Who We Are - Motivated by Purpose. Powered by Clinical Expertise. Founded in 1983, we’re a clinically-driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations. Excellence starts with our people. WE OFFER - A competitive compensation package. - Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation, personal time, and holidays. - Growth and training opportunities. - A team atmosphere with fun events and prizes scheduled throughout the year. POSITION OVERVIEW  Our Clinical Pharmacy Coordinator is responsible to carry out day-to-day departmental tasks and complete all processes for screening incoming pharmacy review requests, preparing review information and materials for assignment to appropriate reviewers, entering pharmacy case review data in the online case summary/tracking system, receiving and reviewing Reviewer decisions, completing outreach over the phone to gather additional information for cases, taking inbound phone calls from medical professionals, issuing appropriate, timely and accurate review outcome notifications and completion of pharmacy case review data in the online case summary/tracking system and client system. Roles: - To prepare high quality appropriate pharmacy case review information and materials for submission to the reviewers - To finalize the pharmacy case review process and issue review outcome notifications to appropriate parties of the case - To serve as a company liaison with clients, reviewers and practitioners/providers/facilities whose services are subject to review Major Responsibilities or Assigned Duties: - Screen incoming pharmacy review requests for completeness of materials required to conduct the review of the case - Prepare, organize, distribute and present records, materials and forms required for a complete pharmacy case review by reviewers - Identify appropriate reviewers for pharmacy case review assignment including: determine their availability for a review assignment and obtain information for delivery of the case to the Reviewer if applicable - Contact clients to resolve questions, obtain information, records and/or materials needed for a pharmacy case review and resolve issues about active cases - Respond to reviewers’ requests for additional information/materials necessary for a review and notify clients and other internal departments of these needs, as applicable - Complete outreach via fax and over the phone to obtain missing information necessary to issue appropriate clinical decisions - Receive incoming phone calls from medical professionals checking status on cases and/or providing additional information to decision cases - Create and maintain an in-house review file for each active pharmacy case - Respond to inquiries from clients, other entities referring pharmacy cases for review and practitioners/providers/facilities - Issue oral and written review outcome notifications that comply with standards and requirements for timeliness, content, recipients and accuracy including written notification grammar and spelling as needed - Research clients’ questions about review processes and/or Reviewer decisions - Determine the need for additional information or additional review and notify the client and internal departments of these needs - Support all Quality Management initiatives - Actively participate in the compliance process and Provider Relations assessment process - Support all compliance program activities - Participate in all company meetings and committees as requested - Adhere to all policies and procedures - Take feedback and responsibility for performance - Adapt to the differences of clients - Maintain a flexible schedule to meet client needs - Complete other duties and responsibilities as directed - Collaborate with and cross-train on other teams as needed Requirements Skills and Experience: - Minimum of one year pharmacy experience preferred - Minimum of one year in a similar operation preferred (health insurance, healthcare and/or managed care arena) preferred - Ability to work in a fast-paced and high-functioning environment and meet deadlines while managing multiple high priorities - Ability to work independently with minimal supervision - High level of adaptability, evidenced by the ability to thrive in dynamic environments and rapidly adjust to shifting priorities - Personal computer literacy and high competency in use of Microsoft Word - Strong organizational skills with attention to details - Strong oral and written communication skills - Well-developed training skills - Strong working knowledge of basic anatomy, physiology and medical terminology preferred - Strong working knowledge of medical insurance terminology and processes preferred - Strong working knowledge of prescription drug terminology preferred - Excellent critical thinking capabilities with a strong attention to detail - Exceptional customer service skills - Thorough understanding and knowledge of Company's clients, products, departments and workflows, and applicable regulatory requirements and accreditation standards. Education: - High school diploma or equivalent Work Environment: Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home). Diversity Statement: Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.  Drug-Free Workplace: This company is a drug-free workplace. All candidates are required to pass a Background Screen before beginning employment. All newly hired employees will take a Drug Screen, as well as agreeing to all necessary Compliance Regulations on their first day of employment. Employees are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information. California Consumer Privacy Act (CCPA) Information (California Residents Only): - Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver’s license number, or state identification card number, and passport number. - Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

