Senior Network Security Engineer -USA, Remote - $100,000 – 120,000

Senior Network Security Engineer
Remote Working
Full-Time, Permanent
$100,000 – 120,000

Our client has an opportunity for a Senior Network Engineer - Remote. The Senior Network Engineer establishes and maintains network performance by building net configurations and connections, troubleshooting network problem and overseeing Lifepoint’s vendor relationship with Parallon.

Our client is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioural health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

ESSENTIAL FUNCTIONS:  To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.

·        Act as primary point of contact for Lifepoint’s vendor relationship with Parallon, enforces contractual terms and ensures accountability.

·        Establish networking environment by system design configuration; direct system installation; define, document, and enforce system standards.

·        Maximize network performance through system performance monitoring; troubleshoot network problems and outages and schedule applicable upgrades with vendor.

·        Secure network system: establish and enforce standard policies and monitor processes.

·        Troubleshoot Level 3 issues and involve vendor as appropriate

·        Integrate newly acquired entities into LifePoint network environment.

·        Support Health Support Center (HSC) Health Informatics & Technology Services (HITS) department on various assigned projects.

·        Regular and reliable attendance.

·        Perform other duties as assigned.

Additional Information:

·        Position serves both internal co-workers and external customers, clients, patients, contractors, and vendors.

·        Access to and / or works with sensitive and / or confidential information.

·        Exhibit a comprehensive understanding of healthcare regulatory and compliance (e.g., HIPAA).

·        Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recommended Practices.

Qualifications - External

KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education:  Bachelor’s Degree or equivalent relevant experience.

Experience: Minimum 5 years of relevant experience as Network Administration assisting Level 3 issues.

Minimum overnight travel (up to 10%) by land and/or air.

Senior Analyst- Revenue Analytics - USA, Brentwood TN - $80,000 - $95,000

Senior Analyst- Revenue Analytics

USA, Brentwood TN

$80,000 - $95,000

Job Description

We have an opportunity for a Senior Analyst, Revenue Analytics - Hybrid. The Senior Analyst, Revenue Analytics provides financial analysis and analytics support to operations, financial operations, and the Revenue and Network Management area with a focus on Revenue Cycle. Creates and maintains various monthly/weekly reports and ad hoc patient revenue analyses to support both the revenue cycle and managed care teams.

We are a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

ESSENTIAL FUNCTIONS:

·        Utilize models and several Business Intelligence (BI) tools to gather, manipulate, and analyze data to provide insight into the company and its revenue cycle partners.

·        Collect, aggregate, and analyze data from multiple internal and external sources to drive insights into business performance.

·        Drive business decisions by providing quantitative and qualitative data analysis and reporting of patterns, insights, and trends to decision-makers.

·        Summarize reimbursement by payor, facility, insurance plan, etc., to analyze underpayments or various payment scenarios.

·        Design, develop, and deliver ad hoc reporting and data analysis for the Revenue Cycle departments utilizing SQL, Power BI, Tableau, Business Objects, and other query tools.

·        Redesign reporting processes, creating databases, and build reporting models requiring an understanding of business processes, reporting needs, and a very complex information system.

·        Assist with training and mentoring of other analytic staff.

·        Manage report development lifecycle including requirements, design, development, testing, and support.

·        Troubleshoot and analyze data issues within reports.

·        Develop and maintain other BI and analytics standards including data sources and a data dictionary.

·        Update standard revenue cycle reports per their reporting schedule or as needed.

·        Regular and reliable attendance.

·        Perform other duties as assigned.

Additional Information:

·        Position serves both internal co-workers and external customers, clients, patients, contractors, and vendors.

·        Access to and/or works with sensitive and/or confidential information.

·        Exhibit a basic understanding of healthcare regulatory and compliance (e.g., HIPAA). Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recommended Practices.

Payment Policy Manager - USA, Remote - $95,000 - $105,000

Payment Policy Manager

USA, Remote

$95,000 - $105,000

Job Description

It’s an exciting time to join our company, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

The Payment Policy Manager is responsible for managing cross-departmental implementation of changes to payment and billing policies as necessary due to regulatory changes, contractual changes, or as a result of claims data findings. The Payment Policy Manager will collaborate with internal departments to define requirements and to document those requirements sufficiently to ensure accurate implementation of payment rules within the Plan’s adjudication system, including the claim editing system, iCES. The Payment Policy Manager will also review current payment policies and compare them to those used by competitors, state regulatory agencies, and CMS to evaluate and recommend changes, and upon approval incorporate such changes into materials. As directed by the department manager, he/she will project manage regulatory changes that impact payment methods or rates, and help drive analytics to support decision-making. Additional specific duties and responsibilities include:

Our Investment in You:

·        Full-time remote work

·        Competitive salaries

·        Excellent benefits

Key Functions/Responsibilities:

·        Develops and maintains corporate payment policies, and works collaboratively with the Clinical Editing Manager to ensure consistency with the Plan’s adjudication system(s)

·        Monitors DHHS, EOHHS, and CMS websites, listservs and other sources to identify existing payment practice and upcoming changes. Determines the scope and impact of the change on Plan operations and seek to implement changes as necessary

·        Staffs and participates in various work groups and committees to support payment policies and provides input into processes and workflows reliant on payment policy outcomes

·        Serves as the department’s project manager for: (1) regulatory information such as proposed and final Medicare and/or Medicaid payment regulations, Medicare Manual updates, DHHS and EOHHS fee schedules; and (2) regulatory issues. Determines the scope and impact of the information/issues and take appropriate action

·        Collaborates with Public Partnerships, Contracting, Medical Economics, Provider Relations, Benefit Administration, Business Configuration, and Provider Audit/OPL to determine the impact of implementing recommended policy changes

·        Develops project plans including: setting timelines and deliverables; determining resource requirements; documents decisions; draft communication plan; information-sharing with appropriate staff and seek approval from the Payment Policy Committee; and subsequently ensure successful completion of change

·        Serves as the company’s research specialist regarding Medicare and Medicaid payment policies.

