Geisinger

Analyst

• Reviews and resolves complex claims issues
• Educates contracted and non-contracted providers regarding appropriate claims submission requirements
• Evaluates and resolves complex claim and provider billing issues in a timely manner
• Works with the customer service team to ensure accurate interpretation of billing guidelines
• Provides feedback to the configuration team to ensure payment terms are set-up correctly
• Initiates process improvement projects resulting from operational concerns

Claims Investigation Analyst I

Counselor

• Assesses patient needs and abilities and develops treatment plans to facilitate improved patient functioning/symptom resolution.
• Provides individual, family, couple and group psychotherapy as deemed clinically appropriate.
• Participates with program planning with the psychiatry team and other applicable team members.
• Evaluates the ongoing biopsychosocial needs of patients, identifying needs and problems and determining a treatment plan.
• Provides psychotherapies and case management to assigned patients as well as input regarding the care of program patients.
• Engages as a primary therapist or co-therapist in group therapy to psychiatric patients and as the primary therapist in individual, family, and couple therapies.
• Obtains pertinent data in accordance with program and regulatory standards.
• Upholds agency policies and standards as well as ethical standards of appropriate discipline.
• Collaborates with outpatient and inpatient teams to provide triage evaluation and crisis intervention.
• Work is typically performed in a clinical environment.
• Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.

Licensed Professional Counselor – Outpatient Adult

Marketing

• Responsible for member communications, including newsletters and web/social content
• Implements marketing plans by preparing marketing materials and coordinating distribution
• Creates and distributes materials
• Serves as managing editor and writer for member, employer, and provider newsletters
• Establishes and maintains marketing budgets for assigned projects
• Creates layout for projects
• Coordinates printing and distribution of projects
• Responsible for vendor relationship management
• Works cooperatively with digital marketing specialist and social media team on all aspects of social media campaigns
• Contributes to internal communications strategy development
• Ensures consistency and style guidelines are followed among printed materials

Marketing Coordinator

Communications

• Collaborates with the entire Marketing team in the development and implementation of innovative and strategic employee communications designed to support Geisinger’s strategic plan
• Performs analyses and prepares reports for use in the planning process
• Writes, edits, and distributes content designed to increase awareness and understanding among employees and providers on a variety of organizational priorities and initiatives
• Engages and educates department colleagues to ensure that all activities make the best use of colleagues’ talents, tools and expertise

Senior Communications Specialist

Account Executive

• Cultivates and maintains contact with key accounts for sales of products and services
• Leads sales efforts for GHP pharmacy benefit management services and Geisinger Pharmacy services
• Creates sales strategies and responds to RFPs
• Presents to sales prospects and clients
• Develops relationships with clinical provider offices, clients, broker partners, and industry consultants
• Implements sales strategies in conjunction with various departments
• Grows business by identifying new opportunities
• Maintains sales pipeline and reports monthly progress
• Communicates with new and existing customers to grow the base of business
• Develops marketing materials related to Geisinger Pharmacy
• Documents client visits and inquiries
• Attends trade shows and maintains relationships with chambers of commerce
• Coordinates pharmacy RFP requests and responses
• Collaborates with marketing teams to present customized sales materials
• Remains informed about trends and regulations in the PBM industry

Pharmacy Sales Representative

Business Analyst

• Responsible for providing support, education, issue resolution and development of analytical and technical skills within the Workforce Management (WFM) Department
• Utilizes innovative thought processes to arrive at solutions
• Effectively presents trends and issues in a comprehensive concise format to all levels within the organization
• Develops and conducts user acceptance testing
• Reviews and recommends appropriate action on user requests for services

Workforce Management Analyst

Financial Planning and Analysis

• Provides seamless pre-registration for scheduled ambulatory appointments and hospital scheduled admissions
• Completes insurance verification
• Documents any out-of-pocket expenses and acquire any necessary referrals
• Reviews insurance benefits with patient and attempts to collect copays, deductible and coinsurance along with outstanding balance and pre-service payments
• Conducts patient outreach to verify demographics and insurance information while maintaining HIPAA guidelines
• Performs insurance verification for various payers via automated and manual processes
• Reviews and selects appropriate insurance and visit indicator
• Reviews and requests referrals as needed
• Completes Medicare Secondary Payer Questionnaire for eligible patients
• Enters Financial Comments and Financial Clearance indicator in appointment info tab
• Advises supervisor of unusual circumstances to get them resolved
• Reviews and explains necessary forms for patient signatures upon arrival
• Responsible for meeting productivity, quality, and Point of Service (POS) Collections goals
• Functions as a team member to organize and prioritize individual assigned work queues