Job Description Summary The Clinical Application Specialist (CAS) will deliver clinical and operational expertise by providing excellent education and training support within a specific modality (XR) or product portfolio to clinical end-users. These clinical experts will facilitate evidence-based practice and support the customer experience and commercial teams from pre-sale through post implementation by providing effective outcome-based education and training solutions. GE Healthcare is a leading global medical technology and digital solutions innovator. Our mission is to improve lives in the moments that matter. Unlock your ambition, turn ideas into world-changing realities, and join an organization where every voice makes a difference, and every difference builds a healthier world. Job Description Responsibilities - Serve as a subject matter expert (XR) and technical liaison to the sales organization with the goal of strengthening technical capabilities of the team and customer relationships, while also driving business opportunities forward. - Advance new product (NPI) features and imaging techniques; partner with customers in developing training plans / strategies that support new product assimilation (XR) and ongoing training needs. - Coordinate, schedule, and execute objective based system training; monitor and report on training outcomes. - Act as focal point for modality / team, identify customer satisfaction issues, assist in escalations, problem determination and specialty training requests. - Develop meaningful relationships with key opinion leaders (KOLs) to standardize and optimize protocols and support our clinical education initiatives. Required Experience - Associate’s degree or equivalent and 5+ years of XR technical/clinical industry experience. - ARRT (R) certification. - Demonstrated experience working on GE HealthCare XR systems. - Deep understanding of clinical education training and associated process implementation. - Demonstrated experience delivering complex information and modifying messaging based on audience. - Willingness to travel extensively 80+% (4-5 days per week including overnights and some weekends) within the US and Canada via multiple modes of transportation (car, air travel, & train, etc.). We expect all employees to live and breathe our behaviors: to act with humility and build trust; lead with transparency; deliver with focus, and drive ownership –always with unyielding integrity. Our total rewards are designed to unlock your ambition by giving you the boost and flexibility you need to turn your ideas into world-changing realities. Our salary and benefits are everything you’d expect from an organization with global strength and scale, and you’ll be surrounded by career opportunities in a culture that fosters care, collaboration, and support. #LI-AK4 #LI-Remote We will not sponsor individuals for employment visas, now or in the future, for this job opening. For U.S. based positions only, the pay range for this position is $92,000.00-$138,000.00 Annual. It is not typical for an individual to be hired at or near the top of the pay range and compensation decisions are dependent on the facts and circumstances of each case. The specific compensation offered to a candidate may be influenced by a variety of factors including skills, qualifications, experience and location. In addition, this position may also be eligible to earn performance based incentive compensation, which may include cash bonus(es) and/or long term incentives (LTI). GE HealthCare offers a competitive benefits package, including not but limited to medical, dental, vision, paid time off, a 401(k) plan with employee and company contribution opportunities, life, disability, and accident insurance, and tuition reimbursement. Additional Information GE HealthCare offers a great work environment, professional development, challenging careers, and competitive compensation. GE HealthCare is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law. GE HealthCare will only employ those who are legally authorized to work in the United States for this opening. Any offer of employment is conditioned upon the successful completion of a drug screen (as applicable). While GE HealthCare does not currently require U.S. employees to be vaccinated against COVID-19, some GE HealthCare customers have vaccination mandates that may apply to certain GE HealthCare employees. Relocation Assistance Provided: No

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **RN required. Must be licensed in Nevada. Position Purpose: Develops, assesses, and coordinates complex discharge plans for high-risk members based upon needs assessment. Assists with the facilitation of a smooth transition from the acute care setting to the next level of care and educates members and their families/caregivers on discharge plan to ensure appropriate high-quality transitional care. - Develops complex discharge plans based on level of care of members needs determined by needs assessment to ensure appropriate level of care - Interacts with providers, community agencies, and other utilization review staff to coordinate and ensure a safe, effective, and clinically appropriate transition plan for the member - Assists with managing member’s discharge plans to ensure a timely and smooth discharge between levels of care and facilities - Collects, documents, and maintains all discharge plans taken on member medical records in health management systems according to utilization management policies and guidelines - Assists with providing education to members and their families on discharge plan and utilization processes to ensure high quality appropriate care to members, as applicable - Provides feedback to leadership on opportunities to improve the discharge planning process for members to ensure high-quality transitional care - Coordinates and assists with completion of prior authorizations as they related to discharge planning, as applicable - Assists concurrent review team as needed - Performs other duties as assigned - Complies with all policies and standards Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience. 2+ years of acute care experience required. Clinical knowledge of discharge planning competencies preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: - LPN - Licensed Practical Nurse - State Licensure required **RN required. Must be licensed in Nevada. Location: Position is remote. Hours: 8:00-5:00 PST. Pay Range: $27.02 - $48.55 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Site: Mass General Brigham Community Physicians, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. The Opportunity Across the country, governments, employers, and American families have struggled in the face of rising healthcare costs. Efforts historically have targeted narrow programs and patient populations, and while many have succeeded, healthcare costs continue to rise. It’s time to take a radically different approach. A new approach involves putting the patient at the center with the goals of improving value and providing better outcomes at lower cost for patients. The Population Health Management (PHM) department at Mass General Brigham is charged with the challenge to drive better value for patients across Mass General Brigham. To achieve its