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Study Shows Most Counties Have primary Care physician Shortageonly eight counties meet federal benchmarkA new study that analyzed health statistics by county found that California scored poorly in most areas of clinical care, including access to primary care physicians.
The 2013 County Health rankings report commissioned by the robert Wood Johnson Foundation and the University of Wisconsin population Health institute found that only eight of California’s 58 counties met the nation-al benchmark for primary care physicians per capita. The study also found that the state scored below average in having patients undergo routine screenings such as mammograms.
The study estimates that California has an average of one primary care physi-cian for every 1,341 residents compared to the national benchmark of one physician for every 1,067 residents. San Francisco County had the most primary care physi-cians per capita with one for every 688 residents. The only other counties to meet or exceed the national benchmark were Marin, placer, Santa Cruz, Santa Clara, Yolo, Alameda, and tuolumne counties. on the flip side, Glen County ranked at the bottom with only one primary care physician for every 7,028 residents.
Dawn Jacobson, MD, director of strategy and impact at the public Health institute in oakland—which compiled health data for the California section of the report—said the state needs to do more to attract primary care physicians to under-served counties.
“Physicians live where they do for a reason,” said Jacobson. “So the state really needs to build incentive programs to get physicians to work and live in the under-served counties.” The study estimates that people living in the most-healthy counties are 1.4 times more likely to have access to a primary care physi-cian than people living in the least-healthy counties.
In addition to clinical care, the study looked at more than 25 social and environ-mental factors including rates of smoking, obesity, and unemployment. overall, the five healthiest counties in California were Marin, Placer, Santa Clara, San Mateo and Yolo. The five least-healthy counties were Lake, Siskiyou, tehama, Kern, and Del Norte.
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» The San Francisco Board of Supervisors last week approved a plan to build two new hospitals and medical buildings in downtown San Francisco. In a unanimous vote, supervisors gave California pacific Medical Center the green light to bui ld a 274-bed hospital in the city’s Cathedral Hill section and a 120-bed replacement hospital for St. Luke’s Hospital in the Mission District. The project also calls for construction of medical buildings adjacent to each hospital. The project will be considered next by the city’s planning commission in May and—if approved—will return to the board of supervisors for final approval in July. original plans called for a 555-bed Cathedral Hill hospital and an 80-bed replacement hospital for St. luke’s but the project was scaled down to address concerns about traffic and environmental impacts on neighborhoods near Cathedral Hill. Construction is slated to start by the end of the year if final plans are approved this summer.
» officials for the Covered California health insurance exchange have signed a lease to operate a call center in the city of rancho Cordova . Covered California expects to employ up to 500 people at the call center with an opening scheduled for August. The center will be staffed by multi-lingual workers who will field calls from residents who have questions about the patient protection and Affordable Care Act and how to purchase health insurance through
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The state also had a 21% rate of uninsured residents, nearly double the national average of 11%. Statewide, the percentage of people who needed dia-betes screenings and received them was 81% compared to the national average of 90%. The rate of women needing mammograms who received them was 62% compared to the national average of 73%.
Jacobson said the low screening rates could be due to a number of factors, including a high rate of uninsured residents and a “fragmented” healthcare sys-tem that often makes it difficult even for people with insurance to access care. “A physician can make an appointment for a woman to have a mammogram but it doesn’t always happen,” said Jacobson. “For low-income people without a vehicle, it can be difficult to navigate the system and make it to appointments.”
And while rural counties are often the regions with access-to-care issues, that’s not always the case. “Finding a primary care physician in the Los Angeles area isn’t difficult overall but you have some pockets where there are plenty of physicians and others with a severe shortage,” said Jacobson.
The same dynamic applies to some rural areas. Mountain Valleys Health Centers is a network of five health centers that serves patients in several rural northern California counties including Lassen and Siskiyou. “The areas of the counties we serve are fully staffed,” said Dave Jones, CEo of Mountain Valleys. “But in many areas of those counties, finding a primary care physi-cian is a real problem.”
And it’s a problem that’s likely to grow worse in California and other states. “Most surveys of medical school students find that most of them are going into specialty care because the hours tend to be better and the pay is better than pri-mary care,” said Jones. —Doug DesjarDins
Los Angeles Hospital opens Wing for Korean patientsSt. Vincent Medical Center debuts unique Korean pavilionSt. Vincent Medical Center in Los Angeles has opened a 30-bed wing designed exclusively for Korean-American patients.
The Korean pavilion is staffed with nurses and physicians who speak fluent Korean and can communicate directly with Korean patients. St. Vincent Medical Center CEo Cathy Fickes said the new wing is a reflection of the 366-bed hospi-tal’s mission to meet the cultural needs of its ethnically diverse patient base.
primary Care physician Shortage cont.
