Measles Cases on the Rise in State as Flu Outbreak Wanes
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March 3, 2014 | VOLUME 26 | NUMBER 08
TOP STORIES
Measles Cases on the Rise in State
as Flu Outbreak Wanes
New cases of childhood paralysis also reported
With the statewide influenza outbreak beginning to ease, state health officials are
now dealing with an increasing number of cases of measles and reports of a polio-like
disease that’s affected more than a dozen children.
The California Department of Public Health (CDPH) has received reports
Published every Monday, California Healthfax is of 20 cases of ailments that have caused partial paralysis in children. Officials with
copyrighted by HealthLeaders Media, a division the Centers for Disease Control and Prevention, which is assisting the CDPH in
of BLR, 75 Sylvan St., Suite A-101, Danvers, its investigation, described the illnesses as a “rare phenomenon” similar to cases that
MA 01923, and is transmitted solely to the sub-
scriber. Any unauthorized copying, duplication or
have appeared in Southeast Asia.
transmission is strictly prohibited. Annual sub- To date, CDPH officials said the root cause of the paralysis remains a mystery.
scriptions are $179. For group and bulk subscrip- “Physicians and public health officials who have encountered similar illnesses have
tions, call 800-753-0131. submitted 20 reports to CDPH and the department has conducted preliminary tests
of 15 of these specimens,” said Gil Chavez, MD, deputy director of the Center for
CUSTOMER SERVICE CENTER Infectious Diseases for CDPH. “Thus far, the department has not identified any
E-mail Subscribers: If you do not
receive your copy of HealthFax, send
common cause that suggests the cases are linked.” In most cases, the paralysis has
a request to: hcprocustomerservice@hcpro.com. been permanent.
For renewals or other subscription questions, Health officials at Stanford University said two cases in the Bay Area that
please call: 800-753-0131. By fax: 866-592-7573. caused partial paralysis in the arms and legs of children appear to be caused by
By e-mail: hcprocustomerservice@hcpro.com.
enterorvirus-68, a disease that’s from the same family as polio. Keith Van Haren,
EDITORIAL SUBMISSIONS MD, a neurologist with Stanford University, said that “during the past decade, newly
To submit an item for consideration, con- identified strains of enterorvirus have been linked to polio-like outbreaks among
tact Doug Desjardins, Editor. By e-mail: children in Asia and Australia” and that the new cases “highlight the possibility of an
ddhealth@netzero.net. By phone: 760-696-3931. emerging infectious, polio-like syndrome in California.” A total of five cases have been
For other questions, contact Bob Wertz, Managing
reported in the Bay Area dating back to 2012.
Editor. By phone: 800-639-7477, ext. 3456.
By e-mail: bwertz@healthleadersmedia.com The CDPH has also received reports of 15 cases of measles in the state. At this
time last year, only two cases of measles were reported. An investigation conducted
ADVERTISING OPPORTUNITIES by CDPH found that three cases of measles were contracted by people who had
To advertise in California recently spent time in the Philippines and two cases were reported by people who
Healthfax, please contact Susan by had recently traveled to India. Both of those countries are currently in the midst of
e-mail: spesaturo@healthleadersmedia.com.
By fax: 781-639-7857. By phone: 978-624-4594. measles outbreaks.
« C ONTINUED ON P AGE 2 »
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IN BRIEF TOP STORIES CO N T IN U E D FR O M PA GE 1
Measles Cases cont.
»»Covered California shut down its
health insurance enrollment portal for “With an outbreak in the Philippines and measles transmission going on in parts
nearly five days to make upgrades and of the world outside North and South America, we can expect to see more import-
repairs. The portal was shut down Feb. 19 ed cases of this vaccine-preventable disease,” said CDPH director Ron Chapman,
for repairs scheduled to last two days but MD. Children typically get their first dose of measles vaccine when they are between
it did not re-open until Feb. 24. In a joint the ages 12 and 15 months and receive a booster shot between the ages of 4 and 6.
statement, Covered California and the Chapman said any child or adult who has not received their vaccines should do so
California Department of Health Care immediately, noting that 99% of people develop immunity to measles after two doses
Services said the website was freez- of vaccine.
ing up while people were filling out their
California is also in the midst of the worst influenza outbreak since 2009.
enrollment forms and speculated that
the problem “may have been brought on During the week ending Feb. 21, the CDPH confirmed an additional 35 deaths related
by a software malfunction” during sched- to influenza to bring the total to 278 for the flu season. There are also another 29
uled maintenance on Feb. 16. “We under- deaths under investigation that will likely be linked to influenza, which would push
stand the disruption of service has been the total number of deaths for the current flu season over 300.
an inconvenience to our consumers and But the number of flu-related hospitalizations and deaths in the state has been
look forward to serving them through the declining since January. For the week ending Feb. 7, the state received reports of 45
online enrollment portal again.” flu-related deaths and confirmed 41 deaths for the week ending Feb. 14.
