Bluemountain and Daughters of Charity Complete Affiliation Deal

December 21, 2015 | VOLUME 22 | NUMBER 48

TOP STORIES

To our Readers and Advertisers BlueMountain and Daughters of California HealthFax will not publish on Monday, December 28, in observance of Charity Complete Affiliation Deal Christmas Day. Publication will resume on Monday, January 4. We hope you have a Daughters of Charity renamed Verity Health System Merry Christmas and a great holiday season. BlueMountain Capital Management and the Daughters of Charity Health System (DCHS) completed their affiliation deal under conditions required by state attorney general Kamala Harris. The New York City–based hedge fund and Los Altos–based DCHS finalized Published Monday, California Healthfax is their partnership on Dec 14. Under terms of the deal, DCHS has been renamed copyrighted by HealthLeaders Media, a division of BLR, 75 Sylvan St., Suite A-101, Danvers, Verity Health System. BlueMountain has pledged to invest up to $260 million MA 01923, and is transmitted solely to the sub- to fund capital improvements and debt reduction for Verity and can exercise an scriber. Any unauthorized copying, duplication or option to buy the health system after three years. transmission is strictly prohibited. Subscriptions “We thank Attorney General Harris for approving this transaction,” said for- are $179 for 48 issues. For group and bulk subscriptions, call 800-650-6787. mer DCHS president and CEO Robert Issai, who has stepped down as CEO. “This large infusion of capital will provide a great jump-start on the many strategic, CUSTOMER SERVICE CENTER operational, and capital initiatives desperately needed at our hospitals.” E-mail Subscribers: If you do A division of BlueMountain called Integrity Health took over day-to-day not receive your copy of HealthFax, operations on December 14. Integrity Health is headed by new CEO Mitchell send a request to: [email protected]. For renewals or other subscription questions, Creem, who has 33 years of experience in the California healthcare industry that please call: 800-650-6787. By fax: 866-592-7573. includes executive posts at Keck Hospital of USC and the UCLA Health System. By e-mail: [email protected]. Integrity Health said it will honor all existing labor agreements at DCHS and pre- serve the pensions of the health system’s more than 17,000 employees. The hospi- EDITORIAL SUBMISSIONS To submit an item for consideration, con- tals will no longer have a Catholic affiliation but Verity Health will remain a not-for- tact Doug Desjardins, Editor. By e-mail: profit health system and be governed by an independent board of directors. [email protected]. By phone: 760-696-3931. “Verity will proudly continue the mission of care begun by Daughters of For other questions, contact Bob Wertz, Managing Charity more than 150 years ago,” said Creem, adding that Verity “will expand and Editor. By phone: 800-639-7477, ext. 3456. create new clinical programs” for its hospitals. The name change is already in place By e-mail: [email protected] at the health system’s website. Verity Health System includes 384-bed St. Francis Medical Center in ADVERTISING OPPORTUNITIES Lynwood; 366-bed St. Vincent Medical Center in Los Angeles; 358-bed O’Connor To advertise in California Healthfax, please contact Susan by Hospital in San Jose; 357-bed Seton Medical Center in Daly City; 93-bed Saint e-mail: [email protected]. Louise Regional Hospital in Gilroy, and 116-bed Seton Coastside in Moss Beach. By phone: 978-624-4594.

« CONTINUED ON PAGE 2 » TO SEE ADDITIONAL JOB OPPORTUNITIES SEARCH NOW — please visit CA Jobs online at — PAGE 2 WWW.HEALTHLEADERSMEDIA.COM/CALIFORNIA-JOBS For subscription services, call 800-753-0131 December 21, 2015

