Hybrid role in Newark, NJ commutable by bus and train to Newark, Penn Station
These positions will support our Medication Therapy Management program and the Stars Medication Adherence Programs. The pharmacists will be supporting high touch outreach to members to complete annual comprehensive medication reviews and close medication adherence gaps. This is a highly telephonic outbound call position with much of the day spent making outbound calls to members, pharmacies, and providers
This position serves as internal and outward-facing, dedicated clinical resource responsible for quality measures supporting the pharmacy department in identifying Star/HEDIS measure needs and expectations, and developing and managing initiatives to achieve 5 stars. The position has oversight responsibilities driven by metrics to manage vendors, retail pharmacy , prime, Magellan and health systems to deliver outcomes as outlined in different programs as well as reporting to internal stake holders
Clinical pharmacist will be responsible for managing outreach efforts and pull-through for Star/HEDIS clinical programs. Coordinate between the pharmacy department, health systems, and Magellan. Clinical pharmacist will be responsible for driving results to obtain 5-Stars for Medicare Part D Star clinical programs including Adherence (DM, RAS, Statins), SUPD, and CMRs for MTM.
• Oversee the daily clinical activities related to Star/HEDIS measure goals for various health systems. Ensure clinical goals and objectives are met.
• Identify problems related to Star/HEDIS measures that require a clinical solution, implement and monitor clinical pharmacy solutions in support of Horizon’s Star/HEDIS goals to save money and improve care. Major responsibility is to serve as clinical liaison between Horizon pharmacy department and health systems, assisting with managing overall relationship and driving adoption of recommended clinical solutions.
• Develop, review and monitor clinical programs, therapeutic initiatives, pathways of care and other drug use policies and practices in support of Star/HEDIS initiatives. Works closely with the pharmacy department managers, vendors, and health systems to ensure execution of programs.
• Maintain continuity among health systems by communicating and documenting program design and execution in accordance with pharmacy department expectations. Track, analyze and report on patient interventions, interactions and findings of disease management activities..
• With support of the Horizon data team, develop and track the appropriate metrics to monitor the quality, care, and cost impact of the Star/HEDIS program and monitor overall healthcare trends within the Medicare populations.
• Conduct member, provider, and pharmacy outreach/interventions and Comprehensive Medication Reviews as needed to achieve Stars goals.
• The position requires communication across all departments; an understanding of the strategic impact of the programs; and extensive knowledge of how the Star/HEDIS programs integrate with other clinical initiatives.
• Understand the financial impact of all clinical recommendations: Programs must address the impact on customers, operations, program integrity, pricing, quality and satisfaction.
BA/BS in Pharmacy or PharmD
2+ years related experience
Health plan or Medicare clinical customer service or Retail management position . Project management experience and knowledge of health plans or Medicare industry. CMS Star/HEDIS measure quality improvement metrics.
A current Pharmacist license in the state of New Jersey
Knowledge: CMS Star/HEDIS measures
Computer Skills: Microsoft Office Suite, access, excel, project management, power point
.- Manages the documentation of the initial and/or reappointment application process at all facilities
- Performs admin duties and verifications within established policy and procedures and State and Joint Commission requirements
- Initiates sending reappointment packet to provider and processes appointments based on departmental assignments
- Completes required data entry into provider database
- Completes required verification of information for assigned credentials files
- Maintains accurate automated data files and ensures the complete and accurate maintenance of files in assigned areas
- Upon file completion , prepares credentials for Chiefs' signature.
- Prepares files for review at hospital specific Credentials Committee meetings.
- Tracks information through various committees
- Specialist will verify primary source for each application: Current/prior hospital affiliations; professional references;
- Specialist will query the following sources; professional license, National Provider Bank (NPDB) , Office of the Inspector General (OIG) , Health Claims Arbitration Office (HCSAO), Board certifications sites , Malpractice insurance carriers
- Maintains comprehensive credentialing database and prepares reports from physician file.