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the Covered California website. “This really allows Covered California to move forward with getting millions of uninsured Californians enrolled with the Affordable Care Act,” said Covered California spokesperson Dana Howard. “We have a tight window to do this in and this is a huge milestone.” open enrollment for the insurance exchange is due to launch on oct. 1.
» U C L A H e a l t h S y s t e m a n d Ascension Health Al l iance are reported to be considering a joint acquisition of St . John ’s Health Center in Santa Monica, according to a report in the Los Angeles Times. Citing “people familiar with the matter,” the report stated the uClA and Ascension are among several potential bidders for St. John’s, which is owned by Denver-based SCL Health System. A uClA spokesperson said the health system has not submitted a bid for St. John’s and Ascension Health stated that “as a matter of general policy, we do not comment on specific inquiries.” other health systems cited as potential buyers include providence Health & Services which, like Ascension Health, is a Catholic hospital chain. SCl Health System stated that it intends to sell St. John’s to a Catholic organization to ensure that the hospital “is strategically positioned so it can continue its faith-based mission as a Catholic health ministry.” The 266-bed hospital has been losing money in recent years and has been looking to merge with a larger health network.
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“As a downtown los Angeles hospital serving a very diverse patient popula-tion, we have learned to effectively communicate in their languages and accom-modate the cultural needs of patients to ensure we provide the best possible care,” said Fickes. “The Korean Pavilion underscores how seriously we take cul-tural needs in caring for our patients.”
In addition to staffing the unit with nurses and physicians fluent in Korean, the pavilion provides patients with a Korean menu, Korean TV channels, and sig-nage in Korean. The hospital even brought in an interior designer to ensure the pavilion’s décor reflected a Korean aesthetic. The pavilion is located on one floor in a separate wing of the hospital.
St. Vincent has more than 80 Korean-American physicians on staff and those physicians were instrumental in establishing the Pavilion. “The new Korean Pavilion allows us to provide integrated inpatient care for our patients with highly sensitized nurses, staff members, and caregivers who understand the cultural needs and can speak the language,” said Sam Lee, MD, a physi-cian at St. Vincent. “We worked hand-in-hand with the hospital to create an environment that provides ease and comfort for our patients and their fami-lies during their time of healing.”
los Angeles has more than 108,000 Korean residents, the largest popu-lation of any city in the united States, according to the U.S. Census Bureau. The majority of those residents live in Koreatown, a section of downtown los Angeles near St. Vincent Medical Center.
“We took a look at our patient mix and saw that, on average, 30% of our inpatient population was of Korean descent,” said Greg Schwarz, vice presi-dent of strategic planning for St. Vincent. “So the Korean Pavilion serves a large segment of our patient population.” St. Vincent already had a large num-ber of physicians and nurses who were fluent in Korean but Schwarz said there was still “some recruitment involved” to ensure the hospital had sufficient staffing for the Pavilion.
Schwarz said the Korean Pavilion has been well received since it opened in mid-February. “The concept is that better communication between patients and caregiv-ers leads to better patient outcomes,” said Schwarz. “And by providing patients with everything from Korean cuisine to Korean TV channels, they really feel at home.”
Schwarz said the Korean Pavilion was an organic idea that originated through discussions with nurses and physicians and isn’t based on something done at another hospital in the area. The Hospital Association of Southern California (HASC) agrees that the concept is unique to the region. “There doesn’t appear to be anything else like it in Southern California,” said Jennifer Bayer, vice president of external affairs for HASC.—Doug DesjarDins
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» ipC the Hospitalist Company has acquired two hospitalist practices in Kansas. North Hollywood-based IPC purchased Kansas inpatient Services, LLC and Kansas Long term Care physicians. The two affiliated practices are collectively called KiS and are based in Wichita. “KIS has successfully developed a balanced and integrated mix of services in community hospitals, long-term care acute care hospitals, skilled nursing faci l i t ies , and behavioral health facilities,” said r . Jeffery taylor , president and Coo of IPC. “This is very much in keeping with IPC’s commitment to providing effective transitions of care to patients across the continuum of acute and post-acute care.”
» Corcoran District Hospital has closed its emergency department, according to a report in the Fresno Bee. Corcoran District Hospital CEo Jonathan Bren told the Fresno Bee that the hospital is planning to convert the emergency department to an urgent care center in order to begin accepting patients again. The closure resulted in 25 positions being eliminated at the 32-bed hospital. Corcoran District Hospital has suffered a decline in patient volume since nearby Corcoran State prison reduced the number of prisoners it sends to the hospital due to policy changes in the state’s prison health system. Prison inmates made up a large percentage of the hospital’s patient base and the reduction in inmate patients has had a significant fiscal impact.
