Job Summary

This position is responsible for achieving profit, growth, service and expense objectives through the financial analysis and pricing of HCSCs RX business by quoting and rating proposals, projection renewal and the preparation of annual settlements and experience reporting.

Under minimal supervision, the Group Underwriting Consultant serves as an expert consultant on matters pertaining to underwriting, performance guarantees, and other financial considerations.

Provides underwriting services to determine pricing and monitors accounts to ensure they remain on a profitable basis. Maintains and applies knowledge of pricing strategies in the health insurance industry.

Required Job Qualifications :

Bachelor’s degree in mathematics or accounting

Minimum of 5 years underwriting experience

Advanced knowledge of mathematical applications used in underwriting, including ability to calculate figures such as discounts, proportions, and percentages, as well as application of basic concepts of business mathematics and algebra in underwriting problems

Knowledge of State and Federal legislation togroup health underwriting

Proficiency in MS Office applications

Preferred Job Qualifications :

Bachelors Degree in mathematics, accounting or similar field

Experience with major pharmacy benefit managers

Apply standard underwriting principles and procedures to evaluate risk for cases with the greatest complexity.

Work management skills in prioritizing and completing work to ensure deadlines are met.

Collaborate effectively across teams, in and outside of underwriting

Represent Underwriting as subject matter expert in assigned projects, client meetings, and corporate committees.

Please note that this role is a flex or hybrid position where you work 3 days in the office and 2 days from home.

We encourage people of all backgrounds and experiences to apply. Even if you don’t think you are a perfect fit, apply anyway - you might have qualifications we haven’t even thought of yet.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement :

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace.

Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Shift Differential - Weekend Days Saturday - Sunday 15%

Sign-on Bonus available

Department : Mobile Integrated Healthcare

FTE : Full Time

Full Time

Shift : Days

Position Summary :

Provide direct patient care under the guidelines and protocols provided by the UNMH Rapid Response Medical Director. Operate within the scope of practice as defined by the New Mexico Bureau of Emergency Medical Services along with any approved UNMH special skills.

Function as a patient advocate. Ensure adherence to Hospitals and departmental policies and procedures. Patient care assignment may include Neonate, Pediatric, Adolescent, Adult and Geriatric Age Groups.

Detailed responsibilities :

• PATIENT CARE - Provide basic life support up to advanced life support to include defibrillation / cardio version, oral / nasal endotracheal intubation, medication administration, needle thoracotomy, surgical cricothyrotomy, deep suctioning, interosseous catheter Insertion, perform / interpret 12-lead EKG's and chemical blood glucose tests
• PATIENT CARE - Perform patient care; work autonomously to stabilize patients and guide care until providers arrive; triage emergency care (outpatient response on hospital property to emergency department);
• stabilize and / or prepare patient for transport; document all patient care activities; assessment of test results and laboratory values for purpose of adjusting patient therapy;

respond to hospital non-patient emergencies

PATIENT CARE - Administer intramuscular and subcutaneous injections, topical application, sublingual and intravenous administration of medications via the seven rights;

provide for nebulized drug administration; document and communicate clinical findings

• ENVIRONMENT - Maintain a safe, comfortable, and therapeutic environment for patients / families in accordance with Hospitals standards
• EQUIPMENT & SUPPLIES - Monitor and stock supply areas; maintain equipment as appropriate
• MEETINGS - Attend education sessions, department and other meetings as appropriate
• CUSTOMER RELATIONS - Establish and maintain good rapport and effective working relationships with patients, visitors, physicians and Hospitals employees
• QUALITY - Participate in department quality programs
• ORIENTATION - Assist in orienting new employees as required
• DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops
• PATIENT SAFETY 1 - Follow patient safety-related policies, procedures and protocols
• PATIENT SAFETY 2 - Demonstrate proactive approach to patient safety by seeking opportunities to improve patient safety through questioning of current policies and processes
• PATIENT SAFETY 3 - Identify and report / correct environmental conditions and / or situations that may put a patient at undue risk
• PATIENT SAFETY 4 - Report potential or actual patient safety concerns, medical errors and / or near misses in a timely manner
• PATIENT SAFETY 5 - Encourage patients to actively participate in their own care by asking questions and reporting treatment or situations that they don't understand or may "not seem right"
• Patient Care - Examines, screens, treats, and coordinates health services for patients (may include point of care (POC) laboratory testing
• Patient Care - Conducts / assists with post-hospital care including, but not limited to, home safety / living condition evaluations, medication adherence / education, dressing changes, checking of vital signs, and reinforcement of post-discharge / post-office visit education
• Education - Conducts patient education including, but not limited to, chromic disease management, fall / injury prevention, basic nutrition, and wound monitoring / care

