Qureos Mentor

Presbyterian Healthcare Services

<div>Overview:
<div>
Presbyterian is seeking a <b>Medical Case Manager LMSW / LCSW </b>to intervene with patients who have complex discharge and psychosocial needs, require assistance with eligibility determination for social programs and funding sources and qualify for community assistance from a variety of special funds and agencies. In addition, offer crisis intervention to patients and families with psychosocial needs and coordinates and facilitates the development of a discharge plan of care for all patient populations. This role will receive referrals and consults for patients from at risk populations from interdisciplinary team members (including physicians, Case Managers, staff nurses and other members of the care team) in addition to case finding.</div><div></div><div><br>
Type of Opportunity: Full Time (1.0 FTE / 40 hours per week)<br>
Work Schedule: Monday - Friday 8 hour days</div><div></div><div><br>
 <b>How you grow, learn and thrive matters here.</b></div><ul><li>
Educational and career development options, including tuition and certification reimbursement, scholarship opportunities</li><li>
Shift differentials for nights and weekends</li><li>
Differentials for higher education, certifications and various lead roles</li><li>
Malpractice liability insurance</li><li>
Loan forgiveness through the New Mexico Higher Education Department</li><li>
EPIC electronic charting system</li></ul><br>
<div></div>
Qualifications:
<ul><li>Masters degree in Social Work required</li><li>
Current license from the State of New Mexico as a Licensed Independent Social Worker-LISW, Licensed Clinical Social worker-LCSW, or Licensed Medical Social Work-LMSW.</li><li>
License with one to two years hospital social work or discharge planning experience in relevant setting required.</li><li>
One to two years hospital social work experience, protective services, or practicum in acute care settings experience desired.</li><li>
National Case Management certification preferred</li></ul>
Responsibilities:
<ul><li>Based on referral, consultation or case finding assesses patients and familys psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope.</li><li>
May provide initial screening in the ED for crisis intervention and overcapacity situations.</li><li>
Intervenes with patients and families regarding emotional, social, and financial consequences of illness and/or disability; accesses and mobilizes family/community resources to meet identified needs: Provides appropriate crisis management to patients and families.</li><li>
Provides support and counseling to patients / families experiencing and/or anticipating issues to adjusting to illness, catastrophic diagnosis, changes in living situations and bereavement.</li><li>
Provides intervention in cases involving child abuse/neglect, domestic violence, elderly abuse, institutional abuse and sexual assault.</li><li>
Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the health care system.</li><li>
Participates and arranges discharge planning activities for patients, to ensure a timely discharge and to provide appropriate linkage with post-acute providers.</li><li>
Other duties as assigned.</li></ul>
Benefits:
<div><b>
We're all about well-being, starting with yours.
</b><br>
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.</div><div></div><div><br>
Learn more about our employee benefits.</div><div></div><div><b><br>
About Presbyterian Healthcare Services</b></div><div>
Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses.</div><div>
Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.</div><div></div><div><br>
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses</div><div></div><div><br>
#CC123</div>
Maximum Offer for this position is up to: USD $40.03/Hr. Compensation Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.</div>