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PAgE 4 of 11 April 1, 2013
Covered California to Launch Marketing Campaign in Mayoutreach effort to start with community groups Covered California officials are preparing to launch a statewide marketing cam-paign next month to inform residents about federal healthcare reform, the insur-ance exchange, and the availability of federal subsidies to buy health insurance.
The multifaceted campaign will be rolled out in increments, with a commu-nity-based outreach program leading to a larger, public advertising campaign in early fall. “In May and June, we’ll be rolling out our on-the-ground campaign,” said oscar Hidalgo, director of communications and public affairs for Covered California. “And that will entail partnering with non-profit organizations, religious groups, and holding town hall meetings. Anything that gets us face-to-face with the people we need to reach.”
Covered California plans to spend $40 million over the next two years on partnerships with local organizations that will also include retail stores and social media outlets. The effort will place an emphasis on reaching Hispanics and other ethnic groups who represent a larger portion of the estimated 5.3 million state residents who are not insured.
According to a report outlining the Covered California marketing strategy, Hispanics represent “the majority of California’s uninsured and nearly half of cov-erage-eligible, uninsured residents in the state.” The report also notes that “low-income African-Americans, Asian and Pacific Islanders, and native Americans are also disproportionately represented among the uninsured and will require targeted outreach efforts.”
In late summer, the exchange will launch a larger campaign with paid media that will extend through March of 2014. That effort will focus on public advertis-ing like billboards designed to reach a specific demographic in targeted communi-ties. “’We’re not going to focus on global advertising,” said Hidalgo. “Most of our efforts are going to be very specific and surgical.”
While California and other states that have opted to operate their own health exchanges all face unique challenges, they share one in common: an audi-ence that is largely unaware of what federal healthcare reform is all about. A Kaiser Family Foundation survey released in March found that 57% of people surveyed don’t understand how federal healthcare reform will impact them.
Hidalgo said the Kaiser survey yielded results similar to those in previous sur-veys that found most u.S. residents know very little about federal healthcare reform. “We knew going into this that it wouldn’t be easy,” said Hidalgo. “That’s why we’re going to launch a very aggressive campaign to inform people.” —Doug DesjarDins
April 6-7. California Medical Association Leader’s toolkit Conference. riverside County Medical Association. A two-day conference for physicians interested in pursuing leader-ship roles in organized medicine. Subjects include team leadership and setting boundaries and priorities. To register, please visit http://www.cmanet.org/events/detail/?event=the-leaders-toolbox
April 12-14. California Society for Healthcare Attorneys Annual Meeting. Balboa Bay Club & resort, newport Beach. A three-day education-al event focused on new developments and upcoming changes to California health law. To register, please visit http://www.csha.info/event/2013-csha-annual-meeting-spring-seminar
April 24-26. 34th Annual Advances in infectious Diseases: New Directions for primary Care. California Hilton, San Francisco. An educational seminar hosted by uC San Francisco designed for general practi-tioners, family physicians, and internists with a focus on identifying and treat-ing new strains of antibiotic-resistant diseases. To register, please visit http://www.cme.ucsf.edu/cme/CourseDetail.aspx?coursenumber=MDM13K03
May 18-19. California rheumatology Alliance 9th Annual Medical & Scientific Meeting. loew’s Santa Monica Beach Hotel. A two-day con-ference focused on the latest advanc-es in care for rheumatic diseases and new regulatory, legislative, and payer issues that could affect patient care. To register, please visit http://www.calrheum.org/events.html
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» Seton Medical Center in Daly City has named Joanne Allen as its new president and CEo. Allen replaces interim CEo James Schuessler, who had filled the position since April 2012. Allen most recently served as CEo of Saint Louise regional Hospital in Gilroy which, like Seton Medical Center, is owned and operated by the Daughters of Charity Health System. Allen will take over as CEo of Seton Medical Center on April 2. Carol Furgurson, the chief operating officer of Saint louise regional Hospital, will serve as interim CEo of the hospital until a permanent replacement for Allen is found. The Daughters of Charity Health System operates four hospitals in the Bay Area and two hospitals in the Los Angeles area.
» The California State rural Health Association (CSrHA) has closed its Sacramento office due to a lack funding. The non-profit CSrHA was formed in the mid-1990s to serve as an advocacy group for rural healthcare issues and to help improve access to care in rural areas of the state. “We still have a volunteer board and we’re hoping to work through other agencies to keep our voice active,” said Dave Jones, the president of the group’s volunteer board of directors. Jones said the CSrHA has relied on donations and grants to staff an office in Sacramento but the board ran out of funding this year.