Qualifications

Education : Essential :

Essential :

High School or GED Equivalent

Nonessential :

• Associate Degree
• Associate Degree
• Bachelor's Degree

Education specialization :

Nonessential :

• EMS or Bachelor's EMS
• Related Discipline
• Related Discipline

Experience : Essential :

Essential :

1 year related experience

Nonessential :

3 years directly related experience

Credentials : Essential :

Essential :

• Advanced Cardiac Life Support Certification
• Emergency Medical Technician Paramedic License
• PALS
• Complete & maintain unit / clinic based required cert & comps

Nonessential :

• CPR for Healthcare / BLS Prov or Prof Rescuers
• Nationally Registered Paramedic License
• Valid New Mexico Driver's License
• UNM Vehicle Operator's Permit w / in 60 days
• Critical Care Paramedic
• UNMH basic arrhythmia course w / in 3 mos of position
• Arterial Blood Gas course w / in 3 mos of position
• CEVO Course within 3 months of position
• Ultrasound guided IV course w / in 3 monts of position
• DOT Medical Certification within 60 days of position

Working conditions : Essential :

Essential :

• Sig Haz : Physical risk / injuries due to combative patients
• Sig Hazard : Chemicals, Bio Hazardous Materials req PPE
• May drive on / off UNMH grounds, traffic / vehicle exposure
• Weather exposure : rain, ice, wind, snow, sun possible

Company Overview

Join us on our mission to elevate customer experiences for people around the world. As a member of the Everise family, you will be part of a global experience company that believes in being people-first, celebrating diversity and incubating innovation.

Our dedication to our purpose and people is being recognized by our employees and the industry. Our 4.5 / 5 rating on Glassdoor and our shiny, growing wall of Best Place to Work awards is a testament to our investment in our culture.

Through the power of diversity, we celebrate all cultures for their uniqueness and strengths. With 13 centers around the world and a robust work at home program, we believe great things happen when we work with people who think differently from us.

Find a job you’ll love today!

Position Purpose :

In this role you will take your exemplary customer service skills, patience, understanding and compassion to answer inbound phone calls for our clients' members.

You will answer questions related to their healthcare benefits. We offer opportunity for you to earn additional cash incentives for reaching your goals in addition to your base pay.

We also offer medical, dental, vision, and 401K benefits as well as earned PTO. If you’ve got the skills to succeed and the motivation to make it happen, we look forward to hearing from you.

Job Requirements :

• Professionally handle a high volume of incoming calls
• Thoroughly and efficiently gather customer information, assess and fulfill customer needs and educate customers where applicable regarding products and services
• Ability to utilize and navigate multiple systems simultaneously
• Be dependable and meet all attendance requirements
• Resolve customer issues via one call resolution guidelines and / or escalated process
• Meet or exceed company and client performance metrics
• Maintain a balance between company policy and client benefit in decision making
• Continuously evaluate and identify opportunities to drive process improvements that positively impact our client and its customers
• Responsible for call disposition or compiling and documenting customer information as required
• Ability to accept and embrace changes within the current business environment

Qualifications :

