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director, patient financial services Jobs in Norfolk

director, patient financial services

financial operations analyst lead Jobs in Norfolk

financial operations analyst lead

director patient financial services

Children's Hospital of the King's Daughters

<div><div><div><div><ul><li><div><div><b>GENERAL SUMMARY</b></div>
<ul><li><div><div>The Director of Patient Financial Services is responsible for overseeing the daily operations in key Revenue Cycle, Patient Access, and assigned physician billing areas, including the management and supervisory positions within the respective areas (including but not limited to registration, pre-registration, insurance verification, cash collections, and eligibility) in Patient Access as well as billing, follow-up and collection activities, credit resolution and customer service in Revenue Cycle. A high level of independence in performance of the role and/or solution of problems is expected, however, demonstrated cooperation and collaboration is equally essential for successful functioning. Reports to a member of senior leadership.</div>
</div></li></ul></div></li><li><div><div><b>ESSENTIAL DUTIES AND RESPONSIBILITIES</b></div>
<ul><li><div>Provides leadership for the central business office, access areas including inpatient admitting and surgery, emergency department, urgent and minor care, offsite ambulatory centers and other decentralized registration areas.
</div></li><li><div>Accountable for teams providing outstanding customer service to external and internal customers.
</div></li><li><div>Provides oversight to ensure responsible areas are at best practice standards for key performance metrics and provides (or develops where necessary) monthly statistical and financial key performance metric report cards.
</div></li><li><div>Ensures collaboration with all staff members with varied backgrounds to form a cohesive, unified team and promote the professional growth of team members through mentoring and in-services.
</div></li><li><div>Ensures the courteous, customer-centered, prompt, and accurate registration and admission of patients to various areas within the health system.
</div></li><li><div>Works closely with ancillary departments, and physician clinics to ensure all responsibilities are met in a collaborative team manner.
</div></li><li><div>Develops and consistently meets key performance indicators that include pre-collections, pre-registration, insurance verification, denials and registration accuracy.
</div></li><li><div>Monitors productivity and quality of work performed by all staff.
</div></li><li><div>Identifies and implements measurable staffing changes to increase departmental productivity.
</div></li><li><div>Responsible for employee satisfaction and staff retention through practices that promote communication, rewards/recognition, teamwork and administration of effective employee relations practices.
</div></li><li><div>Analyzes, communicates and implements government and payer reimbursement and other regulatory changes to ensure continued compliance.
</div></li><li><div>Serves as the department liaison to ensure customer needs are being addressed at all locations.
</div></li><li><div>Effectively communicates upstream and downstream throughout the organization.</div>
</li><li><div>Independently carries out and is accountable for daily operations and other activities as assigned.</div>
</li><li><div>Leads, manages, coaches, and trains a team or department, provides guidance, support, and mentors to ensure optimal performance and productivity.</div>
</li><li><div>Oversees the recruitment, hiring, team/department orientation, performance appraisals and disciplinary actions including up to termination processes for a team or department.</div>
</li></ul></div></li><li><div><div><b>LICENSES AND/OR CERTIFICATIONS</b></div>
<ul><li><div>None</div>
</li></ul></div></li><li><div><div><b>MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS</b></div>
<ul><li><div>Bachelor&rsquo;s degree in business administration, accounting, healthcare administration, finance or other related degree. Master&rsquo;s degree preferred.</div>
</li><li><div>Requires approximately seven to ten years progressively more responsible related work experience, five to seven of which were in a management role.
</div></li><li><div>Thorough knowledge of hospital revenue cycle, registration and admitting processes/procedures, a broad working knowledge of managed care and insurance requirements and a vision to constantly challenge and improve the core processes while ensuring that the organization, patient and clinical needs are not only being met, but exceeded.
</div></li><li><div>Must possess a strong working knowledge of continuous process improvements and customer service improvements.
</div></li><li><div>Demonstrates expertise in end-to-end revenue cycle management; experience preferred performing or managing projects in business office, denials management, healthcare billing and compliance.</div>
</li><li><div>Experience inpatient accounting processes, charge capture integrity, healthcare billing practices and collection practices are essential.
</div></li><li><div>Demonstrates knowledge of third-party and insurance company access requirements, operating procedures, regulations and billing requirements and government reimbursement programs.</div>
</li><li><div>Extensive knowledge of Medicare, Medicaid, Insurance and Program eligibility required.
</div></li><li><div>Previous experience with computerized patient access systems required.
</div></li><li><div>EPIC systems experience preferred.
</div></li><li><div>Proficiency in MS Office required.
</div></li><li><div>Ability to function independently and as a team member in a fast-paced environment required.
</div></li><li><div>Strong communication (written and verbal), interpersonal and collaboration skills a must.
</div></li><li><div>Ability to interact effectively with a variety of people within and outside the organization.
</div></li><li><div>Must be detail-oriented and organized, with good analytical and problem solving ability.
</div></li><li><div>Must possess a valid Virginia driver&rsquo;s license and be able to meet the insurance requirements of the hospital, if required by position.</div>
</li></ul></div></li><li><div><div><b>WORKING CONDITIONS</b></div>
<ul><li><div><div>Normal office environment with little exposure to excessive noise, dust, temperature and the like.</div>
</div></li></ul></div></li><li><div><div><b>PHYSICAL REQUIREMENTS</b></div>
<ul><li><div><div>Click here to view physical requirements.</div>
</div></li></ul></div></li></ul></div></div></div><br>
Location: Childrens Hospital of The Kings Daughters &middot; Patient Financial Services PFS<br>
Schedule: Full-Time, Days</div>

