Category: Uncategorized

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 107,000 colleagues serve people in more than 160 countries

1.        POSITION SUMMARY
 
The scope of this position includes deploying a comprehensive coverage and reimbursement strategy for the Infectious Disease (ID) portfolio in the US which includes the leading the point-of-care (POC) molecular platform ID NOW and other tests as required.  During the Public Health Emergency, the Market Access Managers (MAM) is laser focused is on coverage and appropriate reimbursement Influenza Like Illness (COVID-19, Influenza, RSV and Strep) tests, and implementation of a One Abbott solution for COVID-19 testing.
 
The Market Access Manager, Westwill be responsible for executing on the broader coverage and reimbursement strategy by developing regional/local reimbursement initiatives in conjunction with Market Access Advocacy Manager (MAAMs), other MAMs, KOLs and the field sales team(s).   Similarly, the MAM is responsible for coordinating efforts between S&L Government Affairs Directors on FFS Medicaid challenges, and working in concert with the Market Access Director on FFS Medicare related issues and opportunities as appropriate. 
 
The ID NOW and other Abbot Point of Care testing products are used across multiple market segments including:  Health Systems, Hospitals and Physician Offices, Urgent Care, Retail Health/Pharmacy with other emerging potential sites of care testing due to the COVID-19 pandemic.  This individual will be the Subject Matter Expert (SME); and field based resource for their assigned Regional and National, Medicare Advantage and Managed Medicaid accounts on all coverage and reimbursement activities.  They will also be responsible for having a comprehensive understanding of FFS Medicare, Medicaid and other Government entities such a VA/DoD, BIA, etc.
 
 
2.        ESSENTIAL DUTIES AND RESPONSIBILITIES – (KEY ACTIVITIES)

–   Compliantly engage directly with payers in assigned Region to effectively communicate value of ID portfolio to secure favorable coverage reimbursement policy decisions.
–     Communicate effectively and build strong relationship with field sales teams to support complaint access and appropriate reimbursement in POL setting.  Align on deliverables and needs with ASD’s, RD’s, TS’s and AE’s in  the markets for both current and future needs.
–     E xecute on payer advocacy efforts in coordination with MAAM, local/regional ARDx and IDDM cross-functional and Abbott cross-divisional teams in Region to support appropriate.
–      Support field sales teams and MAAM in identifying clinician advocates (KOLs) to support and further IDDM initiatives impacting payers, associations and government policy. 
–       Work with Abbott S&L Government Affairs counterparts on Medicaid coverage and reimbursement challenges.
–     Develop compliant regional Market Access reimbursement strategy by key product sector by analyzing data from various sources to inform comprehensive strategy and to build organizational alignment.
–     Contribute to the broader IDDM organization and other Abbott Divisions as a Subject Matter Expert (SME) for the US reimbursement landscape across the broad continuum of sites of care.  Be prepared to engage in special projects as assigned by Market Access Director.
–       Participate in complaint third party support initiatives with established companies and organizations including CodeMap, leading outside reimbursement law firms, and consultants as appropriate with guidance from Market Access Director and Marketing Analyst.
–       Complete all training and other administrative responsibilities in a timely fashion.

        EXPERIENCE/EDUCATION

–        Seven to ten (7-10) + years of relevant (Market Access/Managed Care) industry experience.  History in point-of-care (POC) diagnostics and molecular platforms preferred.  
–       People management experience highly desirable or comparable professional experience.
–        Demonstrated understanding of the varied payment methodology utilized at the sites of care for the ID NOW portfolio.
–       Strong communication skills with demonstrated ability to create and deliver professional and impactful presentations.
–        Strong multi-tasking and project management skills needed.
–       Demonstrates understanding of the applicable industry regulations and quality management systems including approved product labeling. 
–       Bachelor’s degree required.  MD, PhD, PharmD, MS/MHA/MBA preferred.