» The Blue Shield of California Foundation allocated $10.7 million in grants to community organizations during the first quarter of 2013, with the majority of funds targeting safety-net providers and community health centers. A total of $5 million in grants went to more than 200 community health centers that serve low-income patients in the state as part of Blue Shield’s Community Health Center Core Support initiative. Another $1.65 million was donated to 10 county health departments and safety-net providers to help them expand coverage to more residents and prepare for federal healthcare reform. “our foundation is investing in community health centers and county health systems because they will play critical roles in reaching the full potential of the Affordable Care Act,” said peter Long, president and CEo of the Blue Shield of California Foundation.
» A new study from the National Center for policy Analysis found that California had the second-highest percentage of residents enrolled in Medicaid in 2009 but the lowest rate of spending per patient in the country. The report found that 23.1% of state residents were enrolled in Medicaid in 2009 but that spending per beneficiary averaged only $4,569 or 67% of the national average, lower than any other state. The study also found that California had the sixth-lowest percentage of residents enrolled in Medicare at 12.5% of the population but that spending per beneficiary averaged $10,954, the eighth-highest level among u.S. states. In terms of overall spending on healthcare as a percentage of the economy, California had the sixth-lowest percentage in the u.S. at 12.5%.
E V E N t S
PAgE 5 of 11 April 1, 2013
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page 6 of 11april 1, 2013
clinical ManageMent services, supervisor, rn Fullerton, CA
Supervise the daily operations and process improvement for the Clinical Management Services (CMS) Department in collaboration with the Director of Healthcare Services. Minimum Qualifications: aa Degree in nursing or related field. 3 years experience in utilization management and high risk care management. Minimum of 5 years clinical and administrative experience. Current California RN license.
coMplex care Manager Fullerton, CA
provides care management throughout the healthcare continuum to promote quality, cost effective care of the member who has suffered a catastrophic injury or illness, needs a transplant, or has other complex health-care needs. Minimum Qualifications: Nursing school graduate. 3 years experience in utilization management and/or case management. Minimum of 3 years clinical experience in an HMO, MSO, hospital or medical office/clinic setting. Current California RN license.
case Manager, rn Mission Viejo, CA
assesses planning, implementing, evaluating and pro-viding specialty care management to promote quality, cost effective care throughout the health care continu-um to patients with health problems that are identified as high cost/high risk cases. Minimum Qualifications: Nursing school graduate. 3 years experience in utiliza-tion management and/or case management. Minimum 3 years clinical experience in hospital or medical office/clinic setting. Current California RN license.
Manager, utilization/Quality/care ManageMent Mission Viejo, CA
Manages staff providing services of Utilization, Quality, and Care Management for the HMO population. This position is responsible for the operations of the UM/
QM/CM Department for MHap/MIMg members includ-ing, but not limited to data collection for the creation of reports to measure productivity, utilization patterns, and goal setting. Minimum Qualifications: Bachelor’s in nursing or healthcare related field. 5 years experience in high risk care management, utilization management, or hospital care management. Current California RN license or Licensed Clinical Social Worker. experience with evidence based criteria, Milliman, Interqual, Medicare and/or health plan criteria.
nurse practitioner Orange, CA
provides direct patient care in the ambulatory setting and reports to the Chief of Staff and Medical Office administrator at the medical office site where services are provided. Minimum Qualifications: 2 or more years experience as a Nurse practitioner. Current BLS, RN license and Dea license. graduate of an accredited Nurse practitioner training program, Board of Registered Nursing Certification of Nurse practitioners and Board of Registered Nurses Certification Furnishing Number.
clinical supervisor, lvn Fullerton, CA
Oversees all aspects of care delivered by back office staff within the office setting and accountable for the on-going assessment of competency for the clinical staff. Reports to the Site Manager, ensures compliance of policy and procedure, continually does system analysis for improve-ment. Minimum Qualifications: preferred minimum of 4 years of work experience within their scope of practice. Minimum of 2 years in a lead/supervisor capacity. Current California Licensed Vocational Nurse license. Current BLS and I.V. certification competency certificate.
For immediate consideration, please submit your resume via email to
Our reputation for compassionate care and medical excel-lence is built on the work of hundreds of committed physicians, nurses and other members of our health care team. Care to join us? You will enjoy excellent wages and benefits and the satisfaction that comes from more than a job, but working together to help others help heal the mind, body and soul of the lives we touch.