Financial Clearance Specialist Associate

• Responsible for development, review and maintenance of contracts according to applicable regulations, policies and standards
• Identifies and notifies management of potential operational, legal and financial issues and recommends alternatives throughout document development
• Develops and manages the maintenance of contract template documents and/or reference materials
• Maintains precise documentation of contractual records and retention of resolutions for future situations
• Manages all database requirements with respect to contracts

Contract Analyst

Procurement

• works independently and strategically to identify, project plan, implement and monitor supply chain expense or utilization opportunities
• collaborates with clinical and operational leadership in a team-based environment
• ensures that product and services are priced accurately, available timely, carried in the appropriate quantities and locations, and delivered efficiently to meet patient care needs

Strategic Sourcing Specialist III

Consultant

• Leads all clinical aspects of home infusion pharmacy business case development for partner health systems, implementation planning, and on-going operational support
• Provides clinical validation and support to data assumptions and analysis used to develop home infusion business plans
• Develops best practice policies and procedures where applicable, including but not limited to, clinical medication protocols for existing and new specialty infused products
• Assesses, recommends, and implements frictionless workflows to ensure ease of referral to home infusion, including standard documentation, informatics tools, and bi-directional communication between referring clinic staff and Home Infusion
• Develops recommended initial staffing model and hours of operation based upon economic volume indicators for clinics and discharges
• Recommends, provides guidance, and supports the implementation of business operations and workflow
• Effectively engages with all partner health system clinic stakeholders to inform business plan development process

Senior Pharmacist Consultant

Medical Billing and Coding

• Reviews the content of the medical record for hospital and professional inpatient or outpatient records
• Reviews documents such as laboratory findings, radiology reports, discharge summaries, and consultations
• Translates diagnostic and procedural phrases into coded form procedure codes as required
• Determines the codes for all diagnoses and procedures using Encoder software
• Assigns appropriate codes based on coding guidelines and regulations
• Queries physicians as needed to clarify documentation
• Provides training for coding professionals in coding guidelines and practices
• Completes coding quality audit reviews

Senior Coder

• Facilitates multidisciplinary improvement teams, gathers data, performs research, completes analytics and compiles best practice information while providing project management.
• Manages work to meet project milestones through application of project management discipline, consistent follow through, relationship management and creative organizational problem solving.
• Hardwires process improvements and embeds process and outcome metrics in improvement initiatives.
• Identifies and analyzes performance opportunities across various processes through the use of administrative and clinical systems.
• Streamlines clinical and operational workflows to support improved outcomes and efficiency.
• Manages relationships to achieve transformational change with staff, providers and leaders.

Improvement Optimization Consultant – Intermediate

Product Manager

• Responsible for the day to day management of products including prototype development, regulatory and compliance submissions, project planning, team management, project tracking, financial oversight, product testing and implementation.
• Works with the product team on the overall management of funded products and projects.
• Responsible for the management of the product and project budget and contracts.
• Ensures adherence to federal or other compliance or regulatory requirements.
• Responsible for the development, implementation and management of product and project plan.
• Develops and leads all technical documentation and testing related to the product and project.
• Communicates resource needs, issues, portfolio and product statuses and milestones met.
• Responsible for the management of the development and delivery of innovation and product specific materials.
• Coordinates with clinical informatic analysts, nurse informaticists, and software engineers in managing data, following compliance requirements, and implementing quality control procedures.
• Assists in helping to prepare final reports, abstracts manuscripts.

Accountant

• Coordinates and oversees accounting and finance functions
• Establishes relationships with financial and operational teams
• Reviews, refines, and automates department procedures to improve workflow efficiency

Senior Accountant

• Responsible for all related aspects of strategic marketing; planning, strategizing, directing and executing for assigned specific areas and initiatives.
• Supports and collaborates with the entire Marketing and Communications team in the development and implementation of innovative and strategic brand and marketing plans.
• Plans, develops and implements innovative strategies and solutions, budgets and programs designed to support Geisinger Health Plan's audiences.
• Gathers and interprets primary data accumulated through campaigns, surveys and other intelligence collection.
• Analyzes and prepares reports for use in the internal communications planning process.
• Engages and educates department colleagues so that all activities make the best use of colleagues’ talents, tools and expertise.
• Supports the management of external vendors: advertising/PR agencies, consultants, media planning and placement agencies, strategic communications experts, information services vendors, printers, mail houses, videographers, photographers, etc.