Senior Whole Health 58 Charles Street, 2nd Floor
Cambridge, MA 02141 1-617-494-5353
Contact Information
Directions
Job Opportunities
Current Job Openings as of 06/20/2008
If interested, please forward resumes to hr@seniorwholehealth.com or fax to (617) 494-5599. No phone calls, please. Click on a job title below for more detailed information
Community Resources Coordinator (Raynham)
Community Resources Coordinator (Cambridge)
Marketing Outreach Representative
Network Development Specialist
Provider Operations Specialist
Marketing Outreach Representative
Community Resource Coordinator (CRC)
Marketing Outreach Representative
Massachusetts
Community Resources Coordinator (Raynham) - The Community Resource Coordinator (CRC) will work directly with members, Case Managers, providers and community service organizations to ensure that members have access to the range of supportive services needed to promote optimal functioning and quality of life. The CRC will educate the member regarding plan benefits, identify and arrange needed social and health support services and follow up with the member on an ongoing basis. Ideal candidates will have extensive knowledge and experience with community organizations, social services and public resources and outstanding communication skills. Candidate must have the willingness to meet directly with members, their families and providers in office or home settings, be a self-starter with high level of accountability and responsibility for outcome of care and be highly organized and able to manage multiple priorities appropriately. Must be able to work collaboratively and build enduring relationships with providers, community and social service organizations, members and the multidisciplinary team. Strong computer skills. Looking for Bi–lingual /Vietnamese/ English speaking candidates
Business Analyst
- Our IT team is seeking a highly-motivated, self-starter to work with business and technology experts
to evaluate new ideas and system extensions to align our IT needs with company growth.
Responsibilities will include: design and develop business and functional specifications for new systems, modify and improve
existing systems and user acceptance/testing plans; integrate new and modified systems into the organization; manage ongoing
projects; develop training guides, procedures and seminars for new and existing systems; and other responsibilities as required.
Candidate will be skilled in Microsoft Office suite, proven project management skills, knowledgeable on MS SQL, RDBMS and
data warehouse concept and design. Healthcare background / HMO experience preferred.
Community Resources Coordinator (Cambridge) - The Community Resource Coordinator (CRC) will work directly with members, Case Managers, providers and community service organizations to ensure that members have access to the range of supportive services needed to promote optimal functioning and quality of life. The CRC will educate the member regarding plan benefits, identify and arrange needed social and health support services and follow up with the member on an ongoing basis. Ideal candidates will have extensive knowledge and experience with community organizations, social services and public resources and outstanding communication skills. Candidate must have the willingness to meet directly with members, their families and providers in office or home settings, be a self-starter with high level of accountability and responsibility for outcome of care and be highly organized and able to manage multiple priorities appropriately. Must be able to work collaboratively and build enduring relationships with providers, community and social service organizations, members and the multidisciplinary team. Strong computer skills. Looking for Bi–lingual / Cambodian / Spanish / English speaking candidates.
Marketing Outreach Representative
- We are searching for dynamic go-getters to generate sales leads and information requests for potential
participants. The qualified candidates will assist potential Senior Whole Health members in the application
process and submit for processing. Experience with Medicare and/or Medicaid enrollment is preferred.
Candidates who are bi-lingual in Vietnamese /Cambodian or candidates with nursing home experience are encouraged to apply.
SQL Developer - Seeking an individual with strong experience in ASP or ASP.NET, SQL, stored procedures, database design, mining and data warehousing. Responsibilities will include: design and develop SQL databases for data storage and reportage; integrate multiple data structures from a variety of sources into SQL tables; create, maintain and schedule stored procedures; troubleshoot issues; and research, recommend, implement and maintain new technologies. Ideal candidate will have a strong knowledge of SQL, particularly stored procedures, data mining, complex queries, database design and data warehousing, together with ASP, DTS, Visual Basic, and Microsoft Office.
RN Care Manager -
Nurses work independently within a supportive organization of professional colleagues. SWH
cares for elders through the care continuum. In collaboration with the elder’s primary
care physician and an interdisciplinary team, the Nurse Care Manager develops, implements
and monitors an individual care plan and comprehensive services’ package for our members. Our
goal is to improve the health status, functioning and quality of life for SWH members in their
preferred place of residence.