Even though this year’s strain of influenza—H1N1—can cause serious complications
»»According to a release from the in people who are otherwise healthy, the vast majority of flu-related deaths in the state
United States Attorney’s Office for the
have been among people with pre-existing health conditions. The number of deaths in
Central District of California, the for-
the current flu season isn’t likely to eclipse the 596 flu-related deaths reported in 2009–
mer CEO of Pacific Hospital in Long
Beach has pleaded guilty to charg- 2010, which was the last time the H1N1 flu hit the state. —DOUG DESJARDINS
es of giving physicians kickbacks over
a 16-year period. Michael D . Drobot ,
the former owner and CEO of the now-
defunct Pacific Hospital, was charged by Oral Hygiene Program Helps Reduce
the U.S. Attorney’s Office with orches-
trating a wide-ranging conspiracy and Hospital Pneumonia Rates
with paying illegal kickbacks. Drobot Hospital-acquired pneumonia rates declined 37%
said in his plea agreement that he paid
bribes to state Sen. Ronald Calderon A pilot program conducted at three Sacramento hospitals helped reduce the
(D -Montebello ) to support legislation incidence of hospital-acquired pneumonia among patients through improved oral
that delayed or limited changes to work- hygiene.
ers compensation laws that determined The study was conducted by researchers from the California State
how much money medical providers are
University, Sacramento over a one-year period from 2012 to 2013. The pilot
reimbursed for performing spinal surger-
ies, laws that federal prosecutors suggest involved a strict oral care regimen among patients that included use of toothbrushes
were essential to Drobot’s spinal surgery recommended by the American Dental Association along with antiseptic mouth-
wash and toothpaste with sodium bicarbonate.
« C O N T IN U ED O N PAGE 3 »
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I N B R I E F Continued from page 2
TOP STORIES CO N T IN U E D FR O M PA GE 2
kickback scheme. Calderon was indicted
Oral Hygiene cont.
Feb. 20 on federal charges for allegedly During the study period, the incidence of non-ventilator-associated pneumonia
accepting bribes from Drobot, as well as among patients declined 38% from 0.49 cases per 100 patient days to 0.30 cases
undercover FBI agents seeking official per 100 patient days. The authors of the study, which appeared in the January edi-
acts in relation to other matters. In a tion of the Journal of Nursing Scholarship, concluded that hospital-acquired pneu-
plea bargain, Drobot agreed to accept a monia among the general patient population “needs to be elevated to the same level
10-year prison sentence and to assist the
of concern, attention, and effort as prevention of ventilator-associated pneumonia in
government in its investigations Calderon
hospitals.”
turned himself in to federal authorities on
Feb. 24, the Los Angeles Times reports, Barbara Quinn, a clinical nurse specialist at Sutter Health who spearheaded
and pleaded not guilty to the charges. He the initiative, said Sutter clinicians came up with the concept for the pilot program
is scheduled to appear in court on April when trying to determine ways to reduce pneumonia rates among the general patient
22. population.
“Once somebody is in the hospital, there’s only so much you can do in terms of
»» The National Labor Relations interventions,” said Quinn. “So we figured we’d try to focus on the one thing we had
Board (NLRB) has ratified the results control over, and that was germs.” She noted that oral hygiene is often overlooked
of an election at California Pacific in hospitals and that neglect allows bacteria to build up in patients’ mouths. “When
Medical Center in San Francisco people are tired and sick, they tend to forgot about oral hygiene,” said Quinn. “And
that will allow 800 nurses to join the
that allows the bacteria to build up and eventually get down into the lungs and can
California Nurses Association -
lead to pneumonia.”
National Nurses United (CNA) union.
The results of the December 2013 elec- Hospitals involved in the study included two Sutter Medical Center cam-
tion, in which nurses voted 351 to 321 to puses in Sacramento and Kaiser Permanente South Sacramento. The two Sutter
join the union, were challenged due to the hospitals have a combined total of 650 patient beds and the Kaiser Permanente facil-
slim margin of victory and issues over dis- ity has 217 beds.
puted ballots. In a statement, California Before the study began, participating hospitals were equipped with oral hygiene
Pacific Medical Center said it has accept- products and nurses were trained in how to properly brush the teeth of patients who
ed the NLRB’s decision. “We have long were unable to do it themselves. The study involved all adult patients in all units.
respected the rights of all of our employ- According to the study, the pilot program resulted in “an estimated eight lives saved,
ees to decide whether or not they want to $1.72 million in costs avoided, and 500 extra hospitals days averted.” The cost of oral
be represented by a labor union, and they care equipment for all hospitals for the program was $117,600. Quinn said the impact
have now spoken.” The election boosted
on cost-savings and patient quality of life was even greater when post-discharge care
the number CNA-affiliated nurses work-
is considered.