Medical Case Manager LMSW / LCSW - Behavioral Health

<div>Overview:
<div>
Presbyterian is seeking a <b>Manager - Provider Network Operations.</b></div><div></div><div><br>
The person in this position will ensure the <b>integrity</b> of <b>provider service</b>, <b>contracting</b>, <b>development of new networks</b>. Build and maintain <b>strong relationships</b> with <b>providers</b> to foster <b>collaboration</b> and improve <b>communication</b>. Educates <b>providers</b> with current and new <b>protocols</b>, <b>policies</b>, <b>procedures</b>. Provides <b>leadership</b> to the <b>department staff</b> whose focus is <b>education</b>, <b>support</b>, <b>engagement</b>, <b>fostering relationships</b> while <b>recruiting providers</b>. Acts as a <b>key resource</b> in <b>mentoring</b> and <b>education of staff</b>. Responsible for identifying <b>issues</b>, resolving and coordinating resolution of <b>complex disputes</b> or <b>issues</b>. Contributes to the overall <b>optimization</b> of the <b>provider network</b>, ensuring adequate <b>access</b> and <b>coverage</b> for <b>members</b>.</div><div></div><div><br>
Will manage and coordinate <b>assignments</b> and <b>work productivity</b> of <b>supervised staff</b>. Provides <b>leadership</b> and <b>assistance</b> to <b>Supervisor</b>, <b>Trainer</b>, <b>Provider Executives</b>, <b>Provider Associates</b> of <b>Provider Network Operations</b>. Provides <b>direction</b> and <b>support</b> for ensuring successful execution of <b>contract compliance</b> with <b>Presbyterian Health Plan policy</b> as well as compliance with applicable <b>Medicare</b>, <b>Medicaid</b>, <b>third-party guidelines</b>. Executes <b>Presbyterian Health Plan&rsquo;s network development strategies</b> and <b>initiatives</b>.</div><ul><li>
This is a Full Time position - Exempt: Yes</li><li>
Job is based at Rev Hugh Cooper Admin Center</li><li>
Work hours: Days</li></ul><div><b>
The ideal candidate will have:</b></div><ul><li>
Strong leadership skills in coaching, mentoring, and conflict resolution, with 2+ years of management experience preferred</li><li>
Excellent communication &amp; relationship-building abilities with providers, staff, and stakeholders&mdash;plus regional travel required for provider engagement</li></ul><div><i>
Join a workplace where compassion meets purpose. Apply today!</i></div>
Qualifications:
<ul><li>Bachelors degree in business administration, or related health care field, 6 years of additional experience can be substituted in lieu of degree.</li><li>
Three years experience in provider relations, provider contracting, claims processing, correct coding, and customer service in a managed care organization.</li><li>
Four years of application specific experience.</li><li>
Two years management experience preferred.</li><li>
Requires effective coaching, counseling, and conflict management skills.</li><li>
Must be able to work collaboratively with other employees and the ability to multi-task.</li><li>
Demonstrated ability to sustain quality standards.</li><li>
Demonstrated ability to communicate in verbal and written form with peers, subordinates and the public, including physicians, physician office staff and staff.</li><li>
Ability to handle fluctuating workloads, conflicting priorities, and concurrent activities.</li><li>
Regional travel is required to meet with providers for purposes of recruitment, re-contracting, provider education, and/or attendance for any provider related functions.</li></ul>
Responsibilities:
<ul><li>Manages and oversees all aspects of Provider Network Operations as is necessary to accomplish:
<br>
a) Establishing and maintaining strong relationships with the provider community.
<br>
b) Ensuring access to quality health care for health plan beneficiaries.
<br>
c) Meeting enterprise goals of improving affordability and fiscal sustainability.
<br>
d)Meeting health plan standards regarding operational administration.</li><li>
Oversee the daily operations of a healthcare provider network, ensuring smooth and compliant operations.</li><li>
Facilitate positive relationships with providers, addressing their questions, concerns, and providing support.</li><li>
Resolves complex provider contracts and reimbursement issues. Research problems and negotiate with internal/external partners/customers to resolve highly complex and/or escalated and sensitive issues. Identifies necessity for additional escalation and communicates issues effectively to senior leadership.</li><li>
Oversee compliance, oversight, and reporting of monthly departmental key indicators.</li></ul>
Benefits:
<div><b>
About Presbyterian Healthcare Services
</b><br>
Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.</div><div><br>
The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift to earn gift cards and other incentives.</div><div><br>
As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships. Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.</div><div><i><br>
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.</i></div>
Maximum Offer for this position is up to: USD $52.95/Hr. Compensation Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.</div>

Manager - Provider Network Operations

<div>Overview:
<div>
Presbyterian is seeking a <b>Expert EPIC Configuration Analyst.</b></div><div></div><div><br>
This position is responsible for <b>in-depth knowledge</b> of assigned <b>Epic System software</b>. The role involves <b>regular day-to-day communication</b>, <b>software review</b>, and a <b>deeper understanding of business operations</b>. It includes collaboration with <b>Epic</b>, <b>Subject Matter Experts (SMEs)</b>, and <b>end users</b> to <b>tailor the system</b> to fit the <b>organization's needs</b>.</div><div>
This position routinely performs <b>in-depth analysis</b> of <b>workflows</b>, <b>data collection</b>, and other <b>technical issues</b> associated with the use of <b>Epic software</b>. Responsibilities include <b>design</b>, <b>build</b>, <b>testing</b>, and <b>maintenance</b> of those <b>solutions</b>.</div><ul><li>
This is a Full Time position - Exempt: Yes</li><li>
Job is based at Rev Hugh Cooper Admin Center</li><li>
Work hours: Days</li></ul><div><b>
Preferred Qualifications:</b></div><ul><li><b>
Epic Professional Billing Certified</b></li><li>
Experience with claims and charge router</li></ul><div>
Join <i>a wo</i><i>rkplace where compassion meets purpose. Apply today!</i></div>
Qualifications:
<ul><li>Bachelor's degree plus 3 years of IT or business experience.</li><li>
3 years of Epic specific experience.</li><li>
6 years' of additional experience can be substituted in lieu of degree.</li><li>
Epic certified in supporting application plus additional proficiency/certification/badges in related application area</li></ul>
Responsibilities:
<ul><li>Provide tier-2 support for Epic application incidents, including 24/7 on-call coverage as needed. Troubleshoot issues within and outside your application, resolve incidents, maintenance items, enhancement requests, upgrades, and projects. Advocate for customer needs and promote teamwork across teams.</li><li><div>
Modify Epic records, tables, and master files to support application design and changes. Develop and maintain requirements, specifications, and test cases for new or enhanced functionality. Ensure test scripts reflect workflow solutions and follow quality assurance processes including change management and testing.</div></li><li><div>
Demonstrate expert understanding of supported Epic applications and their integration with other systems. Analyze workflows, create new ones in collaboration with SMEs, and implement solutions that improve end-user productivity and effectiveness. Support training teams by communicating system changes and new functionality.</div></li><li><div>
Actively participate in team and cross-team meetings, facilitate discussions, and drive next steps. Mentor and guide other analysts, tailoring support to individual needs. Lead knowledge transfer efforts and serve as a go-to resource for team members and end users.</div></li><li><div>
Assist leadership in project scoping and timeline assessment. Create and deliver presentations to large cross-functional groups. Maintain strong communication and collaboration skills, identify and implement process improvements, and contribute to strategic planning and relationship-building with other Epic customers.</div></li></ul>
Benefits:
<div><b>
About Presbyterian Healthcare Services
</b><br>
Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.</div><div><br>
The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift to earn gift cards and other incentives.</div><div><br>
As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships. Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.</div><div><i><br>
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.</i></div>
Maximum Offer for this position is up to: USD $71.81/Hr. Compensation Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.</div>

