Location: US-WV-ClarksburgOrganization: TUVAJob: Information TechnologyTUVA provides turnkey solutions that offer better systems, tools, and methods to further your goals, reduce costs, and streamline operations. From requirements analysis, design, and implementation to operations and training TUVA's personnel are well-versed in best practices across Enterprise IT, Mission Support Services, and Specialized Technologies..TUVA is seeking an experienced IT Professional with Program Management Expertise in support of a government client.The SME will provide expertise to teams focused on system development methodologies and best practices; development operations of large scale IT projects; agile development strategies; performance analysis and effectiveness of client development processes; implementation plans for new processes; and the analysis of network, computing, storage, and software solutions for the client's system of systems.QualificationsQualifications: Must have a current Top Secret Security Clearance, SCI eligible At least 15 years of experience with IT program management consultation, program management performance, analysis, and best practices including earned value management, relevant expert knowledge of agile development strategies. Possess superior verbal and written communication skills. Possess excellent analytical, interpersonal and presentation skills. Bachelor's Degree desired, may substitute addition experience for education requirement. Prospective employees will receive consideration without discrimination because of race, color, religion, creed, gender, national origin, age, disability, marital status, veteran status, sexual orientation, or any other legally protected status.We are committed to Equal Employment Opportunity and providing reasonable accommodations to applicants with physical and/or mental disabilities. If you have a physical and/or mental disability and are interested in applying for employment and need special accommodations to use our website to apply for a position please contact, Recruiting Services at job-assist@akima.com or 571-353-7053. Reasonable accommodation requests are considered on a case-by-case basis.The dedicated email and telephonic options above are reserved only for individuals with disabilities needing accessibility assistance to apply to an open position using our website. Please do not use the dedicated email or phone number above to inquire on the status of your job application.We wish to thank all applicants for their interest and effort in applying for the position; however, only candidates selected for interviews will be contacted.In order for our company to stay compliant with government regulations, please apply on line. Please DO NOT email resumes or call in lieu of applying online unless you have a physical and/or mental disability and need assistance with the online application. PM19PI107903783
Feb 20, 2019
Location: US-WV-ClarksburgOrganization: TUVAJob: Information TechnologyTUVA provides turnkey solutions that offer better systems, tools, and methods to further your goals, reduce costs, and streamline operations. From requirements analysis, design, and implementation to operations and training TUVA's personnel are well-versed in best practices across Enterprise IT, Mission Support Services, and Specialized Technologies..TUVA is seeking an experienced IT Professional with Program Management Expertise in support of a government client.The SME will provide expertise to teams focused on system development methodologies and best practices; development operations of large scale IT projects; agile development strategies; performance analysis and effectiveness of client development processes; implementation plans for new processes; and the analysis of network, computing, storage, and software solutions for the client's system of systems.QualificationsQualifications: Must have a current Top Secret Security Clearance, SCI eligible At least 15 years of experience with IT program management consultation, program management performance, analysis, and best practices including earned value management, relevant expert knowledge of agile development strategies. Possess superior verbal and written communication skills. Possess excellent analytical, interpersonal and presentation skills. Bachelor's Degree desired, may substitute addition experience for education requirement. Prospective employees will receive consideration without discrimination because of race, color, religion, creed, gender, national origin, age, disability, marital status, veteran status, sexual orientation, or any other legally protected status.We are committed to Equal Employment Opportunity and providing reasonable accommodations to applicants with physical and/or mental disabilities. If you have a physical and/or mental disability and are interested in applying for employment and need special accommodations to use our website to apply for a position please contact, Recruiting Services at job-assist@akima.com or 571-353-7053. Reasonable accommodation requests are considered on a case-by-case basis.The dedicated email and telephonic options above are reserved only for individuals with disabilities needing accessibility assistance to apply to an open position using our website. Please do not use the dedicated email or phone number above to inquire on the status of your job application.We wish to thank all applicants for their interest and effort in applying for the position; however, only candidates selected for interviews will be contacted.In order for our company to stay compliant with government regulations, please apply on line. Please DO NOT email resumes or call in lieu of applying online unless you have a physical and/or mental disability and need assistance with the online application. PM19PI107903783
Have you ever gazed up during a concert and noticed all the truss and lighting? Theres a possibility that gear belonged to 4Wall! We are a nationally recognized entertainment lighting company that operates in ten offices in the US- Las Vegas, Los Angeles, New York, DC, PA, Nashville, Houston, Orlando, Boston, and Miami. 4Wall has made its mark in the California Desert for the Coachella Valley Music and Arts Festival, to the High Roller in Las Vegas, to Saks Fifth Ave in New York City for the Land of 1000 Delights display.We are looking for a Cable Department Technician to come join the 4Wall team!What you will be doing: While every day is different at 4Wall, you will be responsible for checking in cable orders as they return, cleaning, coiling and organizing the cables for re-stock, pulling cable orders to go out on rentals and the general repair/maintenance and building of cable. In addition, you will also be required to help in other areas of the shop, as needed.What you bring to the table: Our ideal candidate will have a solid work background, basic computer skills and some customer service experience. The candidate will also need to be able to take directions and multi-task in a fast-paced environment, without supervision. Experience in the entertainment lighting industry is preferred, but not necessary. Must have a high school diploma/GED, speak fluent English and be able to lift 75-100 lbs.What you should know: This position is full time Why You Should Work for 4Wall Our People Rock! We pride ourselves on having a family feel where everyone feels welcomed and valued. No matter what your role is at 4Wall, you are a key piece to the success of the company. Perks, perks and more perks! We make it a priority to take care of everyone who works at 4Wall. Beyond comprehensive medical, dental, and vision, our benefits package features a 401(k) with 5% company match, company-paid life insurance, short and long term disability, Personal Time Off (PTO), tuition reimbursement, pet insurance and much more! The A+ Environment Its casual Friday every day! We strive to create a culture that encourages everyone to interact with each other and have fun. Everything from Star Wars day, to employee contests, to health and wellness months, to chili cook offs. Giving back in our communities is also important as we donate our time and gear to numerous charities. Our Future is Bright Pun intended! 4Wall is a growing business and there are a lot of exciting things happening here. We are involved in various markets in the industry and are looking to continue our surge in serving the nation with the highest quality rental gear with outstanding customer service. So you want the job, now what?Our recruitment process goes as follows: Apply for the job Our recruitment team will review your application. If you are qualified, we will pass it along to the hiring manager. If you arent, we will let you know as we dont like to leave people hanging. Interviews most likely a phone interview and then an in-person interview. Job offered if selected, the hiring manager will contact you to offer the role. If you arent selected, dont worry, we will let you know so you arent left wondering. Complete a background check, and possibly a drug test, depending on the role you are hired for. Start new job life changed! Not interested, but know someone who might be? Refer them! If they get the job, theyll owe you one for helping them get an awesome job! P.S. 4Wall is an EOE. PM18PI107897487
Feb 20, 2019
Have you ever gazed up during a concert and noticed all the truss and lighting? Theres a possibility that gear belonged to 4Wall! We are a nationally recognized entertainment lighting company that operates in ten offices in the US- Las Vegas, Los Angeles, New York, DC, PA, Nashville, Houston, Orlando, Boston, and Miami. 4Wall has made its mark in the California Desert for the Coachella Valley Music and Arts Festival, to the High Roller in Las Vegas, to Saks Fifth Ave in New York City for the Land of 1000 Delights display.We are looking for a Cable Department Technician to come join the 4Wall team!What you will be doing: While every day is different at 4Wall, you will be responsible for checking in cable orders as they return, cleaning, coiling and organizing the cables for re-stock, pulling cable orders to go out on rentals and the general repair/maintenance and building of cable. In addition, you will also be required to help in other areas of the shop, as needed.What you bring to the table: Our ideal candidate will have a solid work background, basic computer skills and some customer service experience. The candidate will also need to be able to take directions and multi-task in a fast-paced environment, without supervision. Experience in the entertainment lighting industry is preferred, but not necessary. Must have a high school diploma/GED, speak fluent English and be able to lift 75-100 lbs.What you should know: This position is full time Why You Should Work for 4Wall Our People Rock! We pride ourselves on having a family feel where everyone feels welcomed and valued. No matter what your role is at 4Wall, you are a key piece to the success of the company. Perks, perks and more perks! We make it a priority to take care of everyone who works at 4Wall. Beyond comprehensive medical, dental, and vision, our benefits package features a 401(k) with 5% company match, company-paid life insurance, short and long term disability, Personal Time Off (PTO), tuition reimbursement, pet insurance and much more! The A+ Environment Its casual Friday every day! We strive to create a culture that encourages everyone to interact with each other and have fun. Everything from Star Wars day, to employee contests, to health and wellness months, to chili cook offs. Giving back in our communities is also important as we donate our time and gear to numerous charities. Our Future is Bright Pun intended! 4Wall is a growing business and there are a lot of exciting things happening here. We are involved in various markets in the industry and are looking to continue our surge in serving the nation with the highest quality rental gear with outstanding customer service. So you want the job, now what?Our recruitment process goes as follows: Apply for the job Our recruitment team will review your application. If you are qualified, we will pass it along to the hiring manager. If you arent, we will let you know as we dont like to leave people hanging. Interviews most likely a phone interview and then an in-person interview. Job offered if selected, the hiring manager will contact you to offer the role. If you arent selected, dont worry, we will let you know so you arent left wondering. Complete a background check, and possibly a drug test, depending on the role you are hired for. Start new job life changed! Not interested, but know someone who might be? Refer them! If they get the job, theyll owe you one for helping them get an awesome job! P.S. 4Wall is an EOE. PM18PI107897487
Have you ever gazed up during a concert and noticed all the truss and lighting? Theres a possibility that gear belonged to 4Wall! We are a nationally recognized entertainment lighting company that operates in ten offices in the US- Las Vegas, Los Angeles, New York, DC, PA, Nashville, Houston, Orlando, Boston, and Miami. 4Wall has made its mark in the California Desert for the Coachella Valley Music and Arts Festival, to the High Roller in Las Vegas, to Saks Fifth Ave in New York City for the Land of 1000 Delights display.We are looking for a Moving Lights Technician to come join the 4Wall team!What you will be doing: While every day is different at 4Wall, you will be responsible for testing and troubleshooting all moving light equipment functions, the general repair and maintenance of the equipment, including providing technical support to customers as needed, and preparing/prepping equipment for orders, as well as returning equipment back to inventory. What you bring to the table: Our ideal candidate will have a solid work background including recent consistent work experience, demonstrated technical/electronics training, good computer skills, a proactive approach to troubleshooting/repairs, as well as the ability to take direction and multi-task in a fast pace environment. Experience working with moving lights and in the entertainment lighting or a comparable industry is preferred, high school diploma or GED required, and must be able to lift 75-100 lbs.What you should know: This position is full time and may include evening and weekend work, as required. Why You Should Work for 4Wall Our People Rock! We pride ourselves on having a family feel where everyone feels welcomed and valued. No matter what your role is at 4Wall, you are a key piece to the success of the company. Perks, perks and more perks! We make it a priority to take care of everyone who works at 4Wall. Beyond comprehensive medical, dental, and vision, our benefits package features a 401(k) with 5% company match, company-paid life insurance, short and long-term disability, Personal Time Off (PTO), tuition reimbursement, pet insurance and much more! The A+ Environment Its casual Friday every day! We strive to create a culture that encourages everyone to interact with each other and have fun. Everything from Star Wars day, to employee contests, to health and wellness months, to chili cook offs. Giving back in our communities is also important as we donate our time and gear to numerous charities. Our Future is Bright Pun intended! 4Wall is a growing business and there are a lot of exciting things happening here. We are involved in various markets in the industry and are looking to continue our surge in serving the nation with the highest quality rental gear with outstanding customer service. So you want the job, now what?Our recruitment process goes as follows: Apply for the job Our recruitment team will review your application. If you are qualified, we will pass it along to the hiring manager. If you arent, we will let you know as we dont like to leave people hanging. Interviews most likely a phone interview and then an in-person interview. Job offered if selected, the hiring manager will contact you to offer the role. If you arent selected, dont worry, we will let you know so you arent left wondering. Complete a background check, and possibly a drug test, depending on the role you are hired for. Start new job life changed! Not interested, but know someone who might be? Refer them! If they get the job, theyll owe you one for helping them get an awesome job! P.S. 4Wall is an EOE. PM18PI107897489
Feb 20, 2019
Have you ever gazed up during a concert and noticed all the truss and lighting? Theres a possibility that gear belonged to 4Wall! We are a nationally recognized entertainment lighting company that operates in ten offices in the US- Las Vegas, Los Angeles, New York, DC, PA, Nashville, Houston, Orlando, Boston, and Miami. 4Wall has made its mark in the California Desert for the Coachella Valley Music and Arts Festival, to the High Roller in Las Vegas, to Saks Fifth Ave in New York City for the Land of 1000 Delights display.We are looking for a Moving Lights Technician to come join the 4Wall team!What you will be doing: While every day is different at 4Wall, you will be responsible for testing and troubleshooting all moving light equipment functions, the general repair and maintenance of the equipment, including providing technical support to customers as needed, and preparing/prepping equipment for orders, as well as returning equipment back to inventory. What you bring to the table: Our ideal candidate will have a solid work background including recent consistent work experience, demonstrated technical/electronics training, good computer skills, a proactive approach to troubleshooting/repairs, as well as the ability to take direction and multi-task in a fast pace environment. Experience working with moving lights and in the entertainment lighting or a comparable industry is preferred, high school diploma or GED required, and must be able to lift 75-100 lbs.What you should know: This position is full time and may include evening and weekend work, as required. Why You Should Work for 4Wall Our People Rock! We pride ourselves on having a family feel where everyone feels welcomed and valued. No matter what your role is at 4Wall, you are a key piece to the success of the company. Perks, perks and more perks! We make it a priority to take care of everyone who works at 4Wall. Beyond comprehensive medical, dental, and vision, our benefits package features a 401(k) with 5% company match, company-paid life insurance, short and long-term disability, Personal Time Off (PTO), tuition reimbursement, pet insurance and much more! The A+ Environment Its casual Friday every day! We strive to create a culture that encourages everyone to interact with each other and have fun. Everything from Star Wars day, to employee contests, to health and wellness months, to chili cook offs. Giving back in our communities is also important as we donate our time and gear to numerous charities. Our Future is Bright Pun intended! 4Wall is a growing business and there are a lot of exciting things happening here. We are involved in various markets in the industry and are looking to continue our surge in serving the nation with the highest quality rental gear with outstanding customer service. So you want the job, now what?Our recruitment process goes as follows: Apply for the job Our recruitment team will review your application. If you are qualified, we will pass it along to the hiring manager. If you arent, we will let you know as we dont like to leave people hanging. Interviews most likely a phone interview and then an in-person interview. Job offered if selected, the hiring manager will contact you to offer the role. If you arent selected, dont worry, we will let you know so you arent left wondering. Complete a background check, and possibly a drug test, depending on the role you are hired for. Start new job life changed! Not interested, but know someone who might be? Refer them! If they get the job, theyll owe you one for helping them get an awesome job! P.S. 4Wall is an EOE. PM18PI107897489
Recaro Aircraft Seating Americas, Inc.
