lead care manager

Titanium Healthcare

<div>WE ARE TITANIUM HEALTHCARE

Titanium is a healthcare company that puts heart and compassion above all else. Millions of Americans just aren&rsquo;t getting the medical care they need. We&rsquo;re on a mission to change that. For patients that means exceptional support and better care. For providers it means better support and time to focus on patients, and for partners that means higher quality and lower cost. 


Join us in our mission! 


POSITION SUMMARY

The Lead Care Manager (LCM) is responsible for case management of members and their families in obtaining and understanding services and programs available through the Enhanced Care Management (ECM) program. The LCM is tasked with improving health and overall well-being through our services. The ideal LCM is an energetic self-starter who can collaboratively and cross-functionally work in a team environment and with external representatives. 


WHERE YOU&rsquo;LL WORK

This position is hybrid. Work from home while servicing members in the Santa Barbara region; 30% of duties will be performed remotely, 70% of duties will involve traveling to conduct in-person member visits. You will have full control over your schedule when meeting members. Lead Care Managers are required to travel to their members within their designated areas. You are eligible for mileage reimbursement for the use of your vehicle for business-related travel. Standard business hours are Monday through Friday from 8:30 am to 5:00 pm. 
WHAT YOU&rsquo;LL DO
<ul>
<li>The LCM is responsible for an assigned caseload of adult and pediatric members</li>
<li>Conduct comprehensive assessments to determine the physical, emotional, and social needs of members</li>
<li>Develop individualized care plans based on assessment findings, considering medical history, preferences, and specific needs</li>
<li>Tailor care plans to individual needs and goals</li>
<li>Coordinate and facilitate communication between healthcare providers, social workers, therapists, and other members of the care team to ensure a comprehensive and integrated approach to care</li>
<li>Collaborate with Medical Doctors, Clinical Consultants, Housing Navigators and Leaders to make recommendations tailored to member needs</li>
<li>Monitor the progress of members and update care plans as needed per policy and compliance requirements</li>
<li>Ensure prescribed treatments and interventions are being followed and communicate to PCP and specialty care providers any significant changes to member concerns along with any updates on member status</li>
<li>Provide positive member client service experience through multiple support channels including telephone and in-person</li>
<li>Maintain accurate and up-to-date records of assessments, care plans, and interactions with members Ensure compliance with relevant regulations and standards</li>
<li>Complete all required documentation accurately, in a timely manner and in accordance with company standards</li>
<li>Provide leaders with case progress periodically/required basis</li>
<li>Advocate for patients or clients, helping them navigate the healthcare system, understand their treatment options, and access the services they require</li>
<li>Provide education to members and their families on health-related topics, treatment options, and self-care strategies</li>
<li>Identify and connect members with appropriate community resources, support services, and programs to address their needs, such as housing assistance, financial aid, or counseling services</li>
<li>Plan and coordinate the discharge process for members leaving hospitals or long-term care facilities, ensuring a smooth transition to home or another care setting</li>
<li>Participate in training new employees</li>
<li>Perform other duties as assigned or required per departmental policy</li></ul> 


WHO YOU ARE
<ul>
<li>Fluent in English (written and verbal), Bilingual in Spanish</li>
<li>Excellent verbal and written communication skills, including the ability to convey and exchange information in a clear and concise manner</li>
<li>Adequate hearing and vision (with corrective devices if necessary) to conduct assessments and documentation</li>
<li>Ability to identify problems and use logic and related information to develop and implement solutions</li>
<li>Excellent organizational skills and attention to detail</li>
<li>Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures</li>
<li>Ability to communicate clearly in-person, by phone, and electronically</li>
<li>Frequent use of computers, keyboard, and handheld/mobile devices</li>
<li>Competent with computers, email, virtual platforms, and Microsoft Office based programs</li>
<li>Ability to type for extended periods</li>
<li>Must be able to remain in a stationary position</li>
<li>Ability to operate a vehicle and travel to meet with members around the community; attend meetings and events as required or requested</li>
<li>Must be able to move around the office and/or travel throughout community</li>
<li>Work may occur in homes, shelters, outdoor settings, hospitals, or community organizations, which may include exposure to pets, smoke, odors, clutter or unsanitary condition, and varying temperature conditions</li>
<li>Ability to climb stairs or navigate uneven terrain in community and home environments</li>
<li>Ability to lift, carry, push, or pull up to 20&ndash;25 pounds (e.g., laptop bag, forms, mobile equipment)</li>
<li>Ability to bend, reach, and conduct in-person visits in non-traditional environments</li>
<li>Commitment to maintaining patient confidentiality and adhering to ethical standards in healthcare practice</li>
<li>Ability to maintain professionalism and safety in diverse environments</li></ul> 


