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View BenefitsCare Management RN Supervisor
Location: Central Valley, CA
Care Management RN Supervisor
Job Description
Location: Central Valley, CA
Employment Status: Full Time
General Summary: Supervises the care management staff in serving defined populations by using a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and influence beneficiary decisions related to achieving and maintaining optimal health status.. The Care Management RN uses a combination of proactive telephone calls, hospital, MD office, and home visits to beneficiaries who are enrolled in Meritage’s medical and wellness programs. Responsible for departmental quality assurance functions, assessing activities, developing and analyzing reports, and assigning staff to ensure quality care and cost containment. Responsible for department audits and developing, maintaining and reporting department productivity and outcomes reports, metrics and measures. This is a working nurse supervisor role, with approximately 70% of time spent serving as department supervisor and 30% of the time as a Care Manager.
Specific Duties: A supervisor engages in leadership and first-line management responsibilities on average, greater than 51% of the time.
Principal Accountabilities:
- Reaches out to patients to provide information and education regarding their medical condition and to guide the patient in self-management of the chronic
- Emphasizes the value of health education and behavior modification in a population that has historically lacked access to medical care
- Participates in all aspects of the Care Transitions Program, which supports patients from hospital to home.
- Works in collaboration with the individual patient and his/her attending physician
- Applies the standard elements of assessment, planning, implementation, coordination, monitoring, and evaluation and will use state-of-art information tools
- Is highly organized, effective at managing her/his time, and is skilled in the use of computers and multiple software systems
- Coordinates care among multiple treating physicians including specialists, primary care, hospitalists, and behavioral health care, as
- Review and approve staff timecards
- Encourage professional development of staff
- Preform annual reviews
- Collaborate with other department supervisors and managers
- Additional supervisory duties according to Supervisor Role Designation.
Job Requirements
Qualifications:
- Current California RN License with no restrictions and a minimum of 5 years clinical experience, previous case/care management and IPA experience is
- Associates in Nursing or comparable healthcare-related degree with an RN Coleman model trained is a plus.
Requirements:
- Familiarity with data collection and methods of analyzing and reporting data, metrics, and related information pertaining to clinical health
- Professional written and verbal communication
- Ability to function effectively in a team with patients, families, physicians, MD office, and other Meritage departments and
- Treats others in a respectful, kind, and patient
- Demonstrates sound clinical judgment and critical thinking in accordance with the California Nurse Practice Act
- Self-motivated, able to ask for assistance, and adapts easily to
- Has a strong sense of accountability for work performed and in meeting
- Knowledgeable about the available health care and community resources for the populations
- Understanding of family dynamics and the influence of cultural and spiritual values in health care.
- Current valid driver’s license and reliable transportation with the required level of automobile liability insurance coverage.
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Network Contracting Coordinator
Location: Novato, CA - Remote
Network Contracting Coordinator
Job Description
Location: Novato, CA - Remote
Employment Status: Full Time
The Network Contracting Coordinator is responsible for performing numerous clerical and coordination support functions within the Contract Department in support of daily operational activities, assigned projects and other clerical support duties deemed necessary for the department to complete assignments, meet deadlines and overall department success. A strong focus will be on maintaining electronic contract files, including tracking of contracts in negotiations, completing contract cover sheets, and ensuring all supporting documents are complete and accurate to include regular auditing of information maintained in multiple systems. Will assist in general outreach calls to providers and Health Plans, respond to general department inquiries via telephone and email, and serve as the point of contact for assigned projects.
PRIMARY DUTIES AND RESPONSIBILITIES
- Completes provider contract updates, to include demographic and contract changes, for submission to the Network Relations team.
- Completes Contract Cover Sheet ensuring all data inputted is complete, timely and accurate to include any required supporting documents as well as obtaining various department approvals.
- Assist in researching, in collaboration with the Network Contracting Specialist, issues regarding provider data, fee schedules, configuration, originating from various departments as assigned.
- Provides on-going auditing of the contract database through various reports, research and outreach via email and phone calls.