IN BRIEF TOP STORIES CONTINUED FROM PAGE 1 BlueMountain And Daughters cont. °°Kaiser Permanente plans to build a medical school in Southern California Harris approved the affiliation deal on December 3 contingent on a list of with a projected opening date in 2019. conditions that includes keeping St. Vincent Medical Center open with all existing According to a Dec. 17 report in the Los services for at least five years and all other hospitals open for at least 10 years. Angeles Times, Kaiser has not selected During that time, the hospitals must maintain current levels of charity care and a site for the medical school campus or honor all existing Medi-Cal contracts. “This approval includes strong conditions that will maintain the charitable determined how large it will be. Kaiser purpose of the Daughters of Charity Health System, ensuring that low-income Permanente chairman and chief execu- Californians will continue to have access to critical healthcare services, includ- tive Bernard Tyson said the medical ing emergency, trauma, surgical, and reproductive health services,” Harris said school will allow Kaiser to train physi- in a statement. cians its own way. “We have the oppor- DCHS was in poor financial shape and losing up to $10 million per month in tunity to help train future physicians on 2014 when it began exploring a merger or affiliation with a larger partner. The 21st century medicine and be on the health system attributed its financial woes in part to a patient mix made up largely cutting edge of all the changes we are of Medicare and Medicaid beneficiaries and a high percentage of uninsured experiencing,” said Tyson. “Our model patients. It explored a merger with Ascension Health but began looking else- of care is best for current and future where in late 2014 when those merger talks fell apart. diverse populations in this country.” DCHS signed a deal with Prime Healthcare Services in late 2014 but the deal fell through in March 2015 when Prime chose not to pursue the acquisition. °°Beverly Hospital in Los Angeles Prime cited the attorney general’s mandate that Prime keep five DCHS hospitals secured a $39.7 million bond from the open for at least 10 years as a deal-breaker. But patient advocates said that condi- California Statewide Communities tion is essential to ensuring continued access to care for residents in communities Development Authority. Beverly served by DCHS. “We think it’s appropriate for the attorney general to impose similar condi- Hospital CEO Alice Cheng said the tions on this deal as she did on the previous proposal to sell to Prime Healthcare,” bond will be used to reduce debt and said Tam Ma, policy counsel for patient advocacy group Health Access fund capital improvements for the hos- California.—DOUG DESJARDINS pital. “This is a significant milestone in the history of Beverly Hospital as well as a pledge to our patients and Nurse at Santa Clara Valley Medical the communities we serve,” said Cheng. “The bond will allow us to expand our Center Diagnosed With Tuberculosis key services, including our emergency department and maternity unit, and More than 1,000 people potentially exposed will allow us to continue our mission Santa Clara Valley Medical Center officials said more than 1,000 people may as an independent, nonprofit hospi- have been exposed to tuberculosis in the maternity ward of the hospital by a nurse tal for many years to come.” Officials who was diagnosed with the disease in mid-November. for the 247-bed hospital say plans call Hospital officials estimate that 1,026 people may have been exposed during for spending $36.7 million on capital a two-month period. They include 350 infants, 368 parents, and 308 employees. improvements through fiscal 2018. Santa Clara Valley officials said they are contacting all staff members, patients, and visitors who may have been exposed during the period. A spokesperson for « CONTINUED ON PAGE 3 » « CONTINUED ON PAGE 3 » HIRE POWER: HEALTHFAX CLASSIFIED ADS WORK! PAGE 3 CALL 978-624-4594 For subscription services, call 800-753-0131 December 21, 2015