Fort Worth, Texas
US-TX-Fort WorthJob ID 2019-1384# of Openings 1Category EngineeringOverviewPosition Summary: The Technical Writer I will write and manage technical documents for RECARO's customers, delivering the highest standards in Aeronautical Engineering Maintenance Publications. This person will be responsible for the writing, issuing, and controlling of Component Maintenance Manuals, Temporary Revisions, and Service Bulletins. All of these documents will be prepared in accordance with ATA-100, iSpec 2200, and S1000D specifications.Responsibilities Essential Duties and Responsibilities:Fundamental understanding of Recaro engineering drawings, nomenclature, usage, and change process. Readily able to assist with incorporation of lay out drawings, envelope drawings, and TSO/seat assembly without IFE drawings. Able to read basic assembly drawings and apply to CMM and TR requirements.Fundamental understanding of Recaro Bills of Material (BoMs), and how they apply to technical documentation. Basic understanding of Design Change (DC) processes and implementation. Apply this knowledge in the authoring of Temporary Revisions (TRs) with little supervision.Fundamental use of Catia models to create illustrations of assemblies and components.Proficient application of ATA 100 technical publication standards in the authoring and reviewing of CMMs and TRs. Basic understanding of iSpec 2200 and S1000D standards, and the requirements for relevant authoring platforms.Proficient understanding of technical publications (CMMs and TRs) and how they are used by customers/aerospace industry. Support customer support by evaluating and incorporating customer requested modifications.Fundamental understanding of aerospace manufacturing techniques and assembly processes. Written instructions included in TRs and CMMs are acceptable within industry standard practices.Fundamental understanding of industry requirements on spare parts ordering and maintenance procedures. Support Airbus delivery requirements by authoring Line Maintenance Part (LMP) sheets.Proficient understanding of overall department processes and workflow as defined by PA 4.2-10.Fundamental understanding of new program workflow and requirements on technical publications. Responsible for individual performance for on-time delivery of technical documents.Any other duties as directed by management that are deemed necessary in facilitating configuration management for RECARO. QualificationsQualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Education/Experience: Minimum 4 year Bachelor's degree in a technical or related field.Technical Experience:Minimum of 2 years of equivalent work experience.Working knowledge with a PC (Word, Excel, PowerPoint, etc.) is required.Previous experience directly related to creating & revising tech documentation is desired.Aviation maintenance and/or mechanical engineering experience is desired.SAP, Interleaf/QuickSilver, and CDB experience is desirable.This position requires a comprehensive understanding of aircraft seat parts and some familiarity with FAA and air framer rules and regulations along, with working knowledge of ATA guidelines.Ability to interpret Engineering Drawings, Schematics, BOMs, and CMMs are essential to perform duties.PI107897296
Feb 20, 2019
US-TX-Fort WorthJob ID 2019-1384# of Openings 1Category EngineeringOverviewPosition Summary: The Technical Writer I will write and manage technical documents for RECARO's customers, delivering the highest standards in Aeronautical Engineering Maintenance Publications. This person will be responsible for the writing, issuing, and controlling of Component Maintenance Manuals, Temporary Revisions, and Service Bulletins. All of these documents will be prepared in accordance with ATA-100, iSpec 2200, and S1000D specifications.Responsibilities Essential Duties and Responsibilities:Fundamental understanding of Recaro engineering drawings, nomenclature, usage, and change process. Readily able to assist with incorporation of lay out drawings, envelope drawings, and TSO/seat assembly without IFE drawings. Able to read basic assembly drawings and apply to CMM and TR requirements.Fundamental understanding of Recaro Bills of Material (BoMs), and how they apply to technical documentation. Basic understanding of Design Change (DC) processes and implementation. Apply this knowledge in the authoring of Temporary Revisions (TRs) with little supervision.Fundamental use of Catia models to create illustrations of assemblies and components.Proficient application of ATA 100 technical publication standards in the authoring and reviewing of CMMs and TRs. Basic understanding of iSpec 2200 and S1000D standards, and the requirements for relevant authoring platforms.Proficient understanding of technical publications (CMMs and TRs) and how they are used by customers/aerospace industry. Support customer support by evaluating and incorporating customer requested modifications.Fundamental understanding of aerospace manufacturing techniques and assembly processes. Written instructions included in TRs and CMMs are acceptable within industry standard practices.Fundamental understanding of industry requirements on spare parts ordering and maintenance procedures. Support Airbus delivery requirements by authoring Line Maintenance Part (LMP) sheets.Proficient understanding of overall department processes and workflow as defined by PA 4.2-10.Fundamental understanding of new program workflow and requirements on technical publications. Responsible for individual performance for on-time delivery of technical documents.Any other duties as directed by management that are deemed necessary in facilitating configuration management for RECARO. QualificationsQualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Education/Experience: Minimum 4 year Bachelor's degree in a technical or related field.Technical Experience:Minimum of 2 years of equivalent work experience.Working knowledge with a PC (Word, Excel, PowerPoint, etc.) is required.Previous experience directly related to creating & revising tech documentation is desired.Aviation maintenance and/or mechanical engineering experience is desired.SAP, Interleaf/QuickSilver, and CDB experience is desirable.This position requires a comprehensive understanding of aircraft seat parts and some familiarity with FAA and air framer rules and regulations along, with working knowledge of ATA guidelines.Ability to interpret Engineering Drawings, Schematics, BOMs, and CMMs are essential to perform duties.PI107897296
Recaro Aircraft Seating Americas, Inc.
Fort Worth, Texas
US-TX-Fort WorthJob ID 2019-1381# of Openings 1Category Customer Service/SupportOverviewThe Assistant Technical Support Program Manager is responsible to support Technical Support Program Managers in for the coordination of all post-delivery activities for assigned customers starting from the time a product is delivered and enters into service. The primary focus of the Assistant Technical Support Program Manager is to support the Technical Support Program Managers in their efforts to ensure complete customer satisfaction with the delivered RECARO products and related after sale services and to ensure spares, repairs, field modifications, and other post delivery services are performed at optimum levels, meeting or exceeding customer expectations and RECARO's quality standards.ResponsibilitiesEssential Duties and Responsibilities include supporting / assisting the Technical Support Program Managers with the following tasks - other duties may be assigned:Responsible for ensuring overall customer satisfaction with regards to product in-service performance and after sales services and support.Responsible for accurate and effective management of KPI's for each area of services and support ensuring that appropriate internal support team members are thoroughly informed of customer expectations, maintenance requirements/changes, and/or any internal adjustments needed to achieve exceptional service levels primarily regarding to the following areas of services:Spares DeliveryRepairs DeliveryProduct ReliabilityField ImprovementsWarranty Ensure that each new sales contract, with regards to Product Support obligations, is carried out within defined standards and established timelines. Responsible for establishing a strong business relationship with each assigned customer to gain strategic positioning for RECARO aftermarket sales and services.Responsible for marketing new design and/or improved design products to ideal customers creating and growing the spares and repair/overhaul business.Effectively negotiate and execute the terms and conditions of MCPs for after sales modifications; managing these projects from sales to completion of projects meeting all established financial budgets, delivery timelines, and other committed obligations.Responsible to adhere to Department processes and proceduresActively participate in team and program meetings to support process upgrades or develop new processes/procedures.Develop and adhere to Product Support guidelines and standards for project execution. Responsible for obtaining regular input from customers through customer surveys in accordance with department processes. QualificationsTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Education/Experience: Minimum of a Bachelor's degree is required. A degree in Business / Engineering is desired.Additional Skills:Must possess strong negotiation skills and the ability to positively influence customer decisions, while maintaining a high level of customer satisfaction.Proven track record of meeting commitments. Strong problem solving skills with the ability to exercise mature judgment are required. Ability to multi-task and operate in a fast-paced, high pressure environment. Excellent organization skills are essential.Must have excellent internal and external communication and presentation skills.Ability to take initiative and work with minimum supervisionStrong, proven customer relations skills are required.PI107897298
Feb 20, 2019
US-TX-Fort WorthJob ID 2019-1381# of Openings 1Category Customer Service/SupportOverviewThe Assistant Technical Support Program Manager is responsible to support Technical Support Program Managers in for the coordination of all post-delivery activities for assigned customers starting from the time a product is delivered and enters into service. The primary focus of the Assistant Technical Support Program Manager is to support the Technical Support Program Managers in their efforts to ensure complete customer satisfaction with the delivered RECARO products and related after sale services and to ensure spares, repairs, field modifications, and other post delivery services are performed at optimum levels, meeting or exceeding customer expectations and RECARO's quality standards.ResponsibilitiesEssential Duties and Responsibilities include supporting / assisting the Technical Support Program Managers with the following tasks - other duties may be assigned:Responsible for ensuring overall customer satisfaction with regards to product in-service performance and after sales services and support.Responsible for accurate and effective management of KPI's for each area of services and support ensuring that appropriate internal support team members are thoroughly informed of customer expectations, maintenance requirements/changes, and/or any internal adjustments needed to achieve exceptional service levels primarily regarding to the following areas of services:Spares DeliveryRepairs DeliveryProduct ReliabilityField ImprovementsWarranty Ensure that each new sales contract, with regards to Product Support obligations, is carried out within defined standards and established timelines. Responsible for establishing a strong business relationship with each assigned customer to gain strategic positioning for RECARO aftermarket sales and services.Responsible for marketing new design and/or improved design products to ideal customers creating and growing the spares and repair/overhaul business.Effectively negotiate and execute the terms and conditions of MCPs for after sales modifications; managing these projects from sales to completion of projects meeting all established financial budgets, delivery timelines, and other committed obligations.Responsible to adhere to Department processes and proceduresActively participate in team and program meetings to support process upgrades or develop new processes/procedures.Develop and adhere to Product Support guidelines and standards for project execution. Responsible for obtaining regular input from customers through customer surveys in accordance with department processes. QualificationsTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Education/Experience: Minimum of a Bachelor's degree is required. A degree in Business / Engineering is desired.Additional Skills:Must possess strong negotiation skills and the ability to positively influence customer decisions, while maintaining a high level of customer satisfaction.Proven track record of meeting commitments. Strong problem solving skills with the ability to exercise mature judgment are required. Ability to multi-task and operate in a fast-paced, high pressure environment. Excellent organization skills are essential.Must have excellent internal and external communication and presentation skills.Ability to take initiative and work with minimum supervisionStrong, proven customer relations skills are required.PI107897298
SUPPORT SERVICES OF VIRGINIA INC.
