with predictable bi-weekly payments you can count on. Built-in EHR features Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more. Free continuing education Nurture your long-term professional goals and earn CEUs with complimentary courses on Headway Academy. How Headway supports your clients Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Please note: At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license.

Licensed Mental Health Therapist (LMHT) Wage: Between $120-$131 an hour Licensed Mental Health Therapist — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required. About you ? You're a fully-licensed Mental Health Therapist at a Master's level or above with LMHC, LPCMH, LIMHP, LMFT, LMFTS, LCMFT, LPC, LPCC, LCPC, LCPCS, LPCC-S, LCSW, LICSW, or LCSCW licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. ? You're ready to launch a private practice, or grow your existing business by taking insurance. About Headway Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need. How Headway supports providers Start taking insurance, stress-free: Get credentialed for free in multiple states in as little as 30 days and start seeing covered clients sooner. Built-in compliance Stay compliant from day one with audit support and ongoing resources. Expansive coverage: Work with the plans that most clients use, including Medicare Advantage and Medicaid. Increase your earnings: Secure higher rates with top insurance plans through access to our nationwide insurance network. Dependable payments: Build stability in your practice with predictable bi-weekly payments you can count on. Built-in EHR features Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more. Free continuing education Nurture your long-term professional goals and earn CEUs with complimentary courses on Headway Academy. How Headway supports your clients Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Please note: At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license.

Licensed Mental Health Therapist (LMHT) Wage: Between $120-$131 an hour Licensed Mental Health Therapist — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required. About you ? You're a fully-licensed Mental Health Therapist at a Master's level or above with LMHC, LPCMH, LIMHP, LMFT, LMFTS, LCMFT, LPC, LPCC, LCPC, LCPCS, LPCC-S, LCSW, LICSW, or LCSCW licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. ? You're ready to launch a private practice, or grow your existing business by taking insurance. About Headway Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need. How Headway supports providers Start taking insurance, stress-free: Get credentialed for free in multiple states in as little as 30 days and start seeing covered clients sooner. Built-in compliance Stay compliant from day one with audit support and ongoing resources. Expansive coverage: Work with the plans that most clients use, including Medicare Advantage and Medicaid. Increase your earnings: Secure higher rates with top insurance plans through access to our nationwide insurance network. Dependable payments: Build stability in your practice with predictable bi-weekly payments you can count on. Built-in EHR features Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more. Free continuing education Nurture your long-term professional goals and earn CEUs with complimentary courses on Headway Academy. How Headway supports your clients Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Please note: At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license.

Experience with EMRs such as Homecare Homebase, NetSmart, or Epic. Supplemental Health Care is hiring Home Health Physical Therapists (PTs) to provide compassionate, patient-centered care in West Orange, New Jersey and the surrounding areas. Document all care in compliance with Medicare, OASIS-E, an

The Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans.The team serves as MSHPs s Coordinator, Contracts, Healthcare, Business Servic

Job Description Position: Manager of Business Analysts Location: Hybrid (Must Reside in NY/NJ/CT) Compensation:$135,292.44 - $152,204.00 Join VillageCare as a Manager of Business Analysts and take the lead in transforming healthcare insights into actionable solutions. Located in the heart of New York, NY, this position offers an opportunity to shape strategies that impact patient care and operational excellence. With a competitive salary range of $135,292.44 - $152,204.00, you will not only be rewarded for your expertise but also for your innovative contributions to our customer-centric mission. Collaborate with a dynamic team of problem-solvers and forward-thinkers, driving excellence in a high-performance environment. Your leadership will inspire a culture of integrity, ensuring that our services remain top-notch. Embrace the chance to elevate your career while making a meaningful difference in healthcare delivery at VillageCare. A little about us VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. What would you do as a Manager of Business Analysts The Manager of Business Analysts at VillageCare will play a pivotal role in shaping the Strategy & Analytics team by establishing a robust framework for analytics and reporting across the organization. This innovative position goes beyond simple requirement gathering; it demands a thought leader who collaborates strategically with the technical team to develop integrated analytics solutions. As this is a new role, you will have the unique opportunity to build and lead a team of Business Analysts, effectively bridging business needs with technical solutions. Responsibilities include improving business analysis processes, assessing the analytics landscape, defining key performance indicators, and designing reports that enhance operational efficiency. Additionally, you will facilitate collaboration with business partners to ensure requirements are clearly articulated and documented, while establishing deadlines for the requirement gathering process. Your leadership will be key in nurturing a high-performing, collaborative team dedicated to achieving VillageCareMax's strategic goals. Are you a good fit for this Manager of Business Analysts job? To thrive as the Manager of Business Analysts at VillageCare, candidates must possess a robust background in healthcare analytics and team management. A minimum of 7 years of Business Analyst experience, preferably within a healthcare setting on the payor side, is essential. Experience with healthcare consulting firms is advantageous, alongside at least 2 years in a leadership role. Candidates should hold certifications such as Certified Business Analysis Professional (CBAP) or Project Management Professional (PMP), which are highly desired. Proficiency in writing simple SQL statements for data review is necessary, as is familiarity with visualization software like Tableau. Additionally, effective facilitation of meetings and collaborative sessions with diverse stakeholders is critical for gathering requirements and driving solutions. A solid understanding of Medicare operations, compliance, and the factors influencing health plan success will further enhance your ability to lead and implement innovative analytics strategies. A bachelor's degree is required for this position. Knowledge and skills required for the position are: • 7+ years in Business Analyst experience in health care setting, • ideally on the payor side; In addition, • experience working with healthcare consulting firms is a plus · 2+ years of managing a team in similar role., • · Certified Business Analysis Professional (CBAP), • PMP certification or other applicable certifications are highly desired · Familiarity and ability to write simple SQL statements to review data. · Experience with Tableau or other visualization software as an end user · Experience running effective meetings and working sessions with various stakeholders. · Must have an understanding of Medicare operations, • compliance Job Posted by ApplicantPro

Job DescriptionDescription: Why Join ADAPT? It's more than a job; it's a calling. It's where passion meets purpose. ADAPT Community Network, formerly United Cerebral Palsy (UCP) of NYC provides a multitude of services to people with developmental disabilities. At ADAPT, we are 3,000 strong, and it takes every one of us to empower the lives of the people we support. With caring and great resources at hand, we know what it takes to help people live fuller, happier, healthier lives. Our employees show their commitment to the people we support every day, and we all deliver on our promise to provide innovative and comprehensive services to individuals with developmental disabilities. For your next career move, apply with us at ADAPT Community Network! Wherever you work among our many locations around New York City, ADAPT offers paid training, competitive benefits, and we foster a team culture of learning, support, collaboration and career growth. SUMMARY The Vice President of Clinical Services provides executive leadership, strategic direction, and operational oversight for ADAPT Community Network’s clinical service delivery system, including all Article 28 Clinics and the organization’s medical affiliate, ADAPT Medical Professional Services (MPS). This role is responsible for ensuring the delivery of high-quality, accessible, person-centered healthcare services to individuals with disabilities across a broad spectrum of medical, rehabilitation, and mental health services. The VP of Clinic Services ensures regulatory compliance, financial sustainability, clinical excellence, and alignment with ADAPT’s mission, values, and strategic priorities. ESSENTIAL DUTIES AND RESPONSIBILITIES The key duties and responsibilities of the Vice President of Clinical Services include but are not limited to: • Provide executive leadership and oversight for all Article 28 clinics and ADAPT Medical Professional Services (MPS)., • Set the strategic vision and direction for clinical services in alignment with ADAPT’s mission, values, and organizational goals., • Ensure delivery of high-quality, accessible, person-centered care for individuals with disabilities across all service lines., • Oversee the full continuum of services, including primary and specialty care, rehabilitation therapies, adult physiatry, care coordination, and mental health services., • Lead and supervise clinical staff, ensuring accountability for performance, outcomes, and compliance., • Ensure effective integration and coordination among medical, rehabilitation, mental health, and care coordination teams., • Promote a wellness philosophy that supports active participation of individuals and families in all phases of care., • Ensure compliance with Article 28 regulations, Medicaid and Medicare requirements, Patient-Centered Medical Home standards, HIPAA, and all applicable laws and regulations., • Provide executive oversight of Quality Assurance and Performance Improvement activities across all clinical programs., • Monitor clinical outcomes, patient experience data, incident trends, and risk indicators, and direct corrective actions as needed., • Ensure timely, accurate, and complete reporting to regulatory agencies, payors, and funding sources., • Partner with Finance and Operations leadership to develop, manage, and monitor clinical budgets and financial performance., • Oversee clinician productivity, service utilization, billing integrity, and revenue cycle performance., • Analyze operational and financial data to support program growth, service line development, and operational efficiency., • Leads recruitment, hiring, onboarding, scheduling, supervision, and performance management of all program staff; initiates corrective action and termination procedures when needed., • Foster a culture of accountability, collaboration, inclusion, and continuous improvement., • Support succession planning and leadership development within clinical operations., • Represent ADAPT with regulatory bodies, healthcare partners, community organizations, and external stakeholders., • Support outreach, marketing, and partnership initiatives to expand access to clinical services., • Stay informed of industry trends, regulatory changes, and best practices impacting healthcare delivery., • Investigate and resolve high-level clinical, operational, and patient-related concerns., • Serve on agency-wide committees, task forces, and leadership initiatives. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. • Master’s degree required in Healthcare Administration, Public Health, Nursing, Social Work, or a related clinical or healthcare field., • Minimum of ten (10) years of progressively responsible leadership experience in healthcare or clinical operations, including oversight of multi-site programs., • Extensive knowledge of Article 28 regulations, Medicaid and Medicare reimbursement, managed care, and healthcare compliance requirements., • Demonstrated experience leading interdisciplinary clinical teams across medical, rehabilitation, and behavioral health services., • Strong understanding of Patient-Centered Medical Home models, care coordination, and value-based care principles., • Proven ability to oversee complex budgets, analyze financial and operational data, and drive sustainable growth., • Exceptional leadership, strategic planning, and change management skills., • Highly developed interpersonal skills and the ability to build positive relationships with the people we support, families, staff, and external partners., • Excellent written and verbal communication skills with the ability to engage effectively with executive leadership, clinicians, staff, and external stakeholders., • Proficiency in electronic health records, data analytics, and healthcare information systems., • Strong commitment to ADAPT’s mission and to advancing equitable, accessible healthcare for individuals with disabilities., • Ability to maintain strict confidentiality, including compliance with HIPAA regulations., • Proven supervisory and leadership skills with the ability to coach, mentor, and motivate staff., • Passion for ADAPT's mission and demonstrates a commitment to the non-profit disability sector. COMPENSATION: $130,000 - $140,000 Annually + Industry-Leading Benefits! At ADAPT, we value diversity, equity, inclusion, accessibility, and belonging. We strive to ensure that our employees are comfortable bringing their whole, authentic self to work and that the people we support can also be their authentic selves. We value diverse backgrounds, opinions, ideas, and ways of thinking. We aim to build an inclusive and diverse workforce that is empowered and supported with leaders who create diverse and inclusive teams. We continuously seek opportunities for the organization to foster a more positive, respected, united, and collaborative culture. ADAPT Community Network is proud to be an equal opportunity employer and is committed to creating an inclusive environment for all employees. Qualified candidates of diverse ethnic and racial backgrounds and status are encouraged to apply for vacant positions at all levels. Requirements:

