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The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California.Work Culture:GCHP strives to create an inclusive, highly collaborative work culture where our people are empowered to grow and thrive. This philosophy enables us to create the health plan of the future and do our best work – Together.GCHP promotes a flexible work environment. Employees may work from a home location or in the GCHP office for all or part of their regular workweek (see disclaimer).GCHP’s focuses on 5 Core Values in the workplace:• Integrity• Accountability• Collaboration• Trust• RespectDisclaimers:• Flexible work schedule is based on job duties, department, organization, or business need.• Gold Coast Health Plan will not sponsor applicants for work visas.POSITION SUMMARYUnder the direction of the Chief Medical Officer, this position is an enterprise leadership role responsible for connectivity with our members, and medical community and analyzing effects of social determinates of health on our membership. The position partners with other leaders to guide the organization’s commitment and strategy to be a diverse, equitable, and inclusive (DEI) organization. The position is responsible for setting and implementing an overarching vision of DEI for the member community with a primary emphasis on health disparities both at the programmatic and administrative levels —that works to eliminate systemic member marginalization and promotes inclusion and anti-racist practices. To accomplish these efforts collaboration will be required with Health Services and Community Relations and the departments within. It will also include departments outside Health Services such as Provider Network Management, Clinical Operations and more. The position is responsible for the promotion of external DEI for Gold Coast Health Plan’s members and providers of the greater Ventura County area.Reasonable Accommodations StatementTo accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.ESSENTIAL FUNCTIONSJob Function &amp; Responsibilities• Provides strategic leadership to ensure that organizational culture, practice and leadership development programming are primary to the DEI vision.• Design and implement culturally specific and responsive policies, programs and service delivery models, as well as standardized guidelines and criteria to ensure health equity is prioritized and addressed.• Oversees regulatory compliance, including monitoring, implementing and reporting for all new regulatory requirements focused on health equity and disparities. Ensures compliance with contracted services and performance metrics.• Ensure compliance with California Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Covered California, and Centers for Medicare and Medicaid Services (CMS) regulatory and contractual requirements.• Ensures all policies and procedures consider health inequities and are designed to promote health equity and reduce health disparities, including but not limited to:o Member and Provider outreach.o Medical and other health services policies.o Community Advisory Committee.o Quality improvement activities, including delivery system reforms.o Appeals and grievances, and Utilization management.• Develops and implements policies and procedures aimed at improving Health Equity and reducing Health Disparities.• Engages and collaborates with staff, subcontractors, network providers, and entities included, but not limited to local community-based organizations, local health department, behavioral health and social services, child welfare systems and members in health equity efforts and initiatives.• Implements strategies designed to identify and address root causes of health inequities, which includes but is not limited to systemic racism, social drivers of health, and infrastructure barriers for Gold Coast staff, providers and members.• Develops targeted interventions designed to eliminate health inequities and collaborates with other departments as necessary to ensure implementation. Develops quantifiable metrics that can track and evaluate the results of the targeted interventions designed to eliminate Health Inequities.• Ensures employees, subcontractors, and Network Provider staff receive mandatory diversity, equity and inclusion training (sensitivity, diversity, communication skills, and cultural competency training).• Ensure the records of such training are maintained in the Learning Management System.• Creates, implements and reports on the organizational equity plan in partnership with organizational stakeholders.• Collaborates with Human Resources and the Chief Diversity Officer, to design and implement strategies for recruiting and retaining employees and management.• Collaborates with Learning and Development to develop educational and training for employees and staff.• In collaboration with the Chief Medical Officer and Clinical Leadership Team, oversees Quality Improvement and Health Equity activities, which includes:o Analyze and evaluate the results of QI and Health Equity activities, including annual review of the results of performance measures, utilization data, and consumer satisfaction surveys.o Institute actions to address performance deficiencies, including policy recommendations.o Ensure appropriate follow-up of identified performance deficiencies.• Serve on the Diversity, Equity and Inclusion Council. Communicates clearly in writing and verbally the principles, initiatives and outcomes of the DEI work. Develops media messaging to internal and external constituencies.• Develops communication systems to share best practices, keeping staff apprised of key initiatives and activities. Forges strong relationships and continuing communication links with other health equity advocates, and the local community.