Lynchburg, Virginia
SUPPORT SERVICES OF VIRGINIA COMPANY OVERVIEWAt SSVA, helping others realize their success isnt just a job, its our passion. Our unique and innovative company realizes that happy teams make happy customers, so we strive to make a positive and lasting impact on everyone we encounter. To create engaged and inspired teams, our culture promotes being positive and peaceful; pursuing growth and learning; making a difference; and collaborating well with others. SSVA has a positive reputation of being a leading provider of Community Based Day Support; Therapeutic Consultation; Professional Training and Development; and In-Home, Group Home and Sponsored Residential Services for people with developmental disabilities.Our commitment to our team members, positive work environment, comprehensive benefits package, and opportunities to make a real difference in someones life make SSVA one of the top places to work in Virginias human services field.ROLE SUMMARYAs Regional Human Resources Coordinator, you will play a vital and mission critical role in the management of workforce size, records, workers compensation, workforce advocacy, workforce policy, rewards program, and assist in payroll approval and employee benefits. This role is also expected to provide guidance, support, mentorship, advocacy for prospective and current employees and sponsors, and act as a role model for Positive Practices in the workplace. The ideal candidate is friendly and positive, open minded and flexible, highly organized, motivated, and detail-oriented. You will be involved in implementing labor-related policies, recruitment and retention of employees, and other aspects as they relate to the SSVA workforce. Team Member BenefitsSSVA offers a competitive benefits package for full time employees including three medical plan options, heath savings account (HSA) match, dental insurance, employee assistance program (EAP), life insurance, paid vacation and holidays, Team thisABILITY and numerous other perks. Combined, these benefits add up to over 30% increase over the base wage. SSVA is an Equal Opportunity Employer and committed to diversity in its workforce.
Feb 20, 2019
SUPPORT SERVICES OF VIRGINIA COMPANY OVERVIEWAt SSVA, helping others realize their success isnt just a job, its our passion. Our unique and innovative company realizes that happy teams make happy customers, so we strive to make a positive and lasting impact on everyone we encounter. To create engaged and inspired teams, our culture promotes being positive and peaceful; pursuing growth and learning; making a difference; and collaborating well with others. SSVA has a positive reputation of being a leading provider of Community Based Day Support; Therapeutic Consultation; Professional Training and Development; and In-Home, Group Home and Sponsored Residential Services for people with developmental disabilities.Our commitment to our team members, positive work environment, comprehensive benefits package, and opportunities to make a real difference in someones life make SSVA one of the top places to work in Virginias human services field.ROLE SUMMARYAs Regional Human Resources Coordinator, you will play a vital and mission critical role in the management of workforce size, records, workers compensation, workforce advocacy, workforce policy, rewards program, and assist in payroll approval and employee benefits. This role is also expected to provide guidance, support, mentorship, advocacy for prospective and current employees and sponsors, and act as a role model for Positive Practices in the workplace. The ideal candidate is friendly and positive, open minded and flexible, highly organized, motivated, and detail-oriented. You will be involved in implementing labor-related policies, recruitment and retention of employees, and other aspects as they relate to the SSVA workforce. Team Member BenefitsSSVA offers a competitive benefits package for full time employees including three medical plan options, heath savings account (HSA) match, dental insurance, employee assistance program (EAP), life insurance, paid vacation and holidays, Team thisABILITY and numerous other perks. Combined, these benefits add up to over 30% increase over the base wage. SSVA is an Equal Opportunity Employer and committed to diversity in its workforce.
Fallon Community Health Plan
Worcester, Massachusetts
Job ID: 5484# Positions: 1Posted Date: 2019-01-22Category: Risk AdjustmentProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Brief Summary of Purpose:The Chart Review Specialist I's primary responsibility is to review, Analyze and report on FCHP patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist I will collect diagnostic details and documentation observations from multiple chart sources to validate diagnostic profiles. The CRS I must demonstrate the ability to oversee the chart review life cycle from scheduling access, collecting images coding chart and updating data software. The CRS I must have the ability to code on both and INP and OPD basis. Will participate in bi-weekly Inter-rater reliability discussions to develop and enforce coding P&Ps and define Coding Standards and best practices. Accept assignment from Chart Review Coordinator and Nurse Chart Review Coordinator as appropriate. Maintain strong interdepartmental relationships. Responsibilities: Perform retrospective chart reviews for designated populations & volumesOwn chart review process from start to endCollect documentation feedback and submit to Nurse Chart Review Coordinator and Chart Review Coordinator for provider education effortsUpdate risk adjustment software with all relevant chart review observationsMeet or exceed daily chart review targetsDevelop and present concise provider-specific feedback for targeted providers and provider groups.Identify diagnoses for submission as well as deletion in support of claims adjustment effortsEnsure chart reviews and related claims adjustment activities completed within regulatory data submission timelines and within CMS Coding and Coding Clinic guidelinesParticipate in corporate projects and subgroup meetings. Complete analyses related to corporate projects and business needs as needed.Participate in regional Coding Chapter meetings Qualifications: Education: High School diploma or GED required. Associated degree preferred. Certification: CPC-A, CPC-C or CPC-P is requiredExperience: Completion of 135 Internship/Externship hours in the health care industry.Medical billing/claims processing ,medical record auditing, medical record review, Medical record abstraction or combinationMedical terminologyICD-9 & ICD-10 compliantBasic MS Office skills; Excel and or AccessJT18PI107897060
Feb 20, 2019
Job ID: 5484# Positions: 1Posted Date: 2019-01-22Category: Risk AdjustmentProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Brief Summary of Purpose:The Chart Review Specialist I's primary responsibility is to review, Analyze and report on FCHP patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist I will collect diagnostic details and documentation observations from multiple chart sources to validate diagnostic profiles. The CRS I must demonstrate the ability to oversee the chart review life cycle from scheduling access, collecting images coding chart and updating data software. The CRS I must have the ability to code on both and INP and OPD basis. Will participate in bi-weekly Inter-rater reliability discussions to develop and enforce coding P&Ps and define Coding Standards and best practices. Accept assignment from Chart Review Coordinator and Nurse Chart Review Coordinator as appropriate. Maintain strong interdepartmental relationships. Responsibilities: Perform retrospective chart reviews for designated populations & volumesOwn chart review process from start to endCollect documentation feedback and submit to Nurse Chart Review Coordinator and Chart Review Coordinator for provider education effortsUpdate risk adjustment software with all relevant chart review observationsMeet or exceed daily chart review targetsDevelop and present concise provider-specific feedback for targeted providers and provider groups.Identify diagnoses for submission as well as deletion in support of claims adjustment effortsEnsure chart reviews and related claims adjustment activities completed within regulatory data submission timelines and within CMS Coding and Coding Clinic guidelinesParticipate in corporate projects and subgroup meetings. Complete analyses related to corporate projects and business needs as needed.Participate in regional Coding Chapter meetings Qualifications: Education: High School diploma or GED required. Associated degree preferred. Certification: CPC-A, CPC-C or CPC-P is requiredExperience: Completion of 135 Internship/Externship hours in the health care industry.Medical billing/claims processing ,medical record auditing, medical record review, Medical record abstraction or combinationMedical terminologyICD-9 & ICD-10 compliantBasic MS Office skills; Excel and or AccessJT18PI107897060
Fallon Community Health Plan
Lowell, Massachusetts
Job ID: 5488# Positions: 1Posted Date: 2019-01-25Category: Medical ManagementProduct Line: Overview: To Help Serve the Lowell Region we welcome all candidates that also Speak Khmer, Spanish or Portuguese SUMMIT ELDERCARE (www.summiteldercare.org)Fallon Health's - Summit Elder Care program one of the largest PACE programs (Program of All-Inclusive Care for the Elderly) in the country and the very first PACE program in the nation to be associated with a Health Plan. Summit ElderCare currently already serves residents of Hampden County, Worcester County, and the communities of Easthampton, Granby, Hudson, Marlborough, Southampton and South Hadley. We help give elderly adults and their caregivers an innovative choice in health care as a welcome alternative to nursing home care. Participants in Summit ElderCare have access to most medical services through a Summit ElderCare site while they keep living in their own homes and communities.FALLON HEALTH (www.fallonhealth.org)Founded in 1977, Fallon Community Health Plan is a nationally recognized, not-for-profit health care services organization. From traditional health insurance products available throughout Massachusetts for all populations, to innovative health care programs and services for independent seniors, Fallon Health supports the diverse and changing needs of all those it serves. Consistently ranked among the nation's top health plans, Fallon is the only health plan in Massachusetts to have been awarded "Excellent" Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products.Position Overview: Provides program level guidance and recommendations relevant to the provision of clinical and nursing services. Oversees implementation of discipline specific policies and procedures. Responsible for the operations of the PACE center clinic. Oversees all nursing services provided to the participants at the center. Supervises and directs RNs, LPNs and Health Aides assigned to the ADHC. Functions as the Assistant Program Director as needed/assigned.Responsibilities: Assists with recruitment and training of staff within the discipline.Participates in the oversight of related contracted vendors.Monitors PACE, ADHC and state discipline specific regulations to identify, communicate and when appropriate, implement needed changes.Represents the program and related discipline at assigned community and external events upon request.Develops and maintain discipline specific competency tools.Coordinates the provision of patient care throughout the clinic.Collaborates with participants, caregivers, physicians, nurse practitioners and other staff to meet participants' needs.Delegates work to nursing staff members according to their scope of practice by establishing work assignments and coordinating staff schedules.Participates in all types of Interdisciplinary Team meetings.Participates in management and quality meetings as required.Collaborates with the Site Director to establish goals and objectives related to the clinical setting.Coordinates/supervises the purchase of medical/surgical/pharmaceutical supplies.Assures that clinical equipment is in good working condition in collaboration with the Quality and Risk Manager.Assumes responsibility for inservice education for nursing staff.Interviews potential nursing staff candidates and makes recommendations for hiring to Site Director.Conducts new staff orientation and performance evaluations for clinical staff in a timely manner.Conducts regular staff meetings with clinical staff.Assists with routine nursing duties as required.Assures that corrective action plans are completed for incidents related to clinical services.Assists the Site Director to carry out administrative duties as needed. Functions as acting Site Director in the Site Director's absence.Accepts "on-call" duty on a rotating basis and assists the Site Director with scheduling the rotation.Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Qualifications: Education: Graduate of an accredited school of nursing.BSN strongly preferred.License: Licensed as an RN in MassachusettsCertification: CPR certificationor willingness to be certified.Experience: At least two years of managerial experience working with frail elders in a health care setting.Ambulatory clinic experience is helpful but not essential.PM16PI107897619
Feb 20, 2019
Job ID: 5488# Positions: 1Posted Date: 2019-01-25Category: Medical ManagementProduct Line: Overview: To Help Serve the Lowell Region we welcome all candidates that also Speak Khmer, Spanish or Portuguese SUMMIT ELDERCARE (www.summiteldercare.org)Fallon Health's - Summit Elder Care program one of the largest PACE programs (Program of All-Inclusive Care for the Elderly) in the country and the very first PACE program in the nation to be associated with a Health Plan. Summit ElderCare currently already serves residents of Hampden County, Worcester County, and the communities of Easthampton, Granby, Hudson, Marlborough, Southampton and South Hadley. We help give elderly adults and their caregivers an innovative choice in health care as a welcome alternative to nursing home care. Participants in Summit ElderCare have access to most medical services through a Summit ElderCare site while they keep living in their own homes and communities.FALLON HEALTH (www.fallonhealth.org)Founded in 1977, Fallon Community Health Plan is a nationally recognized, not-for-profit health care services organization. From traditional health insurance products available throughout Massachusetts for all populations, to innovative health care programs and services for independent seniors, Fallon Health supports the diverse and changing needs of all those it serves. Consistently ranked among the nation's top health plans, Fallon is the only health plan in Massachusetts to have been awarded "Excellent" Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products.Position Overview: Provides program level guidance and recommendations relevant to the provision of clinical and nursing services. Oversees implementation of discipline specific policies and procedures. Responsible for the operations of the PACE center clinic. Oversees all nursing services provided to the participants at the center. Supervises and directs RNs, LPNs and Health Aides assigned to the ADHC. Functions as the Assistant Program Director as needed/assigned.Responsibilities: Assists with recruitment and training of staff within the discipline.Participates in the oversight of related contracted vendors.Monitors PACE, ADHC and state discipline specific regulations to identify, communicate and when appropriate, implement needed changes.Represents the program and related discipline at assigned community and external events upon request.Develops and maintain discipline specific competency tools.Coordinates the provision of patient care throughout the clinic.Collaborates with participants, caregivers, physicians, nurse practitioners and other staff to meet participants' needs.Delegates work to nursing staff members according to their scope of practice by establishing work assignments and coordinating staff schedules.Participates in all types of Interdisciplinary Team meetings.Participates in management and quality meetings as required.Collaborates with the Site Director to establish goals and objectives related to the clinical setting.Coordinates/supervises the purchase of medical/surgical/pharmaceutical supplies.Assures that clinical equipment is in good working condition in collaboration with the Quality and Risk Manager.Assumes responsibility for inservice education for nursing staff.Interviews potential nursing staff candidates and makes recommendations for hiring to Site Director.Conducts new staff orientation and performance evaluations for clinical staff in a timely manner.Conducts regular staff meetings with clinical staff.Assists with routine nursing duties as required.Assures that corrective action plans are completed for incidents related to clinical services.Assists the Site Director to carry out administrative duties as needed. Functions as acting Site Director in the Site Director's absence.Accepts "on-call" duty on a rotating basis and assists the Site Director with scheduling the rotation.Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Qualifications: Education: Graduate of an accredited school of nursing.BSN strongly preferred.License: Licensed as an RN in MassachusettsCertification: CPR certificationor willingness to be certified.Experience: At least two years of managerial experience working with frail elders in a health care setting.Ambulatory clinic experience is helpful but not essential.PM16PI107897619
