Clinical Project Manager Salary in Montgomery, AL

Job DetailsAre you passionate about improving the quality of healthcare? Are you ready to leverage your talents to make healthcare better for everyone? Do you want the opportunity to give back to your community? Do you want to have fun at work? Then join the growing team at Health Services Advisory Group (HSAG) that is transforming the delivery of healthcare in the United States!SummaryHSAG is nationally recognized as an industry leader in the areas of audits, data analysis, measure development, and patient satisfaction surveys. We are in search of talented individuals who are interested in a career in healthcare performance measure auditing as an Auditor, Sr. in HSAG's Audits department within the Data Science & Advanced Analytics division. Together we can spread positive change to make healthcare better. The Auditor, Sr. position benefits from HSAG's desire to grow its staff into future leaders of healthcare quality improvement in the nation. HSAG's auditors are provided formal training in an assortment of healthcare-related topics, including health policy, clinical concepts, overview of analytic methods, data sources, and management techniques. HSAG offers:A comfortable work-life balance, and flexible work schedules.Three weeks of paid time off and 15 company-paid holidays where staff leave two hours early prior to each holiday to get a "jump start" on holiday festivities.HSAG offers a competitive benefit package which includes medical, dental, vision, tuition reimbursement and 401(k).The Auditor, Sr. is a primary contributor to the Audit department's work that spans the broad spectrum of healthcare performance measurement projects at HSAG. Driven by intellectual curiosity and a passion for healthcare quality, this position performs-under supervision-healthcare auditing, data validation, and performance measurement projects through various stages including implementation, day-to-day operations, audit support, evaluation, and reporting. Activities include independently developing work plans, report templates, and timelines; independently leading contracts and project tasks; guiding coordination and Auditor I, II, and III staff in oversight and maintenance of project files and other project tasks; leading client teleconferences and meetings; performing online research on healthcare topics; leading performance measure validation audits; and providing regular progress reports to Data Science & Advanced Analytics management staff.Details regarding potential project assignments will be discussed with potential candidates during the interview process.Essential Competencies, Duties and ResponsibilitiesServe as a primary contributing member of HSAG's Audits department within DSAA.Serve as a lead auditor for all performance measure validation audits.Lead and manage multiple client contracts as primary point-of-contact and subject matter expert.Mentor and train junior staff with limited supervision.Provide oversight of supplemental Healthcare Effectiveness Data and Information Set (HEDIS®)[1] audit operations.Independently act in a liaison capacity between appropriate management personnel and staff, transmitting decisions and information to organizational units as appropriate, as well as outside agencies and organizations.Lead project management tasks, including communication (written, phone, fax).Communicate directly and manage project partners, consultants, subcontractors, and other entities on audit and performance measure validation-related projects.Maintain, tag, and sort documents for assigned projects on appropriate SharePoint team sites and HSAG's corporate and federal networks following HSAG prescribed governance rules.Prepare project deliverables and lead documentation and submission of deliverable using the appropriate mechanism (i.e., electronic, hard copy, direct data entry etc.).Develop and adhere to project time and task schedules, identify opportunities to improve the project process, and develop quality improvement activities accordingly.Meet agreed-upon deadlines in a timely fashion and independently and accurately prepare and type deliverables, reports, various project documents, letters, and other material.Lead and complete the development of written and data-oriented reports in Microsoft Word and Excel.Conduct research via the Internet including literature searches of clinical topics as assigned.Participate in and lead pertinent healthcare educational and training presentations as required.Conduct Internal Quality Control (IQC) monitoring regarding efficiency/effectiveness of activities conducted. Present issues and recommended solutions and take corrective actions as indicated.Serve as a subject matter expert to HSAG staff and clients on HEDIS measures and non-HEDIS performance measures as applicable.Represent HSAG in a professional manner at all times.