Grand Valley State University

Introduction:

Grand Valley is looking for a part-time instructor to teach in seat HIM courses during the day time starting Winter 2018.

Job Description:

Seeking Part-Time faculty to teach Health Information Management courses starting Winter 2018. The qualifications needed include possession of a Bachelor Degree, Certified through the American Health Information Association as a Registered Health Information Administrator (RHIA), and a minimum of three years of professional related experience.

Required Qualifications:

The qualifications needed include possession of a Bachelor Degree, Certified through the American Health Information Association as a Registered Health Information Administrator (RHIA), and a minimum of three years of professional related experience.

Instructions for Resume Submission:

Please have all interested individuals email ahs@gvsu.edu

RecordConnect

Introduction:

RecordConnect is seeking a highly professional, self-motivated leader to provide direct supervision to our Release of Information team. This individual will also focus on developing strong client relationships and ensure all service commitments are met for daily operations.

Job Description:

The talented individual:

• Must possess excellent communication skills
• Will conduct client update meetings
• Will provide training development
• Will recruit and welcome new associates to the team as needed
• Will monitor attendance, productivity and quality standards

We require solution-oriented thinkers with the desire to suggest new ideas and the confidence to help us implement those new ideas and ensure we are operating with the most effective practices. Additionally, the successful candidate will have a willingness to monitor and maintain the highest standards of customer service, honest reporting, complaint resolution and the desire to grow and advance within our expanding company. This position will report directly to our Director of Operations.

Required Qualifications:

• High school or equivalent
• Willing to undergo a background check, in accordance with local law/regulations
• Two years+ of HIM/ROI experience
• Two years+ of management experience within HIM/ROI

Preferred Qualifications:

• Associate’s degree+ in healthcare related field
• Five years+ of HIM/ROI experience
• Five years+ of management experience within HIM/ROI
• RHIT or RHIA credential

Education Qualifications:

• High school or equivalent required
• Associate’s degree+ in healthcare related field preferred
• RHIT or RHIA credential preferred

Compensation/Benefits:

Base compensation:

$34,000 to $45,000 dependent upon background and experience

Bonus compensation:

Uncapped bonus compensation potential based upon achievement against performance benchmarks

Benefits Include:

• Health, Dental and Vision Benefits with Company Premium Contribution
• Paid Time Off
• Paid Vacation (including your birthday)
• 401(k) Plan with Company Contribution
• Education Assistance
• Flexible Spending Account (FSA) for Healthcare and Dependent Care

Instructions for Resume Submission:

Prospective candidates are encouraged to submit along with your resume a letter describing your top three leadership qualities that make you stand out as well as any written letters of recommendation. Resume and any associated documents should be sent via email to hr@recordconnectinc.com.

Baker College Professional Services, Inc.

Introduction:

Baker College Professional Services, Inc. seeks to hire an individual to be assigned to the position of FACULTY – HEALTH INFORMATION TECHNOLOGY PROGRAM (FULL-TIME) for the benefit of and to be located at Baker of Clinton Township.

Job Description:

GENERAL STATEMENT OF DUTIES:

The cyclical nature of teaching and learning is the foundation of duties for Baker College’s faculty. To strive for continual improvement of student success, faculty members must plan an optimal learning environment; provide high quality instruction; assess themselves, their students, and their teaching techniques in order to foster teaching effectiveness; continue their own professional development and maintain their discipline skill and knowledge expertise.

 MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS:

• Bachelor’s degree from an accredited college or university preferred, Associate’s degree from an accredited college or university required with RHIA or RHIT credentials
• Teaching experience at the college level and three years’ work experience in the related field is preferred.
• Previous college teaching experience preferred.
• Knowledge of Blackboard or other educational platform preferred
• Microsoft Office Suite, Google Apps, as well as other program/discipline-specific technologies.
• Must have excellent presentation skills
• Must have excellent interpersonal, verbal, and written communication skills
• Must have the ability to teach daytime and evening classes

DUTIES AND RESPONSIBILITIES:

• Manage class and learning environments:
  • Teach a specified number of classes.
  • Maintain attendance records, submit grades on time, and provide constructive student feedback.
  • Utilize the College’s Learning Management System in accordance with the usage expectations.
• Deliver effective instruction:
  • Assume primary responsibility and exercise oversight of the required curriculum, ensuring both rigor for course/program and the quality of instruction.
  • Design and support a range of learning activities to engage all learners.
  • Use technology appropriate to the nature and objectives of the course/program outcomes and communicate clearly the expectations concerning the use to students.
• Assess student learning:
  • Complete Direct Measure Assessments.
  • Use a variety of techniques to assess student learning.
  • Participate in course and program learning assessment results analyses.
  • Communicate assessment results to students regularly and identify learning opportunities for students.
• Maintain professional expertise and or professional proficiencies:
  • Pursue professional development.
  • Stay current in academic fields, e.g., belonging to professional societies, participating in pedagogical professional development, attending conferences, working or volunteering in the field.
  • Maintain required professional credentials, licensing, and continuing education hours as discipline standard dictates.
  • See addendum for specific program requirements.
• Provide service to the program:
  • Participate in curriculum development.
  • Attend campus and system events.
  • Participate in off-campus community oriented events.
  • Mentoring others.
  • See addendum for specific program requirements.
• Engage in scholarly activities (as determined by program requirements) examples include:
  • Engage in course or program level action research.
  • Secure and utilize external grants.
  • Secure and utilize internal grants.
  • Present at local or national conference.
  • Serve as an invited lecturer.
  • Author publication(s).
  • Support student success.
  • Participate in student orientations, registration, and mentoring activities.
  • See addendum for specific program requirements.
• Revise, review and/or develop curriculum, as needed
• Complete all required professional development/training
• Collect and submit required assessment of student learning data
• Participate in appropriate campus and system committees, meetings, projects, and activities
• Other duties as assigned
• See addendum for additional program requirements.

WORK SCHEDULE:

Standard-Academic Contract, evening and weekend hours will be required

REPORTS TO:

Program Director

STARTING DATE:

September 15, 2017

COMPENSATION:

Salary based on education, experience, and existing wage rates paid for similar positions within Baker College Professional Services, Inc. Full benefit package.

APPLICATION PROCEDURE: 

Please submit cover letter and resume via email only by September 4, 2017 in care of:

Baker College Professional Services, Inc.-CT
Human Resource Department
E-mail: hr-ct@baker.edu
www.baker.edu

Health Alliance Plan (HAP)

Introduction:

Health Alliance Plan (HAP)

Health Alliance Plan (HAP) is a nonprofit, regional health plan based in Detroit, Michigan and a subsidiary of the Henry Ford Health System. We are actively recruiting a Director – Payment Integrity to join our team in our Southfield, Michigan office.  HAP provides health coverage to more than 670,000 members and to companies of all sizes. For more than 50 years, HAP has partnered with leading doctors and hospitals, employers and community organizations to improve the health and well-being of its members. HAP offers a product portfolio with six distinct product lines: Group Insured Commercial, Individual, Medicare, Medicaid, Self-Funded and Network Leasing. HAP delivers award-winning preventive services, disease management, wellness programs and personalized customer service. The National Committee for Quality Assurance has awarded HAP’s commercial HMO and HAP Senior Plus Excellent Accreditation.

Job Description:

General Summary:

Responsible for developing and implementing an analytically driven approach to fraud and abuse identification and prevention.  Responsible for creating and implementing detection, recovery and prevention processes to reduce unnecessary medical expense. Develops and implements the long-term strategy for creation, quantification, and implementation of fraud and abuse services across the company.  This position will be responsible for the day to day operations of the Payment Integrity team to include project assignments, review of reports, and staff developmental issues.  Responsible for ensuring HAP remains in and can demonstrate compliance with all federal and state statutes and contract requirements relating to fraud, waste, and abuse.  Oversees the direct accountability to ensure compliance with federal and state regulations; development, implementation and coordination of all fraud, waste, and abuse activities and program requirements including areas with no direct reporting.

