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. Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. - Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. - Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. - Supports effective implementation of performance improvement initiatives for capitated providers. - Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. - Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. - Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. - Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes. - Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. - Participates in provider network development and new market expansion as appropriate. - Assists in the development and implementation of physician education with respect to clinical issues and policies. - Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. - Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. - Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. - Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment. - Develops alliances with the provider community through the development and implementation of the medical management programs. - As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues. - Represents the business unit at appropriate state committees and other ad hoc committees. - May be required to work weekends and holidays in support of business operations, as needed. Education/Experience: - Medical Doctor or Doctor of Osteopathy. - Utilization Management experience and knowledge of quality accreditation standards preferred. - Actively practices medicine. - Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous. - Experience treating or managing care for a culturally diverse population preferred. License/Certifications: - Active Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services. - Certification in Internal or Family Medicine, preferred - Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs. Pay Range: $236,500.00 - $449,300.00 per year 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

At Roche you can show up as yourself, embraced for the unique qualities you bring. Our culture encourages personal expression, open dialogue, and genuine connections, where you are valued, accepted and respected for who you are, allowing you to thrive both personally and professionally. This is how we aim to prevent, stop and cure diseases and ensure everyone has access to healthcare today and for generations to come. Join Roche, where every voice matters. The Position Medical Science Partner - Ophthalmology Location : Pharma Field - Quebec A healthier future. It’s what drives us to innovate. To continuously advance science and ensure everyone has access to the healthcare they need today and for generations to come. Creating a world where we all have more time with the people we love. That’s what makes us Roche. We are Medical Science Partners. In Canada, we are at the forefront of transforming clinical practice. We serve as the vital bridge between Roche and the Canadian medical community, bringing the "outside-in" perspective to everything we do. By ensuring our science is effectively communicated and deeply understood by healthcare professionals (HCPs) across the country, we act as a trusted partner in improving patient outcomes from coast to coast. Our work is deeply collaborative. We thrive within the unique Canadian landscape—working across provinces and integrating closely with our global strategy and development teams to ensure international innovation meets local needs. Our mission is to drive the introduction and informed use of life-changing medicines and services, tailored to the realities of the Canadian healthcare system. We are committed to the continuous growth of our medical talent, leveraging digital-first thinking to stay ahead of the curve in a rapidly evolving market. Join us in making a collective difference. The Canadian healthcare environment is more complex than ever. At Roche, we aim to go beyond traditional treatments to address the daily struggles faced by Canadian patients and caregivers. As a Medical Science Partner your scientific expertise will be the catalyst for integrating these solutions into our healthcare system—meeting the needs of today while building a healthier tomorrow for all Canadians. The Opportunity: - Develops and apply scientific expertise to advance clinical practice - Establish and maintain network connections to maximize potential and prioritize patient impact - Integrate insights and data from the healthcare ecosystem strategically to prioritize activities to achieve the highest patient impact - Fosters a culture of trust, empowerment, and shared leadership through peer-to-peer coaching and mentorship - Collaborates with external stakeholders to co-create solutions for improved patient care - Continuously learn and grow through transparent and productive feedback while delivering on executional excellence and upholding compliance, ethics, and safety standards and grow in a self-directed way by giving and receiving transparent & productive feedback - Delivers on executional excellence and act as a guardian for high standards of compliance, ethics, and safety Who you are: We are seeking a professional who has the ability to communicate with impact and empathy while focusing on Systems & Strategic Enterprise thinking. In this role, you will translate big-picture strategy into reality through disciplined project management, sharp prioritization, and executional excellence. You are a skilled influencer & negotiator with the ability to build strong relationships and work across networks.In addition, you also: - Hold a university Degree in a Science Based Program (PhD, MSc,MD, Pharm D, Biomedical, allied Health) and/or relevant experience in life sciences or health care system sector. - Have 7+ years’ of experience in life sciences or health care system sector including clinical or therapeutic knowledge of Ophthalmology. - Have a good understanding of the pharma, health care system environment, industry codes (eg. IMC), relevant regulations (eg. GCP, PV) and the development of assets (drugs, devices, etc.). - In this position, you will be in contact with colleagues across Canada, so a proficient level of English and fluency