Sutter Health

• Regulates and maintains patient appointment schedules for interventional radiology, diagnostic imaging and special procedures.

• Performs day-to-day activities to analyze primary source verification of licensure, education, training, professional references, and experience of applicants for medical staff or Allied Health membership • Prepares and sends primary source verification requests • Reviews received primary source verification and follows up as necessary • Reviews new applications to ensure no data is missing and enters any new information into Credentialing Verification database • Generates re-application reports and corresponds with affiliates to initiate the re-application process • Regularly performs more complex Credentialing Verification functions

Role Description Conducts concurrent and retrospective reviews of patient medical records to evaluate the accuracy and completeness of clinical documentation, ensuring notes reflect the severity of patient's illness and quality of care. Interacts thoughtfully and effectively with physicians, patient care team, and ancillary departments to gather and clarify medical record documentation. Identifies opportunities for improvement to ensure understanding of documentation requirements, optimize reimbursement for the level of service rendered, and enhance the measurement and reporting of outcomes. Qualifications - Graduate of an accredited school of nursing OR Foreign trained physician - RN-Registered Nurse OR Foreign trained physician - CDIP or CCDS - 5 years recent relevant experience Requirements - Clinical knowledge of diagnoses, severity of illness, risk of mortality, co-morbidities and complications - Knowledge of age-specific needs and the elements of disease processes and related procedures - Knowledge of current coding classification and reimbursement guidelines and regulations - Critical thinking with the ability to analyze and interpret medical record/clinical documentation and formulate appropriate physician queries - Ability to define issues, collect data, establish facts and draw valid conclusions - Demonstrates a proactive approach in identifying and addressing issues and concerns - Collaboration skills to facilitate open sharing of information and cooperation with various stakeholders to problem solve and achieve desired results/outcome - Displays a customer service focus in all decisions and actions - Ability to communicate through verbal and written means, and to present information to a variety of audiences - Ability to create and translate data into reports and presentations for appropriate audience - Organization skills to effectively manage and/or re-prioritize activities and projects to meet deadlines while maintaining a high degree of responsiveness - Ability to interact and maintain effective working relationships with those contacted in the performance of required duties - Demonstrates respect for cultural and linguistic differences and promotes an inclusive work environment - Demonstrates initiative in providing feedback/input to improve workflow/processes - Ability to work effectively in a dynamic and fast-paced environment with changing business priorities - Ability to maintain and work discreetly with confidential information - Ability to use essential applications and/or databases associated with the role’s duties and responsibilities Benefits - Comprehensive benefits package

• Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations • Ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. • Evaluate changing regulatory and payer requirements, conducting research and analysis, and recommending applicable changes to the CDM. • Review and update Charge Description Master in the CDM software and serves as a primary knowledge point of contact in regards to the Charge Description Master. • Maintain the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software. • Communicate changes made to the corporate CDM to impacted users/areas. • Perform Epic pre-work activities related to the CDM mapping of chargemaster from legacy system to Epic.

Role Description Regulates and maintains patient appointment schedules for interventional radiology, diagnostic imaging and special procedures. Qualifications - HS Diploma or General Education Diploma (GED) - 2 years of recent experience (preferred) Requirements - Organizational and multi-tasking skills - Intermediate computer skills including keyboarding, mouse movement, data entry and scheduling programs - Verbal/written communication skills for frequent and challenging contact with physicians, employees, patients and patient families; requires patience and compassion - Ability to effectively organize and prioritize tasks to complete assignments within the time allotted and maintain standard workflow - Ability to work with others in a flexible and cooperative manner - Ability to maintain composure during challenging interpersonal interactions - Active listening skills, including interpersonal skills and telephone communication - Applies moderate mental application and concentration to handle multiple procedures and interruptions throughout the day Benefits - Comprehensive benefits package

