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Senior Vice President

Approves, revises, and implements overall corporate growth strategies and personnel activities. As title practices vary among organizations, this level may be called Executive Vice President, Senior Vice President, or other variations depending on the organization. In smaller organizations the Senior or Executive title may not exist and the position may be referred to as a Vice President. This position is distinguished in that it is responsible for a broad range of activities or functions in the organization and typically reports to the President/Chief Executive Officer. In larger organizations, Vice President level position(s) may report to the Executive Vice President.: Develops, recommends, evaluates and obtains approval of all major corporate personnel and operational plans and programs. Selects, develops, and motivates necessary management talent. Guides the development of innovative compensation and benefit programs and provides cost control of this element. Contributes to solutions of major public problems. May direct operations and/or administration functions. May provide staff support services to operating groups in the areas of operations, distribution, personnel, and corporate office administrative services, and participate as a member of the Executive Committee in planning and controlling corporate growth and evaluating performance against objectives.

Senior Physician Executive

Directs, plans, and coordinates activities of employees engaged in medical services. Position requires extensive experience as a medical doctor. Typically reports to Hospital Administrator and advises Hospital Administrator on matters related to medical services.: Interprets company policy to employees and enforces medical services and safety regulations. Advises staff and supervisors on administrative changes. Recommends measures to improve methods, performance, and quality of medical service, and suggests changes in working conditions to increase efficiency. Assists medical officials in preparation of department budget. Conducts specified classes and provides training material to assist in student training program. Interprets, prepares, and distributes statistical data regarding department operations. May recruit, hire, train staff, evaluate employee performance, and recommend or initiate promotions, transfers, and disciplinary action.

Associate Medical Director

Supports the direction and coordination of medical affairs to include quality management, utilization management, case management, and preventive health services. Provides direct assistance to the Medical Director. Requires a medical degree from an accredited medical school and a license to practice. Experience in a managed health plan is typically desired.: Reviews and makes determinations on all questionable physician review decisions. Assists in the development of clinical practice guidelines or case management guidelines. Participates in the review and approval of inter-rater reliability monitoring. Provides medical input into the development of preventive health, quality improvement, and utilization management activities. Assists with the analysis of provider profiles to identify areas for improvement. Serves as an interface in professional or institutional matters between the plan and its providers. May conduct provider profile consultation visits.

Economic Analyst Senior

Plans, designs, and conducts research to aid in interpretation of economic relationships and in solution of problems arising from production and distribution of goods and services. Studies how society distributes scarce resources such as land, labor, raw materials, and machinery to produce goods and services. Conducts research, collects and analyzes data, monitors economic trends, and develops economic forecasts. Utilizes mathematical models to help forecast answers to economic questions. Studies economic and statistical data in area of specialization. Typically requires a master's degree in the field of economics; however, some organizations may accept equivalent education and experience combined.: Devises methods and procedures for collecting and processing data, utilizing knowledge of available sources of data and various econometric and sampling techniques. Compiles data relating to research area, such as employment, productivity, and wages and hours. Reviews and analyzes economic data in order to prepare reports detailing results of investigation, and to stay abreast of economic changes. Organizes data into report format and arranges for preparation of graphic illustrations of research findings. Formulates recommendations, policies, or plans to aid in market interpretation or solution of economic problems, such as recommending changes in methods of agricultural financing, domestic, and international monetary policies, or policies that regulate investment and transfer of capital. May supervise and assign work to staff. May testify at regulatory or legislative hearings to present recommendations.

Lobbyist Senior

Represents a major client, usually at the national level, and provides strategic policy direction, and lobbies for client's interests on issues of major importance. Contacts and confers with members of legislature and other holders of public office to persuade them to support legislation favorable to client's interest. Studies proposed legislation to determine possible effect on interest of client, who may be a person, specific group, or general public. May direct lower level lobbyists.: Confers with legislators and officials to emphasize supposed weaknesses or merits of specific bills to influence passage, defeat, or amendment of measure, or introduction of legislation more favorable to client's interests. Contacts individuals and groups having similar interests in order to encourage them also to contact legislators and present views. Prepares news releases and informational pamphlets and conducts news conferences in order to state client's views and to inform public of features of proposed legislation considered desirable or undesirable. Plans and coordinates meetings between members and elected officials to discuss legislative issues and proposals and allow officials to respond to membership concerns. May contact regulatory agencies and testify at public hearings to enlist support for client's interests. May be legally required to register with governmental authorities as lobbyist and to submit reports of regulated expenditures incurred during lobbying activities. May attend and represent local organization at state and national association meetings. May instruct individuals or organization members in lobbying techniques.