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CHIEF FINANCIAL OFFICER Foster City, Ca
pacific partners Management Services, Inc. is a full-service Management Services Organization (MSO) providing administrative services to single and multi-specialty Ipa’s, Medical groups, aCO’s and Healthcare Delivery Systems.
Our organization has established exciting and strategic cor-porate goals and healthcare initiatives and we are well-posi-tioned for growth in 2013 and beyond.
We have an immediate opening for a full-time Chief Financial Officer to be responsible for all financial mat-ters of the organization. The CFO will report to and work closely with the CeO, in addition, as a key member of the executive Team, will partner with the CeO and Board of Directors to implement policies and strategies across the organization, and to communicate and gain approval of short, and long-term financial plans, as well as present financial reports to the finance committee of the Board and to the Board of Directors. additionally, the CFO will develop, implement, and maintain a strategic financial plan to ensure the financial integrity of the organization and maintenance of required levels of tangible net equity (TNe). This position will also oversee the accounting department to ensure proper maintenance of all account-ing systems and functions.
The effectiveness of the CFO will be measured by his/her ability to work effectively through others, to align people and strategy, and demonstrate sound judgment when tough decisions are necessary. They must also be able to adapt to a continually evolving environment and thrive in a fast-paced, deadline-oriented environment.
the successful candidate must have: Bachelor’s degree in Finance or accounting (MBa or Cpa is strongly pre-ferred). 5-10 years of experience in health care, prefer-ably in physician based organizations or Knox Keene Health plan, with experience in managing risk. 2-5 years management and supervisory experience. Demonstrated knowledge of and reporting requirements for all health care State and Federal regulatory agencies. experience in new business start-up environment is a plus. possesses an executive demeanor, strong qualitative, analytical and financial management skills. a team player with excellent written and verbal communication skills.
We offer competitive salaries, comprehensive benefits & a 401(k)-retirement plan.
For immediate consideration, please e-mail cover letter, CV & salary requirement to:
UCLA Health is home to some of the most technologically advanced hospitals in the world, providing an extraordinary opportunity to practice the kind of health care that every patient deserves. With our extensive resources, world-class training and passion for excellence, every day at UCLA brings new opportunities to be great. We invite you to join us in this key contract management role:
Contracts Manager
You will be responsible for developing and negotiating service contracts. This position involves working with departments and team members to solve problems and meet the challenge of evolving managed care requirements. You will review, analyze and compile data for clinical procedures/treatments, including case frequency, rates and referral points. In collaboration with other Marketing staff, you will evaluate the profitability of clinical services and case types to develop contracts.
This role requires advanced analytical ability and knowledge of the Southern California managed care marketplace. Must have experience with a health care provider organization. Preferred candidates will possess advanced managed care contract negotiation skills, preferably within a hospital, medical group or health plan environment. Experience with capitation contracting and database applications desired. A Bachelor’s degree is preferred.
T H E B E N E F I T S O F B E L O N G I N G Beginning on your first day, you’ll enjoy outstanding benefits, including health, dental and vision plans, a great retirement plan, 13 paid holidays and 15 vacation days. Relocation assistance is available for those who quality.
For more information, please visit www.uclahealthcareers.org or contact Robin Clayton at [email protected]. EOE
Strong leaderShip haS the power to tranSform.
APPLY TODAY AT: UCLAHEALTHCAREERS.ORG
EMERGENCY MEDICAL SERVICES ADMINISTRATOR$102,502 - $128,128 Annually
San Mateo County Health System is seeking an experienced Emergency Medical Services Administrator. Our Emergency Medical Services (EMS) system features centralized dispatch for 911 medical emergencies, a response time performance-based contract for emergency ambulance and paramedic �rst response, supportive and involved emergency department physicians and nurses, excellent air ambulance providers and two Level I trauma centers.
As a member of our leadership team, you will plan, coordinate, organize, direct and implement a large regional County wide EMS System. Responsibilities include developing, implementing and evaluating goals, objectives, policies and procedures related to EMS services, providing leadership and coordination to public and private agencies, advisory boards and volunteers in planning and implementing EMS programs, and communicating with elected o�cials, community groups and the media regarding EMS.
The ideal candidate will have 4 years of experience managing EMS programs, demonstrated skill in making presentations before public agencies; proven ability to negotiate multi-agency contracts for medical services personnel; and knowledge of SEMS, NIMS and ICS.