• Ability to pass a drug screen and background check
• Dedicated area to work from in your home
• Internet speed requirement of 20 Mb / s for download speeds and 10 Mb / s for upload speeds (Wireless access is not permitted)
• Demonstrated passion for excellence with respect to treating and caring for customers, especially senior citizens
• Strong decision making and analytical abilities
• Ability to identify customer needs and clearly articulate products and services
• Schedule flexibility to include weekends, evenings, possible holidays and occasional overtime
• Highly developed sense of integrity and commitment to customer satisfaction
• Meet all attendance and dependability requirements
• Be a team player

System Requirements for Work At Home :

The employee is responsible for purchasing / using their own equipment

per specifications below :

Only Windows 10+OS Based devices are allowed devices are allowed and a device validation tool will be required to verify device configuration.)

PC / Laptop Configuration

CPU (Intel / AMD)

No MacOS (Apple) or Google Chromebook supported

Intel i5 / AMD (8th Gen)

2.0 GHz

Cores 2

Memory (RAM)

8 GB DDR4

Hard Disk (Storage)

256 GB SATA / SSD (20 GB Free space for Everise’s Corporate Applications)

USB Ports

3 Free (For USB Headset, Webcam and one spare)

Network Interface (NIC) Card

RJ 45, 100 / 1000 Mbps Speed

Monitors

2- 21 -22 TFT Monitor with a supporting resolution of 1920 x 1080

Sound Card

Full duplex on-board sound card

Webcam

Laptop Inbuilt Webcam

PC - Logitech or equivalent with HD 1280 x 720 pixels at 30 fps

Headset

USB Headset- Specific models will be shared during the interview process

Bluetooth / Mobile Headphones are not recommended

Operating System

Windows 10 x64 (Home / Professional / Enterprise)

Active Windows license is must

Supported Browser(s)

MS Edge and Google Chrome

Antivirus

MS Defender, Symantec, McAfee etc. (Licensed Version and should be updated regularly)

Broadband

Stable Internet Broadband with 25 Mbps Down / 10 Mbps Up speed.

Wired Broadband is recommended instead of Wi-Fi.

If you’ve got the skills to succeed and the motivation to make it happen, we look forward to hearing from you.

Employers Pro Advantage Inc. a Native Alaskan Women owned sdb specializing in the placement of highly skilled professionals in Accounting, Finance, IT / MIS and Cleared Federal Government positions.

Employers Pro Advantage Inc. has been in business since 1997 servicing New Mexico and the surrounding states with high results.

We are recruiting for a Controller wi th Healthcare experience for a client in Albuquerque, NM.

Job Duties :

• Implements financial policies and procedures and other internal controls to provide for the control and safeguard of hospital assets.
• Establishes and maintains appropriate accounting system to provide complete, timely, and accurate financial information;

provides financial analysis of operations to identify areas for cost reduction, improved cash flow, and revenue enhancement.

• Develops, implements, and maintains entire budgeting process including monitoring and reporting of hospital and department performance.
• Manages and directs the accounting and payroll departments to ensure that departments work closely together to effect a smooth, efficient, financial operation.
• Coordinates third party reimbursement functions, including acting as liaison with reimbursement consultant, ensuring compliance with all reporting requirements relative to cost reports and other required reports, and monitoring of the computation of contractual and other deductions.
• Works closely with the Director of Information Services on issues impacting the financial operations of the hospital.
• Provides timely, complete, and accurate financial reports and analyses for presentation to the monthly Board Meeting.
• Provides monthly report of status of capital expenditures compared to budget.
• Maintains commitment to personal development to improve professional and business skills.
• Develops and implements internal audit program which can be used to further ensure adequate controls are in place, and acts as liaison with audit firm to insure appropriate and complete information is provided;

hires, orients, supervises, trains (and / or ensures that training is provided) and evaluates the accounting / payroll department and staff.

Represents the hospital in community and professional organizations related to financial management.

Qualifications

• Bachelors Degree in Business, Finance, Accounting, or Business Administration.
• Healthcare experience required.