ing at California Pacific Medical Center to
nearly 1,600. “The study didn’t look at what happens to people after they leave a hospital,”
said Quinn. “But many people who develop pneumonia are discharged to rehabilita-
»»Children’s Hospital Los Angeles tion facilities before they’re allowed to return home and that type of care is expen-
received a $17 million grant from the sive.” She added that both Sutter hospitals have maintained the oral hygiene program
National Institutes of Health to con- since the study ended and that the incidence of hospital-acquired pneumonia has been
duct HIV and AIDS research. The grant reduced by 50% since the program was launched in 2012. —DOUG DESJARDINS
« C O N T IN U ED O N PAGE 4 »
« C ONTINUED ON P AGE 4 »Medical Staff Leadership Seminars
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I N B R I E F Continued from page 3 TOP STORIES CO N T IN U E D FR O M PA GE 3
will fund research that will be part of the
International Pediatric-Adolescent
Judge Rules Fresno County Can’t
AIDS Clinical Trials, which will include
more than 50 research teams and orga-
Terminate Safety-Net Program
nizations. “HIV infection is a global public Supervisors contend county can no longer afford MISP
health issue, with children, adolescents,
A superior court judge denied a request from Fresno County officials to shut down a
and women being particularly vulnera-
safety-net program that provides medical care for indigent patients.
ble,” said Grace Aldrovandi, MD, prin-
cipal investigator at Children’s Hospital’s The ruling from Judge Donald Black rejected an effort by the Fresno County
Saban Research Institute. “Our work Board of Supervisors to terminate the county’s Medically Indigent Services
on optimizing the prevention, diagnosis, Program (MISP), which provides care for uninsured patients through a contract
and treatment of HIV infection in these with Community Regional Medical Center in Fresno. The board of supervisors
populations will benefit nations, commu- voted to terminate the program due to a recent cut in state funding for the MISP. In
nities, and families throughout the world.” his ruling, Judge Black said there wasn’t enough evidence to support the board’s con-
tention that it is not “financially feasible” to continue the program.
»» A California Field Poll found that The effort to terminate the MISP program was opposed by several groups
74% of state voters support legisla-
including Fresno Faith in Community and Health Access California. Those
tion that would require beverage mak-
groups contend the county should maintain its responsibility as a provider of last
ers to include warning labels on sugary
drinks. Senate Bill 1000—dubbed the resort for healthcare. The program provided care for more than 14,000 uninsured
Sugar-Sweetened Beverages Safety county residents in 2013.
Warning Act—would require any soft “This court decision is a big boost for not just thousands of Fresno families who
drink containing sugar and more than 75 will remain insured but for Fresno’s entire health system and those who rely on it,”
calories per 12-ounce container to carry said Anthony Wright, executive director of Health Access California. “Rather
a label warning consumers of the link than spending any more time trying to get out of these requirements, Fresno County
between sugary drinks and problems like should be spending its time maximizing the benefits of the Affordable Care Act
obesity and diabetes. The bill authored and getting as many people insured as possible.”
by state Sen. Bill Monning (D-Carmel) Supervisors said state funding for the program has been reduced by $14 million
is opposed by CalBev , the California under a state initiative that is realigning healthcare spending due to charges brought
division of the American Beverage
about by federal healthcare reform. In a statement regarding its request to discon-
Association. In a statement, CalBev said
tinue the program, county officials said that “without this funding, the county is not
that “we agree that obesity is a serious
and complex issue” but added that “it able to continue the MISP unless other public programs are cut.”
is misleading to suggest that soft drink The county can request another hearing on the tentative court ruling and is
consumption is uniquely responsible for expected to consider the issue at its next meeting on March 4. The county has been
weight gain.” administering the MISP program since 1984.
Though 25 counties in California have MISP programs, Fresno County is one of
»»L.A. Care Health Plan has launched only nine that provides coverage for all indigent people regardless of their citizenship
a Blue Button program that allows its status and one of only two (along with Alameda County) to provide the same type
Medi-Cal beneficiaries to access their of medical services available under Medi-Cal. The program provides coverage for people
« C O N T IN U ED O N PAGE 5 » with annual incomes of up to 200% of the federal poverty level. —DOUG DESJARDINSHIRE POWER: HEALTHFAX
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I N B R I E F CONTINUED FROM PAGE 4 EVENTS
M a rc h 6 - 8 . S t e p p i n g U p to
prescription drug information online. L.A. Care said the program is the first of its kind in
Leadership Conference. Loews
California designed for Medicaid members. The original Blue Button plans were devel- Coronado Bay Hotel. A three-day
oped for Medicare beneficiaries. “We are excited to bring such innovative technology interactive physician training pro-
as Blue Button to Los Angeles County residents who can now more easily share their gram focused on best practices and
information with their doctors and other caregivers,” said Howard Kahn, the CEO of innovative ways to address com-
L.A. Care Health Plan. “It empowers patients to take an active role in their own health- mon problems. Sponsored by UC
San Diego and the Institute for
care, increases effective communications, and helps avoid prescription errors.” The Blue Medical Quality. To register, please
Button program was developed and implemented through a $400,000 grant from the visit http://www.imq.org/Hospitals/
UC Davis Institute for Population Health Improvement. L.A. Care Health plan is SteppingUptoLeadershipConference.
one of the largest public health plans in the United States with nearly one million mem- aspx
bers.
