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Correo: Health New England, Human Resources, One Monarch Place, Suite 1500, Springfield, MA 01144-1500.
Fax: (413) 233-2747
Correo electrónico:humanresources@hne.com
Para más información sobre las vacantes que puedan interesarte, por favor lee a continuación.
Associate Medical Director
Provider Contracting Manager:
Position Summary:
Provider Contracting Manager is responsible for leading or assisting with network development activities including: preparing contract proposals, drafting and negotiating contract terms, contract implementation and maintenance. Manager is responsible for designated provider types which may include hospitals, physicians, physician groups, PHO's or ancillary providers. Serves as a key contact to providers and their leadership for resolution of contractual, operational and financial issues. Coordinates with internal departments to facilitate ongoing service and support for contracted providers. Staff management and development.
Qualifications:
- Bachelor’s Degree in Business, Finance or related field, plus 5-7 years of experience in the health care industry (at least 3 years in managed care contracting), or an equivalent combination of education and experience.
- Strong knowledge of commercial and government provider reimbursement methodologies and risk sharing models.
- Proficient in Microsoft Word, Excel and PowerPoint.
- Ability to use financial targets and evaluate financial impact of changes in payment terms.
- Initiative and ability to solve problems at the strategic and tactical level.
- Demonstrates solid communication, interpersonal, relationship-building and negotiation skills.
- Ability to form and lead teams as necessary for development, and implementation of new or modified policies, programs or processes to support provider contracting objectives.
- Demonstrates team leadership, facilitation and coaching skills.
For consideration, please email your resume and salary requirements to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
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Senior Applications Developer
Position Summary:
As part of the IT Production Support Team, this position is responsible for developing custom applications as well as leveraging third party applications to meet the needs of the customers/users of the Amisys and other ancillary systems. For Department-specific and company-wide projects, assist in project management by identifying issues and recommending solutions and communicating the status of the project in a timely fashion. The nature of the work will include performing systems analysis, detailed design, programming, testing and training in the implementation of departmental and interdepartmental applications. Individuals will participate in a post-implementation support role including troubleshooting and enhancing installed applications. These tasks should be completed without supervision but will include manager checkpoints for relevant milestones.
Qualifications:
- BS Degree in Computer Science with 5+ years experience or an equivalent combination of education and experience.
- Required Technical skills: HP-UX, AMISYS, Oracle, Cognos Powerhouse, Robelle Suprtool and COBOL.
- Preferred Technical skills: PLSQL, Oracle Scripts, Sybase ECMap, X12 EDI Standards, MS Windows and MS Office.
- Prior experience with health care insurance or health care vendor organizations desirable.
- Excellent customer service skills.
- Excellent oral and written communication skills.
- Excellent analytical skills.
For consideration, please email your resume and salary requirements to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
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Associate Medical Director
Position Summary:
The Associate Medical Director will have responsibility for utilization management and quality improvement for the delivery system. Other responsibilities include working with physicians to improve performance and utilization. The Associate Medical Director also participates in physician recruitment, peer activity, credentialing, clinical advisory healthcare teams, and utilization review. The Associate Medical Director shall function as a consultant representing the medical department to internal and external customers, including providers, employers and brokers.
Qualifications:
The successful candidate will have:
- A Medical Degree with board certification, holding an active, unrestricted license to practice, with a minimum of 5 years post-residency clinical/direct patient care experience
- Advanced Management Training
- Practical experience in health care administration and managed care experience desirable
Additional skills include:
- Demonstrated knowledge of the regulatory environment of managed care
- Excellent clinical, analytical, and facilitation and negotiation skills
- Must show evidence of leadership skills and possess excellent interpersonal skills required to interact with associates and customers.
- Able to exercise good judgment in problem solving and decision-making situations
- Excellent presentation, oral and written communication skills
We are committed to the people we serve, our providers and our community.