Principal Duties and Responsibilities:

• Provides complete oversight of fraud and abuse initiatives, identifies new opportunities, and provides monthly reporting of successes and barriers. Project manages cross-functional corporate business teams and meetings in the development of fraud and abuse initiatives, baseline targets, and results as they relate to specific corporate strategies and programs.
• Oversight of all fraud, waste, and abuse requirements, including routine audits, reporting to third parties, investigations, education, outreach, publications, and effectiveness reviews.
• Strategic planning and vision of the fraud, waste, and abuse and payment integrity program to ensure HAP is in compliance with federal and state statutes and regulations.
• Makes decisions that have significant and broad impact to cross-sections of the company.
• Advises and assists with the development and implementation of processes to reduce risk to the organization.
• Identify and address potential areas of fraud, waste, and abuse or payment integrity risks.
• Serve as the point person and advocate for fraud, waste, and abuse and payment integrity matters.
• Refine and sustain a mechanism to ensure timely and consistent reporting of fraud, waste, and abuse activities as required by government agencies and federal contracts.
• Oversee and directly accountable for all investigations and audits are conducted as required by law and federal contracts and performed in a continuous and systematic manor.
• Understand and communicate to leadership and the Corporate Compliance Committee the breadth and complexities associated with fraud, waste, and abuse regulatory requirements.
• Maintain a matrix and direct oversight and central reporting of vendors impacting healthcare affordability and medical trend management.
• Assess preparedness for new and emerging fraud, waste, and abuse trends, schemes, and draft regulations.
• Direct and oversee all activities of the Payment Integrity team to ensure that all commitments are met, target budgets are achieved and resources are used effectively and efficiently. Organize, coordinate and ensure the team adheres to departmental standards, policies and procedures.
• Drives the development of best in class and forward thinking methods/criteria for identifying and correcting fraud and abuse issues. Integrates information from multiple sources, discerns implications for future analysis and identifies opportunities for enhancing integrity of medical data.
• Works in conjunction with external vendors to implement best in class programs that are needed within the organization.
• Coordinates with Compliance Department to satisfy governmental programs fraud, waste and abuse requirements (Medicare, FEHB and Medicaid).
• Partners with IT, Finance, Product Management and Market Intelligence, Claims, Client Services and areas within Health & Network Management to champion, develop, and monitor fraud and abuse initiatives for medical and/or network management programs.
• Prepares and delivers well-organized and compelling presentations to reflect key findings,    analytic methods to determine such findings, future analysis and implications; and the identifications of opportunities to drive business improvements.
• Create reporting that identifies trends and patterns of fraud and abuse through data analysis.
• Performs cost benefit analysis for key organizational programs and initiatives impacting medical cost and performance.
• Assures compliance with sound principles of economic assessment and uses explanatory and predictive models in the development, support and analysis, and determining the value of future medical management initiatives.
• Performs other related duties as assigned

Required Qualifications:

Experience Required:

• Certified coding credential (RHIT, RHIA, CPC, CPC-P, CPCH, CCS, CCS-P) preferred
• Minimum of three (3) years in a management role directing fraud and abuse programs or related activities for a manage care, health insurance, pharmaceutical or other health related organization required.
• Minimum of three (3) years of experience in leading staff in projects or supervisory/management position required.
• Demonstrated experience with data interpretation, analysis, and reporting; clinical and financial data; predictive modeling and forecasting; key performance indicators as it relates to medical cost data.
• Demonstrated project management experience in running corporate wide projects
• Nature of the work requires progressive  interpersonal communication, decision making, financial and technical skills; ability to introduce new ideas, processes, measures and tools to improve healthcare performance
• High energy; strong leadership, analytical, project planning and coordination skills to enable efficient, timely task completion of deliverables that meet or exceed customer expectations.
• Demonstrated ability to function in a creative, “out-of-the-box” thinking in order to develop original solutions to overcome roadblocks and meet or exceed customer requirements and expectations.
• Knowledge of medical claims data and managed care membership data
• Knowledge of business intelligence applications, data, and tools
• Advanced technical skills which includes, but is not limited to,  MS Access and Excel skills
• Knowledge of Medicare and Medicaid Reimbursement methodologies a plus.

Preferred Qualifications: Education Qualifications:

• Bachelor’s Degree in Finance, Accounting, Statistics, Health-related Science or Computer Science. Masters degree preferred.

Compensation/Benefits:

Henry Ford Health System offers family health, dental, and retirement plan options.  More details will be provided during the interview process.