March 22-23. California Medical
»» Covered California has launched a new ad campaign with the tagline “I’m in.” The As s o c i at i o n Le a d e r ’s To o l k i t
commercials, which are airing in both English and Spanish, include personal stories of Conference. Orange County Medical
formerly uninsured people who now have health coverage and the impact it has made on Association, Irvine. A two-day confer-
their lives. The campaign launched with television commercials that began Feb. 21 and ence for physicians interested in pursu-
ing leadership roles in organized medi-
will be followed by billboards, transit stop ads, and posters in convenience stores rolling cine. Topics include team leadership and
out this month. “We want Californians to see these ads and relate to the people in them,” setting priorities and boundaries. To reg-
said Covered California executive director Peter Lee. “These new ads complement our ister please visit http://www.cmanet.
overall marketing strategy by having Californians, in their own words, share why get- org/events/detail/?event=the-leaders-
ting coverage matters.” The new campaign follows the February launch of a Spanish- toolbox0
language ad campaign dubbed “I have a plan.”
March 24-26. IHA Ninth National
»»El Camino Hospital in Mountain View has launched a program using a mobile Pay-for-Performance Summit. Hyatt
Regency, San Francisco. A national
app that recruits individuals to help provide on-site assistance for people suffering heart forum focused on new pay-for-perfor-
attacks. The mobile app, developed by the PulsePoint Foundation through funding mance models, healthcare payment
from El Camino Hospital, alerts those trained in CPR to the exact location of emergency reform, and value-driven healthcare.
calls that involve cardiac arrest. By using the app, individuals can sometimes respond Sponsored by the Integrated Healthcare
to an incident faster than emergency crews and begin administering CPR before para- Association. To register, please visit
medics arrive. “Every day, we treat patients in our emergency rooms that have sudden http://www.pfpsummit.com/
cardiac arrest and we know that quick action to restore heart function is essential to full April 11-13. 17th Annual Western
recovery,” said Tomi Ryba, president and CEO of El Camino Hospital. “This is an impor- Health Care Leadership Academy. San
tant investment to bring life saving technology to Santa Clara County. Diego Convention Center. A three-day
educational conference for physicians,
»»A computerized safety checklist that provides caregivers with best practice guide- physician group administrators, and
hospital executives and administrators.
lines produced a sharp decrease in hospital-acquired bloodstream infections at Lucile
Packard Children’s Hospital at Stanford University. The automated checklist helps Sponsored by the California Medical
Association. To register, please visit
caregivers maintain and change central lines in patients and provides alerts when a cen- http://www.westernleadershipacademy.
tral line is due to be changed or cleaned. The program was used in the hospital’s intensive com
care unit and reduced the number of central-line bloodstream infections from 2.7 per
1,000 patient days to 0.7 per 1,000 patient days. The findings of the study were pub- Get your event listed in Healthfax!
E-mail the details to:
lished online Feb. 23 in the medical journal Pediatrics.
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Exceptionally developed skills, a dedication to excellence and a be able to demonstrate strong contract analysis and negotiating
desire to transcend the ordinary. This is the source of true art. skills. Must be proficient in operating most products in the
It is also the foundation for the world-class healthcare provided Microsoft products suite (e.g. Word, Excel, PowerPoint).
at Cedars-Sinai Health System. Our people bring an unmatched
passion to their craft and it shows in everything they accomplish, Manager, Performance Improvement
including achieving unprecedented four-time Magnet® recognition. Requisition #10510
If you want to be your best, you owe it to yourself to work with The Manager, Performance Improvement is responsible
the best. You’ll have that opportunity when you work at Cedars- for overseeing all performance improvement activities and
Sinai Medical Network in Beverly Hills. independently facilitating complex performance improvement
initiatives within Cedars-Sinai Medical Network, which includes
Manager, Contracting leading large cross –functional process improvement teams
Requisition #10581 and delivering results in specific time frames. Additionally, this
The Manager, Contracting is accountable for administration position is responsible for implementing performance improvement
and operation of the Contracting Department and its various components of the annual quality strategic plan. This position
functions. This includes, and is not limited to, overseeing trains/mentors junior staff and other members of the organization.
all daily administrative functions of the department as well Master’s Degree required; degree in a quantitative field (e.g.
as performing manger level contracting activities. The position business, engineering, mathematics) preferred. A combination
is responsible for maintaining financial integrity of the of education/experience will be considered. Background in
Cedars-Sinai Medical Network and its affiliated organizations, statistics is required. 5 years of progressive responsibility in
through successful attraction, analysis, negotiation and the application of process improvement and statistical process
maintenance of contracts with downstream providers for the control methodologies; 2 years of prior work experience in a
service of risk bearing payor agreements. This position will health care setting highly desired. Extensive knowledge of health
also be directly responsible for negotiating and managing various care regulations, accreditation and licensing requires. Must have
other third party payor agreements. Requires bachelor’s expertise in advanced process improvement methodologies, project
degree in Business Administration, Finance, or Health Care management and team facilitation.