Expert EPIC Configuration Analyst

<div>Overview:<div><br>
Under the direction of the Clinic Manager, works as a part of the leadership team to provide clinical and operational shift supervision of care processes which includes efficient patient flow, exceptional care experiences, quality processes, patient safety, effective communication and direction of clinical staff. Will provide direct patient care.<br>
</div><div><br>
Type of Opportunity: Part Time (.45 to .89)
<br>
FTE: 0.600000
<br>
Exempt: No
<br>
Work Schedule: 12 Hour Days</div><div></div><div><b><i><br>
How you belong matters here.</i></b></div><div>
At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. Our employees make a meaningful impact on the healthcare provided to our patients and members.</div><div><b><br>
Why Join Us</b></div><ul><li>
Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.</li><li>
PRN/PT (working less than a .45 FTE) employee benefits available for this position such as medical, gym memberships and an employee wellness program.</li></ul><div></div>
Qualifications:
<div>
Other information:<br>
Minimum ADN preparation with expectation of BSN completion within 5 years of hire Experience: Minimum Two years of nursing experience required Licensure: State of New Mexico or Compact State Nursing License required.
<br>
<br>
<ul><li>Additional Requirements
</li><li>Emergency Departments: ACLS, PALS
</li></ul><br>
Academic Preparation:
<br>
<ul><li>Degree from accredited academic nursing program (If a program is under conditional status, approval may be granted by system CNO)
</li><li>Minimum ADN preparation with expectation of BSN completion within 5 years of hire
</li></ul>Specialty Certifications: Specialty Certifications in area of practice preferred</div><div><br>
</div><div>Education:<br>
Essential:<br>
<ul><li>Associate Degree</li></ul></div><div></div><div><br>
Credentials:<br>
Essential:<br>
<ul><li>Registered Nurse-NM</li></ul></div>
Responsibilities:
<div>
Responsibilities:<br>
Summary of Major Duties:
<br>
<ul><li>Provides clinical and operational shift supervision of care processes which includes patient flow, exceptional care experiences, quality processes, patient safety, and direction of clinical staff. Plan, direct, and coordinate operational and personnel activities for assigned shift nurses in collaboration with Clinic Manager.
</li></ul>Expected to meet Key Performance Indicators (KPIs) identified by management<br>
<ul><li>Facilitate shift change huddles while incorporating continuous improvement methodologies, including documenting daily operational performance metrics for huddle evaluation and rapid action planning. Regularly communicate action plans with leadership for evaluation and approval.
</li><li>Implement and champion effective communication and teaming strategies to ensure an optimized model of care delivery that meets operational objectives.</li><li>Facilitate efficient patient flow and ensure ED tracking board is regularly monitored throughout shift. Perform quick team huddles if there is a need to redirect staff or reassign to improve flow.</li><li>Maintain clear and consistent communication with shift Providers
</li><li>Review and monitor shift staff assignments and/or make assignments for staff to ensure adequate shift staffing.</li><li>Report all shift nursing personnel behavioral issues to Clinic Manager</li><li>Ensure safe, timely, effective, efficient, equitable, and patient-centered care of all patients
</li><li>Perform previous days patient call backs &amp; address current patient complaints per shift</li><li>Perform all shift/daily regulatory checks, including narcotic counts with previous shift charge nurse</li><li>Ensure all rooms and crash carts are stocked and supplies ordered prior to start of shift</li><li>Ensure situational packet readiness per shift (staff injury, patient injury, death, etc.)
</li><li>Ensure all nursing shift logs are current and accurate</li><li>Maintain frequent communication with facility security</li><li>Other duties as assigned</li></ul></div>
Benefits:
<div><b>
We're all about well-being, starting with yours.</b><br>
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.</div><div>
Learn more about our employee benefits.</div><div><b><br>
About Presbyterian Healthcare Services</b></div><div>
Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses.</div><div>
Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.</div><div>
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.</div><br>
<div></div>
Maximum Offer for this position is up to: USD $54.00/Hr. Compensation Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.</div>