Fallon Community Health Plan
Worcester, Massachusetts
Job ID: 5483# Positions: 1Posted Date: 2019-01-17Category: Claims AdministrationProduct Line: Overview: About Fallon Health: Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.Position Summary:The Claims Processor should have a thorough knowledge of claim entry in the core and external vendor processing systems, as well as a general knowledge of claims processing. Responsible for claims corrections involving data entry errors in the data entry vendor's queue, processing of member reimbursement requests and Customer Service cases, triage/assignment of requests for claim review and other claims documents, as well as other claims entry and processing tasks as assigned. Ensures member and provider satisfaction by providing appropriate and timely processing of claims. Must be able to work on tasks both independently and as part of a team.Responsibilities: Meets or exceeds all department standards: productivity; quality; and attendance.Responsible for claims editing on claims due to data entry errors.Processes member reimbursement requests, including Part D and other prescription reimbursements in the core and external vendor processing systems.Claims entry and processing tasks as assigned. Evaluation and resolution of Customer Service cases related to reimbursement requests.Review and validation of requests for claim review and other claims documents. Demonstrate solid judgment and discretion working with confidential information.Comply with all department and company guidelines including all applicable laws and regulations.Seeks assistance from Team Subject Matter Experts (SMEs), the Trainer and Claims Manager to ensure accuracy of adjudicating claims and to develop individual skills and grow professionally.Work with teams inside and outside the department, and external customers as needed.The above is intended to describe the general content of the requirments for the performance of the job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements. Qualifications: Qualification Requirements:High school diploma, college degree preferred. Medical billing and coding or equivalent experience preferred. Experience:Minimum of 1 year health care industry experience or equivalentGeneral knowledge of CPT, ICD-10, HCPCS coding guidelines and medical terminology preferred. General ability to perform data entry and process claims efficiently and in a quality manner.Ability to follow policy and procedural documentationSome knowledge of claim processing from all perspectives (submissions, processing, dependencies)MS Office and general PC skills.Specific competencies essential to this position:Analytical ability Gathers relevant information systematically. Considers issues or factors. Seeks input from others as appropriate.Problem solving - Solves problems with effective solutions. Asks good questions. Can see underlying or hidden problems and patterns.Results oriented - Can be counted on to exceed goals successfully. Steadfastly pushes self for results. PM16PI107897617
Feb 20, 2019
Job ID: 5483# Positions: 1Posted Date: 2019-01-17Category: Claims AdministrationProduct Line: Overview: About Fallon Health: Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.Position Summary:The Claims Processor should have a thorough knowledge of claim entry in the core and external vendor processing systems, as well as a general knowledge of claims processing. Responsible for claims corrections involving data entry errors in the data entry vendor's queue, processing of member reimbursement requests and Customer Service cases, triage/assignment of requests for claim review and other claims documents, as well as other claims entry and processing tasks as assigned. Ensures member and provider satisfaction by providing appropriate and timely processing of claims. Must be able to work on tasks both independently and as part of a team.Responsibilities: Meets or exceeds all department standards: productivity; quality; and attendance.Responsible for claims editing on claims due to data entry errors.Processes member reimbursement requests, including Part D and other prescription reimbursements in the core and external vendor processing systems.Claims entry and processing tasks as assigned. Evaluation and resolution of Customer Service cases related to reimbursement requests.Review and validation of requests for claim review and other claims documents. Demonstrate solid judgment and discretion working with confidential information.Comply with all department and company guidelines including all applicable laws and regulations.Seeks assistance from Team Subject Matter Experts (SMEs), the Trainer and Claims Manager to ensure accuracy of adjudicating claims and to develop individual skills and grow professionally.Work with teams inside and outside the department, and external customers as needed.The above is intended to describe the general content of the requirments for the performance of the job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements. Qualifications: Qualification Requirements:High school diploma, college degree preferred. Medical billing and coding or equivalent experience preferred. Experience:Minimum of 1 year health care industry experience or equivalentGeneral knowledge of CPT, ICD-10, HCPCS coding guidelines and medical terminology preferred. General ability to perform data entry and process claims efficiently and in a quality manner.Ability to follow policy and procedural documentationSome knowledge of claim processing from all perspectives (submissions, processing, dependencies)MS Office and general PC skills.Specific competencies essential to this position:Analytical ability Gathers relevant information systematically. Considers issues or factors. Seeks input from others as appropriate.Problem solving - Solves problems with effective solutions. Asks good questions. Can see underlying or hidden problems and patterns.Results oriented - Can be counted on to exceed goals successfully. Steadfastly pushes self for results. PM16PI107897617
Fallon Community Health Plan
Worcester, Massachusetts
Job ID: 5463# Positions: 1Posted Date: 2018-12-19Category: PharmacyProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Summary:Leads the development, implementation and maintenance of the health plan's prescription medication benefit including, but not limited to, vendor procurement and management, outpatient formulary design, management of injectable specialty medications and oversight of all regulatory, contractual and accreditation requirements. Directs Pharmacy Operations and Medication Therapy Management program and staff to improve the quality and cost-effectiveness of pharmaceutical care of Fallon members.Responsibilities: Lead and implement strategies to achieve corporate financial Cost of Care goals for pharmacy cost and utilization through analysis of industry trends, clinical issues, regulatory and compliance requirements, and advise on cost of care opportunities.Develop and implement managed care strategies to integrate the pharmacy program into care management and UM programs, to include utilization, risk and case management, grievance and appeals activities. Recruit, retain, develop, and motivate staff in Pharmacy Operations and MTM.Clearly define and communicate team performance goals for each area of responsibility and assure delivery of those goals.Responsible for the budgeting/forecasting process, expense control, capital planning, operation budget of Pharmacy Department.Manage PBM relationship in partnership with NDM/Contracting.Oversees relationships with the pharmaceutical industryChair of the Pharmacy and Therapeutics CommitteeWorking with Medical Economics, develop reports to meet project and account management needs.Analyze data to identify opportunities to influence individual prescriber practices. Work directly, either individually or in large group settings, with prescribers to identify and address prescription utilization trends and issues of clinical performance and effect change in prescribing patterns.Oversee Medication Therapy Management Program.Formulate and implement delivery methodologies for the MTM program that ensure the financial performance of the program.Manage the development and the on-going review of the formularies for multiple product lines.Oversee Pharmacy Utilization Management processes, compliance, and staffing.Support corporate effort to maintain accreditation by agencies including but not limited to CMS, MassHealth, and NCQA.Meet with customers, employer groups, benefit representatives, brokers and internal account management staff to explain pharmacy utilization, pharmacy strategy, and programs for improving member satisfaction, quality, and cost management.Design and interpret potential impact of benefit design changes for customers.Assist in developing responses to Requests for Proposals from potential customers.Support Pharmacy-related Fraud Waste, and Abuse efforts. Coordinate with NDM/Provider Relations to facilitate and resolve provider pharmacy related issues and concerns.Coordinate with Member Services to facilitate and resolve member pharmacy related issues and concerns. Qualifications: Doctor of Pharmacy (PharmD)Or, BS Pharmacy degree with optional postgraduate training or residency, or with three to five years of experience in managed care delivery, or other clinical or management role with frequent interaction with physicians and other healthcare providers.Active Massachusetts license or ability to obtain MA licenseMinimum of four years clinical experience (broad scope preferred).A minimum of five years of managed care pharmacy experience, including responsibility for formulary management, prior authorization and other clinical initiatives in a health plan setting required.Experience with tenets of quality improvement.Excellent presentation and interpersonal skills with effective oral and written communication. Board experience in managed care with particular emphasis in managed Medicaid and Medicare Part D.Experience in managing pharmacy trend through vendor management, formulary management and collaborative relations with providers, either working on the payer side or working with providers in an integrated delivery system/ACO.Experience managing both professional staff (other pharmacists) and support staff.A comprehensive knowledge of Pharma, PBMs, rebates, and 340B pricing.Minimum of ten years clinical experience and at least five in managed care or ambulatory clinical operations leadership.JT18 PI107897062
Feb 20, 2019
Job ID: 5463# Positions: 1Posted Date: 2018-12-19Category: PharmacyProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Summary:Leads the development, implementation and maintenance of the health plan's prescription medication benefit including, but not limited to, vendor procurement and management, outpatient formulary design, management of injectable specialty medications and oversight of all regulatory, contractual and accreditation requirements. Directs Pharmacy Operations and Medication Therapy Management program and staff to improve the quality and cost-effectiveness of pharmaceutical care of Fallon members.Responsibilities: Lead and implement strategies to achieve corporate financial Cost of Care goals for pharmacy cost and utilization through analysis of industry trends, clinical issues, regulatory and compliance requirements, and advise on cost of care opportunities.Develop and implement managed care strategies to integrate the pharmacy program into care management and UM programs, to include utilization, risk and case management, grievance and appeals activities. Recruit, retain, develop, and motivate staff in Pharmacy Operations and MTM.Clearly define and communicate team performance goals for each area of responsibility and assure delivery of those goals.Responsible for the budgeting/forecasting process, expense control, capital planning, operation budget of Pharmacy Department.Manage PBM relationship in partnership with NDM/Contracting.Oversees relationships with the pharmaceutical industryChair of the Pharmacy and Therapeutics CommitteeWorking with Medical Economics, develop reports to meet project and account management needs.Analyze data to identify opportunities to influence individual prescriber practices. Work directly, either individually or in large group settings, with prescribers to identify and address prescription utilization trends and issues of clinical performance and effect change in prescribing patterns.Oversee Medication Therapy Management Program.Formulate and implement delivery methodologies for the MTM program that ensure the financial performance of the program.Manage the development and the on-going review of the formularies for multiple product lines.Oversee Pharmacy Utilization Management processes, compliance, and staffing.Support corporate effort to maintain accreditation by agencies including but not limited to CMS, MassHealth, and NCQA.Meet with customers, employer groups, benefit representatives, brokers and internal account management staff to explain pharmacy utilization, pharmacy strategy, and programs for improving member satisfaction, quality, and cost management.Design and interpret potential impact of benefit design changes for customers.Assist in developing responses to Requests for Proposals from potential customers.Support Pharmacy-related Fraud Waste, and Abuse efforts. Coordinate with NDM/Provider Relations to facilitate and resolve provider pharmacy related issues and concerns.Coordinate with Member Services to facilitate and resolve member pharmacy related issues and concerns. Qualifications: Doctor of Pharmacy (PharmD)Or, BS Pharmacy degree with optional postgraduate training or residency, or with three to five years of experience in managed care delivery, or other clinical or management role with frequent interaction with physicians and other healthcare providers.Active Massachusetts license or ability to obtain MA licenseMinimum of four years clinical experience (broad scope preferred).A minimum of five years of managed care pharmacy experience, including responsibility for formulary management, prior authorization and other clinical initiatives in a health plan setting required.Experience with tenets of quality improvement.Excellent presentation and interpersonal skills with effective oral and written communication. Board experience in managed care with particular emphasis in managed Medicaid and Medicare Part D.Experience in managing pharmacy trend through vendor management, formulary management and collaborative relations with providers, either working on the payer side or working with providers in an integrated delivery system/ACO.Experience managing both professional staff (other pharmacists) and support staff.A comprehensive knowledge of Pharma, PBMs, rebates, and 340B pricing.Minimum of ten years clinical experience and at least five in managed care or ambulatory clinical operations leadership.JT18 PI107897062
Fallon Community Health Plan
Worcester, Massachusetts
Job ID: 5446# Positions: 1Posted Date: 2018-12-05Category: Product DevelopmentProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Brief summary of purpose:Under the direction of the Director of Product Management, the Product Manager III works independently and collaboratively with both internal customers and external stakeholders. The Product Manager III will take high profile and strategic projects from development through implementation.Responsibilities: Responsible for the management of assigned high profile projects, including the development and implementation of performance standards encompassing regulatory, finance, operations, sales, marketing, market research, provider relations, and other functional areas as required and in support of Fallon Health strategic initiatives.Assist in the product positioning for the assigned product line. Responsible for moving projects through the various phases of project managementIdentifies and manages risks throughout the project and/or product lifecycle Work for this role is generated typically from the Sales and Marketing Division in conjunction with various other departments such as regulatory and actuarial. Generally, projects are those approved by the Strategic Prioritization Group or Market Strategy. Product Management also interacts.Customers are typically internal. The products and projects that the Product Manager III will manage are various in nature and will interact with most of the various departments throughout the organization. Successful implementations will ensure that project goals are met Qualifications: 5 - 10 years in a healthcare setting and 5+ years as Product/Project Manager. Managed care experience with knowledge of plan operations, finance, product implementation, regulations, marketing and product management. Broad knowledge of Medicare, Connector or Commercial products. Experience with, M/S Project, M/S PowerPoint, Visio, Sharepoint and Data base application knowledge.Bachelor's DegreeNational PMP Certification PreferredPM16PI107897613