TOP STORIES CONTINUED FROM PAGE 2 IN BRIEFContinued from page 2 Nurse at Santa Clara cont. °°Kaiser Foundation Hospital in Vallejo was fined nearly $150,000 for Santa Clara said “the vast majority” of potentially affected visitors and parents have problems related to its disposal of nee- been contacted but that the hospital is “still working on outreach” with others. As of dles. According to a report in the San December 17, no new cases of tuberculosis have been linked to the hospital. Jose Mercury News, the state Division Stephen Harris, MD, the chair of pediatrics at Santa Clara Valley, said of Occupational Safety and Health infants potentially exposed to tuberculosis are being monitored for the disease and conducted an investigation that found treated with isoniazid on a daily basis. Isoniazid is an antibiotic that kills tuberculo- Kaiser did not properly maintain a needle collection box and that at least three sis and can prevent infants from becoming ill. Santa Clara officials said that while custodial employees at the hospital it’s “very unlikely that infants who may have been exposed will come down with were stuck by needles as a result. Since the disease,” the hospital must take every precaution. the inspection, Kaiser has replaced the “While the risk of infection is low, the consequences of tuberculosis in infants needle disposal box with two larger can be severe,” said Harris. “That’s why we decided to do widespread testing and units and requires them to be monitored start preventative treatment for these infants as soon as possible.” In infants every 30 minutes. whose immune systems are not fully developed, tuberculosis can spread from the lungs to other parts of the body. In older children and adults, it can be serious but °°The Petaluma Health Care District tends to stay confined to the respiratory system. Santa Clara officials said mothers this month launched a series of pub- and infants in the hospital’s Mother Infant Care Center may have been exposed lic hearings to help it select a com- from mid-August through mid-November. pany to manage Petaluma Valley The nurse diagnosed with tuberculosis was placed on leave in November Hospital starting in 2017. According after her diagnosis. The nurse tested negative for tuberculosis in an annual test to a December 3 report in The Press in September 2015 but the disease was later discovered by the nurse’s physician Democrat, the Petaluma Health Care District board conducted its first pub- during evaluation for an unrelated medical condition. Hospital officials said all lic hearing on December 2 and will employees “undergo rigorous annual tuberculosis screening” in keeping with best hold three more in the coming months. practice guidelines. The board is considering bids from Tuberculosis can be spread through the air when an infected person coughs or four candidates that want to operate sneezes and only a person with an active case can spread the disease. Sara Cody, Petaluma Hospital once its current man- MD, public health officer for Santa Clara County, said tuberculosis is no longer agement agreement ends in 2017. The common but that the disease is still active. candidates are Sutter Health, Prime “This incident is an unfortunate reminder that TB remains an ongoing health Healthcare Services, Strategic Global concern for our community,” said Cody. “The CDPH is working closely with our Management, and St. Joseph Health, Santa Clara Valley Medical Center colleagues to support their efforts in addressing which is currently managing Petaluma the needs of their patients and staff.” Valley Hospital. “We need to have a According to the California Department of Public Health (CDPH), discussion with the public to deter- there were 2,191 cases of tuberculosis reported in California in 2012, the mine what’s best for Petaluma,” said most recent year when data was available. The CDPH report found that 79% Petaluma Health Care District board of all cases were among people born outside of the U.S. headed by people member Robert Ostroff. born in Mexico (491 cases) followed by the Philippines (376 cases), and « CONTINUED ON PAGE 4 » Vietnam (129 cases).—DOUG DESJARDINS T O P S B T O lue R I t Shi E S Published o R eld copyrighted Insur e ever v o y o to Ap f BLR, Mo er sa k M by nda Blue Shield of Californiae A 75 HealthLeadery, C s 019 Sy alifo ys appealsN pr p criber 23 lvan rn ex o ea , an St., ia em t tra . An d i s He p - nsmi y s tra Suite Media, alt t s f l St scriptionssion unauthori ns hfa tatus in Cali o mitted A-101Sing a upx ais cooegueT forhe ruling a free four r- tion is z divi Shield ocess couldP tak a s s are strictly ed solely , Dan sio r te D , call $ copyi week trialn to Californiao t Healthfaxfornia aplans o 8 17 prohibited.n to vers f corpoo p b fit S 00 9. F g, the , ay y the to appeal a PAGE 4 ec -650 or duplicatio s decisio millio s -6 group ub- rat FREECalifornia TRIAL a nFranchise Tax Board i 787 WWW.HEALTHLEADERSMEDIA.COM Annual e communins ot- t si . and n o tw n. “ o fo December 21, 2015a o For subscription services, call 800-753-0131CUSTOMER SERVICE bulk r o W f dollars i r-p sta e t t n sub t years e h ro te de w u E-mail subs - eam firm beli av ca fit i c o y s crip to de e filed atio p n r nsu isio S - commu ns et r n ears For recei ub cide Steve Shivinskyroacti er. to renewals v scr n e ,” said rot res e your iber CENTER ity ves it is fulfilling eits n ve cind its t c s Shivi . 