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Most recent job postings at priorityhealth
via Workday
posted_at: 4 days agoschedule_type: Full-timework_from_home: 1
Job Summary Our Payment Integrity Lead is responsible to improve the availability of data that should be used to set priorities for pre-processing implementations. Show what must/should come from the vendor and what is PH internal to identify where confirmation of presented data might be needed while supporting implementation. Responsible for defining how data will be used to set actions that increase pre-processing savings and day to day operations,
Job Summary Our Payment Integrity Lead is responsible to improve the availability of data that should be used to set priorities for pre-processing implementations. Show what must/should come from the vendor and what is PH internal to identify where confirmation of presented data might be needed while supporting implementation. Responsible for defining how data will be used to set actions that increase pre-processing savings and day to day operations, how should the data be used to find opportunities to proceed to savings and set a plan for what needs to be done next to get to savings. Collaborate with Advanced Analytics, the Value Team and IS to ensure optimize potential within the program and optimize current SOW terms to get as much data as possible. Essential Functions Responsible for high level/complex payment integrity initiatives including vendor implementation, identifying and coordinating solutions for payment leakage. Coordinate vendor initiatives and findings to identify... methods to design and implement prevention solutions on the front end of claims processing Assist leadership in tracking the success of implemented processes and develop enhancements as needed. Collaborate with other departments as needed to resolve conflicts resulting from payment integrity initiatives. Coordinate coding and payment issues with other areas and departments as required. Educate providers on coding, documentation, contractual and regulatory requirements as needed. Assist leadership in partnering with technical and operational teams to implement data driven systems and design payment accuracy programs that can be measure for impact and success. Identify opportunities for payment policy initiatives or enhancements to current payment or medical policies. Utilization of new tools and the output impact Prepare and develop along with leadership strategy for following years goals Qualifications Required Bachelor's Degree or equivalent Preferably in health or business administration, finance or related degree 5 years of relevant experience Progressively more responsible experience in healthcare. Understanding of claims end to end processes Required 5 years of relevant experience Knowledge of health care medical terminology including understanding of CPT, ICD-10, HCPCS, Rev codes, APC and DRG’s Required 3 years of relevant experience Knowledge of different payment methodologies Required Physical Demands Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs Waist to Waist > 5 lbs: Seldom up to 10 lbs Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs Waist to Overhead > 5 lbs: Seldom up to 10 lbs Bilateral Carry > 5 lbs: Seldom up to 10 lbs Unilateral Carry > 5 lbs: Seldom up to 10 lbs Pushing Force > 5 lbs: Seldom up to 10 lbs Pulling Force > 5 lbs: Seldom up to 10 lbs Sitting: Frequently Standing: Occasionally Walking: Occasionally Forward Bend - Standing: Seldom Forward Bend - Sitting: Occasionally Trunk Rotation - Standing: Seldom Trunk Rotation - Sitting: Occasionally Reach - Above Shoulder: Seldom Reach - at Shoulder or Below: Seldom Handling: Seldom Forceful Grip > 5 lbs: Seldom Forceful Pinch > 2 lbs: Seldom Finger/Hand Dexterity: Frequently Primary Location SITE - Priority Health - 1239 E Beltline - Grand Rapids Department Name PH - Payment Integrity - Value and Analysis Employment Type Full time Shift Day (United States of America) Weekly Scheduled Hours 40 Hours of Work 8:00 a.m. to 5:00 p.m. Days Worked Monday to Friday Weekend Frequency N/A CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors and community. That is why we require a drug-free workplace and various vaccinations as a requirement for employment. Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category. An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team. If you are a qualified individual with a disability, you may request assistance in completing the application process by calling 616.486.7447. We are committed to granting reasonable accommodations in accordance with applicable laws. People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness
Show more details...
via BeBee
posted_at: 7 days agoschedule_type: Full-time
The person holding this position must live in the state of Michigan due to its Flexible Virtual (hybrid) workplace category.
Job Summary
...
This role requires subject matter expertise, analyzing employer-specific clinical and claims data, and then being able to prove key points with this information as it relates to medical trends.
Beyond proving key points, the individual will also need to prepare and deliver strategic health care analysis and
The person holding this position must live in the state of Michigan due to its Flexible Virtual (hybrid) workplace category.
Job Summary
...
This role requires subject matter expertise, analyzing employer-specific clinical and claims data, and then being able to prove key points with this information as it relates to medical trends.