Job Description Benefits Pulled from the full job description • Paid training, • Parental leave, • Health insurance, • Paid time off, • Vision insurance, • Dental insurance, • Paid sick time Full job description Position Summary The Receptionist/ Patient Care Coordinator will strive to deliver five-star concierge-level customer service to every patient from their initial evaluation through each subsequent contact until discharge. This includes fielding and responding to patient questions and requests and providing prompt, thorough follow-up. The ability to travel between offices and flexibility (with notice) to cover additional shifts or work extended ours is required Accountabilities The Receptionist / Patient Care Coordinator is the face of the practice and must make an excellent first impression. Friendly, outgoing, engaging, with a positive, can-do attitude, commitment to delivering an excellent patient experience, and the highest standards of professionalism and courtesy are required. This position reports to the Office Manager who may at times not be onsite and therefore requires confidence, resourcefulness, an entrepreneurial spirit, and superior problem-solving capabilities, as well as the ability to work independently without direct day-to-day supervision. Success will be measured based upon the following: • Displaying top notch professional etiquette in all interactions with both patients and H&D staff., • Articulate and strong communication skills both written and verbal, including use of correct grammar, spelling, and punctuation., • Attention to details and consistent follow-up to ensure accuracy and process completion., • Crisis management skills; the ability to triage unexpected events to help mitigate any adverse effects on the practice or patient., • Discretion when handling confidential information., • Check in patients for their appointments and collect copays., • Cancel and/or reschedule patients as needed., • Assist new patients in completion of intake paperwork., • Respond to all phone and email queries., • Monitor and follow-up on needed referrals., • Fill last minute cancellations from the clinic’s waitlist., • Close-out and reconciliation of daily receipts., • Run copay reports daily to ensure optimal collection rates., • Daily quality assurance checks., • Basic office technology skills including Microsoft Office Suite (Outlook, Word, Excel, Teams), PDF, Scanners, copy machines and fax machines, Telephone, • Electronic Medical Records (EMR) systems and online scheduling (we use PromptEMR), • High School Diploma (associate degree or higher preferred), • Minimum of 1-year front desk experience in a healthcare setting (required) H&D Physical Therapy is a therapist-owned, family-oriented practice that prioritizes personalized, one-on-one care over the pressures of large-scale, high-volume settings. With locations across Manhattan and Brooklyn and onsite partnerships at top firms, we foster a supportive, collaborative environment for both our patients and our team. We specialize in: • Orthopedics and sports rehab, • Pelvic floor therapy (all genders), • Vestibular and balance disorders Better Begins Here. With us—and with you. Job Type: Full-time Pay: $20.00 - $24.00 per hour Expected hours: 40 per week Benefits: • Dental insurance, • Health insurance, • Paid sick time, • Paid time off, • Paid training, • Parental leave, • 8 hour shift

Job Description Key Responsibilities • Coordinate and execute the initial credentialing and recredentialing processes for physicians and allied health professionals, • Collect, verify, and maintain provider documentation, including licenses, certifications, education, training, and work history, • Ensure compliance with NCQA, Joint Commission, CMS, and state-specific regulatory requirements, • Submit and track provider enrollment applications with commercial and government payers (e.g., Medicare, Medicaid), • Maintain accurate provider data in credentialing databases and CAQH profiles, • Monitor expiration dates for licenses, certifications, malpractice insurance, and other required documents, • Prepare and present credentialing files for review by the Credentialing Committee, • Respond to payer and provider inquiries related to credentialing and enrollment status, • Perform primary source verification in accordance with organizational policies, • Assist with audits and ensure documentation meets compliance standards, • Collaborate with HR, medical staff services, and provider relations teams to support onboarding and offboarding processes, • Identify process improvement opportunities to enhance efficiency and turnaround times Qualifications Education & Experience: • High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred, • 2–5 years of experience in healthcare credentialing, provider enrollment, or medical staff services, • Experience working in a remote environment preferredCompany DescriptionThe Bachrach Group (TBG) is a New York-based staffing and recruiting agency founded in 1974 by Richard Bachrach. The agency specializes in facilitating placements for professionals across various industries on a nationwide scale. TBG's overarching mission is to deliver tailored staffing solutions to its client base while simultaneously providing job seekers with career prospects. The company relies on its team of recruiters, who leverage their industry knowledge and networks to connect employers with top talent. TBG provides a comprehensive range of staffing services, including direct hire, temporary staffing, Recruitment Process Outsourcing (RPO), and contract staffing. The agency has consistently achieved notable rankings in Crain's lists, ranking as the largest search firm in NYC since 2020.The Bachrach Group (TBG) is a New York-based staffing and recruiting agency founded in 1974 by Richard Bachrach. The agency specializes in facilitating placements for professionals across various industries on a nationwide scale. TBG's overarching mission is to deliver tailored staffing solutions to its client base while simultaneously providing job seekers with career prospects. The company relies on its team of recruiters, who leverage their industry knowledge and networks to connect employers with top talent. TBG provides a comprehensive range of staffing services, including direct hire, temporary staffing, Recruitment Process Outsourcing (RPO), and contract staffing. The agency has consistently achieved notable rankings in Crain's lists, ranking as the largest search firm in NYC since 2020.

Job DescriptionDescription: The primary function of the HEDIS Retriever - Seasonal is to conduct onsite abstraction of services from medical charts in compliance with HEDIS/QARR, Medicare Advantage Star measure specifications. This position will be an integral part of the annual Medical Record Review project required to report HEDIS and QARR measures to the NYS Department of Health and Centers for Medicare & Medicaid Services (CMS). The position requires the ability to travel within the five boroughs daily. Scope Of Role and Responsibilities: • Maintain knoowledge of medical record review and EMR systems, • Maintain up to date knowledge of HEDIS, QARR and STAR specifications., • Proficiency in MS Office applications, scanning and accurate Data entry into our systems, • Distibute requests for records and schedules appointments with provideroffices to ensure timely completion of duties to meet internaland regulatory standards and requirements., • Perform abstractions via EMR, in house paper medical records, on- site provider visits to collectdocumentationof easure complaince., • High School/GED with a minimum of two yeards HEDIS review experience. Clinical background preferred ( Medical Assistant, Nursing Assistant, Health Educator, LPN, RN, LMSW, or LCSW), • Experience with medical record working on HEDIS/QARR in a managed care, health plan and provider office setting., • Proficient in Microsoft Office applications including Work, Excel, PowerPoint and Access.

Job Description Position overview: The Coding Specialist I is responsible for independently reviewing, analyzing, and resolving all assigned front-end claims to ensure accurate and timely claim submission. This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies. The Coding Specialist I works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes. This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment. Essential Functions: • Averages 10 front-end holds per hour, • Maintains a minimum of 90% coding accuracy., • Assigns ICD-10-CM and CPT codes with appropriate modifiers for services provided in the professional fee environment., • Reviews medical records and all applicable documentation to determine appropriate codes for documented services and diagnoses., • Ensures all diagnosis codes meet local and national medical necessity guidelines., • Utilizes internal coding resources, payer guidelines, and other reference materials to ensure accurate and compliant coding for all assigned services., • Follows all HIPAA regulations and upholds the highest standards of privacy and confidentiality., • Maintains current knowledge of laws, regulations, payer policies, and industry guidance impacting compliant coding practices., • Independently reviews and resolves all assigned front-end claim holds., • Actively participates in department meetings, one-on-one meetings, and mentorship meetings with the assigned Coding Team Lead., • Escalates identified client trends to the assigned Coding Team Lead., • Escalates all coding-related questions to the assigned Coding Team Lead for guidance and clarification., • Maintains and completes all CEU requirements., • Must hold a current AAPC or AHIMA Certification for a minimum of 3 years., • Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, and state and federal Medicare reimbursement guidelines., • Familiarity with proper English grammar, usage, and professional documentation standards., • Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation issues., • Ability to read, interpret, and apply policies, procedures, laws, and regulations., • Ability to accurately read and interpret medical documentation, clinical terminology, and documented procedures., • Demonstrated ability to exercise independent judgment in coding and claim resolution., • Excellent written and verbal communication skills, including the ability to prepare reports, clarify documentation needs, and maintain collaborative working relationships with physicians and staff., • Strong commitment to maintaining confidentiality and safeguarding protected health information., • Prior experience working in a medical billing environment with strict adherence to HIPAA compliance requirements., • Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams)., • Standard business office environment with moderate noise levels., • Requires extended periods of computer and monitor use., • Ability to lift and move up to 30 pounds on a non-routine basis., • Ability to sit for extended periods while performing coding and claim review tasks., • Frequent handling, including seizing, holding, grasping, and fingering objects, tools, and controls., • Close vision required to read medical documentation, electronic health records, and coding resources., • Hearing ability sufficient to receive and interpret detailed information through oral and telephonic communication.

Job DescriptionDescription: About Us Union County Orthopaedic Group, a division of OrthoNJ, LLC, is a fast-paced, patient-centered medical practice specializing in orthopaedics, pain management, and podiatry across three convenient New Jersey locations. We are seeking an experienced Billing Supervisor to lead our billing team, drive revenue cycle performance, and ensure the accuracy and efficiency of our billing operations. Position Overview The Billing Supervisor is responsible for overseeing the day-to-day workflow of the billing department, including follow-up on rejected claims and overdue balances, payor relationship management, and patient accounts receivable. This role is both a hands-on operational position and a people leadership role — requiring someone who can coach and develop staff while also rolling up their sleeves to keep the revenue cycle running smoothly. Requirements: What You'll Do Leadership & Supervision • Assist with recruitment, discipline, and termination of Reimbursement and Patient Collections staff, • Train, develop, and oversee the performance of billing team members; conduct regular one-on-ones to address key issues, A/R performance, and growth opportunities, • Monitor overall department workload and distribute work accordingly; ensure coverage during vacations and absences, • Maintain working knowledge of all key billing functions including claims processing, payment posting, insurance follow-up, and patient collections, • Analyze aged A/R reports, days in receivable, and collection statistics by payor; present findings to physicians as needed, • Perform quarterly billing audits to ensure timely and accurate charge and payment posting, • Conduct quarterly reviews of EOB forms from commercial and managed care payors, • Meet with physicians to discuss complex or difficult claims, • Monitor patient payment plan adherence and intervene as needed, • Maintain and update the practice fee schedule, CPT, ICD-10-CM, adjustment, and payment codes, • Maintain and distribute contracted payment schedules from carriers; input/update into the practice management system, • Request updated payment schedules from contracted carriers annually and prepare quarterly fee/payment comparative reports, • Maintain carrier contracts and assist with credentialing applications and reapplications as requested, • Uphold HIPAA compliance standards; report identified or suspected violations to the Privacy Officer, • Maintain coding compliance standards; actively participate on or support the Compliance Team, • Maintain detailed knowledge of practice management systems and EMR as it relates to job functions, • Minimum 2 years of medical office management experience, preferably in a physician group practice — required, • Revenue cycle experience in a physician group practice setting — required, • Orthopaedic billing experience — required, • Commercial insurance billing experience (e.g., BCBS, Aetna, Cigna, UHC) — required, • Proven knowledge of CPT and ICD-10-CM coding for orthopaedic, podiatry, and pain management procedures, • Strong understanding of managed care contractual arrangements and accounts receivable processes, • Working knowledge of practice management systems and electronic medical records (ModMed/EMA experience a plus), • Strong analytical skills with the ability to interpret and present A/R data, • Excellent verbal, written, and interpersonal communication skills, • Bilingual (English/Spanish) a plus — our patient population includes Spanish-speaking patients and the ability to communicate in both languages is highly valued, • Knowledge of HIPAA and OSHA guidelines We offer a collaborative, supportive environment where strong performers are recognized and leadership is valued. If you're an experienced billing professional ready to take ownership of a department and make a meaningful impact, we'd love to hear from you. Union County Orthopaedic Group is an equal opportunity employer. OrthoNJ, LLC is required by New Jersey law to include the salary range for this role. The hiring range for this role is $62k-$80k annually. The range for this role is typically determined by several factors, including the geography in which the selected candidate will be working, and alignment with qualifications and experience. Certain roles may also be eligible for additional compensation (bonus, etc.) and/or benefits. In addition, full-time employees are eligible for standard benefits package including paid time off, medical, dental, vison and retirement plan.