Director, Patient Financial Services

<div><div><div><div><div><div><ul><li><div><div><b>GENERAL SUMMARY</b></div>
<ul><li><div><div>The Respiratory Care Clinical Practice Manager is responsible for developing processes to assure evidence based clinical outcomes and patient safety initiatives. The manager is responsible for the daily planning, work scheduling and coordination of education, and operational performance. Retains 24-hour responsibility, but may utilize supervisory staff to operationalize activities. The manager is expected to independently carry out assigned responsibilities but seeks guidance from the director and/or upper management given unusual or unanticipated circumstances that require deviation of policy/practice or allocation of funds to resolve. Reports to the Director or Respiratory Care.</div>
</div></li></ul></div></li><li><div><div><b>ESSENTIAL DUTIES AND RESPONSIBILITIES</b></div>
<ul><li><div>Develops strategies for frontline patient safety engagement and accountability.
</div></li><li><div>Facilitates a safe environment and just culture of patient safety through the development and management of activities that reduce the risk of injury to patients, visitors, and stakeholders and promotes reporting of events.</div>
</li><li><div>Leads efforts associated with new knowledge and innovation including interdisciplinary quality initiatives (unit specific quality improvement projects, Patient Satisfaction, and Culture of Safety surveys), evidence based practice projects and clinical research.</div>
</li><li><div>Performs other duties as assigned.
</div></li></ul></div></li><li><div><div><b>LICENSES AND/OR CERTIFICATIONS</b></div>
<ul><li><div>Current registration as a Registered Respiratory Therapist from the National Board of Respiratory Care. NPS certification required. Must maintain licensure in the Commonwealth of Virginia as a Respiratory Care Practitioner.</div>
</li></ul></div></li><li><div><div><b>MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS</b></div>
<ul><li><div>Bachelor&rsquo;s degree required.
</div></li><li><div>Minimum of three to five years&rsquo; experience in pediatric Respiratory Care required.
</div></li><li><div>One to three years&rsquo; management level experience preferred.
</div></li><li><div>Demonstrated excellent leadership and communication skills, with the ability to plan, develop, coordinate and maintain a professional work environment.
</div></li><li><div>Must have interpersonal skills to communicate detailed clinical observations and evaluations with other members of the healthcare team.
</div></li><li><div>Must have analytical skills necessary to assess and prioritize care based on assessments.
</div></li><li><div>Besides managerial activities, must possess the ability to identify problems and implement solutions for operational and organizational issues.
</div></li><li><div>Interpersonal skills necessary in order to direct and assign work to subordinates, explain hospital and department policies and procedures and communicate effectively with other professionals.
</div></li><li><div>CPR Training, PALS, and Neonatal Resuscitation Provider (NRP) designation required and/or must be obtained within 45 days of hire.</div>
</li></ul></div></li><li><div><div><b>WORKING CONDITIONS</b></div>
<ul><li><div><div>Normal office environment with little exposure to excessive noise, dust, temperature and the like</div>
</div></li></ul></div></li><li><div><div><b>PHYSICAL REQUIREMENTS</b></div>
<ul><li><div><div>Click here to view physical requirements.</div>
</div></li></ul></div></li></ul></div></div></div></div></div><br>
Location: Childrens Hospital of The Kings Daughters &middot; Respiratory Care<br>
Schedule: Full-Time, Days/Nights</div>