2 immediate full time roles, top Medical practice, 2 days on site 3 days remote
Coder: Hybrid 2 days in office, 3 remote
Must have comprehensive, working knowledge of CPT & ICD codes.The ability to read and code directly from Progress Notes and Op Reports – this is NOT a data entry position. They will not have the codes handed to them by the doctor, they are reading clinical documentation and coding appropriately.They are advising physicians on their coding – if something is billed too high, too low, if the physician missed something he/she could have billed for. They are the experts the doctors turn to for advice and guidance.Communication, specifically proactive communication is a must.Familiarity with office, hospital, and procedure billing.Organization, speed, and accuracy are crucial for this role – each Coder bills around 150-200 claims per day, if a candidate is not comfortable with that threshold this is not the right position for them.CPC & E-Clinical Works experience preferred; minimum of two years’ experience required.
The Mammography Technologist is responsible for performing mammography examinations following ACR requirements.
-This position assists with breast ultrasound, stereotactic biopsy, breast localization and other radiologic guided procedures performed within the Breast Center.
-Performs diagnostic and screening mammographic examinations on adult, adolescent, and geriatric patients in an expedient and professional manner.
-Performs mammographic imaging for breast needle localization procedures and stereotactic procedures inclusive of set up and clean up.
-Assists in procedures using ultrasound guidance.
-Provides immobilization devices, select proper technical factors based on individual patient needs and selects and operates equipment for specific procedures.
-Identifies patient’s films with the correct name, x-ray number, and correctly marks film as to side of the patient and initials all films.
-Develops exposed x-ray film by using processing methods.
-Completes patient requisitions with technologist’s initials, date number, and size of films.
-Assists with quality control procedures and documenting of: phantom image, darkroom fog test, screen-film contact test, repeat analysis, fixer retention analysis, screen cleanliness, compression test, visual machine checks, processor quality control, view box and reviewing conditions and darkroom cleanliness, as delegated by Chief Mammography Technologist.
-Assists in BSE instruction and other patient education to include pre and post procedure instructions.
-Prepares cases to be imaged including chart and films.
-Assists with compiling statistics for: patient follow-ups, tracking of breast localizations, patient needing biopsies, and ultrasound examinations, follow-up on positive biopsy reports.
-Documents procedures regarding quality control and quality assurance for mammography in compliance with ACR, MQSA, NJ State and FDA.
-Documents in the Breast Center chart any pertinent information regarding patients.
-Identifies the needs of the patient population served and modifies and delivers care that is specific to those needs (i.e., age, culture, language, hearing and/or visually impaired, etc.).
-This process includes communicating with the patient, parent, and/or primary caregiver(s) at their level (developmental/age, educational, literacy, etc.).
-Minimum 2+ years prior experience as a Licensed Mammography Technologist.
Preferred Skills & Experience:
-N/A
Required Hard Skills Screening mammography
Diagnostic mammography
Breast positioning
Breast compression techniques
Patient education
Breast imaging protocols
Advanced Breast Imaging
Breast ultrasound assistance
Stereotactic breast biopsy
Tomosynthesis (3D mammography)
Needle localization
Breast MRI coordination
Dexa scanning (sometimes)
Required Soft Skills Screening Breasts.
Graduate of an AMA approved School of Radiologic Technolo
-Must have ARRT.
-Must obtain mammography certification within the first three months of employment.
-Must have active Diagnostic Radiography License.
Breast imaging competencies
Mammography-specific certification
Radiologic technologist licensure
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The Certified Medical Assistant is responsible for assisting in providing clinical care to select patients under the supervision of the professional nurse or licensed medical practitioner and provides clerical office assistance.
-Prepares exam room, treatment room, supplies and instruments.
-Prepares patients for physician visit and examination assisting as directed.
-Takes patient’s vital signs and records in medical chart.
-Understands proper function and care of special equipment.