Feb 20, 2019
Job ID: 5446# Positions: 1Posted Date: 2018-12-05Category: Product DevelopmentProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Brief summary of purpose:Under the direction of the Director of Product Management, the Product Manager III works independently and collaboratively with both internal customers and external stakeholders. The Product Manager III will take high profile and strategic projects from development through implementation.Responsibilities: Responsible for the management of assigned high profile projects, including the development and implementation of performance standards encompassing regulatory, finance, operations, sales, marketing, market research, provider relations, and other functional areas as required and in support of Fallon Health strategic initiatives.Assist in the product positioning for the assigned product line. Responsible for moving projects through the various phases of project managementIdentifies and manages risks throughout the project and/or product lifecycle Work for this role is generated typically from the Sales and Marketing Division in conjunction with various other departments such as regulatory and actuarial. Generally, projects are those approved by the Strategic Prioritization Group or Market Strategy. Product Management also interacts.Customers are typically internal. The products and projects that the Product Manager III will manage are various in nature and will interact with most of the various departments throughout the organization. Successful implementations will ensure that project goals are met Qualifications: 5 - 10 years in a healthcare setting and 5+ years as Product/Project Manager. Managed care experience with knowledge of plan operations, finance, product implementation, regulations, marketing and product management. Broad knowledge of Medicare, Connector or Commercial products. Experience with, M/S Project, M/S PowerPoint, Visio, Sharepoint and Data base application knowledge.Bachelor's DegreeNational PMP Certification PreferredPM16PI107897613
Fallon Community Health Plan
Worcester, Massachusetts
Job ID: 5398# Positions: 1Posted Date: 2018-10-30Category: FinanceProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Brief Summary of purpose:The Medical Economics Senior Analyst will partner with the Manager, Medical Economics as a subject matter expert in data and analysis, demonstrating an in-depth understanding of financial, clinical, and other business data. The position works directly with operational leadership in the design and development of analytical capabilities, reports, and dashboards needed for short and long-term decision-making to achieve success in managing care. This individual provides complex ad hoc analysis and reporting as directed by management to include the evaluation of financial, operational, clinical and general business programs and processes. The Senior Analyst is responsible for data quality and data integrity as they relate to reporting and analytical activities. Responsibilities: Analysis, Decision Support and Business Intelligence - 45%Provide actionable analyses and reports that help monitor performance and drive decision making to reduce total medical expense and utilizationAssist in designing initiatives to impact cost drivers, including measurement and monitoring of initiatives. Identify the cost drivers, quantify variances, formulate and propose strategies and communicate the outcomes to customer, business owners and senior managementEvaluate the impact of current vs. proposed financial arrangements with providers; compare payment terms against Medicare and Medicaid reimbursement methodologiesPerform cost and utilization trend analyses at the provider, PHO, employer or other group variation. Measure actual performance against benchmarks or targetsProvide advanced analytical and reporting support to customers on various projectsLeads or assists in process improvement and special projectsRegulatory & Clinical Model Design and Support - 30%Provide support for regulatory reporting; analyze specifications to develop accurate responses or summaries for timely submissions Provide analytical support for clinical initiatives including development, evaluation and ROI analyses Evaluate the effectiveness of clinical initiatives in improving patient outcomes and reducing health care costsAd-Hoc Support - 25%Provide support for ad-hoc (i.e. one time) requests that require clinical, financial, regulatory, pharmacy and operational analysis and reporting. Prepare reports and supporting analysis for internal and external customers focused on reducing costs and utilization and enhancing healthcare system efficiency. Act as a resource for other members of the department on business issues.As a subject matter expert, train and guide other associates in the department in data understanding and analytical processes. Qualifications: EducationBachelor's degree in Business, Finance or Public Health ExperienceMinimum of 5 years of financial or analytical experience in healthcare environmentExperience with data analysis, interpretation and reporting of clinical and financial data Experience with Microsoft Excel, ACCESS, SSMS or SQLAbility to design, evaluate and interpret complex data setsKnowledge of managed care and health care claims Excellent oral and written communication skills JT18PI107897064
Feb 20, 2019
Job ID: 5398# Positions: 1Posted Date: 2018-10-30Category: FinanceProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Brief Summary of purpose:The Medical Economics Senior Analyst will partner with the Manager, Medical Economics as a subject matter expert in data and analysis, demonstrating an in-depth understanding of financial, clinical, and other business data. The position works directly with operational leadership in the design and development of analytical capabilities, reports, and dashboards needed for short and long-term decision-making to achieve success in managing care. This individual provides complex ad hoc analysis and reporting as directed by management to include the evaluation of financial, operational, clinical and general business programs and processes. The Senior Analyst is responsible for data quality and data integrity as they relate to reporting and analytical activities. Responsibilities: Analysis, Decision Support and Business Intelligence - 45%Provide actionable analyses and reports that help monitor performance and drive decision making to reduce total medical expense and utilizationAssist in designing initiatives to impact cost drivers, including measurement and monitoring of initiatives. Identify the cost drivers, quantify variances, formulate and propose strategies and communicate the outcomes to customer, business owners and senior managementEvaluate the impact of current vs. proposed financial arrangements with providers; compare payment terms against Medicare and Medicaid reimbursement methodologiesPerform cost and utilization trend analyses at the provider, PHO, employer or other group variation. Measure actual performance against benchmarks or targetsProvide advanced analytical and reporting support to customers on various projectsLeads or assists in process improvement and special projectsRegulatory & Clinical Model Design and Support - 30%Provide support for regulatory reporting; analyze specifications to develop accurate responses or summaries for timely submissions Provide analytical support for clinical initiatives including development, evaluation and ROI analyses Evaluate the effectiveness of clinical initiatives in improving patient outcomes and reducing health care costsAd-Hoc Support - 25%Provide support for ad-hoc (i.e. one time) requests that require clinical, financial, regulatory, pharmacy and operational analysis and reporting. Prepare reports and supporting analysis for internal and external customers focused on reducing costs and utilization and enhancing healthcare system efficiency. Act as a resource for other members of the department on business issues.As a subject matter expert, train and guide other associates in the department in data understanding and analytical processes. Qualifications: EducationBachelor's degree in Business, Finance or Public Health ExperienceMinimum of 5 years of financial or analytical experience in healthcare environmentExperience with data analysis, interpretation and reporting of clinical and financial data Experience with Microsoft Excel, ACCESS, SSMS or SQLAbility to design, evaluate and interpret complex data setsKnowledge of managed care and health care claims Excellent oral and written communication skills JT18PI107897064
Fallon Community Health Plan
Worcester, Massachusetts
Job ID: 5354# Positions: 1Posted Date: 2018-10-25Category: NursingProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Job Summary This position is accountable for supporting the delivery system to improve member's health outcomes, oversight of assigned delegated activities and participation in the company's STARS and GIC quality improvement initiatives by: 1) Assisting providers to deliver improved patient care. 2) Educating the provider community on impact of CAHPS, HOS and HEDIS on member outcomes and STARs performance. 3) Assessing provider office practices for opportunities that positively impact member experience and impact HEDIS, CAHPS and HOS ratings. This position will be required to communicate and collaborate with value based and non-valued based partners as well as other stakeholders to effectively manage the delivery of strategies, plans and improvements to HEDIS, Medicare Stars, GIC Quality Improvement Initiatives, Qualified Health Plans/Quality Rating Systems and other clinical quality measurements. Knowledge and utilization of health analytic tools is required to identify opportunities to improve satisfaction and quality. Responsibilities: Primary Job ResponsibilitiesProvides staff education on the health plan's STAR & GIC initiatives, to include HEDIS, CAHPS and HOS surveys as it relates to improving member experience and health outcomes. Utilize health analytic tools to identify trends and opportunities (within a population in a specific geographic area) To enhance the health of Fallon Health members and support value based arrangements and collaborative care providers with management of their members. Assist members to obtain preventive screenings and review for adherence with prescribed medications Obtain supplemental data contained in the medical record and make it available to the health plan for integration into the HEDIS data base. Inform and educate the care team on care gaps, activities, issues or concerns about the population and from the value based programs. Collaborate with Member, Member's Personal Representative, Member's Physicians, Plan Medical Directors, Managers, as well as other functional area to assist the member to meet their health care goals, reduce care gaps, improve health outcomes, and reduce the total cost of care. Identify and report on healthcare disparities within a geographic region. Oversight of assigned delegated medical management functions Responsibility for monitoring and tracking of delegate's performance to ensure they are meeting or exceeding contracted service level agreements.Analyzes and summarizes delegate reports and audits and identifies variances and trendsMaintains the First Tier Auditing and Monitoring (FTEAM) Universe on an ongoing basisBe familiar with abstracting clinical data from EMRsHEDIS data collection using NCQA Certified HEDIS Software to prospectively collect data during the measurement year.Assist in medical chart review and data collection during HEDIS season.Perform other duties as assigned. Qualifications: Qualifications RequirementsCurrent Massachusetts RN licensureBachelors' degree in related field (i.e. Nursing, Healthcare, Business) or equivalent experience 4+ years' experience in health insurance or managed care (defined as previous experience with health plan/hospital compliance, risk management). Previous case management experience preferred. Experience or working knowledge of HEDIS, Stars and the Qualified Health Plan/Quality Rating System Ability to interact with medical staff, peers, and internal company staff at all levels Non-traditional working hours to meet the member's availability Basic to intermediate experience in MS Word, Excel, tablet and/or smartphone Travel up to 30% (subject to change) for on-site member/provider meetings, events or manager requests.Must have valid driver's license and reliable transportation Ability to talk and type simultaneouslyFlexibility Must be able to work in a multi-functional team setting Preferred Criteria Intermediate experience and or knowledge of HEDIS/Stars/CMS/Quality preferred Intermediate health care data management and project management skills Experience with healthcare quality improvement strategiesPM16PI107897610
Feb 20, 2019
Job ID: 5354# Positions: 1Posted Date: 2018-10-25Category: NursingProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Job Summary This position is accountable for supporting the delivery system to improve member's health outcomes, oversight of assigned delegated activities and participation in the company's STARS and GIC quality improvement initiatives by: 1) Assisting providers to deliver improved patient care. 2) Educating the provider community on impact of CAHPS, HOS and HEDIS on member outcomes and STARs performance. 3) Assessing provider office practices for opportunities that positively impact member experience and impact HEDIS, CAHPS and HOS ratings. This position will be required to communicate and collaborate with value based and non-valued based partners as well as other stakeholders to effectively manage the delivery of strategies, plans and improvements to HEDIS, Medicare Stars, GIC Quality Improvement Initiatives, Qualified Health Plans/Quality Rating Systems and other clinical quality measurements. Knowledge and utilization of health analytic tools is required to identify opportunities to improve satisfaction and quality. Responsibilities: Primary Job ResponsibilitiesProvides staff education on the health plan's STAR & GIC initiatives, to include HEDIS, CAHPS and HOS surveys as it relates to improving member experience and health outcomes. Utilize health analytic tools to identify trends and opportunities (within a population in a specific geographic area) To enhance the health of Fallon Health members and support value based arrangements and collaborative care providers with management of their members. Assist members to obtain preventive screenings and review for adherence with prescribed medications Obtain supplemental data contained in the medical record and make it available to the health plan for integration into the HEDIS data base. Inform and educate the care team on care gaps, activities, issues or concerns about the population and from the value based programs. Collaborate with Member, Member's Personal Representative, Member's Physicians, Plan Medical Directors, Managers, as well as other functional area to assist the member to meet their health care goals, reduce care gaps, improve health outcomes, and reduce the total cost of care. Identify and report on healthcare disparities within a geographic region. Oversight of assigned delegated medical management functions Responsibility for monitoring and tracking of delegate's performance to ensure they are meeting or exceeding contracted service level agreements.Analyzes and summarizes delegate reports and audits and identifies variances and trendsMaintains the First Tier Auditing and Monitoring (FTEAM) Universe on an ongoing basisBe familiar with abstracting clinical data from EMRsHEDIS data collection using NCQA Certified HEDIS Software to prospectively collect data during the measurement year.Assist in medical chart review and data collection during HEDIS season.Perform other duties as assigned. Qualifications: Qualifications RequirementsCurrent Massachusetts RN licensureBachelors' degree in related field (i.e. Nursing, Healthcare, Business) or equivalent experience 4+ years' experience in health insurance or managed care (defined as previous experience with health plan/hospital compliance, risk management). Previous case management experience preferred. Experience or working knowledge of HEDIS, Stars and the Qualified Health Plan/Quality Rating System Ability to interact with medical staff, peers, and internal company staff at all levels Non-traditional working hours to meet the member's availability Basic to intermediate experience in MS Word, Excel, tablet and/or smartphone Travel up to 30% (subject to change) for on-site member/provider meetings, events or manager requests.Must have valid driver's license and reliable transportation Ability to talk and type simultaneouslyFlexibility Must be able to work in a multi-functional team setting Preferred Criteria Intermediate experience and or knowledge of HEDIS/Stars/CMS/Quality preferred Intermediate health care data management and project management skills Experience with healthcare quality improvement strategiesPM16PI107897610