Clinical Practice Manager, Respiratory Care

PRIMEPLUS SENIOR CENTER

<p>Primeplus Senior Center is a dedicated nonprofit organization serving seniors aged 50 and above in the local community. With over fifty years of experience, we offer a variety of programs and services designed to support the social, emotional, physical, intellectual, and economic well-being of our members.</p><p><b>OBJECTIVE:</b></p><p>The Part-Time Fiscal Analyst provides analytical, financial, and operational support across multiple departments, with a strong focus on revenue maximization, business management, and operational efficiency. This role increases organizational capacity by supporting accounting functions, Senior Center operations, Adult Day Services (ADS), and emerging initiatives. This position reports directly to the Executive Director and Business Analyst.</p><p><b>ESSENTIAL JOB DUTIES:</b></p><ul><li>Support payroll administration, accounts receivable, audits, and fiscal year-end closeout</li><li>Assist with annual budget process, month-end reconciliation, and financial reporting</li><li>Perform basic fiscal and operational analysis</li><li>Serve as a functional counterpart between Salesforce and QuickBooks</li><li>Provide business management and operational support</li><li>Assist with revenue optimization and data-driven decision-making</li><li>Support special projects as assigned</li><li>Prepare and process Accounts Receivables</li><li>Reconcile credit card transactions</li><li>Record and track payments</li><li>Generate and distribute Salesforce revenue reports</li><li>Support new ideas, business development efforts, marketing initiatives and cross-departmental projects</li><li>Meet with Directors and admission staff on a regular basis to ascertain current referrals and admissions status; aid in converting inquiries into actual admissions.</li><li>Assess and provide feedback on areas that can be improved in the referral to admission process.</li><li>Identify current and potential opportunities for the Center to expand its services to meet emerging needs and increase utilization.</li><li>Assist the Director in resolving issues that may impede admission or lead to premature discharges.</li><li>Provides input for the development of collateral materials as needed, including brochures, informational folders, and other media for referral sources.</li><li>Monitors and resolves computer system issues when applicable</li></ul><p><b>EDUCATION AND EXPERIENCE</b></p><ul><li>Bachelor&rsquo;s Degree Required</li><li>Experience in business analysis, fiscal analysis, accounting, or operations</li><li>Strong analytical, organizational, and problem-solving skills</li><li>Experience with or ability to learn <b>Salesforce and QuickBooks</b></li><li>Ability to manage multiple priorities and work collaboratively</li><li>Effective communication skills, both written and verbal</li><li>Commitment to excellence and the mission of Primeplus</li></ul><p><b>KNOWLEDGE</b></p><ul><li>Excellent verbal and written communications skills, including the ability to effectively communicate and make presentations to a wide variety of audiences.</li><li>Requires excellent record-keeping skills including maintenance of confidentiality of files.</li></ul><p><b>ABILITIES</b></p><ul><li>Results driven: Sees the big picture, assists with the development and monitoring of key performance metrics to produce the desired results.</li><li>Strong business acumen: Sees opportunities and emerging trends, and is knowledgeable about the operations, unique needs, and goals specific to member-driven, not-for-profit organizations.</li><li>Organizational agility: Has a thoughtful, respectful communication style that fosters an open environment, enabling thought-provoking discussions and collaborative decision making.</li><li>Perceptive: Is creative and intuitively recognizes opportunities and takes appropriate action.</li><li>This is a part-time, weekday position offering paid annual, sick, and holiday leave. After the first three months, there is potential to transition to a hybrid work schedule. The role presents an opportunity to attract early-career talent and enhance generational diversity within the organization.</li></ul><p>---Equal Opportunity Employer---</p><p>Primeplus Senior Center reserves the right to revise or change job duties and responsibilities as the need arises. This position description does not constitute a written or implied contract of employment.</p><p>Job Type: Part-time</p><p>Pay: $17.00 - $19.00 per hour</p><p>Benefits:</p><ul><li>Flexible schedule</li><li>Paid time off</li></ul><p>Work Location: In person</p>

