Competition # : 48518 Department: Health and Wellness Location: HALIFAX Type of Employment: Term Union Status: Exclusion - Non Union - NSPG Closing Date: 04-May-26 (Applications are accepted until 11:59 PM Atlantic Time) About Us The Department of Health and Wellness offers opportunities to grow and advance in a dynamic sector that touches the lives of all Nova Scotians. Along with our partners, including the Nova Scotia Health Authority and the IWK Health Centre, we are committed to continually improving our health system. With a focus on collaborative primary health care, continuing care, improved supports for mental health and addictions, digital health, capital infrastructure, and more, the department is thinking differently about how to plan, fund, legislate and monitor to improve access and service delivery. To do this, we are recruiting leaders at all levels of the organization who embrace a challenge and believe in their ability to make a difference. About Our Opportunity The Associate Regional Medical Officer of Health (ARMOH) directly contributes to improved health and safety for our population. As the ARMOH, you support Nova Scotia Health (NSH) and the IWK through your leadership and expertise in promoting and protecting health and preventing disease and injury. Through interdisciplinary and inter-sectoral partnerships, you will assist in providing leadership in assessing and measuring the health of populations, and in developing strategies to improve health and well-being through health protection, disease prevention, and health promotion initiatives. You are a key support for the Regional Medical Officers of Health (RMOHs) and the Office of the Chief Medical Officer of Health (OCMOH), and where necessary, through delegation, legislated health protection responsibilities. Under legislation, you are responsible for informing, investigating, and acting on any health hazard, notifiable disease or condition, communicable disease or public health emergency that poses a health risk to the population. You will have opportunities to engage in strategic prevention and health care initiatives led by the Department. Primary Accountabilities In this role, you have a direct impact on the high-quality public health in Nova Scotia and the improved health of our population. We count on your expertise to: - Provide leadership, strategic direction, and content expertise to the health protection function of DHW, Nova Scotia Environment (NSE), the Department of Agriculture and NSH Public Health under the Health Protection Act - Provide leadership, strategic direction, and content expertise to the disease and injury prevention and health promotion functions of the NSH and IWK - Provide public health physician expertise to NSE and the Department of Agriculture on issues involving the interface between human health, food systems and the environment - Provide a public health perspective to DHW and/or NSH/IWK discussions and decisions regarding health services and patients - Support the Senior Regional Medical Officer of Health (SRMOH) in the provision of public health physician expertise to the Senior - Director of Public Health, NSH and their senior leadership team - Support the OCMOH in providing the public with an independent assessment and voice on issues impacting the health of the public - Contribute to research and knowledge translation on issues that are of public health relevance to Nova Scotia, and participate in the teaching and training of current and future public health and other health care practitioners Qualifications and Experience As our next ARMOH, you must be a physician licensable by the College of Physicians and Surgeons of Nova Scotia. A fellowship in Public Health and Preventive Medicine from the Royal College of Physicians and Surgeons of Canada (or equivalent training) is preferred. Post-graduate training in public health with public health experience will also be considered. You demonstrate an understanding of disease control, risk assessment and management, the framework of legislation, public health science, inter-sectoral relationships, government policy and general executive direction. You are an innovative thinker with an ability to negotiate and communicate complex ideas and information in concise, meaningful ways. You identify opportunities to encourage greater integration of programs and activities and work collaboratively with a wide range of stakeholders and partners across health systems. Your decisiveness, along with your superior organizational and time-management skills, is essential to your success. We will assess the above qualifications using one or more of the following tools: written examination, standardized tests, oral presentations, interview(s), and reference checks. Benefits The Government of Nova Scotia offers its employees a wide range of benefits, including a Defined Benefit Pension Plan, Health, Dental, Life Insurance, General Illness, Short- and Long-Term Disability, Vacation, and Employee and Family Assistance Programs. For information on all our Benefit program offerings, click here: Benefits for government employees. Working Conditions - Normal work week is 35 hours/week, 7 hours/day (will require availability 24/7 during times of emergency) - May be required to work overtime on occasion and will participate in a provincial on-call system for NSH Public Health. - The position may be performed virtually; the candidate must be based in Canada and eligible for licensure with the College of Physicians and Surgeons of Nova Scotia - If based in Nova Scotia, the candidate may work within an office environment in Nova Scotia with some travel at local, provincial, and national levels - Requires intense ability to concentrate and decipher complex information into decisions and easily understood concepts for senior management and public at large - Is a key spokesperson for the health of the population and requires interfacing with the media, senior levels of government, and national/international forums - Often, the decisions may require a risk assessment, which requires keen listening and analytic skills - Dealing with highly complex and often scientific/technical issues which will require decisions on an urgent or timely basis - With the need to balance competing demands of individuals with those