Columbia City Job Description Sample
VP Health Services And Medical Management - Managed Care
VP will be a part of strong & collaborative leadership team with the opportunity to be a key strategist in this market. ???????? Incredible growth opportunities and perks for this executive role ?????????????????????????????? GENEROUS relocation & competitive compensation. ?? We are seeking an experienced leader with a proven background in ???????????? an MCO/health plan/ACO. ?? Direct and coordinate the medical management, quality improvement and credentialing functions for the for the SC market,?? establishing the strategic vision and policies and procedures for the entire medical management team.
Direct and coordinate activities of department and aid the chief officer of the health plan and appropriate corporate staff in formulating and administering organizational and departmental policies.
Review analyses of activities, costs, operations and forecast data to determine department progress toward stated goals and objectives.
Serve as a member of management committees on special studies.
Administer and ensure compliance with National Committee on Quality Assurance (NCQA) and/or Joint Commission on Accreditation of Healthcare Organization (JACHO) standards as determined for accreditation of the health plan. ?-Participate in, attend and plan/coordinate staff, departmental, committee, sub-committee, community, State and other activities, meetings and seminars.
- Participate in provider education and contracting, as necessary.
- Bachelor's degree in Nursing, related field or equivalent experience. ?? -10+ years of clinical nursing, quality improvement, and management experience in a managed care setting.
Thorough knowledge of a specialized or technical field such as clinical nursing, managed care, and healthcare administration.
Thorough skills knowledge of quality improvement practices. Working knowledge of medical information systems, medical claims payment process, medical terminology and coding, case management practices, managed care, and Medicaid programs.
Familiarity of National Committee on Quality Assurance (NCQA) accreditation process and standards.
Strong Leadership skills with succession planning experience. Ability to lead both in person and remote direct reports. ??
- Bar Admission, active and in good standing in SC.
- Minimum 8 years of experience in real estate, title, and litigation.
- Litigation skills
- Default experience with lenders and mortgage services in the state of SC, preferred.
- Previous experience with electronic case management systems, especially CaseAware preferred.
- Knowledge of laws related to practice areas, legal codes and court procedures.
- Outstanding written and oral communication skills to communicate with other attorneys, staff and clients.
- Must have outstanding interpersonal skills, and able to positively interact and collaborate with clients and employees at all levels.
- Must be flexible, self-directed, and motivated.
- Outstanding organizational skills.
- Ability to handle a large volume of cases
- Proficient in Microsoft Office products, such as Outlook and Word
- Valid Driver’s License
Pharmacist Career Prep Program
- Submitting resumes and job applications but not hearing back?
- You have the skills, but can't seem to get an interview?
- Have interviews, but still don't get an offer?
- Struggling with your resume or cover letter?
- Not sure where to begin your job search?
- Wondering what hiring managers are "really" looking for?
- Wanting to get out of Retail and don't know how?
- Have too much or too little experience?
- Don't have a big enough network?
- Must be a licensed Pharmacist (or soon to be)
- Must be willing to systematically work through the program
- Must be driven and open to new techniques
- Computer access
- Email access
Junior Software Developer
Challenging convention. Trying new things. Reshaping an industry.
Our team helps insurance companies bring amazing ideas to life quickly and easily with software that thinks and works like they do. We're fueled by sharing ideas openly, challenging conventions, trying new things, and valuing "Why not?" over "Why?" Our certainty that there is always a better way to do things keeps carriers ahead of their competition and is helping to reshape an industry.
If having a hand in transforming one of the world’s oldest and largest industries into a standard for innovation, open exchange, and peerless user experience sounds exciting, let us know. We may be looking for you.
Field Engineer – Senior Analyst/Software Developer (Professional Services)
Estimated travel: 25-50%
- Bachelor of Science in Computer Science
- 2-3 years related industry experience in system development and implementation
- Knowledge of insurance products
- Experience/knowledge of P&C Insurance software applications
- Experience/knowledge of software development life cycle for P&C insurance software
- Experience with .Net Solutions and SQL and relational database design
- Experience with XML and XSL
- Experience with systems integration (Policy, Billing, Claims, Reinsurance, third-party systems)
- Experience with implementation of our Example Platform solutions for Policy Administration, Billing and/or ASW Claims a plus
- Assist in defining and reviewing the technical requirements for the application, including security, integration, performance, quality, and operations requirements
- Design individual technology components of the application development, execution, or operations architecture
- Work with other designers and the Technical Architect to make sure that the architecture components interact to fulfill the requirements and meet performance goals
- Develop application prototype and conduct conference room pilot to evaluate solution options
- Confirm the completeness and consistency of the design deliverables. Resolve any inconsistencies discovered
- Inform the Technical Architect and Project Manager of any issues that may affect any other project areas
- Participate in quality management reviews as outlined in the Quality Management practice to ensure adherence to all quality management plans and standards
- Complete technical designs that are in line with the technical requirements, following the applicable design standards and ensuring that those designs are functionally/technically sound and integrate with other related system components
- Identify and communicate issues and risks to the team lead or end user to facilitate timely resolution
- Participate in quality management reviews as outlined in the Quality Management practice to ensure adherence to all quality management plans and standards
Chief Medical Director
Successful health plan continues to grow in this market and is adding a senior clinical leader to build on the already strong practices.??