Fiscal Analyst - Part Time

<div><p><b>ADP is hiring a Director, Global Sanctions &amp; Export Controls.
</b></p><ul><li><i>Are you a sanctions and export controls expert with a track record of building robust, globally scalable compliance frameworks within a financial services, fintech, payments, or SaaS environment?</i></li>
<li><i>Are you looking to join a dynamic, inclusive team environment with a culture of collaboration and belonging?</i></li>
</ul><p>Well, this may be the role for you.</p>
<p>As Director, Global Sanctions &amp; Export Controls, within ADP&rsquo;s Global Financial Crimes Compliance (FCC) function, you will be responsible for enhancing and maintaining an innovative and sustainable global sanctions and export controls compliance program. Reporting to the Senior Director, AML, Sanctions &amp; Export Controls, you will provide subject matter expertise and collaborate with Compliance leaders, Legal, Operations, and Business stakeholders across ADP products and functions to develop and maintain a framework of internal controls.
</p><p>In addition to providing enterprise-wide guidance and compliance program oversight, your responsibilities will include governance, risk and control assessments, policies and procedures, analysis of key risk metrics and indicators, escalations, oversight of monitoring tools, reporting, and training development. You will ensure effective compliance with applicable sanctions and export control laws and regulations including U.S. Office of Foreign Assets Control (OFAC) sanctions programs and lists, Bureau of Industry and Security (BIS) regulations, the UK Sanctions List, Canada Special Economic Measures Act (SEMA) sanctions, EU, China, and Australia sanctions.</p>
<p>Like what you see? <b>Apply now!</b></p>
<p><b>Learn more about ADP at jobs.adp.com</b></p>
<p><b>What you&rsquo;ll do:</b></p>
<p><b>Here&rsquo;s what you can expect on a typical day:
</b></p><ul><li>Oversee ADP&rsquo;s global sanctions and export controls compliance program and provide subject matter expertise on global sanctions requirements, regulatory expectations, and industry practices
</li><li>Continually assess the risks associated with a complex portfolio of clients and products across ADP entities and jurisdictions</li>
<li>Monitor updates to regulatory requirements, laws, and industry practices to ensure the compliance program incorporates evolving requirements and expectations</li>
<li>Drive consistency in global compliance initiatives and collaborate with AML Officers to identify local requirements</li>
<li>Oversee implementation and execution of key compliance controls</li>
<li>Partner with internal legal stakeholders and external counsel
</li><li>Act as a liaison with regulators and internal audit regarding sanctions matters</li>
<li>Serve as an escalation point by providing guidance on high-priority investigations and regulatory reporting, including SARs and VSDs</li>
<li>Analyze key risk metrics and track necessary KPIs/KRIs to support strategic initiatives</li>
<li>In coordination with the Senior Director, AML, Sanctions &amp; Export Controls, prepare periodic reports for senior management and the Audit Committee of the Board of Directors regarding sanctions and export controls program compliance</li>
<li>Collaborate with operations teams to ensure controls are implemented and operationalized in accordance with policies and procedures</li>
<li>Advise on sanctions screening methodologies, tuning and logic, list management, vendors, and tools</li>
<li>Partner with technology, development, and analytics teams to identify compliance solutions and efficiencies, advise on system requirements, and provide guidance as solutions are implemented</li>
<li>Identify sanctions and export controls AI use cases, collaborate with various stakeholders on AI pilots, and participate in AI-related trainings</li>
<li>Provide sanctions subject matter expertise in product development and acquisitions</li>
<li>Develop and oversee enterprise-wide general training and targeted trainings, including identifying training needs and opportunities</li>
</ul><p><b>Experience. </b>You have 10+ years of experience in relevant skills gained and developed in the same or similar role.</p>
<p><b>TO SUCCEED IN THIS ROLE:
</b></p><ul><li>Demonstrated experience building and leading end-to-end, risk-based sanctions and export controls compliance programs, including policy and procedure development, risk assessment, operational processes, and ongoing program monitoring within a global organization</li>
<li>Enterprise-level experience in financial services, fintech, payments, or SaaS where risk centers on software, services, and money movement rather than physical goods or supply chain</li>
<li>OFAC sanctions expertise, including SDN list screening and OFAC licensing processes</li>
<li>Multi-jurisdictional sanctions knowledge including OFAC, UK, EU, China, Australia, and Canada</li>
<li>Experience defining and translating compliance requirements for sanctions screening tools and automated compliance technology, effectively communicating those requirements to system owners and technology teams, and working collaboratively with them to configure, maintain, and update those tools as requirements evolve.</li>
<li>Adept at managing sanctions and AML list management vendors, including evaluating vendor data quality, ensuring delivered information meets business screening requirements, and identifying and resolving downstream operational impacts of vendor processes</li>