WHAT YOU&rsquo;LL NEED
<ul>
<li>Associate degree and 2+ years of healthcare or care coordination experience</li>
<li>Current and valid Driver&rsquo;s License</li>
<li>Proof of auto insurance</li>
<li>Current BLS certification from the American Heart Association upon start date</li>
<li>Distraction-free home workspace with a secure internet connection</li></ul> 


WHAT YOU&rsquo;LL ENJOY 
<ul>
<li>Make an impact: an organization who cares about its employees, communities, and the future of healthcare</li>
<li>Inclusivity: be a part of a workplace where you not only belong but also can be the best version of yourself</li>
<li>Growth: opportunities to develop and grow your career with us</li>
<li>Community: you are encouraged to have a voice, share your opinions, and have an individual impact on the business</li>
<li>Paid Time Off: 12 holidays and up to 15 days of accrued PTO to rest and recharge plus additional time for sick, jury duty, bereavement, reproductive loss, and therapy</li>
<li>Work Life Balance: enjoy flexibility to maximize your well-being and success with our hybrid work model</li>
<li>Medical, Dental, &amp; Vision Benefits: we cover up to 100% of your premium and 50% of your dependents depending on the plan</li>
<li>Prioritize your mental health with unlimited therapy sessions funded 100% by Titanium Healthcare</li>
<li>Flexible Spending, Health Savings &amp; Dependent Care Accounts</li>
<li>Life/AD&amp;D insurance funded 100% by Titanium Healthcare</li>
<li>Supplemental Short-Term Disability</li>
<li>Employee Assistance Programs</li>
<li>Protect your pet(s) with Pet Insurance</li>
<li>401(k) plan</li></ul> 
EEO Statement

At Titanium Healthcare, our mission is to fearlessly reengineer the way healthcare works to reduce costs, ensure better outcomes, and provide everyone, everywhere, with the kind of compassionate and coordinated care they deserve. We believe that achieving this mission starts with a diverse and inclusive workforce. 


Titanium Healthcare is an equal opportunity employer. We are committed to promoting and celebrating all backgrounds and encourage all applicants, regardless of race, religion, gender, sexual orientation, disability, age, marital status, parental status, military or veteran status, or any other legally protected status, to apply. We believe that diversity and inclusion drive innovation and equity in healthcare, enabling us to better serve our communities and make a lasting impact.</div>

Bilingual Lead Care Manager

Pair Team

<div><h2 class="jobSectionHeader">About Pair Team</h2> 


At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social - by partnering with organizations deeply connected to the communities we serve.

We're building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support.

Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients.

We're one of the largest Enhanced Care Management providers in California and are on track to build the nation's largest clinically integrated network supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions.

At Pair Team, were not just delivering care - we're building the future of more equitable, community-driven healthcare. 


Our Values
<ul>
<li>Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection.</li>
<li>Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness.</li>
<li>Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo.</li>
<li>Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent.</li>
<li>Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others.</li>
</ul><h3 class="jobSectionHeader">In the News</h3>
<ul><li>Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most</li>
<li>TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team</li>
<li>Axios: Pair Team collects $9M for Medicaid-based care</li>
</ul>
<h2 class="jobSectionHeader"> 
About the Opportunity</h2>

Pair Team is building a team of deeply passionate individuals ready to change primary care operations for those who need it most. We are looking for a highly motivated full-time Lead Care Manager who is willing to think creatively and empathically to help our team change the way people access healthcare.

We seek a full-time Bilingual Member Services Representative to play a critical role in our whole-person, interdisciplinary care model, responsible for directly outreaching and engaging with individuals living with Serious Mental Illness/ Substance Use Disorder, experiencing homelessness, and/or those who have high medical needs. We believe in the power of trust and relationships to successfully engage those who may have never received the kind of whole-health care that Pair Team can provide. The Bilingual Member Service Representative will hold the title of a Lead Case Manager. 