Job Description Hi, we're Oscar. We're hiring a Manager, Regulatory Complaints to join our Regulatory team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Manager, Regulatory Operations is responsible for managing the collaborative filing processes with cross-functional stakeholders, inclusive of conducting research and regulatory outreach. This role also oversees the alignment across submission documents, execution of executive signatures, and any required notarizations in submissions to CMS, SBEs, and State DOI's, while managing the objection cycle through regulatory approval. This position works closely with internal Oscar teams and interfaces with our external federal and state regulators. You will report into the Senior Manager, Regulatory Operations. Work Location: This is a remote position, open to candidates who reside in: Arizona, California, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. Pay Transparency: The base pay for this role in the states of NY, NJ and CA is: $123,372 - $161,925 per year. The base pay for this role for all other locations is: $111,034 - $145,733 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Ensure the accurate and timely submission of Oscar's annual regulatory obligations., • Maintain a repository of internal procedural guides on filing obligations to support teams and retain institutional knowledge., • Help maintain and grow relationships with regulatory bodies in the states where Oscar operates., • Prepare, file, and secure approval and certification of Oscar's insurance products through the annual Qualified Health Plan (QHP) filings application process (form, binder, rate, network) with state regulators, state exchanges, and Centers for Medicare & Medicaid Services (CMS)., • Compile and maintain filing deadlines for form, binder, rate, and network annual QHP submissions by state and lines of business., • Manage, train, provide feedback and assign responsibilities for direct reports to support their professional growth, • Oversee special filings, such as the quarterly (Rate & Benefits Information System) RBIS submission files to CMS to ensure risk adjustment data can be processed timely and/or provider and vendor contract filings, • Work independently under remote management, encouraging solid relationships with regulators and colleagues., • Compliance with all applicable laws and regulations., • Bachelor's degree or commensurate experience, • 1+ years of SERFF and HIOS experience, • Familiarity with ACA marketplace plans, rules and regulations This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job DescriptionWelcome to Hudson Regional HealthTechnology Transforming Care Hudson Regional Health is a newly unified healthcare network serving Hudson County through four hospitals. Together, these hospitals form a single, integrated system with a shared vision—to deliver modern, patient-first care supported by innovation. From robotic-assisted surgery and AI-powered diagnostics to real-time monitoring and precision neurosurgery, HRH is redefining what’s possible in community healthcare. Patients across the region now have access to state-of-the-art procedures and nationally recognized specialists, all within a connected, local network designed to put care first. Our ServicesWe focus on the care our patients need most, delivered with precision, innovation, and a commitment to excellence. * Advanced Emergency Services - 24/7 emergency departments across all four hospitals * Robotic-Assisted Surgery - featuring the Da Vinci XI and ExcelsiusGPS systems * Neurosurgery & Spine Care - including Stealth Navigation and precision-guided treatment * Women’s Health & Maternity - comprehensive services tailored for every stage * Imaging & Diagnostics - AI-enhanced systems for faster, more accurate results * Outpatient & Specialty Care - coordinated care across multiple disciplines Our HospitalsExplore our hospitals and discover care that’s high-tech, high-touch, and close to home: * Secaucus University Hospital: Flagship campus featuring the Robotic Surgery Institute and modernized emergency care. * Bayonne University Hospital: A full-service community hospital offering personalized acute care. * Hoboken University Hospital: A local leader in women’s health, family medicine, and outpatient services. Job Title: Lead Social Worker Role Overviews a Lead Social Worker at Hudson Regional Health, you will serve as a critical link between clinical innovation and compassionate patient advocacy. You are responsible for steering the psychosocial aspects of the patient journey, ensuring that individuals and their families are supported from admission through a seamless transition back into the community. By blending clinical expertise with a deep understanding of the continuum of care, you will help navigate complex medical and social landscapes to optimize patient outcomes. Key Responsibilities * Assessment & Intervention: Conduct comprehensive psychosocial assessments to identify barriers to care and develop personalized intervention plans. * Counseling & Advocacy: Provide high-level clinical counseling to patients and families, offering emotional support and crisis intervention during acute medical episodes. * Care Coordination: Facilitate the movement of patients through the healthcare continuum by collaborating with multidisciplinary teams to ensure efficient and safe discharge planning. * Regulatory Navigation: Apply expert knowledge of Medicare/Medicaid regulations and JCAHO (Joint Commission) guidelines to ensure all care transitions meet stringent compliance and quality standards. * Resource Management: Act as a liaison to community resources, ensuring patients have access to the necessary post-acute support systems, including home health, rehabilitation, or outpatient mental health services. * Education: Educate patients and their support networks on disease management, healthcare rights, and the available community-based social services. Qualifications & Requirements * Education: Bachelor’s degree in Social Work or a related field. * Experience: 2–4 years of related clinical experience in a healthcare or hospital setting. * Licensure: Must be a New Jersey Licensed Clinical Social Worker (LCSW). * Communication: Exceptional ability to communicate clearly in English, both orally and in writing, to facilitate complex discussions between medical staff and families. * Technical Knowledge: Proven proficiency in discharge planning, JCAHO guidelines for continuity of care, and Medicare/Medicaid regulatory frameworks. * Preferred Skills: Previous experience in a psychiatric or behavioral health setting is highly preferred and considered a significant plus

Job DescriptionAbout Pair TeamPair Team is a public benefit company reimagining care for the safety net. As an AI-enabled medical group for Medicaid and Medicare, we deliver medical, behavioral, and social care by integrating shelters, pantries and other community-based organizations into our whole-person model. As California's largest complex care provider, we've proven our impact to reduce avoidable emergency care, including a 52% and 26% reduction in ER visits and hospitalizations respectively. Once scaled nationally, our approach would save tax payers $150B per year. With our years of experience and vast data collected, we are now building an AI platform that embeds social work agents across the safety net to truly unify our fragmented healthcare and welfare system. By scaling our country's frontline medical and social services workforce, we aim to bring high-touch care to everyone. At Pair Team, we're not just delivering care—we're transforming it. We're building a future where high-touch, community-driven care is accessible to everyone, especially the most underserved. • Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most, • TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team This is a fully remote position. What You'll Do • Own the full accounting function (AP/AR, GL, close, reporting), • Lead month-end/year-end close and deliver accurate, board-ready financials, • Develop, maintain, and enforce internal controls, accounting policies, and procedures that are scalable and audit-ready, • Partner with FP&A on budgeting, forecasting, and cash management, • Ensure compliance with Medicaid/Medicare billing, tax filings, and regulatory requirements, • Select, implement, and optimize accounting systems to scale with growth, • Build scalable, automated processes that support a fast-moving startup environmentWhat You'll Need, • 8+ years of progressive Accounting experience; minimum of 2 years of controller or senior accounting experience, • Experience building and leading in a high-growth, early-stage startup and strong knowledge of equity accounting and cap table management, • Bachelor's degree in Accounting, Finance, or related field; CPA preferred, • Solid grasp of healthcare finance (CPOM, Medicaid/Medicare billing, value based care, compliance, etc.), • Experience supporting revenue cycle management a plus, • Experience coordinating external audits, SOC compliance, and GAAP audit readiness, • Proficiency with accounting software (NetSuite, QuickBooks, etc.), expense management platforms (Bill.com, Brex, etc.), and advanced Excel and financial modeling skills, • Familiarity with HRIS and payroll systems (e.g., Rippling, Gusto, ADP), • Familiarity with state and federal tax compliance, including multi-state requirements, • Strong collaboration skills with executive and senior thought partners, • Ownership mindset – own driving results for the mission, business, and customer experience, • Strong desire to work in an early stage startup environment that is fast paced, complex, and has minimal barriers to make decisions (no "red tape"), • Passion for helping individuals experiencing complex chronic needs such as homelessness, severe mental illness, and substance use disorderOur Values, • Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection., • Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness., • Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo., • Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent., • Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others.Because We Value You, • Competitive salary: $190,000 - $210,000, • Equity compensation package, • Flexible vacation policy – take the time you need to recharge, • Comprehensive medical, dental, and vision coverage, • 401(k), • 100% company-sponsored short and long-term disability and life insurance, • Subsidized backup childcare and caregiver supports through Wellthy, • Work entirely from the comfort of your own home, • Monthly $100 work from home expense stipend, • We provide the equipment needed for the role Pair Team participates in E-Verify to verify employment eligibility for new hires. Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use. We do not conduct any TA business outside of our @pairteam.com emails. If you're ever concerned about spam or fraudulent activity, please reach out to . Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!

Job DescriptionDescription: Under the direct supervision of the Chief Medical Officer, the Optometrist provides direct clinical care to patients at the health center. The Optometrist is a member of the Care Team with the purpose of providing evidenced-based and quality medical care to Zufall Health Center patients. Essential Functions, Duties, and Responsibilities • Provides eye care services for patients of Zufall Health, including but not limited to comprehensive eye examinations, diagnosis and management of ocular diseases, prescription of corrective lenses (if applicable), referral to ophthalmologists or other specialists when appropriate, and other duties as assigned. Ensures continuity and quality of patient care., • Leads and collaborates with assigned clinical support staff to deliver exceptional and accessible preventive, acute, and chronic eye care to a diverse patient population. Educates patients and families about eye health and vision care., • Participates in extended service hours including occasional evenings or weekends as scheduled. Adjusts availability as needed to support patient demand and clinic operations., • Assists patients in obtaining additional services such as low vision aids, specialty referrals, or surgical consultations. Works closely with the Chief Medical Officer to build relationships with external providers, optical labs, and vision care networks to enhance patient access and care coordination., • Participates in clinical quality improvement initiatives and peer chart reviews as assigned. Attends and contributes to regular medical staff and team meetings as deemed necessary by leadership., • Supports clinic operations by maintaining compliance with all applicable local, state, and federal regulations. Ensures that licensure, certifications, and continuing education requirements are current. Adheres to and helps refine clinical protocols and practice guidelines., • Participates in community outreach including vision screenings, health fairs, and educational workshops. Supports staff training, mentorship, and may precept optometry students or interns as needed., • Maintains professional affiliations and stays informed of advancements in optometric care, techniques, and public health concerns. To perform successfully, the individual must be able to perform the essential duties satisfactorily. The requirements below are representative of the knowledge, skill and ability required. • Doctor of Optometry (OD) degree from an accredited optometry school., • Strong verbal and written communication skills., • Ability to work effectively with a diverse range of patients and colleagues., • Flexibility and commitment to working variable hours as required to meet clinic needs., • Proficiency with EHR systems and general computer applications including Microsoft Word and Excel., • Bilingual and/or bicultural candidates are highly valued; ability to speak both English and Spanish strongly preferred., • Doctor of Optometry (OD) from a program accredited by the Accreditation Council on Optometric Education (ACOE)., • Active license to practice optometry in the state of New Jersey, in good standing., • Certification to use therapeutic pharmaceutical agents (TPA) as required by New Jersey regulations., • National Provider Identifier (NPI) and eligibility to participate in Medicare, Medicaid, and other health programs., • Current BLS certification; other certifications (e.g., Advanced Procedures, Low Vision) may be preferred depending on clinic scope., • Minimum 1 year of post-graduate clinical experience preferred; new graduates with strong clinical training may be considered.

