Hospital Nurse Salary in Boise, ID

Pharmacy Services TechnicianLooking for candidates within Idaho, but the right candidate will be eligible for a remote role within our 4-state footprint (WA, ID, OR, and UT).Primary Job PurposeThe Pharmacy Services Technician is a corporate-wide technical support resource for pharmacy benefit, reimbursement, and other drug use issues which do not require clinical judgment. This function assists the Clinical Pharmacy Consultants and Pharmacy Services staff with formulary-related operations and other operational processes which require knowledge and experience with pharmaceuticals.Normally to be proficient in the competencies listed below:Pharmacy Services Technician would have a high school diploma or related certificate and five years of experience as a pharmacy services technician in a retail, hospital, or other licensed pharmacy setting or equivalent combination of education and experience. Pharm tech certificate may be substituted for two years of experience.Responsibilities:Performs all duties as described in this document unless doing so would require clinical judgement. In any situation in which clinical judgment is necessary, the Pharmacy Services Technician will seek assistance from appropriate medical personnel. Appropriate medical personnel will be available for support during normal business hours.Responds to non-clinical pharmacy issues from providers, pharmacy services staff, case managers, preauthorization nurses, ENCC personnel, and government programs personnel and customer service. These pharmacy issues include formulary drug coverage, appeal and reconsideration claim status, and pricing for drug claims.Completes daily formulary operational processes, including tracking, processing, and obtaining appropriate documentation for pharmacy medical exception requests, prior authorization requests, reconsiderations, and appeals. Prepares reconsideration requests for Clinical Pharmacy Consultant review by obtaining and organizing appropriate documentation, including, but not limited to medical chart notes/reports and medication profiles. Communicates (orally and by written documentation) information and determinations to providers and members as necessary.Obtains and organizes drug utilization data, including patient specific and population-based data, in a manner which facilitates clinical review and decisions by Clinical Pharmacist Consultants. Organizing data includes but is not limited to sorting drugs into appropriate therapeutic and generic categories.Assists with auditing and investigations of medication-related claims, cases, and providers to identify misuse of medications, misuse of (Regence HMO Oregon) resources, substance abuse, and erroneous and fraudulent billing practices. Investigates and organizes workflow for claims referred to Pharmacy Services for review and allowable determination (misc. J codes, providers on review, reconsiderations).Supports wellness and disease state management programs for Pharmacy Service and corporately which contribute to NCQA accreditation and ongoing quality improvement.Contributes to and supports the corporation's quality initiatives through process improvement teams and by encouraging team and individual contributions toward the corporation's quality improvement efforts.Minimum Requirements:Knowledge of medical terminology, health care coding systems such as ICD-10, CPT and HCPCS and HIPAA regulations.Knowledge of pharmaceutical products, including orals, injectables, infusion products, and chemotherapy.Knowledge of general office practices and procedures.Demonstrated knowledge of grammar and techniques of business practice.Ability to interact effectively with a variety of health care professionals, including physicians, nurses, pharmacists, and billing staff both internally and externally.Demonstrate maturity, tact, diplomacy, and persuasiveness.Demonstrated ability to perform pharmaceutical pricing calculations.Ability to type 30 words per minute, 60 wpm preferred.Demonstrated ability to operate a variety of standard business machines including calculators, copiers, and faxes.Basic computer programs skills (Word, Excel, etc.).Ability to organize, plan, and prioritize daily workflow and projects within time constraints.Experience with health insurance and/or prescription benefits preferred.Work Environment:Work primarily performed in an in-home environment.May be required to work overtime.The base pay annual salary range for this job is $18.80 - $34.10/hour,depending on candidate's geographic location and experience.The annual incentive payment target for this position is 5%.Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:medical, dental, and vision coverage for employees and their eligible family membersannual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)paid time off varying by role and tenure in addition to 10 company holidaysup to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)one-time furniture and equipment allowance for employees working from homeup to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our External Total Rewards page.We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple, clinical, social and community resources.•Conducts in depth health risk assessment and/or comprehensive needs assessment which includes, but is not limited topsycho-social, physical, medical, behavioral, environmental, and financial parameters.•Communicates and develops the care plan and serves as point of contact to ensure services are rendered appropriately, (i.e.during transition to home care, back up plans, community based services).• Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.•Develops, documents and implements plan which provides appropriate resources to address social, physical, mental,emotional, spiritual and supportive needs.• Acts as an advocate for member`s care needs by identifying and addressing gaps in care.• Performs ongoing monitoring of the plan of care to evaluate effectiveness.• Measures the effectiveness of interventions as identified in the members care plan.• Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes.• Collects clinical path variance data that indicates potential areas for improvement of case and services provided.• Works with members and the interdisciplinary care plan team to adjust plan of care, when necessary.•Educates providers, supporting staff, members and families regarding care coordination role and health strategies with afocus on member-focused approach to care.