 
 
 
 

Clipped from: https://www.jobs.abbott/us/en/job/ABLAUS30966560ENUSEXTERNAL/Market-Access-Manager-West?utm_source=linkedin&utm_medium=phenom-feeds

 
 

Requisition ID:

32806

Work Location:

Human Services – Virginia Beach Blvd offices

Pay Range:

A.18, $79,393.60 – $120,369.60

Starting Salary:

Minimum of the Pay Range

Work Schedule:

Monday-Friday; 8am – 5pm

Part Time Hours/Wk:

Application Deadline:

12/28/20

Job Duties:

The City of Virginia Beach is seeking an experienced administrator to oversee the Department of Human Services Eligibility Benefits Program.  Responsibilities are as follows:

• Provide supervision, consultation and leadership for the program of 161 full-time equivalent and contract positions.
• Oversee and administer eligibility benefits programs, most of which are funded by the federal and state government. Programs include the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid, Energy Assistance, Child Care, Virginia Initiative for Education and Work (VIEW) and local programs which include General Relief and the City’s Water Assistance Program. As it relates to these programs, this position oversees services and benefits to over 70,000 Virginia Beach residents and a total budget of over $15 million dollars.
• Ensure state and federal goals are met and program is in compliance with federal, state, and local policies; develop corrective action plans as needed and interpret agency policies and programs for other agencies and the public; analyze and monitor the effectiveness of service delivery within the department and ensure timely responses to clients’ needs, achieving state and federal mandates.
• Directly supervise two (2) Eligibility Coordinators, two (2) Human Services specialists I’s and one (1) Administrative Assistant.
• Work closely with state and federal officials; elected officials, citizens and other community and state organizations and partners.  
• Interpret agency policies and programs for other agencies and the public.
• Receive and respond to community inquires, concerns, and complaints and continuously monitor and analyze the effectiveness of service delivery within the department. 
• Participate in the development of new initiatives, business process improvements and resources; receive and make appropriate referrals, and develop new resources to enhance the departments services to clients. 
• Serve on the department’s Senior Leadership team as well as other task force groups and collaborate with other agencies to bridge the gaps in services and programs.  
• Prepare regular reports for the Deputy Director on divisional activities and collaborate with the administrative team to ensure total agency effectiveness. 

Working Conditions:

Minimum Requirements:

Minimum Qualifications: Requires a Bachelor’s degree or higher and eight (8) years of experience associated with positions such as director or assistant director of a small social services agency or supervisor of a social services program unit OR any combination of education (above the high school level) and/or experience equivalent to twelve (12) years in fields providing the required knowledge, skills, and abilities.

Special Requirements: All employees may be expected to work hours in excess of their normally scheduled hours in response to short-term department needs and/or City-wide emergencies.

Additional Requirements:


DMV Transcript:  Required
CDL:  Not Required                                       
DOT History:  Not Required                                                 
CPS Check:  Not Required
Physical:  Not Required    
Respirator:  Not Required
Polygraph Review:  Not Required
Psychological Screening:  Not Required


Attachments Required: 

Preferences:

Bachelor’s degree in or higher in a related field.
Ten (10) or more years of experience in positions such as director or assistant director of a small social services agency or as supervisor of a social services program or unit.
Fourteen (14) or more years of experience in working in public benefit programs to interpreting polices as well as federal, state and local regulations related to eligibility programs.
Experience working with eligibility benefits case management systems.
Five (5) or more years of experience with strategic planning, process improvement, quality improvement tools and methods, and use of results-based accountability in a human service agency.
Five (5) or more years of experience working with performance management systems, using evaluation tools and metrics, and applying data driven decision making.
Three (3) or more years of experience leading multiple teams and managing multiple projects, budgets and funding streams.
Three (3) or more years of experience facilitating presentations to groups varying in size, including staff, leaders, elected officials and/or other organizations and or providers.

Special Instructions:

• Please complete the application in its entirety. The application is the primary required document used to screen qualifications and years of experience. A resume does not replace a completed application. Fields on the application left blank, including but not limited to job duties, dates of employment, and hours worked, may cause your application to be incomplete. 
• You will not be able to access the details of this job ad once the closing date has passed.   If you would like to retain this information, please   take a screen shot or  print using your browser’s printing capability.
• Your responses to any “Supplemental Questions”, if attached to this requisition, must be supported by the information you give us in the work experience section of this application. Be sure you are thorough in describing your skills and duties as you complete the work experience section. If the information cannot be verified you will not receive credit. 
• Please provide a copy of any certifications or related professional licenses.