- Maintains organization of files on departmental shared drives, assigned systems and databases to ensure such information is up-to-date and easily accessible.
- Recommends process, practice and procedural changes and improvement to streamline, simplify and strengthen department efficiencies in assigned areas.
- Assists in the gathering, coordinating, and reporting of various contract department data grids for use by other departments as required.
- Handles all aspects of department mailings, including securing needed supplies, organizes, compiles, and prepares materials for mailings. If non-electronic outgoing mail is needed, will operate equipment used to stuff, fold, and seal envelops before running envelops through the postage machine.
- Accountable for work performed, works to develop, and maintain trusting working relationships with staff, co-workers, leadership, and external business partners, e.g. Health Plan and provider representatives.
- Provides excellent internal/external customer service, maintains a professional work attitude and approach, works well and in a positive manner with all other Meritage staff, and maintains strict confidentiality
- Performs related work as required, special projects and other duties as assigned, within or outside of the Contracting department.
- Consistently demonstrate behaviors, conduct and communications that support Meritage’s Practices and Values of Accountability, Diversity, Integrity and Respect for others, and will seek to influence these behaviors in others.
- Continuously endeavors to “raise the bar” of performance and teamwork through a focus on Innovation, Collaboration, Equality and
Job Requirements
- Associate degree with two (2) years related experience, or equivalent combination of education and experience. Managed Care experience preferred.
- Strong attention to detail and organizational skills a must.
- Effective written, verbal and listening communication skills.
- Ability to learn and utilize company database systems, i.e., QuickCap.
- Proficient with MS Office (Word, Excel and Access), Outlook and Internet.
- Demonstrates a strong customer service orientation, including a professional and respectful demeanor with customers, co-workers, and other business partners.
- Strong sense of accountability for work conducted and expected deliverables.
- Processes contract related forms efficiently and accurately.
- Knowledge of provider data elements, provider contracts, claims a plus.
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Accountant
Location: Novato, CA
Accountant
Job Description
Location: Novato, CA
Employment Status: Full Time
Position Summary
Responsible for accounting and full-cycle accounts payable functions for Prima Medical Group (PMG) and back-up for payroll administration for Meritage Medical Network and PMG.
Essential Job Responsibilities
- Prepare, run, examine, or analyze accounting records, financial statements, or other financial reports to assess accuracy, completeness, and conformance to reporting and procedural standards.
- Prepare journal entries and reconcile accounts.
- Participate in month/quarter/year-end close processes and prepare accurate and timely financial statements in accordance with established schedules.
- Make recommendations for and implement policies and procedures pertaining to the payment of invoices and reimbursement of applicable expenses for PMG within established timeframes.
- Develop, organize, and maintain accounts payable ledgers and electronic files for service agreements and contracts, business associate agreements, and related records for vendors, suppliers, business partners, independent contractors, consultants and other third parties with whom the organization has financial arrangements for payment in exchange for goods and services.
- Develop and coordinate workflow and processes for disbursements with other Meritage and PMG representatives.
- Oversee vendor, consulting, and Independent Contractor agreements/contracts to ensure compliance with payment after services are rendered up to prescribed timeframes and capped fees. Maintain vendor files and Forms W-9.
- Obtain and maintain a thorough understanding of the data management and reporting capabilities and requirements of accounting and disbursements systems and adhere to all applicable accounting standards (GAAP) and requirements.
- Prepare ACH payments and use on-line banking to research payment status.
- Back-up for processing payroll for multiple entities on a bi-weekly or semi-monthly basis.
- Assist with payroll-related state and local filings.
- Establish, monitor, and regularly audit systems to ensure payments are accurate and there are no duplicative, late, miscoded or overpayments made to third parties.
- Responsible for processes and records pertaining to year end reporting including, but not limited to Forms 1099 and W-2s.
- Analyze workflow, practices, and procedures for process improvement opportunities that support improved efficiency and employee and customer service and satisfaction.
- Perform related work as required, special projects and other duties as assigned.