Job Description TITLE: Discharge Coordinator REPORTS: Clinical Director FLSA CODE: Non-exempt PRIMARY DUTY: Direct Care OUR MISSION: Since 1967, Odyssey House has been providing innovative services and programs to a broad population of individuals and families struggling with substance use and mental health disorders. Odyssey House helps New Yorkers of all ages—and across all five boroughs—beat drugs and alcohol with highly individualized treatment programs. Odyssey House provides high quality, holistic treatment impacting all major life spheres, including: psychological, physical, social, family, educational and spiritual in order to support personal rehabilitation, renewal and family restoration. If that sounds different than other treatment programs, you’re right. Because Odyssey is where recovery gets real. MAJOR FUNCTIONS: The Discharge Coordinator is responsible for guiding consumers and their families through the health care and supportive housing system by providing referrals, assisting with access issues, developing relationships with service providers, and tracking interventions and outcomes. The Discharge Coordinator assumes a central role in ensuring community based services and supports are available for those consumers participating in the Reintegration phase and/or prior to discharge. S/he works directly with consumers in individual and group sessions on issues surrounding discharge planning, identifying community based supports and securing appropriate living arrangements. SPECIFIC DUTIES & RESPONSIBILITIES: • Monitor and evaluate consumer needs, including prevention, wellness, medical, mental health, care transitions, and social and community services where appropriate., • Maintain up-to-date consumer charts including referrals and outcomes., • Support adherence to treatment plan recommendations, • Responsible for ongoing consumer discharge planning., • Review and generate daily referrals., • Coordinate schedules, troubleshoot conflicts and ensure compliance with all appointments for designated consumers., • Develop and facilitate Independent Living Skills workshops to build skills and increase knowledge related to activities of daily living, ability to access community-based resources, spending habits and money management., • Assist consumers in navigating the subsidized housing identification and application process. This includes completing 2010e applications on all residents seeking subsidized housing., • Assist consumers in filling out all necessary paperwork, accompanying residents to interviews, following up with supportive housing agencies and ensuring that all housing units applied for are safe and affordable., • Link consumers to instrumental support services such as Medicaid, Medicare, Social Security, food stamps, home health care, Senior Citizen Rent Increase Exemption (SCRIE) and home delivered meals prior to discharge., • Link consumers to psychosocial/healthcare support services (e.g. SUD recovery supports, aftercare, mental health, primary care, social adult day services, senior centers, etc.) prior to discharge., • Attend regularly scheduled staff meetings and case conferences., • Attend all required in-service training seminars., • Participate in quality improvement activities., • Other relevant duties as assigned. REQUIREMENTS: EDUCATION/TRAINING AND EXPERIENCE KNOWLEDGE, SKILLS AND ABILITIES • Bachelor’s Degree or Associate’s Degree with two (2) years of related experience in health insurance, care coordination, entitlement, or housing placement services for low income and/or homeless populations., • Experience providing service coordination and information, linkages, and referrals for community-based services., • Knowledge of city, state, and federal guidelines for public and private low-income housing, entitlements and health insurance., • Ability to research and network with other agencies/community based services to meet a variety of client needs., • Proficiency with computer operation (Microsoft Word, Excel, AWARDS, and Outlook programs)., • Excellent written and verbal communications skills., • Must be able to work a flexible schedule., • This position requires regular travel throughout the five (5) boroughs. In addition, Odyssey House offers: • A 35-hour work week (as opposed to a 40-hour work week), • Vacation Plan and Holiday Schedule, • Life Insurance, • Medical Insurance (Two Plans), • Dental and Vision Insurance, • Additional Insurance Coverages (hospitalization, accidental, critical illness coverage), • Long-Term & Short-Term Disability, • Flexible Spending Account/Health Reimbursement Account, • 403(b) Plan, • Corporate Counseling Associates (CCA) EAP benefit, • Ability Assist Counseling Services (through The Hartford), • Commuter Benefits, • Educational Assistance Programs, • Special shopping discounts through ADP Marketplace and PlumBenefits, • RUFit?! Fitness Program, • Pet Insurance, • Legal Assistance, • Optum Financial Service through ConnectYourCare, • Benefit Advocacy Center through Gallagher Odyssey House is an equal opportunity employer maintaining a non-discriminatory policy on hiring of its personnel. Odyssey House, and its operational divisions, will not discriminate against any employee or applicant because of race, creed, color, national origin, sex, disability, marital status, sexual orientation or citizen status in all employment decisions including but not limited to recruitment, hiring, upgrading, demotion, downgrading, transfer, training, rate of pay or other forms of compensation, layoff, termination and all other terms and conditions of employment.

Job DescriptionHealthcare Fraud Investigator Employment Type: Full-Time, Mid-Level Department: Litigation Support CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Responsibilities will Include:- Review, sort, and analyze data using computer software programs such as Microsoft Excel.- Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.).- Develop HCF case referrals including, but not limited to:- Ensure that HCF referrals meet agency and USAO standards for litigation.- Analyze data for evidence of fraud, waste and abuse.- Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence.- Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings.- Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc. - Assist conducting witness interviews and preparing written summaries. Qualifications:- Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field.- Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work.- Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc.- Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data).- Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy.- U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.- Experience and expertise in performing the requisite services in Section 3.- Must be a US Citizen.- Must be able to obtain a favorably adjudicated Public Trust Clearance.Preferred qualifications:- Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3.- Relevant experience working with a federal or state legal or law enforcement entity. #CJ We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job Description Certified Financial Officer Position Overview: The CFO is a key member of the executive leadership team with a large healthcare organization and will lead all aspects of financial management, including strategic financial planning, budgeting, revenue cycle operations, grants management, and regulatory compliance. The ideal candidate is a hands-on leader and strategic partner to the CEO, with the ability to drive financial sustainability and support innovation in a rapidly evolving healthcare environment. Key Responsibilities: • Provide strategic financial leadership aligned with the Health Center’s mission and long-term goals., • Oversee all accounting and financial operations, ensuring compliance with GAAP, federal cost principles, and FQHC requirements., • Direct the preparation of monthly, quarterly, and annual financial statements and reports., • Develop and manage the annual operating and capital budgets in collaboration with the executive team., • Prepare financial reports for grants, contracts, and funding sources, ensuring timely and accurate submissions., • Oversee business office operations, including registration, billing, collections, and reimbursement from Medicaid, Medicare, and other payers., • Monitor cash flow, manage banking relationships, and perform regular reconciliations of bank accounts and cash receipts., • Lead financial forecasting, analysis of revenue and expenditure trends, and make data-driven recommendations to the CEO and Board., • Ensure effective internal controls and risk management processes are in place., • Supervise and develop fiscal department staff, including hiring, training, performance management, and workflow improvement., • Present financial updates to the Board of Directors and Executive Leadership as requested., • Evaluate and implement technology solutions to improve operational efficiency and data integrity., • Bachelor’s degree in accounting, Finance, or Business Administration required; Master’s degree (MBA, MHA, or similar) or CPA preferred., • Minimum of 5–10 years of progressive financial leadership experience, with strong preference for experience in FQHCs, community health, or nonprofit healthcare., • Proven track record of managing complex budgets, grants, and reimbursement systems., • Deep understanding of value-based care, healthcare compliance, and federal funding mechanisms., • Strong leadership, communication, and team-building skills. Company DescriptionWe provide full-service Healthcare Recruitment solutions. We identify, attract, engage, and connect the best possible talent with quality healthcare professionals. We build teams, provide executive recruitment solutions and discover high-performance candidates on behalf of our client partners. Our strength lies in our proven recruitment strategies, leadership in the larger healthcare community (regional and national), and networking.We provide full-service Healthcare Recruitment solutions. We identify, attract, engage, and connect the best possible talent with quality healthcare professionals. We build teams, provide executive recruitment solutions and discover high-performance candidates on behalf of our client partners. Our strength lies in our proven recruitment strategies, leadership in the larger healthcare community (regional and national), and networking.

Job Description Join VillageCare as a Full-Time HealthCare Claims Analyst and take your career to the next level while working from the comfort of your home. With a competitive salary range of $65,294.40 - $72,277, this position offers great financial incentives while allowing you to maintain a flexible work-life balance through hybrid schedule. At VillageCare in New York, NY, you will have the opportunity to contribute to a forward-thinking organization that emphasizes customer-centric solutions and excellence in healthcare. You will be part of an energetic team that values problem-solving and integrity, empowering you to drive meaningful change in the industry. You will be given great benefits such as Medical, Dental, Vision, Life Insurance, Health Savings Account, Competitive Salary, and Paid Time Off. This role not only enhances your professional skills but also places you at the heart of a mission-driven environment focused on making a positive impact in healthcare. Apply today to be part of our dynamic team! A little about us VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. Are you excited about this HealthCare Claims Analyst job? The Full-Time HealthCare Claims Analyst position at VillageCare requires a seasoned professional with a minimum of five years of experience in healthcare claims reporting and processing, alongside in-depth knowledge of Medicaid and Medicare guidelines. The ideal candidate should possess advanced SQL coding and Excel skills to create insightful reports and dashboards. You will play a critical role in understanding healthcare reimbursement from both financial and operational perspectives, conducting audits, and performing root cause analysis to resolve identified issues with internal teams and third-party administrators (TPAs). This position involves identifying gaps in various aspects of claims processing, communicating trends and contract issues to management, and preparing comprehensive narratives and visual aids for leadership presentations. You will also coordinate workflows across departments, ensure compliance with regulations, and contribute to the development of policies and quality assurance measures. Your analytical skills will be essential in evaluating claims system coding to validate pricing and improve overall operational efficiency. Would you be a great HealthCare Claims Analyst? To excel as a Full-Time HealthCare Claims Analyst at VillageCare, candidates must possess a Bachelor's Degree in a relevant field such as Computer Science, Mathematics, Statistics, or Engineering, with a Master's degree preferred. A minimum of 3-5 years of experience in business intelligence and analytics is crucial, particularly in a healthcare environment where complex data analysis and report/dashboard development are key responsibilities. Familiarity with medical terminology and coding systems, including ICD-10, CPT, HCPCS, along with knowledge of CMS guidelines and EncoderPro, is essential. The analyst should demonstrate excellent technical proficiency in tools such as MS Excel, SQL, Tableau, and Access. Strong communication skills, both written and verbal, are imperative for effectively conveying analytical findings and collaborating with various departments. The ability to work independently while maintaining a high level of productivity will significantly contribute to success in this role. Knowledge and skills required for the position are: • Education: Bachelor's Degree required ideally in a relevant field such as Computer Science, Mathematics, Minimum Statistics and/or Engineering. Master's degree preferred., • This position requires a minimum of 3-5 years' experience in business intelligence and analytics performing increasingly complex data analysis and report/dashboard development preferably in a healthcare setting., • Knowledge of medical terminology, ICD-10, CPT, HCPCS coding CMS guidelines and EncoderPro are required., • Must be able to work independently with high level of productivity and advanced written and verbal communication skills., • Excellent technical skills (MS Excel, SQL, Tableau, Access, etc.) · Strong communication skills. MUST RESIDE IN NY, NY OR CT Will you join our team? If you believe that this position matches your requirements, applying for it is a breeze. Best of luck! Job Posted by ApplicantPro

Job DescriptionContracting, Credentialing & Billing Specialist (Remote) Employment Type: Full-Time, W-2 Compensation: $20–$25 per hour (based on experience) About Understood Care Understood Care was founded by clinicians, patient advocates, and healthcare leaders to make healthcare simpler, safer, and more supportive for older adults. We provide Medicare-covered patient advocacy services and work only for our clients, not hospitals or insurance companies, pairing each person with a dedicated advocate who helps them navigate care, reduce costs when possible, and make confident healthcare decisions because healthcare should feel human. Position Overview Understood Care is seeking a detail-oriented and highly organized Contracting, Credentialing & Billing Specialist to support our provider operations. This role is critical in ensuring providers are properly contracted, credentialed, and reimbursed in a timely and accurate manner. The ideal candidate is proactive, organized, and comfortable managing multiple workflows simultaneously. Key Responsibilities Contracting & Credentialing • Manage end-to-end provider contracting and credentialing processes, • Prepare, submit, and track credentialing applications with payers, • Maintain accurate and up-to-date provider records and documentation, • Monitor credentialing timelines and proactively follow up with payers, • Assist with billing setup for newly credentialed providers, • Support claim submission, tracking, and follow-up as needed, • Identify and help resolve basic billing issues or discrepancies, • Maintain organized documentation in internal systems, • Ensure compliance with payer, state, and organizational requirements, • Communicate effectively with internal teams and external partnersQualifications, • 2–5 years of experience in healthcare contracting, credentialing, licensing and billing, • Familiarity with payer portals and credentialing processes, • Strong attention to detail and organizational skills, • Ability to manage multiple deadlines in a fast-paced environment, • Excellent written and verbal communication skills, • Experience with healthcare administration systems is a plusWhat We Offer, • Full-time W-2 employment, • Competitive hourly pay ($20–$25/hour), • Collaborative and supportive team environment, • Opportunity to grow within a mission-driven healthcare organization