 
 

VRS Contribution:   All full-time employees are required to contribute 5% of annual salary toward their retirement account; in accordance with VRS retirement provisions. This will be handled through a pre-tax payroll deduction.  

Clipped from: https://phg.tbe.taleo.net/phg02/ats/careers/v2/viewRequisition?org=VBGOV&cws=37&rid=32806&source=LinkedIn&src=LinkedIn&gns=LinkedIn

 
 

 
 

Description

SHIFT: Day Job

SCHEDULE: Full-time

 

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

 
 

 
 

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health care companies and a Fortune Top 50 Company.

 
 

 
 

This is an office based position and will be required to report to 9133 West Russell Road Las Vegas, NV post Covid.  Remote work within the state of NV will be allowed until Anthem is cleared to return to the office.    

 
 

 
 

The selected candidate will be supporting the NV Medicaid market, including implementation of new products, supporting the plan President and operations lead. This associate will be the go to person for the state on a daily basis.

 
 

 
 

Responsible for operations functions, including coordination between internal departments, ensuring the appropriate strategy, tactics and processes are in place to affect solid organizational operations and oversight.

 
 

 
 

 
 

Primary duties may include, but are not limited to: 

 
 

   
 

 
 

Champions initiatives by developing and managing key relationships with state agencies, regulatory, Medicaid/SCHIP and other stakeholders as appropriate.

 
 

Resolves programmatic challenges related to operations including member issues, provider claims issues, provider network/contract configuration issues, etc.

 
 

Serves as liaison to Health Plan support services, which could include: Claims, Enrollment, NCC, PDM/PDQ, configuration; Quality, Regulatory Compliance, IT, Reimbursement policy, etc.

 
 

Identifies opportunities for Operational Excellence and works to create seamless processes between shared services and the Health Plan.

Clipped from: https://anthemcareers.ttcportals.com/jobs/6058761-nv-medicaid-state-ops-dir?tm_job=PS43144&tm_event=view&tm_company=2522&bid=56

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

Develops and implements key operational indicators to be used for monitoring and analysis of the Health Plan operations.

 
 

Serves as a liaison with state regulatory agencies when appropriate.

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

Resolves programmatic challenges related to program operations including member issues, provider claims and provider network.

 
 

 
 

Represents business unit on national/state/regional boards, task forces, and work groups that impact the health care delivery system and other key health care issues.

Collaborates with senior management to develop and implement new programs to enhance relationships with key stakeholders and to promote programs and services.

Ensures all policies and procedures related to Field Operations are compliant with all applicable laws and regulations governing the State Sponsored Business.
 

Qualifications

• Requires a BA/BS in Business, Healthcare Administration or related field
• 10 years of relevant experience including 8 years of in-depth experience in managed care operations
• Or any combination of education and experience, which would provide an equivalent background
• Masters degree preferred
• Six Sigma Black Belt preferred
   

 
 

 
 

This is a Director level position, operating as an individual contributor without direct reports.

 
 

 
 

Additional skills:

 
 

OPERATIONS EXPERIENCE / PROVIDER CONTRACTING EXPERIENCE A PLUS

 
 

FACETS KNOWLEDGE A PLUS

 
 

MS OFFICE

 
 

STRONG COMMUNICATION SKILLS

 
 

PEOPLE MANAGEMENT A PLUS

 
 

MEDICAID EXPERIENCE A PLUS

 
 

ABILITY TO MEET WITH PROVIDERS WHEN NECESSARY  

 
 

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.  Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

 
 

Job Description:

• Processing Provider Enrollment applications submitted by Medicaid enrolled providers.
• Working on complex Provider Enrollment applications that are under strict deadlines.
• Ensuring Provider Enrollment applications are following Medicaid policy and procedures.
• Working with both Gainwell and State employees.
• Providing outreaches to providers if needed.