[1] HEDIS Certified Measures® is a registered trademark of the National Committee for Quality Assurance (NCQA).Compensation: 101,000 to 125,000/annually DOEJob Requirements:Education and/or ExperienceMaster's degree in business, science, or healthcare-related field.At least seven years of work experience in healthcare and a minimum of ten years of work experience are required.Certified HEDIS Compliance Auditor (CHCA) required.At least five years of auditing experience and four years of experience as a lead auditor; at least four years in HEDIS auditing and/or data validation, with at least one year as a lead are required.Advanced knowledge of performance measures is required.Experience writing client reports as a lead author and report designer is required.Prior experience leading multiple medium and large projects or contracts is required.Experience writing responses to requests for proposals is required.At least two years of supervisory experience, including experience mentoring junior staff.Other QualificationsProficient English/communication skills (i.e., public speaking, spelling, composition, grammar, proofreading and editing).Proficient interpersonal skills.Experience in Microsoft Word, PowerPoint, and Outlook.Experience in Microsoft Excel.Experience in conducting research via the Internet.Ability to handle several projects simultaneously and work with multiple teams.Work EnvironmentThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.HSAG All User Information Security ResponsibilitiesAll workforce members, volunteers, contractors or third-party agents of HSAG, Inc. who are authorized to access information systems and/or associated company data on paper or in electronic format are responsible for the following:Adhering to policies, procedures and guidelines pertaining to the protection of HSAG Company Data.Reporting actual or suspected breaches or vulnerabilities in the confidentiality, integrity or availability of HSAG Data to your immediate supervisor/manager, Corporate Compliance or Information Technology/Security Personnel.Reporting actual or suspected breaches or vulnerabilities in confidentiality, integrity or availability of Corporate Data, may be reported anonymously, via the NAVEX Global Compliance hotline at 1-800-992-9892.HSAG publishes various policies, guidelines and procedures related to the protection of Corporate Data and Information Systems. They can be found on the corporate SharePoint website. Information on requirements that may be unique to your business unit or a system you have access to can be found by talking to your supervisor/manager or designated system administrator.DisclaimerThis is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, workload, rush jobs requiring non-regular work hours, or technological developments).HSAG is an EEO Employer of Veterans protected under Section 4212.If you have special needs and require assistance completing our employment application process, please feel free to contact us. EOE M/F/Vet/DisabilityGet job alerts by email.Sign up now!

The Program Manager Lead (PL) is responsible for program management and strategic leadership in partnership with the Clinical Development Lead, and will drive short-term and long-term program strategy, goals and plans for the assigned asset. The successful candidate will integrate experience and knowledge in program management, clinical development and finance to manage research programs and deliver key milestones for a high-profile asset. This is role reports directly to the Head of Clinical Development.Responsibilities may vary according to business priorities, but may include:Partner with the clinical development lead in leading the matrixed team through an evaluation of the viability of the program, integrating scientific, regulatory, and commercial considerations. Drive execution of plans and critical decision-making. Track progress against project plans and ensure team deliverables are met on time and on budget. Assist teams to appropriately navigate urgent situations.Manage and lead cross-functional meetings, including scheduling meetings and managing attendee list; creation, distribution, and archiving of meeting agendas and minutes; meeting facilitation; and driving completion of action items. Minutes should document a record of events including important scientific discussions and rationale for key decisions.Drive the completion of two or more scientific and medical advisory boards in 2024 to develop robust Go/No-Go criteria and to evaluate data from a proof-of-concept study. Tasks may include recruiting external advisors, assisting with contracting and scheduling, developing and critically reviewing materials (e.g. pre-meeting surveys, presentation decks, agendas, minutes, executive summaries). Facilitate the development of clear, prospective Go/No-Go decision points and serve as a credible leader for the program. Review and analyze data objectively and collaborate with the matrixed team to highlight opportunities, address potential risks, and proactively provide appropriate mitigations.Has or develops a solid understanding of the disease state, standard of care, and competitive landscape for the assigned asset, through interactions with team members and reading the medical literature.Prepares presentation decks or executive summaries of recommendations for presentation to senior management. Develop communication plans for key decisions or data readouts to senior management.Interact in a professional manner with external stakeholders, including corporate development partners, external consultants, academic research collaborators, and patient advisors, to support the clinical development plan and the scientific communication and publication strategy.We are looking for professionals with these required skills to achieve our goals:Bachelor's Degree with at least five years of industry experience in a scientifically relevant field; Advanced degree highly preferred (e.g. Masters degree or PhD).Relevant experience in a pharmaceutical/biotech setting, preferably in translational or clinical development. Experience