EDI Specialist

Location: Albany, NY

Description:

Our client is seeking an experienced EDI Specialist to join their team. The EDI Specialist will be responsible for the assessment of transaction files and error reports in order to identify improvement opportunities and achieve optimal efficiency and automation. This is a full-time, permanent position.

Responsibilities Include:

  • Management and analysis of incoming transaction files. Identify error trends and initiate changes to the system as necessary.
  • Minimizing the reject rate by working with submitters and working with developers to minimize the pend rate.
  • Assist in the preparation and implementation of process improvements.
  • Leverage technology in order to identify and promote efficiencies in claim reporting and analysis.
  • Assist leadership with the evaluation of team performance. Evaluation of incoming claim volumes accuracy of claim transactions.
  • Recommend improvements as necessary.
  • Ensure privacy, confidentiality, and propriety policies and procedures compliance.

Qualifications:

  • A minimum of a Bachelor’s Degree in Business Administration and 4 years of experience working in electronic data exchange solutions are required. 4 years of professional office experience is required.
  • Must be proficient using Microsoft Office Suite software.
  • Advanced Business tools and software knowledge: Business Objects, Crystal Reports, 837, 834, 277 files, etc.
  • Compuvision voucher processing and billing functions experience is preferred.
  • Working knowledge of CPT/HCPCS codes.

 

If you are qualified for this position, please apply using our secure online form.

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Director of Implementation Services

Location: Albany, NY

Description:

Our client is seeking an experienced managed care professional to join their team as the Director of Implementation Services. The Director of Implementation Services will be responsible facilitating the successful implementation of client services and products while meeting customer expectations and ensuring high quality customer satisfaction throughout the entire process. This is a full-time, permanent position.

Responsibilities Include:

  • Management of the Implementation, Benefit Setup and CVX Configuration Analysis functions.
  • Providing leadership to direct reports and matrixed project resources.
  • Document requirements for new and existing clients.
  • Ensure timely implementation and a client satisfaction.
  • Establishing service levels and communication standards for client implementations.
  • Evaluate business needs to identify and implement innovative solutions for business and solutions.
  • Improve integration across products through communication with internal partners and 3rd party vendors.
  • Assist with business acquisition activities; prepare materials, present solutions, attend finalist meetings.
  • Mentor, counsel, and coach as necessary.

Qualifications:

  • A Bachelor’s Degree and at least 7 years of management experience (2 in a matrix organization) are required.
  • Managed care program administration and product implementation experience (10 years of senior leadership in a healthcare or managed care company).

 

If you are qualified for this position, please apply using our secure online form.

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Patient Care Manager

Location: Greenfield, MA

Description:

Our client is seeking an experienced and licensed Patient Care Manager to ensure the proper provision of medical care to long-term care patients. The primary responsibilities of the Patient Care Manager will be the coordination of medical care for patients with the nursing staff and necessary parties to ensure patients understand their medical conditions and needs and that high quality care is being administered. This is a full-time, permanent position.

Responsibilities Include:

  • Coordinating patient care with the supporting nursing services with all necessary clinical departments.
  • Ensure high quality management of patient care through compliance with the quality assurance program.
  • Assessing and screening patients.
  • Providing patients with all necessary information about medical processes and procedures.
  • Coordinate patient medical care with the patients, family members, and care providers.

Qualifications:

  • A minimum of a Bachelor’s Degree in Nursing from an accredited School of Nursing and a current Massachusetts Registered Nurse license and CPR certification are required. A Master’s Degree is preferred.
  • Graduate training in nursing or management and advanced training in palliative, oncology, and long-term care are desired.
  • A minimum of 2 years experience in direct patient care in hospice, home care, palliative care, oncology, or long term care is required.
  • At least 2 years of direct supervision of clinical staff is preferred.
  • Must have knowledge of Medicare/Medicaid hospice regulations and COPs.
  • Business management, governmental regulations, and assistance program knowledge is required.
  • Must have excellent interpersonal, written, and verbal communication skills and must possess strong computer skills.

 

If you are qualified for this position, please apply using our secure online form.

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Nursing Case Manager

Location: Greenfield, MA

Description:

Our client is currently seeking an experienced Nursing Case Manager to join their expanding organization. The Nursing Case Manager will be providing direct nursing care to patients in addition to directing and supervising staff aides and acting as a patient / provider liaison. This is a full-time, permanent position.