Administration preferred, or commensurate experience. Five
years experience in personnel management with experience in If working for a respected leader in healthcare intrigues you,
managed care contracting and/or network management. Must apply for employment with Cedars-Sinai.
For immediate consideration, please create a profile via our website and indicate the requisition#
http://www.cedars-sinaimedicalcenter.apply2jobs.comClient: AltaM
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Quality Care Without Exception
AltaMed is Southern California’s premier network of clinics, senior care programs, and health
and human services. Working together, we provide patient-focused care to underserved
communities throughout Los Angeles and Orange Counties. We are currently seeking
compassionate health care professionals who understand these communities and share
Business office Manager director,
our desire to make themManaged
better, stronger, care
healthier places to live. We have an immediate
Operations Analysts II & III opportunity for the following experienced professional:
Children’s Hospital Los angeles Medical group, a 500-physician adventistVice
Health Managed Managed
President, Care is seekingCarean experienced
academic practice affiliated with Children’s Hospital Los angeles, is
Children’s Hospital Los Angeles Medical Group, a 500-physician aca- managed care professional to support hospital
The successful applicant will manage the operational and business functions associated with
seeking an experienced Business Office Manager. contracting and strategic
the company’s managed careinitiatives in ourwith
contracts and operations Kern and
the goal of enhancing access to
demic practice affiliated with Children’s Hospital of Los Angeles, is seeking an OperationsVentura care,
markets.
improving The applicant
the quality of care, will have responsibility
and continuing the financial success of our managed
Analyst
TheII and an Operations
Business Analyst III.
Office Manager These positions
manages design,the
and ensures maintain and control for market and regional negotiations as assigned.
uniformity, care programs.
integrity
database systemsand implementation
in support of all data of all business
collection officeactivities
and analysis functions
for of a
physicians a minimum ofcandidates
Qualified five years experience
will possess in successfully
a bachelor’s degree in healthcare, business administration
medical
in pediatric group practice.
specialties. provides
The Analysts leadership,
perform and customer
reimbursement, service
accounts to and negotiating
receivable various
or related types
field (master’s of managed
preferred); care contracts,
7+ years’ experience in managed care operations and
contracting including a working knowledge of areas such as eligibility, claims, credentialing,
ensure effective, efficient performance of the team is established and
financial analysis and prepare report summaries of financial and operations information. developing revenue growth opportunities
utilization management, and customer service. and establishing
maintained. ensures quality and production measures are in place. strategic alliances is required. Local market knowledge
Responsibilities also include performing ongoing systems and applications support to Explore new opportunities at AltaMed, recently voted among the Top 25 Places to Work in Los
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andnew modules and
payment Dental/ Vision/Life, Continuing Medical Education (includes five workdays and up to $2000
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posting are essential functions of this position. analytical thinker Qualified
per year candidates should
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exercising initiative, judgment, problem-solving and decision-making. For immediate consideration, please send your resume to:
TheseSkill
positions require a bachelor’s
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and researching, for the Analyst
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III), proficiency
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medical billing systems andability
reports. DBMS to queries,
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staff and skills,
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use analytical,
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Health care experience in reimbursement, accounts receivable and financial analysis
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management and vision insur-
ance. Knowledge
Please sendofyour
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Managed to billing practices preferred.
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proficiency in a physician practice management. system, MS Word and excel. EOE
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to pmghumanresource@chla.usc.edu. eOe
Director, Managed Care Analytics
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CCI Operations. Responsible for staffing and managing nursing, management experience, UM and Case Management
departmental functions. Ensures effective cooperation experience, preferably at HMO level. Knowledge of Medi-Cal,
and collaboration with other departments. Develops and NCQA, DOC, SDHS, and CMS regulations.
implements programs related to CCI Initiative. Ensures
Care1st Health Plan offers a competitive and attractive
program complies with CMS, DHCS, DMHC and all other
benefits package. Qualified candidates are invited to visit
regulatory requirements.
our Careers page at www.care1st.com and submit a resume.
Requires 5-10 years experience with Medicare and Medi- Care1st is an equal opportunity employer.
Cal in operational or leadership positions in a managed
care organization or organized health system(s). Strong
knowledge of CMS and DHCS regulations and guidelines. We’re not the biggest or the oldest.