with rare disease or biologics is an asset.Ability to assimilate new knowledge rapidly and apply that to asset strategy.Demonstrated experience managing complex projects and exhibiting strategic thinking. Polished skills in influencing, communicating, problem-solving, and working collaboratively with diverse stakeholders in a matrixed environment. Willing to skillfully challenge team members and manage conflict, to facilitate comprehensive team assessment of opportunities, risks, and mitigations.Adaptable team player able to work independently, exhibit sound judgement, and hold self and team members accountable in meeting timelines.Excellent written and oral presentation skills.This is a 0.5 FTE role that is based in Boston. Remote candidates will be considered. Occasional travel within the U.S. (estimated 1-3 trips) may be required.Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply. Company Profile:Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.Learn more about Beacon Hill Staffing Group and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.beaconhillstaffing.com . We look forward to working with you!Beacon Hill. Employing the Future™

Job DetailsSUMMARYAre you passionate about improving the quality of healthcare? Are you interested in exploring a rapidly expanding universe of clinical data? Are you ready to leverage your talents to make healthcare better for everyone? Are you fascinated by the growing field of data science?Then join the new Data Science & Advanced Analytics team at Health Services Advisory Group (HSAG) that is transforming the delivery of healthcare in the United States!HSAG has been a pioneer in the field of healthcare quality improvement for over three decades, serving approximately:25 percent of the nation's Medicare population46 percent of the nation's Medicaid population20 percent of the nation's dialysis populationHSAG is nationally recognized as an industry leader in the areas of data analysis, measure development, and patient satisfaction surveys. We are in search of talented individuals that are interested in a career in analytics as an Analytics Coordinator in HSAG's Data Science & Advanced Analytics division. Together we can spread positive change to make healthcare better. UNIQUE BENEFITSThe Analytics Coordinator also benefits from HSAG's desire to grow its staff into the future leaders of healthcare quality improvement in the nation. New HSAG coordinators are provided formal training in an assortment of healthcare-related topics. HSAG offers:A comfortable work-life balance, including half-day Fridays and flexible work schedules.Three weeks of paid time off and 15 company-paid holidays where staff leave two hours early prior to each holiday just to get a "jump start" on holiday festivities.HSAG offers a competitive benefit package which includes, medical, dental, vision, tuition reimbursement and 401(k). DESCRIPTIONThe Analytics Coordinator is a key contributor to cutting edge analytic work that spans the broad spectrum of healthcare data projects at HSAG. Driven by intellectual curiosity and a passion for healthcare quality, this position coordinates healthcare analytic projects through various stages including implementation, day-to-day management, analysis, and reporting. Activities include developing work plans and timelines; documenting and overseeing project tasks; organizing and maintaining project files; supporting and attending client teleconferences and meetings; performing online research on healthcare topics; and providing regular progress reports to Data Science & Advanced Analytics management staff.Details regarding potential project assignments will be discussed with potential candidates during the interview process.ESSENTIAL COMPETENCIES, DUTIES, AND RESPONSIBILITIESServe as an integral part of HSAG Data Science & Advanced Analytics division.Act in a liaison capacity between appropriate management personnel and staff, transmitting decisions and information to organizational units as appropriate, as well as outside agencies and organizations.Maintain, tag and sort documents for assigned projects on appropriate Share Point team sites and HSAG's corporate and federal networks following HSAG prescribed governance rules.Develop and adhere to analytic project time and task schedules, identify opportunities to improve the project process, and develop quality improvement activities accordingly.Participate in pertinent healthcare educational and training presentations as required.Coordinate project management tasks, including communication (written, phone, fax), coaching, and training.Assist with developing written and data-oriented reports in Microsoft Word and Excel.Communicate with project partners, subcontractors, and other entities on analytic-related projects.Meet agreed upon deadlines in a timely fashion and accurately prepare and type deliverables, reports, various project documents, letters, and other material from copy, rough draft, transcribing machine or other prescribed instructions.Conduct research via the Internet including literature searches of clinical topics as assigned.Prepare support documents needed for project deliverables and assist with documentation and submission of deliverable using the appropriate mechanism (i.e., electronic, hard copy, direct data entry etc.).Conduct Internal Quality Control (IQC) monitoring regarding efficiency/effectiveness of activities conducted. Present issues and recommended solutions and take