Description Individual will have oversight for eligibility, enrollment and billing functions for Individual (On and Off Exchange), Medicare Advantage, Small Group and Uniformed Services Family Health Plans, for a multi-state health insurer. Primary responsibilities include management of both internal and external (via vendor) processes supporting enrollment, membership reconciliation, data accuracy, discrepancy resolution, billing, payment, collections, financial reconciliation, and all related member correspondence and service. The successful candidate will have extensive experience in a functional leadership role, and familiarity with both commercial and regulated health insurance. This position is responsible for managing and coordinating team efforts toward a specific service deliveryfunctionof the health plans. The position provides coaching, feedback, and corrective action to health plan associates where needed. The Director of Eligibility, Enrollment and Billing is also responsible for leading discussions with the applicable regulatory agencies, and will act as the primary liaison between the CHRISTUS Health Plan and any third party vendors providing relevant services. MAJOR RESPONSIBILITIES Manages multiple teams responsible for preparing, processing and maintaining new member or group enrollments, and overseeing the loading of new members or group data into appropriate eligibility systems. Collaborates with other service function leaders to prioritize emerging issues and coordinate timely resolutions, including Call Center Operations and Complaints & Appeals. Has oversight for ongoing data reconciliation activities, with both government entities and employers; will lead teams in analyzing transactional data, prioritizing discrepancies and providing timely and accurate resolution. Establishes and executes a detailed renewal plan for all lines of business, focusing on member retention and member satisfaction. Primary liaison to external vendors supporting enrollment and/or billing, with oversight to both day-to-day functions and ad hoc needs. Oversees the documentation of business requirements to enhance or expand operational efficiencies supporting enrollment and billing; provides input to cross-functional prioritization meetings, to establish both tactical and strategic improvements. Manages staff in daily functions to ensure all processes are completed within regulatory and quality standards Meets and exceeds department quality audits and provide coaching to team members Oversees internal enrollment agents, trains and supervises agents on the enrollment process Handle all escalations courteously, politely and professionally Act as back-up support for departmental managers and leadership as needed for meetings and other departmental responsibilities Serves as the subject matter expert for the enrollment process for multiple plans, including Medicare Advantage, Small Group, Uniformed Services Family Health Plan, and Health Insurance Exchange. Acts as the liaison with federal and state contacts on eligibility and enrollment topics Supports external audits focused on enrollment and/or billing data and functions, as needed. Perform other duties as assigned Requirements College degree and/or minimum of 10 years healthcare supervisory experience. Strong knowledge and experience with Medicare policies and standards of eligibility. Strong knowledge and experience with Individual and Small Group enrollment, rating and billing regulations, post ACA. Must have strong analytical, and writing skills Demonstrated maturity and capacity to navigate a complex structure and respond to shifting and fluid priorities Excellent judgment, the ability to communicate openly among colleagues at all levels, a 'hands-on' approach, and the ability to think strategically and produce strong results Ability to prioritize, work on tight deadlines and work on multiple projects Demonstrated success with building and guiding a team to develop and monitor enrollment, eligibility and billing functions within the health plan
May 20, 2019
Description Individual will have oversight for eligibility, enrollment and billing functions for Individual (On and Off Exchange), Medicare Advantage, Small Group and Uniformed Services Family Health Plans, for a multi-state health insurer. Primary responsibilities include management of both internal and external (via vendor) processes supporting enrollment, membership reconciliation, data accuracy, discrepancy resolution, billing, payment, collections, financial reconciliation, and all related member correspondence and service. The successful candidate will have extensive experience in a functional leadership role, and familiarity with both commercial and regulated health insurance. This position is responsible for managing and coordinating team efforts toward a specific service deliveryfunctionof the health plans. The position provides coaching, feedback, and corrective action to health plan associates where needed. The Director of Eligibility, Enrollment and Billing is also responsible for leading discussions with the applicable regulatory agencies, and will act as the primary liaison between the CHRISTUS Health Plan and any third party vendors providing relevant services. MAJOR RESPONSIBILITIES Manages multiple teams responsible for preparing, processing and maintaining new member or group enrollments, and overseeing the loading of new members or group data into appropriate eligibility systems. Collaborates with other service function leaders to prioritize emerging issues and coordinate timely resolutions, including Call Center Operations and Complaints & Appeals. Has oversight for ongoing data reconciliation activities, with both government entities and employers; will lead teams in analyzing transactional data, prioritizing discrepancies and providing timely and accurate resolution. Establishes and executes a detailed renewal plan for all lines of business, focusing on member retention and member satisfaction. Primary liaison to external vendors supporting enrollment and/or billing, with oversight to both day-to-day functions and ad hoc needs. Oversees the documentation of business requirements to enhance or expand operational