Knowledge of managed care with experience providing care
We’re just out to be the best.
to seniors, low income and vulnerable populations.
TOC Transition Coach
Support members, clinical staff
through completion of transiton of
MDS Consulting is a healthcare consulting firm recognized for providing care and utilization management
customized advisory services. We are an entrepreneurial company looking programs. Will work, monitor
for similarly minded people that want career growth opportunities in the members recently discharged from
following roles: hospital and ensure appropriate
Manager, Delegated Oversight follow-up including outbound
SENIOR CONSULTANT/MANAGER, member phone calls,member
PHYSICIAN COMPENSATION SERVICES Develop, manage an effective referrals.
A healthcare leader able to work with hospitals and physicians to evalu- delegated oversight program to meet
ate and design provider compensation plans. A successful candidate must NCQA, CMS, DHCS and contractual, Experience/Requirements:
be knowledgeable in a variety of physician compensation models and be regulatory, operational and financial Current unrestricted CA RN, LPN
able to facilitate change processes. The preferred candidate will have a requirements. Responsibilities license or social worker preferred.
Master’s degree and at least two years of relevant experience. include develop, maintain delegation Three years’ in clinical setting.
policies, procedures, acting resource Experience in care coordination,
SENIOR CONSULTANT/MANAGER during contract negotiations, managed care, health plan or
The successful candidate will have excellent knowledge of issues related overseeing annual compliance audit medical group a plus. Bilingual
to healthcare reform, managed care, physician alignment, clinical integra- delegated entites. preferred. Strong interpersonal
tion, etc. Strong analytic, writing and communication skills are required. skills, experience with diverse or
The preferred candidate will have a Master’s degree and at least two Experience/Requirements: low income community, working
years of relevant experience. Bachelor’s degree or equivalent, knowledge of RVS, CPT, ICD-9, and
nursing/clinical a plus. Three years CPT 4.
HEALTHCARE CONSULTANT health care compliance or quality
Responsibilities involve supporting projects with skilled analysis. Expertise HMO audits. Ability to lead, motivate
will include industry knowledge, advanced written and oral communica- & supervise.
tion skills, financial analysis and modeling, etc.
Alameda Alliance for Health offers excellent salary, benefits. Visit us at
Positions require a desire to work in teams and excellent communication www.alamedaalliance.org and click on Employment button for full job
and analytic skills. information and to apply. EEO
Email resumes to info@mdsconsulting.comTO PLACE A LISTING, PAGE 9 of 12
PLEASE CALL 978-624-4594
For subscription services, call 800-753-0131 March 3, 2014
FEATURED CAREER OPPORTUNITIES
New Century Health is a leading innovator of specialty care
management programs for oncology and cardiology. We are
currently seeking candidates for the following career opportunities:
3 C
HIEF MEDICAL OFFICER 3 DW/BI ARCHITECT Assistant Director - Contract &
BOSTON, MA BREA, CA Network Development
UC Irvine Health, Orange, CA
3 M
EDICAL CONSULTANT 3 SSRS/BI DEVELOPER
BREA, CA, & MIRAMAR, FL BREA, CA Job ID: # 4810 Full Time, Days
3 M
ANAGER,IMPLEMENTATION 3 NETWORK OPERATIONS UC Irvine Health is an exciting place! Ranked as one of
BREA, CA ASSISTANT - MIRAMAR, FL the Top 50 hospitals in the nation for the last 11 years
(U.S. News & World Report), we are Orange County’s
3 H
EALTHCARE SR. BUSINESS 3 INTAKE COORDINATOR/ only academic medical center, and only Level I trauma
ANALYST, BREA, CA PHARMACY TECHNICIAN center. We hold magnet status for nursing excellence,
BREA, CA and 80 of our affiliated doctors are ranked as America’s
3 UTILIZATION REVIEW RN Top Doctors. But we don’t just take good care of our
BREA, CA patients; our employee benefits are unparalleled,
including medical benefits active on day one of employ-
ment, and a generous retirement plan. If you are some-
New Century Health pays 100% of employees’ health ben one that strives for excellence like we do, then consider
joining our team.
Please submit resumes to Reporting to the Chief Contracting Officer, the Assistant
careers@newcenturyhealth.com Director is responsible for all physician clinical services
www.newcenturyhealth.com/Careers.html
contracting including medical group contracts on behalf
of UC Irvine University Physicians & Surgeons (UPS),
and contracts on behalf of clinical departments, clinical
divisions, and individual physicians.
Responsibilities:
Contact Susan to Advertise in • Identify, establish, maintain contract relationships with medical
groups, independent practice associations, HMOs, PPOs and
California Healthfax Today! other third-parties to enable patient referrals. Collaborating with
UPS President creating, updating, executing physician contract-
ing strategic plan.
• Monitoring physician contract performance and assuring compli-
ance to contract terms.