goals, PHM leverages financial and clinical data to examine opportunities, designs and delivers innovative care models using product development and design thinking disciplines, and leverages problem solving, teamwork, and leadership skills to drive ongoing improvement. As an integral member of the Population Health Management Operations team, The Transition of Care Nurse Care Manager provides episodic care management for Medicare Shared Savings Program (MSSP) and Medicaid ACO patients from inpatient admission to home. This includes follow up phone calls after discharge, medication reconciliation, and ensuring patient has appropriate follow up appointments scheduled as well as documenting and ensuring all billing requirements are met prior to submitting TCM charges. The Transition of Care Nurse Manager directly interfaces with patients (via phone), Primary Care physicians, pharmacists, care managers, and health care teams involved in patient care as well collaborating with PHM Clinical Operations leadership. Job Summary Primary Responsibilities: 1. Manages episodic transitions of care for Medicare Risk and Medicaid risk patients from inpatient discharge to home as applicable. a. Calls all discharged patients within two business days of discharge and conducts post discharge assessments. b. Works alongside the PHM Clinical Pharmacist to identify and perform Medication Reconciliation for identified patients within the two day follow up phone call. c. Reviews discharge instructions/paperwork prior to call to review with patient any action items needed prior to follow up appointment. d. Facilitate face to face follow-up appointment with their PCP within 7-14 days after discharge (or according to discharge instructions if applicable). e. Document patient interaction (phone calls) in the appropriate patient chart in the electronic medical record. f. Manages and coordinates transitions of care by communicating the care plan to other providers and care managers and applicable practice staff. g. Maintains all documentation according to standards and requirements. h. Ensures all Transitions of Care (TCMs) meet appropriate billing requirements prior to submitting documentation to the billing department per protocol yet TBD. 2. Demonstrates effective teamwork and collaboration with the primary care provider and the care team a. Engages the patient and caregiver as active members of the care team and facilitates an organized and effective, warm hand off for transitions of care back to the patient's medical home (PCP). b. Participates in regular meetings with the providers and the care team to identify opportunities for better transitions or to modify workflows as needed. c. Communicates with other PHM and (Regional Service Operation (RSO) departments and sites to foster collaboration as a 'system' around the patients served. Organizational Responsibilities: 1. Demonstrates a positive attitude in dealing with patients, co-workers, and other health care providers and in addressing problems and/or crisis situations. 2. Requires the ability to work independently as well as function effectively within a team-based model of care. 3. Able to establish collegial relationships with physicians, office staff and health care providers in physician's offices, community agencies, hospitals, and other health care facilities. 4. Functioning within the patient centered model of care, demonstrates a commitment to meeting the patient’s needs and expectations. 5. Functioning within the team-based model of care 6. Demonstrates initiative and creativity to continuously improve services, work processes, and other activities that affect quality and utilization. 7. Follows applicable policies and procedures for general safety, fire safety, infection control, attendance, punctuality, and appearance. 8. Performs all duties as assigned. Other Duties and Responsibilities: 1. Assumes accountability for professional growth and development. 2. Acts as a role model for patients by practicing behaviors consistent with the program goals of health promotion and disease prevention. 3. Identifies quality of care issues and reports the concerns to the appropriate person. 4. Collects, prepares, and reports data as directed. 5. Assists in preparation for external audits and surveys as applicable. Qualifications Qualifications - Required: - Associate’s Degree Nursing (ASN) or Bachelor’s Degree Nursing (BSN). - RN License for State of MA. - 3+ years of experience in hospital, health plan or community case management or utilization management role. - Care management or home care background. - Managed Care or previous healthcare reimbursement knowledge. - Preferred: - Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care. - Certification in Case Management (CCM) and/or other applicable professional certification preferred. - Previous experience working in a post-acute setting such as LTAC, acute rehabilitation, skilled nursing facility, or homecare. - Bedside nursing experience. Additional Skills, Knowledge and Abilities: - Excellent organizational skills. - Excellent oral, written, and telephonic skills and abilities. - Critical thinking and problem-solving ability. - Demonstrated ability to present and speak in front of groups. -Demonstrated competency working with health care setting computer systems. -Competence in Microsoft Word, Excel and PowerPoint. -Ability to work effectively with physicians and their staff in a physician practice setting. -Ability to work a flexible schedule including some required evenings or early mornings. -Knowledge of levels of care and the continuum of health care services. -Ability to handle routine work, unexpected priorities, and multi-task. -Requires autonomy in decision making using sound judgment based upon factual information, clinical experience and nursing process. -Ability to work with various practice sites. Additional Job Details (if applicable) Schedule and Work Model - Full-Time Monday through Friday, standard business hours (approximately 8:30am-5pm ET) - Remote with ability to travel to Assembly Row in Somerville, MA for team building, best practice sharing meetings and/or events. - As a remote employee, must use a stable, secure, and compliant workstation in a quiet environment. Teams video is required and must be accessed using MGB-provided equipment. Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $58,656.00 - $142,448.80/Annual Grade 98TEMP At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: 6010 Mass General Brigham Community Physicians, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.