in French is required. - Have experience in principles and techniques of critical data analysis, statistical analysis, interpretation, and assessment of clinical relevance for the purpose of understanding and communicating scientific concepts and study results. - Have the ability to travel depending on the business need. May vary from limited travel to up to 40%. Relocation benefits are not available for this job posting. Partenaire en sciences médicales - Ophtalmologie Lieu : Pharma Field - Québec Un avenir plus sain. C’est ce qui nous pousse à innover. À faire progresser la science en permanence et à veiller à ce que chacun ait accès aux soins de santé dont il a besoin, aujourd’hui et pour les générations à venir. Créer un monde où nous avons tous plus de temps avec les personnes que nous aimons. Voilà ce qui définit Roche. Nous sommes des partenaires en sciences médicales. Au Canada, nous sommes à l'avant-garde de la transformation de la pratique clinique. Nous servons de pont essentiel entre Roche et la communauté médicale canadienne, en apportant une perspective externe à tout ce que nous faisons. En veillant à ce que notre science soit communiquée efficacement et profondément comprise par les professionnels de la santé à travers le pays, nous agissons comme un partenaire de confiance pour améliorer les résultats des patients, d'un océan à l'autre. Notre travail est hautement collaboratif. Nous évoluons au sein du paysage canadien unique, travaillant à travers les provinces et collaborant étroitement avec nos équipes mondiales de stratégie et de développement pour nous assurer que l'innovation internationale répond aux besoins locaux. Notre mission est de favoriser l'introduction et l'utilisation éclairée de médicaments et de services transformateurs, adaptés aux réalités du système de santé canadien. Nous nous engageons à la croissance continue de nos talents médicaux, en misant sur une approche numérique pour rester à l'avant-garde dans un marché en constante évolution. Joignez-vous à nous pour faire une différence collective. L'environnement des soins de santé au Canada est plus complexe que jamais. Chez Roche, nous visons à aller au-delà des traitements traditionnels pour répondre aux défis quotidiens des patients et des soignants canadiens. En tant que partenaire en sciences médicales, votre expertise scientifique sera le catalyseur de l'intégration de ces solutions dans notre système de santé — répondant aux besoins d'aujourd'hui tout en bâtissant un avenir plus sain pour tous les Canadiens. L'opportunité : - Développer et appliquer une expertise scientifique pour faire progresser la pratique clinique. - Établir et maintenir des connexions réseau pour maximiser le potentiel et prioriser l'impact sur les patients. - Intégrer stratégiquement les données et les perspectives de l'écosystème de la santé afin de prioriser les activités générant le plus grand impact pour les patients. - Favoriser une culture de confiance, d'autonomisation et de leadership partagé par le biais de l'encadrement et du mentorat entre pairs. - Collaborer avec les parties prenantes externes pour co-créer des solutions améliorant les soins aux patients. - Apprendre et progresser continuellement grâce à des commentaires transparents et productifs, tout en assurant l'excellence opérationnelle et le respect des normes de conformité, d'éthique et de sécurité. - Assurer l'excellence dans l'exécution et agir en tant que gardien des normes élevées de conformité, d'éthique et de sécurité. Qui vous êtes : Nous recherchons un professionnel possédant la capacité de communiquer avec impact et empathie, tout en se concentrant sur une vision systémique et stratégique de l'entreprise. Dans ce rôle, vous transformerez la stratégie globale en réalité grâce à une gestion de projet rigoureuse, une priorisation pointue et une excellence opérationnelle. Vous êtes un influenceur et un négociateur chevronné, capable de bâtir des relations solides et de travailler en réseau. De plus, vous possédez les qualifications suivantes : - Diplôme universitaire dans un programme scientifique (Ph. D., M. Sc., MD, Pharm. D., biomédical ou domaine de la santé connexe) et/ou une expérience pertinente dans le secteur des sciences de la vie ou du système de santé. - Plus de 7 ans d'expérience dans le secteur des sciences de la vie ou du système de santé, incluant des connaissances cliniques ou thérapeutiques en Ophtalmologie. - Bonne compréhension de l'environnement pharmaceutique et du système de santé, des codes de l'industrie (ex. : Médicaments novateurs Canada - MNC), des réglementations pertinentes (ex. : BPC, PV) et du développement d'actifs (médicaments, dispositifs, etc.). - Dans ce poste, vous serez en contact avec des collègues partout au Canada ; donc la maîtrise de l'anglais et du français sont requises. - Expérience des principes et techniques d'analyse de données critiques, d'analyse statistique, d'interprétation et d'évaluation de la pertinence clinique afin de comprendre et de communiquer des concepts scientifiques et des résultats d'études. - Capacité à voyager selon les besoins de l'entreprise (peut varier d'un niveau limité jusqu'à 40 %). Les avantages liés à la relocalisation ne sont pas offerts pour ce poste. The expected salary range for this position based on the primary location of Mississauga is 136,936.00 and 179,728.50 of hiring range. Actual pay will be determined based on experience, qualifications, and other job-related factors as determined by the company. We use artificial intelligence to screen, assess or select applicants for this role. This posting is for an existing vacancy at Hoffmann-La Roche Ltd. Who we are A healthier future drives us to innovate. Together, more than 100’000 employees across the globe are dedicated to advance science, ensuring everyone has access to healthcare today and for generations to come. Our efforts result in more than 26 million people treated with our medicines and over 30 billion tests conducted using our Diagnostics products. We empower each other to explore new possibilities, foster creativity, and keep our ambitions high, so we can deliver life-changing healthcare solutions that make a global impact. Let’s build a healthier future, together. Roche is an Equal Opportunity Employer.