 
 

• Processing 377+ applications through analyst review within a week, with 0 errors identified. 
• Processing 213+ applications through quality review within a week, with 0 errors identified. 

Education and Experience:

• High School Diploma or equivalent; may hold 2 year post- high school Degree; may hold Bachelor’s degree.

Knowledge and Skills:

• Ability to follow written policies, procedures and guidelines.
• Self-motivated with good time management and organizational skills.
• Ability to read and interpret basic to moderately complex documents such as operating and maintenance instructions, procedure manuals, and government/healthcare guidelines.
• Excellent written and verbal communication skills and customer service skills.
• Insurance background preferred.
• Provider Enrollment background preferred.
• Experience with Medicaid policy preferred.
• Experience with Medicaid Provider Enrollment submissions preferred.
• Knowledge of Medicaid systems desired.
• Ability to access and retrieve information using a PC and basic understanding of Microsoft office products.
• Ability to work on assignments with limited instruction from leadership.
• Ability to work under pressure with strict deadlines.
• Multitasking and detail oriented.

Being flexible to learn another provider type/application in order to help the department succeed

 
 

Clipped from: https://jobs.gainwelltechnologies.com/job/12020070/

 
 

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health care companies and a Fortune Top 50 Company.

Job Title: MO Plan President (Medicaid)

Location: St. Louis, MO

Responsible for leading the fiscal, operational management, legislative and regulatory objectives of the Health Plan including running a plan and leading cross-functional teams. A leader must focus on what it takes to win in the market every day, driving the ground game, strategy, meeting the state’s goals and company’s goals, driving growth within the market, implementing community health and population health programs, addressing health disparity gaps while meeting financial, compliance and performance objectives.  The leader of the health plan will bring thought leadership and innovations to the state customer, demonstrating the value of managed care.  Developing high performing, high potential talent within the team and other functional areas who are mission-driven is critical to success.

Primary duties may include, but are not limited to: 

• Aligns strategy and leadership to achieve business goals and build a culture of accountability with people who are results-driven, innovative and committed to excellence
• Establishes strategies that create or sustain a competitive advantage
• Manages the Profit & Loss of the assigned Health Plan
• Execution on the operating gain, growth, cost of care commitments, revenue and quality accreditation goals 
• Collaborates with shared services including but not limited to Provider Services, Clinical, Operations and Quality to reach Health Plan objectives
• Ensures contract compliance, as well as oversight of risk management programs
• Manages customer and regulatory relationships, including state regulatory and legislative processes
• Responsible for strategic growth through local relationships; local community engagement with FQHCs and CBOs; and maximize visibility, innovation, and improve reputation
• Proven track record of leading a highly matrixed team
• Hires, trains, coaches, counsels, and evaluates the performance of direct reports. Develops talent.

 
 

Qualifications

• 12 years relevant experience, including 8 years’ experience in government-sponsored health insurance programs; managed care or healthplan experience
• Managed Care Organization (MCO) and Medicaid experience required
• Proven track record of progressive responsibility leading teams within a matrixed environment
• Requires a BA/BS in Business, Healthcare Administration or related field or any combination of education and experience, which would provide an equivalent background
• Master’s degree preferred
• Travel may be required

 
 

Clipped from: https://anthemcareers.ttcportals.com/jobs/6048642-medicaid-plan-president-mo?tm_job=PS41818&tm_event=view&tm_company=2522&bid=56

 
 

 
 

The Director of Quality Management (QM) will lead and direct the efforts of the QM Department staff in the collection, analysis, and reporting of quality data metrics. The Director will facilitate improvement projects, assessing for and implementing risk reduction measures and assessing and coordinating activities related to achieving and maintaining ongoing regulatory compliance. The Director will work collaboratively with clinical leadership staff in support of quality goals and objectives and serves as subject matter expert to ancillary areas by providing strategic improvement plans with a focus on quality operations. Acts as LIBERTY Dental Plan’s point‐person for interactions with regulatory agencies and provides corporate-wide support for quality outcomes and related initiatives as developed and implemented.