We are seeking an experienced Medical Director who is Board Certified, a skilled leader who engages effectively with internal and external stakeholders.???????? If you are seeking an opportunity that is more than UR and truly influences the quality and economics of care delivery, this may be the next step in your career.
???????????????????????? Generous relocation- exceptional leadership
Chief will guide and mentor a team of 3 Medical Directors.??Coordinate the medical management, quality improvement and credentialing functions for the assigned business unit based on, and in support of the strategic plan, establishing the strategic vision and attendant policies and procedures.
Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all medical management determinations.
Oversees internal medical review guidelines to ensure clinical integrity and compliance and acts as a resource for staff members throughout the operation.
Coordinates with other departments, the responses needed to address regulatory accreditation concerns pertaining to medical management issues
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
Facilitates the achievement of the Medical Management Program goals through an effective health services delivery system.
Responsible for physician review and oversight of all potential adverse determinations including pre-certifications/prior authorizations, concurrent review and appeals/retrospective review.
Responsible for HEDIS improvement and strategy.
Actively participates in the auditing process of medical management processes and corrective action team projects for medical management
Achieves utilization, cost management and quality goals.
Participates and advises in the development of corporate medical policies for UM, pharmacy, and new technology
Directly involved in the CHC-MCO's recruiting and credentialing activities
Knowledge of current peer review standards and techniques.
Knowledge of risk management standards.
Directly accountable for all Quality Management and Utilization Management activities.
-??MD or DO
-Board Certified in a specialty recognized by the American Board of Medical Specialists.
- Ability to do some weekly??patient care (outside the organization) required.
- Previous experience as Medical Director is preferred. This should include an indepth understanding of PMPM costs and MLR and the ability?? to identify the drivers and develop action plans for improvement.
-??Current state medical license without restrictions.
Chief Medical Director - Managed Care
- Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all medical management determinations.
- Oversees internal medical review guidelines to ensure clinical integrity and compliance and acts as a resource for staff members throughout the operation.
- Coordinates with other departments, the responses needed to address regulatory accreditation concerns pertaining to medical management issues
- Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
- Facilitates the achievement of the Medical Management Program goals through an effective health services delivery system.
- Responsible for physician review and oversight of all potential adverse determinations including pre-certifications/prior authorizations, concurrent review and appeals/retrospective review.
- Responsible for HEDIS improvement and strategy.
- Actively participates in the auditing process of medical management processes and corrective action team projects for medical management
- Achieves utilization, cost management and quality goals.
- Participates and advises in the development of corporate medical policies for UM, pharmacy, and new technology
- For Home State Health Plan only – responsible for the sufficiency and supervision of the health plan provider network
- Directly involved in the CHC-MCO's recruiting and credentialing activities
- Familiar with local standards of medical practice and nationally accepted standards of practice, including those for LTSS and with most integrated setting requirements under the ADA.
- Knowledge of due process procedures for resolving issues between Network Providers and the CHC-MCO administration, and between participants and the CHC-MCO, including those related to medical decision making and utilization review.
- Available to review, advise and take action on questionable hospital admissions, Medically Necessary days and all other medical care and medical cost issues.
- Directly involved in the CHC-MCO's process for prior authorizing or denying services and is available to interact with Providers on denied authorizations.
- Knowledge of current peer review standards and techniques.
- Knowledge of risk management standards.
- Directly accountable for all Quality Management and Utilization Management activities.
- Oversees and is accountable for: (a) referrals to the Department and appropriate agencies for cases involving quality of care and services that have adverse effects or outcomes; and (b) the processes for potential Fraud, Waste, and Abuse audit, investigation, review, sanctioning and referral to the appropriate oversight agencies.
- Medical Doctor or Doctor of Osteopathy, board certified in a specialty recognized by the American Board of Medical Specialists.
- Volunteer patient care required.
- Previous experience as Medical Director is preferred. Master’s degree in Business Administration, Public Health, Healthcare Administration or related field preferred.
License/Certificates: Board Certification through American Board of Medical Specialists. Current state medical license without restrictions.
Hvac/Bas Controls Technician
This position provides controls service support to clients and customers in a proactive role to identify and correct HVAC control issues. This position will also be heavily involved in the point to point and sequence check out of engineering projects. Finish assigned engineering projects in accordance with customer specifications and within schedule and budget limitations, coordinating activities of the engineering team, contractors, and vendors.