This position primarily allows for remote work; however, it includes 2-3 times a month on-site visits in the community alongside a fellow PairMate. You can expect to engage in these in-person activities 2-3 times per month, close to your city, while the majority of your duties, approximately 90%, will be performed from your home 

<h3 class="jobSectionHeader">
What You'll Do</h3>
<ul><li>Maintain ongoing caseload of individuals through the utilization of evidence based approaches to promote engagement and achievement of health goals</li>
<li>Use relationship-based strategies to support members with social support navigation, understanding that many may have lived personal experiences causing them to be initially hesitant or distrusting of the health care system</li>
<li>Conducts periodic telephonic and SMS outreach to ensure timely follow-up to members</li>
<li>Work with member to identify health/wellness goals and incorporate goals into Health Action Plan/Shared Care Plan</li>
<li>Supports nurse care manager, behavioral health care manager, nurse practitioner and Community Engagement Specialist with delegated tasks</li>
<li>Collaborates on care issues with Enhanced Care Management team by participating in systematic case reviews and consulting with nurse care manager, behavioral health care manager, and nurse practitioner before taking clinical actions</li>
<li>Consistently meet monthly encounter metrics to ensure compliance with health plan regulations</li>
<li>Identify and break down barriers ensuring individuals' continuation with the program</li>
<li>Assists individuals in securing connection to community supports by scheduling appointments, managing referrals, and ensuring timely follow-ups</li>
<li>Coordinate physical care management appointments through collaboration with external and internal providers</li>
<li>Utilize external and internal online platforms to collaborate with team members and carry out daily tasks</li></ul> 

<h3 class="jobSectionHeader">
What You'll Need</h3>
<ul><li>3+ years of general work experience (healthcare call environments preferred)</li>
<li>You are physically located in California
<ul><li>Field Ops requires you to maintain reliable transportation for engagement at clinic, community based organization, and health system partner locations</li>
<li>Virtual Ops requires a quiet, HIPAA compliant and internet connected space</li>
</ul></li><li>Bilingual &ndash; English/Spanish</li>
<li>Telehealth experience in high volume call settings (inbound and outbound)</li>
<li>Strong understanding of cultural fluency</li>
<li>High degree of empathy</li>
<li>Ability to work collaboratively in a multidisciplinary team</li>
<li>An eye for optimization</li>
<li>Organizational skills</li>
<li>Ability to remain patient when faced with adversity</li>
<li>Strong technical skills and comfort with technology innovation, past experience with CRM databases, basic Excel, Word, email, and video conferencing</li>
<li>A valid driver's license and auto liability insurance</li>
</ul><h3 class="jobSectionHeader">Preferred Qualifications:</h3>
<ul><li>Demonstrated professional or personal lived experience working closely with individuals experiencing complex chronic needs, homelessness, or Severe Mental Illness/Substance Use Disorder</li>
<li>2+ years of healthcare call center experience</li>
<li>Experience with motivational interviewing</li>
<li>Metrics driven
</li><li>Zest for problem solving, seeking answers, and thinking outside the box</li>
<li>Detail-oriented and organized self-starter who is a rockstar multitasker</li>
<li>Reliable and comfortable in an ever-changing environment</li></ul> 

<h3 class="jobSectionHeader">
Because We Value You</h3>
<ul><li>Salary: $25/hour</li>
<li>Comprehensive health, vision &amp; dental insurance</li>
<li>401k</li>
<li>Monthly $100 work from home expense stipend for your WFH days</li>
<li>Gas reimbursements for your on-site engagement days</li>
Flexible vacation policy <li>- take the time you need to recharge!</li>
<li>We provide all of the equipment needed for the role</li>
<li>Opportunity for rapid career progression with plenty of room for personal growth!</li></ul><div> 
Pair Team is an Equal Opportunity Employer. At Pair Team, we value diversity and strive to provide an inclusive environment for all applicants and employees. All applicants will be considered without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, marital status, age, disability, political affiliation, military service, genetic information, or any other characteristic covered by federal, state, or local law.

Pair Team participates in E-Verify to verify employment eligibility for new hires. 
 
Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use.

We do not conduct any TA business outside of our @pairteam.com emails. If you're ever concerned about spam or fraudulent activity, please reach out to recruiting@pairteam.com.

Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!</div></div>

Bilingual Member Services Representative (Remote, Spanish Speaking)

American TrueCare, Inc.

<div>Job Summary:

The official job title is Lead Care Manager (LCM).

The Lead Care Manager (LCM) role involves developing personalized care plans, coordinating member services, and collaborating closely with members and families, as well as Primary Care Providers to ensure they receive necessary medical treatment and support. The LCM will consult with members to determine their needs, develop individualized action plans, and work with care teams to manage the member experience effectively. Providing emotional support, resolving administrative issues, and ensuring timely access to care are key aspects of the position. Compassion, healthcare knowledge, and exceptional customer service are essential qualities for assisting members in becoming self-sufficient in health. The LCM will work with a diverse population of members enrolled in the Enhanced Care Management program, which may involve one or multiple members from the population of focus section below.