corrective actions as indicated.Represent HSAG in a professional manner at all times.Compensation: 62,000 - 65,000 DOEJob Requirements:EDUCATION AND/OR EXPERIENCEBachelor's degree in business, science, or healthcare-related field. Master's degree and formal healthcare education preferred.Minimum of two (2) years of work experience in a business or health care setting.OTHER QUALIFICATIONSExcellent English/communication skills (i.e., spelling, composition, grammar, proofreading and editing).Excellent interpersonal skills.Advanced MS Office Suite (Word, Excel, Outlook, Power Point, and Visio) computer skills as well as working knowledge of database management (Microsoft Access).Ability to assist others on MS Office Suite systems usage.Experience in conducting research via the Internet.Experience monitoring budgets.Ability to handle several projects simultaneously and work with multiple teams.Typing speed of at least 50 wpm.WORK ENVIRONMENTThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.DISCLAIMERThis is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, work load, rush jobs requiring non-regular work hours, or technological developments).HSAG is an EEO Employer of Veterans protected under Section 4212. If you have special needs and require assistance completing our employment application process, please feel free to contact us.EOE M/F/Vet/Disabled.Get job alerts by email.Sign up now!

Summary of Position The Senior Manager of Regulatory Affairs is responsible for Nuclear Medicine Regulatory Affairs dossiers and associated regulatory affairs activities in the US. The responsibilities include, yet are not limited to, defining and or authoring compliant content for new and existing dossiers, implementing and managing tracking systems, and preparation of electronic submissions. The main focus of this position will be on new submissions associated with new chemical entity (NCE) as well as products already in non-clinical and/or clinical studies. This position will have a secondary focus on existing marketed products or those obtained through acquisition. This position will facilitate the success of key regulatory projects that may require concept building, Target Product Profile (TPP), claims definition, regulatory strategy (including non-clinical and clinical), Non-clinical and clinical protocol review, defining dossier Table of contents, submission building, health authority management, obtaining approvals, managing post-approval commitments, and product launch. The regional focus for project deliverables is North America, that is, Food and Drug Administration and Health Canada, although the position will rely on the Canadian RA staff for country-specific regulations. The Senior Manager Regulatory Affairs will directly participate in project teams managing key projects, regulatory deliverables, prioritization, strategy, providing guidance, and tracking regulatory process. The Senior Manager is expected to be able to identify risk and make risk-based decisions to facilitate solutions for process and submission. The candidate will direct and mentor less experienced staff on Risk-Based Decision making. Essential Functions Manage submissions and projects as assigned by Regulatory leadership assuring compliance, planning, and execution Represent regulatory on cross-functional teams Process, interpret and provide recommendations for complex strategies Provide regulatory and technical expertise to cross-functional teams Critically review documentation for regulatory submissions and provide input for necessary revisions Contribute to defining Target Product Profile and build compliant drug "approvable" dossiers and registration Serve as Liaison for third party service providers Maintain associated database for tracking individual and department project deliverables for regulatory submissions and milestones Develop and implement policies, procedures, practices, and strategies for Regulatory Affairs, based on current Health Authority guidelines and regulations Manage multiple, sometimes conflicting priorities, define issues and obstacles, define risk analysis and execute solutions Execute objectives in alignment with Regulatory leadership, Marketing, and Global Business Units Communicate regulatory governmental policy changes to management in a timely manner and provide plans for meeting and complying with new requirements. Understand and recommend strategies based on current local registration requirements and applicable industry standards Supports the professional development of regulatory staff through mentorship and guidance Present to upper management at required intervals and effectively communicate successes and challenges Must maintain operational compliance with US and international regulatory agencies and guidelines (i.e. FDA, EU, HC, TGA, PIC/S, ISO, USP, NRC, cGMP, etc.) Requirements Bachelor of Science in Chemistry, pharmacy, biology or other life science, plus direct experience managing regulatory activities Twelve or more years of relevant Regulatory Affairs pharmaceutical industry experience. Two years of supervisory experience of direct reports required, matrix management experience preferred. Experience in leading new project submission efforts including strategy, compilation, submission, and approval by a health authority. Experience writing Target Product Profiles, non-clinical studies, reviewing Clinical protocols and summary reports. Preparing for and executing Health Authority meetings. Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: https://jobs.beaconhillstaffing.com/eeoc/Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records. Company Profile:Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.Learn more about Beacon Hill Staffing Group and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.beaconhillstaffing.com . We look forward to working with you!Beacon Hill. Employing the Future™