Analyst Senior Economic

Plans, designs, and conducts research to aid in interpretation of economic relationships and in solution of problems arising from production and distribution of goods and services. Studies how society distributes scarce resources such as land, labor, raw materials, and machinery to produce goods and services. Conducts research, collects and analyzes data, monitors economic trends, and develops economic forecasts. Utilizes mathematical models to help forecast answers to economic questions. Studies economic and statistical data in area of specialization. Typically requires a master's degree in the field of economics; however, some organizations may accept equivalent education and experience combined.: Devises methods and procedures for collecting and processing data, utilizing knowledge of available sources of data and various econometric and sampling techniques. Compiles data relating to research area, such as employment, productivity, and wages and hours. Reviews and analyzes economic data in order to prepare reports detailing results of investigation, and to stay abreast of economic changes. Organizes data into report format and arranges for preparation of graphic illustrations of research findings. Formulates recommendations, policies, or plans to aid in market interpretation or solution of economic problems, such as recommending changes in methods of agricultural financing, domestic, and international monetary policies, or policies that regulate investment and transfer of capital. May supervise and assign work to staff. May testify at regulatory or legislative hearings to present recommendations.

Pharmacy Associate

Assists Pharmacists in filling orders, checking prices, and stocking shelves in a retail pharmacy establishment. Serves customers at a pharmacy counter and processes purchases. Typically requires on-the-job training.: Takes customer orders, delivers customer orders, computes charges, handles payment, and enters data in computer. Cleans equipment and sterilizes glassware according to prescribed methods. Types and files reports and completes forms as directed. Assists in receiving and storing supplies, stocking shelves, checking prices, and maintaining inventory.

Insurance & Senior Benefits Clerk

Specializes in a more complex aspect of the Benefit Clerk duties. Requires more in-depth knowledge of benefit programs, company policies, and administrative procedures than the Benefit Clerk. This is a paraprofessional job and excludes jobs whose responsibilities typically require a four-year college degree.: Researches, analyzes, and integrates data to provide information on benefits and group insurance programs and utilization. Duties may involve identifying needs for modification or changes in program design and administrative procedures. Records employee enrollment in benefits. Explains and interprets more complex aspects of company insurance programs to employees and dependents. Answers more complex questions regarding benefits, such as pension and retirement plan, and group insurance, such as life, hospitalization, and workers' compensation. Fills out application forms or verifies information on forms submitted by employees. Mails applications to insurance company. Files records of claims and fills out cancellation forms when employees leave company service. May make employee presentations on benefit programs. May correspond with or telephone physicians, hospitals, and employees regarding claims. May perform complex aspects of benefit accounting and reconciliation.

Credentialing Associate

Provides technical and clerical assistance to facilitate effective and efficient operation of the provider credentialing function.: Coordinates and performs enrollment of assigned providers and physicians in appropriate health plans to ensure satisfaction of the health plan requirement for acceptance. Reviews and processes provider applications and determines eligibility by applying NCQA, JCAHO and URAC standards as related to the network. Performs primary source verification for initial and re-credentialing of assigned providers utilizing NCQA and other federal and state regulatory requirements. Analyzes and resolves basic provider issues relative to credentialing, enrollment, billing and payers. Communicates with providers regarding credentialing status and information. Creates and maintains participating provider or practitioner credentialing files. Reviews and analyzes provider file changes. Creates practitioner profiles for re-credentialed practitioners. Prepares and sends application packets to participating providers and facility applicants, requesting the return of basic credentialing information. Reviews applications for completeness and assists the applicant in completing the application. Prepares routine credentialing reports. This position typically requires a experience sufficient to provide a working knowledge of NCQA and JCAHO.

Associate General Counsel

Provides general legal support and advice for a corporation, as directed by the General Counsel, through timely responses to inquiries and requests. Negotiates agreements with key strategic partners. Serves as a subject matter expert to the Law Department, Compliance, Government Relations, and other business units.: Negotiates contracts and performs legal analysis and drafting. Advises and counsels senior business clients in connection with sales practice issues and other issues. Reviews applicable statutes and regulations. Assists with the preparation of responses to various regulatory inquiries. Supervises and manages regulatory examinations conducted by external agencies. Prepares and reviews registration statements of business development companies. May manage and obtain licenses in various states. May collaborate with business partners on healthcare insurance issues and healthcare regulatory issues. May prepare and report corporate information to the SEC. May collaborate with a team of legal professionals.



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