Recruitment Closing Date: April 18, 2013To learn more about the position and to apply online, please visit our website at www.smcgov.org/hr/jobs. Applications are only accepted online. EOE
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IEHP offers a competitive compensation and benefits package. Please apply on-line or FAX your resume:
inland eMpire HealtH plan, san Bernardino, cafax (909) 890-2929
Business analyst - Quality ManageMent
Requires general knowledge of documenting assessments. ensures the quality of reporting requirements by tracking and monitoring completeness of reports. ability to research and analyze data and make sound recommendations. Strong rela-tionship skills. Minimum of 3 years healthcare experience pre-ferred. experience with delegation oversight activities to Ipas, Health plans, and Hospitals to ensure compliance with state, federal, NCQa, and IeHp requirements favorable. Bachelor’s degree required.
care Manager BeHavioral HealtH lcsW
LCSW required. Minimum 5 years experience in the provision of social services within county agencies. possession of a valid Ca driver’s license. 5 or more years experience in a health care envi-ronment and knowledge of the County Mental Health system. experience working within psychiatric Hospitals and outpatient behavioral health treatment settings. ability to undertake and write up assessments (often with medical staff), which meet specified standards and timescales. Conduct interviews with Members and their families to assess and review their situation; assess crisis intervention needs. Skillful at offering informa-tion and counseling support to Members and their families. Knowledge of community resources and health plan benefits. Clinical knowledge of how mental disorders and psychosocial stressors can impact health conditions. Clinical assessment skills to review treatment plans.
care ManageMent nurse Manager
Valid RN license issued by the State of Ca required. possession of a valid Ca driver’s license. Bachelor’s degree in related field. Significant relevant experience (beyond required experience) may be substituted for education requirement. 3 or more years of utilization management/case management in a health care delivery setting. experience in HMO or managed care setting preferred. 3 years or more of supervisory experience required. Thorough knowledge of state and federal requirements includ-ing CMS, DHCS, DMHC and NCQa standards. Knowledge of Medi-Cal, Healthy Kids, and Medicare managed care. effective written and oral communication skills: ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors.
ccs care Manager rn
Valid RN license issued by the State of Ca required. possession of a valid Ca driver’s license. 1 or more years of case management experience in a health care delivery set-ting. experience with California Children’s Services (CCS), in an HMO or experience in Managed Care setting preferred.
contract Manager
The Contract Manager is responsible for ensuring the adequacy of IeHp’s provider network by developing and maintaining the network in his/her assigned geographic region. This responsibil-ity will be accomplished by negotiating, managing and evaluating contractual relationships with physicians, ancillary providers and hospitals. Contract negotiation experience is required. 1 year experience negotiating contracts in managed care is preferred. analytical skills with emphasis on time management, financial analysis, and problem solving. Microcomputer applications for use in all aspects of an office environment. Bachelor’s degree required. possession of a valid Ca driver’s license.
HealtHcare financial analyst
This position directs and provides analyses by extracting and summarizing a wide variety of data, and makes recommenda-tions. The incumbent is self-directed, has the ability to manage multiple tasks in a timely manner, provides in depth knowledge of current health care payment methodology used by MediCaid, Medicare and Commercial. This position also develops math-ematical model templates to formulate conclusions and rec-ommendations from a cost and quality perspective; prepares ad hoc analysis as needed. 5 years of experience in healthcare analysis preferred. Strong oral and written communication skills required. proficiency in Microsoft software applications such as Word, powerpoint, excel, access; experience with formula, pivot tables, and advanced features. Knowledge of Healthcare payment methodology such as RVRBS, DRg, apR_DRg, eapg, CpT Codes and apC. Bachelor’s degree required.
BeHavioral HealtH care ManageMent Manager
The Behavioral Health Care Manager is responsible for the development and implementation of the Behavioral Health services, processes and policies. Responsible for managing staff assigned to the Behavioral Health section of the Medical Services Department. Responsible for oversight of the day-to-day clinical triage and referral of members needing Behavioral Health care and level of care decisions in accordance with established clinical guidelines. possession of Master’s or Doctoral degree, LCSW or licensed psychologist in the State of Ca, and valid Ca driver’s license required. 3 years of supervi-sion/management experience. 5 years experience in the provi-sion of social services within county agencies. experience in an HMO or experience in managed care setting preferred.