Monitors customer control systems to identify and correct issues
Visit customer locations to diagnose, recommend corrective actions, and complete repairs as needed
Work with operations department in troubleshooting problems
Complete project point to point and sequence check out for commissioning
Act as a project coordinator for initiatives assigned by Project Manager and provide accurate records
Submit a daily report to the department managers listing all tasks completed, in progress, or pending
Perform other related duties as requested or assigned
Associates Degree in Mechanical or Electrical Studies or
Minimum 1-2 years related experience with mechanical or control systems or
Related military experience
Job Requirements / Skills
Must be a highly motivated individual, possessing time management and multitasking skills
Can work independently without supervision and also within a team environment
Possesses above average verbal and written communication skills including technical writing, reports and procedure manuals
Basic ability to read blueprints, schematics, and understanding of data center and facility infrastructure desirable
Ability to quickly learn, install and support software and hardware packages deemed necessary to perform assigned initiatives
Interpersonal skills for coordinating projects with multidisciplinary requests and functions
Along with a competitive pay structure, we offer all employees comprehensive benefits including health care, dental, disability insurance, retirement plan, vacation, company provided cell phone, laptop and car allowance for company vehicle or mileage.
For immediate consideration please contact Josh Mathis at 864-979-7395 or email@example.com
Do you love working with children and preparing healthy, nutritionally balanced and attractive family-style meals for them? Join the Bright Horizons family at Bright Horizons at USC in Columbia! You will work with the administrative team to plan menus taking into account the center budget and state and federal nutritional requirements for children.
Keeps an accurate inventory of supplies and orders replacement of supplies as needed.
Child care has special demands in that we care for children who in many instances, cannot care for themselves.
Must be at least 18 years old and a high school diploma or equivalent.
Should be knowledgeable of state nutritional requirements of children.
Has relevant experience in a licensed child care facility kitchen, commercial kitchen, public school cafeteria, or equivalent.
Have food service/food handlers permit or license according to state/local regulations.
Bright Horizons is dedicated to creating a workforce that promotes and supports diversity and inclusion. We provide equal employment opportunities to all individuals without discrimination. Bright Horizons complies with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW.
Applicants requiring reasonable accommodation for any part of the application and hiring process should contact the recruitment helpdesk at 855-877-6866 or firstname.lastname@example.org. Determinations on requests for reasonable accommodation will be made on a case-by-case basis.
Having technical issues with your online application? Contact us at email@example.com or 855-877-6866.
Once again, RMS has the inside track on the best opportunities in the industry!!
Have you hit the glass ceiling? Is your company not growing? Positions above you being cut? If you are an experienced Full-Service Restaurant Manager who wants to work for a growth company with a bright future, where you are rewarded for your performance, please apply now (in strict confidence) for immediate consideration.
Our Client is a leader in the industry, offering a unique casual dining, sports bar, and entertainment complex all under one roof. They are in the middle of a huge growth spurt and are seeking experienced Managers to fuel their growth. If all you need to advance your career is an opportunity, look no further!
ABOUT THE BRAND:
Our mission is to create our Guest’s first choice for frequent fun through the best combination of the latest and greatest games, ultimate sports-viewing, extraordinary food and remarkable drinks.
The Restaurant Manager is the heart of the management team- motivating and coaching the hourly team, running stellar shifts, and ensuring each of our guests has an unparalleled experience.
The physical demands described here are representative of those that must be met by a team member to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this position, the team member will regularly be required to:
- Work days, nights, and/or weekends as required.
- Work in noisy, fast paced environment with distracting conditions.
- Move about facility and stand for long periods of time.
- Read and write handwritten notes.
- Lift and carry up to 30 pounds.
- Must have regular and predictable attendance.
- Relocatability is a plus and could speed up advancement opportunities
- Health, Dental, Vision, Long/Short Disability, (following 30 days of employment)
- 401k Match (after 6 mo. match varies based on company performance)
- $225/mo on company card to use towards food at our restaurant
Job Title: Outdoor Service Technician
Pay Range: $13-15/hour
Schedule: Monday – Friday, occasional Saturday 40+ hours
Recently named one of the Top Workplaces in South Carolina, our award-winning and growing client is looking for Outdoor Service Technicians for their pest control company. The individual selected must have attention to detail and an ownership mentality. We are looking for a candidate that has a can-do attitude, excellent customer service skills, stays on task, and operates with integrity.
Technicians will spray customer's property per client’s policies and procedures. Technicians will be trained and equipped with the knowledge to fully communicate the expectations, procedures, and tips applicable to the service being provided to the customer.
Essential Duties and
- Visually inspects and applies treatments in customer location
- Maintain customer relations and customer service standards
- Thoroughly explains to the customer the expectations for service and procedures
- Monitors previous treatment locations for quality control reasons
- Examine building to determine means of reaching affected areas, and cut openings to gain access
- Use hand tools, power tools; electric drills, pneumatic hammers, saws and chisels
- Able to walk customer property while carrying equipment weighing 50 lbs. for long periods of time in warm temperatures
- Previous customer service experience required
- Must have a clean driving record
- Must pass background and pre- employment drug screen upon job offer
- Able to walk, sit, stand for long periods of time and in extreme temperatures
- Able to lift up to 50lbs, use ladders, crawl and bend into tight spaces
Equal Employment Opportunity Employer
Use of Company Vehicle
Medical/Health Benefits and 401k plan after 90 days of employment
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