• Reporting directly to the Chief Executive Officer, the Chief Medical Officer is a vital member of the Executive Leadership team. • Serve as the senior executive for all clinical and medical-related matters. • Champion the needs of end-users, including clinicians, nurses, and administrative staff. • Drive clinical innovation, oversee patient safety, and advance OP's overarching business strategy. • Collaborate with the Executive Leadership team to align clinical solutions with organizational goals. • Monitor healthcare industry trends and provide actionable competitive intelligence. • Identify macro-level strategic growth areas. • Serve as a thought leader in pediatric healthcare and advocate for OP at industry events. • Develop and maintain relationships with national pediatric organizations and industry leaders. • Lead and engage with the OP Clinical Advisory Board.

Role Description Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions as an active team member of the Utilization Management Team. - Performs utilization review of outpatient and ancillary services as well as inpatient and post-acute services when indicated. - Determines medical necessity and appropriateness of services using clinical review criteria. - Accurately documents all review determinations and contacts providers and members according to established timeframes. - Appropriately identifies and refers cases that do not meet established clinical criteria to the Medical Director. - Appropriately identifies and refers quality issues to Medical Management leadership. - Appropriately identifies potential cases for Care Management programs. - Collaborates with physicians and other providers to facilitate provision of services throughout the health care continuum. - Performs accurate data entry. - Communicates appropriate information to other staff members as necessary/required. - Participates in continuing education initiatives. - Collaborates with other departments as needed. - Performs other duties as assigned. Qualifications - Knowledge of managed care and associated group benefit plans. - Possess strong oral and written communication skills. - Ability to reason logically and to use good judgment when interpreting materials or situations. - Knowledge of community-based resources. - Must have excellent organizational skills and be able to perform multiple tasks. - Proficient in Microsoft applications. - Excellent time management and documentation skills. - Successful completion of Health Care Sanctions background check. Requirements - Graduation from accredited School of Nursing. - Current, active, unrestrictive license to practice as a Registered Nurse in the State of Oklahoma. - Three years of acute care experience preferred. - Two years of experience working with population health preferred. - Previous discharge planning or case management experience preferred. - Managed care experience a plus. Company Description CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin.

Role Description The Medical Management Clinician Associate is responsible for ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or medical policies. Location: Virtual - This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. How you will make an impact: - Confirms medical services are appropriate based on assigned benefit plan, medical policies, clinical guidelines, plan benefits, and/or scripted algorithms within scope of licensure. - Work may be facilitated, in part, by algorithmic or automated processes. - Handles less complex benefit plans and/or contracts. - Conducts and may approve precertification, concurrent, retrospective, out-of-network, and/or appropriateness of treatment setting reviews by assessing clinical information against appropriate medical policies, clinical guidelines, and the relevant benefit plan/contract. - May process a medical necessity denial determination made by a Medical Director. - Refers complex or non-routine reviews to more senior nurses and/or Medical Directors. Qualifications - Requires H.S. diploma or equivalent. - Requires a minimum of 2 years of clinical experience and/or utilization review experience. - Current active, valid and unrestricted LPN/LVN or RN license and/or certification to practice as a health professional within the scope of licensure in applicable state(s) or territory of the United States required. Multi-state licensure is required if this individual is providing services in multiple states. Requirements - For candidates working in person or virtually in the below locations, the salary range for this specific position is $28.44 - $42.67. - Locations: New York. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

Role Description Johnson & Johnson is hiring for an Assoc. Director, Medical Education – Shockwave Medical to join our team. The position is FULLY REMOTE and can sit anywhere in the US. The Associate Director, Medical Education is a critical, high-visibility customer facing role within Shockwave Medical (SWAV) with the intention of developing and executing medical education and physician relations activities. The position has global responsibility across all lines of therapy and reports to the Director of Professional Education. The incumbent will lead a growing effort to educate and train health care professionals on SWAV therapies. He/She must be skilled at the appropriate coaching of physicians in the development and delivery of scientific communications and peer-to-peer training. This individual is core to physician relationship management at SWAV and will develop and maintain productive relationships with many Key Opinion Leaders (KOLs) from disciplines such as interventional cardiology, vascular surgery, interventional radiology, cardiothoracic surgery, and allied healthcare professionals. Essential Job Functions - Develop, plan and execute Shockwave Medical-managed HCP programs, including identifying educational needs, and development of programs and formats that meet customer and business needs. - Develop and maintain key relationships with Healthcare Professionals in area of therapeutic area of focus. - Responsible for execution of events, contracting of new speakers, maintenance of compliance standards, preparation of speaker materials, documentation and tracking. - Develop educational objectives and curricula / agenda for programs, including both CME and Non-CME accredited content. - Identify and contract new training sites and physician speakers. - May oversee execution of symposia, virtual or at-conference, including agenda design, content development, and physician speaker coaching. - Will facilitate preparation of presentation materials and physician speaker coaching for podium presentations. - Contribute to the operations and continued improvement of speaker’s bureau process and portal, as well as the development and maintenance of speaker slide decks and appropriate compliance / approvals. - Partner with meeting planners to coordinate seamless execution of logistical details. - Act as an advisor and consult with the field organization to uncover HCP learning needs and develop educational solutions to meet those needs. - Partner with medical societies and fellowship programs. - Maintain up-to-date knowledge of therapies, scientific literature, and products in within areas of focus. - Develop and maintain annual budgets. - Contribute to annual Needs Assessment Process and maintain compliance and reporting standards in line with Shockwave Medical HCP education procedures and guidelines. Qualifications - A Bachelor’s Degree in a related field of study. Advanced degree preferred. - 8+ years of experience in education, training, sales or marketing in the med-tech space. Prior experience in the cardiovascular space is highly preferred. - Highly organized and strong project management skills with attention to detail and accuracy. - Ability to work in a fast-paced environment, managing multiple priorities. - Excellent critical thinking skills. - Excellent influencing and negotiation skills. - Operate in a cross-functional team and independently, with adaptability to changing requirements. - Demonstrated willingness to make decisions and to take responsibility for such. - Effective written, verbal and presentation skills with all levels of management and organizations. - Demonstrated proficiency in PowerPoint. - Previous experience in CVENT and/or Sales Force is a plus. - Ability to travel up to 40%. - There may be continuous sitting for prolonged periods (more than 2 consecutive hours in an 8-hour day). - Employee may be required to lift objects up to 25lbs or more. - Employees will be required to work in an air-conditioned office space and possibly perform some tasks in our non-temperature-controlled warehouse space. Requirements - Educational Strategies - Key Performance Indicators (KPI) - Outcome-Driven Innovation (ODI) - Product Demonstrations - Subject Matter Experts (SME) Collaboration Benefits - Vacation – 120 hours per calendar year - Sick time - 40 hours per calendar year; for employees who reside in the State of Colorado – 48 hours per calendar year; for employees who reside in the State of Washington – 56 hours per calendar year - Holiday pay, including Floating Holidays – 13 days per calendar year - Work, Personal and Family Time - up to 40 hours per calendar year - Parental Leave – 480 hours within one year of the birth/adoption/foster care of a child - Bereavement Leave – 240 hours for an immediate family member; 40 hours for an extended family member per calendar year - Caregiver Leave – 80 hours in a 52-week rolling period - Volunteer Leave – 32 hours per calendar year - Military Spouse Time-Off – 80 hours per calendar year