<li>Proven track record of building KPI and KRI frameworks to monitor compliance program performance, identify emerging risks, and inform data-driven decision-making</li>
<li>Experience interacting with legal counsel, law enforcement, regulators (including OFAC, FinCEN, BIS), and examiners on sanctions/export controls issues</li>
<li>Experience leading and influencing cross-functional stakeholders including Legal, Product, Technology, and Finance to drive compliance outcomes across functions, levels, and jurisdictions</li>
<li>Demonstrated ability to translate regulatory risk into business language for senior leaders, with excellent written and verbal communication skills</li>
<li>Strong presentation skills with the ability to develop and deliver clear, compelling materials for diverse audiences, including senior leadership and external stakeholders, with demonstrated proficiency in PowerPoint and Excel</li>
<li>You&rsquo;ll have a bachelor&rsquo;s degree or equivalent</li>
</ul><p>For additional comfortability in the role:</p>
<ul><li>Master&rsquo;s degree or Juris Doctor</li>
<li>BIS/Export Administration Regulations (EAR) experience</li>
<li>Familiarity with AML/CFT frameworks including BSA and FinCEN requirements</li>
<li>CAMS or CGSS certifications</li>
</ul><p><b>YOU'LL LOVE WORKING HERE BECAUSE YOU CAN:</b></p>
<ul><li><b>Have courageous team collaboration.</b> Courage comes from how associates are willing to have difficult conversations, speak up, be an owner, and challenge one another's ideas to net out the best solution.</li>
<li><b>Deliver at epic scale.</b> We deliver real user outcomes using strong judgment and good instincts. We're obsessed with the art of achieving simplicity with a focus on client happiness and productivity.</li>
<li><b>Be surrounded by curious learners.</b> We align ourselves with other smart people in an environment where we grow and elevate one another to the next level. We encourage our associates to listen, stay agile, and learn from mistakes.</li>
<li><b>Act like an owner &amp; doer.</b> Mission-driven and committed to leading change, you will be encouraged to take on any challenge and solve complex problems. No tasks are beneath or too great for us. We are hands-on and willing to master our craft.</li>
<li><b>Give back to others. </b>Always do the right thing for our clients and our community and humbly give back to the community where we live and work. Support our associates in times of need through ADP's Philanthropic Foundation.</li>
<li><b>Join a company committed to equality and equity. </b>Our goal is to impact lasting change through our actions.</li>
</ul><p>What are you waiting for? <b>Apply today!</b></p>
<p>Find out why people come to ADP and why they stay: https://youtu.be/ODb8lxBrxrY</p>
<p>(ADA version: https://youtu.be/IQjUCA8SOoA )</p>
<p></p><p>#LI-JR3</p>
<p>#LI-HYBRID</p><p></p>
<div>Base salary offers for this position may vary based on factors such as location, skills, and relevant experience. Some positions may include additional compensation in the form of bonus, equity or commissions. We offer the following benefits: Medical, Dental, Vision, Life Insurance, Matched Retirement Savings, Wellness Program, Short-and Long-Term Disability, Charitable Contribution Match, Holidays, Personal Days &amp; Vacation, Paid Volunteer Time Off, and more. The compensation for this role is $0.00 - $0.00 / Year*<br>
<br>
<ul><li>Actual compensation will not be less than the applicable minimum wage or minimum exempt salary requirement under federal, state and local laws.</li></ul><br>
</div><p><b>A little about ADP:</b> We are a comprehensive global provider of cloud-based human capital management (HCM) solutions that unite HR, payroll, talent, time, tax and benefits administration and a leader in business outsourcing services, analytics, and compliance expertise. We believe our people make all the difference in cultivating a down-to-earth culture that embraces our core values, welcomes ideas, encourages innovation, and values belonging. We've received recognition for our work by many esteemed organizations, learn more at ADP Awards and Recognition.</p>
<p><b>Diversity, Equity, Inclusion &amp; Equal Employment Opportunity at ADP:</b> ADP is committed to an inclusive, diverse and equitable workplace, and is further committed to providing equal employment opportunities regardless of any protected characteristic including: race, color, genetic information, creed, national origin, religion, sex, affectional or sexual orientation, gender identity or expression, lawful alien status, ancestry, age, marital status, protected veteran status or disability. Hiring decisions are based upon ADP&rsquo;s operating needs, and applicant merit including, but not limited to, qualifications, experience, ability, availability, cooperation, and job performance.</p>
<p><b>Ethics at ADP:</b> ADP has a long, proud history of conducting business with the highest ethical standards and full compliance with all applicable laws. We also expect our people to uphold our values with the highest level of integrity and behave in a manner that fosters an honest and respectful workplace. Click https://jobs.adp.com/life-at-adp/ to learn more about ADP&rsquo;s culture and our full set of values.</p></div>