Summary of Position The Senior Manager of Regulatory Affairs is responsible for Nuclear Medicine Regulatory Affairs dossiers and associated regulatory affairs activities in the US. The responsibilities include, yet are not limited to, defining and or authoring compliant content for new and existing dossiers, implementing and managing tracking systems, and preparation of electronic submissions. This position requires a highly skilled and experienced individual capable of navigating the complex regulatory landscape related to CMC. The main focus of this position will be on new submissions associated with new chemical entity (NCE) with a secondary focus on existing marketed products or those obtained through acquisition. This position will facilitate the success of key regulatory projects that may require concept building, Target Product Profile (TPP), claims definition, regulatory strategy (including non-clinical and clinical), Non-clinical and clinical protocol review, defining dossier Table of contents, submission building, health authority management, obtaining approvals, managing post-approval commitments, and product launch. The regional focus for project deliverables is North America, that is, Food and Drug Administration and Health Canada, although the position will rely on the Canadian RA staff for country-specific regulations. The Senior Manager Regulatory Affairs will directly participate in project teams managing key projects, regulatory deliverables, prioritization, strategy, providing guidance, and tracking regulatory process. The Senior Manager is expected to be able to identify risk and make risk-based decisions to facilitate solutions for process and submission. The candidate will direct and mentor less experienced staff on Risk-Based Decision making. Essential Functions Manage submissions and projects as assigned by Regulatory leadership assuring compliance, planning, and execution Represent regulatory on cross-functional teams Process, interpret and provide recommendations for complex strategies Provide regulatory and technical expertise to cross-functional teams Critically review documentation for regulatory submissions and provide input for necessary revisions Develop and implement regulatory strategies for CMC aspects of drug development and registration Lead the preparation and submission of CMC sections of regulatory documents (e.g., INDs, NDAs, BLAs, MAAs) in compliance with global regulations and guidelines Contribute to defining Target Product Profile and build compliant drug "approvable" dossiers and registration Serve as Liaison for third party service providers Maintain associated database for tracking individual and department project deliverables for regulatory submissions and milestones Develop and implement policies, procedures, practices, and strategies for Regulatory Affairs, based on current Health Authority guidelines and regulations Manage multiple, sometimes conflicting priorities, define issues and obstacles, define risk analysis and execute solutions Execute objectives in alignment with Regulatory leadership, Marketing, and Global Business Units Communicate regulatory governmental policy changes to management in a timely manner and provide plans for meeting and complying with new requirements. Understand and recommend strategies based on current local registration requirements and applicable industry standards Supports the professional development of regulatory staff through mentorship and guidance Present to upper management at required intervals and effectively communicate successes and challenges Must maintain operational compliance with US and international regulatory agencies and guidelines (i.e. FDA, EU, HC, TGA, PIC/S, ISO, USP, NRC, cGMP, etc.) Requirements Bachelor of Science in Chemistry, pharmacy, biology or other life science, plus direct experience managing regulatory activities. Twelve or more years of relevant Regulatory Affairs pharmaceutical industry experience. Two years of supervisory experience of direct reports required, matrix management experience preferred. In-depth knowledge of global CMC regulatory requirements, guidelines, and industry practices. Experience in leading new project submission efforts including strategy, compilation, submission, and approval by a health authority. Experience writing Target Product Profiles, non-clinical studies, reviewing Clinical protocols and summary reports. Preparing for and executing Health Authority meetings. Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: https://jobs.beaconhillstaffing.com/eeoc/Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records. Company Profile:Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.Learn more about Beacon Hill Staffing Group and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.beaconhillstaffing.com . We look forward to working with you!Beacon Hill. Employing the Future™