efficiencies supporting enrollment and billing; provides input to cross-functional prioritization meetings, to establish both tactical and strategic improvements. Manages staff in daily functions to ensure all processes are completed within regulatory and quality standards Meets and exceeds department quality audits and provide coaching to team members Oversees internal enrollment agents, trains and supervises agents on the enrollment process Handle all escalations courteously, politely and professionally Act as back-up support for departmental managers and leadership as needed for meetings and other departmental responsibilities Serves as the subject matter expert for the enrollment process for multiple plans, including Medicare Advantage, Small Group, Uniformed Services Family Health Plan, and Health Insurance Exchange. Acts as the liaison with federal and state contacts on eligibility and enrollment topics Supports external audits focused on enrollment and/or billing data and functions, as needed. Perform other duties as assigned Requirements College degree and/or minimum of 10 years healthcare supervisory experience. Strong knowledge and experience with Medicare policies and standards of eligibility. Strong knowledge and experience with Individual and Small Group enrollment, rating and billing regulations, post ACA. Must have strong analytical, and writing skills Demonstrated maturity and capacity to navigate a complex structure and respond to shifting and fluid priorities Excellent judgment, the ability to communicate openly among colleagues at all levels, a 'hands-on' approach, and the ability to think strategically and produce strong results Ability to prioritize, work on tight deadlines and work on multiple projects Demonstrated success with building and guiding a team to develop and monitor enrollment, eligibility and billing functions within the health plan
Provides professional nursing care for the comfort and well-being of patients. Prepares equipment and assists physician during examinations and treatments. Administers prescribed medications, changes dressings, cleans wounds, and monitors patient vital signs. Observes and maintains records on patient care, condition, reaction, and progress. The CHRISTUS Spohn South Labor and Delivery, Antepartum and Obstetrical Emergency Departments are all staffed by one group of associates that are crossed trained in all three areas. Registered Nurses, OB Surgical Technicians, Certified Nurse Aides and Unit Secretaries make up our wonderful team of associates. In addition we have 24-hour CRNA coverage for maternity anesthesia and our OBED is staffed with in-house OB Hospitalist to accept transfers, care for patients and handle emergencies 24 hours a day. We average about 220 deliveries per month. We are capable of providing care for our patients in need of Non-stress test, Amniocentesis, Induction of Labor, Management of Postpartum complications such as hemorrhage or elevated blood pressure, and have the capability to begin an emergency section within 30 minutes of decision time and recognized as a Texas Ten Step for Breastfeeding. Our department is a happy environment for the patient and family, and our team provides an exceptional patient experience. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Spohn family! Click here for a tour of our birthing suites: **This position qualifies for Relocation Assistance as well as a SIGN-ON BONUS based on experience.** Graduate of an accredited school of nursing. Able to assess, plan, implement and evaluate nursing care One-year experience in nursing preferred. Will accept new graduate. Current Texas State RN License CPR (American Heart Association) ACLS required within six months of hire or transfer NRP required within 90 days of hire or transfer date AWHONN Fetal Heart Monitoring Certification required; Experienced RNs have 6 months from hire/transfer date to obtain certification. New grads and transfers new to Labor & Delivery will have one year from hire/transfer date to obtain certification.
May 14, 2019
Full time
Provides professional nursing care for the comfort and well-being of patients. Prepares equipment and assists physician during examinations and treatments. Administers prescribed medications, changes dressings, cleans wounds, and monitors patient vital signs. Observes and maintains records on patient care, condition, reaction, and progress. The CHRISTUS Spohn South Labor and Delivery, Antepartum and Obstetrical Emergency Departments are all staffed by one group of associates that are crossed trained in all three areas. Registered Nurses, OB Surgical Technicians, Certified Nurse Aides and Unit Secretaries make up our wonderful team of associates. In addition we have 24-hour CRNA coverage for maternity anesthesia and our OBED is staffed with in-house OB Hospitalist to accept transfers, care for patients and handle emergencies 24 hours a day. We average about 220 deliveries per month. We are capable of providing care for our patients in need of Non-stress test, Amniocentesis, Induction of Labor, Management of Postpartum complications such as hemorrhage or elevated blood pressure, and have the capability to begin an emergency section within 30 minutes of decision time and recognized as a Texas Ten Step for Breastfeeding. Our department is a happy environment for the patient and family, and our team provides an exceptional patient experience. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Spohn family! Click here for a tour of our birthing suites: **This position qualifies for Relocation Assistance as well as a SIGN-ON BONUS based on experience.** Graduate of an accredited school of nursing. Able to assess, plan, implement and evaluate nursing care One-year experience in nursing preferred. Will accept new graduate. Current Texas State RN License CPR (American Heart Association) ACLS required within six months of hire or transfer NRP required within 90 days of hire or transfer date AWHONN Fetal Heart Monitoring Certification required; Experienced RNs have 6 months from hire/transfer date to obtain certification. New grads and transfers new to Labor & Delivery will have one year from hire/transfer date to obtain certification.