 
 

Essential Duties:

• Responsible for the overall department operations, monitoring and compliance of all quality policies and procedures, contractual obligations and URAC activities and performance; determines thresholds for action plans when needed.
• Provides leadership to quality staff; ensures validity of measurement, accuracy of data, patient safety and regulatory compliance with quality improvement.
• Facilitates organizational enhancement of quality of care, processing and system improvements, and compliance through comprehensive quality assessment and improvement programs.
• Oversees the effective development, implementation, and evaluation of the QM Programs, workplans, key performance indicators, planned activities and interventions.
• Leads a visible and transparent project prioritization process to align resources with initiatives and to ensure interdisciplinary efforts are in support of organizational strategic priorities.
• Collaborates with quality initiative teams and process innovation to improve care delivery and documentation.
• Continuously reviews all applicable State and Federal regulations and proposes changes to existing QM policies and procedures, ensuring consistency across all product lines.
  

Clipped from: https://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=46621&clientkey=FA85C9F98D78F8540353D8E367B0B6BC

 
 

Registered Nurse

The City of Alexandria is located in northern Virginia and is bordered by the District of Columbia (Potomac River), Arlington and Fairfax counties. With a population of approximately 150,000 and a land area of 15.75 square miles, Alexandria is the seventh largest city in the Commonwealth of Virginia. Alexandria has a charming waterfront and is a unique and historic place to live and work. About one-quarter square miles in the city have been designated as a national or local historic district. We proudly embrace our rich history and seize the endless opportunities that lie ahead. If you are interested in working for the vibrant City of Alexandria, we invite qualified candidates to apply for our Registered Nurse position.

An Overview

The Registered Nurse is responsible for coordination, implementation and evaluation of consumer s health care. In conjunction with the residential staff, maintains all health care and training documentation and requirements to assure consistency and compliance with the licensure standards; Develops and conducts training for all residential staff; Acts as a liaison between Physicians, Pharmacists, medical health insurance companies and other health care personnel; Performs administrative and coordinating duties as required.

What You Should Bring

The ideal candidate should have knowledge of nursing and clinic policies and procedures; good knowledge of approved medical terminology and abbreviations; good knowledge of the function, use, maintenance, and safety precautions of all equipment used; ability to clinically evaluate patients/clients before medicating; ability to monitor clients on a variety of medications; ability to communicate clearly and effectively, both orally and in writing; ability to provide nursing services to difficult and complex patient and client cases; ability to establish and maintain effective working relationships between staff, hospital employees, administration, physicians, visitors and patients; ability to chart accurately, legibly, and completely all entries on medical records/controlled substance inventories.

The Opportunity
 

• Coordinates care for consumers needing treatment for chronic medical/psychological problems;
   
• Assess consumers for current health status;
   
• Refers consumers with medical needs to an appropriate resource for care;
   
• Performs treatment procedures for consumers when feasible;
   
• Follows up on consumers receiving medical care;
   
• Schedules appointments, and verifies appointment when necessary;
   
• Coordinates care for consumers, develops and implements nursing plan for consumers;
   
• Develops and implements nursing care for consumers with a variety of special medical needs;
   
• Evaluates and modifies health care treatment as needed for all consumers;
   
• Develops and conducts approved health care training such as, but not limited to medication administration and annual medication refresher training;
   
• Provides feedback and follow up for staff as needed;
   
• Performs related duties as assigned.
   

About the Department

The Center for Adult Services (CAS) provides programs and services in Aging; Adult Protective Services; Clinical & Emergency Services; and Community & Residential Support Services for seniors and for persons with mental illness, intellectual disabilities and substance use disorders. CAS provides compassionate and effective person-centered services based on best practices. Our teams support self-determination, safety and recovery for Alexandria residents affected by abuse, neglect, mental illness, intellectual disabilities and substance abuse disorders.