Responsibilities:
<ul>
<li>Interview members to assess medical and social determinant of healthcare gaps and provide education about their condition and medication, while developing individualized care plans.</li>
</ul><ul><li>Respond to member inquiries and concerns, ensuring adherence to hospital and legal requirements.</li>
</ul><ul><li>Collaborate with interdisciplinary teams, locate medical and social resources, and coordinate social service plans.</li>
</ul><ul><li>Maintain on-going contact with members, via telehealth and in-person visitation.</li>
</ul><ul><li>Advocate for members, consult with healthcare providers, arrange appointments and treatment plans, evaluate member progress, and assist with healthcare barriers.</li>
</ul><ul><li>Maintain empathy and professionalism while contacting members and families.</li>
</ul><ul><li>Supporting behavioral health coordination, Substance Abuse and Community Resources.</li>
</ul><ul><li>Perform additional duties as assigned.</li></ul> 


Populations of Focus:
<ul>
<li>Individuals experiencing homelessness: Lacking a fixed, regular, and adequate nighttime residence.</li>
</ul><ul><li>Individuals at risk for avoidable hospital or emergency department utilization: Five or more emergency room visits in a six-month period that could have been avoided with appropriate outpatient care or improved treatment adherence.</li>
</ul><ul><li>Individuals with Serious Mental Health and/ or substance use disorder needs: Adults who meet the eligibility criteria for participation in, or obtaining services through Specialist mental health services or the Drug Medi-Cal organized delivery system or Drug Medi-Cal program.</li>
</ul><ul><li>Individuals transitioning from incarceration/Justice Involved: Adults transitioning from a correctional setting or transitioned from a correction setting within the past 12 months, or children and youth who are transitioning from a youth correctional facility or transitioned from being in a youth correctional facility within the past 12 months.</li>
</ul><ul><li>Adults living in the community and at risk for long-term care institutionalization: Adults who are living in the community who meet the SNF Level of Care criteria; or who require lower-acuity skilled nursing or equipment for prevention, diagnosis, or treatment of acute illness or injury.</li>
</ul><ul><li>Adult nursing facility residents transitioning to the community: Adult nursing residents who are interested in moving out of the institution, and are likely candidates to do so successfully, and are able to reside continuously in the community.</li>
</ul><ul><li>Children and youth enrolled in California Children's Services (CCS) or CCS Whole Child Model (WCM) with Additional Needs Beyond the CCS condition: Children and youth enrolled in CCS or CCS WCM and are experiencing at least one complex social factor influencing their health.</li>
</ul><ul><li>Children and Youth Involved in Child Welfare</li>
</ul><ul><li>Individuals with Intellectual/ Developmental Disabilities: Adults who have a diagnosed I/ DD and qualify for eligibility in any other adult ECM population of focus.</li>
</ul><ul><li>Pregnant and Postpartum individuals; Birth Equity Population of Focus: Adults and youth who are pregnant or postpartum and qualify for eligibility in any other adult or youth ECM POF, or are subject to racial and ethnic disparities.</li>
</ul>
Education and Experience:
<ul>
<li>High school diploma or GED required.</li>
</ul><ul><li>Minimum of 1 year experience in case management, member care, customer 
service, call center, or member care required.</li>
</ul><ul><li>Valid California driver's license and valid vehicle insurance required.</li>
</ul><ul><li>MA certificate or medical terminology knowledge preferred.</li>
</ul>
Required Skills/Abilities:
<ul>
<li>Excellent communication, interpersonal, customer service and organizational skills.</li>
</ul><ul><li>Computer skills for documentation, email and chat support.</li>
</ul><ul><li>Proficient skills in working independently and collaboratively in a team to provide member care.</li>
</ul><ul><li>Proficiency in multitasking, organization, and attention to detail is required for effectively providing care to multiple members simultaneously.</li>
</ul><ul><li>Candidates should exhibit the capability to utilize resources effectively for problem-solving while maintaining composure under pressure in a compassionate manner.</li>
</ul><ul><li>Applicants must demonstrate proficient speaking, reading, and typing abilities and possess strong proofreading skills.</li>
</ul>
Physical Requirements:
<ul>
<li>Must be able to travel using personal vehicle to complete outreach visits. Mileage reimbursement for the use of your vehicle is at a standard rate.</li>
</ul><ul><li>Must successfully complete and maintain current Tuberculosis (TB) testing and clearance in accordance with company policy and applicable local/state health regulations as a condition of employment.</li>
</ul><ul><li>Prolonged periods of sitting at an office desk on the computer.</li>
</ul><ul><li>Lifting: Able to lift up to 15lbs.</li></ul></div>