Role Description Performs day-to-day activities to analyze primary source verification of licensure, education, training, professional references, and experience of applicants for medical staff or Allied Health membership. - Prepares and sends primary source verification requests. - Reviews received primary source verification and follows up as necessary. - Reviews new applications to ensure no data is missing and enters any new information into Credentialing Verification database. - Generates re-application reports and corresponds with affiliates to initiate the re-application process. - Regularly performs more complex Credentialing Verification functions. Qualifications - HS Diploma or General Education Diploma (GED) - 1 year recent relevant experience. - Knowledge of computer systems and their software applications, including Microsoft Word and Excel. - Interpersonal skills necessary to represent the organization in a professional and positive manner. - Ability to handle complex organizational arrangements, documentation, and requests from multiple committees and/or individuals. - Ability to organize, prioritize, carry out assignments, and problem solve with minimal supervision. - Ability to communicate ideas both verbally and in writing and listening skills. Requirements - Job Shift: Days - Schedule: Full Time - Shift Hours: 8 - Days of the Week: Monday - Friday - Weekend Requirements: None - Position Status: Non-Exempt - Weekly Hours: 40 - Employee Status: Regular Benefits - Comprehensive benefits package. Company Description Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $29.52 to $41.33 / hour. California Pay Range is $29.52 to $41.33 / hour. Utah Pay Range is $23.62 to $33.07 / hour. The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program.

Role Description Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations in order to ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. - Evaluates changing regulatory and payer requirements, conducting research and analysis, and recommending applicable changes to the CDM. - Reviews and updates Charge Description Master in the CDM software and serves as a primary knowledge point of contact in regards to the Charge Description Master. - Maintains the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software. - Communicates changes made to the corporate CDM to impacted users/areas. - Performs Epic pre-work activities related to the CDM mapping of chargemaster from legacy system to Epic. Qualifications - Bachelor's in Healthcare, Accounting, Math or related field (Equivalent experience will be accepted in lieu of the required degree or diploma). - RHIA-Registered Health Information Administrator OR RHIT-Registered Health Information Technician OR CPC-Certified Professional Coder OR COC-Certified Outpatient Coder OR None. - 2 years recent relevant experience. Requirements - In-depth knowledge of charge master coding requirements including Revenue Codes, Current Procedural Terminology, Healthcare Procedural Coding Systems and modifiers. - Familiarity with medical terminology and medical record coding process. - Knowledge of Outpatient Code Editor edits/National correct coding edits. - Knowledge of Revenue Cycle applications, including Electronic Medical Records systems. - Knowledge/awareness of all areas related to CDM/Charge Capture management functions in acute and non-acute settings and how they interrelate. - Knowledge of principles, methods, and techniques related to compliant healthcare billing. - Ability to execute strategy and communicate knowledge of business processes and enabling technologies, specifically in a CDM/Charge Capture function. - Well-developed process design, implementation, and improvement skills. - Accuracy, attentiveness to detail and time management skills. - Aptitude to conceptualize, plan, and implement stated goals and objectives. - Ability to manage own schedule and responsibilities. - Must have initiative to work effectively without constant supervision and direction, meeting all deadlines. - Ability to work concurrently on a variety of tasks/projects in a fast-paced environment with identified productivity requirements and with individuals having diverse personalities and work styles. - High-level problem identification/mitigation/resolution, analytical and financial skills. - Ability to develop effective working relationships/networks within and outside the organization. - Ability to communicate ideas both verbally and in writing to interact with others using one-on-one contact and group discussions. - Ability to recognize the appropriate style, level of detail, and message for the audience. - Ability to use spreadsheet, word processing, statistical, project management, and presentation software applications, Microsoft Suite and knowledge of Patient Management information system applications, preferably EPIC. Benefits - Comprehensive benefits package.

Role Description This position facilitates utilization management (UM) processes to support that the right care is provided at the right place and at the right time. To accomplish these goals, he/she applies established criteria to evaluate the appropriateness of admission, level of care, continued hospitalization and readiness for care transition. The role assures timely movement of patients throughout the continuum of care by: - Conducting concurrent review - Proactively resolving care, service, or transition of care delays/issues as necessary Collaboration with the Facility Acute Care Manager (CM) is essential. This position also provides third-party payers clinical information to assure reimbursement and coordinates care with the treatment team, patient, family, and others as necessary. Qualifications - Graduate of an accredited school of nursing - RN-Registered Nurse of California Upon Hire - 2 years recent relevant experience preferred Requirements - Demonstrates basic knowledge of the role of UM, Care Transition, and/or CM for patients within an acute hospital and/or ED setting - Awareness of healthcare reimbursement systems: HMO, PPO, PPS, CMS, all value-based reimbursement models, and alternative payment systems preferred - Working knowledge of laws, regulations, and professional standards affecting case management practice in an integrated delivery system - A broad knowledge base of post-acute levels of care and associated regulatory compliance requirements - Ability to effectively communicate with and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses, and other ancillary partners - Demonstrates ability to efficiently and independently manage own time and tasks with minimal supervision - General understanding of coding and DRG assignment process preferred - Excellent verbal and written communication skills required - Ability to read, write, hear, and communicate verbally in English to the degree required to perform the job - Willingness to act and dress in a professional manner at all times - Proficient in using a computer to accurately enter and extract data, send and receive email, calendar appointments, and use task lists associated with a variety of computer software programs - Proficient in the use and application of evidence-based level of care and medical necessity criteria such as InterQual and/or MCG - Must be able to meet accuracy and productivity requirements by the organization standards - Maintain proficiency in conducting utilization reviews using MCG/InterQual by keeping up with practices and technology, participating in all training and education requirements, and certification or accreditation as applicable - Ability to use Microsoft Office Suite products (Outlook, Word, Excel, Power Point) preferred Benefits - Comprehensive benefits package Company Description Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $82.48 to $115.46 / hour. The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program.