Director, Global Sanctions & Export Controls

Concentra

<div>Overview:
<div>
Are you ready to take your career to new heights? At Concentra, you will be a vital member of our patient care team and play a crucial role in providing exceptional care to our patients. Our mission is to improve the health of America's workforce, one patient at a time. Join us at Concentra and see how your clinical competency and compassion can make a meaningful difference in the lives of the patients you serve.</div><div></div><div><br>
As a Nurse Practitioner, you initiate, develop and implement nursing care plans in accordance with state laws and concurrent with Concentra medical protocols in accordance with Concentra policies, practices and procedures and applicable.</div>
Responsibilities:
<ul><li>Administers prescribed medications and treatments in accordance with approved nursing techniques and protocols.</li><li>
Observes and evaluates patient, records condition and reaction to drugs, treatments, and significant incidents</li><li>
Evaluates outcome of patient care</li><li>
Performs physical examinations and preventive health measures within prescribed guidelines and instructions of physician.</li><li>
May direct nursing care through nursing staff</li><li>
Prescribes or recommends drugs or other forms of treatment such as physical therapy, inhalation therapy or related therapeutic procedures.</li><li>
Arranges referrals, consultations, therapeutic services and confers with other specialists on course of care and treatment.</li><li>
Draws blood and prepares appropriate paperwork for laboratory pick-up.</li><li>
Performs urine drug screens, using proper chain of custody; ensures preparation for pick-up and shipment to appropriate laboratory.</li><li>
Assists in medical record maintenance by keeping health, administrative, and program records onsite, safeguarding confidentiality of employee health information.</li><li>
Dispenses medications as directed by practitioner and in accordance with state regulations.</li><li>
Maintains and operates all clinical equipment, including calibration and record keeping in accordance with current policy and procedures.</li><li>
Performs ancillary testing and tasks as ordered by the Center Medical Director (PFT, EKG, injections, audiograms, blood draws) in accordance with established policies and procedures</li><li>
Provides excellent customer service to all patients, clients and peers while incorporating Orange Book values.</li><li>
Dedicated to exceeding customer and patient expectations as measured by NPER/NPS/TATs.</li><li>
Ensures accuracy when completing and executing tasks such as drug screens, DOTs, bandaging, dressings and performing quality assurance checks.</li><li>
Ensures accurate, concise, timely and complete documentation of results and paperwork.</li><li>
Provides an excellent, compassionate and warm patient experience regardless of patient volume.</li><li>
Ability to manage time, prioritize and multi-task in a busy environment</li><li>
Ability to adapt to changing business needs such as scheduling and working additional/different hours/shifts when appropriate.</li><li>
Ability to consistently deliver quality care in a busy clinical environment.</li><li>
Takes action to assist in other areas and to do what is needed to ensure an excellent patient experience.</li><li>
Seeks out opportunities for additional clinical training and self-development in order to consistently provide quality care.</li><li>
Effectively communicates with all patients, clients, supervisors and peers while incorporating Orange Book values.</li><li>
Listens to and understands internal and external client needs in order to act and address</li><li>
Committed to personal excellence and understands how daily work contributes to center operation as a whole.</li><li>
Holds self and others accountable. Is willing and able to assist others in order to achieve results.</li></ul><div>
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.</div>
Qualifications:
<ul><li>Bachelors&rsquo; degree in Nursing or related health field from an accredited college or university</li><li>
Master&rsquo;s Degree in nursing or related health field from an accredited college or university</li><li>
Graduate of an accredited Nurse Practitioner program</li><li>
Current licensed nurse practitioner in the state where employed and in accordance with state laws of practice</li><li>
Must maintain work state nurse practitioner licensure throughout the course of employment</li><li>
Customarily has at least two years of demonstrated experience in occupational medicine, urgent care or an emergency setting</li></ul><div>
Job-Related Skills/Competencies</div><ul><li>
Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility</li><li>
Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions</li><li>
Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism</li><li>
The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies</li><li>
Demonstrated knowledge of occupational medicine requirements (state specific)</li><li>
Demonstrated working knowledge of clinical operations</li><li>
Knowledge of laws and regulations that govern delivery of rehabilitation services</li><li>
Knowledge of worker&rsquo;s compensation and clinical procedures and all processes involved in the delivery of quality care.</li><li>
Demonstrated excellent communication skills</li><li>
Demonstrated willingness to participate in Continuing Medical Education</li></ul>
Additional Data:
<ul><li>401(k) Retirement Plan with Employer Match</li><li>
Colleague Referral Bonus Program</li><li>
Employee Discounts</li></ul><div>
This job requires access to confidential and critical information, requiring ongoing discretion and secure information management.</div><div><br>
We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation</div><div></div><div><br>
Concentra is an equal opportunity employer that prohibits discrimination, and will make decisions regarding employment opportunities, including hiring, promotion and advancement, without regard to the following characteristics: race, color, national origin, religious beliefs, sex (including pregnancy), age, disability, sexual orientation, gender identity, citizenship status, military status, marital status, genetic information, or any other basis protected by federal, state or local fair employment practice laws.</div></div><div></div>