Job Description About Shields Advanced Therapies Shields Advanced Therapies partners with health systems to accelerate advanced therapy access and operations, ensuring lifechanging breakthroughs reach more patients. Our management services and technology solutions serve as a horizontal support hub to empower health system-led, world-class advanced therapy care across 50+ disease states. Launched in September 2024, Shields Advanced Therapies is anchored by partnerships with five of the Top 20 Academic Medical Centers in the United States. Additionally, Shields' track record partnering with over 1,000 hospitals across 43 states in prior ventures provides a national channel for expansion. Role Overview The Cell & Gene Therapy Benefits Specialist will play a crucial role in managing and coordinating patient financial services, ensuring that patients understand and can access available financial resources from payers, manufacturers, and foundations. The role will report to the Director, Clinical Operations. This is a full-time, hybrid role based in New York City (4 days/week in office). Core Responsibilities • Benefits Investigation & Verification: Work with all payers (Government, Commercial, and otherwise, including out-of-state Medicaid agencies), pharmacy benefit managers (PBMs) and third-party administrators (TPAs) to identify, investigate and verify patient insurance coverage and benefits as early as possible within the care journey to ensure timely access to care, accurate billing, and minimal claim denials. This involves confirming eligibility and understanding the specifics of various insurance plans, including site-of-care considerations., • Prior Authorization Facilitation: Work with patient, Cell & Gene Therapy Clinical Coordinators, clinical staff, payer, and others to secure prior authorizations for each component of the treatment plan as applicable/required., • Benefit Enrollment Assistance (if applicable): Guide patients through the process of enrolling in appropriate benefit programs, such as Medicaid, Medicare, or other financial assistance options. This may involve helping patients complete necessary applications and providing information on program requirements., • Patient Financial Counseling: Assist patients in understanding their insurance benefits, out-of-pocket costs, and available financial assistance programs. This includes explaining coverage details and guiding patients through the complexities of healthcare billing, including site-of-care considerations., • Collaboration with Departments: Work closely with clinical staff, patient accounting, billing & collections, and other hospital departments (e.g., research) to communicate benefits considerations and serve as point of contact during financial clearance process, ensure accuracy, and enhance patient satisfaction. This collaboration ensures that financial considerations are integrated into patient care planning., • Collaboration with Manufacturers: In partnership with the Cell & Gene Therapy Clinical Coordinators, work with manufacturers to attempt securing additional financial assistance as applicable/appropriate., • Compliance and Documentation: Maintain accurate records of patient interactions, financial agreements, and assistance provided, ensuring compliance with healthcare regulations and privacy laws. This includes documenting all financial counseling sessions and maintaining confidentiality of patient information., • Development and Execution of Financial Pathways: Codify and execute benefits investigation and prior authorization pathways tailored to each product covered by advanced therapy programs across Health System Partner's service lines and therapeutic programs., • Programmatic Expansion: Contribute to development of centralized Benefits Specialist function that will augment dedicated teams at our Health System Partners and other future partners. Experience The ideal candidate will have 5+ years of experience in healthcare billing, insurance coordination, or patient financial counselling, and familiarity with healthcare financial systems and the insurance verification process. Strong communication and interpersonal skills are crucial for effectively assisting patients, and attention to detail, organizational abilities, and proficiency with healthcare information systems are also important. Prior experience/familiarity with payer navigation specifically related to cellular therapy (CAR T, TIL, etc.), gene therapy, and/or bone marrow transplant patient journeys and applicable prior authorizations required to enable is preferred. Prior exposure with both inpatient & outpatient site-of-care also preferred but not required. Compensation The base salary for this role is expected to be between $65,000 and $80,000. Bonus opportunity tied to quality metrics/outcomes and comprehensive benefits coverage also offered. Job Posted by ApplicantPro

Job Description Job Title: Office Manager – Medical Practice Location: Brooklyn Heights, NY Employment Type: Full-Time Schedule: Full-Time | Monday–Friday Salary: $66,000 - $70,000 annually (DOE)*** Position Overview: We are seeking an experienced Office Manager to oversee the business operations of a medical practice site in Brooklyn Heights. This role ensures smooth daily operations, strong staff engagement, regulatory compliance, and excellent patient service. Key Responsibilities: • Manage day-to-day operations of a single-site medical office, • Maintain efficient patient flow including reception, scheduling, records, and chart preparation, • Ensure compliance with HIPAA, OSHA, labor laws, and healthcare regulations, • Supervise staff performance, including reviews, recognition, and discipline, • Address patient concerns and implement process improvements, • Oversee billing processes and insurance workflows, • Assist with surgical authorizations, scheduling, and billing, • Bachelor’s degree in Public Health Administration, Business, or related field, • 5–7 years of medical office administration management experience, • Medical billing and insurance processes, • Medicare, Medicaid, and commercial insurance regulations, • Workers’ Compensation and No-Fault claims, • Strong leadership and organizational skills, • Professional communication with staff, clinicians, and patients, • Experience with healthcare software systems, • High attention to detail and customer service focus Competitive Salary, Paid Time Off Medical Dental Vision 401(k) Legal Insurance Pet Insurance. Company DescriptionLanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Job Description Job Summary: Responsible for the timely and accurate resolution of insurance claims, primarily for Medicare, Medicaid, and HMO plans. This role involves follow-up on claims from billing through final resolution, identifying and correcting errors, and ensuring prompt payment of outstanding accounts. Key Responsibilities: • Claim Follow-up:, • Monitor the progress of insurance claims from submission to payment, • Payers Include Medicare, Medicare HMO's, Medicaid and Medicaid HMO's, • Identify and resolve claim denials, rejections, and delays., • Follow up with insurance carriers to expedite claim payments., • Error Correction:, • Review daily electronic billing reports, paper claim submissions, and third-party confirmation reports for errors., • Make necessary corrections in the billing system to ensure accurate claims., • Medicare Claims:, • Process Medicare RTP claims and denial reports on a daily basis., • Ensure timely and accurate submission of Medicare credit balance quarterly reports., • Account Resolution:, • Research outstanding accounts and take appropriate action to secure prompt payment., • Analyze system-generated reports to identify accounts requiring research., • Document all resolution activities in the appropriate system and log., • Alert supervisors or managers of non-payment trends., • Contractual Allowance:, • Research partial payments to determine if the appropriate contractual allowance was calculated., • Initiate corrective action for miscalculated allowances, including collaboration with clinical departments., • Document results and alert supervisors or managers of trends., • Rejected and Denied Services:, • Research rejected or denied services and determine corrective action., • Complete corrective action using departmental procedures and policies., • Document results and alert supervisors or managers of non-payment trends., • Reporting:, • Complete productivity reports and submit to supervisors within the established timeframe., • Customer Service and Performance Improvement:, • Support the department's customer service and performance improvement goals., • Collaborate with other staff to enhance patient care and service., • Compliance:, • Experience: 1-3 years of experience in healthcare billing or Hospital billing., • Technical Skills: Proficiency in using billing systems and software., • Knowledge: Knowledge of Medicare, Medicaid, and HMO billing regulations.

Job Description Job Title: Medical Office Manager Location: Brooklyn Heights, NY Job Type: Full-Time Salary: $66,000 – $96,000 per year (DOE) About the Opportunity A busy and well-established medical practice in Brooklyn Heights, NY is seeking an experienced Medical Office Manager to lead the administrative and operational functions of the office. This role is ideal for a highly organized professional with strong leadership skills and experience managing healthcare office operations, staff, and patient workflows. The Medical Office Manager will ensure efficient daily operations, maintain regulatory compliance, support staff development, and deliver an exceptional patient experience. Key Responsibilities • Oversee day-to-day operations of a single-site medical office, • Manage office workflow including patient scheduling, records management, and front desk operations, • Ensure compliance with HIPAA, OSHA, labor laws, and healthcare regulations, • Supervise and support administrative staff, including performance evaluations, coaching, and training, • Address patient concerns and implement improvements to enhance patient satisfaction, • Oversee reception, patient intake, scheduling, and chart preparation, • Manage medical billing processes and insurance workflows, • Coordinate surgical authorizations, scheduling, and billing, • Maintain office supplies, medical inventory, and equipment, • Support additional administrative and operational tasks as needed Qualifications • Bachelor’s degree in business administration, Public Health Administration, Healthcare Management, or related field, • 5–7 years of experience in medical office administration or healthcare operations, • 3+ years of supervisory experience managing teams of five or more employees, • Strong knowledge of healthcare office operations and regulatory compliance Required Experience • Medical billing and insurance processing, • Medicare, Medicaid, and commercial insurance regulations, • Human resources processes including hiring, onboarding, and performance management, • Workers’ Compensation and No-Fault claims, • Surgical authorization and scheduling coordination Skills • Strong leadership and organizational skills, • Excellent communication with physicians, staff, and patients, • Experience with electronic medical records (EMR) and healthcare software, • Strong attention to detail and ability to manage multiple priorities, • Commitment to providing excellent patient service Additional Requirements • Bilingual in Spanish and English (Required) Physical Requirements • Prolonged periods of sitting and working on a computer, • Ability to occasionally lift up to 25 pounds Benefits • Competitive Salary, • Paid Time Off (PTO), • Medical, Dental & Vision Insurance, • 401(k) Retirement Plan, • Legal Insurance, • Pet InsuranceCompany DescriptionLanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Job DescriptionOur mission: to eliminate every barrier to mental health. At Spring Health, we're on a mission to revolutionize mental healthcare by removing every barrier that prevents people from getting the help they need, when they need it. Our clinically validated technology, Precision Mental Healthcare, empowers us to deliver the right care at the right time—whether it's therapy, coaching, medication, or beyond—tailored to each individual's needs. We proudly partner with over 450 companies, from startups to multinational Fortune 500 corporations, as a leading provider of mental health service, providing care for 10 million people. Our clients include brands you use and know like Microsoft, Target, and Delta Airlines, all of whom trust us to deliver best-in-class outcomes for their employees globally. With our innovative platform, we've been able to generate a net positive ROI for employers and we are the only company in our category to earn external validation of net savings for customers. We have raised capital from prominent investors including Generation Investment, Kinnevik, Tiger Global, Northzone, RRE Ventures, and many more. Thanks to their partnership and our latest Series E Funding, our current valuation has reached $3.3 billion. We're just getting started—join us on our journey to make mental healthcare accessible to everyone, everywhere. Reporting to the Senior Director of Product Management, the Lead Product Manager, Claims and Insurance Eligibility will own the development of systems and experiences that support eligibility verification, claims generation, and reimbursement. This role is part of the Care Foundations Product team and is critical to scaling our healthcare infrastructure and optimizing financial outcomes for members, Providers, and Spring. Please note that this is a hybrid role based in New York City, with an expectation to be in office 2-3 days a week. Our office is located at 60 Madison Avenue. What you'll do: • Define and drive the product roadmap for eligibility verification, claims processing, EDI integrations, and payer reimbursement workflows., • Partner with engineering, revenue cycle operations, data, and compliance teams to deliver reliable, accurate, and scalable systems., • Improve real-time eligibility checks and automate claims submission processes to reduce administrative overhead., • Ensure products meet HIPAA and other regulatory requirements while optimizing for user experience and operational efficiency., • Identify and resolve pain points that lead to claim denials, slow reimbursements, or friction for members and providers., • Measure and enhance the success of claims workflows through product analytics, stakeholder feedback, and A/B testing., • Strategically leverage AI and other technologies to gain large efficiencies, • High level of accuracy for eligibility checks, • Lower processing cost per appointment, • 90%+ claims auto-submitted, • Significant increase in "clean claims"/reduction in claim denial rates, • Improve revenue cycle automation to reduce manual interventions, • 5+ years of product management experience, including experience in healthcare tech, • Experience developing and delivering on strategic roadmaps tied to longer term company objectives, • Deep familiarity with claims workflows, eligibility checks, and healthcare billing standards (e.g., EDI, X12), • Demonstrated ability to lead cross-functional teams across operations, engineering, and compliance, • Strong technical acumen and systems thinking, especially with complex data workflows and the ability to improve them with AI and automation, • Experience with payer-provider systems or clearinghouses, • Familiarity with Medicare, Medicaid, or commercial insurance billing nuances, • Health, Dental, Vision benefits start on your first day at Spring. You and your dependents also receive access to One Medical accounts HSA and FSA plans are also available, with Spring contributing up to $1K for HSAs, depending on your plan type., • Employer sponsored 401(k) match of up to 2% for retirement planning, • A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents., • We offer competitive paid time off policies including vacation, sick leave and company holidays., • At 6 months tenure with Spring, we offer parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents., • Access to Noom, a weight management program—based in psychology, that's tailored to your unique needs and goals., • Access to fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses., • Access to Wellhub, which connects employees to the best options for fitness, mindfulness, nutrition, and sleep in one subscription, • Access to BrightHorizons, which provides sponsored child care, back-up care, and elder care, • Up to $1,000 Professional Development Reimbursement a year. Ready to do the most impactful work of your life? Learn more about our values, what it's like to work here, and how hypergrowth meets impact at Spring Health: Our Values Our privacy policy: Spring Health is proud to be an equal opportunity employer. We do not discriminate in hiring or any employment decision based on race, color, religion, national origin, age, sex, marital status, ancestry, disability, genetic information, veteran status, gender identity or expression, sexual orientation, pregnancy, or other applicable legally protected characteristic. We also consider qualified applicants regardless of criminal histories, consistent with applicable legal requirements. Spring Health is also committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. If you have a disability or special need that requires accommodation, please let us know.