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By co the time. T ta forms hield to th t ert : 8 t Bob : 76More0- e-mail nthan- 54,000 peoplete auditenroll tha in two-dayB exceeds period 45%S an ’ e z@healthleader00 696 t ax Boar t lue Shield pla hiv s s December 14 report in the Sacramento-63 Wert : o 2 t o the in tatus i 9-7477, z, -3931 013 he decisioned the will in oalsof a li sr sky Ma . . t led td declinedfede t . “B n th Bee, a group called Transparents ext.Coverednagi California last week extendedt theo enrollment deadliner by two days forlue e ADV media ng the y While s orma f companies tha al t ns in thenuall S ER .co 3456 o its decision issuedax in A y hiel California said many publicT ISemployee mconsumers. whoears, want the tot actiona enroll tak for coveragetion effectiveon its w Januaryo comment 1 andcode avoid on app the a ruling 2016 …” or d ING nonpr te and f U.S. Blu O o equir lo e salaries are under-reported becausePPO penalty forto beingBlue Shield,”fit uninsured. health said insu Gerr eder t had their ta rov st thei p RTUN e Blue Shieldebsit t ed i they don’t include things suchle aseas paid CoveredFielding California School of said Public more Health althan l aand 22,000 dir consumers signed up for coveragen 1 on r s u s a n p @ hcont c p C a ITI en againws e but did no 986 l i f ES s r ugus . act o rDecemberPolicy 14 Researchand more. than er32,000 tha enrolledegar on December 15, pushingx-e totalt 2enroll- health insurance, pensions, and other Susan n i a ding no o file ta xemp 01 t has beent Blue s Shield is unusual. “I am not comment on it 4.a T benefits. “Government salaries arer o . c o mentby to date to more than 197,000.ald K That prompted officials to pushx r the Decembert sta he15 m but thKomins t-f e tus . ominski, a pr or-pr turns da often misreported in the news,” said deadlinethe forat enrolling it ki said for coverage effective trippedJanuary o 1 to Decemberofits ha 17. F ’s mo ting b t Robert Fellner, research director “Thera interestnc we’veBlue seen over the past ofew daysf its ista furtherv proofe changed of theo con- his re li S fessor o ack e Ta kely hield has the o ect x-e for Transparent California. “Base pay tinued demand thatx B Californians to have for quality,or o affordablef health policyxem healthp a t aw coverage,” said oa neg f the ver is often reported when that is often Covered California executiverd decision directoroti Peter Lee. “We want to tmake sta surear that ate a s ption tus priore o f an only half of actual pay.” Some of the everyone who is working to getf in thee door ohas the time they needt the to get they cover- ails ttlementf cwitho top salaries include $329,023 for the . “I imagine th nverti age they deserve.” ng s to a chief physician of Placer County and The Healthcare.gov federal exchange anda othertate statefo exchanges also extend- t Blue o¢ r-pro $302,562 for the mental health servic- S cial fit i ed their deadlines to accommodate the late flurry of activity.hield wills if tr“We’re it nsu following the es medical director of El Dorado County. lead of Healthcare.gov with this two-day extension,” said Covereds appeal Californiare r infor- y t o reac of mation officer James Scullary. h °°Dignity Health said it will limit its Historically, Covered California has been flooded with last-minute insurance investments in thermal coal companies shoppers whenever a deadline for coverage nears. “It’s been this way since we and focus more on investments that opened the exchange,” said Scullary. “We always advise people not to wait until the address climate change. Dignity Health last minute but we always get people who wait until the last minute.” also said it will increase its use of renew- The surge in enrollment is good news for Covered California, which had been able energy to 35% of total energy con- running below projected enrollment of 295,000 to 450,000 for the current period sumption and cut its greenhouse gas that began November 1 and ends January 31, 2016. From November 1 to December emissions by 40% by 2020, goals the 14, about 140,000 people had enrolled for coverage but the two-day surge pushed company said it is on track to reach. “Our total enrollment close to 200,000. healing mission requires us to recognize On December 13, Covered California unveiled a list of ‘hot spots’ in the state the impact of climate change as a promi- with high rates of uninsured residents eligible for subsidies. Riverside and San nent public health issue,” said Shelly Bernardino had 11 hot spots where an estimated 7.3% of residents are uninsured Schlenker, vice president of public policy, and eligible for subsidies followed by Orange County with nine hot spots. Covered advocacy, and government affairs for San California estimates there are currently about 750,000 uninsured people in the Francisco–based Dignity Health. “Because state who are eligible for federal subsidies. of this, we’ve taken a hard look at our Consumers are more motivated to purchase insurance because fines for people environmental policies and taken steps to without insurance increase in 2016 under federal healthcare reform. The fine for make sure that we limit our relationships 2016 will be $695 per uninsured adult or 2.5% of annual household income, which- with the worst environmental offenders.” ever is higher. A Kaiser Family Foundation study estimates the average household penalty for not having insurance will be $969 in 2016.—DOUG DESJARDINS « CONTINUED ON PAGE 5 »