Requirements - Massachusetts Registered Nurse License; strong clinical and assessment
skills; outstanding communication skills; self-motivation, organization and flexibility; commitment
to improve care in underserved populations; collaborative work style; relationship building; may
entail meeting directly with members, their families and providers in office or home settings; high
level of accountability; personal car for job related travel; computer skills. Home care, long
term care, care management experience a plus.
Network Development Specialist -
The Network Development Specialist will provide education, training and relationship management to
all types of network providers in accordance with network recruitment plans, contracting initiatives
and will remain in compliance with regulatory and corporate requirements. The position will cover an
assigned regional area and will encompass providers of hospital, ancillary, long term care and
physician services. This position may also be responsible for projects including, but not limited
to, regulatory language compliance for provider contracts.
The Candidate will have a Bachelor’s Degree or equivalent related experience, 3-5 years experience
working in a health care environment; preferably in an HMO/PPO setting and 1-3 years contract
negotiations and/or provider relations experience. An excellent working knowledge of healthcare
contract language is required. Up to 70% travel within assigned region required so candidate must
have driver’s license and reliable transportation. The Network Development Specialist will have
strong communication skills, both verbal and written, excellent interpersonal skills and the demonstrated
ability to influence internal and external customers.
Documentation Specialist -
The Documentation Specialist position within Senior Whole Health manages the production, distribution,
revision, cataloging and submission of documents to State and Federal government agencies, as necessary. The
Documentation Specialist is familiar with regulatory requirements and ensuring document compliance.
The ideal candidate will possess a Bachelor Degree in English, Library Sciences or related field and a
minimum of 5 years experience. Knowledge of health care or medical terminology and familiarity with
Medicare and Medicaid programs an advantage. Experience with documentation issues such as style template
management, revision and change control, cataloging and maintaining detailed, multi-level tracking mechanisms/tools
is required.
Internal Auditor -
The Internal Auditor will be responsible for performing Internal Audits within the Operation
areas of the company with the primary focus on Claims processing. They will document and test
all processes within internal departments and assist in developing correction action plans
on improvements needed. Assist in the development and implementation of the Operations Departments’ policies
and procedures. Document process work flows for each operational area within company.
The ideal candidate will possess an Associate Degree with 3-5 years experience in an Accounting/Claims
Systems position. Bachelor’s of Accounting preferred, or comparable experience in a healthcare
industry environment. Excellent PC skills required including Excel, Access and Word, Claims systems
Provider Operations Specialist -
The Provider Operations Specialist will initiate and maintain vendor credentialing through the credentialing/re-credentialing
process; enroll vendors into the appropriate plan and manage the ongoing maintenance of provider/vendor records.
Responsibilities will include but are not limited to:
-Review and analyze vendor provider applications and credentialing documents to ensure completeness of information relative
to established policies and procedures;
-Conduct primary source verification of vendor credentialing/re-credentialing files and prepare files and provider contracts for approval process
-Enter, maintain and reconcile provider data in a variety of databases and verify accuracy of information
-Implement and communicate new fee schedules and updated fee schedules both in the system(s) and to internal departments.
Associates Degree in Business Administration, Healthcare, IS or equivalent experience required and at least 5 years of
healthcare experience. Certified Provider Credentialing Specialist preferred. Must have excellent attention to detail and
follow through skills and ability to multitask. Strong oral and written communication skills. Proficiency with Microsoft
Office products together with a strong working knowledge of Medicare and Medicaid programs, NCQA, CMS and other quality
requirements.
New York
Marketing Outreach Representative - Searching for dynamic go-getters to generate sales leads and information requests for potential participants; assist potential members in the application process and submit for processing. Candidates must have experience with Medicare and/or Medicaid enrollment and Spanish and Russian-speaking applicants are encouraged to apply.
RN Care Manager -
In this unique position, the Nurse Care Manager will meet directly with members, their families and providers in
office or home settings to formulate a care plan that best meets the member’s needs. The nurse will facilitate, integrate
and monitor all facets of the care plan in order to provide necessary medical and supportive services to achieve the
highest quality outcome for the member.
