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At Tribal Health, we believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. Tribal Health as a team delivers on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at Tribal Health is more than a job- It's a passion.Job SummaryProvides direct patient care using the nursing process in accordance with applicable scope and standards of practice and with the policies, values, and mission of the organization. Job DutiesPlans, implements, evaluates, and delivers patient care based on patient assessment to optimize outcomes and maximize available resources. Monitors, records, and communicates patient condition as appropriate.Collaborates as needed across disciplines to coordinate patient care, including patient transfer, discharge, referral, and spiritual/psychosocial support needs.Evaluates learning needs of patient and/or family and provides patient/family education appropriate to age, culture, condition, and circumstances. Maintains clinical skills and competency through orientation, annual and ongoing education, and clinical practice. Follows Tribal Health and client specific policy and procedures.All other duties as assigned and specified by clinical assignment and site. Requirements: <ul><li>Graduate of an accredited Registered/Professional Nursing program.</li><li>Experience Required- 3 years in nursing specialty which includes Labor &amp; Delivery, Postpartum and Nursery.</li><li>Active and unencumbered state licensure; Any State License; Any licensure action information if it applies</li><li>Required BLS, ACLS, NRP, (American Heart Association required)</li><li>Must have recent delivery logs from the past 12 months </li><li>Please submit: CV (with current cell/email as Director will want to set up call to discuss contract with MD) DEA List of 3-4 current references with Name/Address/Phone/Email; Any malpractice settlement information if it applies. NPI; DOB;</li><li>COVID vaccine required- Yes, exemptions considered</li></ul>Facility Overview:Pine Ridge Service Unit- ObstetricsWeekly schedule<ul><li>Schedule: Shift will be 7 / 12-hour shifts (within a two-week period). Rotating 36 and 48. Day or Night based on needs.</li><li>Shift rotation is required and will be based off of staffing, day shift: 0700-1930 and night shift: 1900-0730 with a 30-minute break.</li><li>The schedule will be maintained and monitored by the Department Nurse Supervisor.</li></ul> <ul><li>Patient volume<ul><li>Average 20-25 births per month.</li></ul></li></ul><ul><li>Additional Clinical Details:<ul><li>1. We follow AWHONN guidelines for RN to PT ratio. Of course, there may be be times where everyone wants to have a baby at once and we might run over the guidelines, but my staff know that they can call me if needed to help on the floor.</li><li>2. If they deliver and keep everything that comes in or if they have a gestational age cut off where they would send the mom on to a bigger facility? We transfer if a pt is less than 36 weeks' gestation. We also do not do high risk deliveries here. Again, if for some reason we can?t transfer like the mom is too far along then we would deliver here and transfer newborns, if necessary, we do have an OB doctor and midwifes? the midwifes do the majority of the deliveries.</li><li>3. We have 3 labor rooms 1 triage/obs room and 7 Postpartum rooms and 1 Isolation room</li></ul></li></ul> Native American Preference: Preference in filling vacancies is given to qualified Native American candidates in accordance with federal law (Title 25, USC Section 472). Form <a href="https://nam02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.bia.gov%2Fsites%2Fdefault%2Ffiles%2Fdup%2Fassets%2Fpublic%2Fraca%2Fonline_forms%2Fpdf%2F1076-0160_INDIAN-PREF_Expires-10.31.24_508.pdf&amp;data=05%7C02%7Cjdauer%40tribalhealth.com%7Cfc787280d80e4853986908dc44785cd4%7Ce151a1e1dab54092a29a1b6cdfb81f35%7C0%7C0%7C638460530941872149%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&amp;sdata=CjLNgE8S%2BFhpS5SSDdxIKwvDV8axPZOtv67%2FBSyYWWM%3D&amp;reserved=0" target="_blank">BIA-4432</a> should be submitted with the application. For more information about Native American Preference in employment please <a href="https://nam02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.bia.gov%2Fjobs%2FIndian_Preference&amp;data=05%7C02%7Cjdauer%40tribalhealth.com%7Cfc787280d80e4853986908dc44785cd4%7Ce151a1e1dab54092a29a1b6cdfb81f35%7C0%7C0%7C638460530941882020%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&amp;sdata=LI03vTivs%2B%2Bqqx4i5Y6nR6li4hvRbxfnGrA6%2BYIeqXI%3D&amp;reserved=0" target="_blank">click here</a>. Equal Opportunity Employer: Tribal Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. We value the skills, experience, and dedication that veterans bring to the workplace and qualified veterans are encouraged to apply. Tribal Health is also committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans in our job application procedures. If you need assistance or an accommodation due to a disability, please let us know during the application process. 
 PI244011705