Job Description Position: Risk Adjustment Coder Location: Remote (Must reside in NY/NJ/CT) Schedule: Monday - Friday 9am-5pm Compensation: $77,506.87 - 87,195.23 annual salary CPC, CCS, RHIT or RHIA and CRC are required Join VillageCare as a Full Time Risk Adjustment Coder and embrace the opportunity to work remotely while making a significant impact in the Health Care sector. This role offers the flexibility of a work-from-home environment, allowing you to balance your professional and personal commitments without the daily commute. You'll be part of a dynamic team that thrives on innovation, problem-solving, and a customer-centric approach, all while contributing to the excellence and integrity that VillageCare stands for. With a competitive salary up to $77,506.87 - $87,195.23, this is not just a job but a chance to build your career in a forward-thinking organization dedicated to healthcare improvement. As a team member you'll be able to enjoy benefits such as PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life and Disability, Commuter Benefits, Paid Family Leave, and Additional Employee Discounts. Seize the opportunity to grow in a high-performance culture that values your contributions. Apply today and help shape a healthier future! A little about us VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. What's your day like? As a Full Time Risk Adjustment Coder at VillageCare in New York, NY, you will perform critical code abstraction of medical records, ensuring accurate assignment of ICD-9-CM, ICD-10-CM, CPT, and HCPCS codes supported by clinical documentation. Your role involves a comprehensive review of medical records, validating that documentation meets CMS requirements, including provider signatures and relevant dates. You will identify improvement opportunities in documentation and coding processes and participate in quality initiatives that enhance overall outcomes. By maintaining current knowledge of coding standards and regulations, you will support the Medicare Risk Adjustment team in educating providers on compliance and consistency. Your contributions will include reporting findings from audits, assisting in analysis, and maintaining a minimum accuracy of 95% on coding quality audits while meeting productivity requirements. This is an exciting opportunity to make a meaningful impact in healthcare while advancing your coding expertise. Requirements for this Risk Adjustment Coder job To thrive as a Full Time Risk Adjustment Coder at VillageCare, candidates must possess a robust understanding of clinical terminology, disease processes, anatomy and physiology, as well as pharmacology. A strong foundation in claims processing procedures, state and federal regulations, and Medicare Coordination of Benefits applications is essential. Ideal candidates will have at least three recent years of experience in HCC/Risk Adjustment and/or inpatient coding, complemented by relevant certifications such as CPC, CRC, RHIT, or RHIA from AAPC or AHIMA. Additionally, successful candidates will exhibit exceptional attention to detail, basic computer skills, and the ability to maintain a productive home office environment with high-speed internet. Residing in New York, New Jersey, or Connecticut is also a prerequisite to ensure alignment with local regulations and standards. Strong problem-solving skills and a commitment to coding excellence are crucial for contributing to the organization's mission in improving healthcare quality. Knowledge and skills required for the position are: • Strong knowledge of clinical terminology, disease processes, anatomy/physiology and pharmacology, • Have high speed internet at their house and a distraction free home office, • Must be detail oriented and have basic computer skills, • Strong knowledge of claims processing procedures and systems, • State, Federal and Medicare Regulations and Coordination of Benefits applications required, • Must reside in NY, NJ or CT, • 5 recent years of HCC / Risk Adjustment and/or inpatient coding are required, • Certified through AAPC or AHIMA(CPC, CRC, RHIT or RHIA), • CPC, CCS, RHIT or RHIA and CRC are requiredConnect with our team today! VillageCare is an Equal Opportunity Employer. Job Posted by ApplicantPro

Job Description PRIMARY FUNCTION/PURPOSE: Supervise the delivery of services provided by Client Care Coordinators (Social Workers) to enhance existing services to homeless families. This includes the completion of a thorough assessment, and the development and completion of a bio-psychosocial for each family upon intake, crisis intervention, counseling, client advocacy, and referrals to government and/or community-based resources. If needed, this individual will ensure that recommendations of achievable goals be implemented on each family’s service plan, leading to permanent housing, and strengthening the overall permanency outcome for clients in shelter. MINIMUM QUALIFICATIONS: • Must be a Licensed Clinical Social Worker (LCSW) in the state of New York, • Minimum of 3-5 years of experience in social services, counseling, crisis intervention, family services, preventive services, housing services, or homeless services, • At least two years of supervisory experience in social services, counseling, crisis intervention, family services, preventive services, housing services, or homeless services, • Knowledge in three or more of the following areas:, • Experience in supervision of social workers, • Experience in client assessment, service plan development, and case management, • Child and adolescent development, • Parent-child relationships, family dynamics, and diagnostic classifications, • Mental health and Emotional/Behavior health, • Child Welfare policies and procedures, • Government Entitlements: TANF, Social Security, Medicare etc., • Knowledge and experience working with diverse cultures and ethnicities, • Expertise in strengths-based, solution-focused, and family-centered practice, • Experience facilitating groups for adults, • Proficiency in Spanish a plus, • Excellent oral and written communication skills coupled with strong interpersonal skills, • Proficient in MS Office, Outlook, Excel, PowerPoint, and Adobe PRIMARY RESPONSIBILITIES: • Manage and supervise a team of Client Care Coordinators to develop a team of skilled professional staff, including recruitment, training, supervision, evaluation, and staff scheduling to achieve the objectives of both CRF and Agency Funders, • Guide client care coordinators in the development, implementation, and achievement of program goals, • Handle administrative, operational, and programmatic issues that might affect client care coordinator staff, • Assign cases to client care coordinators for newly admitted clients to be assessed immediately upon admission and managed throughout shelter stay, • Ensure the timely completion of comprehensive bio psychosocial assessments for each client to understand strengths and service needs, • Work effectively as a part of a multi-disciplinary team to enhance client engagement and the delivery of quality service, • Enhance the delivery and coordination of mental health and related services to clients in shelter, • Ensure that Client Care Coordinator reports are clearly written and capture assessment findings and recommendations, • Confer and consult with professional and technical personnel in implementing a multidisciplinary approach to client care and well-being, • Ensure that Client Care Coordinators are providing short-term counseling, outreach services, crisis intervention, risk assessment, safety planning, and psycho-education for clients, • Collaborate with ACS and/or prevention services agencies, and participate in conferences to advocate on behalf of clients as needed, • Ensure that Client Care Coordinators are providing clients with appropriate referrals and linkages between mental health providers, government agencies, and other related community-based services as needed, • Serve as agency/program liaison between DHS, government agencies, community-based organizations and/or groups, • Develop and Implement group work to be facilitated by Client Care Coordinators to address family issues, enhance life skills etc., • Ensure that Client Care Coordinators are completing all documentation in a timely manner, • Ensure that Client Care Coordinators assess each client/family for supportive housing, complete supportive housing applications when applicable, and accompany residents to supportive housing interviews when needed, • Ensure that Client Care Coordinators complete and discuss exit summaries with each client, and provide clients/families with referrals and supportive services identified in their new community, • Participate in family meetings with case work and housing teams to discuss planning efforts and progress, • Networking and establishing successful linkages with government and community-based organizations to create resources for both families and staff, • Work in collaboration with the Director of Social Services and the Housing Coordinator to ensure that all services lead to permanent housing placement, • Complete special projects and assignments as needed or identified by leadership, • Must work one late a week from 11 am -7 pm to accommodate both staff and families, • Provide on-call crisis intervention support to Client Care Coordinators, • Perform other duties as assigned CLIENT CHARTS / STAFF COMPLIANCE: • Manages, reviews, and monitors Client Care Coordinators’ maintenance of client records (paper and electronic) by conducting case audits, ensuring both internal and external quality assurance standards are being met in accordance with CRF and DHS standards, • Provides training to new staff and existing Client Care Coordinator staff, • Provide individual and group supervision to Care Coordinators to provide coaching, guidance, and support on service delivery and work performance, • Ensure that high-risk cases are monitored closely and serviced effectively, • Provide Client Care Coordination team with support and guidance on high-risk and challenging cases, • Collects and analyzes data provided on client services to evaluate team success in service delivery, • Provides Client Care Coordination services in the absence or vacancy of Client Care Coordinator staff MEASURABLE AREAS: • Ability to team lead and provide effective supervision, guidance, and oversight of subordinates, • Timely reporting of critical/priority one incidents to DHS, • Ability to respond and troubleshoot crisis situations, • Comply with and promote compliance with all agency policies, helping to strengthen and maintain an ethical organizational culture Completion of DHS Monthly Metrics. • Number of biopsychosocials completed, • Number of mental health referrals, • Number of successful referrals (3 MH referrals kept), • Number of substance use referrals, • Number of successful referrals (3 SU referrals kept), • Number of other referrals, • Number of successful other referrals, • Number of linkage agreements finalized, • Number of training sessions conducted, • Number of client groups/workshops facilitated, • Timely completion and submission of CCC Unit DHS Monthly Metrics Report SECONDARY RESPONSIBILITIES: • Facilitate effective communication with other staff within an interdisciplinary context, participate in and contribute to staff meetings and the development of policies and procedures, • Participate in trainings and staff-development activities to acquire and maintain both the interpersonal and operational skills necessary for successful job performance, • Provide professional development to Client Care Coordinators to enhance skill-sets as it relates to appropriately assessing the needs of clients in shelter, • Work in collaboration with site leadership to provide training and consultation to shelter-based case management team, and to increase the ability of shelter staff to address mental health issues, • Ensure that staff attend CORE trainings within (6) months of employment, such as the mandated Reporter Training, CARES Getting Started, CARES Incident Reporting, CARES Intimate Partner Violence 101, Bio-Psychosocial & Engagement 101, Bio-Psychosocial & Engagement 102, Risk & Safety Assessment, Motivational Interviewing, and CPR/First Aid PRINCIPAL RELATIONSHIPS: • Frequent interaction with diverse clients to assess and respond to their needs, • Collaborative working relationships with and volunteers who aid in the facility, • Regular contact with other program and Social Services staff to ensure team delivery of consistent high-quality services EEO Statement – Children’s Rescue Fund is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, sexual orientation or protected veteran status. #IND1