• Represents GCHP’s commitment to equity and acts as subject matter expert at the local, state, and national level.• Functions as a subject matter expert for senior leadership and report to the Medical Commission as needed.• Works with senior leadership in deploying standardized evidence-based best practices in medicine and clinical content and ensure adoption of best practices.MINIMUM QUALIFICATIONSEducation &amp; Experience:• Master's Degree, Field of Study: Social work promoting equity, inclusion and social justice.• 6 years of related experience in the health care industry.• 10 plus years of experience in recent relevant management experience, a majority of which should be in a senior leadership position.• 5+ years of management experience within a health care organization (managed care or prepaid health system experience preferred), which included Medi-Cal program, general and fiscal operations, customer service and provider relations, health care information systems, and regulatory compliance.• 5+ years of experience in developing and implementing initiatives/programs related to health equity.• Knowledge of the Medi-Cal, entitlement programs, Utilization Management, Care Management &amp; Disease Management programs &amp; procedures.• Knowledge of health care fiscal principles &amp;operations, managed care provider payment methods &amp; contracting.• Knowledge of public policy &amp; regulatory issues in health care, customer service &amp; quality improvement methods; general knowledge of MIS applications in health care systems.Equivalent In lieu of degree:• Will accept 2+ additional years of experience in lieu of a master’s degree or which demonstrates the ability to perform the duties of the position.KNOWLEDGE, SKILLS &amp; ABILITIESPreferred Qualifications:• Doctorate, Field of Study: Nursing, Business, Public Health or Health Administration or a related field preferred, or equivalent.• Direct work experience with the vulnerable and at-risk communities.• Bilingual in English and in Spanish.• 5 years of experience advocating for and implementing change within a multicultural environment, preferably with some experience in project planning, developing, and implementing diversity, equity, and inclusion programs, managing outcomes, and using data to inform continuous decision-making and improvement.• Experience facilitating large multi-stakeholder collaborations related to health equity is a plus.• Proven track record of successful project and program leadership.• Experience with historically underrepresented, low-income, traditionally disenfranchised, and differently labeled populations in diverse environments.• Experience with building and maintaining effective working relationships with providers, community representatives and regulators.• Proven experience organizing and directing multiple cross-departmental teams, simultaneously, on large, complex, and high-stakes work plan execution.• Proven success leading large, complex, cross-functional, and high-stakes projects.• Excellent communicator in written and verbal form with considerable experience in highly effective corporate communications with internal and external stakeholders.• Extremely versatile, dedicated to efficient productivity.• Ability to plan, assign, direct, supervise &amp; evaluate the work of others.• Establish and maintain effective and cooperative working relationships with Gold Coast staff and others contacted in the course of the work.• Assume responsibility&amp; exercise good judgment in making decisions within the scope of authority of the position• Effectively prioritize multiple tasks and deadlines.• Ability to accurately complete tasks within established times.• Ability to maintain confidentialityTechnology &amp; Software Skills: Advanced computer skills in MS Office products.Certifications &amp; Licenses: A valid and current Driver's License, Auto Insurance, and professional licensure(s)Competency Statements• Management Skills - Ability to organize and direct oneself and effectively supervise others.• Business Acumen - Ability to grasp and understand business concepts and issues.• Decision Making - Ability to make critical decisions while following company procedures.• Goal Oriented - Ability to focus on a goal and obtain a pre-determined result.• Interpersonal - Ability to get along well with a variety of personalities and individuals.• Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.• Time Management - Ability to utilize the available time to organize and complete work within given deadlines.• Consensus Building - Ability to bring about group solidarity to achieve a goal.• Relationship Building - Ability to effectively build relationships with customers and co-workers.• Presentation Skills - Ability to effectively present information publicly.• Delegating Responsibility - Ability to allocate authority and/or task responsibility to appropriate people.• Leadership - Ability to influence others to perform their jobs effectively and to be responsible for making decisions.• Strategic Planning - Ability to develop a vision for the future and create a culture in which the long-range goals can be achieved.• Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards.• Judgment - The ability to formulate a sound decision using the available information.• Communication, Oral - Ability to communicate effectively with others using the spoken word.• Communication, Written - Ability to communicate in writing clearly and concisely.• Problem Solving - Ability to find a solution for or to deal proactively with work-related problems. <a href="https://www.click2apply.net/4xA4aKcYrDX6JcWMmFJBqR" target="_blank">Apply Here</a> PI250412579