Advanced Systems Design is seeking a Business Analyst Advanced for our client located in Montgomery, AL. This position is onsite in Montgomery, AL, and requires in-person availability starting day 1. Job Overview:Our client is preparing for a major transition from a monolithic system with 14 different business functions to an interoperable, modular system based on a Service Oriented Architecture (SOA).This multi-year “Modularity” project will include working with multiple vendors and may include multiple project methodologies.The project must comply with Federal standards and regulations such as Medicaid Information Technology Architecture (MITA), CMS Seven Conditions and Standards, Outcomes-Based Certification (OBC), 21st Century Cures Act (Cures Act), Health Information Technology for Economic and Clinical Health Act (HITECH act).There are two vendors already in the program and there are three more contracts being actively worked on.The first Vendor to join the project was the Program Management Office (PMO) vendor which is responsible for managing the project, defining the client's enterprise architecture, defining requirements, and leading the organizational change management effort.The client is moving away from custom software development to procuring software that is configured to meet the business needs.This will require the Business Analyst to be very comfortable understanding the contract, the business, and the requirements.The Business Analyst will be working collaboratively with a team of dynamic individuals working in a fast-paced environment.The Business Analyst will be responsible for reviewing and approving artifacts related to the program, project, or software.The Business Analyst must also understand the contract and be able to verify the contract requirements are met.The Business Analyst will be working directly with the business areas to support them and ensure their understanding of the vendor-proposed solutions.This position will work closely with the business areas, vendors, and Project Management Office (PMO) vendor. Required Qualifications:7 years of experience as a Senior Business Analyst with 3 years working on business process modeling and management.3 years of experience supporting provider management (This is critical for this position. If they have not worked with provider management in prior positions, please do not respond.)5 years of experience in MMIS or domain knowledge of Medicare, Medicaid, or with a major healthcare payer2 years of experience with multi-vendor projectExpert/Advanced experience in using Visio, MS Project, Office 365, Webex/Teams Understand contract monitoring for development, configuration, and operational activitiesReview and follow the processes and procedures defined to support a program with multiple vendors.Work with multiple vendors and multiple in-person or virtual teams.Review program, project, or software artifacts developed by multiple vendors and comment or approveInteract professionally with a diverse group of executives, managers, and subject matter experts.Perform standard project functions such as creating documents or presentations, scheduling meetings, producing meeting minutes, disbursing reports, track artifacts, issues, and action items, etc.Provide business and requirements oversightUnderstand all phases of a project management and software development life cycle.Support multiple software development methodologies or software configuration activitiesAssist with CMS reporting and certification processMaintain project assets, and communications, and track items to completion.Identify and report on abnormalities or variancesExcellent and effective stakeholder management skills - comfortable speaking and discussing requirements and scope with users and senior stakeholders.Excellent written and verbal communication and presentation skills.A team player with strong interpersonal skills to build team rapportExcellent research capabilitiesAbility to multitask in an environment that has multiple conflicting prioritiesStrong analytical, problem-solving, data and business process analysis and design skills.Ability to adapt and work in a fast-paced and dynamic group environment.Ability to manage complexity well and demonstrated experience managing across functions to accomplish large-scale goals.Understand all phases of a project management and software development life cycle.Have knowledge of multiple project management methodologies.A result-driven, independent thinker and initiative individual who is detail-oriented, meticulous, and able to handle loads of information.Ability to work independently with minimal direction from State or other team members.Experience using and working with virtual and in-house team membersPreferred Qualifications:10+ years of experience as a Senior Business Analyst with 3 years working on business process modeling and management.3 years of experience supporting provider management (This is critical for this position. If they have not worked with provider management in prior positions, please do not respond.)5+ years of experience in MMIS or domain knowledge of Medicare, Medicaid, or with a major healthcare payer2+ years of experience at large multi-contractor organizations, including leading centralized or matrixed teams.3+ years of experience as a technical writerExpert/Advanced knowledge of all Microsoft Office products including MS Project and SharePoint.Strong interpersonal skills to build team rapportExcellent verbal and written communication skillsAbility to work independently with minimal direction from State or other team members.Ability to work under pressure / to a deadline.Strong analytical