Recovery Room/PACU opening in Beaumont, Texas. Description The staff Registered Nurse (RN) is a vital part of an interdisciplinary team assessing, planning, implementing, evaluating, and documenting care in efforts to deliver the highest levels of care to the patient and family. This position requires the full understanding and active participation in fulfilling the Mission of CHRISTUS Health St. Elizabeth Hospital, and demonstrating behavior consistent with the Core Values. Requirements Graduate of a State Board accredited School of Nursing or equivalent Current licenses or permit to practice professional nursing in the State of Texas Current BLS Must be able to communicate effectively and professionally with patients, families, and medical staff both verbally and written One year prior nursing experience preferred Today, we are one of the largest, most advanced facilities in the CHRISTUS Health System and the only Magnet Hospital between Houston and Baton Rouge. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Health St. Elizabeth Family!
May 09, 2019
Full time
Recovery Room/PACU opening in Beaumont, Texas. Description The staff Registered Nurse (RN) is a vital part of an interdisciplinary team assessing, planning, implementing, evaluating, and documenting care in efforts to deliver the highest levels of care to the patient and family. This position requires the full understanding and active participation in fulfilling the Mission of CHRISTUS Health St. Elizabeth Hospital, and demonstrating behavior consistent with the Core Values. Requirements Graduate of a State Board accredited School of Nursing or equivalent Current licenses or permit to practice professional nursing in the State of Texas Current BLS Must be able to communicate effectively and professionally with patients, families, and medical staff both verbally and written One year prior nursing experience preferred Today, we are one of the largest, most advanced facilities in the CHRISTUS Health System and the only Magnet Hospital between Houston and Baton Rouge. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Health St. Elizabeth Family!
Description The staff Registered Nurse (RN) is a vital part of an interdisciplinary team assessing, planning, implementing, evaluating, and documenting care in efforts to deliver the highest levels of care to the patient and family. This position requires the full understanding and active participation in fulfilling the Mission of CHRISTUS Health St. Elizabeth Hospital, and demonstrating behavior consistent with the Core Values. Requirements Graduate of a State Board accredited School of Nursing or equivalent Current licenses or permit to practice professional nursing in the State of Texas Current BLS Must be able to communicate effectively and professionally with patients, families, and medical staff both verbally and written One year prior nursing experience preferred Today, we are one of the largest, most advanced facilities in the CHRISTUS Health System and the only Magnet Hospital between Houston and Baton Rouge. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Health St. Elizabeth Family! Keyphrases: gastroenterology jobs, gastroenterologist jobs, gastro jobs, gastroenterologist associates jobs, pediatric gastroenterology jobs, pediatric gastroenterologist jobs
May 08, 2019
Full time
Description The staff Registered Nurse (RN) is a vital part of an interdisciplinary team assessing, planning, implementing, evaluating, and documenting care in efforts to deliver the highest levels of care to the patient and family. This position requires the full understanding and active participation in fulfilling the Mission of CHRISTUS Health St. Elizabeth Hospital, and demonstrating behavior consistent with the Core Values. Requirements Graduate of a State Board accredited School of Nursing or equivalent Current licenses or permit to practice professional nursing in the State of Texas Current BLS Must be able to communicate effectively and professionally with patients, families, and medical staff both verbally and written One year prior nursing experience preferred Today, we are one of the largest, most advanced facilities in the CHRISTUS Health System and the only Magnet Hospital between Houston and Baton Rouge. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Health St. Elizabeth Family! Keyphrases: gastroenterology jobs, gastroenterologist jobs, gastro jobs, gastroenterologist associates jobs, pediatric gastroenterology jobs, pediatric gastroenterologist jobs
Description The staff Registered Nurse (RN) is a vital part of an interdisciplinary team assessing, planning, implementing, evaluating, and documenting care in efforts to deliver the highest levels of care to the patient and family. This position requires the full understanding and active participation in fulfilling the Mission of CHRISTUS Health St. Elizabeth Hospital, and demonstrating behavior consistent with the Core Values. Our 78-bed comprehensive Medical Telemetry Unit specializes in acute or chronic multi-system organ failure affecting the heart, lungs and kidneys. Requirements Graduate of a State Board accredited School of Nursing or equivalent Current licenses or permit to practice professional nursing in the State of Texas Current BLS Must be able to communicate effectively and professionally with patients, families, and medical staff both verbally and written One year prior nursing experience preferred Today, we are one of the largest, most advanced facilities in the CHRISTUS Health System and the only Magnet Hospital between Houston and Baton Rouge. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Health St. Elizabeth Family! Keyphrases: cardiac telemetry jobs, medical telemetry jobs