Minimum & Additional Requirements

Graduation from an accredited school of Nursing; eligibility for, or current licensure with the State Board of Nursing of the Commonwealth of Virginia as a Registered Nurse. or any equivalent combination of experience and training which provides the required knowledge, skills, and abilities.

Preferred Qualifications

Basic computer skills and two years of experience in Mental Health, Mental Retardation and Substance Abuse environment. Must have a valid driver’s license.

Notes

This position requires the successful completion of pre-employment background checks including but not limited to: FBI/Federal Records Check; VA State Child Abuse/Neglect Registry; Medicare/Medicaid Fraud Database; education/certifications; drug screening; and driver’s license.

Schedule:

Monday through Friday 9:00AM – 5:00PM, occasional weekends and evenings.

As an Essential Employee, staff will be expected to be at work during weekends, holidays, or inclement weather if they have been scheduled.

 
 

Clipped from: https://jobs.washingtonpost.com/job/41723674/registered-nurse/

 
 

 
 

The Performance Improvement Manager partners with business leaders to drive performance improvement and transformation efforts aligned to organizational strategy and goals. He/she is responsible for coordinating improvement focused on increasing efficiency and reducing costs through the application of performance improvement, quality tools and methodologies.

Duties and Responsibilities:

• Works with business leaders to discover and identify project opportunities
• Organizes and leads assigned performance improvement projects using methods of team building, data gathering and analysis, process mapping, and problem solving
• Establishes appropriate tools to monitor progress of planned improvement implementation and achievement of expected benefits
• Develops and maintains required documentation throughout the project life cycle
• Builds and develops working relationships through coaching/mentoring of project team members and business partners to foster a culture of continuous improvement
• Participates in developing and delivering training content in support of the Performance Improvement Strategy
• Additional duties as assigned

Minimum Qualifications:

• Bachelor’s degree from an accredited institution or equivalent relevant work experience
• Certification in Lean Six Sigma or other process improvement methodology training
• Experience working with data sets and/or Microsoft Excel modeling
• Experience utilizing valuation and impact analysis methodologies
• Experience using workflow diagramming applications to document business processes

Preferred Qualifications:

• Master’s degree from an accredited institution
• Experience teaching Lean Six Sigma or other process improvement methodologies
• Healthcare/ Health Plan work experience
• Knowledgeable of Department of Health (DOH) and Center for Medicare & Medicaid Services (CMS) regulations
• Knowledge of Scaled Agile Framework

Compliance & Regulatory Responsibilities: N/A

License/Certification: Lean Six Sigma or other PI methodology

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

 
 

Clipped from: https://www.indeed.com/viewjob?jk=da70f3455feb692e&tk=1eq2deimjt51g801&from=serp&vjs=3&advn=1768959768617549&adid=344627720&ad=-6NYlbfkN0C2UqVY0eO9XBLriZEDdTcgBPf9YGxYHxIXZwdXEwTqdjz7xEP9PkiOUMfX5Uxmvzghs3SsUlJUivDMUoXLQgimtD0kJ72GaQAMeMJ5stJim9l6yehHFBhhcCBpFXRZYAZaysVJ8Mnb34MfE7XROSMPqYoGeeuqXFfaPzeSIunbt886JuMKrFcQXfdw9hRCwf79uPfknFnweC0kqQ1ZNv4WKoNxGM-1eYXoJqTMfK8EvW9_wduuRt7qTSrSrvnc3JnrddzAwsFOyVeXLR4ZfahNVQUnBStEKN9bB6vSyf-AQJZHIOF3ND7MA6sBQx87GOqJVVL6mWDBJw==&sjdu=0ZFwD5rbjMRcHz87Kzx_g0JUzSLjEAZRvUrbA1HeVjWZWXcLm8CKxcO1rj6wLuxXE8EVOzevHSgNE0hpvmRlEc7RE1uUWRT2yHXlOSm0YIjJ7SxhCvNfmkv_eBPAn3D-z4jo6uMatbSKr4nMbRfrzQ

 
 

 
 

Clipped from: https://vhr-otsuka.wd1.myworkdayjobs.com/en-US/External/job/Remote/Associate-Director—State-Government-Affairs—Advocacy_R319?mode=job&iis=Job+Board+-+Indeed&iisn=Indeed.com