Patient Care Coordinator

Park Center

<div><div><div>Job Title 
Lead Recovery Support Coordinator</div><div> 
Reports to: 
Permanent Supportive Housing Manager</div><div> 
FLSA / WAGE 
Non-Exempt / $26.87 - $29.02 per hour 
Orig. Date 
May 2024</div><div> 
Revised:</div></div> 
JOB SUMMARY
This position is an advanced practitioner of recovery support services in a Permanent Supportive Housing program model, offering both Housing First and Sober Living options. The Lead Recovery Support Coordinator will serve Park Center members as part of a recovery-oriented, housing-focused intensive case management (ICM) team. 
ESSENTIAL FUNCTIONS<ul><li> 
Member Support Duties:<ul><li>
Engage residents in vivo utilizing a trauma lens and cultural humility to quickly establish trust and build rapport.</li><li>
Provide recovery-oriented tenancy support taking a strengths-based, person-centered approach.</li><li>
Partner with PSH members to help them achieve goals that are personally meaningful to them, extending beyond those areas traditionally addressed by clinical care.</li><li>
Support PSH members in recovery by offering experience with whole health recovery that includes addressing wellness of both mind and body.</li><li>
Provide insight into the experience of internalized stigma and how to combat it, sharing personal experience of moving from hopelessness to hope.</li><li>
Coach PSH members on independent living skills, connect with community resources, and develop systems to support sustainability.</li><li>
Encourage PSH members to engage with their community through employment, volunteering, and/or recreational/social activities.</li><li>
Assist PSH members with developing interpersonal skills to connect with their housemates and neighbors, and to expand their natural support system.</li></ul></li><li>
Create, maintain, and review documentation for agency and funding requirements within all designated deadlines.</li></ul><ul><li> 
Public/Staff Relations:<ul><li>
Communicate with internal and external partners utilizing telephone, email, and chat.</li><li>
Communicate regularly with the Permanent Supportive Housing team to meet the needs of residents.</li><li>
Develop effective working relationships with human services organizations.</li></ul></li></ul><ul><li> 
Value cultural competence and diversity</li></ul><ul><li>
Collaborate with staff, members, and the community to gain the perspectives of others having diverse opinions, abilities, values, beliefs, perspectives, and ethnic or cultural backgrounds.</li><li>
Take deliberate steps to increase their own cultural competency by attending trainings, events, discussions, workshops, etc.</li></ul> 
<ul><li>
 Other duties as member of the Permanent Supportive Housing team:<ul><li>
Attend all staff and supervision meetings.</li><li>
Assist with program events and outings.</li><li>
Participate in on-call rotation.</li><li>
Maintain schedule flexibility in the event of after-hours responsibilities.</li><li>
Maintain good attendance and inform supervisor in advance of time off.</li><li>
Complete Relias Learning courses by deadline.</li><li>
Follow all Personnel Policies and uphold Park Center&rsquo;s Code of Ethics.</li><li>
Perform all other duties assigned.</li></ul></li><li>
Team Lead specific duties:<ul><li>
Mentor and train PSH Recovery Support Coordinators on basic care management skills (i.e., documentation process and content, resources, advocacy, referrals, motivational interviewing, trauma-informed care, and harm reduction/housing first principles).</li><li>
Assist with facilitating supervision meetings with PSH Recovery Support Coordinators as necessary.</li><li>
Develop connections with community resources to provide ongoing training and education to team members to further professional development for the team.</li><li>
Serve as a resource for education/training, community resources, and fellow team members&rsquo; feedback.</li><li>
Answer team members' questions and provide additional assistance around member needs.</li><li>
Assist with completing monthly reports and pulling necessary data for reports.</li><li>
Lead team meetings and provide training as needed.</li><li>
Complete note audits as needed.</li><li>
Provide support to the Program Manager with running the day-to-day operations of the program.</li><li>
Serve as a leader at community meetings as a support for PSH Manager(s) as needed.</li></ul></li></ul> 
QUALIFICATIONS 
<ul><li>
Must have at least 3 years of experience working in a peer recovery support role and/or</li></ul>
at least 5 years&rsquo; experience working in a human services field.<ul><li>
Able to demonstrate strong support competencies and ethical behaviors.</li><li>
Must have proven written and verbal communication skills and computer literacy.</li></ul><ul><li>
Bachelor&rsquo;s degree in a human services field required; 5 years&rsquo; experience in a peer support role may be substituted for college degree.</li><li>
Must have a valid Tennessee Driver&rsquo;s License.</li><li>
Must be able to show proof of personal automobile insurance.</li></ul> 
WORKING CONDITIONS 
<ul><li>
Modified remote work available for this position, shared workstation in office.</li><li>
Able to operate with many distractions.</li><li>
Routine office environment.</li><li>
Able/willing to use vehicle to transport members.</li><li>
Able/willing to operate a large van/bus to transport clients.</li></ul> 
PHYSICAL DEMANDS 
<ul><li>
Able to sit for long periods of time.</li><li>
Able to move or lift over ten pounds.</li></ul> 
DISCLAIMER 
This job description is not intended to be all-inclusive, and the employee will be expected to perform other reasonably related duties as assigned. Park Center reserves the right to revise or change job tasks and responsibilities.</div>

