Careers at New Century Health

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 - Oncology

Department:   Utilization Review

Location:       Brea, CA or 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: Utilization Review Nurse - Cardiology

Department:   Utilization Review

Location:       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.

Job Title: Network Operations Representative

Department:     Network Operations

Location:         Miramar, FL

Reports To:      Manager, Network Operations

Status:             Exempt

Work Hours:    Full-time

Job Duties: The Network Operations Representative will be responsible for provider contracting and maintaining positive working relationships with all participating providers. Serves as the liaison between provider and New Century Health’s internal departments to address and resolve issues, as needed. Conducts provider in-servicing which provides a clear interpretation of organization’s policies and procedures related to various administrative/operations functions and will provide continuous provider education to all network providers.

Qualifications: Bachelor’s degree or 3 plus years’ experience in healthcare with strong emphasis in Provider Relations and/or Network Development. Must have strong knowledge of managed care terminology; broad knowledge of delivery systems and related industry terms. The candidate must have excellent verbal, writing, presentation skills and interpersonal skills. Extremely organized and detail oriented with exceptional follow through skills. Ability to multi-task in a fast pace environment; can adapt quickly to change; have strong negotiations skills. Must have the ability to conduct physician in-servicing (training sessions) and excellent relationship building skills. Must have knowledge of Microsoft programs (i.e. Word, Excel). Able to travel as needed. Bilingual English/Spanish preferred.

Job Title: Claims Coordinator

Department:     Claims

Location:         Brea, CA

Reports To:      Supervisor, Claims

Status:             Non-Exempt

Work Hours:    Full-time

Job Duties: The Claims Coordinator will review claims and reports to ensure accurate adjudication and proper coding and correct payment of claims. Briefly state the primary duties and responsibilities of this position. Reviews claims to make sure that billing requirement are met, updates accounts as necessary, and answers inquiries regarding claims status or denial. Will process clean claims and investigates problem claims. Resolves discrepancies and incorrect coding or billing on claims received. Reviews estimated utilization review medical records from all specialties. Answer Provider phone calls in regards to claims status and eligibility. Respect and maintain HIPAA confidentiality guidelines .

Qualifications: Bachelor’s degree in a related filed, or, one or two years’ experience in the healthcare filed, or, any similar combination of education and experience. Certificate in coding or related to health claims specialties (CCS, CCS or CCS-P). Experience in medical billing, previous employment in the insurance industry or in a healthcare facility is also preferred.

Job Title: Site Support Engineer

Department:     IT

Location:         Brea, CA

Reports To:      Director, IT Infrastructure

Status:             Non-Exempt

Work Hours:    Full-time

Job Duties: The Site Support Engineer will be responsible for the providing technical assistance to computer system users both local and remote. Answer questions or resolve computer problems for users in person, by phone or by remote access to the system. Install, configure and support all computer hardware, software and peripherals such as scanners, fax machines, printers and ShoreTel phones in the location and remote. Provide assistance to the Infrastructure Engineer in troubleshooting network issues as it relates to the end users.

Qualifications: Preferred BA or BS degree in related field or equivalent work-life experience; three to five years technical experience with Windows operating systems, computer hardware, application support, Microsoft Exchange, Active Directory and wireless networks. Proficient with all Microsoft office applications. Knowledge of assessing customer needs, evaluating customer satisfaction, analyzing information and evaluating results to choose the best solution and solve problems. Requires being reliable, responsible, dependable, and fulfilling obligations. Requires attention to detail and thoroughness in completing work tasks, analyzing information and using logic to address work-related issues. Must be able to administrate and support Active Directory Services, mail and other application servers in a Microsoft environment. Knowledge of computers, servers, storage systems and computer related equipment. Experience supporting ShoreTel VoIP applications and systems. Ability to interact with people of diverse backgrounds.

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