-Performs EKG, PFT, Audiometry, Titmus Test as indicated after a performance evaluation checklist completion.
-Also performs UDS, BAT, Phlebotomy, and other lab testing as indicated after performance evaluation checklist completion.
-Maintains records by completing patient records as directed; file record and reports.
-Assists with collections/billing procedures as needed.
-Uses computer software to maintain office systems.
-Identifies and responds to issues of confidentiality.
-Lifts a minimum of 5 lbs., pushes and pulls a minimum of 10 lbs. and stands a minimum of 6 hours a day.
-Identifies the needs of the patient population served and modifies and delivers care that is specific to those needs (i.e., age, culture, language, hearing and/or visually impaired, etc.). This process includes communicating with the patient, parent, and/or primary caregiver(s) at their level (developmental/age, educational, literacy, etc.).
-Adheres to the standards identified in the Medical Center's Organizational Competencies.
-Performs telephone and in-person screening.
-Obtains and records patient history.
-Prepares patient for and assists with procedures, treatments, and minor office surgeries.
-Applies pharmacology principles to prepare and administer oral and parenteral (excluding medications).
-Medication reconciliation.
-Screens and follow-up test results.
-Performs inventory of supplies and equipment.
-Performs routine maintenance of administrative and clinical equipment.
-Provides instruction for health maintenance and disease prevention.
-Schedules appointments; obtains patient demographic and financial information and enters information into electronic practice management tools.
-Communicates with licensed medical practitioners and delivers information to patients as directed.
-Schedules inpatient and outpatient admissions and procedures.
-Organizes and files medical records.
taking vitals, insurance authorizations, medical history taking, medication list reconciliation, documentation
-High School diploma or equivalent such as a GED.
-Graduate of an accredited Medical Assistant program.
Qualifications
· Status: Certified Medical Assistant
· The ideal candidate will meet the following requirements and competencies
· Epic knowledge
· Authorization experience
· Medical Terminology
· High School Graduate or equivalent or 2+ years of Medical Assistant/PCT experience
· Current CPR Certification
· Certified Medical Assistant (CMA)/Registered Medical Assistant (RMA)
· Certification required for injection administration and medication documentation/handling
Responsibilities
· Under general supervision, and according to well defined policies and procedures, the MA/MR assists in the delivery of primary health and patient care management, interviews patients and/or patients’ representatives to obtain necessary personal, demographic, and financial information and identification
· Performs routine clerical, secretarial and administrative work in answering telephones, receiving the public, providing customer assistance, data processing, computer data entry and other record keeping tasks related to the patients’ registration within the registration areas
· This position assists with flow of patients from the waiting area to exam rooms and perform preparatory work on patients to ensure efficient use of the physician’s time
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We are seeking a dedicated and compassionate Medical Assistant to join our dynamic interventional pain management team. This role provides both clinical and administrative support to ensure efficient patient care and a seamless clinic experience. The ideal candidate is a team player who thrives in a fast-paced environment and is committed to delivering high-quality care. We also focus on cross training all individuals from the clinical team to front desk.
Room patients, obtain vital signs, and update all patient medical history in the EMR (eClinicalWorks)Assist physicians with exams and in-office proceduresPrepare exam rooms and ensure they are cleaned and stocked between visitsMonitor patient safety and comfort throughout their visitJob Type: Full-time
Benefits:
401(k)Dental insuranceHealth insurancePaid time offWork Location: In person Somerset NJ with travel to other NJ offices.
Read LessUrology office CMA- Mon. thru Thurs., no Fridays, no weekends, no holidays. Busy, fast paced urology office, some duties include but not limited to: assist doctor with office procedures, give injections, bladder scans, use of EPIC charting, obtain patient information, use of autoclave, logging, stock rooms, follow up with medication deliveries, must have good communication skills, be attentive to detail, professional, respectful of office policies, polite, work as a team player, and must be patient- centered.
Expected hours: 34.0 – 36.0 per week
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