Inland Empire Health Plan (IEHP) is one of the largest not-for-profit health plans in California. We serve over 580,000 members in Riverside and San Bernardino counties in Medi-Cal, Healthy Kids and a Medicare Special Needs Plan. Our success is attributable to our Team who share the IEHP mission to organize the delivery of quality healthcare services to our members. Join our dedicated Team!
please visit our website at www.iehp.org to get more information on our relocation to rancho cucamonga. EOE
to place a listing, please call 888/834-4678
For subscription services, call 800/753-0131
f e a t u r e d c a r e e r o p p o r t u n i t i e s
page 9 of 11april 1, 2013
coMpliance specialist (MultIPlE OPEnIngs) Requisition # 12-918
actuarial analyst Requisition # 12-973
HealtHcare researcHer, researcH & analysis Requisition # 12-916
HealtHcare services data analyst Requisition # 12-940
clinical pHarMacist Requisition # 12-957
inpatient rn case Manager, nepHrology Requisition # 13-989
encounter data specialist – tecHnical Requisition # 13-1029
Quality/5 star initiative developer Requisition # 13-1057
For more information about these and other exciting career opportunities, visit the jobs page of our website at
www.scanhealthplan.com/about-scan/resources/job-postings
CONTRACTS MANAGER - Los angeles, Ca
The Contracts Manager is responsible for negotiating, manag-ing and evaluating contractual relationships with health plans, medical groups / Ipa’s hospitals/health care systems, government programs and other payors, as assigned. Serves as back up to Director for Centers of excellence transplant programs contract-ing. In conjunction with Decision Support analyst, develops pricing packages for hospital programs. Reviews contract language for operational impact and to ensure compliance with JCaHO and other regulatory agencies. Must have ability to develop contrac-tual language, as needed. Co-manages Senior Contract Specialist on a daily basis. assists Director and associate Vice president in the development and implementation of department operational goals and on various special initiatives.
Qualifications: Master’s Degree in Business, Health administration, or other related field preferred. Minimum 6 years contracting or relevant health care experience required. prior management experience preferred.
Please send resumes to Claudia Mares [email protected], or call 323-361-7693.
New Century Health is a leading innovator of specialty care management programs for oncology and cardiology. We are cur-rently seeking candidates for the following career opportunities:
ü crM developer
ü peer revieWer – Md
ü utilization revieW nurse
ü intake coordinator
ü sr. director of netWork operations
ü staff accountant
ü oncology pHarMacist
ü director, oncology pHarMacy ManageMent
Please submit resumes to [email protected]
www.newcenturyhealth.com/Careers.html
senior Marketing coMMunications specialist
Manage the creation of complex marketing and health education collateral for the benefit of current and prospective members, physicians/providers and stakeholders. Responsible for coordinat-ing projects through the entire development process from creative, writing, translations, editing, proofreading, layout (within established branding guidelines) including the successful hand-off for production and fulfillment. plan human and financial resources, anticipate con-straints, identify project milestones, budgets/estimates and sched-ules, and communicate this information to stakeholders efficiently and effectively to gain buy-in and the best possible work product. all efforts should be executed within established organizational and departmental guidelines for product line development and mainte-nance, communications and marketing objectives, cultural and lin-guistic standards, readability, language and regulatory requirements. Key to this role are a related degree and project management experi-ence in a marketing or communication collateral development role, with different targets, including experience developing non-english pieces. Strong written & verbal communication skills are essential; healthcare marketing experience is strongly preferred.
For complete job description, qualifications/requirements, and addi-tional opportunities, visit our website: www.lacare.org. To apply, email resume to [email protected], referencing “Healthfax ad”.
TAKE YOUR CAREER SUCCESS
TO THE NEXT LEVEL!
to place a listing, please call 888/834-4678
For subscription services, call 800/753-0131
f e a t u r e d c a r e e r o p p o r t u n i t i e s
page 10 of 11april 1, 2013
Inland Empire Health Plan (IEHP) is one of the largest not-for-prof-it health plans in California. We serve over 580,000 members in Riverside and San Bernardino counties in Medi-Cal, Healthy
Kids and a Medicare Special Needs Plan. Our success is attributable to our Team who share the IEHP mission to organize the delivery of quality healthcare services to our members. Join our dedicated Team!
COMMUNICATIONS WRITER - (MaRKeTINg)
4 years experience (3-5 years) in writing directly to the consumer, formulating copy/editing in the following indus-tries: Hospital, Health plan, advertising, Health Care, public Relations, or other relevant industries. Knowledge of Microsoft Office Suite and adobe InDesign, CS5, pC and MaC. Responsible for gathering all information required to write directly to the consumer including IeHp members, providers, partners, general community, and to internal staff. provide strategic support for IeHp’s communications and public rela-tions initiatives. Responsible for project management from the first stage of creative development to project completion. Develop material requested, work with applicable depart-ments to develop the strategic/ creative criteria, work with the graphic designers and coordinators. Bachelor’s degree required.