Responsibilities Include:

  • Providing nursing care to hospice patients.
  • Coordinating clinical and support services within the hospice care plans.
  • Developing patient hospice care plans from referral through release.
  • Inform patients and families of plan changes, act as a liaison between patients, family members, health providers, and the necessary team members.

Qualifications:

  • A minimum of a Bachelor’s Degree in Nursing from an accredited School of Nursing and a current Massachusetts Registered Nurse license and CPR certification are required. A Master’s Degree is preferred.
  • Experience working in an interdisciplinary healthcare setting is preferred.
  • Must have knowledge of Medicare/Medicaid hospice regulations.
  • Business management, governmental regulations, and assistance program knowledge is required.
  • Must have excellent interpersonal, written, and verbal communication skills and must possess strong computer skills.
  • Travel is required for this position. A valid driver’s license and reliable transportation are required.

 

If you are qualified for this position, please apply using our secure online form.

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.Net Developer

Location: Albany, NY

Description:

Our client is currently seeking to employ an experienced .Net Developer. The .Net Developer will play an active role in all phases of the Software Development Life Cycle and be working on a variety of healthcare IT projects. This is a full-time, permanent position.

Responsibilities Include:

  • Define project objectives by analyzing user requirements. Performing analysis, design, functionality, testing and support for a variety of healthcare IT projects.
  • The development of large scale web and database applications and the integration of applications through database architecture design and server scripting. Connectivity with network systems and search engines
  • Developing documentation and assistance tools.
  • Maintain and support multiple projects and deadline.
  • Project reporting / documentation.

Qualifications:

  • A minimum of a Bachelor’s Degree in Computer Science or related field is required.
  • 5-10 years of experience working as a developer.
  • 2-3 years working in backend software design.
  • Must have proven experience using .NET technologies. (ASP.NET, ADO.NET)
  • Must know the following languages: C#, VB.NET, SQL/T-SQL, JavaScript/DHTML, VBScript, HTML, XML.
  • Adobe GoLive or Macromedia Dreamweaver experience is required.
  • Must have experience developing websites using CMS systems.
  • Front end UI design experience is preferred.

 

If you are qualified for this position, please apply using our secure online form.

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Business Analyst – Healthcare

Location: Albany, NY

Description:

Our client is currently seeking an experienced Business Analyst to take on the role of a trusted advisor to the IT team on behalf of the Healthcare Management area of the organization. As a technical and process expert the Business Analyst will have the primary responsibility of facilitating process and systems changes between Healthcare Management and IT. This is a full-time, permanent position.

Responsibilities Include:

  • Evaluate and analyze state processes. Identify areas for process improvement.
  • Evaluate and analyze business and customer needs in relation to system redesign.
  • Evaluate vendor software applications.
  • Lead requirement and design sessions to identify system change specifications.
  • Documenting design and development change specifications.
  • Identify project deliverables and create project schedules.
  • Project reporting. Status, successes, blockers, challenges.
  • Identify manual, batch, and online environment issues through error code interpretation. Facilitate problem resolution.
  • Data mapping; source to target mapping. Create file specifications as necessary.
  • Create test scenarios, test and analyze outcomes.

Qualifications:

  • A minimum of a Bachelor’s Degree is required. A degree in Computer Programming is a plus.
  • 5-8 years of experiences as a Business/Systems Analyst. Must have prior experience working in the Healthcare industry.
  • Must have knowledge of Medicare, Medicaid, Commercial and Managed Long Term Care programs.
  • TriZetto Facets Utilization Management system and Clinical Care Advance applications is a plus.
  • Must be proficient in SQL (querying, mapping, and analyzing data).
  • Must be experienced in the full SDLC.
  • Must understand batch and online environments.
  • Must have excellent interpersonal, written and verbal communications skills.
  • Must be able to multitask, prioritize, and manage multiple projects.

 

If you are qualified for this position, please apply using our secure online form.

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Business Analyst – Claims

Location: Albany, NY

Description:

Our client is currently seeking an experienced Business Analyst to take on the role of a trusted advisor to the IT team on behalf of the Claims area of the organization. As a technical and process expert the Business Analyst will have the primary responsibility of facilitating process and systems changes between Claims Management and IT. This is a full-time, permanent position.

Responsibilities Include:

  • Evaluate and analyze state processes. Identify areas for process improvement.
  • Evaluate and analyze business and customer needs in relation to system redesign.
  • Evaluate vendor software applications.
  • Lead requirement and design sessions to identify system change specifications.
  • Documenting design and development change specifications.
  • Identify project deliverables and create project schedules.
  • Project reporting. Status, successes, blockers, challenges.
  • Identify manual, batch, and online environment issues through error code interpretation. Facilitate problem resolution.
  • Data mapping; source to target mapping. Create file specifications as necessary.
  • Create test scenarios, test and analyze outcomes.
  • Mentor customer and staff.