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EVENTS IN BRIEFCONTINUED FROM PAGE 4 Jan. 13–16. 39th Annual Emergency The Centers for Medicare & Medicaid Services (CMS) has penalized 88 °° Medicine in Yosemite. Yosemite Lodge California hospitals and a total of 758 hospitals in the U.S. under its Hospital- at the Falls. An educational conference for Acquired Condition Reduction Program. The program evaluates hospitals on a emergency medical personnel and adminis- number of quality measures and penalizes hospitals that fall in the bottom quartile trators. Co-sponsored by the California divi- with a 1% reduction in Medicare payments. The quality care metrics used by CMS to sion of the American College of Emergency measure hospital safety include the incidence of central-line bloodstream infections, Physicians. To register, please visit urinary tract infections caused by catheters, and surgical-site infections. CMS data http://californiaacep.org/event/2016- shows that 51 of the 88 hospitals in California being penalized for fiscal 2016 were emergency-medicine-in-yosemite/ also penalized in fiscal 2015. Jan. 24–27. Personalized Medicine World Conference. Computer History °°Sutter Health has acquired Alliance Home Health. According to a Dec. 14 Museum, Mountain View. A person- report in the Sacramento Business Journal, the acquisition of Salinas-based Alliance alized medicine educational confer- will expand Sutter Care at Home, the health system’s home-based care program. ence that brings together leaders in government, business, and research Earlier this year, Sutter signed a similar deal to partner with Hospice of the Valley and technology. To register, please visit in Santa Clara County. “Demand for healthcare services continues to increase across http://2016sv.pmwcintl.com/ the United States due to a number of factors, including an aging population,” said John Cullen, vice president of mergers and acquisitions for Sutter Health. “Our part- Feb. 13–16. Scripps’ 36th Annual nerships with Alliance Home Health and Hospice of the Valley enable us to expand Conference: Clinical Hematology and Oncology. Omni San Diego Hotel. A con- our capacity to provide timely, affordable, and high quality home care services to the ference for hematologists and oncolo- residents of Monterey and Santa Clara counties.” gists focused on the latest advances in the treatment of blood-based cancers °°Annette Walker has been appointed division president of St. Joseph Health. and diseases. To register, please visit “Annette is an exceptional mission leader whose actions speak from the heart of St. http://www.scripps.org/events/ Joseph Health,” said St. Joseph Health president and CEO Deborah Proctor. “She is scripps-36th-annual-conference- well regarded by our leadership team and physicians for bringing people together in clinical-hematology-oncology-Febru- a manner reflective of the values of the Sisters of St. Joseph of Orange.” Walker has ary-13-2016 more than 30 years of experience and currently serves as executive vice president of Feb. 17–19. 11th Annual National strategic services for St. Joseph Health. In her new role, Walker will lead St. Joseph Value-Based Payment and Pay for Health facilities in California, Texas, and New Mexico. St. Joseph Health is scheduled Performance Summit. Hyatt Regency, to merge with Providence Health & Services in 2016. San Francisco. Annual gathering of healthcare professionals focused on new pay- °°The Blue Shield of California Foundation announced $7.6 million in fourth quar- for-performance models, payment reform, ter grants that include grants to several California healthcare organizations. The and value-driven payment systems. Co-sponsored by the California Medical California Pan-Ethnic Health Network received a grant of $420,000 followed by Association and the California Association the California Institute for Behavioral Health Solutions with a $400,000 grant of Health Plans. To register, please visit and the Center for Vulnerable Populations at the University of California, San http://www.pfpsummit.com/ Francisco with a grant of $350,000. “Promoting value-based care in the safety net remains our top priority for 2016,” said Blue Shield of California Foundation presi- Get your event listed in Healthfax! E-mail the details to: dent and CEO Peter Long. [email protected].