Job DescriptionManager of Credentialing (Healthcare) Location: Remote (US) or Hybrid (City, State) Type: Full-time Reports to: Head of Operations / Director of Provider Operations (or similar) Comp: Competitive base + equity + benefits About the Company Our client is a venture-backed healthcare startup building a modern platform that makes it easier for patients to access high-quality care and for clinicians to practice at the top of their license. The team is scaling quickly, operating in multiple states, and credentialing is core to the ability to grow safely and compliantly. The Role Our client is hiring a Manager of Credentialing to own and scale the credentialing function. You’ll lead day-to-day credentialing operations, build repeatable systems, and partner cross-functionally with Operations, Clinical, Legal/Compliance, and Product to reduce time-to-credential while maintaining rigorous quality standards. This is a high-ownership role for someone who can execute in the details and improve the system. What You’ll Do * Own end-to-end credentialing for clinicians/providers across multiple states and payers (as applicable), including new credentialing, recredentialing, and ongoing maintenance. * Manage a small team and/or vendors (CVOs) and drive clear KPIs (time-to-credential, first-pass yield, aging, rework rate). * Create and maintain SOPs, checklists, and QA processes to ensure accuracy, completeness, and audit readiness. * Partner with Provider Operations to forecast pipeline needs and proactively manage throughput/capacity. * Serve as escalation point for complex cases (sanctions queries, gaps in work history, adverse actions, board issues, expiring coverage, etc.). * Build strong relationships with hospitals/health systems, payers, state boards, CAQH, and third-party credentialing partners. * Maintain credentialing files and documentation standards (primary source verification, attestations, NPDB queries where applicable, licensure, DEA, malpractice, education, references). * Collaborate with Compliance/Legal to ensure adherence to NCQA/URAC standards where required and internal policies. * Work with Product/Engineering to improve tooling: workflow automation, document collection, status transparency, integrations (CAQH, NPPES, PECOS, etc.), and reporting. * Lead continuous improvement initiatives that reduce cycle time and increase reliability as we scale. What We’re Looking For * 5+ years in provider credentialing and/or provider enrollment operations, including 1–3+ years in a lead/manager capacity. * Deep familiarity with credentialing best practices (primary source verification, file auditing, recredentialing cadence, documentation standards). * Experience working with CAQH and common verification sources (state boards, OIG/SAM exclusions, NPDB where applicable, malpractice carriers, education verification). * Track record building processes in a fast-moving environment (startup, high-growth healthcare org, or building a new function). * Strong operational rigor: you can manage multiple queues, deadlines, and stakeholders without dropping details. * Comfort with ambiguity and ownership—able to diagnose problems, propose fixes, and implement improvements. * Excellent written and verbal communication; able to work cross-functionally and manage escalations calmly. * Proficiency with tools like Google Workspace/Excel; experience with credentialing platforms (e.g., Modio, symplr, VeraSuite, Medallion, or similar) is a plus. Nice to Have * Experience credentialing across multiple specialties and state footprints. * Familiarity with NCQA/URAC standards and audits. * Experience with payer enrollment (commercial, Medicare/Medicaid) or delegated credentialing. * Prior experience managing a CVO relationship and negotiating SLAs. * Product-minded operator who’s helped implement or improve credentialing software/workflows. Why Join * Meaningful mission with direct impact on patient access and provider experience. * Opportunity to build and own a critical function at a high-growth, venture-backed company. * Competitive compensation, equity upside, and benefits. * High-trust environment with autonomy and room to grow.

Job DescriptionABOUT VITALIEF Vitalief is a trusted partner to Sponsors, CROs, and Sites across the research and clinical trials landscape. By blending deep subject matter expertise with strong business acumen, we deliver Consulting and Functional Service Provider (FSP) solutions that empower organizations to do more with less, streamlining operations, reducing costs, and accelerating breakthroughs that ultimately benefit patients. POSITION OVERVIEW We are seeking a highly experienced, strategic yet hands-on Clinical Research Operations Leader to join our delivery team as a full-time, fully benefited employee. In this role, you will partner with a multi-location community hospital system to transform its research enterprise into a scalable, high-performing, world-class clinical research operation. As the primary subject matter expert (SME), this leader will collaborate closely with the Vitalief delivery team to design and implement enterprise-level operational initiatives, with a strong emphasis on Non-Oncology programs and enhancing cross-system communication and coordination. A central focus of the role will be leading the operational build-out and execution of a Cardiovascular clinical trials pilot, including infrastructure development, staffing strategy, workflow optimization, and technology deployment. WHY VITALIEF? • Professional Growth: Join a team of experienced practitioners who bring both business acumen and domain expertise., • Impactful Work: Contribute to scientific advancements that directly improve patient lives., • People-First Culture: Thrive in an environment that fosters growth, innovation, and collaboration., • Comprehensive Benefits: Enjoy 20 PTO days, 9 paid holidays, company-paid life insurance, short- and long-term disability, a 401(k) retirement plan, and robust healthcare options., • Flexible Work Location: Hybrid role with 2–3 days per week onsite in the Orange, NJ area., • Successful design, launch and operational stabilization of a scalable Cardiovascular research pilot across multiple hospital campuses and ambulatory sites., • Aligned research strategy with institutional priorities through close partnership with executive, clinical, and administrative leadership., • Established standardized workflows, SOPs and enterprise-wide performance metrics for research operations., • Strengthened investigator engagement and increased research participation across service lines., • Established scalable infrastructure and service line activation frameworks, in collaboration with investigators and sponsors, to reduce study activation timelines, enhance start-up predictability, and support sustainable research growth., • Successfully managed cross-functional initiatives within matrixed reporting environments and complex academic-clinical governance structures., • Bachelor’s degree required; Master’s degree in Clinical Research Administration, Public Health, Nursing, or related field strongly preferred., • Minimum of 7 to 10 years of progressive clinical research operations experience, including 3 to 5 years in leadership or management roles., • Experience building and launching a clinical research multi-location operation from scratch, enabling timely initiation of multiple studies across diverse therapeutic areas., • Demonstrated experience leading and supporting complex multi-site clinical research settings, including academic medical centers, affiliated and non-academic health systems, and disparate research locations., • Demonstrated experience managing complex drug, device, adaptive, or multi-arm trials., • Cardiovascular clinical research experience strongly preferred., • Expertise in study start-up optimization, IRB processes, and regulatory compliance., • Experience with CTMS platforms (e.g., OnCore) and Epic research integration., • Strong knowledge of research billing compliance and Medicare clinical trial requirements., • Proven ability to develop SOPs, quality systems, and performance dashboards., • Experience strong relationships with sponsors and CRO partners to enhance site reputation and repeat business opportunities., • Strong executive presence with the ability to influence across matrixed environments. IMPORTANT NOTE: Vitalief partners with clients such as major medical centers and academic institutions that often requires all on-site resources such as prospective Vitalief consultants to be inoculated annually for Influenza and successfully pass a Mantoux Tuberculin Skin Test (TST) for Mycobacterium Tuberculosis. Powered by JazzHR r6vZMkintD

Job DescriptionAbout Baba Baba is rebuilding healthcare for older adults. Navigating healthcare can be overwhelming. By 2030, over 65 million older adults will make up nearly a quarter of the U.S. population, creating one of the largest and most urgent challenges in healthcare. Baba makes it easier by pairing older adults with an expert advocate (usually a nurse or social worker) who coordinates their care. Baba's insurance-covered advocates have supported thousands of families by writing insurance appeals, researching specialists, getting medical equipment and cheaper medications, and scheduling appointments. Baba's investors include General Catalyst, Genius Ventures, Soma Capital, and Ground Up Ventures, along with angel investors who were founders or executives of leading companies. More than 50% of the Baba team are former founders, with backgrounds from MIT, Carnegie Mellon, Stripe, Palantir, and Liquid AI. The Role We're looking for a Clinical Operations leader to build and run the engine that powers Baba's care delivery, the people, processes, and systems that turn a patient into consistent, high-quality advocacy, and follow through on the KPIs for positive, high NPS outcomes. Today, Baba's advocate team is growing fast. We need someone who has actually built and managed a clinical workforce at scale, hiring, training, supervising, and holding accountable a distributed team of community health workers, social workers, nurses, and care coordinators. Someone who understands what it takes to deliver measurable outcomes for complex elderly patients. This is not a "strategy and decks" role. You'll be in the weeds, building scheduling and assignment systems, designing QA processes for clinical documentation, establishing supervision structures between advocates and physicians, and creating the operational playbook that lets us 10x the team without quality falling apart. You’ll also be instrumental in new product and service offerings to create a scalable platform. You'll work closely with our product, engineering, and growth teams to shape how Baba scales. What You'll Do * Build the clinical workforce machine. Own recruiting pipelines, onboarding, training curricula, and competency assessments for healthcare advocates. Design tiered staffing models (CHWs, social workers, RNs) matched to patient acuity and service requirements. * Create systems for quality and compliance. Build audit-ready QA processes, chart reviews, peer supervision, and corrective action workflows. * Design and manage the advocate-physician supervision model. Define escalation pathways, clinical oversight cadence, and co-signature workflows that satisfy Medicare requirements without creating physician bottlenecks. * Operationalize patient panels and caseload management. Build assignment logic, capacity planning, and workload balancing across a distributed remote team. Define what "right-sized" caseloads look like for different advocate tiers and patient complexity levels. * Own clinical outcomes and operational KPIs. Track and improve engagement rates, documentation completion, billing capture rates, patient satisfaction, and downstream outcomes (readmission reduction, care plan adherence). Build dashboards and reporting cadences that surface problems before they compound. * Partner with product and engineering. Shape EHR workflows, AI tools, and care coordination features based on frontline clinical reality. Translate operational pain points into product requirements. Pressure-test new features with the team before rollout. * Expand clinical programs. Support the launch of adjacent services. Define clinical protocols, staffing models, and supervision structures for each new line. What You Bring * 7+ years in clinical operations, care management, or social work leadership within a health system, managed care organization, or post-acute provider. You've personally built and managed a team of 20+ clinical staff (social workers, care managers, CHWs, nurses). * Experience with care transitions and post-acute populations. You've worked at the intersection of hospitals, SNFs, home health, and community-based services. You know the discharge planning ecosystem and its failure modes intimately. * Operational builder, not just operator. You've created clinical programs, training curricula, QA systems, or workforce models from scratch, not just managed inherited ones. You're comfortable with ambiguity and can design v1 systems that work today while scaling tomorrow. * Comfort with technology and data. You work fluently with EHRs and care management platforms. You can define metrics, read dashboards, and use data to drive decisions. You don't need to code, but you need to think in systems. * Clinical licensure or credential (LCSW, RN, LMSW, or equivalent) preferred. What matters more is that you can credibly lead, train, and evaluate clinicians. Nice to Have * Experience at a healthcare startup or high-growth environment where you built clinical operations from early stage. * Background in social work leadership within a large health system (managing social work and case management departments across multiple sites). * Exposure to value-based care contracts and outcomes-based reporting. * MSW, MPH, MBA, or equivalent advanced degree. Compensation & Benefits * Competitive base salary + equity * Health, dental, and vision insurance * Unlimited PTO * Work in our beautiful SoHo, NYC office * The opportunity to define how consumer healthcare works for millions of families