Medical Education Prog Splst Requisition ID req36333 Working Title Medical Education Prog Splst Position Grade 12 Position Summary The office of Internal Medicine is seeking an organized, detail-oriented individual who can work effectively with others and independently in a multi-task environment. The primary purpose of the Medical Education Program Specialist is to ensure continuity of key operations and accreditations for UNM Graduate Medical Education accredited residency and clinical fellowship programs when a program coordinator vacates the position or takes an extended leave from the program. This person will serve as a liaison between the Program Director, Associate Program Director, Residents/Fellows and Internal Medicine leadership to assist in the daily operational activities of an ACGME accredited residency or fellowship if a coordinator resigns or is out for an extended period of time in the day to day managing of residents/fellows. Duties may vary depending on the department assigned to the Medical Education Program Specialist. This position will also participate and assist programs with recruitment to include updating and manage program information in ERAS (Electronic Residency Application Service, The Match, and J1 Visa applicants if a program does not have a coordinator. GME Responsibilities will include identifying areas for systems improvements across programs, provide recommendations and feedback to GME office. This position will also attend GME events, meetings and trainings and as a member of the GME office, work on special projects in the office as needed, when not assigned to a training program. This position may also assist in assessment of program operations, including making recommendations for operational/quality improvements. This position will oversee and supervise the day-to-day work of 10 fellowship coordinators within Internal Medicine. This individual will develop a familiarity with the ACGME Specialty-Specific requirements of the programs; develop program policies to comply with accreditation requirements, if needed. Complete annual surveys and ensure information is up to date in various GME systems (Specialty Board, FREIDA, ACGME ADS, professional organizations, GMETrack). Assist with administration of annual ACGME Resident/Fellow and Faculty surveys and ensure resident/fellow reporting compliance in New Innovations. Assist the program director in maintaining the program’s required ACGME documentation, and other essential documents required for program accreditation. Maintain program information in ACGME Accreditation Data Systems. This position will also assist in managing the workload of team members who are on leave or unavailable. See the Position Description for additional information. Conditions of Employment Minimum Qualifications High school diploma or GED; at least 6 years of experience directly related to the duties and responsibilities specified. Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis. Preferred Qualifications - Knowledge of ACGME accreditation and certification requirements and standards. - Demonstrated ability to communicate effectively, both orally and in writing with a wide range of constituencies in a diverse community. - Proficient in Microsoft Office (Word, Excel, PowerPoint and SmartSheets. - Candidate must have demonstrated strong organizational skills and ability to handle multiple complex componants of a program.  - Demonstrated ability to prioritize tasks in a busy environment on a daily, weekly, and monthly basis to meet deadlines. - Candidate must have demonstrated effectiveness at working in a team environment and supporting fellow employees in their work. Additional Requirements Campus Health Sciences Center (HSC) - Albuquerque, NM Department IM Central Administration (852B) Employment Type Staff Staff Type Regular - Full-Time Term End Date Status Exempt Pay Monthly: $3,844.53 - $5,399.33 Benefits Eligible This is a benefits eligible position. The University of New Mexico provides a comprehensive package of benefits including medical, dental, vision, and life insurance. In addition, UNM offers educational benefits through the tuition remission and dependent education programs. See the Benefits home page for a more information. ERB Statement As a condition of employment, eligible employees working greater than .25 FTE as determined by the New Mexico Education Retirement Act must make mandatory retirement contributions. For more information, review the Benefits Eligibility at a Glance grid. Background Check Required Yes For Best Consideration Date 4/29/2026 Eligible for Remote Work Yes Eligible for Remote Work Statement This position is eligible for a remote work agreement (RWA), to include Hybrid, In-State, and Out-of-State. All Regular employees hired for an Out-of-State RWA must agree to an employee status of Term Appointment and subject to regular renewals no longer than yearly, in accordance with UAP 3200, Employee Classification. Renewal of Term Appointments is not guaranteed; the remote work arrangement, operational, and business needs will be considered in determining whether to renew the Term Appointment. Application