•  

 
 

• LOCATION: REMOTE NJ, DC OR MD

The Associate Director, State Government Affairs & Advocacy, Mid Atlantic Region will be responsible for interfacing with  patient advocacy groups, professional associations, government officials, and coalitions to align healthcare policy, advocacy, and legislative priorities at the state level. Other responsibilities include;

• Develop strategies and coordinate initiatives with alliances that promote access to therapies, preserve patient/provider choice, and eliminate barriers to treatment.
• Help shape and influence healthcare policies and provide feedback to OAPI regarding emerging regulatory/legislative issues that impact OAPI business.
• Interact with state policy decision-makers and influencers, advocacy leaders, governor’s office policy staff, relevant state legislative committee chairs, members, and support staff and Medicaid policy officials regarding issues impacting access to the continuum of care within the health care delivery system, in accordance with OAPI strategic objectives.
• Develop working partnerships to support OAPI goals (i.e. consumer advocacy groups, professional associations, provider/medical organizations, government agencies, government officials, community leaders)
• Identify key influencer stakeholders and work within a team environment to develop strategies to effectively support OAPI policy positions.
• Conduct all activities in compliance with all applicable local, state, and federal laws and regulations and company policies.
• Position OAPI policy platform and corporate commitment; liaising between State MH authority, Medicaid Directors, and Patient Advocacy organizations.
• Monitor federal, state, and local payer systems and regulatory/legislative trends that potentially impact access to treatment and OAPI initiatives.
• Gain insight regarding risks, issues, and opportunities through alliance development, translating into value-added propositions.
• Represent OAPI in state PhRMA task force activities within assigned states.
• Manage relationships and activities with local lobbying counsel in support of OAPI’s crisis issues and/or opportunities.
• Communicate potential access risks to internal OAPI team with a sense of urgency, embracing a “no surprises” philosophy.
• Collaborate cross-functionally across OAPI departments to ensure favorable access/non-disadvantaged positioning.
• Develop and implement state/regional advocacy plans on an annual basis.
• Participate and drive in Matrix Team meetings.
• Execute appropriate marketing/policy initiatives with stakeholders through discussions, formal presentations, workshops, and programs as directed.
• Implement patient and caregiver education and outreach programs via advocacy and professional organizations as directed.
• Represent OAPI at state/local conferences, symposia, and events, with the goal of becoming a recognized partner within the stakeholder community.

Qualifications Required:  

• Bachelor’s degree, Master’s degree preferred
• Demonstrated knowledge in federal, state, and local healthcare  delivery systems, payer reimbursement, and policies impacting access to appropriate treatment.
• Establish a network of key patient advocacy groups, professional associations, and coalitions.
• Working knowledge of state policy and legislative environment; preferred executive-level lobby and regulatory experience.
• Neuroscience and Nephrology disease state knowledge is preferred.
• Proven track record in aligning and mobilizing advocacy organizations to shape the healthcare environment and advance initiatives.
• Established high-level relationships with a network of key thought leaders and influencers.
• 3-5 years within the pharmaceutical industry preferred; with direct reports and/or manager-level positions.
• Experience in working with Matrix Teams. Skills and Competencies
• Demonstrated networking, consensus building, and influencing skills.
• Strong communication and presentation skills, interacting with both external and internal audiences.
• Critical thinking skills, relationship management, conflict resolution, and the ability to work collaboratively.
• Demonstrated skills in leading and managing projects and the ability to work cross-functionally.
• Ability to effectively position messaging to multiple stakeholders, while working towards a common goal.
• Strong strategic planning ability, considering short-term and long-term implications of initiatives.
• Ability to quickly distill complex information from multiple sources into an easy-to-understand message.
• Self-starter, ability to proactively direct and manage cross-functional and cross-geographic teams.
• Ability to foster stakeholder cooperation; coordinate projects, manage community partnerships.
• Ability to be tenacious and resilient under pressure, while maintaining a strong sense of integrity.
• Scenario planning skills; recommend novel strategies to mitigate risk and capitalize on opportunities.  