Compensation : DOE

Employers Pro Advantage, Inc. is an equal opportunity employment agency. We do not discriminate based on race, color, national origin, religion, ancestry, sex, age, disability, serious medical condition, spousal affiliation, sexual orientation, gender identity, or other classifications protected under the law.

Job Type Full-time Description

A. POSITION SUMMARY

Under the direction of the Human Resources Officer, the FCCH Recruiter is responsible for the coordination and management of the full-cycle recruiting process for all positions, providers, staff and management.

• Responsible for full cycle recruiting for providers, management and staff.
• Establishes and maintains relationships locally and nationally with sources for new candidates including but not limited to professional healthcare organizations, residency / fellowship training programs, and external recruitment firms.
• Actively organizes, participates and manages organizational job fairs, and participates in community job fairs and FCCH events to promote FCCH.
• Source and recruit candidates by using databases, social media, community resources, outreach and academic programs.
• Provide timely follow up with candidates throughout the recruiting process including offer, backgrounds, drug screening, start dates and hiring contingencies.
• Develop strong relationships with candidates and effectively maintain contact and communication throughout the hiring / onboarding process.
• Maintains internal Applicant Tracking System to ensure compliance with non-discriminatory hiring practice.
• Assist management in development and updating job descriptions and job analysis .
• Prepare recruitment materials and post jobs to appropriate job board / associations / colleges.
• Follow up on referrals and leads provided by community outreach personnel, academic program and other sources.
• Partner with hiring managers and others to identify recruitment needs on an annual, quarterly, and monthly basis
• Provide analytical and well documented recruiting reports to management
• Coordinate with HR and Credentialing teams to onboard new employees.
• Partners with HR team members to support miscellaneous job-related duties as assigned.

Requirements

C. MINIMUM EDUCATION AND EXPERIENCE

D. BS / BA degree in Business, Healthcare Administration, Human Resources, or related field, or an equivalent combination of education and experience.

E. Two (2) years of direct experience managing full-scope recruitment

F. LICENSES / CERTIFICATIONS REQUIRED

Must have valid NM driver’s license and reliable personal transportation

G. KNOWLEDGE, SKILLS AND ABILITIES REQUIRED

• Hands on experience with various aspects involved in the selection processes (video interviewing, phone interviewing, reference check etc.)
• High level of verbal and written communication skills with a strong capacity for detail, maintaining clear / effective contact with providers, employees, and administration.
• Strong organizational and planning skills to manage multiple priorities and meet required deadlines.
• Strong interpersonal skills necessary in order develop and maintain collaborative relationships with staff and providers.
• Familiarity with HR databases, Applicant Tracking Systems (ATS)
• Knowledge of laws, regulations, methods, and techniques in area of specialty.
• Ability to foster a cooperative environment.
• Ability to exercise good judgment in appraising difficult situations and in making appropriate decisions.
• Ability to maintain confidentiality of records and information.

H. PHYSICAL CHARACTERISTICS / WORKING CONDITIONS

A person in this position has sufficient time to complete most tasks although under pressure depending on patient and organization demands.

There are frequent opportunities to relax from any physical exertion or to change position in work activities.

• Physical Effort and Dexterity : Good dexterity to operate personal computer, Moderate physical activity. Requires handling of average-weight objects up to 25 pounds or standing and / or walking for more than four (4) hours per day.
• Machines, Tools, Equipment required to be operated : Capable of using office machines and personal computers for word processing, data entry and retrieval.
• Visual Acuity, Hearing, and Speaking : Must be able to read computer monitor output and results of basic medical tests accurately.

Must be able to communicate clearly and accurately for work and safety compliance.

Environment / Working Conditions : Work is mostly inside a clinic in a controlled environment. Normal clinic safety precautions and practices are required.

Position may require travel throughout the Albuquerque metropolitan area. Work regularly scheduled Monday-Friday, although weekends may be required to meet deadlines.

This description lists the major duties and requirements of the job and is not all-inclusive. Applicants may be expected to perform job-related duties other than those contained in this document and may be required to have specific job-related knowledge and skills.