If you are interested in applying for any of the open job positions listed below, please forward a resume to careers@newcenturyhealth.com. Please submit only one (1) resume per position.
Job Title: Managed Care Attorney and Compliance Advisor
Department: Compliance
Location: Boston, MA
Reports to: Chief Executive Officer
Status: Exempt
Work Hours: Full Time
Job Duties: The Managed Care Attorney and Compliance Advisor will focuses on providing counsel on contracting and regulatory matters. The successful candidate will be responsible for understanding and interpreting utilization review and health insurance laws and regulations. Other responsibilities include drafting and reviewing company policies and procedures, and preparation and negotiation of contracts and other legal documents. Will provide legal and compliance advice regarding complex and routine managed care/ insurance operations as well as regulatory matters.
Qualifications: 3-5 five years' health insurance legal and regulatory experience, or similar Juris Doctor from ABA accredited law school; Active membership in a state bar association; Strong legal writing, research and analytical skills; Strong written and verbal communication skills; Ability to work collaboratively and under general supervision of senior legal and compliance resources.
Job Title: Peer Reviewer
Department: UM
Location: Brea, CA
Reports to: Chief Medical Officer
Status: Exempt
Work Hours: Full Time
Job Duties: Peer Reviewer performs utilization management services under the purview of the Chief Medical Officer (CMO) of New Century Health. The Peer Reviewer is responsible for communicating with ordering physicians toward resolution of medical necessity organization determinations.
Qualifications: Current Medical license, with continuing education credits. Minimum of 5 years’ experience in practice, knowledge of regulatory requirements.
License/Certification:: Active license to practice medicine with no restrictions; Board Certified. Strong clinical, time management, and organizational skills; excellent communication skills. Must be available on call as scheduled. Computer literacy and willingness to learn and effectively use UM software.
Job Title: Utilization Review Nurse
Department: Utilization Review
Location: Brea, CA and Miramar, FL
Reports to: Director, Utilization Management
Status: Exempt
Work Hours: Full Time
Job Duties: The UR Nurse is involved with every aspect of the utilization process to include: referrals, case preparation for medical review, claims review, request and review medical records. This position plays a pivotal role in the clinical management of the New Century Health’s Utilization Management programs.
Qualifications: Unrestricted Registered Nurse, LPN or LVN license required for the state of employment. Two to four years UM experience preferred as well as 2 – 3 years in an inpatient or outpatient setting a must. Specialty certification preferred. Ability to review medical records and identify codes for claims processing, preferred
Job Title: Oncology Clinical Informatics/Pharmacoeconomic Specialist
Department: Utilization Management
Location: Brea, CA
Reports to: Medical Director
Status: Exempt
Work Hours: Full Time
Job Duties: The Oncology Clinical Informatics/Pharmacoeconomic Specialist is responsible for evaluating and measuring activities associated with the care of cancer patients. New Century Health is the business of managing healthcare quality and cost using hematologic and oncologic therapeutic management. .
Qualifications: Must be licensed as a pharmacist in the State of California or state of work. Must have completed the required number of continuing education credits and be in good standing with the State Board of Pharmacy. Preferred a Doctor of Pharmacy degree; a minimum of internship, residency, and/or fellowship training. Must have demonstrated expertise with a minimum of two years relevant experience. Structured and well organized with excellent work ethic. Functions well in a team atmosphere. Knowledge of clinical medicine, outcomes research, disease management, and clinical/translational research. Working knowledge of treatment guidelines, and clinical research processes. Ability to organize, prioritize, and maintain high quality work output in a high paced dynamic environment. Proficiency with Microsoft Office Suite (Word, PowerPoint, Excel). Excellent writing skills as well as the ability to communicate complex material in presentations and discussions in a straightforward manner. Ability to network and partner with key external customers, including pharmaceutical companies, medical thought leaders, academic institutions, large group practices, medical directors and pharmacy directors.
Job Title: Intake Coordinator (Several Positions)
Department: Utilization Review
Location: Brea, CA
Reports To: Intake Coordinator Supervisor
Status: Non Exempt
Work Hours: Full-time
Job Duties: The Intake Coordinator is a Licensed Pharmacy Technician responsible for all documentation and initial processing of a telephonic medication authorization request. For medication safety, the oncology Intake Coordinator calculates and documents minimum and maximum allowable drug dosing for all chemotherapies ordered. These professionals, based on client contractual agreements, are responsible for the coordination of medication delivery to providers.
Qualifications: Requires a High School diploma or GED equivalent, with completion of an accredited pharmacy technician program, and current state clinical license. One year experience in a pharmacy or prior authorization environment, preferred. Must be self-motivated and be able to perform multiple tasks efficiently and accurately, follow verbal and written instructions, must pay close attention to detail and be able to work in a fast-paced environment, demonstrate excellent problem solving and critical thinking skills, have experience using office equipment – e.g. computer, fax, copier, scanner, etc, and ability to work individually as well as with others as part of a team.
Job Title: Sr. Director of Network Operations
Department: Network Operations
Location: Miramar, FL
Reports To: VP of Network Operations
Status: Exempt
Work Hours: Full-time
Job Duties: The Sr. Director of Network Operations will be responsible for management of the Network Operations department. Directs all activities associated with the Network Operations team including but not limited to network development, provider contacting, in servicing/educating providers, trend analysis and on-going provider support.
Qualifications: Bachelor’s degree in business, healthcare or related field, or equivalent experience; and a minimum of 10 plus years experience working in a Provider Relations/Network Development environment. Excellent oral and written communication skills. Effective presentation skills. Strong customer service and analytical skills. Ability to analyze and resolve complex issues, both logical and interpersonal. Ability to negotiate and defuse conflict. Self-motivator, independent, cooperative, flexible, creative. Ability to lead people and get results through others. Must be able to foster a positive and productive work environment with ability to build teams and motivate staff. Ability to organize and manage multiple priorities.
Job Title: Programmer (Microsoft CRM)
Department: IT - Development
Location: Brea, CA
Reports To: Director, Development
Status: Exempt
Work Hours: Full-time
Job Duties: The CRM Programmer participates and contributes to the planning, designing, and implementing of new systems or changes in existing data processing systems to support management control and decision-making activities. Participates in program design and architecture where needed.
Qualifications: Bachelor's degree in Computer Science, Math, Physics, or Engineering, or equivalent work experience; a minimum of 2 years development programming experience, data processing, software development or a similar field. Requires experience with a variety of software development methodologies. Comprehensive understanding of object-oriented programming design and analysis, UML, SQL, HTML and JavaScript. 2 years’ experience in developing and configuring Microsoft Dynamics CRM 4 or 2011. Understanding of CRM architecture and design principles. Strong problem solving and communication skills. Attention to detail and emphasis on quality and accuracy. Excellent oral and written communication skills. Working knowledge of designing techniques for computerized programming systems. Knowledge of modern principles and practices of program application and design. Comprehensive understanding of current development tools/version control systems.
Join Our Team
New Century Health is rapidly growing and is consistently looking for great people to fill positions. External candidates can apply to any open position by submitting a resume to careers@newcenturyhealth.com or complete and Employment Application and submit to Human Resources.
Internal employees wishing to apply for any open position can complete and Internal Job Application and submit it to Human Resources. Please refer all questions regarding open positions to Human Resources.
New Century Health is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, gender, religion, age, national origin, marital status, veteran status, sexual orientation, disability or any other basis protected by law. The employment relationship between New Century Health and the employee is on an "at-will" basis.
You may submit your completed application to careers@newcenturyhealth.com
For the employment application, click here