Lead Recovery Support Coordinator

Community Clinic

<div>About Us
Community Clinic is a trusted regional healthcare system dedicated to delivering exceptional, whole-person care in a compassionate, professional, and welcoming environment. As we continue to grow across the region, we remain grounded in one belief: people matter. That includes our patients&mdash;and our team. Every employee plays a vital role in living out our promise: We care. You belong.
Position summary
The Lead Value-Based Care (VBC) Specialist plays a critical role in improving the organization&rsquo;s performance under value-based care and population health programs. This position supports the execution of quality improvement strategies designed to improve clinical outcomes, enhance patient engagement, and maximize value-based incentive revenue across federal, state, and commercial payer programs. The role bridges clinical teams, analytics, quality improvement initiatives, and payer programs to support implementation of quality initiatives designed to improve value-based care performance
Position Details
Location: Flexible, can choose from multiple locations in Northwest Arkansas
Employment Status: Full-Time
Department: Quality
Reports to: Value-Based Care Strategy Manager
Classification: Non-Exempt (Hourly)
Essential job functions<ul><li>
Monitor performance across HEDIS, UDS, Medicaid, Medicare, and commercial payer programs.</li><li>
Review quality reports to identify care gaps and support improvement efforts with clinic teams.</li><li>
Develop dashboards and track progress toward quality targets.</li><li>
Use EHR and reporting tools to review patient care gaps and support clinic teams.</li><li>
Validate reporting accuracy for payer submissions and regulatory reporting.</li><li>
Identify patient care gaps and develop strategies with clinics, providers, and care teams to improve preventive care and chronic disease management outcomes.</li><li>
Provide education and support to clinic teams on quality metrics, documentation, and best practices for improving value-based performance.</li><li>
Collaborate with Revenue Cycle, Care Coordination, Managed Care, and Clinical Operations to align workflows supporting VBC success.</li><li>
Assumes responsibility for VBC Specialist activities in the absence of the VBC Strategy Manager and reports to the Vice-President of Revenue Cycle Management/Quality.</li><li>
Oversees the daily functions of VBC Specialists, or other Population Health staff</li><li>
Assists the VBC Strategy Manager in leading VBC Specialists and population health staff by:<ul><li>
Training and onboarding new VBC Specialists or staff supporting quality and population health initiatives.</li><li>
Providing ongoing mentorship, guidance, and technical support related to quality metrics, reporting processes, and value-based program requirements.</li><li>
Supporting the development and maintenance of training materials, workflows, and best-practice guides for clinic teams.</li></ul></li><li>
Adhere to applicable regulatory guidelines and laws, including but not limited to HIPAA/HITECH, CLIA, HRSA and OSHA/Blood-Borne Pathogens regulations and standards.</li></ul>
Community Clinic Essential Competencies<ul><li>
Service: Treats every patient and coworker with empathy, respect, and a genuine desire to help.</li><li>
Ownership: Takes responsibility for their actions, follows through on commitments, and upholds high standards even when no one is watching.</li><li>
Adaptability: Remains flexible, open to change, and willing to learn in order to meet the evolving needs of our patients, teams, and organization.</li><li>
Collaboration: Works together with openness and respect, shares information freely, and supports co-workers to provide seamless, high-quality care.</li><li>
Problem Solving: Approaches challenges with curiosity, finds practical solutions, and takes initiative to improve processes and patient experiences.</li></ul>
Role Specific Essential Skills<ul><li>
Analyze clinical quality data, dashboards, and reports</li><li>
Perform root cause analysis to close care gaps through workflow improvements and patient outreach</li><li>
Translate payer requirements and quality measures into effective clinical and operational workflows</li><li>
Lead and mentor VBC Specialists and population health staff</li><li>
Develop, and update training materials and standard operating procedure descriptions</li><li>
Communicate complex data insights, performance results, and improvement strategies clearly to clinical teams and leadership</li><li>
Proficiency with EHRs, population health platforms, and reporting tools</li><li>
Organizational and project management skills</li><li>
Commitment to continuous improvement</li></ul>
Required qualifications<ul><li>
Bachelor&rsquo;s degree in Public Health, Healthcare Administration, Health Informatics, Business, or related field or equivalent experience</li><li>
Two or more years of experience in healthcare quality improvement, population health, analytics, or value-based care</li><li>
Experience with HEDIS, UDS, or payer quality programs</li><li>
Strong analytical and communication skills</li><li>
Experience with electronic health records and reporting tools</li><li>
Proficiency in Microsoft Excel and data analysis tools</li></ul>
Preferred qualifications<ul><li>
Master&rsquo;s degree (MPH, MHA, MBA, or related field)</li><li>
Experience in a Federally Qualified Health Center (FQHC) or safety-net healthcare setting</li><li>
Experience supporting population health platforms</li><li>
Experience working with payer incentive or risk-based programs</li></ul></div>