Fallon Community Health Plan
Worcester, Massachusetts
Job ID: 5405# Positions: 1Posted Date: 2018-11-02Category: SalesProduct Line: Overview: THE OPPORTUNITYAbout Fallon Health: Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.About Summit ElderCare: Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon's PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities. Summary:This position requires that the Account Executive achieves personal referral/sales/outreach goals for Summit Elder Care. Manages a territory and group of referral source accounts, providing regular follow up and overcoming barriers with each account to obtain referrals. Second Language a plus preferabley spanish.Responsibilities: 1. Relationship BuildingCreates productive and collaborative relationships with internal and external referral sources in order to obtain qualified referrals and enrollments. Works with referral sources to obtain qualified referrals that are willing to meet with a Summit ElderCare nurse for the Summit ElderCare program (a "home visit request").Participates in community outreach activities, such as senior fairs, community events, and elder services professional association events..Develops and implements their own Territory Development Plan, and carries out activities to penetrate accounts listed on the plan. 2. Lead GenerationWorks collaboratively with SE enrollment team to discuss progress of referrals and ideas for resolving issues.Provides inservice orientations to new and existing Summit ElderCare program vendors on an annual basis.Tours both professionals and prospects at the Summit ElderCare PACE sites.Shows accountability and follows up with prospects until the lead is closed/withdrawn.Achieves monthly referral and home visit request goals for Summit ElderCare program4. Tracking & ReportingDocuments all sales activities in the department's CRM application in a timely manner.Meets weekly sales activity deliverables consistently, and tracks these in the CRM and their Outlook calendar.5. AssessmentRegularly reviews effectiveness of efforts against goals. Provides market intelligence to the SE Manager and the Marketing director so that adjustments can be made to tactical plans.Manages their own professional development by seeking advice, training, and coaching from their colleagues, manager, and the Director of Outreach.6. Regulatory GuidelinesOperates within the marketing and outreach guidelines and regulations provided by CMS and EOHHS.Retains Scope of Appointment and other Enrollment Records.Submits information on NaviCare prospect events to Outreach Support in a timely manner, for CMS submission.When in doubt, asks questions pertaining to compliance or privacy regulations. Qualifications: Education:BS or BA degree and/or comparable experienceLicense:Massachusetts Driver's License Experience:3 years of sales experience in healthcare or group insurance strongly preferred.Must have proven experience working in a customer facing role focused on sales, lead generation in a high paced customer service or sales environment.Knowledge of Medicare, Medicaid and insurance products is desirable. Knowledge of customer service, sales, outreach and marketing principles and practices.Possession of a valid Mass. driver's license and a vehicle to be used for marketing activities and home visits. PM16PI107897609
Feb 20, 2019
Job ID: 5405# Positions: 1Posted Date: 2018-11-02Category: SalesProduct Line: Overview: THE OPPORTUNITYAbout Fallon Health: Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.About Summit ElderCare: Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon's PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities. Summary:This position requires that the Account Executive achieves personal referral/sales/outreach goals for Summit Elder Care. Manages a territory and group of referral source accounts, providing regular follow up and overcoming barriers with each account to obtain referrals. Second Language a plus preferabley spanish.Responsibilities: 1. Relationship BuildingCreates productive and collaborative relationships with internal and external referral sources in order to obtain qualified referrals and enrollments. Works with referral sources to obtain qualified referrals that are willing to meet with a Summit ElderCare nurse for the Summit ElderCare program (a "home visit request").Participates in community outreach activities, such as senior fairs, community events, and elder services professional association events..Develops and implements their own Territory Development Plan, and carries out activities to penetrate accounts listed on the plan. 2. Lead GenerationWorks collaboratively with SE enrollment team to discuss progress of referrals and ideas for resolving issues.Provides inservice orientations to new and existing Summit ElderCare program vendors on an annual basis.Tours both professionals and prospects at the Summit ElderCare PACE sites.Shows accountability and follows up with prospects until the lead is closed/withdrawn.Achieves monthly referral and home visit request goals for Summit ElderCare program4. Tracking & ReportingDocuments all sales activities in the department's CRM application in a timely manner.Meets weekly sales activity deliverables consistently, and tracks these in the CRM and their Outlook calendar.5. AssessmentRegularly reviews effectiveness of efforts against goals. Provides market intelligence to the SE Manager and the Marketing director so that adjustments can be made to tactical plans.Manages their own professional development by seeking advice, training, and coaching from their colleagues, manager, and the Director of Outreach.6. Regulatory GuidelinesOperates within the marketing and outreach guidelines and regulations provided by CMS and EOHHS.Retains Scope of Appointment and other Enrollment Records.Submits information on NaviCare prospect events to Outreach Support in a timely manner, for CMS submission.When in doubt, asks questions pertaining to compliance or privacy regulations. Qualifications: Education:BS or BA degree and/or comparable experienceLicense:Massachusetts Driver's License Experience:3 years of sales experience in healthcare or group insurance strongly preferred.Must have proven experience working in a customer facing role focused on sales, lead generation in a high paced customer service or sales environment.Knowledge of Medicare, Medicaid and insurance products is desirable. Knowledge of customer service, sales, outreach and marketing principles and practices.Possession of a valid Mass. driver's license and a vehicle to be used for marketing activities and home visits. PM16PI107897609
Fallon Community Health Plan
Worcester, Massachusetts
Job ID: 5166# Positions: 1Posted Date: 2018-07-24Category: FinanceProduct Line: Overview: ABOUT FALLON HEALTHFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.OVERVIEWThe primary role of the RAC will be to function as the Encounter SME for the Risk Adjustment & Analytics Department. The RAC maintains and operates the Encounter Data vendor software solutions and implements reporting specific to: Edge Server, RAPS, EDPS and Medicaid Encounter data submission analytic reports, as well as analyzes and researches all Encounter data errors and issues, collaborating with internal departments to work toward error resolution. The Risk Adjustment Consultant will be a SME for the respective risk adjustment model(s) and related Encounter Data submission requirements. The RAC will review and apply all related regulatory requirements to department activities for example: audits, changes in rate models, changes in submissions, audit responses and selection, etc. The RAC will use a combination of SAS, SQL, Risk Adjustment vendor software tools and other commonly used software, such as Excel, to establish an understanding and expertise for the assigned product line(s).The Risk Adjustment Consultant will be responsible for leading projects and engaging collaborating staff within Finance, IT, Care Services and Operational areas to optimize Risk Adjustment results. The RAC will interface with external and internal customers and vendors to identify and/or analyze business problems and develop solutions, as well as improve workflows and business processes to improve Risk Adjustment outcomes. The RAC will represent the Senior Director and department in corporate meetings. The RAC will represent the Risk Adjustment team, participating in corporate project workgroups and team initiatives as assigned. The position will also be responsible for the direction and completion of other projects, data oversight and analyses as needed. Responsibilities: Analyze & Resolve Claims/ Encounter Data ErrorsEncounter Data/Claims SMEPrioritize error resolutionCollaborate with internal departments to work toward error resolutionManage Encounter Data softwareProduct Line SupportEducate specified product line management on drivers of variances from budget for all revenue streams.Meet regularly with the specified product manager(s) to identify and implement reports to improve revenue optimization efforts.Regulatory ComplianceKnowledgeable of data submission timelines and lags - RA factor impactSME for regulatory rate release notes and summaries - review and oversee application of risk adjustment changes specific to Annual Rate Notices and interim rate bulletins from state and federal regulatory agencies.Corporate Project SupportParticipate in corporate projects and subgroup meetings. Complete analyses related to corporate projects and business needs as required. Qualifications: BA or BS - Business Administration, Finance, Economics, Healthcare Administration, otherExperience working in Medicare, Medicaid and/or Merged Markets support role: Risk Adjustment, Regulatory, Enrollment, Internal Audit, Accounting, Underwriting, Marketing, Claims - otherProficient/Advanced in ExcelAbility to create presentations & exhibits in formats that meet various audience levelsSQL- Navigator and/or SAS experience~7 years - Managed Care setting~5 years - Excel~3 years - SQL/SAS Experience PM16PI107897607
Feb 20, 2019
Job ID: 5166# Positions: 1Posted Date: 2018-07-24Category: FinanceProduct Line: Overview: ABOUT FALLON HEALTHFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.OVERVIEWThe primary role of the RAC will be to function as the Encounter SME for the Risk Adjustment & Analytics Department. The RAC maintains and operates the Encounter Data vendor software solutions and implements reporting specific to: Edge Server, RAPS, EDPS and Medicaid Encounter data submission analytic reports, as well as analyzes and researches all Encounter data errors and issues, collaborating with internal departments to work toward error resolution. The Risk Adjustment Consultant will be a SME for the respective risk adjustment model(s) and related Encounter Data submission requirements. The RAC will review and apply all related regulatory requirements to department activities for example: audits, changes in rate models, changes in submissions, audit responses and selection, etc. The RAC will use a combination of SAS, SQL, Risk Adjustment vendor software tools and other commonly used software, such as Excel, to establish an understanding and expertise for the assigned product line(s).The Risk Adjustment Consultant will be responsible for leading projects and engaging collaborating staff within Finance, IT, Care Services and Operational areas to optimize Risk Adjustment results. The RAC will interface with external and internal customers and vendors to identify and/or analyze business problems and develop solutions, as well as improve workflows and business processes to improve Risk Adjustment outcomes. The RAC will represent the Senior Director and department in corporate meetings. The RAC will represent the Risk Adjustment team, participating in corporate project workgroups and team initiatives as assigned. The position will also be responsible for the direction and completion of other projects, data oversight and analyses as needed. Responsibilities: Analyze & Resolve Claims/ Encounter Data ErrorsEncounter Data/Claims SMEPrioritize error resolutionCollaborate with internal departments to work toward error resolutionManage Encounter Data softwareProduct Line SupportEducate specified product line management on drivers of variances from budget for all revenue streams.Meet regularly with the specified product manager(s) to identify and implement reports to improve revenue optimization efforts.Regulatory ComplianceKnowledgeable of data submission timelines and lags - RA factor impactSME for regulatory rate release notes and summaries - review and oversee application of risk adjustment changes specific to Annual Rate Notices and interim rate bulletins from state and federal regulatory agencies.Corporate Project SupportParticipate in corporate projects and subgroup meetings. Complete analyses related to corporate projects and business needs as required. Qualifications: BA or BS - Business Administration, Finance, Economics, Healthcare Administration, otherExperience working in Medicare, Medicaid and/or Merged Markets support role: Risk Adjustment, Regulatory, Enrollment, Internal Audit, Accounting, Underwriting, Marketing, Claims - otherProficient/Advanced in ExcelAbility to create presentations & exhibits in formats that meet various audience levelsSQL- Navigator and/or SAS experience~7 years - Managed Care setting~5 years - Excel~3 years - SQL/SAS Experience PM16PI107897607
Fallon Community Health Plan
Webster, Massachusetts
Job ID: 5093# Positions: 1Posted Date: 2018-01-26Category: Medical ManagementProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.About Summit ElderCare: Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon's PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities. Summary:Responsible for the coordination and supervision of all clinical, financial and business aspects of a PACE center serving 250 participants or more.Responsibilities: Primary Job Responsibilities:Coordinates all program services, activities and day-to-day operations of the PACE center including: referral and intake, health monitoring, personal care, rehabilitative services, recreational activities, nutrition, transportation, care management and business administration.Recruits and hires staff. Supervises and evaluates Clinical Nurse Manager, Social Workers, Office Coordinator, Activities Coordinator, Rehab Lead, and Dietician. Indirectly supervises professional and non-professional staff including, but not limited to Provider staff, administrative support staff, medical assistants, nurses, social workers, activities assistants, rehab staff, health aides and others. In collaboration with the Summit ElderCare Executive Director, prepares the annual budget for the site and conducts ongoing monitoring of all expenses. Conducts site specific staff and management meetings.Plans and implements appropriate staff development and support activities.Oversees site specific safety and emergency evacuation plans.In collaboration with the SE Director of Facilities Management, oversees maintenance of the facility to meet necessary certification and quality standards.Oversees and participates in establishing and implementing the care plan for individual participants and ongoing care management.Facilitates daily interdisciplinary team meetings.Ensures close coordination between participant, family, program staff, primary medical providers and external providers in carrying out individual care plan.Participates in quality and management committees as assigned.Works closely with the SE Senior Director of Operations in the development and ongoing monitoring of contracted services. Monitors quality of service provision, authorizes payments to contractors and reports concerns in a timely manner to the SE Senior Director of Operations.Participates in marketing and outreach activities and contributes to the development of the annual marketing plan. Meets with Enrollment staff to ensure coordination of effort as it relates to enrollment targets and provides feedback in a constructive and timely manner.Acts as a liaison with community agencies as appropriate. Represents PACE center and Summit ElderCare with community organizations and committees, as requested.Maintains consistent contact with designated existing and potential referral sources. Makes presentations to professional and community groups, as needed.Participates in other administrative activities relating to the Summit ElderCare site including fiscal management, program planning and development. Demonstrates innovative approach to program development and expansion. Qualifications: Education, Licenses, certification and experience requirements:Education: Bachelors in business administration, health care administration or related field. Bachelor of Science in Nursing strongly preferred. Licensed as a Registered Nurse in the State of MA required.Certification: Alzheimer's and CPR certification or willingness to be certified is essentialExperience: Three - Five years of clinical and supervisory experience in geriatric care. At least one year experience working with frail elders is required.Competencies:Coaching and developing othersUtilization ManagementBudget Development & ManagementConcise Decision MakingEffective Problem solvingFosters open communicationAbility to exercise independent judgmentAdaptabilityApproachabilityConflict Resolutionpm16PI107897605