Job DescriptionPOSITION SUMMARYSupports the VP of Revenue Cycle Operations and Optimization in managing aspects of revenue cycle optimization, including maintaining relationship and monitoring of third-party billing organization and EPIC hosting organization, identifying and implementing revenue optimization strategies, regulatory compliance with third-party insurers (Medicaid, Blue Cross/Blue Shield, etc.), and maintenance of billing and reporting systems. Supports fee schedule, contract review and credentialing activities for managed care contracts. ESSENTIAL JOB DUTIES AND RESPONSIBILITIES Management (10%) · Recruits, retains and develops a diverse and highly qualified staff; provides ongoing performance feedback and maintains a safe and professional work environment.· Trains or assists in training staff in other departments on revenue cycle related areas (both administrative and program) as needed.· Evaluates staff in a timely manner in accordance with PPGNY’s policies.· Performs other training and mentoring related duties as required. Revenue Cycle Optimization and Revenue Cycle Liaison (55%)· Performs analysis of revenue cycle trends and identifies areas of focus to reduce denials and increase overall collections.· Performs root cause analysis for areas identified, proposes solutions to achieve overall enhancement of revenue and implements changes.· Develops workplans to address billing corrections needed, works closely with EPIC hosting organization to implement automated solutions· Collaborates with third party RCM vendor and health center operations to implement process changes.· Collaborates with cross functional teams to ensure alignment between clinical operations and PPGNY billing practices· Tracks adherence to process changes implemented and quantify financial impact. · Monitor health centers’ adherence to charge reconciliation processes and metrics measured by key performance indicators and work with HC leadership to address issues/ trends identified· Ensure changes within the charge description master (CDM) coincide and are implemented with clinical systems· Review changes in CPT®, HCPCS, and revenue codes for accuracy, compliance with applicable billing guidelines, and optimization of reimbursement· Develop, deliver, and revise integrity education and training programs in coordination with clinical operations and leadership· Perform revenue integrity reviews and present findings for corrective actions Monitoring tools (25%)· Develops and implements reporting tools to identify revenue cycle trends, including root cause of denials.· Builds reporting tools to monitor productivity and quality of work performed by staff that impacts RCM results, including front desk, financial counselors, and third-party RCM vendor. · Creates reports to monitor the impact of RCM enhancements and ensure compliance with new processes.· Works closely with Data Analytics team to develop dashboards, scorecards and other tools to monitor performance. Monitoring tools (25%)· Develops and implements reporting tools to identify revenue cycle trends, including root cause of denials.· Builds reporting tools to monitor productivity and quality of work performed by staff that impacts RCM results, including front desk, financial counselors, and third-party RCM vendor. · Creates reports to monitor the impact of RCM enhancements and ensure compliance with new processes.· Works closely with Data Analytics team to develop dashboards, scorecards and other tools to monitor performance. Education and Training (10%) · Evaluates the results of the periodic coding audits conducted by an outside agency, and partners with the VP of Revenue Cycle Operations and Optimization and clinical services leadership to provide training and feedback to the clinical providers on their performance and areas for improvement.· Actively maintains an up-to-date knowledge base of developments in third-party billing, such as changes in Medicaid reporting requirements. Identifies changes required to department procedures in response to such developments.· Responsible for identification of training needs for all registration areas and provide training material working in conjunction with RDO of operations. · Maintain up to date knowledge of CMS billing rules and payer requirements to proactively identify policy changes· Remain current on payer billing requirements· Remain current on Epic reporting tools CORE COMPETENCIES· A demonstrated commitment to PPGNY’s mission related to bodily autonomy, health equity, gender and racial justice · A demonstrated commitment to learning about and enhancing practices related to racial equity and its impact on healthcare systems. · Strong relationship building and communication skills, including an ability to work and build trust across cultural differences related to related to race, class, age, gender, gender identity and expression, sexual orientation, religion, ethnicity, national origin or ability; and to reflect on one’s personal identity with humility. · Strong knowledge of data and analytics to ensure good decision making, performance measurement and financial analysis.· Ability to work collaboratively in cross-organization workgroups. · Customer service and interpersonal skills and the ability to coordinate work with others, both internally and externally, to accomplish tasks. · Engages in mutual problem solving · Facilitates continuous process improvements · Strong time management skills, including ability to work in a high distraction environment and to juggle multiple deliverables at one time · Strong project management skills, identifying all steps required to meet a deliverable, key stakeholders, deliverables by other units in order to achieve goals, and barriers to success. REQUIRED SKILLS/ABILITIES:Interpersonal · Excellent customer service and communication skills · Ability to remain focused and calm in stressful situations · Excellent interpersonal, written and verbal skills · Ability to develop and maintain effective, professional relationships with internal and external stakeholders · Ability to work effectively as part of team Technical · Proficient with Microsoft Office Suite; Advanced Excel skills including Pivot Tables and V Look Ups· Deep understanding of EMR systems; Experience in an EPIC environment· Strong data management and data analysis skills; research oriented with the ability to critically analyze large data sets Subject Matter Knowledge · In-depth knowledge of Medicare/Medicaid regulations, including billing, coding, and documentation requirements. · Strong experience in revenue cycle management and optimization· Previous experience with Charge Master Management· Experience with principles of process improvement Work Habits/Attributes · Excellent organizational skills · Outstanding time management skills, including the ability to work under deadline · The ability to produce high quality work in a fast-paced environment with changing and/or competing priorities · Ability to exercise sound judgment and independent decision-making skills · Ability to produce reliable, high-quality work with minimal direct supervision · Ability to exercise discretion in the handling of confidential information · Possess strong work ethic REQUIRED QUALIFICATIONS • Minimum of an associate degree in business administration, accounting, healthcare administration, or other related degree., • 10 years of experience related to billing, coding, denial management and underpayment analysis, • Demonstrated leadership skills, • Two years’ experience with EPIC Reporting. Preferred Qualifications:, • Bachelor's degree in Finance or IT related areas of focus, • EPIC related certifications and reporting experience, • Coding certification (e.g. CCS, RHIA, RHIT) or applicable experienceTYPICAL PHYSICAL DEMANDS, • Requires prolonged sitting and repetitive tasks including use of a computer. Periodic standing, walking, bending. Requires lifting or moving of up to 15 pounds. Visual acuity sufficient to perform frequent work on a computer screen and review printed reports and other materials. Requires the ability to hear and to communicate orally with others. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets, and will require reaching, grasping, pushing and pulling.TYPICAL WORKING CONDITIONS

Job Description About Us At Greenbrook Medical, we believe seniors deserve more from the healthcare system—more time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volume—so we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to taking the best care of our patients. About the Role The Vice President of Finance will serve as the organization's senior financial leader, responsible for financial strategy, planning, operations, and performance management across the business. As our first financial leader, you'll help guide the organization through its next stage of scale and complexity. This role will play a critical part in elevating the Finance function from a tactical function to a strategic driver of the business—bringing financial rigor, leadership, and insight. The ideal leader will help build the foundation for a world-class finance organization that can support the company's ambitious trajectory. This leader will guide the company through rapid growth, evolving risk-based contracts, and the complexities of value-based care economics. The VP of Finance will oversee all financial functions—FP&A, accounting, spend management, risk arrangements—and serve as a key thought partner to the CEO and executive team. As a VP of Finance, you'll report directly to the Chief Executive Officer. Location: New York City strongly preferred (Hybrid). Open to remote candidates in FL, VA, NY, NJ MO or TX. Key Responsibilities Financial Leadership & Strategy • Serve as a strategic advisor to the CEO and executive team on financial performance, growth planning, and operational decision-making., • Lead long-range financial planning, scenario modeling, and capital allocation strategies., • Partner directly with clinical, operations, and growth leaders to ensure financial sustainability within a full-risk, value-based care model., • Own the annual budgeting process, ongoing reforecasting, and long-term financial models., • Conduct deep FP&A analyses including:, • Budget vs. actual performance, • CAC:LTV modeling, • Churn and retention analysis, • J-curve and cohort performance analysis, • Oversee all financial operations, including outsourced HR/Payroll support responsible for payroll processing, benefits administration, state tax filings, corporate insurance, and related compliance., • Manage the relationship with external bookkeeping and accounting partners., • Ensure timely and accurate month-end closes, reconciliations, and financial statements., • Manage spend discipline across the organization, including:, • Budget adherence, • Hiring salary approvals, • Corporate credit card strategy, provisioning, rules, and controls, • Vendor onboarding and vendor management, • Receipt tracking and spend reporting, • Oversee financial operations related to full-risk and value-based care contracts., • Validate that capitation payments, stop-loss charges, and shared savings distributions are accurate., • Lead contestations and reconciliation processes with payers as needed., • Guide reserve fund allocation and risk corridor decision-making., • Partner with clinical and operational teams to understand drivers of performance and financial outcomes. Accountabilities • Financial Planning & Analysis: Deliver accurate forecasts and budget vs. actual performance, ensuring financial targets are met., • Operational & Spend Management: Maintain disciplined spend, optimize cost efficiency, and ensure compliance with internal policies., • Risk-Based Contract Oversight: Ensure accurate capitation, stop-loss, and shared savings payments while managing reserve funds effectively., • Strategic Leadership: Provide actionable financial insights that drive growth, operational decisions, and strategic initiatives., • Compliance & Controls: Ensure all financial operations meet regulatory, CPOM, and value-based care requirements. About You • Experience:, • 10+ years of FP&A, strategic finance, and accounting experience., • 5+ years of leadership experience building and scaling high-performing finance teams and overseeing strategic financial operations., • Strong experience with value-based care or risk-bearing payment models (e.g., Medicare Advantage, global capitation, ACO REACH), including understanding of drivers of medical spend, capitation flows, and performance economics., • Working knowledge of MSO–PC structures and corporate practice of medicine (CPOM) considerations, with the ability to ensure compliant financial operations in a multi-entity environment., • Skills:, • Proven ability to translate financial analysis into clear operational levers and strategic decisions across the organization, • Comfort operating in a fast-paced, scaling healthcare startup, with a track record of instilling financial discipline and building scalable processes., • Sound judgment and business acumen, with the ability to balance risk, investment, and long-term value creation, • Clear, confident communicator who can articulate financial strategy and insights to executive leadership, the Board, and investors, • Collaborative leadership style with the ability to influence across clinical and operational stakeholders., • Hands-on experience with accounting systems, reporting tools, or ERP platforms., • Strong judgment and business acumen, balancing financial risk with strategic opportunity., • Values: You embody our core values of Heart, Excellence, Accountability, Resilience, and Teamwork. Why You Should be Excited • Innovation: Be part of an innovative clinic setting the standard for senior-focused primary care. Work in a supportive, patient-first environment that values quality care., • Impact: Be part of a mission-driven team focused on transforming healthcare for underserved seniors., • Growth: We're building more than a company - we're building careers. As we grow, we're creating meaningful opportunities for you to expand your skills, take on new challenges, and shape your path forward., • Compensation & Benefits: Competitive base salary and performance-based bonus, paid time off, health, dental and vision benefits, and 401K with a company match. Our Selection Process Our selection process typically includes an online application, initial interview, second round interview, values interview, case study submission and final interview, and reference check. Equal Employment Opportunity and Commitment to Diversity At Greenbrook Medical, we believe the only way we accomplish our mission is by building the best team in healthcare. We do this through a culture of respect and belonging, ensuring our teammates feel cared for first and foremost. We will extend equal employment opportunity to all applicants without regard to age, race, ethnicity, sex, religion, sexual orientation, gender identity, socioeconomic background, disability status, military affiliation, pregnancy or any other status protected under federal, state and local laws. We encourage all who share our mission to apply. Greenbrook Medical will provide reasonable accommodations during the recruitment process. If you need additional accommodations or assistance, do not hesitate to contact our People team at .