Disclaimer:  This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position. It is not intended to include every job duty and responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.Otsuka is an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment without regard to their protected veteran or disabled status, or any protected status.

Statement Regarding Job Recruiting Fraud Scams

Job postings, job offers, or introductions to enter into a business relationship with Otsuka through a third-party vendor may be unauthorized. Avoid being the subject of a scam by dealing only directly with Otsuka through its official Otsuka Career website https://vhr-otsuka.wd1.myworkdayjobs.com/en-US/External . Any authorized third-party vendor job boards should redirect any inquiry to this Otsuka Career website.

•  
   
  •  

   
   

• Otsuka Pharmaceutical Co., Ltd. is a global healthcare company with the corporate philosophy: “Otsuka–people creating new products for better health worldwide.” In the U.S., Otsuka is comprised of two companies, Otsuka America Pharmaceutical, Inc., and Otsuka Pharmaceutical Development & Commercialization, Inc., that share a deep commitment to the development and commercialization of innovative products in the spaces of neuroscience, nephrology, and digital medicine.

Driven by our purpose to defy limitation, so that others can too, we have an unwavering belief in doing more and transcending expectations. In going above and beyond—under any circumstances—for patients, families, providers, and for each other. It’s this deep-rooted dedication that drives us to uncover answers to complex, underserved medical needs, so that patients can push past the limitations of their disease and achieve more than they thought was possible each and every day.

OPDC and OAPI are indirect subsidiaries of Otsuka Pharmaceutical Company, Ltd., which is a subsidiary of Otsuka Holdings Co., Ltd. headquartered in Tokyo, Japan. The Otsuka group of companies employed 47,000 people worldwide and had consolidated sales of approximately USD 13 billion in 2019.

We invite you to explore our open positions for an opportunity to join our 1,700 colleagues in the U.S. whose passion for our mission and pride in our company have earned us certification as a Great Place to Work by the Great Place to Work Institute.

Clipped from: https://jobs.ssmhealth.com/job/11922803/government-affairs-director-madison-wi/

PRIMARY RESPONSIBILITIES

• Ensures organization is compliant with all aspects of the Medicare, Medicaid, and other applicable compliance program requirements defined by the Center for Medicare and Medicaid Services (CMS) and applicable state Medicaid agencies, both with respect to internal operations and vendor solutions. Serves as the primary point of contact for and lead facilitator of regular meetings with CMS Account Manager.
• Oversees accurate and timely data submission and reporting to regulators of government programs. Responsible for ensuring timely and accurate responses are provided to regulators and/or auditors in relation to general inquiries, corrective actions, and necessary deliverables.
• Manages the preparation and review of annual compliance training materials, company intranet articles and/or other training and education materials. Oversees continuous readiness activities, audit support and coordination activities, and remediation activities, related to all Medicare, Medicaid, and regulatory audits.
• Facilitates and supports the annual Compliance Program Effectiveness (CPE) audit and serves as business owner of relationship with external auditors selected to perform the audit.
• Provides operational areas with compliance support and guidance related to Medicare, Medicaid, and GPO requirements and facilitates organizational response to incidents of noncompliance. Performs the annual Compliance Program Effectiveness (CPE) Assessment and develops and implements annual compliance work plan.
• Establishes and maintains performance metrics and provides regular performance dashboards, report-outs of significant matters, and compliance updates.
• Ensures that processes are in place to identify new laws, regulations, sub-regulatory guidance, and contractual requirements applicable to government programs lines of business; distributes new requirements to staff and business partners responsible for or impacted by implementation, and monitors progress of implementation.
• Analyzes the regulatory environment and legal requirements applicable to Medicare, Medicaid, and other government regulated programs and identifies risk areas.
• Serves as government programs compliance subject matter expert in support of growth and expansion initiatives.
• Performs other duties as assigned.

EDUCATION

• Bachelor’s degree or equivalent combination of experience and education

EXPERIENCE

• Five years’ experience

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.