Feb 20, 2019
Job ID: 5093# Positions: 1Posted Date: 2018-01-26Category: Medical ManagementProduct Line: Overview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.About Summit ElderCare: Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon's PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities. Summary:Responsible for the coordination and supervision of all clinical, financial and business aspects of a PACE center serving 250 participants or more.Responsibilities: Primary Job Responsibilities:Coordinates all program services, activities and day-to-day operations of the PACE center including: referral and intake, health monitoring, personal care, rehabilitative services, recreational activities, nutrition, transportation, care management and business administration.Recruits and hires staff. Supervises and evaluates Clinical Nurse Manager, Social Workers, Office Coordinator, Activities Coordinator, Rehab Lead, and Dietician. Indirectly supervises professional and non-professional staff including, but not limited to Provider staff, administrative support staff, medical assistants, nurses, social workers, activities assistants, rehab staff, health aides and others. In collaboration with the Summit ElderCare Executive Director, prepares the annual budget for the site and conducts ongoing monitoring of all expenses. Conducts site specific staff and management meetings.Plans and implements appropriate staff development and support activities.Oversees site specific safety and emergency evacuation plans.In collaboration with the SE Director of Facilities Management, oversees maintenance of the facility to meet necessary certification and quality standards.Oversees and participates in establishing and implementing the care plan for individual participants and ongoing care management.Facilitates daily interdisciplinary team meetings.Ensures close coordination between participant, family, program staff, primary medical providers and external providers in carrying out individual care plan.Participates in quality and management committees as assigned.Works closely with the SE Senior Director of Operations in the development and ongoing monitoring of contracted services. Monitors quality of service provision, authorizes payments to contractors and reports concerns in a timely manner to the SE Senior Director of Operations.Participates in marketing and outreach activities and contributes to the development of the annual marketing plan. Meets with Enrollment staff to ensure coordination of effort as it relates to enrollment targets and provides feedback in a constructive and timely manner.Acts as a liaison with community agencies as appropriate. Represents PACE center and Summit ElderCare with community organizations and committees, as requested.Maintains consistent contact with designated existing and potential referral sources. Makes presentations to professional and community groups, as needed.Participates in other administrative activities relating to the Summit ElderCare site including fiscal management, program planning and development. Demonstrates innovative approach to program development and expansion. Qualifications: Education, Licenses, certification and experience requirements:Education: Bachelors in business administration, health care administration or related field. Bachelor of Science in Nursing strongly preferred. Licensed as a Registered Nurse in the State of MA required.Certification: Alzheimer's and CPR certification or willingness to be certified is essentialExperience: Three - Five years of clinical and supervisory experience in geriatric care. At least one year experience working with frail elders is required.Competencies:Coaching and developing othersUtilization ManagementBudget Development & ManagementConcise Decision MakingEffective Problem solvingFosters open communicationAbility to exercise independent judgmentAdaptabilityApproachabilityConflict Resolutionpm16PI107897605
Fallon Community Health Plan
Worcester, Massachusetts
Job ID: 5171# Positions: 1Posted Date: 3/28/2018Category: FinanceProduct Line: Fallon HealthOverview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Brief summary of purpose:The primary role of the Actuarial Consultant will be to function as the Medicare Advantage financial analyst for the Actuarial Services department. The AC will take the lead in the data collection, analysis and completion of the annual CMS MA Part C and Part D bid submission filing process. These responsibilities will include, but not be limited to, working with the Sr. Director and Actuary, Government Programs and external actuarial consultants to provide detailed reporting of product experience and to support development of medical trends and evaluation of benefit differences. The AC will be very familiar with CMS regulations applicable to the bid and the product and will take a lead role in developing responses to desk review and audit questions.The Actuarial Consultant will be familiar with all revenue streams relevant to our Medicare Advantage products and will work with the Risk Analytics team to understand changes in Fallon's risk scores over time and to recommend ways to optimize risk adjusted revenue.The Actuarial Consultant will also support the Senior Care Sales team in developing pricing for individual and group Medicare Supplement products and Employer Group Waiver Plans (EGWP). The AC will also provide consultative support for these products to the Sales team, respond to RFP/RFI requests and attend client meetings as necessary.This role will be responsible for working with IT to serve as the business SME to drive development of automated medical loss ratio reporting from the company's EDW. The AC will also complete any CMS/DOI reporting requirements related to Fallon's senior plan products, including the annual CMS Medical Loss Ratio reports. The Consultant will also work with the Government Programs Actuary, product line management, Medical Economics and Care Services to provide analysis and recommendations to improve product performance.The AC will represent the Government Programs Actuary and department in corporate meetings as required. The Actuarial Consultant will participate in corporate project workgroups and team initiatives as assigned. The position will also be responsible for the direction and completion of other projects, data oversight and analyses as needed to solve business problems and improve business processes. Responsibilities: Major areas of responsibility and accountability:Medicare Advantage bid processActively participate on corporate bid team Respond to requests from external consultants for dataMaintain accurate records of work and develop process documentationManage CMS/HPMS softwareEnhance EGWP pricing model and provide account specific rates Product Line supportEducate product line management on drivers of variances from budget for all revenue streamsMeet regularly with the product line manager to identify and implement reports to improve product performance and identify opportunities to enhance revenueMedical loss ratio reporting for Medicare Advantage, PACE and SCO productsMedicare Supplement product pricingDevelop standard pricing for individual and group Med Supp productsProvide experience-based rates to large group prospects and renewalsCorporate Project supportParticipate in corporate projects and subgroup meetings. Complete analyses related to corporate projects and business needs as required.Qualifications: Education: BA or BS - Mathematics, Finance, Economics, Management, other ExperienceExperience in managed health care financial analysis. Familiarity with Medicare Advantage and/or Part D preferred.Support role: Actuarial, Finance, Accounting, Regulatory, Enrollment, Claims - otherAdvanced Excel skillsSQL- Navigator and/or SAS experienceAbility to create presentations & exhibits in formats that meet various audience level10 years - Managed Care setting8 years - Excel5 years - SQL/SAS ExperienceAbility to communicate effectively and in a professional manner in both written and verbal form.PM16PI107897603
Feb 20, 2019
Job ID: 5171# Positions: 1Posted Date: 3/28/2018Category: FinanceProduct Line: Fallon HealthOverview: About Fallon HealthFounded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.Brief summary of purpose:The primary role of the Actuarial Consultant will be to function as the Medicare Advantage financial analyst for the Actuarial Services department. The AC will take the lead in the data collection, analysis and completion of the annual CMS MA Part C and Part D bid submission filing process. These responsibilities will include, but not be limited to, working with the Sr. Director and Actuary, Government Programs and external actuarial consultants to provide detailed reporting of product experience and to support development of medical trends and evaluation of benefit differences. The AC will be very familiar with CMS regulations applicable to the bid and the product and will take a lead role in developing responses to desk review and audit questions.The Actuarial Consultant will be familiar with all revenue streams relevant to our Medicare Advantage products and will work with the Risk Analytics team to understand changes in Fallon's risk scores over time and to recommend ways to optimize risk adjusted revenue.The Actuarial Consultant will also support the Senior Care Sales team in developing pricing for individual and group Medicare Supplement products and Employer Group Waiver Plans (EGWP). The AC will also provide consultative support for these products to the Sales team, respond to RFP/RFI requests and attend client meetings as necessary.This role will be responsible for working with IT to serve as the business SME to drive development of automated medical loss ratio reporting from the company's EDW. The AC will also complete any CMS/DOI reporting requirements related to Fallon's senior plan products, including the annual CMS Medical Loss Ratio reports. The Consultant will also work with the Government Programs Actuary, product line management, Medical Economics and Care Services to provide analysis and recommendations to improve product performance.The AC will represent the Government Programs Actuary and department in corporate meetings as required. The Actuarial Consultant will participate in corporate project workgroups and team initiatives as assigned. The position will also be responsible for the direction and completion of other projects, data oversight and analyses as needed to solve business problems and improve business processes. Responsibilities: Major areas of responsibility and accountability:Medicare Advantage bid processActively participate on corporate bid team Respond to requests from external consultants for dataMaintain accurate records of work and develop process documentationManage CMS/HPMS softwareEnhance EGWP pricing model and provide account specific rates Product Line supportEducate product line management on drivers of variances from budget for all revenue streamsMeet regularly with the product line manager to identify and implement reports to improve product performance and identify opportunities to enhance revenueMedical loss ratio reporting for Medicare Advantage, PACE and SCO productsMedicare Supplement product pricingDevelop standard pricing for individual and group Med Supp productsProvide experience-based rates to large group prospects and renewalsCorporate Project supportParticipate in corporate projects and subgroup meetings. Complete analyses related to corporate projects and business needs as required.Qualifications: Education: BA or BS - Mathematics, Finance, Economics, Management, other ExperienceExperience in managed health care financial analysis. Familiarity with Medicare Advantage and/or Part D preferred.Support role: Actuarial, Finance, Accounting, Regulatory, Enrollment, Claims - otherAdvanced Excel skillsSQL- Navigator and/or SAS experienceAbility to create presentations & exhibits in formats that meet various audience level10 years - Managed Care setting8 years - Excel5 years - SQL/SAS ExperienceAbility to communicate effectively and in a professional manner in both written and verbal form.PM16PI107897603
Clemson University: College of Agriculture, Forestry and Life Sciences: Forestry and Environmental ConservationPost Doctoral Fellow, Appalachian Fire EcologyLocation: 261 Lehotsky HallThe Department of Forestry and Environmental Conservation (FEC) at Clemson University (CU), in collaboration with Western Carolina University (WCU), Virginia Tech (VT) and the Consortium of Appalachian Fire Managers and Scientists (CAFMS) is seeking to fill a Post-Doctoral Researcher position, with a specialization in fire ecology. This position is a 9-month appointment, with an anticipated starting date in summer 2019.BACKGROUND Land managers in the southern Appalachians face many challenges, many of which are related to the degradation and homogenization of plant communities due to decades of fire exclusion. While prescribed fire research is active in the region, relatively few long-term/large scale studies have been conducted. With support from CAFMS, the Southern Blue Ridge Fire Learning Network, and the US Forest Service, WCU has accumulated perhaps the largest prescribed fire effects database in the southern Appalachians (NC, SC, TN and GA). The dataset contains pre- and post-fire vegetation and fuels from 16 burn units, some of which have been burned as many as 3 times since 2006. The primary responsibility of the Post-Doctoral Researcher will be to analyze these data to assess the effects of prescribed fire on several variables of management interest, including: overstory dynamics, mountain laurel and rhododendron mortality, tree regeneration, herbaceous layer response, and fuels. The Post-Doctoral Researcher will be expected to take the lead on synthesizing the results in a US Forest Service General Technical Report (GTR) that is geared to both land managers and scientists. Opportunities to prepare peer-reviewed manuscripts and present findings at conferences and meetings will also be available.QUALIFICATIONSApplicants must have a PhD in a natural resources-related field, excellent written communication and quantitative skills, and a strong interest in fire ecology. Familiarity with southern Appalachian forest ecosystems is preferred. Women and minorities are encouraged to apply.To maximize opportunities for interaction and collaboration, we prefer that the Post-Doctoral Researcher be based out of CU, WCU or VT. However, exceptional candidates who wish to work remotely may also be considered.APPLICATION INSTRUCTIONSApplication deadline: To insure full consideration, applications should be submitted via Interfolio by March 18, 2019. The position will remain open until filled.Materials for application: 1. Letter of interest 2. CV 3. Contact info for 3 references 4. Unofficial transcriptsPosition related questions may be directed to:Donald Hagan, PhD Clemson University dhagan@clemson.edu 864-656-7333 ORPete Bates, PhD Western Carolina University bates@email.wcu.edu 828-227-3914 ORAdam Coates, PhD Virginia Tech University acoates4@vt.edu 540-231-5676Clemson University is an AA/EEO employer and does not discriminate against any person or group on the basis of age, color, disability, gender, pregnancy, national origin, race, religion, sexual orientation, veteran status or genetic information. Clemson University is building a culturally diverse faculty and staff committed to working in a multicultural environment and encourages applications from minorities and women.PI107901723
Feb 20, 2019