Beyond proving key points, the individual will also need to prepare and deliver strategic health care analysis and recommendations to C-Suite level audiences.
In collaboration with key business and functional area leaders acts as the primary point of contact, strategic partner, and lead analytical support.
The Lead will develop a deep understanding of the business, financial and clinical drivers, available data and its uses.
As a strategic partner, the Lead will collaborate with key business and functional area leaders with the identification and development of content highlighting Priority Health's value to key clients.
Essential Functions
• Serve as ambassador for Priority Health with our top Key Accounts for annual medical reviews.
• Work with the sales department team to identify and prioritize key accounts both for annual and quarterly reviews.
• Review employer group trends and identify drivers of increased cost.
• Responsible to develop and deliver data-driven, solutions-based presentations as well as to collaborate with and assist in preparing key Priority Health staff for presentations.
• Serve as a key integrator between medical, pharmacy, advanced analytics, and sales.
• Build a strong relationship with business and functional area leaders to understand and design data insights and compile information to help inform key clients.
Qualifications
• Required Bachelor's Degree or equivalent
• Preferred Master's Degree or equivalent
• 7 years of relevant experience with: Healthcare insurance experience, creating, communicating, and executing on client reporting, building relationships with diverse stakeholders, and leading/influencing cross-functional teams in creating successful initiatives, without formal authority Required
• 10 years of relevant experience In the field Preferred
• 5 years of relevant experience Formal or Informal Leadership Preferred
• 5 years of relevant experience Formal or informal LeadershipIn a Large organization in similar size and complexity. Preferred
• 5 years of relevant experience Clinical background Preferred
Physical Demands
• Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs
• Waist to Waist > 5 lbs: Seldom up to 10 lbs
• Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
• Waist to Overhead > 5 lbs: Seldom up to 10 lbs
• Bilateral Carry > 5 lbs: Seldom up to 10 lbs
• Unilateral Carry > 5 lbs: Seldom up to 10 lbs
• Pushing Force > 5 lbs: Seldom up to 10 lbs
• Pulling Force > 5 lbs: Seldom up to 10 lbs
• Sitting:
Frequently
• Standing:
Occasionally
• Walking:
Occasionally
• Forward Bend - Standing: Seldom
• Forward Bend - Sitting: Occasionally
• Trunk Rotation - Standing: Seldom
• Trunk Rotation - Sitting: Occasionally
• Reach - Above Shoulder: Seldom
• Reach - at Shoulder or Below: Seldom
• Handling:
Occasionally
• Forceful Grip > 5 lbs: Seldom
• Forceful Pinch > 2 lbs: Seldom
• Finger/Hand Dexterity:
Frequently
#LI-SH
Primary Location
SITE - Priority Health - 1241 E Beltline - Grand Rapids
Department Name
PH - Employer Reporting
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
40
Days Worked
5
Weekend Frequency
N/A
CURRENT SPECTRUM HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Spectrum Health team members only.
Spectrum Health is committed to providing a safe environment for our team members, patients, visitors and community. That is why we require a drug-free workplace and various vaccinations as a requirement for employment.
Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization.
As a health system, we advocate for equity as we care for our patients, our communities, and each other.
From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do.
We invite those that share in our commitment to join our team.
If you are a qualified individual with a disability, you may request assistance in completing the application process by calling 616.486.7447.
We are committed to granting reasonable accommodations in accordance with applicable laws Show more details...
Job Summary
...
This role requires subject matter expertise, analyzing employer-specific clinical and claims data, and then being able to prove key points with this information as it relates to medical trends.
Beyond proving key points, the individual will also need to prepare and deliver strategic health care analysis and recommendations to C-Suite level audiences.
In collaboration with key business and functional area leaders acts as the primary point of contact, strategic partner, and lead analytical support.
The Lead will develop a deep understanding of the business, financial and clinical drivers, available data and its uses.
As a strategic partner, the Lead will collaborate with key business and functional area leaders with the identification and development of content highlighting Priority Health's value to key clients.
Essential Functions
• Serve as ambassador for Priority Health with our top Key Accounts for annual medical reviews.
• Work with the sales department team to identify and prioritize key accounts both for annual and quarterly reviews.
• Review employer group trends and identify drivers of increased cost.
• Responsible to develop and deliver data-driven, solutions-based presentations as well as to collaborate with and assist in preparing key Priority Health staff for presentations.
• Serve as a key integrator between medical, pharmacy, advanced analytics, and sales.