Job Requirements
Required Education, Experience, and Skills
- Bachelor’s degree in Accounting or related field and a minimum of 2 years of disbursements and accounting experience or an equivalent combination of education and work experience.
- Proficiency with Accounting systems including A/P and Payroll systems/subledgers.
- Proficiency with Microsoft Office applications including Excel, Word, and PowerPoint and Adobe Acrobat.
- Prior healthcare accounting experience is a plus.
- Strict attention to privacy issues and absolute discretion required.
- Demonstrate/model excellent internal/external customer service with a positive and respectful work style and professional work demeanor.
- Highly developed organizational skills and an extreme attention to detail mindset.
- Excellent written, verbal, and listening communications skills.
- An accountable, respectful, and professional demeanor that engenders trust.
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Revenue Accounting Manager
Location: Novato, CA
Revenue Accounting Manager
Job Description
Location: Novato, CA
Employment Status: Full Time
About the role
As the Revenue Accounting Manager for Babylon, you will be responsible for all accounting and financial reporting processes relating to our California Commercial, Medicaid and Medicare Advantage revenue stream (currently around $150M annually and increasing).
This role shall take the lead on designing and executing SOX-compliant processes, establishing monthly contract reporting cadences and developing robust accounting estimates relating to variable elements of the revenue and report into Babylon’s US Controller.
Essential Functions
- Ownership of the end-to-end revenue process relating to the California Commercial, Medicaid and Medicare Advantage revenue stream
- Designs and implements SOX compliant controls relating to the monthly revenue process including membership analysis, comparison of capitation amounts to contracts, month end reconciliations and journal entry processes
- Subject matter expert on the underlying contracts, influences forward looking revenue projections, negotiates contractual revenue risk and quality adjustments and identifies areas of future contract optimization
- Documents judgmental positions relating to the application of ASC 606 to the underlying revenue contracts and performing annual PDR assessments
- Drives automation initiatives to enhance the pace and accuracy of data transfers relating to membership numbers and pricing
- Partners effectively across the global accounting team and with FP&A and commercial team individuals involved in forecasts and contracting negotiations
- Reviews existing accounting policies, procedures, and operational strategies, implements improvements and establishes new ones as necessary
- Assists in coordinating with external auditors and preparing audit schedules and other necessary documents to support both Global (SEC) and local regulatory (DMHC) reporting requirements
- Risk factors experience:
- Audits of risk pool reports
- Ensures claims submitted to maximize risk adjusted factor (RAF) institutional portion risk pool revenue
- Revenue Enhancement / Recoveries
- Stop-loss / reinsurance
- Ensure claims are filed with reinsurance carriers and claims reaching thresholds are received
- Coordinates and supports Senior Accountants’ daily tasks
Assists with special projects as assigned
Go to applicationJob Requirements
Requirements
- 5 years or more in a healthcare environment: e.g. independent physicians associations, medical groups, health plans
- Familiarity with healthcare revenue contracts
- Experience with NetSuite, Ivalua, G Suite platform, and Excel
- Strong and demonstrated working knowledge of US Generally Accepted Accounting Principles (GAAP) and accounting skills, especially relating to ASC 606
- Highly analytical with the ability to evaluate complex accounting and financial data with limited supervision
- Team-focused leader who accomplishes assigned work and who mentors team members, leading with personal accountability
- Expert time management and able to engage on multiple projects
- High attention to detail
- Understanding of health care finance and accounting (knowledge of California DMHC regulatory requirements a bonus)
Qualifications
Education
- Bachelor’s degree or equivalent in Accounting, Finance or related field of study
Experience
- 7+ years professional experience working in accounting role requiring knowledge and use of US GAAP
- Demonstrated growth and success in comparable role
- Management experience strongly preferred
Preferred Experience
- 10+ years professional experience with 2+ years of experience as manager of an accounting team
- Experience working in US healthcare setting, ideally with an IPA or Medical Group
Required Certifications
- CPA or CFA
Apply Below
Accounting Manager
Location: Novato, CA
Accounting Manager
Job Description
Location: Novato, CA
Employment Status: Full Time
About the role
The Accounting Manager function manages the Meritage Medical Network accounting department. The position is responsible for monthly accounting close, financial reporting for the parent company, and its subsidiaries. The Accounting Manager reports to and works directly with the Controller and CFO.