Executive Director, Health Equity

At American Career College, we share a passion for students and transforming healthcare education! As an associate for a certified Great Place to Work, you willjoin a collaborative, student-centric culture valuing academic integrity, mutual respect, student learning, service, responsiveness, innovation, diversity, and stewardship. As a part of this team, you will guide students to do more than change their own lives – you will help change the lives of every patient they care for throughout their career. At American Career College, you will have the opportunity to share your expertise and passion with the next generation of nurses.You will make an impact by:ASSOCIATE DEGREE NURSING PROGRAM<ul><li>Provide each nursing program(s) with the necessary Assessment Technologies Institute (ATI) management and oversight to help each cohort achieve or exceed ACC's outcomes. Benchmarking 90% of each graduating cohort to achieve the green light and the program.</li><li>Should achieve each quarter a 90% or better first-time pass rate on the NCLEX. </li><li>Collaborate with the Director of Nursing (DON), overseeing a comprehensive success plan that evaluates the effectiveness of ATI initiatives, creates new methods to improve specific ATI student/graduate and faculty performance, </li><li>Developing/implementing administrative systems and procedures to monitor and improve ATI effectiveness and provides analysis and remediation strategies to help ensure students/graduates are actively engaged in their ATI program and that graduates pass NCLEX with a satisfactory level of performance on their first attempt.</li><li>Serves as the campus ATI champion to support both existing students and graduates until NCLEX is passed.</li></ul>Your Experience Includes:<ul><li>A minimum of at least one (1) year previous experience with program management.</li><li>Knowledge in technological support and delivery of educational programs and services.</li><li>Knowledge and evidence of strong management skills, and administrative systems management as applicable to specialized program area.</li><li>Knowledge of state, federal and local laws/regulations relating to programs, governmental compliance, and other regulatory standards such as ABHES, BVNPT, BRN, and other accreditation standards.</li><li>Experience: ATI product experience.</li><li>A minimum of one to two years of professional testing and/or statistical data experience involving database management.</li><li>Experience working with nursing programs.</li><li>Experience with Blackboard Learning Management System.</li><li>Experience with Campus Vue.</li></ul>Education:<ul><li>Bachelor's degree from an accredited college or university that includes course work in education or business administration OR equivalent experience required.</li><li>Master's degree in nursing preferred.</li></ul>Licenses/Certifications:<ul><li>Registered nurse licensed required. Must meet faculty requirements.</li></ul>Compensation:$85,402.45-$123,807.03&nbsp;#LI-MJ1

American Career College

Assistant Director, Academic Success-Registered Nurse

<h4>How you will change lives</h4>As a Patient Care Technician (PCT) at US Renal Care, you will be an integral part of a cross-functional team providing care and delegated activities of treatment to patients. The PCT will work under the supervision of a Registered Nurse (RN) or Charge Nurse (CN) for patients with renal failure.<h4>What you'll be doing</h4>Patient care. You will work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include gathering patient stats before and after treatment, initiating treatment, monitoring patients during treatment, terminating treatment, and collecting patient blood samples per physician orders.Technician Duties. You will ensure quality comes first by preparing machines for hemodialysis treatments, cleaning and disinfecting machines after treatment, and conducting machine safety checks and logging results for quality control, ensuring all protocols and regulations are followed.Safety and Quality. You will use appropriate safety measures, including personal protective equipment. Working under the supervision of a Charge Nurse, you will adhere to all company policies, procedures, and state/federal laws and regulations. You will participate in all required staff meetings and continuing education offerings.PATIENT CARE TECHNICIAN STATE SPECIFIC BOARD OF NURSING REQUIREMENTS California<ul><li>Must possess current Certified Hemodialysis Technician (CHT) certificate from California Department of Public Health (CDPH) at time of hire OR</li><li>Hired at USRC location recognized by state of California as an approved dialysis technician training program and obtain California state certification (CHT) within six (6) weeks of successful completion of training program. </li></ul>Maryland<ul><li>Must possess current Certified Nursing Assistants -- Dialysis Technicians (CNA-DT) certificate from Maryland Board of Nursing OR</li><li>Hired at USRC location recognized by state of Maryland as an approved dialysis technician training program and obtain Maryland CNA-DT certificate within three (3) months from date of hire OR</li><li>Out-of-state applicant must have active BONENT certification and provide proof of initial application for CNA-DT certification.</li></ul>New Mexico<ul><li>Must have New Mexico dialysis technician certificate at time of hire OR</li><li>Hired at USRC location recognized by state of New Mexico as an approved dialysis technician training program and obtain New Mexico state certification within six (6) months of successful completion of training program OR</li><li>New Mexico certification of hemodialysis technician is required for out of state applicant with active state or national hemodialysis certification; must obtain New Mexico state certification prior to working as a Certified Hemodialysis Technician. </li><li>After January 1st, 2024, all initial applications for the certified hemodialysis technician will require a national hemodialysis technician certificate.</li><li>The applicant must submit proof of a valid national hemodialysis technician certificate from a recognized organization.</li><li>Hemodialysis technician students must have a current basic life support credential prior to and while the student has contact with patients</li></ul>OHIO<ul><li>Must have Ohio dialysis technician intern certificate at time of hire OR</li><li>Hired at USRC location recognized by state of Ohio as an approved dialysis technician training program and submit application for Ohio dialysis technician intern certificate to board no later than four (4) weeks prior to completion of the approved training program.</li><li>Must obtain Ohio Board of Nursing Certificate (OCDT) not less than twelve (12) months and not later than eighteen (18) months of enrolling in the USRC OCDT program.</li></ul>OREGON<ul><li>Must possess current Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division at time of hire OR</li><li>Must obtain Oregon dialysis technician provisional certificate within three (3) weeks of successful completion of training program and obtain Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division within eighteen (18) months. An Oregon Provisional Certification is valid for six months and can be renewed for one additional six month period.</li></ul>&nbsp;