Clemson University: College of Agriculture, Forestry and Life Sciences: Forestry and Environmental ConservationPost Doctoral Fellow, Appalachian Fire EcologyLocation: 261 Lehotsky HallThe Department of Forestry and Environmental Conservation (FEC) at Clemson University (CU), in collaboration with Western Carolina University (WCU), Virginia Tech (VT) and the Consortium of Appalachian Fire Managers and Scientists (CAFMS) is seeking to fill a Post-Doctoral Researcher position, with a specialization in fire ecology. This position is a 9-month appointment, with an anticipated starting date in summer 2019.BACKGROUND Land managers in the southern Appalachians face many challenges, many of which are related to the degradation and homogenization of plant communities due to decades of fire exclusion. While prescribed fire research is active in the region, relatively few long-term/large scale studies have been conducted. With support from CAFMS, the Southern Blue Ridge Fire Learning Network, and the US Forest Service, WCU has accumulated perhaps the largest prescribed fire effects database in the southern Appalachians (NC, SC, TN and GA). The dataset contains pre- and post-fire vegetation and fuels from 16 burn units, some of which have been burned as many as 3 times since 2006. The primary responsibility of the Post-Doctoral Researcher will be to analyze these data to assess the effects of prescribed fire on several variables of management interest, including: overstory dynamics, mountain laurel and rhododendron mortality, tree regeneration, herbaceous layer response, and fuels. The Post-Doctoral Researcher will be expected to take the lead on synthesizing the results in a US Forest Service General Technical Report (GTR) that is geared to both land managers and scientists. Opportunities to prepare peer-reviewed manuscripts and present findings at conferences and meetings will also be available.QUALIFICATIONSApplicants must have a PhD in a natural resources-related field, excellent written communication and quantitative skills, and a strong interest in fire ecology. Familiarity with southern Appalachian forest ecosystems is preferred. Women and minorities are encouraged to apply.To maximize opportunities for interaction and collaboration, we prefer that the Post-Doctoral Researcher be based out of CU, WCU or VT. However, exceptional candidates who wish to work remotely may also be considered.APPLICATION INSTRUCTIONSApplication deadline: To insure full consideration, applications should be submitted via Interfolio by March 18, 2019. The position will remain open until filled.Materials for application: 1. Letter of interest 2. CV 3. Contact info for 3 references 4. Unofficial transcriptsPosition related questions may be directed to:Donald Hagan, PhD Clemson University dhagan@clemson.edu 864-656-7333 ORPete Bates, PhD Western Carolina University bates@email.wcu.edu 828-227-3914 ORAdam Coates, PhD Virginia Tech University acoates4@vt.edu 540-231-5676Clemson University is an AA/EEO employer and does not discriminate against any person or group on the basis of age, color, disability, gender, pregnancy, national origin, race, religion, sexual orientation, veteran status or genetic information. Clemson University is building a culturally diverse faculty and staff committed to working in a multicultural environment and encourages applications from minorities and women.PI107901723
AlerisAleris is an equal opportunity employer and supports diversity in the workplace. Qualified applications will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Our HR teams will reach out to the applicants who met the qualifications and most closely aligned with requirements of the positions.Function Tech, R&D and EngineeringRelocation Available NoPosition Type Full TimeOverview / Job SummaryAleris is a global leader in the manufacture and sale of aluminum rolled products, with approximately 14 facilities in three geographically aligned business units in North America, Europe and China. We serve a variety of end-use industries, including aerospace, automotive, defense, building and construction, transportation, packaging, and consumer goods.Our North American division is seeking to add a talented Production Supervisor to our team. The purpose of this role is to lead the execution of plans for the Wide Cold Mill/ CALP department. This position will monitor and keep production running with the task of maximizing productivity and quality; engage the team to drive a continuous improvement culture by utilizing the Aleris Operating System (AOS) to eliminate waste, overburden and variability in manufacturing processes; act as a role model for safety by demonstrating behaviors that align with the Aleris safety principles and hold the team accountable for results; and provides leadership, direction, coaching and development to motivate and sustain high levels of employee performance.Responsibilities IncludeHealth, Safety & EnvironmentalLeverage the Aleris Safety System and Safety Principles to create a zero injury culture.Support the implementation of processes (safety observations, housekeeping audits, etc.) that reveal safety hazards, and develop sustainable corrective actions.Conduct daily safety crew briefings.Ensure that company policies and procedures are being executed by his/her team in order to ensure compliance with all health, safety and environmental regulations.Ensure the team is being retrained on the relevant safety procedures in accordance with the HSE Department's schedule.Investigate and document safety related incidents in the assigned area.OperationsEnsures that the daily production goals for throughput, quality, target date and cost are being achieved by his or her team.Ensures that a safe job execution has priority over a quick job execution.Conducts capacity planning and resource allocation for short and medium term production demands.Ensures the availability of materials needed to complete production requirements.Participates in and conducts Safety and Production Meetings.Ensures that quality requirements, sample taking, documentation and report keeping are being executed by his/her team.Ensures deviations from the standard process are effectively communicated to the relevant people/functions.Monitors correctness of material used for production.Conducts layered process audits (LPAs) to improve quality, reduce scrap and rework and reduced internal and external customer rejections.Ensure communication across shifts occurs regarding production concerns, overtime, manning, status of work assignments or any other item that may impact production.Communicate and work closely with the Superintendent regarding the status of production.Continuous ImprovementEngages with his/her team to develop and implement standard work.Engages his/her team to drive a continuous improvement culture by utilizing AOS to eliminate waste, overburden and variability in manufacturing processes.Participates in productivity, safety and quality improvement projects.Supports developing solutions for cost reduction and yield improvement.Management and LeadershipInspires employees to perform at high levels.Sets and communicates clear performance standards and holds direct reports accountable for results.Conducts performance appraisals and maintains performance metrics to monitor employee results; identify and initiate improvements for development and/or training.Provides on-going coaching, feedback and development to increase employee performance and production.Communicates effectively with direct reports and resolves conflicts within and between individual team members.Ensure employees are paid accurately and held accountable for time missed by tracking attendance and entering data in the timekeeping system.Ensure all vacancies are filled by managing and scheduling employees for overtime as needed.Adhere to all applicable rules in the Labor Agreement. Required QualificationsHigh school diploma / GED required. At least 5+ years related work experience with leadership responsibility.Is technically competent and capable of backfilling team members.Has the ability to understand the manufacturing process and technical knowledge to ensure product quality and flow.Has the ability to understand how activities impact cash conversion, EBITDA and other key financial metrics.Ability to read and interpret documents such as safety policies and procedures, HR policies, standard work documents, maintenance instructions, procedure manuals, charts etc.Ability to rotate shifts in a 24/7 operation.Preferred QualificationsCollege or University degree is preferred.Aleris is an equal opportunity employer and supports diversity in the workplace. Qualified applications will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Our HR teams will reach out to the applicants who meet the qualifications and most closely align with requirements of the positionPI107900081
Feb 20, 2019
AlerisAleris is an equal opportunity employer and supports diversity in the workplace. Qualified applications will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Our HR teams will reach out to the applicants who met the qualifications and most closely aligned with requirements of the positions.Function Tech, R&D and EngineeringRelocation Available NoPosition Type Full TimeOverview / Job SummaryAleris is a global leader in the manufacture and sale of aluminum rolled products, with approximately 14 facilities in three geographically aligned business units in North America, Europe and China. We serve a variety of end-use industries, including aerospace, automotive, defense, building and construction, transportation, packaging, and consumer goods.Our North American division is seeking to add a talented Production Supervisor to our team. The purpose of this role is to lead the execution of plans for the Wide Cold Mill/ CALP department. This position will monitor and keep production running with the task of maximizing productivity and quality; engage the team to drive a continuous improvement culture by utilizing the Aleris Operating System (AOS) to eliminate waste, overburden and variability in manufacturing processes; act as a role model for safety by demonstrating behaviors that align with the Aleris safety principles and hold the team accountable for results; and provides leadership, direction, coaching and development to motivate and sustain high levels of employee performance.Responsibilities IncludeHealth, Safety & EnvironmentalLeverage the Aleris Safety System and Safety Principles to create a zero injury culture.Support the implementation of processes (safety observations, housekeeping audits, etc.) that reveal safety hazards, and develop sustainable corrective actions.Conduct daily safety crew briefings.Ensure that company policies and procedures are being executed by his/her team in order to ensure compliance with all health, safety and environmental regulations.Ensure the team is being retrained on the relevant safety procedures in accordance with the HSE Department's schedule.Investigate and document safety related incidents in the assigned area.OperationsEnsures that the daily production goals for throughput, quality, target date and cost are being achieved by his or her team.Ensures that a safe job execution has priority over a quick job execution.Conducts capacity planning and resource allocation for short and medium term production demands.Ensures the availability of materials needed to complete production requirements.Participates in and conducts Safety and Production Meetings.Ensures that quality requirements, sample taking, documentation and report keeping are being executed by his/her team.Ensures deviations from the standard process are effectively communicated to the relevant people/functions.Monitors correctness of material used for production.Conducts layered process audits (LPAs) to improve quality, reduce scrap and rework and reduced internal and external customer rejections.Ensure communication across shifts occurs regarding production concerns, overtime, manning, status of work assignments or any other item that may impact production.Communicate and work closely with the Superintendent regarding the status of production.Continuous ImprovementEngages with his/her team to develop and implement standard work.Engages his/her team to drive a continuous improvement culture by utilizing AOS to eliminate waste, overburden and variability in manufacturing processes.Participates in productivity, safety and quality improvement projects.Supports developing solutions for cost reduction and yield improvement.Management and LeadershipInspires employees to perform at high levels.Sets and communicates clear performance standards and holds direct reports accountable for results.Conducts performance appraisals and maintains performance metrics to monitor employee results; identify and initiate improvements for development and/or training.Provides on-going coaching, feedback and development to increase employee performance and production.Communicates effectively with direct reports and resolves conflicts within and between individual team members.Ensure employees are paid accurately and held accountable for time missed by tracking attendance and entering data in the timekeeping system.Ensure all vacancies are filled by managing and scheduling employees for overtime as needed.Adhere to all applicable rules in the Labor Agreement. Required QualificationsHigh school diploma / GED required. At least 5+ years related work experience with leadership responsibility.Is technically competent and capable of backfilling team members.Has the ability to understand the manufacturing process and technical knowledge to ensure product quality and flow.Has the ability to understand how activities impact cash conversion, EBITDA and other key financial metrics.Ability to read and interpret documents such as safety policies and procedures, HR policies, standard work documents, maintenance instructions, procedure manuals, charts etc.Ability to rotate shifts in a 24/7 operation.Preferred QualificationsCollege or University degree is preferred.Aleris is an equal opportunity employer and supports diversity in the workplace. Qualified applications will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Our HR teams will reach out to the applicants who meet the qualifications and most closely align with requirements of the positionPI107900081
AlerisAleris is an equal opportunity employer and supports diversity in the workplace. Qualified applications will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Our HR teams will reach out to the applicants who met the qualifications and most closely aligned with requirements of the positions.Function ITRelocation Available NoPosition Type Part TimeOverview / Job SummaryAleris is a global leader in the manufacture and sale of aluminum rolled products, with approximately 14 facilities in three geographically aligned business unites in North America, Europe and China. We serve a variety of end-use industries, including aerospace, automotive, defense, building and construction, transportation, packaging, and consumer goods.Our Corporate division is seeking to add a talented Intern to its Information Technology Team at our Lewisport, KY facility. Responsibilities IncludeDemonstrate safety leadership and actively participate in maintaining a zero incident safety culture.Live and champion the Aleris core values; Safety, Integrity, Customer Focus, Ownership, Excellence, and Teamwork.Partner with functional and business stakeholders to understand, analyze, and evaluate IT system processes. Document system requirements, workflow and create training materials. Demonstrating an analytical approach with a problem solving attitude.Provide quality assurance testing.Other projects/responsibilities as assignedDay-to-Day Operations Required QualificationsMust be Full-Time Student (12+ Credit Hours/Semester) and be at a Sophomore Level or abovePursuing a bachelor's degree in computer science, information systems, or any IT related fieldAbility to prioritize workloads and manage requests on time in a fast paced environmentMust be a self-starter who takes initiativeGood communication and interpersonal skillsDelivery focused and problem solving attitudeTechnical proficiency in MS Office.General understanding of HRIS or Timekeeping principles / experience a plus. .PI107900117
Feb 20, 2019
AlerisAleris is an equal opportunity employer and supports diversity in the workplace. Qualified applications will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Our HR teams will reach out to the applicants who met the qualifications and most closely aligned with requirements of the positions.Function ITRelocation Available NoPosition Type Part TimeOverview / Job SummaryAleris is a global leader in the manufacture and sale of aluminum rolled products, with approximately 14 facilities in three geographically aligned business unites in North America, Europe and China. We serve a variety of end-use industries, including aerospace, automotive, defense, building and construction, transportation, packaging, and consumer goods.Our Corporate division is seeking to add a talented Intern to its Information Technology Team at our Lewisport, KY facility. Responsibilities IncludeDemonstrate safety leadership and actively participate in maintaining a zero incident safety culture.Live and champion the Aleris core values; Safety, Integrity, Customer Focus, Ownership, Excellence, and Teamwork.Partner with functional and business stakeholders to understand, analyze, and evaluate IT system processes. Document system requirements, workflow and create training materials. Demonstrating an analytical approach with a problem solving attitude.Provide quality assurance testing.Other projects/responsibilities as assignedDay-to-Day Operations Required QualificationsMust be Full-Time Student (12+ Credit Hours/Semester) and be at a Sophomore Level or abovePursuing a bachelor's degree in computer science, information systems, or any IT related fieldAbility to prioritize workloads and manage requests on time in a fast paced environmentMust be a self-starter who takes initiativeGood communication and interpersonal skillsDelivery focused and problem solving attitudeTechnical proficiency in MS Office.General understanding of HRIS or Timekeeping principles / experience a plus. .PI107900117