Essential Functions
- Oversees all aspects of the financial accounting processes such as journal entry review including expense accruals, monthly close, balance sheet reconciliation, as well as financial reporting, forecasting and budget variance analysis for all entities
- Responsible for revenue and cost analytic activities using capitation invoices, eligibility files, claims and expense data and other relevant reports
- Additional areas of focus include, utilization, claims and cost analysis and evaluation of health plan and provider negotiations, assessing impact of contract changes on financial performance and new lines of business
- Manages Accounts Payable Supervisor activities to ensure vendor onboarding, accuracy and timeliness of payment processing, expense coding, and management of outstanding checks
- Leads analysis in revenue recognition by thoroughly reviewing contracts and customer supporting documentation
- Assists in P&L analysis of health plans and products to determine areas for improvement and make recommendations to management
- Assists in healthcare cost analysis by creating or enhancing reports that monitor trends in cost and utilization
- Prepares monthly membership, revenue, and expense analysis
- Reviews existing accounting policies, procedures, and operational strategies, implements improvements and establishes new ones as necessary
- Establishes highly structured internal controls to identify and prevent fraud and ensures staff is informed of current trends as they change
- Proven experience managing annual audits with large external auditing firms: assists in coordinating the audit as well as preparing audit schedules and other necessary documents
- Manage third party consultants in SOX implementation project
- Optimizes the control environment, minimizes risk and increases control ensuring oversight of all controls and enforcing all policies and procedures
- Responsible for preparation of end-to-end process documentation, risk control matrices, test plans and test results
- Assists in refining internal control deficiencies
- Coordinates and supports Senior Accountants’ daily tasks
- Experience with stop-loss, reinsurance, and health plan carve outs
- Manages IBNR / Claims
- Validates claims triangles to payments
- Liaises with external and internal actuaries
- Reviews claims payments for pricing appropriateness
- Capitation revenue engagement
- Reconciliation of retroactive members
- Reconciliation of capitation against contracts
- Review cap deductions and other withholds for appropriateness
- Contract performance monitoring
- Tracks performance under P4P and other quality incentive programs.
- Sub-capitation to providers
- Calculation of sub-capitation expense
- Reconciliation of capitation revenue/membership to ensure sub-capitation is not paid for members for which we did not receive capitation revenue
- Liaise with provider network to review provider payments:
- Practice transfers
- Member block transfers
- Analysis of provider payments (capitation vs. FFS) to optimize provider reimbursement and align incentives
- Serves as a payroll backup
- Assists with special projects as assigned
Job Requirements
Requirements
- Experience with NetSuite, Ivalua, G Suite platform, and Excel
- Treasury and cash management experience
- Strong and demonstrated working knowledge of US Generally Accepted Accounting Principles (GAAP) and accounting skills
- Highly analytical with the ability to evaluate complex accounting and financial data with limited supervision
- Team-focused leader who accomplishes assigned work and who mentors team members, leading with personal accountability
- Expert time management and able to engage on multiple projects
- High attention to detail
- 5 years or more in a US healthcare environment: e.g. independent physicians associations, medical groups, health plans
- Thorough understanding of US and California healthcare industry, regulation, and regulators and health care finance and accounting, including DMHC
Qualifications
Education
- Bachelor’s degree or equivalent in Accounting, Finance or related field of study
Experience
- 7+ years professional experience working in accounting role requiring knowledge and use of US GAAP
- Demonstrated growth and success in comparable role
- Management experience strongly preferred
Preferred Experience
- 10+ years professional experience with 2+ years of experience as manager of an accounting team
- Experience working in US healthcare setting, ideally with IPA or Medical Group
Required Certifications
- CPA or CFA
Apply Below
Accounts Payable Supervisor
Location: Novato, CA
Accounts Payable Supervisor
Job Description
Location: Novato, CA
Employment Status: Full Time
Babylon is one of the world’s fastest-growing digital healthcare companies whose mission is to make high-quality healthcare accessible and affordable for every person on Earth.