The ideal candidate has strong clinical and assessment skills, problem solving skills, and is a highly organized self
starter. Must be a Registered Nurse licensed in New York and possess a valid driver’s license. Knowledge of Medicare
and Medicaid programs a plus. Combined 5 years experience working in home care, hospital and/or skilled nursing
settings. Bi-lingual candidates (Spanish) encouraged to apply.
Per Diem RN - Positions available for both Albany and Ulster county areas – proficiency with the SAAM and/or OASIS assessment tools required along with excellent assessment skills.
Quality Manager -
The Quality Manager is responsible for maintaining compliance with CMS, State-specific and industry regulations
as appropriate, as well as implementing clinical and service quality management and performance improvement initiatives
on the local level. The position will require the candidate to develop, edit, train and manage the approval process
for all SWH operational and clinical policies and procedures as needed. Additional responsibilities will include
managing complaints, grievances and appeals process and quality of care issues per State and Federal regulations, meeting
benchmarks for all activity.
The ideal candidate will have a strong Quality Improvement background, familiarity with State Department of Health, experience
with QARR, HEDIS and HOS requirements and other Federal and State reporting requirements. Strong problem solving skills
and organized self-starter is a must. Candidate may be a Registered Nurse or other professional with extensive quality background.
Community Resource Coordinator (CRC) -
In this position, the CRC will work directly with members, his/her family & caregiver, RN Case Managers, providers
and community service organizations to ensure that members have access to a broad range of supportive services needed
to promote optimal functioning and quality of life. The CRC will educate the member regarding plan benefits, identify
and arrange needed social and health support services and follow up with the member on an ongoing basis.
The ideal candidate has extensive knowledge and experience in collaborating with community organizations, social
services and public resources; outstanding communication skills; is a self-starter with a high level of accountability
and responsibility for outcome of care. This candidate must possess competent computer skills. Bi-lingual
candidates (Spanish and Russian) are encouraged to apply.
Manager, Clinical Services - This new position will afford the right candidate an exciting opportunity to lead the clinical services department and work in collaboration with the Director, and the experienced RN care managers to execute the unique model of healthcare delivery for SWH members. The role requires hands-on management experience, strong interpersonal and communication skills, and an appreciation of the diverse needs of a fragile population and their families. In addition to the RN Care Manager qualifications, the candidate must have a minimum of 3 years supervisory experience and previous experience in Medicare/Medicaid/long term care management is preferred. Demonstrated excellence in leadership and mentoring ability required, promoting harmony and teamwork.
Connecticut
Marketing Outreach Representative - Searching for dynamic go-getters to generate sales leads and information requests for potential participants; assist potential members in the application process and submit for processing. CT Health License is a plus. Candidates must have experience with Medicare and/or Medicaid enrollment and Spanish and Polish-speaking applicants are encouraged to apply.
Team Leader, Client Services - Candidate will oversee the workflow for the Community Resource Coordinators (CRC’s), will case manage the most complex members assigned to the CRC team, and provide training to the CRC Staff on care management for members. Masters Degree in Social work or equivalent, minimum 5 years experience working with older and disabled adults in a community based and/or health care setting. In-depth knowledge of community organizations, social services and public resources in CT, experience with community-based case management and best practices, knowledge of Medicare and Medicaid programs/managed care preferred. Bilingual language skills (Spanish, Polish, Russian) preferred.
RN Care Manager -
Our nurse care managers act as the liaison between the member and his/her caregiver(s), the Primary
Care Physician (PCP), and all involved providers. These professionals facilitate, integrate and
monitor all facets of the care plan, regardless of the care setting. This unique role allows
a “high-touch” approach for each member that begins with an in-residence assessment and continues
through ongoing coordination of care needs to promote health and prevent unnecessary illness that
contributes to each member’s healthy and productive life.
We are seeking qualified, energetic nurse managers with experience in home care, long term care or
utilization review to become a part of our dynamic team. Knowledge of Medicare and Medicaid
programs/managed care preferred.
We offer a competitive salary and excellent benefits.
Please forward resumes to hr@seniorwholehealth.com or fax to (617) 494-5599. No phone calls, please.
© 2004 Senior Whole Health, LLC