and critical thinking skills.Exceptional research and reporting skillsEducation Required:Bachelor’s Degree in Computer Science, Information Systems, Business Administration, or other related field. Or equivalent work experience.Advanced Systems Design, Inc. is:A leading Information Technology provider for Federal, State & Local government agencies.A certified minority-owned small business government contractor with capabilities related to Public Health IT, Criminal Justice, Transportation, and Defense.A certified service-disabled veteran-owned company with a proud 42-year track record of providing successful innovative solutions for our government customers.A drug-free workplace in accordance with the Drug-Free Workplace Act of 1988. Applicants who have a signed offer of employment or contractor agreement are subject to:the pre-employment testing protocol:background investigationdrug screeningOur Employees:Are actively working on next-generation technology projects with the U.S. Department of Veterans Affairs, CDC, and a wide array of Federal, State, and Local agencies throughout the United StatesAre eligible for wide-ranging benefits and perks, including but not limited to:Comprehensive Health Insurance with PPO and HDHP/HSA optionsDental InsuranceVision InsuranceShort/Long-Term DisabilityGroup Life Insurance - Company PaidVoluntary Life Insurance401(k) Plan with Employer MatchPaid Time Off (Vacation/Sick)Holiday Pay - Company Paid Federal HolidaysTuition AssistanceProfessional Certification Incentive PlanEmployee Referral PlanTechnology ExposureFor additional information regarding Advanced Systems Design, please check out our WEBSITE  or click HERE for all current job openings.Advanced Systems Design is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.Powered by JazzHRAdvanced Systems Design is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.PI242250961

PT Clinical Reviewer Are you looking for an impactful role where you finish the workday knowing you helped someone? Whether you're joining our care coordination team or playing a supporting role, the work you do every day helps us collectively reach our mission of "getting people the care they need when they need it." We believe that by staying committed to our core values of Think Big, Go Fast, Deliver Awe,and Win Together, we can positively impact the lives of the injured workers we serve and get them back to the things that matter most in life. Salary Range: $66100 - $109100 Salary This compensation range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $66100 - $109100 SalaryBenefits Summary: In return for your commitment to our company's mission, we offer a vast array of benefits to help support the whole you. • Opportunities to work from home • Competitive wages with opportunities to earn annual merit increases • Paid development hours to use for professional and community development! • 18 days of Paid Time plus 8 company holidays, and 2 personal days per year • $1,000 Colleague Referral Program • Enterprise Recognition Program rewarding colleagues for their extraordinary work • Exclusive discounts on travel, activities, and merchandise via work discount program • Colleague Assistance Program that provides free counseling and financial services • Tuition Reimbursement Program including certifications • Quantum Health: A healthcare navigation platform to help our colleagues make the best, most cost-effective healthcare decisions • Medical, dental, and vision insurance • Pre-Tax FSA and HSA health savings accounts • 401(k) matching • Company paid life insurance • Company paid short term and long-term disability • Healthcare concierge • Pet Insurance • The One Call Foundation which aims to help colleagues during unexpected emergencies, from car accidents to natural disasters. JOB SUMMARY:Responsible for completing clinical QA audits and/or plan of treatment reviews specific to their licensure and scope of practice. Reviews to provide recommendations related to the medical necessity for ongoing care, progression of treatment, appropriateness of past treatments, and billing accuracy. The Clinical Reviewer's primary stakeholder is the client (Adjuster/NCM) and must ensure their review/explanation assists and does not hinder the client from making the best decision on how to proceed with the file regardless of their opinions on the treatment that should be performed. Also responsible for providing clinical expertise and collaboration on other One Call processes and customer issue resolutions.Physical Therapy Clinical Reviewer IMinimum bachelor's degree (B.A. or B.S.) and current physical or occupational therapy license and practiced for a minimum of 5 years within an outpatient orthopedic setting. Worker's compensation treatment experience strongly preferred but not required. Entry level reviewer role. Demonstrates strong clinical knowledge and experience to apply to clinical review/QA. Generally, performs standard Clinical QA reviews. Works under supervision of Clinical Review Supervisor, but with latitude to make independent clinical recommendations. Consults with senior peers and team leads on non-complex issues to learn through experience. Can talk with treating practitioners and network providers about standard One Call clinical program features and benefits. Understands appropriate communication protocols and standard workers compensation workflows from a treating practitioner perspective. GENERAL DUTIES & RESPONSIBILITIES:Review