Babylon is re-engineering how people engage with their care at every step of the healthcare continuum. By flipping the model from reactive sick care to proactive healthcare through the devices people already own, it offers millions of people globally ongoing, always-on care. Babylon has already shown that in environments as diverse as the developed UK or developing Rwanda, urban New York, or rural Missouri, for people of all ages, it is possible to achieve its mission by leveraging its highly scalable, digital-first platform combined with high quality, virtual clinical operations to provide integrated, personalized healthcare.
Meritage Medical Network is seeking a Accounts Payable Supervisor in Novato, California!
We are looking for people who are flexible with any scenario and who see change as an opportunity!
WHAT YOU’LL WORK ON
- Provides day-to-day oversight of the accounts payable operations.
- Provides leadership, guidance, counseling and continuing education to staff. Select, develop, coach, mentor, and assess performance of staff.
- Partners with finance leadership in maintaining and producing management reports.
- In collaboration with senior leadership, design, develop and implement focused accounts payable strategies for continued growth of the accounting system. Actively participate in the budget and goal setting process.
- Directs preparation of government taxable income reports.
- Interprets company policies and government regulations affecting accounts payable responsibilities.
- Other duties and responsibilities as assigned.
WHAT WE OFFER
- Competitive salary
- New Hire Company Stock Grants (RSU)
- Refresh Company Stock Grants (RSU)
- Unlimited PTO
- Excellent Medical, dental and vision plans
- Access to flexible spending account and health savings account
- Competitive retirement plan
- Flexible working hours
- Weekly remote yoga sessions
Job Requirements
WHAT WE’RE LOOKING FOR
- Education: Associate’s Degree or 2 years equivalent experience in lieu of Associate’s’ Degree.
- Experience: 2 years accounting or related experience.
- Strong working knowledge of the general ledger and its relationship to financial statements
- Prefer large company experience
- Strong supervisory skills with a demonstrated ability to assume ownership and responsibility and lead and mentor others.
- A proven track record of meeting business critical deadlines and managing multiple and shifting priorities in a dynamic environment.
- Detail-oriented individual possessing strong analytical and judgment skills.
- Ability to effectively communicate and interface with individuals at all levels within the organization.
- Advanced Excel skills (vlook ups, pivot tables, macros, etc.)
Apply Below
Accounts Payable Specialist
Location: Novato, CA
Accounts Payable Specialist
Job Description
Location: Novato, CA
Employment Status: Full Time
Babylon is one of the world’s fastest-growing digital healthcare companies whose mission is to make high-quality healthcare accessible and affordable for every person on Earth.
Babylon is re-engineering how people engage with their care at every step of the healthcare continuum. By flipping the model from reactive sick care to proactive healthcare through the devices people already own, it offers millions of people globally ongoing, always-on care. Babylon has already shown that in environments as diverse as the developed UK or developing Rwanda, urban New York, or rural Missouri, for people of all ages, it is possible to achieve its mission by leveraging its highly scalable, digital-first platform combined with high quality, virtual clinical operations to provide integrated, personalized healthcare.
Meritage Medical Network is seeking a Accounts Payable Specialist in Novato, California!
We are looking for people who are flexible with any scenario and who see change as an opportunity!
WHAT YOU’LL WORK ON
- Review electronic invoices for correct vendor information and coding before importing into ERP.
- Review expense reports and credit cards for accurate coding and to ensure they are within company policy.
- Maintains files and documentations thoroughly and accurately, in accordance with company policy and accepted accounting practices.
- Assist in processing of weekly Check/ACH/PCD payment runs for AP disbursements.
- For Invoices without purchase orders, review invoices, prepare and route for approval, obtain signatures; follow up as necessary to ensure open invoices are approved and paid timely.