• Work with UPS President and Business Development staff to
evaluate new clinical programs, evaluating costs and recom-
mending new clinical service contracts.
• Participates with medical center contracting staff to initiate/
review contracts with third-party payers, key referring medical
groups in response to contract proposals.
• Represents UPS in UC System-wide contract negotiations.
• Work in conjunction with Physician Billing Group (PBG) and exter-
nal billing agents to be sure contract terms are easily adminis-
CALL SUSAN: Place your tered.
• Acts as the liaison with the payor on behalf of UPS to resolve
PHONE: 978-624-4594 ad today! operational issues arising from the contract language and terms
FAX: 781-639-7857 • Manage Contract Management staff, including evaluating perfor-
mance, hiring, training, conflict resolution, providing guidance to
staff.
To apply, please go to
http://careers.ucirvinehealth.org/jobs/1436333-manag-
er-contract-network-development-ft-days.
EMAIL spesaturo@healthleadersmedia.com Please be sure to carefully review the “Required
Qualifications” before submitting your application.
AA/EOETO PLACE A LISTING, PAGE 10 of 12
PLEASE CALL 978-624-4594
For subscription services, call 800-753-0131 March 3, 2014
FEATURED CAREER OPPORTUNITIES
The successful candidate will participate in multi-disciplinary man-
agement teams to develop and monitor all mechanisms required for
continued licensure and accreditation, installation of new electronic
health record and the opening of Casa Colina’s new 31-bed med-surg
hospital.
DIRECTOR, OUTPATIENT OPERATIONS/PRACTICE MANAGER
Qualifications for this exciting and highly visible position include a
This executive level position facilitates the optimal delivery of qual-
bachelor’s degree (master’s preferred) in a business or health related
ity services to patients of Casa Colina through oversight of the
field and a minimum of 5 years of supervisory experience in a group
day-to-day operations of thirty-five (35) 1206d physicians’ clinics.
Responsibilities include selection and management of staff; setting practice or similar healthcare setting managing daily operations.
priorities and developing strategies for process improvement; regu-
latory compliance; budgeting and control of salary, non-salary, and Casa Colina has a great benefit package that includes group medi-
capital expenses; continuous update of policies/procedures/protocols, cal, dental and life insurance, voluntary life insurance, dependent life
and maintenance of effective and responsive relationships with insurance, accidental death or dismemberment coverage, 403(b)
physicians, patients and other departments to promote goals of the retirement program with a company match plus a profit sharing
organization. plan, 28 paid time off days per year, tuition reimbursement and other
Successful candidate will possess a proven track record of success attractive features.
in clinical practice management with knowledge of total therapy
treatment process; ability to perform financial assessment including To apply, visit us at www.casacolina.org/jobs.
annual budget process, charge audits and daily planning and expert Principals only at this time.
written and verbal communication.
REQUIRED QUALIFICATIONS FOR THIS POSITION INCLUDE:
Providence is calling a full time
Regional Director Cardiovascular Services • Bachelor’s Degree in health care, business, economics, or related field
to our Southern California Region. • Ten years of progressive management experience in healthcare, preferably with
in-depth knowledge specific to cardiovascular services
IN THIS POSITION YOU WILL: • Experience in an innovative, multi-site regionally integrated health system
The Regional Director is accountable for leadership, direction and implementation • Physician and medical group alignment and integration experience
of Cardiovascular Services for Providence Health & Services Southern California, • Significant experience leading teams, group facilitation, project management,
including developing and implementing a physician-driven regional strategic plan and building management systems
across the care continuum to achieve improved access, Triple Aim performance,
PREFERRED QUALIFICATIONS FOR THIS POSITION INCLUDE:
and market growth. Key responsibilities include creating physician alignment
strategies to drive clinical and financial integration; developing ministry and • Master’s Degree
market-specific growth plans; building innovative cardiovascular programs • Experience with academic and community partnership models
that create an exceptional patient centered, integrated care experience across
the continuum; creating new care delivery models and pricing strategies for
Answer the call. Providenceiscalling.jobs
participation in value-based payment with payers, employers and consumers When applying online, please reference job number 50554.