·        Serves on the Operational Excellence Committee to ensure a consistent understanding of operational changes as they relate to payment policies and their downstream impact within the Claims department

·        Submits recommendations to the Payment Policy Committee and supports Committee efforts through subgroups and individually as needed

·        Collaborates with stakeholder departments to develop and maintain a database to serve a centralized location to store payment methodology information.

·        Researches, identifies and proposes opportunities for medical cost savings, improves claim auto adjudication rate and payment accuracy

Education:

·        Bachelor’s Degree in a related field or the equivalent combination of training and experience

Education Preferred/Desirable:

·        Master’s Degree or graduate work in a related field preferred

·        Coding Certification for Payers (CPC-P) preferred

·        AHIMA or other nationally recognized Coding Certification preferred

Experience:

·        6 or more years experience in a fast paced, managed healthcare environment is required.

·        6 or more years direct work in claims processing, payment policy, or contracting.

·        Extensive background of ICD-9 and CPT coding principles

·        Extensive knowledge of medical claim editing (NCCI, etc.)

·        Experience working with industry standard methods of payment including DRG, APC, RVU, etc.

·        Experience working with Medicaid, Medicare and commercial coding rules/ regulatory requirements.

Experience Preferred/Desirable:

·        Medical chart auditing

Competencies, Skills, and Attributes:

·        Demonstrated proficiency in coding and knowledge of the requirements of industry standards such as Medicare and/or Managed care regulations required.

·        Strong understanding of HIPAA Guidelines

·        Good communication skills, both oral and written, ability to interact well with others at all levels, strong organizational skills, strong customer service skills and orientation.

·        Expertise utilizing Microsoft Office products, including Project and PowerPoint

·        Knowledge of OptumInsight iCES product, or similar claims editing system

Senior HRIS Analyst- Compensation - USA, Remote - $80,000 - $100,000

Senior HRIS Analyst- Compensation

USA, Remote

$80,000 - $100,000

Job Description

Our company has an opportunity for a Sr. HRIS Analyst – Compensation- Remote. The Sr. HRIS Analyst – Compensation is responsible for supporting the design, development, testing, implementation, and on-going administration of our’s Advanced Compensation functionality and ensure HCM configuration supports outsourced benefit enrollment processes. This position also partners with Human Resources to enable system processes and data elements while continually evaluating the effectiveness of HRIS tools and processes to align with business needs. In addition, this position works with Finance to ensure HCM configuration effectively supports payroll and garnishment processing. The Sr. HRIS Analyst – Compensation must be passionate about delivering exceptional customer support while fulfilling HRIS responsibilities for Human Resources and its customers. This individual must have great interpersonal and collaboration skills.

Our company is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

ESSENTIAL FUNCTIONS: To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.

·        System Development: Serves as a system administrator who is responsible for the configuration and maintenance of our companies’ Advanced Compensation HCM business processes, workflow and reporting.

·        Subject Matter Expert: Serves as HRIS compensation subject matter expert for HR and Finance customers, helping to assess business issues, providing knowledge on system configuration and workflow. Collaborates with Core, Talent, Benefits, and other HRIS teams on a variety of projects and initiatives, including design, analysis, budgeting, and implementation of new projects and programs.

·        System Maintenance: Responsible for the review, testing and implementation of system upgrades. Provides notification to customers on impact of system upgrades or maintenance to existing processes, workflow, or reporting.

·        Writes, maintains, and supports a variety of reports or queries using appropriate reporting tools. Assist in development of standard reports for ongoing customer needs and analyzes data flows for process improvement opportunities.

Projects/Process Improvement: Resolves problems, recommending solutions or alternate methods to meet business needs, builds efficiencies and drives optimization. Recommends process improvements, innovative solutions, and ways to remain compliant with policy and legal changes.

User Support: Works directly with internal customers to help troubleshoot issues. Identifies areas needed for extra training or communication, including system or process updates. Initiates efforts and procedures to maintain data integrity, troubleshoot and recommend solutions. Serves as point of contact for HRIS Compensation technical assistance.

Training: Develops user procedures, guidelines and documentation. Trains new system users as needed and ensure successful implementation of change.

System Integration: Takes ownership of HRIS Compensation processes and manages interface between HR systems and third-party systems/solutions, while enhancing and driving efficiencies in support of enterprise initiatives.

Perform other duties as assigned.

Additional Information:

·        Serves as HRIS Compensation point of contact for upgrades, testing and other technical projects as assigned.

·        Supports the continued development of HRIS methodologies, tools, and best practices within the company.

·        Position serves both internal co-workers and external customers and vendors.

·        Access to and/or works with sensitive and/or confidential information.

·        Exhibit a basic understanding of healthcare regulatory and compliance (e.g., HIPAA). Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recommended Practices.

At our company, our Mission of Making Communities Healthier extends to our employees. We offer an excellent total compensation package, including a competitive salary and benefits. Some of our benefits include 401k, flexible PTO, generous Employee illness benefit (EIB), medical, dental, vision, tuition reimbursement, and an Employee Assistance Program. We believe that happy, healthy people have a passionate engagement with life and work and have designed our package to enhance your wellbeing.