Lead Value-Based Care Specialist

ResCare Community Living

<div>Our Company:
<div>
ResCare Community Living</div><div></div>
Overview:
<div>
Are you driven to serve and help others in your community? Caregivers and Direct Support Professionals (DSP) are the heart of our company with their compassion, dependability, and care. If you want to make an impact by helping people live their best life, read more below and apply today!</div>
Responsibilities:
<ul><li>The Lead Direct Care Staff will provide support and training for persons with intellectual or developmental disabilities and/or other related disorders. This support and training will include, but not be limited to: emotional support, physical support and monitoring, and life skills development, which will lead to increased independence and community participation for clients. The Lead Direct Care Staff may assist with hiring, training, scheduling, evaluating employee performance, and other supervisory duties as assigned.</li><li>
Collect and report management information to ensure continuous evaluation and improvement of operations</li><li>
Work to create a positive work environment and proper deployment of direct care staff</li><li>
Report safety and maintenance concerns as necessary</li><li>
Implement fiscal processes and loss control programs to ensure appropriate allocation of financial resources</li><li>
Provide oversight of menu planning and grocery shopping</li><li>
Monitor the budgets and finances of the person(s) served</li><li>
Address and correct health, safety, and environmental concerns</li><li>
Coach and mentor support staff</li><li>
Attend and participate in announced meetings</li><li>
Other duties as assigned</li></ul>
Qualifications:
<ul><li>High school diploma or General Education Diploma equivalent required</li><li>
Obtain credential of Registered Behavior Technician prior to working with clients</li><li>
Have a minimum of one year experience as a Direct Care Staff, in an Acute Rehab Medical facility with a Service Level 4G or higher or Resident Case Load 12-14 facility; prefer experience working with people who have Intellectual and Developmental Disabilities</li><li>
Have certification and/or licensure as a Licensed Psychiatric Technician; Psychological Assistant; or Associate Licensed Clinical Social Staff; or an individual with a combination of experience and education working with the developmentally disabled and mentally ill 
<ul><li>
For Psychological Assistant or Associate Licensed Clinical Social Worker, two years&rsquo; experience in designing and/or implementing behavior modification services are required</li></ul></li><li>
Have completed Direct Support Professionals I and II training and certification prior to working with clients</li><li>
Fingerprint cleared prior to working with residents/facility</li><li>
Must obtain and maintain current certification in Cardiopulmonary/First Aide/Automated External Defibrillator, including training of abdominal thrust technique prior to working with clients</li><li>
Certification must be from an in-person class that includes hands-on instruction</li><li>
Must obtain and maintain current certification of Crisis Prevention Institute training prior to working with clients</li><li>
Must complete Solutions-building curriculum per requirements</li><li>
Lead Direct Support Professionals must be in good physical health, verified by a health screening that includes a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure</li><li>
Training required to implement the health care plan for a resident with a restricted health condition, if applicable</li><li>
Knowledge of the requirements for providing the type of care and supervision needed by clients, including ability to communicate with such clients</li><li>
Capable of working with highly confidential information</li><li>
Ability to work independently as well as part of a team</li><li>
Ability to communicate verbally and written with all levels of personnel, internal and external</li><li>
Possess a valid driver&rsquo;s license</li></ul>
About our Line of Business: ResCare Community Living, an affiliate of BrightSpring Health Services, has five decades of experience in the disability services field, providing support to individuals who need assistance with daily living due to an intellectual, developmental, or cognitive disability. We provide a comprehensive range of high-quality services, including: community living, adult host homes for adults regardless of disability, behavioral/mental health support, in-home pharmacy solutions, telecare and remote support, supported employment and training programs, and day programs. For more information, please visit www.rescarecommunityliving.com. Follow us on Facebook and LinkedIn. Additional Job Information:
<div>
This position is Monday - Friday 8a-4p. Hourly rate contingent upon experience</div>
Salary Range: USD $18.00 - $19.00 / Hour</div>