MARKETING & COMMUNICATIONS MANAGER - (MaRKeTINg)
The Marketing and Communications Manager is respon-sible for the oversight and development of IeHp’s advertising, member and provider materials. Includes leading a creative team: setting strategic direction for the development of cre-ative materials; managing the creative development and pro-duction process; and providing overall project management. Supports the Director of Marketing to develop and drive the marketing plans for IeHp’s products including Medi-Cal, Medicare, and Healthy Kids. Overseeing the translation pro-cess, managing advertising media placement, and purchasing activities for marketing collaterals. 3 or more years in market-ing and communications, copywriting and creative develop-ment preferred. Must possess strong knowledge of marketing and communications in the managed care industry; editing the content and design of creative materials; detail oriented with strong project management skills. Intermediate knowl-edge and experience with adobe Creative Suite applications (Illustrator, photoshop, InDesign, acrobat, etc.) preferred. Bachelor’s degree required.
IEHP offers a competitive compensation and benefits package. Please apply on-line or FAX your resume:
inland eMpire HealtH plan, san Bernardino, cafax (909) 890-2929
Please Visit our website at www.iehp.org to get more information on our relocation to Rancho Cucamonga. EOE.
contact Bill clattenBurg: pHone: 888/834-4678
fax: 781/639-0529
You’re in Good Company When You Advertise in California Healthfax!
Place your ad today!
to place a listing, please call 888/834-4678
For subscription services, call 800/753-0131
e M p l o y M e n t o p p o r t u n i t i e s
page 11 of 11april 1, 2013
case Manager
MeD3OOO, a health care management company in Oxnard, is seeking an office based Case Manager to meet the needs of our Health Services Department. The Case Manager is responsible for coordinating a team based approach to manage patient care. This position works closely with the hospitals, providers and internal staff to evaluate, monitor and assure appropriate utilization man-agement and care for members. This position is an office based position in our Oxnard office.
aco case Manager
Responsible for the coordination of services for patients with med-ically complex conditions, including behavioral health. Coordinate the ambulatory care needs in conjunction with the primary care physician and/or specialist. Refer the member to appropriate health plan sponsored programs based on diagnosis. Be a resource to both member and provider in regards to care coordination.
REQuIREMEnts FOR BOtH POsItIOns InCluDE: Ca Licensed Registered Nurse or LVN required. Minimum of 3 years experi-ence in a managed care setting and / or clinical experience. Strong communication skills. ability to handle difficult situations and people. ability to interface professionally with physicians, hospital staff, health plan and patients.
MeD3OOO offers a comprehensive benefits package includ-ing health, dental, vision, long-term disability, 401(k), FSa’s, holiday pay and paid Time Off. email resume to [email protected] for consideration.
to promote your organization’s events,
products, or services contact Bill Clattenburg:
PHONE: 888-834-4678 | FAX: 781-639-0529
E-mAiL: [email protected]
Read By Top Healthcare Management Professionals
Rate card and special offers ARE available!
utilization revieW nurse
Seeking a LVN/RN with strong clinical and interpersonal skills to review authorization requests for medical appropriate-ness and correct vendors. Responsibilities include Liaison with designated Medical Director for complex authorization requests. Functions as clinical resource for benefit interpreta-tion. Researches complicated cases. Screens for CCS diagno-sis and refers appropriately, Ca License, RN or LVN. Minimum of 3 years utilization management experience in an Ipa, Medical group, or Health plan environment with knowledge of Milliman or Interqual guidelines and computer literate.
Qualified candidates please send resume to: [email protected].
clinical pHarMacist
Responsible for leading research, development and main-tenance of clinical pharmacy programs such as: clinical ini-tiatives impacting drug utilization, clinical education and staff development, management of appropriate drug utiliza-tion, drug spend analysis, and quality improvement activities related to pharmaceuticals. Will assist with oversight of daily operations by ensuring regulatory compliance, interfacing with the pharmacy Benefit Management (pBM) on the coverage determination process, reviewing pharmacy appeals/griev-ances, claims, and formulary maintenance. This role requires a thorough comprehension of Medi-Cal and Medicare part D rules and regulations, to serve as a resource for L.a. Care, on the pharmacy programs, and will interface with internal and external stakeholders. also responsible for participating in care management, as a member of the Interdisciplinary Team and will perform medication assessments for members at risk and Medication Therapy Management participants. additionally responsible for leading new clinical initiatives to improve the health of our members. Responsibilities will also entail interfacing with physicians, nurses, internal employees, pBM representatives and supervising pharmacy technicians, as needed. Key to success in this role is managed care experi-ence. Bilingual Spanish/english is a plus.
For complete job description, qualifications/requirements, visit our website: www.lacare.org
To apply, email resume to [email protected], referencing “Healthfax ad”
We’re growing again! Join us and make a difference in your community & career!
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