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It’s all about doing your life’s best workSM TO PLACE A LISTING, PLEASE CALL 978-624-4594 PAGE 8 For subscription services, call 800-753-0131 December 21, 2015

FEATURED CAREER OPPORTUNITIES

EXCEPTIONAL PEOPLE, EXTRAORDINARY CARE, EVERYTIME At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in Healthcare. Across our family of medical centers and physician groups, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. FEATURED OPPORTUNITIES VP, Cardiovascular Svc Line #325242 Executive Director Claims Administration #322301 Masters or other advanced education both administrative and clinical with Bachelor’s degree or equivalent/relevant experience required, Master’s degree demonstrated ability to provide broad regional clinical service line program preferred. Minimum 12 years of successful history in operations in a managed development and oversight. care environment, a minimum of 7 years directly with IPA or medical group in a claims payment environment. Chief Medical Officer #325307 (Seaside Health Plan) A medical degree, either a M.D. or D.O., board certified in a specialty and 5 Director, Clinical Operations #325191 years of experience in a health plan or quality management administrative Bachelor’s degree in Business Management, Health Care Administration, position. 3 years of experience in developing and maintaining administrative Nursing or related field; Master’s degree preferred;10 years progressively com- claims data set for the purposes of outcomes analyst and management. plex management experience in an ambulatory setting; knowledge of medical practice and clinical management. CLINICAL • RN Supervisor • Practice Manager • Phlebotomist • RN Assistant Supervisor • RN & LVN Team Leaders • Limited X-Ray/MA • Sonographer • Case Managers – Medical Group OPERATIONS • Manager, Marketing • Sr. Financial Analyst • Credentialing Supv • Medical Management Coord • Medical Education • Provider Relations Supv

INFORMATION SERVICES • Epic Care Ambulatory Analyst • Epic Clarity Report Writer • EDI Analyst • Epic Security Coordinator • Epic Tapestry Analyst

Application Process: To learn more about these opportunities and more or to submit an application, please visit our website at http://www.memorialcare.org/careers HEALTHLEADERS INC. LA030971B 1 10/26t/2015 3.65 x 4.25”TO (4c process) PLACE A LISTING, CLIN CSI0000003 PAGE 9 jme PLEASE CALL 978-624-4594 N/A For subscription services, call 800-753-0131 December 21, 2015

FEATURED CAREER OPPORTUNITIES

Exceptionally developed skills, a dedication to excellence and a desire to transcend the ordinary. This is the source of true art. It is also the foundation for the world-class healthcare provided at Cedars-Sinai. Our people bring an unmatched passion to their craft and it shows in everything they accomplish. If you want to be your best, you owe it to Gold Coast Health Plan is currently accepting yourself to work with the best. You’ll have that opportunity when you applications for the following positions: work at Cedars-Sinai Medical Network. Physician Network Development Manager √ Sr. Manager Delegation Oversight Encino & Beverly Hills, CA This position will take on a lead role in building Cedars-Sinai’s HMO √ Sr. Manager, Accounting provider network in strategic markets poised to accept HMO, PPO and Medicare patients. Involves partnering with the Director of Network √ Grievance & Appeals Specialist Development to build a high quality, integrated delivery network while focusing on developing relationships with and recruitment of PCPs, √ Claims Analyst II specialists and ancillary providers. The successful candidate will have the expertise required to research/maintain market intelligence on the √ Director, Government Relations managed care provider landscape, analyze complex business problems and identify optimal solutions. Requires a BA/BS degree with 5+ years √ Manager, Claims Transaction of healthcare industry experience, preferably within a managed care setting. MS degree in Public Health or Health Services Administration √ Member Services Quality Auditor preferred. √ Clinical Operations Assistant In addition to professional development opportunities, Cedars-Sinai offers a competitive compensation and benefits package. For more √ Decision Support Analyst information or to apply, visit us online at: https://www.cedars-sinaimedicalcenter.apply2jobs.com/ √ Case/Care Manager, RN and reference Req #M10579. cedars-sinai.edu/careers All qualified candidates must submit an online application. Online applications and full

job descriptions can be found at: Cedars-Sinai is an Equal Opportunity Employer that welcomes and http://www.goldcoasthealthplan.org/about-us/careers.aspx encourages diversity in the workplace. EEO/AA/F/Veteran/Disabled