U.S. Renal Care

Dialysis Patient Care Technician TTS

Dialysis Patient Care Technician MWF

Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Facility Site Review (FSR) Nurse Specialist RN II conducts Full Scope Reviews, Site Review Surveys, Medical Record Review Surveys, Specialty Site Review Surveys, physical accessibility review survey (PARS) assessments, Focused Reviews, Interim Onsite Reviews, Consultation/Educational Site visits, Investigative visits, and/or other appropriate site visits to ensure quality FSR and physician compliance with Local, State, and Federal requirements.&nbsp; The FSR Nurse Specialist RN II may also conduct face-to-face visits with our high-membership physicians to provide feedback, data, and education on programs and facilitates changes to improve quality of care and service to members.<h4>Duties</h4>Conducts audits utilizing Department of Health Care Services (DHCS) FSR/MRR/PARS tools.&nbsp; Provides pre-audit and /or post audit educational sessions. Issue Corrective Action Plans (CAPs) and provide assistance or follow up in implementing adequate correction(s) on-site. Gives providers health education materials and clinical tools to facilitate improved screening, preventive care, and chronic disease management; promote clinical quality improvements in practices.Acts as the Provider Quality Improvement Liaison (PQIL) to assess and communicate issues and improvement opportunities identified during the physician site visit.Communicates and coordinates information and findings from site visits between FSR Manager, internal and external staff and provider sites.&nbsp; Documents discussions and correspondence in FSR file as appropriate.Assists and participates in the Annual Audit of Plan Partners delegated for FSR.Perform other duties as assigned.<h4>Duties Continued</h4><h4>Education Required</h4>Associate's Degree in Nursing<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4>Required:At least 5 years of clinical experience including, but not limited to Emergency Room (ER)/Acute care nursing or outpatient setting.Preferred:&nbsp; Medi-Cal managed-care auditing experience.At least one (1) year experience in Quality Improvement and/or familiar with DHCS audit tool.<h4>Skills</h4>Required: Excellent verbal and written communication skills.Excellent organizational and time-management skills.Proficient in Microsoft Office.<h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California LicenseMust obtain and maintain successful completion of a DHCS Certified Site Reviewer certification in order to conduct DHCS accepted audits independently within 8 months of date of hire in the position.<h4>Licenses/Certifications Preferred</h4>Department of Health Care Services (DHCS) Certified Site Reviewer<h4>Required Training</h4>1:1 on-site and/or virtual training with Certified Site Reviewers (CSRs) until certification is obtained. Minimum of 8 months.&nbsp; <h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Required:Travel to offsite locations for work.Travel is required 80% of time.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul>