May 08, 2019
Full time
Description The staff Registered Nurse (RN) is a vital part of an interdisciplinary team assessing, planning, implementing, evaluating, and documenting care in efforts to deliver the highest levels of care to the patient and family. This position requires the full understanding and active participation in fulfilling the Mission of CHRISTUS Health St. Elizabeth Hospital, and demonstrating behavior consistent with the Core Values. Our 78-bed comprehensive Medical Telemetry Unit specializes in acute or chronic multi-system organ failure affecting the heart, lungs and kidneys. Requirements Graduate of a State Board accredited School of Nursing or equivalent Current licenses or permit to practice professional nursing in the State of Texas Current BLS Must be able to communicate effectively and professionally with patients, families, and medical staff both verbally and written One year prior nursing experience preferred Today, we are one of the largest, most advanced facilities in the CHRISTUS Health System and the only Magnet Hospital between Houston and Baton Rouge. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Health St. Elizabeth Family! Keyphrases: cardiac telemetry jobs, medical telemetry jobs
This is a PRN position. This position is responsible for administering safe and competent respiratory care as ordered per physician, to patients with respiratory disorders. Education/Skills: Associate's Degree in RT required; Bachelor's degree in RT highly preferred. Experience: Previous experience preferred but not required. Licenses, Registrations, or Certifications: Current practitioner's license in the state of Texas is required. Current Registered Respiratory Therapist is required. Current CPR certification is required. Advanced life support certification is recommended and highly preferred.
May 08, 2019
Full time
This is a PRN position. This position is responsible for administering safe and competent respiratory care as ordered per physician, to patients with respiratory disorders. Education/Skills: Associate's Degree in RT required; Bachelor's degree in RT highly preferred. Experience: Previous experience preferred but not required. Licenses, Registrations, or Certifications: Current practitioner's license in the state of Texas is required. Current Registered Respiratory Therapist is required. Current CPR certification is required. Advanced life support certification is recommended and highly preferred.
Join the team at the hospital that was voted "Best Hospital and Best Workplace" by the readers of the Beaumont Enterprise. The Nursing Unit Secretary is responsible for performing clerical support to nursing staff, physicians, and other members of the healthcare team. This position is responsible for monitoring the nurses' station, ensuring a healing environment for patients and their family members, and promoting a positive and healthy work environment for the staff. This position requires the full understanding and active participation in fulfilling the Mission of CHRISTUS Southeast Texas Health System and demonstrating behavior consistent with the Core Values. High school diploma or equivalent. Certificate of completion from an approved course for Ward Clerks required or one (1) year Ward Clerk experience required, if there is no Ward Clerk certification. Six (6) months experience in a hospital preferred. Demonstrates required computer skills within one month of employment. Basic typing and prior computer skills preferred. For telemetry and/or critical care, successful completion of basic dysrhythmia course for unlicensed personnel within one month or after first available course offered. AHA BLS (cpr) certification within two (2) weeks of employment. Must be able to communicate effectively and professionally with patients, families, and medical staff both verbally and written. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Southeast Texas Health System family!
May 08, 2019
Full time
Join the team at the hospital that was voted "Best Hospital and Best Workplace" by the readers of the Beaumont Enterprise. The Nursing Unit Secretary is responsible for performing clerical support to nursing staff, physicians, and other members of the healthcare team. This position is responsible for monitoring the nurses' station, ensuring a healing environment for patients and their family members, and promoting a positive and healthy work environment for the staff. This position requires the full understanding and active participation in fulfilling the Mission of CHRISTUS Southeast Texas Health System and demonstrating behavior consistent with the Core Values. High school diploma or equivalent. Certificate of completion from an approved course for Ward Clerks required or one (1) year Ward Clerk experience required, if there is no Ward Clerk certification. Six (6) months experience in a hospital preferred. Demonstrates required computer skills within one month of employment. Basic typing and prior computer skills preferred. For telemetry and/or critical care, successful completion of basic dysrhythmia course for unlicensed personnel within one month or after first available course offered. AHA BLS (cpr) certification within two (2) weeks of employment. Must be able to communicate effectively and professionally with patients, families, and medical staff both verbally and written. If you are looking to join a rapidly growing faith-based organization that encourages professional development, we want you to become a part of the CHRISTUS Southeast Texas Health System family!