Instructions for Resume Submission:

To apply- please follow the attached link http://p.rfer.us/HENRYFORDuUu62f

Apply Online: http://p.rfer.us/HENRYFORDuUu62f

Health Alliance Plan

Introduction:

Health Alliance Plan (HAP)

Health Alliance Plan (HAP) is a nonprofit, regional health plan based in Detroit, Michigan and a subsidiary of the Henry Ford Health System. We are actively recruiting a Lead Auditor to join our team.  HAP provides health coverage to more than 670,000 members and to companies of all sizes. For more than 50 years, HAP has partnered with leading doctors and hospitals, employers and community organizations to improve the health and well-being of its members. HAP offers a product portfolio with six distinct product lines: Group Insured Commercial, Individual, Medicare, Medicaid, Self-Funded and Network Leasing. HAP delivers award-winning preventive services, disease management, wellness programs and personalized customer service. The National Committee for Quality Assurance has awarded HAP’s commercial HMO and HAP Senior Plus Excellent Accreditation.

Job Description:

GENERAL SUMMARY: 

Develop, implement and manage strategic fraud, waste, and abuse activities by maintaining state and federal requirements and monitoring trends and schemes. Responsible for planning, organizing, directing, implementing and leading department assignments. Deliver guidance and mentoring to team members. This position will provide senior level expertise in fraud, waste, and abuse analytics, and strategic decision making as it relates to compliance requirements and medical cost savings initiatives. Lead the team appropriately on investigations of all possible fraud, waste, and abuse referrals. Develop educational materials to address/identify waste activities as requested by the health plan and on an ad-hoc basis. Attend state and federal meetings as required by specific contracts. Prepare and distribute monthly, quarterly, and annual savings reports. Prepare and deliver presentations in a clear and concise manner to communicate findings from audits to management, provider groups, and other stakeholders. Consult with business unit leaders and employees regarding implementation of initiatives and support decision making.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Formulate plans to develop an ongoing process to identify opportunities for recovering erroneous or fraudulent claims.
• Possess and maintain in-depth knowledge of HAP business, products, programs (including claims reimbursement, benefits, provider and program data, networks etc.) and complex research principles/ methodologies.
• Identify, evaluate and implement other opportunities for cost savings (not necessarily related to claims payments) or revenue enhancements through operational audits or other means.
• Provide mentoring and guidance to team members. Ensures integrity and reporting accuracy of the department.
• Serve as a subject matter expert and consultant to HAP’s senior leadership. Develop solutions to complex issues and present recommendations to senior management as well as employees at various corporate levels.
• Develop, implement and maintain data mining activities and data analysis using available tools.
• Is the point of contact for all fraud, waste, and abuse vendors.
• Participate in meetings with Providers to explain audits and required corrective action.
• Act as liaison with other departments regarding Provider-related inquiries such as overpayments, settlements, and other financial issues arising from Payment Integrity activities.
• Act as a health care consultant by developing strategies and programs to reduce health care benefit costs and improve quality of care. Collaborate with appropriate business areas to implement proposed solutions and manage programs to evaluate effectiveness and results.
• Perform other duties as assigned.

Required Qualifications:

• Must have a coding credential from AHIMA or AAPC (i.e., CCS, CCS-P, RHIA, RHIT, CPC, etc.)
• Minimum of five (5) years progressive experience in healthcare or managed care/insurance related setting with specific exposure to provider contracting and reimbursement data and methodologies as well as case management, disease management, patient/member data, and fraud, waste, and abuse.
• Minimum two (2) years of experience in leading projects as a project lead and/or lead subject matter expert.
• Demonstrated experience with technical coding concepts and a strong understanding of fraud, waste, and abuse.
• Demonstrated experience analyzing and reviewing fraud, waste, and abuse reports.
• Advanced coding knowledge with practical application.
• Excellent analytical, problem solving, verbal and written skills to communicate complex ideas.
• Excellent skills with ability to integrate and co relate information from different domains and subject areas.
• At least three (3) years of experience in leading staff in projects or supervisory/management position preferred.
• Strong team player with high level of integrity.
• Flexible, self-driving, resourceful, highly focused and high attention to detail.

Preferred Qualifications: Education Qualifications:

• Bachelor’s degree in Business Administration, Economics, Health Care, Finance, Information Systems, Statistics or other related field

Compensation/Benefits:

Henry Ford Health System offers family health, dental, and retirement plan options.  More details will be provided during the interview process.

Instructions for Resume Submission:

To apply- please follow the attached link http://p.rfer.us/HENRYFORDYpC62a

Apply Online: http://p.rfer.us/HENRYFORDYpC62a