For consideration, please email your resume and Curriculum Vitae to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
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Health Services Service Coordinator - Part Time (20 hours)
Position Summary
To act as a primary resource and contact for providers relating to service requests and correspond with members and providers as to decision(s) made regarding requests for these services. Also assist Case Managers with research and correspondence related to service requests. Adhere to all HNE, HIPAA, DOI and NCQA standards, policies and procedures relating to member confidentiality, documentation, quality and turn around times.
Qualifications
- High School diploma plus 1-3 years experience in a medical administrative role in a physician’s office, clinic or other medical facility or the insurance industry; Certified Medical Assistant preferred.
- Experience with and/or specific training in medical terminology.
- Proficiency with computers, especially Microsoft Office products.
- Typing speed and accuracy.
- Ability to work independently and as a team member.
- Problem solving, organizational and prioritizing skills.
- Ability to communicate effectively with others, on the telephone and in person.
- Listening skills.
- Flexibility in hours and days worked each week.
For consideration, please email your resume and salary requirements to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
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Executive Assistant to the CEO and Secretary of the Corporation
Health New England, one of the regions fastest growing HMO’s, is seeking qualified candidates for the Executive Assistant to the CEO and Secretary of the Corporation.
In this highly visible role, this talented individual must have demonstrated ability in exercising sound judgment managing the President’s calendar, triaging priorities and responding to internal and external stakeholders. Individual has demonstrated both strategic and analytic perspective related to coordinating administrative services for a Board of Directors.
Successful candidates will have an Associates Degree in Business or a related field with a minimum of 7-10 years experience providing senior executive level administrative support. Advanced proficiency in Microsoft suite of products, superior written and verbal skills, ability to anticipate changing business needs with high personal integrity is required.
For consideration, please email your resume and salary requirements to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
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Director of Provider Contracting
Health New England, one of the regions fastest growing HMO’s is seeking qualified candidates for the Director of Provider Contracting.
In a fast paced environment, this leadership role must have demonstrated ability to manage and develop all aspects of the contracting cycle. The individual will enhance an existing network while continuing to build internal and external relationships. The successful candidate will have strong and persuasive negotiation skills and demonstrated ability to make sound judgements, both strategically and tactfully.
Successful candidates will have a Masters Degree in Business, Health Care Administration or a related field, JD a plus, with a minimum of 5 years experience in managed care contracting. A well developed knowledge of legislation, payment rules, reimbursement methodologies and risk sharing models is required for the ability to analyze and intrepret financial and utilization data, to formulate rate proposals as well as evaluate the financial impact of changes in payment terms.
Qualified candidates should send their resume, cover letter and salary requirements to:
Health New England
Human Resources Department
One Monarch Place
Suite 1500
Springfield, MA 01144-1500
Fax: (413) 731-5275
Email: humanresources@hne.com
EOE/ smoke free work environment
At Health New England, you’ll enjoy a supportive, fast-paced, progressive work environment, competitive salary, and excellent benefits all in our convenient downtown location.
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Senior Provider Relations Representative
The Sr. Provider Relations Representative is responsible for representing Health New England (HNE) to all levels of its provider network. This position will act as lead representative for HNE vendor agreements, acting as the Provider Relations liaison between the vendor, HNE internal departments, and the provider. This position will be the department lead for complex appeal and audit issues. The Sr. Provider Relations Representative will work in partnership with the Provider Relations Supervisor to ensure that the HNE provider network has access to and understanding of HNE policies and procedures in a timely manner.
Minimum Requirements
- Bachelor's Degree in Business or a HealthCare related field and 5-7 years experience in a managed care or other insurance environment or an equivalent combination of education and experience
- Strong written, verbal, and presentation skills
- Ability to manage multiple priorities
- Ability to understand often complex contracts and configuration
- Ability to establish strong working relationships with internal and external stakeholders
- Solid understanding of standards for HEDIS and NCQA
- Proficient with Microsoft Office Suite (Access, Word, Excel)
For consideration, please email your resume and salary requirements to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
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