Kern Health Systems is currently accepting applications for the following positions:

• Disease Management Case Manager Registered Nurse • Clinical Intake Coordinator Registered Nurse I • UM Registered Nurse Facility Based • Case Management Social Worker • Database Administrator IV • Medical Director • Quality Improvement Registered Nurse

Compensation is based on experience, education and qualifications. For a complete position description on these exciting career opportunities, please visit our career center at kernhealthsystems.com or email resume to: [email protected]. E.O.E TO PLACE A LISTING, PLEASE CALL 978-624-4594 PAGE 10 For subscription services, call 800-753-0131 December 21, 2015

FEATURED CAREER OPPORTUNITIES

Inland Empire Health Plan (IEHP) is one of the largest not-for-profit health plans in California. We serve over 1,000,000 members in Riverside and San Bernardino counties in Medi-Cal,Cal MediConnect Plan, 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! DIRECTOR OF CARE MANAGEMENT multiple projects and meet deadlines. Strong presentation skills. This position reports to the Sr. Director of Care Management. Ability to transform concepts into business operations. Experience Current unrestricted California RN License; BSN required and in a Lean strategy environment highly desired. Masters Degree in Nursing preferred or comparable experience. Solid understanding of Medi-Cal and Medicare rules and Possession of a valid California Drivers license and valid automobile regulations governing claims adjudication practices and insurance. CCM certification a plus. At least three to five years procedures preferred. Demonstrated business training principles as a registered nurse in a clinical setting; and at least 5 years and techniques. Analytical skills with emphasis on time progressively responsible experience in Care Management in a management, quality statistics, and problem solving. Strong managed care setting. writing, organizational, project management, presentation and Operational knowledge of computer applications in an office communication skills required. Must have a high degree of environment. Knowledge of CMSA professional standards patience, excellent interpersonal/communication skills. DIRECTOR OF PROCESS IMPROVEMENT ACCOUNTING SUPERVISOR Bachelor’s degree required, preferably with an emphasis in a Requires a Bachelor’s degree in Accounting/Finance. Five (5) years Technical Science or Engineering. Masters degree in Public or experience in accounting and financial reporting. Experience in Business Administration preferred. Certified Professional in supervising other staff members. Healthcare experience preferred. Healthcare Quality preferred. Certified Lean Six Sigma Black Must have the ability to use financial software, with knowledge of Belt or Master Black Belt preferred. Minimum of ten (10) years relational databases helpful. performance management and quality improvement experience Supervise Accounting Coordinators and Accounts Payable. with an emphasis on Lean/Six Sigma methodologies required. Perform cash management functions, reconcile GL accounts, Proven skills adapting and applying Lean Six Sigma methodologies, prepare management reports, monitor functions for compliance to performance management and quality improvement in a public internal controls, resolve all hardware and software problems for health setting. Demonstrated understanding of business principles, supervised functions, analyze reports and accounts for variance strategy, technology processes and operations with an inherent analysis. Assist with year-end audits, identify and formulate ability to apply technology in solving business problems. Strong process improvement projects. leadership, communication, written and interpersonal skills to execute and manage activities in a fast paced environment. Ability FINANCIAL ANALYST to establish and maintain effective working relationships at all Bachelor’s degree required. Minimum three (3) years of Finance levels within the organization. experience. Experience and knowledge of complicated budgets preparation and budget to actual analysis in Excel. Experience in Ability to exercise discretion and independent judgment, make Managed Care preferred. decisions and must possess strong analytical skills. Ability to influence management and create positive change, as well as Strong knowledge and demonstrative proficiency utilizing gather data, perform analysis, recommend courses of action for Microsoft Applications (Word, Excel, Access & PowerPoint). greater productivity independently. Must have ability to perform Strong understanding of accounting and financial principles and research and analysis in support of company inquiries and modify methodologies and attention to detail. Experience with Oracle or and enhance the modeling effort to accommodate new processes, Hyperion a plus. Principles and practices of health care industry procedures, products and services. Position requires an individual and strategies, health care systems, and budget modeling and who is extremely organized with excellent written and verbal forecasting. communication skills and ability to establish and maintain effective working relationships. Must have the ability to model concepts QUALITY ASSURANCE NURSE and to access and manipulate data through self-system access and RN/LVN – COMPLIANCE personal analysis. Possession of a bachelor’s degree at an accredited four (4) year institution preferred. Possession of a RN/LVN California License. CLAIMS QUALITY AUDITING & Three (3) or more years of demonstrated experience in an office TRAINING MANAGER environment, at a professional level, preferably in a Compliance Bachelor’s degree preferred. Education requirement may be function. Two (2) years experience in a managed care environment. waived if candidate has extensive supervisory and operational Demonstrated proficiency in Microsoft Office products (Word, experience in a medical claims payer environment. Five (5) years Excel, PowerPoint, Outlook, etc.). Excellent interpersonal and of medical claim operations experience with at least three (3) years communication skills, strong organization skills, ability to establish in a related supervisory capacity. Compliance audit experience and maintain effective working relationships both within and preferred. Extensive experience writing policies & procedures and outside of the organization. A wide degree of creativity and latitude training documentation. Highly organized with the ability to balance is expected. Please apply on-line: https://ww3.iehp.org/en/about-iehp/careers/ INLAND EMPIRE HEALTH PLAN Rancho Cucamonga, CA Please visit our website at www.iehp.org TO PLACE A LISTING, PLEASE CALL 978-624-4594 PAGE 11 For subscription services, call 800-753-0131 December 21, 2015