Qualifications:

  • A minimum of a Bachelor’s Degree is required. A degree in Computer Programming is a plus.
  • 5-8 years of experiences as a Business/Systems Analyst. Must have prior experience working in the Healthcare industry.
  • Must have knowledge of Medicare, Medicaid, Dual, Child Health Plus, and Managed Long Term Care programs.
  • TriZetto Facets Utilization Management system and Clinical Care Advance applications is a plus.
  • Must be proficient in SQL (querying, mapping, and analyzing data).
  • Must be experienced in the full SDLC.
  • Must understand batch and online environments.
  • Must have excellent interpersonal, written and verbal communications skills.
  • Must be able to multitask, prioritize, and manage multiple projects.

 

If you are qualified for this position, please apply using our secure online form.

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Project Manager Healthcare

Location: Albany, NY

Our client is currently seeking an experienced Project Manager to manage a wide variety of large scale Healthcare IT projects. The Project Manager will be working with large scale implementations which may vary in size, scope, and complexity. This is a full-time, permanent position.

Requirements Include:

  • Using agile methodologies throughout the SDLC process to ensure quality production and timely closing.
  • Develop and maintain project schedules.
  • Identify product deliverables and ensure cross functional alignment and accountability.
  • Assist with process development / improvement.
  • Track progress and maintain project plans. Create project reports.

Qualifications:

  • A minimum of a Bachelor’s Degree is required for this position (a Master’s Degree is preferred).
  • 5-7 years of project management experience with 3-5 years of healthcare experience is required.
  • Must have vendor management experience.
  • Candidates need to be “tech-savvy” with experience managing technical implementations, upgrades, etc.
  • PMP Certification is preferred.

 

If you are qualified for this position, please apply using our secure online form.

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Director of Development

Location: Pittsfield, MA

Job Description:

Our client is currently seeking a Director of Development to become a part of their expanding company. The Director of Development will have the primary responsibility of improving the professional development of company employees through the development of training programs, new employee orientations, and competency and compliance review. This is a full-time, permanent role.

Responsibilities Include:

  • Assessment of the employee development department and affiliate team management for development needs.
  • Improvement of existing employee development training and creation of new employee development training as necessary.
  • Work with staff coordinators on the creation and implementation of development training.
  • Develop effective methods for recognizing, assessing, and educating employees to enhance their performance.

Qualifications:

  • A Bachelor’s Degree in Education is required (Master’s Degree in Education preferred).
  • Documented proof of continuing education in health and education.
  • A minimum of 5 years of working experience in long-term care (with 2 years in management) is required. Clinical work experience is a plus.
  • Must have knowledge of JCAHO, State and Federal regulations in long-term care.
  • Must possess very strong leadership skills and knowledge of management principles with the ability to work with confidential information.
  • Excellent written and verbal communication skills.

 

If you are qualified for this position, please apply using our secure online form.

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Purchasing Manager

Location: Pittsfield. MA

Job Description:

Our client is currently seeking a Purchasing Manager to join them. The Purchasing Manager position is a full-time permanent role. Their primary responsibility will be to manage the company purchasing functions in order to retain quality and standards but decrease expenses.

Responsibilities Include:

  • Implementing materials, goods, and services programs to fit the needs of company affiliates.
  • Reduction of company expenses through improved contracts, vendor relationships, and providers being used company wide.
  • Negotiation of contracts and purchasing agreements. Then making sure pricing on invoices agree with aforementioned signed contracts.
  • Respond to and resolve vendor and distributor inquiries, issues, and discrepancies.
  • Provide accruals support or other accounting/administrative support to other departments as necessary.
  • Researching resources available to the company, research and approval for new vendors.
  • Assist in affiliates with expense tracking.

Qualifications:

  • Bachelor’s Degree in Business is required.
  • At least three years of experience working in Materials Management/Purchasing.
  • A Healthcare operations background is required.
  • Proven ability to negotiate contracts, analyze and forecast data, and facilitate and mediate.
  • Must be able to multi-task and meet strict deadlines.
  • Excellent written and verbal communication skills are necessary.
  • Proficient with Microsoft Word and Excel.

 

If you are qualified for this position, please apply using our secure online form.

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