Evaluations, plan of treatments, progress notes, and other clinical documentation and provide a report of clinical guidance to client within 48-72 hours of request, dependent on type. Responsible for calling the treating provider to discuss findings and recommendations, with the goal of securing mutual agreement, and to coordinate communication to patient and MD of any revised plan of treatments. May be responsible for calling client to discuss authorization and/or follow up on Plans of Treatment, continuation of care, or other clinical treatment recommendations. Responds to the financial team's requests within 48 hrs. to assist in processing claims received. Acts as a resource for other staff, answering questions and giving guidance when needed on clinical questions within their scope of practice. Collaborates with Operational leaders to share opportunities for improvement with referral data quality. Works all special reports distributed by a supervisor/manager. Reviews and responds to any requests from clients, provider, claimant, or supervisor and performs necessary action steps within 48 hrs. Consistently demonstrates a positive attitude and an overall commitment to excellence and is a team player. Actively participates in continuous operational improvements. Specific activities include, but are not limited to, offering feedback to management related to process, working closely with provider development team to address provider issues, collaborating with financial team to improve efficiency and participates in training/mentorship initiatives. Assists in obtaining necessary clinical documentation from provider as needed. Is open to coaching and willing to find more efficient processes when applicable. Performs miscellaneous tasks and projects as assigned by management. Demonstrates knowledge of CPT and ICD9/10 codes Reviews and corrects in-accurate coding on referral. Assists in provider appeals related to authorization or payment as needed and related to clinical determination. Participates in provider scoring and complaint review as requested. Utilizes and maintains general knowledge of insurance reimbursement and specific knowledge of One Call Care Management processes. Participates in staff meetings, office presentations, training, orientation, and conference calls, as directed. May participate internal file QA to ensure appropriate care coordination internally. Can always maintain professional composure and demeanor with both internal and external communications and interactions, including discussing modified/reduced treatment with our providers.EDUCATIONAL AND EXPERIENCE REQUIREMENTS:Minimum bachelor's degree (B.A. or B.S.) and current physical or occupational therapy license and practiced for a minimum of 5 years within an outpatient orthopedic setting. Worker's compensation treatment experience strongly preferred but not required.GENERAL KNOWLEDGE, SKILLS & ABILITIES: Ability to read, analyze and interpret a vast variety of both handwritten and electronic medical reports, professional journals, newsletters, technical procedures, and/or government regulations. Ability to write business correspondence and completion of business forms. Ability to effectively present information and respond to questions from colleagues, Adjustors, Nurse Case Managers, Providers and Provider's office staff. Ability to create and utilize Microsoft Word documents and Excel spreadsheets. Ability to define problems, collect data, establish facts, and draw valid conclusions. Must have the ability to work with and have knowledge of the physician community, managed care, pre-certification, and utilization review. Must have knowledge of workers' compensation. Must be able to collaborate with individuals at all levels of the organization. Knowledge of the Internet and how to research information is preferred. Must be able to maintain a professional appearance and exhibit strong interpersonal, verbal, and written communication skills for both internal and external customers, including discussing modified/reduced treatment with our providers. Must be able to organize work to ensure tasks are completed in a timely manner. Ability to respond to common inquiries or complaints from customers. To perform this job successfully, an individual should have knowledge of Microsoft Word; Microsoft Works; Microsoft Excel; Microsoft Internet Explorer; and Microsoft Outlook. Confidentiality of One Call business intellectual property and information Current Physical or Occupational Therapy license required, license must be in good standing with Office of Inspector General (OIG) and National Provider Database (NPDB). One Call may check licensure at time of employment and at discretion at any time during employment. Maintain licensure and provide One Call annual proof of compliance. Maintain ongoing Continuing Education Units (CEUs) as required under personal licensure. Must be licensed in the US.PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENT:For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear. The employee is occasionally required to lift objects (up to 10lbs weight; up to 4 ft. height). Specific vision abilities required by this job include ability to see things from a close distance and to adjust focus. The emotional demand of the job may cause undue stress from, but not limited to, moderate/heavy workload. Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position. Please be advised this job description is subject to change at any time.