L.A. Care Health Plan

Facility Site Review Nurse Specialist RN II

Job Description:POSITION SUMMARY:The Enrollment Counselor position at Pacific Oaks supports all recruitment, admissions, and advising efforts at the college. Additionally, it helps with activities by handling communications, information, and paper flow with prospective and admitted students. The successful candidate will be an articulate, organized, results-driven, dynamic, enthusiastic, and collaborative member of the team.This position is located in Pasadena and reports directly to the Director of AdmissionsSUPERVISION RECEIVED:The incumbent performs a variety of routine work within established policies and procedures and receives detailed instructions on new projects and assignments.SUPERVISION EXERCISED:Minimal or no supervisory responsibilities.ESSENTIAL FUNCTIONS:<ul><li>Provide excellent customer service to prospective students throughout the full admission recruitment process</li><li>Meet daily expectations for outbound dials, set campus consultations</li><li>Meet with prospective students to counsel on completing Admissions requirements, discusses academic programs, admission options, and financial aid opportunities and conducts campus tours.</li><li>Meet/exceed Admission benchmark goals</li><li>Availability to work evening shifts and a rotating Saturday shift as needed</li><li>Follow up with prospects and applicants by phone and written correspondence.</li><li>Plan and coordinate on-campus Information Sessions and Open Houses for prospective students</li><li>Regularly attends the school department staff meetings</li><li>Assist new and continuing students with registration process</li><li>Follow up with admitted/current students to ensure they maintain part-time/full-time status</li><li>Liaise with corresponding departments to support the admissions team</li><li>Ensure students meet with Faculty Advisors to outline program completion plans</li><li>Track and document all communication with Inquiries, applications and students through Salesforce and Campus Vue</li><li>Contributes to a work environment that encourages knowledge of, respect for, and development of skills to engage with those of other cultures or backgrounds.</li><li>Perform other duties as assigned.</li></ul>Is regular attendance an essential function?&nbsp; ☒ Yes&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ NoESSENTIAL KNOWLEDGE, SKILLS and ABILITIES:Knowledge:<ul><li>Sales Expertise: Proficient in sales and account management.</li><li>Program Knowledge: Familiarity with CFP, HD, SOE programs, and state licensure requirements.</li></ul>Skills:<ul><li>Consultative Approach: Skilled in addressing concerns and assisting with enrollment decisions.</li><li>Communication Skills: Excellent written and verbal communication.</li></ul>Abilities:<ul><li>Goal-Oriented: Accountable for meeting monthly goals and performance expectations.</li><li>Relationship Building: Effective in establishing rapport with prospective students.</li><li>Time Management: Strong organizational and multi-tasking abilities.</li><li>Independent and Collaborative: Capable of working both independently and collaboratively in a fast-paced environment.</li></ul>PREFERRED KNOWLEDGE, SKILLS, AND ABILITIES:Knowledge:<ul><li>Non-Traditional Students: Experience with non-traditional student populations.</li><li>Credentialing Information: Knowledge about credential program information and school credentialing requirements.</li><li>Industry Knowledge: Familiarity with the education sector.</li></ul>Skills:<ul><li>Professional Interaction: Skilled in networking and group presentations.</li><li>Inquiry Management: Effective in generating and following up on inquiries.</li><li>Public Speaking: Excellent presentation skills.</li></ul>Abilities:<ul><li>Self-Motivated: Goal-oriented and proactive in recruiting students.</li><li>Event Coordination: Proficient in planning logistics and coordinating events.</li><li>Consistent Performance: Proven track record of consistent results.</li><li>Admissions Guidance: Experienced in enrollment and academic advising.</li><li>Positive Attitude: Promotes a healthy work environment.</li><li>Travel and Flexibility: Willing to travel and work flexible hours, including evenings and weekends.</li></ul>POSITION QUALIFICATIONS:<ul><li>Education: Bachelor’s degree or equivalent years of related experience required</li><li>Experience: Minimum of 1 year of college admissions, recruitment or sales required; non-traditional higher education recruitment or sales experience preferred.</li></ul>TYPICAL WORKING CONDITIONS<ul><li>Office environment; typically, 70 degrees</li><li>Noise level is usually quiet to moderately noisy while in the office</li></ul>EQUIPMENT USED:<ul><li>Computer/Laptop</li></ul><ul><li>Telephone</li><li>Copier, scanner and fax machines</li></ul>ESSENTIAL PHYSICAL &amp; MENTAL TASKS: (Check all that apply):Physical Demands: ☒ Standing&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Lifting:&nbsp; 10 Lbs.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Pushing/Pulling&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Driving☐ Walking&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Carrying&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Hearing&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Speaking☐ Reaching&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Writing &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Squatting/Kneeling&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Seeing☐ Climbing&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Pushing&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Other:&nbsp; TypingPhysical Environment - Exposed to:&nbsp; ☒ Noise&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Heat/Cold&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Fumes/Gases&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Human Tissue/Fluids☐ Chemicals&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Carcinogens&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Dirt&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Animal Tissue/Fluids☐ Toxic Chemicals&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Radiation&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐Other:&nbsp;☐ Biohazardous MaterialMental Demands:&nbsp; ☒ Reading&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Frequent Interruptions&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Periods of Concentrated Attention&nbsp;&nbsp;&nbsp;☒ Detailed Work&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐ Irregular Work Schedule&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☒ Frequent Contact with People☒ Frequent Deadlines&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ☐Other:&nbsp;☒ Multiple Concurrent TasksTRAVEL: (% of total time): Up to 5% of total timeENVIRONMENTAL CONDITIONS:The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job:&nbsp;The noise level in the work environment is usually quite to moderately noisy while in the office.&nbsp; The office temperature is about 70 degrees.DECISION MAKING:The position is governed by the policies of Pacific Oaks, along with established procedures for the department.CONTACT RESPONSIBILITIES:Routine exchange or presentation of information.Responsible for demonstrating professionalism and leadership in resolving conflicts with students and employees.&nbsp; Recommends alternative approaches to solve problems and conflicts.&nbsp;FINANCIAL RESPONSIBILITY:This position does not require the management of budgets, but it is required to follow Pacific Oaks policies for purchasing and budget approvals.Compensation &amp; BenefitsThis opportunity is budgeted at $20.00-21.50 base compensation. Additional compensation factors may impact total compensation. To learn more about our competitive benefits and additional rewards, including generous paid time-off, medical and dental insurance coverage, life and disability insurance, retirement plan with employer contribution, multiple flexible spending accounts, tuition reimbursement, click the link below.<a href="https://www.pacificoaks.edu/about/careers-pacific-oaks/" target="_blank">https://www.pacificoaks.edu/about/careers-pacific-oaks/</a>Pacific Oaks is an Equal Opportunity Employer.Pacific Oaks participates in E-Verify and verifies identity and employment eligibility of all persons hired. The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. Pacific Oaks offers equal employment opportunities to all persons without regard to race, color, ethnicity, religion, sex, sexual orientation, national origin, age, marital status, physical or mental disability, parental status, housing status, source of income or military status, in accordance with applicable federal, state and local EEO laws.