• Facilitates a team approach to the coordination and cost effective delivery to quality care and services.•Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effectivedelivery of quality care and services across the continuum.•Collaborates with the interdisciplinary care plan team which may include member, caregivers, member`s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Utilizes licensed care coordination staff as appropriate for complex cases.• Provides assistance to members with questions and concerns regarding care, providers or delivery system.• Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.• Generates reports in accordance with care coordination goal.Coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes. Duties are typically performed during face-to-face home visits. Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Assists with orientation and mentoring of new team members as appropriate.Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple, clinical, social and community resources.Conducts in depth health risk assessment and/or comprehensive needs assessment which includes, but is not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters.Communicates and develops the care plan and serves as point of contact to ensure services are rendered appropriately, (i.e. during transition to home care, back up plans, community based services).Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.Develops, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs.Acts as an advocate for member`s care needs by identifying and addressing gaps in care.Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan.Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes. Collects clinical path variance data that indicates potential areas for improvement of case and services provided. Works with members and the interdisciplinary care plan team to adjust plan of care, when necessary.Educates providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care.Facilitates a team approach to the coordination and cost effective delivery to quality care and services. Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum.Collaborates with the interdisciplinary care plan team which may include member, caregivers, member`s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Utilizes licensed care coordination staff as appropriate for complex cases.Provides assistance to members with questions and concerns regarding care, providers or delivery system.Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.Generates reports in accordance with care coordination goal.Other Job RequirementsResponsibilities3-5 years experience in Social Work, Nursing, or Healthcare-related field, or relevant experience in lieu of degree., Experience in utilization management, quality assurance, home or facility care, community health, long term care or occupational health required.Experience in analyzing trends based on decision support systems.Business management skills to include, but not limited to, cost/benefit analysis, negotiation, and cost containment.Knowledge of referral coordination to community and private/public resources.Requires detailed knowledge of cost-effective coordination of care in terms of what and how work is to be done as well as why it is done, this level include interpretation of data.Ability to make decisions that require significant analysis and investigation with solutions requiring significant original thinking.Ability to determine appropriate courses of action in more complex situations that may not be addressed by existing policies or protocols.Decisions include such matters as changing in staffing levels, order in which work is done, and application of established procedures.Ability to maintain complete and accurate enrollee records.Effective verbal and written communication skills. Ability to work well with clinicians, hospital officials and service agency contacts.General Job InformationTitleCare Coordinator (Bilingual/ Spanish)Grade22Work Experience - RequiredClinical, QualityWork Experience - PreferredEducation - RequiredGED, High SchoolEducation - PreferredAssociate, Bachelor'sLicense and Certifications - RequiredDL - Driver License, Valid In State - OtherLicense and Certifications - PreferredCCM - Certified Case Manager - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtSalary RangeSalary Minimum:$50,225Salary Maximum:$75,335This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Overview To support one symplr in assisting our customers with managing spend related to technologies in use within both acute care and hospital setting by gathering, analyzing, and interpreting gathered data. Duties & Responsibilities Conduct daily analyses of submitted quotes from member facilities Maintain and cleanse surgical pricing databases on a regular basis to keep up with changes in markets and/or products and services Update any self-serve reports within the symplr website to ensure relevance and accuracy Remain educated on assigned technology and/or subject matter including trends and changes over time Review and finalize analysis and recommendations and deliver to clients Meet with industry vendors as requested Consult with clients regarding recommendations which may include live discussions or email interactions Coach and advise clients on how to best interact with symplr products Interact with other members of the surgical team Develop content and deliver webinars, white papers, blog posts and other media to educate clients and market symplr products Skills Required Strong written and verbal communication skills Strong interpersonal / team focused skills Basic computer skills (MS Office, proficiency in Excel) Analytical and strong attention to detail Proactive, effective communication and interpersonal skills necessary to collaborate in cross-functional teams as well as to engage as part of a remote team Customer focused Qualifications Required: Minimum 3-5 years of nursing experience in acute setting Registered Nurse (LVN or LPN acceptable) Experience with medical equipment, such as patient monitoring, infusion pumps, telemetry monitoring, nurse call, defibrillators, dialysis, etc. Clinical experience in any of the following nursing specialties: ICU, Stepdown, PACU, Telemetry, ER, Med-Surg Exposure to equipment or consumables purchasing process within unit Clinical coordinator preferred MinUSD $65,000.00/Yr. MaxUSD $85,000.00/Yr.