FEATURED CAREER OPPORTUNITIES

REPORTING ANALYST – COMPLIANCE PHARMACY PDE MANAGER Possession of a high school diploma or equivalent. Bachelor’s Bachelor’s degree in accounting, finance or equivalent is preferred. degree preferred. Five (5) years experience required in an office Minimum one (1) - three (3) years experience in Medicare Part environment. D and analyzing pharmacy data. CMS Financial reconciliation The Reporting Analyst will be responsible for providing support to experience is preferred. PDE experience is required. the Compliance Department by developing, tracking, manipulating Proficient with Microsoft Office Products with the emphasis on and monitoring reporting activities including working with MS Excel, SQL, and MS Access. Experience in MARx, pharmacy the appropriate departments for regulatory reporting. Strong organizational skills and attention to detail. Proficient knowledge of claims systems and accounting general ledgers is a plus. Ability Microsoft Access, Word and Excel required. Project Management to interpret detailed data and develop accurate, meaningful and experience preferred. reliable reports for management while meeting ongoing deadlines. Excellent written, organizational, data entry and interpersonal skills HCC CODING SPECIALIST is required. Able to handle multiple demanding tasks. Ability to AHIMA or AAPC Certified Coder (CPC license). RN or LVN issued work and make independent decisions, maintains confidentiality, by the State of California required. Two (2) years experience in HCC be an effective communicator and work with other team members. Coding in an HMO setting is preferred. Must have strong chart Capable of working with minimal supervision. Ideal candidates audit experience in HCC Coding. must have strong problem solving abilities Experience in managed care, program/project management, data analysis and interpretation. Working knowledge of Center for MEDICARE CLAIMS PROCESSOR Medicare & Medicaid Services (CMS) HCC coding requirements, Possession of a High School Diploma or equivalent. Three (3) ICD-9 and CPT guidelines are required. Knowledge in HCC-Risk years experience in adjudicating medical claims; professional Adjustment process and health insurance concepts as they relate and institutional preferably in an HMO or Managed Care setting; to Medicare Advantage and Part D plans is required. ICD-10 coding Medicare/Medi-Cal experience preferred. certification preferred. Ability to take general direction and manage complex projects within deadlines. Excellent written, oral, and Microcomputer skills, proficiency in Windows applications presentation skills. Proficiency in Microsoft Word, Excel, and preferred. ICD-9 and CPT coding and general practices of claims other computer applications. Valid State of California license and professing. Professional demeanor, excellent communication and insurance. interpersonal skills, strong organizational skills required.

Please apply on-line: https://ww3.iehp.org/en/about-iehp/careers/ INLAND EMPIRE HEALTH PLAN Rancho Cucamonga, CA Please visit our website at www.iehp.org