Charge Nurse-PresNow-ABQ - 24/7 ED/UC Isleta

<div>Overview:<div><br>
Under the direction of the Clinic Manager, works as a part of the leadership team to provide clinical and operational shift supervision of care processes which includes efficient patient flow, exceptional care experiences, quality processes, patient safety, effective communication and direction of clinical staff. Will provide direct patient care.<br>
</div><div><br>
Type of Opportunity: Full Time
<br>
FTE: 0.900000
<br>
Exempt: No
<br>
Work Schedule: 12 Hour Days</div><div></div><div><b><i><br>
How you belong matters here.</i></b></div><div>
At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. Our employees make a meaningful impact on the healthcare provided to our patients and members.</div><div><b><br>
Why Join Us</b></div><ul><li>
Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.</li><li>
PRN/PT (working less than a .45 FTE) employee benefits available for this position such as medical, gym memberships and an employee wellness program.</li></ul><div></div>
Qualifications:
<div>
Other information:<br>
Minimum ADN preparation with expectation of BSN completion within 5 years of hire Experience: Minimum Two years of nursing experience required Licensure: State of New Mexico or Compact State Nursing License required.
<br>
<br>
<ul><li>Additional Requirements
</li><li>Emergency Departments: ACLS, PALS
</li></ul><br>
Academic Preparation:
<br>
<ul><li>Degree from accredited academic nursing program (If a program is under conditional status, approval may be granted by system CNO)
</li><li>Minimum ADN preparation with expectation of BSN completion within 5 years of hire
</li></ul>Specialty Certifications: Specialty Certifications in area of practice preferred</div><div><br>
</div><div>Education:<br>
Essential:<br>
<ul><li>Associate Degree</li></ul></div><div></div><div><br>
Credentials:<br>
Essential:<br>
<ul><li>Registered Nurse-NM</li></ul></div>
Responsibilities:
<div>
Responsibilities:<br>
Summary of Major Duties:
<br>
<ul><li>Provides clinical and operational shift supervision of care processes which includes patient flow, exceptional care experiences, quality processes, patient safety, and direction of clinical staff. Plan, direct, and coordinate operational and personnel activities for assigned shift nurses in collaboration with Clinic Manager.
</li></ul>Expected to meet Key Performance Indicators (KPIs) identified by management<br>
<ul><li>Facilitate shift change huddles while incorporating continuous improvement methodologies, including documenting daily operational performance metrics for huddle evaluation and rapid action planning. Regularly communicate action plans with leadership for evaluation and approval.
</li><li>Implement and champion effective communication and teaming strategies to ensure an optimized model of care delivery that meets operational objectives.</li><li>Facilitate efficient patient flow and ensure ED tracking board is regularly monitored throughout shift. Perform quick team huddles if there is a need to redirect staff or reassign to improve flow.</li><li>Maintain clear and consistent communication with shift Providers
</li><li>Review and monitor shift staff assignments and/or make assignments for staff to ensure adequate shift staffing.</li><li>Report all shift nursing personnel behavioral issues to Clinic Manager</li><li>Ensure safe, timely, effective, efficient, equitable, and patient-centered care of all patients
</li><li>Perform previous days patient call backs &amp; address current patient complaints per shift</li><li>Perform all shift/daily regulatory checks, including narcotic counts with previous shift charge nurse</li><li>Ensure all rooms and crash carts are stocked and supplies ordered prior to start of shift</li><li>Ensure situational packet readiness per shift (staff injury, patient injury, death, etc.)
</li><li>Ensure all nursing shift logs are current and accurate</li><li>Maintain frequent communication with facility security</li><li>Other duties as assigned</li></ul></div>
Benefits:
<div><b>
We're all about well-being, starting with yours.</b><br>
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.</div><div>
Learn more about our employee benefits.</div><div><b><br>
About Presbyterian Healthcare Services</b></div><div>
Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses.</div><div>
Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.</div><div>
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.</div><br>
<div></div>
Maximum Offer for this position is up to: USD $54.00/Hr. Compensation Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.</div>

Charge Nurse-PresNow-ABQ - 24/7 ED/UC Paseo