Physician Assistant or Nurse Practitioner PRN

Elevance Health

<div>
 <strong>
  Nurse Appeals- Licensed Nurse
  <br/>
  <br/>
 </strong>
 <strong>
  Location:
 </strong>
 Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
 <br/>
 <br/>
 Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
 <br/>
 <br/>
 <strong>
  Hours
 </strong>
 : The work schedule for this position is Tuesday through Saturday with Sunday rotation. Business hours are 8 am to 8 pm EST, and the selected candidate must be able to work an 8-hour shift between those hours, including holidays on a rotational basis.
 <br/>
 <br/>
 The
 <strong>
  Nurse Appeals
 </strong>
 is responsible for investigating and processing and medical necessity appeals requests from members and providers.
 <br/>
 <br/>
 <strong>
  How You Will Make An Impact
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Conducts investigations and reviews of member and provider medical necessity appeals.
  </li>
  <li>
   Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity.
  </li>
  <li>
   Extrapolates and summarizes medical information for medical director, consultants and other external review.
  </li>
  <li>
   Prepares recommendations to either uphold or deny appeal and forwards to Medical Director for approval.
  </li>
  <li>
   Ensures that appeals and grievances are resolved timely to meet regulatory timeframes.
  </li>
  <li>
   Documents and logs appeal/grievance information on relevant tracking systems and mainframe systems.
  </li>
  <li>
   Generates written correspondence to providers, members, and regulatory entities.
  </li>
  <li>
   Utilizes leadership skills and serves as a subject matter expert for appeals/grievances/quality of care issues and is a resource for clinical and non clinical team members in expediting the resolution of outstanding issues.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Minimum Requirements
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Requires a HS diploma or equivalent and a minimum of 2 years of experience in a managed care healthcare setting; or any combination of education and experience, which would provide an equivalent background. Current active unrestricted RN license to practice as a health professional within the scope of licensure in applicable state(s) or territory of the United States required.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred Skills, Capabilities And Experiences
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   AS or BS in Nursing preferred.
  </li>
  <li>
   Three to five years of clinical experience as a Registered Nurse strongly preferred.
  </li>
  <li>
   Have a current active unrestricted RN license to practice nursing within the scope of licensure in applicable state(s) or territory of the United States strongly preferred.
  </li>
  <li>
   Have two years in a managed care healthcare setting - reviewing medical records, investigation, and/or processing appeals within a managed care setting; or any combination of education and experience, which would provide an equivalent background strongly preferred.
  </li>
  <li>
   Experienced researching Medicare clinical guidelines: NCD, LCD; Medicare Benefit Policy and Milliman Care Guidelines is preferred.
  </li>
  <li>
   Experience reviewing claims and researching CPT codes or ICD-9 codes is preferred.
  </li>
  <li>
   Experience with Facets, Macess, and ACMP is preferred.
   <br/>
   <br/>
  </li>
 </ul>
 For candidates working in person or virtually in the below locations, the salary* range for this specific position is $72,492 to $108,738
 <br/>
 <br/>
 <strong>
  Locations: Latham, New York
  <br/>
  <br/>
 </strong>
 In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
 <br/>
 <br/>
 <ul>
  <li>
   The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company&rsquo;s sole discretion, consistent with the law.
   <br/>
   <br/>
  </li>
 </ul>
 Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
 <br/>
 <br/>
 Who We Are
 <br/>
 <br/>
 Elevance Health is a health company dedicated to improving lives and communities &ndash; and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
 <br/>
 <br/>
 How We Work
 <br/>
 <br/>
 At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
 <br/>
 <br/>
 We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
 <br/>
 <br/>
 Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
 <br/>
 <br/>
 The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
 <br/>
 <br/>
 Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
 <br/>
 <br/>
 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
</div>