• Build a strong relationship with business and functional area leaders to understand and design data insights and compile information to help inform key clients.
Qualifications
• Required Bachelor's Degree or equivalent
• Preferred Master's Degree or equivalent
• 7 years of relevant experience with: Healthcare insurance experience, creating, communicating, and executing on client reporting, building relationships with diverse stakeholders, and leading/influencing cross-functional teams in creating successful initiatives, without formal authority Required
• 10 years of relevant experience In the field Preferred
• 5 years of relevant experience Formal or Informal Leadership Preferred
• 5 years of relevant experience Formal or informal LeadershipIn a Large organization in similar size and complexity. Preferred
• 5 years of relevant experience Clinical background Preferred
Physical Demands
• Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs
• Waist to Waist > 5 lbs: Seldom up to 10 lbs
• Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
• Waist to Overhead > 5 lbs: Seldom up to 10 lbs
• Bilateral Carry > 5 lbs: Seldom up to 10 lbs
• Unilateral Carry > 5 lbs: Seldom up to 10 lbs
• Pushing Force > 5 lbs: Seldom up to 10 lbs
• Pulling Force > 5 lbs: Seldom up to 10 lbs
• Sitting:
Frequently
• Standing:
Occasionally
• Walking:
Occasionally
• Forward Bend - Standing: Seldom
• Forward Bend - Sitting: Occasionally
• Trunk Rotation - Standing: Seldom
• Trunk Rotation - Sitting: Occasionally
• Reach - Above Shoulder: Seldom
• Reach - at Shoulder or Below: Seldom
• Handling:
Occasionally
• Forceful Grip > 5 lbs: Seldom
• Forceful Pinch > 2 lbs: Seldom
• Finger/Hand Dexterity:
Frequently
#LI-SH
Primary Location
SITE - Priority Health - 1241 E Beltline - Grand Rapids
Department Name
PH - Employer Reporting
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
40
Days Worked
5
Weekend Frequency
N/A
CURRENT SPECTRUM HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Spectrum Health team members only.
Spectrum Health is committed to providing a safe environment for our team members, patients, visitors and community. That is why we require a drug-free workplace and various vaccinations as a requirement for employment.
Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization.
As a health system, we advocate for equity as we care for our patients, our communities, and each other.
From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do.
We invite those that share in our commitment to join our team.
If you are a qualified individual with a disability, you may request assistance in completing the application process by calling 616.486.7447.
We are committed to granting reasonable accommodations in accordance with applicable laws Show more details...
via Salary.com
schedule_type: Full-time and Part-time
People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of more than 60,000 dedicated people – including more than 11,500 physicians and advanced practice... providers and more than 15,000 nurses providing care and
People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of more than 60,000 dedicated people – including more than 11,500 physicians and advanced practice... providers and more than 15,000 nurses providing care and services in 22 hospitals, 300 outpatient locations and several post-acute facilities – and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.
GENERAL SUMMARY:
Under general direction, performs routine and occasionally more complex technical procedures and support functions in preparation of specimens for microscopic evaluation and reagents for the Histology Department. Organizes, prepares and accessions specimens for processing. Performs diener functions as required.
ESSENTIAL DUTIES:
1. Supports laboratory activities related to laboratory testing (such as specimen labeling, computer order entry, specimen processing, etc.) to ensure accurate result reporting and quick turnaround time.
2. Supports clerical functions (computer order entry, accessioning, etc) of the laboratory to ensure efficient operations.
3. Performs quality frozen sections according to established procedure, including properly stained, thin full sections in a timely manner.
4. Files blocks and slides in organized fashion to allow for quick retrieval. Performs functions related to off-site storage and retrieval of blocks and slides.
5. Changes reagents on, maintains and loads the tissue processors to allow for quality and timely tissue processing. Perform the reagent recycling duties in a timely and safe manner.
6. Assist with tissue disposal tasks as required. Assist with deiner duties related to autopsies as required.
7. Documents and completes all required logs, requisitions, charts, reports and special projects as assigned.
8. Contributes to the efficient operations of the laboratory.
9. Participates in professional development to maintain job performance skills and competencies. Maintains skill levels required for the department.
10. Demonstrates adherence to Compliance policies as related to job duties.
This document represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described.
STANDARD QUALIFICATIONS
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 accommodations may be made to enable individuals with disabilities to perform the essential duties.
A. Education / Training:
• High school graduate or equivalent required
B. Work Experience:
• Minimum 6 months laboratory experience or completion of an accredited clinical laboratory science training program.