Pacific Oaks Children’s School

Enrollment Counselor

Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. Assures timely and accurate determination and notification of referrals and reconsiderations based on the referral determination status. Generates approval, modification and denial communications, to include member and provider notification of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, member/family interaction to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review. Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers. Acts as a department resource for medical service requests /referral management and processes. Receives incoming calls from providers, professionally handles complex calls, researches to identify timely and accurate resolution steps. Follows up with caller to provide response or resolution steps. Answers all inquiries in a professional and courteous manner.<h4>Duties</h4>Promote and support team engagements, programs and activities to create and ensure a positive and productive workplace environment.Perform telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, the member and significant others to develop and implement a successful discharge plan. Process, finalize and facilitate inbound requests that are received from providers. Generate appropriate member and provider communication for all determinations within the required timelines as defined by the most current department policy.Facilitate/review requests for Higher level of care or skilled nursing/discharge planning needs. Research for appropriate facilities, specialty providers and ancillary providers to utilize for all lines of business. Identification of potential areas of improvement within the provider network.Identify and initiate referrals for appropriate members to the various L.A. Care programs/processes and external community based programs or Linked and Carve Out Services (e.g. DDS/CCS/MH). Potential quality of care/potential fraud issues are identified and documented per L.A. Care policy. High risk/high cost cases and reports are maintained and referred to the Physician Advisor/UM Director. Document in platform/system of record. Utilize designated software system to document reviews and/or notes. Receive incoming calls from providers, professionally handle complex calls, research to identify timely and accurate resolution steps. Follow up with caller to provide response or resolution steps. Answer all inquiries in a professional and courteous manner.<h4>Perform other duties as assigned. </h4><h4>Duties Continued</h4><h4>Education Required</h4>Associate's Degree in Nursing<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4>Required: At least 5 years of varied clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting .&nbsp;Preferred: Managed Care experience performing UM and CM at a medical group or management services organization.Experience with Managed Medi-Cal, Medicare, and commercial lines of business.<h4>Skills</h4>Required: Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint. &nbsp;Effectively utilizes computer and appropriate software and interacts as needed with L.A. Care Information System. Knowledge of personal computer, keyboarding, and appropriate &nbsp;software to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Prepare clear, comprehensive written and oral reports and materials.&nbsp;Provision of excellent customer service required due to frequent communication with providers and other members of the interdisciplinary team &nbsp; Excellent time management and priority-setting skills.Maintains strict member confidentiality and complies with all HIPAA requirements.Strong verbal and written communication skills. &nbsp; &nbsp;Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM).&nbsp;Knowledge of Department of Health Care Services (DHCS) or Centers for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM.<h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California License<h4>Licenses/Certifications Preferred</h4>Certified Case Manager (CCM)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>May work on occasional weekends and some holidays depending on business needs.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul>