Instructions Only applications submitted through the official UNMJobs site will be accepted. If you are viewing this job advertisement on a 3rd party site, please visit UNMJobs to submit an application. A completed application consists of the following: 1. Current Resume/UNMJobs application 2. Cover Letter 3. Three supervisory references Positions posted with a Staff Type of Regular or Term are eligible for the Veteran Preference Program. See the Veteran Preference Program webpage for additional details. The University of New Mexico is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, veteran status, disability, or any other protected class. The University of New Mexico requires all regular staff positions successfully pass a pre-employment background check. This may include, but is not limited to, a criminal history background check, New Mexico Department of Health fingerprint screening, New Mexico Children, Youth, and Families Department fingerprint screening, verification of education credentials, and/or verification of prior employment. For more information about background checks, visit https://policy.unm.edu/university-policies/3000/3280.html. Refer to https://policy.unm.edu/university-policies/3000/3200.html for a definition of Regular Staff.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Medical Director will partner with cross-functional teams and senior leaders to ensure that Optum leads the industry in innovative health management strategies and is considered an expert in the field of post-acute care. The role as a physician leader, has a proven track record of innovation, achievement of measurable goals, and exceptional clinical competencies. They take a proactive approach to the marketplace and are responsible for continuously reshaping Optum’s corporate wide strategies. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Provide daily utilization oversight and external communication with network physicians and hospitals - Daily UM reviews - authorization and denial reviews - Conduct peer to peer conversations for clinical case reviews as needed - Conduct provider telephonic review and discussion, share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care - Communicate effectively with providers to ensure the successful administering of Optum’s services - Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers - Collaborate with Team to ensure a coordinated approach toward our member’s health care - The development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals - Provide leadership and guidance to maximize cost management through close coordination with network and provider contracting - Regularly meet with Optum’s leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues - Provide input on local needs for Analytics Team and Care Management Team to better enhance Optum’s products and services - Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME - Perform other duties and responsibilities as required, assigned, or requested You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - Graduate of a recognized accredited medical school - Current, unrestricted medical license and residency in the United States - Board certified in a recognized ABMS specialty - Board Certified in Internal Medicine - 3+ years of experience practicing in an acute inpatient environment, where dealing with managed care organizations made up at least half of inpatient practice - Proven working knowledge of changing U.S. payer and provider landscape - Proven understanding of population-based medicine with preference given to significant experience with the Medicare, Medicaid, and Commercial populations - Proficient computer skills - Dedicated office/work area established that is separated from other living areas and provides privacy - Reside in a location that can receive a high-speed internet connection Preferred Qualifications: - Demonstrated ability to work with others while completing multiple tasks simultaneously and successfully - Demonstrated ability to complete assignments with reasonable oversight, direction, and supervision - Demonstrated ability to be highly motivated, flexible, and adaptable to working in a fast-paced, dynamic environment - Demonstrated ability to positively interact with other clinicians, senior management, and all levels of medical and non-medical professionals - Demonstrated ability to quickly adapt to change and drive innovation within team and market - Demonstrated ability to work across functions and businesses to achieve business goals - Demonstrated ability to develop and maintain positive customer and provider relationships - Proven solid interpersonal skills and necessary business acumen to communicate and build positive relationships with management - Proven high level of organizational skills, self- motivation, and ability to manage time independently - Proven excellent organizational, verbal, and written communication and presentation skills - Proven excellent analytic skills *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy Compensation for this specialty generally ranges from $248,500.00 to $373,000.00. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.