- Process batches of invoices for data entry, back up reports, and manage the weekly check run
- Process weekly wires, including setting up wire template and initiate wires
- Reconcile accounts payable related accounts
- Assists in accounting month-end/year-end closing processes
- Other duties and responsibilities as assigned.
WHAT WE OFFER
- Competitive salary
- New Hire Company Stock Grants (RSU)
- Refresh Company Stock Grants (RSU)
- Unlimited PTO
- Excellent Medical, dental and vision plans
- Access to flexible spending account and health savings account
- Competitive retirement plan
- Flexible working hours
- Weekly remote yoga sessions
Job Requirements
WHAT WE’RE LOOKING FOR
- Education: Associate degree or 2 years equivalent experience in lieu of Associate’s’ Degree.
- Experience: 2 years accounting or related experience.
- Strong working knowledge of the general ledger and its relationship to financial statements
- Prefer large company experience
- Knowledge in Microsoft Dynamics 365 desirable
- Strong supervisory skills with a demonstrated ability to assume ownership and responsibility and lead and mentor others.
- A proven track record of meeting business critical deadlines and managing multiple and shifting priorities in a dynamic environment.
- Detail-oriented individual possessing strong analytical and judgment skills.
- Ability to effectively communicate and interface with individuals at all levels within the organization.
Apply Below
Care Management RN (DCE Focus)
Location: Novato , California
Care Management RN (DCE Focus)
Job Description
Location: Novato , California
Employment Status: Full-Time
General Summary: The Care Management RN (DCE) manages defined populations by using a collaborative process of assessment, planning, implementation, and evaluation, to engage, educate, and promote/influence beneficiary decisions related to achieving and maintaining optimal health status in the Outpatient setting. The Care Management RN (DCE) uses a combination of proactive telephone calls, hospital, MD office, and home visits to beneficiaries who are enrolled in Meritage’s medical and wellness programs. This position is responsible for developing and maintaining ongoing supportive relationships with all members of the Care Management Team and beneficiaries.
Principal Accountabilities:
- Reaches out to patients identified as appropriate to provide information and education in order to deepen their understanding of their medical condition and to guide the patient in self-management of the chronic
- Emphasizes the value of health education and behavior
- Participates in all aspects of the Care Transitions
- Actively participates in the Care Team to improve/maintain positive healthcare outcomes and care
- Works in collaboration with the individual patient and his/her attending
- Supports the Primary Care Physicians and their office
- Applies the standard elements of assessment, planning, implementation, coordination, monitoring, and evaluation and will use state-of-art information
- Is highly organized, effective at managing her/his time, and is skilled in the use of computers and multiple software
- Remains objective in relationships with patients, families, and physicians and promotes a team approach by encouraging communication among all members of the care
- Coordinates care among multiple treating physicians including specialists, primary care, hospitalists, and behavioral health care, as needed
- Performs other clinical and related administrative duties as assigned to support the organization’s operational needs.
Job Requirements
Qualifications:
- Current California RN License with no restrictions
- 5 years clinical experience, previous case/care management experience preferred
- Strong working knowledge of Electronic Health Records, Microsoft Office Suite including Excel, Outlook, Teams
- BSN preferred
- Coleman model trained is a plus.
- Direct Contracting Entity (DCE) and Accountable Care Organization (ACO) experience desired.
Requirements:
- Familiarity with data collection and methods of analyzing and reporting data, metrics, and related information pertaining to clinical health
- Professional written and verbal communication
- Ability to function effectively in a team with patients, families, physicians, MD office, and other Meritage departments and
- Treats others in a respectful, kind, and patient
- Demonstrates sound clinical judgment and critical thinking in accordance with the California Nurse Practice
- Self-motivated, able to ask for assistance, and adapts easily to
- Has a strong sense of accountability for work performed and in meeting
- Knowledgeable about the available health care and community resources for the populations
- Understanding of family dynamics and the influence of cultural and spiritual values in health care.
- Current valid driver’s license and reliable transportation with the required level of automobile liability insurance coverage.
Apply Below
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