of the well-being of the whole community, the decisions made may be controversial (or unpopular) - There may be a requirement to travel to represent the province at FPT meetings and to contribute to scientific meetings Additional Information This is a Locum employment opportunity with an anticipated end date of November 20, 2026. What We Offer - Career development where you have access to career guidance, tools, resources, and ongoing training for every stage of your career - Engaging workplace: our employees feel valued, respected, connected, and tuned in; we have forward-thinking policies and strategies - Countless career paths - A Dynamic, client-focused office environment where service excellence and teamwork are our focus. Pay Grade: MS 10 Salary Range: $8,803.70 - $11,004.62 Bi-Weekly Employment Equity Statement: Our goal is to be a diverse workforce that is representative, at all job levels, of the citizens we serve. The Government of Nova Scotia has an Employment Equity Policy, and we welcome applications from Indigenous People, African Nova Scotians and Other Racially Visible Persons, Persons with Disabilities and Women in occupations or positions where they are under-represented. If you are a member of one of these equity groups, you are encouraged to self-identify on your electronic application. Accommodation Statement: We are committed to providing an inclusive and accessible recruitment process. Candidates may request accommodations based on any grounds protected by the Human Rights Act. If you require an accommodation throughout the recruitment process, please contact us at competitions@novascotia.ca. Current government employees may access this posting through the link below: PLEASE NOTE: Candidates will not be considered for an interview if applications are incomplete or are missing information. Offer of employment is conditional upon the completion of all applicable background checks and confirmation of credentials, the results of which must be satisfactory to the employer. We thank all applicants for the interest, however, only those selected for an interview will be contacted. All questions and concerns may be directed to Competitions@novascotia.ca.

Title: Payer and Medical Policy Coordinator Location: Philadelphia United States Job Description: SHIFT: Day (United States of America) Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation. At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care-and your career. CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means. About the Job The Payer-Medical Policy Coordinator supports the Revenue Integrity team by conducting ongoing payer policy reviews, analyzing and interpreting rules to identify material impacts and ensure accurate billing, coding, and reimbursement. You'll track and report all payer policy activity, act as a liaison between Revenue Integrity, Payment Integrity, hospital departments, and hospital-owned revenue-generating areas to ensure charges comply with payer policy, federal and state regulations while optimizing reimbursement. You'll collaborate with Patient Financial Services to resolve denials tied to billed CPT/HCPCS/revenue codes linked to the CDM. This role includes daily maintenance of assigned work queues, supporting special projects as needed, and partnering across the revenue cycle-PFS, HIM, Case Management, Contracting and Reimbursement Services-so strong communication and the ability to interact effectively across the organization are essential. The ideal candidate is highly detail-oriented and maintains a clear, organized process to catalog all payer policies for easy recall and efficient application. This is an excellent opportunity for someone who thrives in a hospital setting and understands the complexities of payer policies and denial management. Work Environment & Flexibility Mostly Remote (Monday-Friday; 8am-5pm) for optimal work-life balance Onsite requirements: Quarterly onsite meetings with team required at CHOP- to inspire teamwork by bringing the group together to plan boldly, connect meaningfully, and innovate for lasting impact. Apply today and help strengthen the financial health of our hospital system-while enjoying the flexibility of a remote role. What you will do 1)Payer Policy Maintenance - meet with Payer Relations team to communicate findings of payer policy reviews - monitoring and interpreting payer policies to help ensure accurate billing, coding, reimbursement. - provide education and training on payer policies - maintaining compliance with government and commercial payer requirements and minimizing revenue loss due to policy misalignment or denials - serves as the subject matter expert for payer policy content and interpretation - prepare reports and presentations for leadership on payer performance and policy impact 2)Coordinate monthly/periodic payer policy updates - Tracking, trending, documenting all monthly payer policies received from Payer Relations. - Identify any policy that may have a material impact and communicate to the Payment Integrity team. - Assess the impact of policy changes on hospital services, including inpatient, outpatient, and ancillary departments. - Collaborate with clinical, HIM, and billing teams to implement necessary workflow or documentation changes - Develop educational documents to be presented, shared with the RCO teams Prepare reports and presentations for leadership on payer performance and policy impact - Develop and maintain a payer policy repository and knowledge base for internal stakeholders 3)New service/New Supply requests - Works with CDM team, providing insight regarding services/supplies determined to be chargeable or not separately chargeable - work with Reimbursement Manager in the analysis and determination of charge pricing and changes - with CDM team for new service/supply requests to help ensure completed requests will be in line with the payer policy interpretations - Support the implementation of new service lines or care models by evaluating payer policy implications. 