Utilization Management Nurse Specialist RN II

The RN Charge Nurse is responsible for overseeing nursing services each shift and functions as a nursing supervisor. This position provides daily supervision of staff on duty during operational hours.Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.<ul><li> Assist with clinical and operational processes to improve patient health and minimize hospitalizations and missed treatments.</li><li> Demonstrate effective use of supplies and staff labor hours.</li><li> Complete and document monthly review of patient medication profiles. Administer medications as ordered by the physician.</li><li> Assist physician during patient rounds and transcribe and implement physician orders timely.</li><li> Assist with the implementation of anemia management and medication protocols as requested.</li><li> Knowledge of and comply with federal, state, local laws and regulations, including health care professionals practice act requirements.</li><li> Perform duties at all times within limitations established by and in accordance with company policy and procedures, applicable state and federal laws and regulations.</li><li> May give direct patient care to the extent of performing efficient, safe dialysis, if allowed by state regulations.</li><li> Responds to all emergencies in clinic.</li><li> Communicate results of patient assessment, reassessment, and ongoing monitoring to the physician, team members, and others as appropriate to the individual needs of the patient.</li><li> Maintain collaborative working relationship with Medical Director and physicians.</li><li> Participate as a member of the Interdisciplinary team in all required patient assessment and care planning activities.</li><li> Assist in orientation of new staff as a preceptor or in assigning a preceptor.</li><li> Acts as resource person and participates in implementing and evaluating dialysis services and assures that policies and procedures are updated.</li><li>Assists Administrator in interviewing, hiring, evaluating, and disciplinary actions of center staff</li></ul>