Nurse Appeals

Spektrum

<div><div><p>Spektrum have a wide range of exciting opportunities in several global locations.</p>
<p>
We are always looking to add great new talent to our team and look forward to hearing from you.</p></div><p>
Spektrum supports apex purchasers (NATO, UN, EU and National Government and Defence) and their Tier 1 supplier ecosystem with a wide range of specialist services. We provide our clients with professional services, specialised aerospace and defence sales, delivery, and operational subject matter expertise. We are looking for personnel to join our team and support key client projects.</p>
<p></p>
<p><b>Who we are supporting</b></p>
<p><b>
Allied Command Transformation (ACT) </b>is NATO's leading agent for change: driving, facilitating, and advocating the continuous improvement of Alliance capabilities to maintain and enhance the military relevance and effectiveness of the Alliance. The main objectives of ACT are: providing appropriate support to NATO missions and operations; leading NATO military transformation; and improving relationships, interaction and practical cooperation with partners, nations and international organisations. ACT therefore leads Alliance concept development, capability development, training and lessons-learned initiatives and provides unfettered military support to policy development within NATO.</p>
<p></p>
<p><b>The program</b></p>
<p><b>
Capability Development &amp; Management Support (CDMS)
</b></p><p><b>DCOS Capability Development (CAPDEV) </b>acts as the Supreme Allied Commander Transformation's Director for guidance, direction and coordination of the activities and resources of the Capability Development Directorate.</p>
<p><b>
The Requirements Division</b> will execute all tasks and activities needed to support requirements management for NATO capabilities</p>
<p><b>
The Capability Requirements (CR)</b> Branch will develop the Capability Requirements Brief and recommended courses of action to resolve issues through the life cycle management of requirements using matrixed, cross-functional project-specific Requirements Management teams.</p>
<p><b>
The Requirements Forward Branch (Mons)</b> is responsible for conducting requirements development and management representation and engagement-related functions in Europe.</p>
<p><b>
The Capability Division</b> coordinates the development of capabilities from capability planning through acceptance and then disposal with management entities, NATO Headquarters staff and the NATO Governance Structure</p>
<p><b>
The Capability Forward Branch (Mons)</b> coordinates with ACO, NCIA, NSPA, NATO HQ, territorial Host Nations, and NATO Centres of Excellence (COEs) to support the development of capabilities.</p>
<p><b>
Strategic Plans and Policy (SPP)</b> supports Allied Command Transformation in formalizing military advice to shape future military strategy, political guidance, and other policy documents supporting NATO's strategic objectives.</p>
<p></p>
<p><b>Role ID: ACT-CDMS-26-02-B-22</b></p>
<p><b>
Role Duties and Responsibilities
</b></p><ul><li>Conducts compliance and integrity audits, inspections, reviews, and audit tests in accordance with international auditing standards, and ACT audit policies and procedures. Reviews protocols and advises ACT leadership on regulations and policies.</li>
<li>Assess and evaluate ACT's compliance with applicable laws and regulations. This involves conducting detailed reviews of travel activities (travel plans, travel approvals, travel claims, etc.).</li>
<li>Analyze, consolidate, and update the ACT audit universe (requires significant spreadsheet analysis) to reflect the actual activities undertaken, in Travel, Finance, programmes of work, and Human Resources. Reconciliation and joining of branch information and plans will be necessary to provide organizational overview, branch review, and deep dive audits and inspections where necessary.</li>
<li>Determine the effectiveness of management response to previous audit recommendations, internal control risk and compliance with applicable NATO and ACT financial policies. Support senior leadership in their daily decision-making relating to emerging travel non-compliance and ACT's implementation of NATO's and ACT's anti-fraud and corruption strategies and directives.</li>
<li>Respond to potentially serious or irregular compliance issues and violations, and consults with management on appropriate responses.</li>
<li>Support to other audit activities approved in ACT's annual Risk Based Audit Plan covering all aspects of the ACT audit universe.</li>
<li>Analyze internal audit processes and update ACT internal audit manuals to adapt to agile auditing of areas that rapidly changes within the yearly planning cycle.</li>
<li>Develop and conduct audit risk assessment of ACT resource management activities to continue risk-based auditing and identify risk areas. When needed, update internal audit methodology to reflect the right risk assessments and audit universe.</li>
<li>Review the execution, implementation, status and effectiveness of ACT's travel management and risk management process; report on the status and effectiveness of risk registers and advise on all governance issues arising from these reviews.</li>
<li>To undertake ad-hoc analyses and studies if relevant as tasked by the Chief of Staff and ACT Head of Internal Audit.</li>
</ul>
<p><b>Essential Skills and Experience</b></p>
<ul>
<li>6 or more years of experience performing compliance, integrity, and/or forensic auditing.</li>
<li>4 or more years of experience in travel management (and associated Internal Controls) and/or auditing travel management (planning, requisitions, claim liquidation, etc.) in a large organization.</li>
<li>Experience in retrieving, compiling, structuring, statistical and non-statistical sampling, and analyzing large data sets of financial and travel information.</li>
<li>Experience with Accounting software and Microsoft office, particularly Excel, PowerPoint and Word applications.</li>
<li>Hold a recognized professional fraud examiner (CFE) and/or professional accounting (CPA, CMA, etc.) qualification.</li>
<li>Proven forensic accounting or forensic investigation experience.</li>
<li>Proven ability to communicate clearly and persuasively, both orally and in writing to senior management (specialist and non-specialist audiences).</li>
<li>Without conflicts of interest with any ACT staff.</li>
</ul>
<p><b>Education</b></p>
<ul>
<li>University Degree in accounting, finance, business administration or related discipline and 4 years function related experience, or Higher Secondary education and completed advanced vocational training in that discipline leading to a professional qualification or professional accreditation with 5 years post related and 4 years function related experience.</li>
</ul>
<p><b>Language Proficiency</b></p>
<ul>
<li>Advanced Proficiency in English</li>
</ul>
<p><b>Working Location</b></p>
<ul>
<li>Norfolk, VA, USA</li>
</ul>
<p><b>Working Policy</b></p>
<ul>
<li>On-Site</li>
</ul>
<p><b>Contract Duration</b></p>
<ul>
<li>June 2026 &ndash; December 2030</li>
</ul>
<p><b>Security Clearance</b></p>
<ul>
<li>Valid National or NATO Secret personal security clearance</li>
</ul><div><p>
We never know what new opportunities might be just over the horizon. If this opportunity isn't for you please feel free to send us your resume anyway and be the first to know if something suitable for your skills and experience comes up.</p></div></div>

Audit Specialist

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