that recognize and reward improved performance; and facilitating strategies
to promote collaboration, share best practices and drive clinical transformation Apply online:
throughout the region and Providence to improve health outcomes and create http://bit.ly/Providence50554HealthFax
healthier communities. Providence Health & Services is an equal opportunity employerTO PLACE A LISTING, PAGE 11 of 12
PLEASE CALL 978-624-4594
For subscription services, call 800-753-0131 March 3, 2014
FEATURED CAREER OPPORTUNITIES
SUPERVISOR, PHARMACY TECHNICAL OPS Req. #13-1107
About Us: QUALITY/5 STAR INITIATIVE DEVELOPER Req. #13-1057
Located in Huntington Beach, CA and backed with a significant PROVIDER FINANCIAL AUDITOR Req. # 14-1370
capital commitment from Francisco Partners, a leading global CARE PLANNER RN SERVICE EXPANSION Req. #13-1264
private equity firm, Landmark Health is committed to improving VP RISK ADJUSTMENT Req. #13-1202
healthcare for the highest acuity patients. Landmark works with
health plans, providers, and other risk-bearing entities to manage MARKETING ANALYST Req. #14-1357
their sickest members on at at-risk basis. PHARMACY RELATIONS COORDINATOR Req. #13-1235
CONFIGURATION SUPPORT SPECIALIST Req. # 14-1375
Open Positions: HEDIS ANALYST SR. Req. #13-1282
• VP, Human Resource Talent REGIONAL DIRECTOR NETWORK MANAGEMENT Req. #13-1310
NURSE PRACTITIONER (STOCKTON) Req. #13-1311
• Senior Health Economics Lead
CARE PLANNER RN – MEDICATION SAFETY Req. #13-1314
• Director, Health Plan Operations DELEGATION OVERSIGHT SPECIALIST Req. #13-1318
• Director, Outreach & Engagement ACTUARY Req. #14-1325
• Director, Coding HCC TOOLS SPECIALIST Req. # 14-1367
MEDICAL MANAGEMENT PROGRAM SPECIALIST Req. #14-1372
CLINICAL REVIEW NURSE Req. #14-1355
For more information and to apply for an open position,
please visit our career page at www.landmarkhealth.org. STRATEGIC PROJECT PROFESSIONAL Req. # 13-1285
SALES REPRESENTATIVE (CONTRA COSTA COUNTY) Req. #14-1358
For more information, please visit our website at:
www.scanhealthplan.com/about-scan/resources/job-postingsTO PLACE A LISTING, PAGE 12 of 12
PLEASE CALL 978-624-4594
For subscription services, call 800-753-0131 March 3, 2014
EMPLOYMENT OPPORTUNITIES
SENIOR BUSINESS SYSTEMS ANALYST,
HEALTHCARE INFORMATION TECHNOLOGY
BREA, CA
The Senior Business Systems Analyst (BSA) is responsible for
the improvement of business processes for gaining operational
efficiency through process reengineering and automation. The
position will partner with internal and external Subject Matter
Senior and Disability Community Advisor Experts (SMEs) to build detailed requirements and provide
L.A. Care, America’s largest publicly-operated health plan, is end-to-end project management oversight during project life
leading the way in L.A. County during this time of great change in cycle. The incumbent will act as a dependable interface between
health care. We seek a talented individual to be responsible for Information Technology (IT) and business partners to manage
developing and cultivating strong relationships with community- expectations and timely resolution of open items for meeting
based organizations, advocacy groups, government leadership project commitments. This position reports to the Vice President,
and community leaders. The Advisor will identify and engage
key advocacy groups that represent L.A. Care’s special needs
Process Improvement & Program Management.
populations served by the Coordinated Care Initiative (CCI ), the ESSENTIAL DUTIES AND RESPONSIBILITIES:
Duals Demonstration Pilot (Cal MediConnect), and L.A. Care’s
Medicare Advantage Special Needs Plan. In addition, this position √ Provides subject matter expertise in healthcare claims pro-
will oversee strategic outreach initiatives targeting L.A. Care’s cessing and utilization management processes.
special needs populations who use specialized services such as long
term care services and supports (LTSS), and will ensure that their √ Identifies process areas for improvement in collaboration
needs and preferences are successfully supported in organizational with IT and business operations team. Uses fact base data
efforts and programs. Health Plan Operations Experience Desired. analysis for sizing opportunity and recommends prioritization
Located in downtown Los Angeles, L.A. Care offers a great working based on ROI (Return on Investment).
environment, competitive salaries and excellent benefits.
√ Improves business processes through process reengineering
and automation as appropriate.
ABOUT L.A. CARE √ Conducts requirement gathering sessions with SMEs, docu-
L.A. Care Health Plan (Local Initiative Health Authority of Los ment requirements, and builds prototype (as required) to
Angeles County) is a public entity and community-accountable health obtain stakeholder sign-off.
plan serving residents of Los Angeles County through a variety
of programs including L.A. Care Covered™, Medi-Cal, L.A. Care’s √ 5-10 years in healthcare required
Healthy Kids, L.A. Care Health Plan Medicare Advantage HMO, and Please submit resumes to
PASC-SEIU Homecare Workers Health Care Plan. L.A. Care is a careers@newcenturyhealth.com
leader in developing new programs through innovative partnerships
designed to provide health coverage to vulnerable populations and
www.newcenturyhealth.com/Careers.html
to support the safety net. With more than one million members, L.A.
Care is the nation’s largest publicly operated health plan.
Qualified candidates please send resume to clefebvre@lacare.org.You can also read