4)Responsible for analyzing code denials - Ensure policies align with federal and state regulations, payer contracts, and organizational goals - Track and analyze updates to payer policies, including NCDs, LCDs, CCI edits, and commercial payer - Serve as a subject matter expert on payer policy issues and reimbursement strategies - Analyze denial trends and reimbursement data to identify payer-specific issues - Participate in PFS meetings in order to provide feedback on policy issues, denial findings - Analysis of WQ issues, CDM denials for possible recommendation in relation to payer policy trends 5)Responsible for coordinating periodic update meetings with key stakeholders: - including Reimbursement, Compliance, PARC Support - Support contract management teams with policy insights during negotiations - Help to reduce our compliance risks through studying, reporting and making recommendations relative to on- going and emerging coding compliance issues - Participates in project team meetings that involve the review of system programs/services relative to the development of possible changes that impact hospital charge capture or charge entry process - Serves as the subject matter expert for payer policy content and interpretation - Prepare reports and presentations for leadership on payer performance and policy impact Standards for Payer and Medical Policy Coordinator 1)Establishes department standards of excellence. - Annually, reviews, revises and documents all key departmental processes and develops standards of excellence consistent with the Hospital's mission, values, and quality vision. - Compares and integrates industry best practices in the department. - Annually evaluates and measures department's achievement of defined standards of excellence. 2)Establishes integrated systems which improve services and support the Hospital's mission. - Collects and/or reviews data from customer surveys on specific departmental programs or hospital-wide systems. - Uses institution-wide surveys to enhance department services on an ongoing basis. - Annually, participates in and/or contributes to at least one (1) CQI cross-functional and/or departmental quality improvement initiative. 3)Develops, tests, implements and evaluates new and creative approaches to meeting departmental and institutional goals. - Annually prepares written measurable goals for the department. - Participates in a work group to improve departmental or cross-functional processes. - Uses innovative and/or non-traditional approaches to implement changes, which enhance department/institution's ability to meet goals. 4)Integrates trends in healthcare and own profession to forecast future departmental and institutional needs for program development, space, and financial resources. - Initiates at least one realistic tactical/strategic planning recommendation annually based on trend data and/or benchmarking - Makes recommendations for technical enhancements (i.e. tools, software, etc.) which will support the department's vision of increased automation of the necessary work-efforts unique to CDM maintenance. 5)Responds promptly and positively to patients, families, associates, and all others in a respectful, courteous and confidential manner. 6)Follows hospital and department procedures and policies, including but not limited to patient safety, mandatory education, confidentiality, attendance, etc. Licenses and Certifications - Certified Professional Coder (CPC) - AAPC - upon hire - Preferred Education - Bachelor's Degree - Required - Bachelor's Degree Clinical Field - Preferred Experience - At least five (5) years related professional experience in a hospital patient financial services function - Required - Experience with coding, billing and CDM maintenance - Required - At least five (5) years related professional experience in a hospital patient financial services function - Required - At least three (3) years prior supervisory experience - Preferred - Clinical experience - Preferred Required Knowledge, Skills and Abilities - Experience with coding, billing and policy maintenance - Strong database and analytic skills; working knowledge of key computer applications such as EPIC and Microsoft Office suite of products - Ability to promptly recognize, evaluate and manage multiple priorities. - Excellent organizational skills. - Ability to function efficiently and professionally with minimum supervision. - Ability to interact effectively across the organization - Ability to work independently, achieves specific goals and objectives, and provides recommendations for improvement - Ability to work collaboratively with a strong orientation for bottom line results. - Understanding of the local managed care environment, including, but not limited to, managed care policies and procedures, payment models and managed care models. To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more. EEO / VEVRAA Federal Contractor | Tobacco Statement SALARY RANGE: $89,840.00 - $114,550.00 Annually Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.

Role Description READY TO ROUND LLC is seeking an organized and customer-focused Patient Coordinator to support healthcare providers with scheduling and front-office operations. This role is essential in ensuring smooth patient flow and a positive patient experience. - Schedule and confirm patient appointments - Answer inbound calls and respond to patient inquiries - Manage cancellations, rescheduling, and follow-ups - Verify patient information and update records - Coordinate with clinical and billing teams - Maintain accurate scheduling systems Qualifications - Strong communication and customer service skills - Experience in scheduling, call center, or admin support preferred - Basic understanding of healthcare environments (a plus) - Ability to multitask and stay organized - Comfortable working in a remote setting Requirements - Experience with EMR/EHR scheduling systems - Prior medical office or front desk experience - Bilingual (a plus, not required) Benefits - Remote work flexibility - Paid training and onboarding - Performance-based bonuses - Career growth within administrative or clinical departments - Supportive and structured team environment Company Description Remote position with coordination through Oradell, NJ office. Works closely with Clinical Support and Billing departments.

Conduct coverage reviews and render determinations based on member benefits. Document clinical findings and engage in peer discussions, while collaborating with providers to ensure accurate benefit determinations and quality medical care for members.