Lead Direct Care Staff

Humana

<div><h1 class="jobSectionHeader">Become a part of our caring community and help us put health first 
</h1>
The Lead Business Intelligence Engineer defines and implements best practices to collect, integrate, analyze, and transform raw data into actionable business intelligence. In this position, you will ensure that all encounter submissions exceed compliance standards through advanced data analysis, rigorous quality assurance, and the development of tools to optimize encounter acceptance rates. The Lead Business Intelligence Engineer identifies opportunities to produce applicable insights and enhance submission processes. This role collaborates with partners to design and refine workflows, addresses complex data and process challenges, and leads by example in project execution and technical innovation. This position also promotes a culture of knowledge sharing and continuous improvement, supporting the team's overall success.
The Lead Business Intelligence Engineer is a senior member of the Encounter Submission organization and is responsible for accomplishment of strategic goals, operational efficiency, and compliance. This role is instrumental in building a high-performing, collaborative, and innovative Business Intelligence team that delivers strategic value to the organization.
Key Responsibilities:<ul><li>
Identify, evaluate, and lead strategic intelligence programs that improve and long-term goals.</li><li>
Lead the analysis and resolution of data challenges, critically assessing situations, and applying organizational resources to build resilient and scalable code, dashboards, and data solutions.</li><li>
Develop a range of technical solutions, including Python scripts, SQL queries, Databricks notebooks, Azure DevOps pipelines, Power BI dashboards, and process automations.</li><li>
Supports compliance, advancing operational efficiency, and ensuring the execution of strategic team goals.</li><li>
Mentor and guide junior Business Intelligence team members, encouraging technical and professional development.</li><li>
Translate complex requirements into clear technical specifications.</li><li>
Support partners by addressing data issues, performing root cause analysis, and proposing, applicable resolutions.</li><li>
Present clear and meaningful insights to internal and external partners, adapting communications for varied audiences.</li><li>
Advocate and guide continuous improvement in data processes, data quality, and data management practices.</li><li>
Promote a culture of innovation, collaboration, and best practices within the BI team.</li></ul><h1 class="jobSectionHeader"> 

Use your skills to make an impact 

</h1>Required Qualifications<ul><li>
Bachelor's degree in a technical field.</li><li>
Experience with scalable coding in Python, using SQL, to create and apply advanced analytics and strategies</li><li>
6+ years of experience in data analysis with complex datasets that includes working within the healthcare industry</li><li>
3+ years of experience building applicable dashboards.</li><li>
Experience with project/technical leadership focused on implementing strategic solutions</li><li>
Experience managing multiple priorities while maintaining deadlines.</li></ul>
Preferred Qualifications<ul><li>
Master's degree in a technical field.</li><li>
Experience using machine learning and statistical models to obtain insights from data.</li><li>
Prior knowledge of EDI formats, such as X12, 834, 835, 270/271, 276/277, 278, and 999.</li><li>
Experience with data governance frameworks and BI (Business Intelligence) best practices.</li></ul>
Work at Home Requirement
To ensure Home or Hybrid Home/Office employees&rsquo; ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:<ul><li>
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.</li><li>
Satellite, cellular and microwave connection can be used only if approved by leadership.</li><li>
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.</li><li>
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.</li><li>
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.</li></ul>
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. 

$94,900 - $130,500 per year 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 04-02-2026<h1 class="jobSectionHeader"> 

About us 
</h1>
Humana Inc. (NYSE: HUM) is committed to putting health first &ndash; for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health &ndash; delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. 
 
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</div>

Lead Encounter Data Management

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