Title: Business Intelligence Engineer III Location: Sacramento United States Job Description: Full time job requisition id R-135731 We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: REQUIRES IN OFFICE 2 DAYS A WEEK IN SACRAMENTO A specialized mid-level technical professional who exercises independent judgment to architect, engineer, and optimize full-stack data products. This role acts as a technical authority, designing complex, end-to-end decision support systems. They are responsible for the entire product lifecycle: from consultative systems analysis and backend data engineering to frontend application architecture and user experience engineering. Responsible for the full-stack engineering of the department's analytics applications. This role requires the exercise of discretion to solve novel technical problems, such as engineering complex interactivity patterns, optimizing end-to-end application performance, or designing custom data integration logic for specific business use cases. This position is hybrid (work-from-home eligible on some days and on-site on other days). California residents only. Job Description: EDUCATION: Equivalent experience will be accepted in lieu of the required degree or diploma - Bachelor's degree in Computer Science, Information Systems, Engineering, or a related technical field CERTIFICATION & LICENSURE: - Epic Cogito Certification within one year of start date. - One tool-specific certification (Microsoft Certified: Power BI Data Analyst Associate OR Tableau Certified Data Analyst) within one year of start date. TYPICAL EXPERIENCE: - 3 years of progressive experience in BI Engineering, Data Product Development, or Full Stack Analytics. - Experience independently architecting and managing the full lifecycle of complex data products (from raw data to finished app). - Experience in data transformation and ETL development (SSIS, ADF) to support reporting needs. SKILLS AND KNOWLEDGE: - EXPERT knowledge of Microsoft Structured Query Language (SQL) and Microsoft specific relational database concepts. - EXPERT knowledge of database programming and data analysis. - ADVANCED knowledge of reporting, analytics, dashboarding, specifically in Power BI. - ADVANCED knowledge of BI tools and data visualization concepts. - WORKING knowledge of DAX, calculated measures, semantic models, or tabular models. - WORKING knowledge of spreadsheet, presentation, database, and documentation tools. - Excellent technical communication skills; ability to translate complex business problems into engineered solutions. - Ability to work independently, manage multiple complex projects, and define technical strategy to complete work in a timely manner. - Perform a variety of duties and often change from one task to another of a different nature with frequent interruptions and/or distractions. Job Shift: Days Schedule: Full Time Days of the Week: Monday - Friday Weekend Requirements: As Needed Benefits: Yes Unions: No Position Status: Exempt Weekly Hours: 40 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $117,436.80 to $176,155.20 / annual salary The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

Role Description Responsible for performing the appropriate processes to verify patient eligibility, coordinate benefits, ensure insurance coverage, and determine if prior authorization is needed for said order. If needed, obtains authorization and documents in the patient electronic medical record. Facilitates responses to patient inquiries regarding authorizations within turnaround standards. Qualifications - HS Diploma or GED - 1 year recent relevant experience - Medical terminology knowledge - Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS)/International Classification of Diseases (ICD)-9 coding knowledge - Knowledge of medical terminology/anatomy - Ability to exercise discretion and make independent judgments - Knowledge of Microsoft Office programs including Excel, Word or similar programs - Ability to maintain composure during challenging interpersonal interactions - Active listening skills; including interpersonal skills and telephone communication - Organizational skills with attention to detail and follow-up Requirements - Job Shift: Days - Schedule: Full Time - Shift Hours: 8 - Days of the Week: Monday - Friday - Weekend Requirements: None - Position Status: Non-Exempt - Weekly Hours: 40 - Employee Status: Regular Benefits - Comprehensive benefits package - Pay Range: $28.75 to $40.24 / hour