Dialysis Registered Nurse - Charge

The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California.Work Culture:GCHP strives to create an inclusive, highly collaborative work culture where our people are empowered to grow and thrive. This philosophy enables us to create the health plan of the future and do our best work – Together.GCHP promotes a flexible work environment. Employees may work from a home location or in the GCHP office for all or part of their regular workweek (see disclaimer).GCHP’s focuses on 5 Core Values in the workplace:• Integrity• Accountability• Collaboration• Trust• RespectDisclaimers:• Flexible work schedule is based on job duties, department, organization, or business need.• Gold Coast Health Plan will not sponsor applicants for work visas.POSITION SUMMARYThe Medicare Compliance Manager reports directly to the Senior Director, Compliance and is responsible for developing, administering and overseeing the Medicare Compliance Program and initiatives in alignment with overall D-SNP strategy as set by the D-SNP leadership. This role will manage and implement compliance projects and program activities focusing on integrating regulatory requirements, industry standards, and organizational policies for Medicare, Medi-Cal, and Knox Keene. Support the oversight and management of the compliance program, implemented to ensure that Gold Coast Health (GCHP) and its first-tier, downstream and related entities (FDRs) consistently operate in accordance with all applicable federal and state laws, regulations, and regulatory guidance.The Medicare Compliance Manager will possess a deep knowledge of Medicare regulations, strong leadership skills, and a commitment to promoting a culture of compliance throughout the organization.Duties may also include additional compliance activities assigned by the Chief Compliance Officer or Privacy Officer.Amount of Travel Required: 10%Reasonable Accommodations StatementTo accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.ESSENTIAL FUNCTIONSJob Function &amp; Responsibilities• Develop, implement, integrate, and manage the Medicare compliance program for D-SNP line of business, ensuring it aligns with regulatory requirements and industry best practices. Ensure integration of the Medicare compliance program with GCHP’s existing compliance program and alignment with overall D-SNP strategy as set by the D-SNP leadership.• Provide guidance and leadership to cross-functional teams involved in Medicare, Medi-Cal, and Knox Keene compliance activities.• Collaborate with the Government Affairs Department to maintain compliance with CMS, DHCS, and DMHC requirements, including GCHP’s Knox Keene license and contractual obligations with regulatory agencies.• Collaborate with the Compliance Department, Operations Oversight Department, D-SNP leadership and other internal stakeholders to address compliance issues, develop corrective action plans (CAPs), and monitor progress towards resolution.• Responsible for daily monitoring of CMS’s Health Plan Management System (HPMS), required DHCS reporting, DMHC filings, and other required regulatory submissions.• Work with the Sr, Director, Compliance, Government Affairs Department, and D-SNP leadership, in the creation, maintenance and implementation of HPMS memos, policies, procedures and compliance documents.• Ensure that communication of Medicare regulatory information is clear and concise and disseminated. Ensure that responsible parties are implementing solutions to support internal and external operational compliance.• Consult on investigations for any incoming Medicare Part C and D compliance complaints of potential non-compliance, including collaborating with SIU regarding potential Fraud, Waste and Abuse, as needed.• Maintain proficiency of changes in Medicare Part C and D, Medi-Cal, and Knox Keene regulations, guidance, and enforcement priorities as it pertains to MMP/D-SNP line of business.• Support the development and implementation of compliance training and educational materials on Medicare, Medi-Cal, and Knox Keene.• Participate in Medicare compliance-related committees, working groups, and initiatives to promote a culture of integrity, ethics, and compliance.• Work with Compliance team to create and maintain an effective Medicare compliance program, including processes for the review, analysis and stratification of compliance risks and issues.• Provide routine updates regarding compliance performance concerns and risks to the Sr, Director, Compliance and D-SNP leadership, including supporting technical and analytical information as needed.• Support external audits, and educate internal business partners, vendors and delegates on Medicare requirements in preparation for audits, data reporting, and data validation activities to ensure the best possible outcomes.• Collaborate with Human Resources and Compliance Program Manager to ensure that covered persons are checked against the Office of Inspector General (OIG) exclusion lists and General Services Administration (GSA) debarment lists monthly and FDR attestation/certifications are signed.MINIMUM QUALIFICATIONSEducation &amp; Experience:Required Education and Experience:• Bachelor's degree in Healthcare Administration, Business Administration, or in a related field• Minimum of 5 years of experience in healthcare compliance, with a focus on Medicare compliance and regulations.• Medicare part C and D expertise, including demonstrable knowledge of Medicare regulations, guidelines, audit protocols and processes.Preferred Education and Experience:• Master's degree in Healthcare Administration, Business Administration, or in a related field• Prior experience with CMS audits (program, timeliness, and data validation) as well as DHCS and DMHC compliance requirements.• Broad and detailed knowledge of health plan operations and best practices.• Experience with Corporate Integrity Agreements.• 3 years of experience in program management or project management• Equivalent In lieu of degree: Will accept experience in any combination of academic education, professional training, or work experience, which demonstrates the ability to perform the duties of the position.• 9 years of healthcare compliance experience, with a minimum of 6 years in the Medicare compliance space.KNOWLEDGE, SKILLS &amp; ABILITIESPreferred Qualifications:• Ability to establish, nurture and maintain strong and effective working relationships with GCHP staff, governmental and regulatory staff, legal counsel, and others.• Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes.• Ability to assume responsibility and exercise good judgment with making decisions within the scope of the position.• Technology &amp; Software Skills: Advanced computer skills in MS Office products.• Certifications &amp; Licenses: A valid and current Driver's License, Auto Insurance, and professional licensure(s)• Healthcare compliance certification: Certification in Healthcare Compliance (CHC), Certified in Healthcare Privacy and Compliance (CHPC) or will obtain certification within 18 months of employment.Competency Statements• Management Skills - Ability to organize and direct oneself and effectively supervise others.• Business Acumen - Ability to grasp and understand business concepts and issues.• Decision Making - Ability to make critical decisions while following company procedures.• Goal Oriented - Ability to focus on a goal and obtain a pre-determined result.• Interpersonal - Ability to get along well with a variety of personalities and individuals.• Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.• Time Management - Ability to utilize the available time to organize and complete work within given deadlines.• Consensus Building - Ability to bring about group solidarity to achieve a goal.• Relationship Building - Ability to effectively build relationships with customers and co-workers.• Presentation Skills - Ability to effectively present information publicly.• Delegating Responsibility - Ability to allocate authority and/or task responsibility to appropriate people.• Leadership - Ability to influence others to perform their jobs effectively and to be responsible for making decisions.• Strategic Planning - Ability to develop a vision for the future and create a culture in which the long-range goals can be achieved.• Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards.• Judgment - The ability to formulate a sound decision using the available information.• Communication, Oral - Ability to communicate effectively with others using the spoken word.• Communication, Written - Ability to communicate in writing clearly and concisely.• Problem Solving - Ability to find a solution for or to deal proactively with work-related problems. Apply Here: <a href="https://www.click2apply.net/llaJzGUXoY5epHQBaiPea5" target="_blank">https://www.click2apply.net/llaJzGUXoY5epHQBaiPea5</a> PI249579339

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