Labor and Delivery Registered Nurse

Location: Req Number: Req #1095 Date Posted: Tuesday, July 2, 2024 Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs. Job Title: Medical Bill Processor SUMMARY: This position holds accountability for accurate and timely processing and payment of considerably difficult bills to include pre-coding, data entry and adjudication of medical bills/claims. DUTIES AND RESPONSIBILITIES: <ul><li>Examines, enters and adjudicates Network Manager (NWM) bills to include: case coding, vendor look-up, data entry, calculating benefits based on provider contract discounts, plans, exclusions; </li><li>Examines, enters and adjudicates patient reimbursement bills, PCA invoices, prescription bills, and medical bills/claims to include: case coding, vendor look-up, data entry, calculating benefits based on provider contract discounts, rates, plans, exclusions; </li><li>Monitors itemized billings for excessive charges, duplications, and appropriate medical bills/claims coding; </li><li>Reviews bills for required information, pends claims if appropriate and maintains follow-up / alert systems, updates files and releases pends when indicated; </li><li>Adjusts benefit calculation for under/overpayments; </li><li>Meets or exceeds department contractual and/or industry standards for accuracy and turnaround time; </li><li>Tracks and reports production, downtime, issues and trends; </li><li>Corresponds with Business Owners (BO), Network Managers (NWM), Clinical Service Coordinators (CSC), patients &amp; providers; </li><li>Updates and maintains current Claims policies and procedures manuals. </li><li>Responsible for complying with Paradigm IT security requirement and policies. </li><li>Responsible for safeguarding Paradigm or Paradigm related IT passwords. </li><li>Responsible for notifying Paradigm of any IT security incidents per policy 16.0 Information Security Incident Management </li><li>May be responsible for special projects. </li></ul>QUALIFICATION REQUIREMENTS: To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. <ul><li>Education -High School Diploma; successful completion of continuing education in insurance, medical terminology/coding, and/or accounting preferred. </li><li>Experience - 2 years customer service experience with a minimum of 2 years claims or bill review experience. Intermediate computer experience using Microsoft Word, Excel &amp; Outlook required. Typing speed of 60 WPM and 10-key experience. Excellent organizational skills. Knowledge of ICD-9; CPT; RVS; U&amp;C; Fee Schedule; HCPCS &amp; other coding schemes preferred. </li><li>Language Skills - Excellent oral communication skills and phone presence. Ability to effectively present information to providers as well as to employees of the organization. </li><li>Reasoning Ability - Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret a variety of instructions and deal with abstract and concrete variables.</li></ul> Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We’re striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is able to bring their whole self to work. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Other details Job Family Active Pay Type Hourly Min Hiring Rate $20.00 Max Hiring Rate $24.47 PI243223093

Medical Bill Processor

At Tribal Health, we believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. Tribal Health as a team delivers on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at Tribal Health is more than a job – it’s a passion. Job SummarySupervise, coordinate, and provide leadership while directing activities of clinical/non-clinical or interdisciplinary teams of licensed and non-licensed caregivers and support staff delivering quality patient care and ensuring implementation of clinical objectives in an assigned area.Job DutiesAssess daily patient care needs and develop and distribute patient care assignments of clinical/non-clinical or an interdisciplinary team of licensed and non-licensed caregivers and support staff, ensuring that population appropriate patient care is given.In accordance with the applicable State Nurse Practice Act, delegate appropriate duties to clinical/non-clinical or interdisciplinary teams of licensed and non-licensed caregivers and support staff based on their assessed skills and abilities.Gather information from other members of the clinical/non-clinical or interdisciplinary team and use this data to plan for the care of all patients on the unit for the shift.Evaluate the care delivered by other licensed and non-licensed caregivers and support staff by providing direct and immediate feedback and coaching, ongoing verbal, and written feedback to the clinical/non-clinical leader on the performance of staff and evaluating the performance trends under his/her direction and recommend and participate in corrective/disciplinary action as required.Oversee all scheduling and staffing needs. Participate in the hiring process for new staff members assigned to the shift by conducting interviews and making hiring recommendations to the clinical/non-clinical leader.Requirements: <ul><li>Any state license accepted –Any state license accepted - </li><li>Certifications required –<ul><li>ACLS, PALS, BLS, TNCC</li><li>Experience requirements –<ul><li>2 Years of Experience in Specialty and supervisory role</li></ul></li></ul></li><li>COVID vaccine required –<ul><li>TBD</li></ul></li></ul> Facility Overview/Details:Pine Ridge Service Unit, Pine Ridge, South DakotaSpecialty: RN Supervisor Emergency DepartmentWeekly schedule: 12-hour shifts 36 hours, 13 Weeks or longerPatient volume per day: TBD Native Preference: Preference in filling vacancies is
given to qualified Native American candidates in accordance with federal law
(Title 25, USC Section 472). Form <a href="https://nam02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.bia.gov%2Fsites%2Fdefault%2Ffiles%2Fdup%2Fassets%2Fpublic%2Fraca%2Fonline_forms%2Fpdf%2F1076-0160_INDIAN-PREF_Expires-10.31.24_508.pdf&amp;data=05%7C02%7Cagarcia%40tribalhealth.com%7C4c7ccb92c39548adc0fa08dc3fb22a30%7Ce151a1e1dab54092a29a1b6cdfb81f35%7C0%7C0%7C638455281654623963%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&amp;sdata=kxZt3Ey7K9M2N2bTG92ftppXUKhset9%2FiUt6Sfm55n8%3D&amp;reserved=0" target="_blank">BIA-4432</a> should be submitted with the application. For more
information about Native Preference in employment please <a href="https://nam02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.bia.gov%2Fjobs%2FIndian_Preference&amp;data=05%7C02%7Cagarcia%40tribalhealth.com%7C4c7ccb92c39548adc0fa08dc3fb22a30%7Ce151a1e1dab54092a29a1b6cdfb81f35%7C0%7C0%7C638455281654634307%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&amp;sdata=QoOp3I0xbsMDCGZMI1chK5zcD%2BUofAT52IzgCf%2FNW9Q%3D&amp;reserved=0" target="_blank">click here</a>. Equal Opportunity Employer: Tribal Health is an equal opportunity employer. All
qualified applicants will receive consideration for employment without regard
to race, color, religion, sex, sexual orientation, gender identity, national
origin, disability, or protected veteran status. We value the skills,
experience, and dedication that veterans bring to the workplace and qualified
veterans are encouraged to apply. Tribal Health is also committed to providing
reasonable accommodations for qualified individuals with disabilities and disabled
veterans in our job application procedures. If you need assistance or an
accommodation due to a disability, please let us know during the application
process. 
 
 PI243096920

3 Healthcare / Pharmacy Jobs in South Dakota