C. Certification, Licensure, Registration:
• None
D. Other Qualifications:
• Problem solving ability, mathematical skills, able to coordinate technical and support operations computer knowledge, good communication skills, excellent organizational and interpersonal skills.
BENEFITS:
Corewell Health offers a comprehensive benefits package to meet your financial, health and life-work balance goals.
• NEW On-demand pay program – powered by Payactiv
• Generous paid time off, holidays and flexible scheduling
• Our employees receive special discounts on a wide range of products and services
• Exceptional health, dental, vision and prescription drug insurance plans
• Relocation assistance
• Generous retirement savings, disability insurance, identify theft protection and even home and auto insurance
• Free onsite parking at all campuses
This is where extraordinary begins. Find out where it can take you and your career. Apply Now!
Primary Location
SITE - Taylor Hospital - 10000 Telegraph - Taylor
Department Name
Lab - Anatomic Clinical Path - CH East - South - Taylor
Employment Type
Part time
Shift
Day (United States of America)
Weekly Scheduled Hours
20
Hours of Work
Variable
Days Worked
Variable
Weekend Frequency
N/A
CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members, patients, visitors and community. That is why we require a drug-free workplace and various vaccinations as a requirement for employment.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
If you are a qualified individual with a disability, you may request assistance in completing the application process by calling 616.486.7447. We are committed to granting reasonable accommodations in accordance with applicable laws Show more details...
GENERAL SUMMARY:
Under general direction, performs routine and occasionally more complex technical procedures and support functions in preparation of specimens for microscopic evaluation and reagents for the Histology Department. Organizes, prepares and accessions specimens for processing. Performs diener functions as required.
ESSENTIAL DUTIES:
1. Supports laboratory activities related to laboratory testing (such as specimen labeling, computer order entry, specimen processing, etc.) to ensure accurate result reporting and quick turnaround time.
2. Supports clerical functions (computer order entry, accessioning, etc) of the laboratory to ensure efficient operations.
3. Performs quality frozen sections according to established procedure, including properly stained, thin full sections in a timely manner.
4. Files blocks and slides in organized fashion to allow for quick retrieval. Performs functions related to off-site storage and retrieval of blocks and slides.
5. Changes reagents on, maintains and loads the tissue processors to allow for quality and timely tissue processing. Perform the reagent recycling duties in a timely and safe manner.
6. Assist with tissue disposal tasks as required. Assist with deiner duties related to autopsies as required.
7. Documents and completes all required logs, requisitions, charts, reports and special projects as assigned.
8. Contributes to the efficient operations of the laboratory.
9. Participates in professional development to maintain job performance skills and competencies. Maintains skill levels required for the department.
10. Demonstrates adherence to Compliance policies as related to job duties.
This document represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described.
STANDARD QUALIFICATIONS
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 accommodations may be made to enable individuals with disabilities to perform the essential duties.
A. Education / Training:
• High school graduate or equivalent required
B. Work Experience:
• Minimum 6 months laboratory experience or completion of an accredited clinical laboratory science training program.
C. Certification, Licensure, Registration:
• None
D. Other Qualifications:
• Problem solving ability, mathematical skills, able to coordinate technical and support operations computer knowledge, good communication skills, excellent organizational and interpersonal skills.
BENEFITS:
Corewell Health offers a comprehensive benefits package to meet your financial, health and life-work balance goals.
• NEW On-demand pay program – powered by Payactiv
• Generous paid time off, holidays and flexible scheduling
• Our employees receive special discounts on a wide range of products and services
• Exceptional health, dental, vision and prescription drug insurance plans
• Relocation assistance
• Generous retirement savings, disability insurance, identify theft protection and even home and auto insurance
• Free onsite parking at all campuses
This is where extraordinary begins. Find out where it can take you and your career. Apply Now!
Primary Location
SITE - Taylor Hospital - 10000 Telegraph - Taylor
Department Name
Lab - Anatomic Clinical Path - CH East - South - Taylor
Employment Type
Part time
Shift
Day (United States of America)
Weekly Scheduled Hours
20
Hours of Work
Variable
Days Worked
Variable
Weekend Frequency
N/A
CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members, patients, visitors and community. That is why we require a drug-free workplace and various vaccinations as a requirement for employment.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
If you are a qualified individual with a disability, you may request assistance in completing the application process by calling 616.486.7447. We are committed to granting reasonable accommodations in accordance with applicable laws Show more details...
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