(610) 832-2001

 

Open Positions



We offer: Competitive pay, generous benefits, including 401K, medical and dental benefits, LTD, PTO, a flexible work schedule, partial telecommuting (after training period), and a friendly, business casual work environment.

ProgenyHealth is an Equal Opportunity Employer.





Send resume AND salary history to:
HR Department, ProgenyHealth
Email: jobs@progenyhealth.com
Fax: 484-362-6558

Case Manager – Pediatric Nurse

Job Description:

The Case Manager is a registered nurse managing the continuum of care for infants and their families. The Case Manager works in a telephonic managed care setting combining strong clinical knowledge and critical thinking to facilitate a care plan that will ensure quality medical care for the high risk member population serviced by ProgenyHealth based on national standards for case management practice. The Case Manager will focus on empowering the family to support optimal wellness while advocating for necessary medical services.

Job Responsibilities:
  • Making introductory calls to families to provide them with an overview of our services
  • Completing needs assessments for all infants in case management and developing care plans individualized to the needs of each infant and their family
  • Stratifying infants based on their needs at the appropriate case management level and providing frequent outreach calls to manage ongoing needs
  • Interfacing with the infant’s PCP and other neonatal providers to assist with activities which can include coordinating appointments, transportation, medical equipment etc
  • Provides ongoing case management services to assist families after discharge as the primary contact to assist with care coordination needs throughout the first year of life
Job Requirements:
  • Registered Nurse (RN) with a current, unrestricted license is required
  • Three or more years of clinical experience in a pediatric environment
  • CCM preferred
  • Two or more years of managed care experience in a hospital, integrated health system or health plan in a case management and/or discharge planning role is preferred
  • Data entry skills required. Must be computer literate
  • Excellent communication skills and organizational ability is required. Must be self-motivated and willing to learn multiple tasks. Must be well organized and able to prioritize tasks
  • Must demonstrate accuracy in spelling and documentation
  • Ability to perform job functions with autonomy and be a self-starter
  • Demonstrated strength in working independently as well as collaboratively within a team environment
  • Must possess excellent interpersonal skills, telephone etiquette and maintain positive communication at all times
  • Must have commitment to excellence in customer service
Job Location:
  • Plymouth Meeting, PA


Send resume AND salary history to:
HR Department, ProgenyHealth
Email: jobs@progenyhealth.com
Fax: 484-362-6558

Concurrent Review Nurse

Job Description:

The Concurrent Review Nurse is a registered nurse managing the continuum of care from the moment an infant is admitted to a special care nursery/NICU. This process ensures that all resources are used efficiently and effectively from pre-admission, continued stay (concurrent review), discharge planning and post-hospitalization care. Concurrent Review Nurses coordinate overall member care, utilizing the principle of continuous quality improvement as stated in our company mission statement. The Concurrent Review Nurse serves as a hospital nurse reviewer for admissions, lengths of stay and a facilitator for discharge planning. She/he is responsible for the implementation of managed care policies and must be very knowledgeable about the criteria and guidelines used for reviews. Must be adept at identifying and referring potential quality of care issues.

Job Responsibilities:
  • Initiating the continuum of care process for neonatal admissions
  • Interacting telephonically with hospital staff to collect clinical information for newborns in intensive care nurseries in order to facilitate hospital reimbursement for services
  • Coordinating discharge planning needs for newborns being discharged home from intensive care nurseries
  • Documenting all activities in the electronic medical record
Job Requirements:
  • Registered Nurse (RN) with a current, unrestricted license is required
  • Three or more years of clinical experience required
  • NICU or Pediatric Intensive Care nurse preferred
  • Two or more years of managed care experience in a hospital, integrated health system or health plan in a concurrent review and discharge planning role is preferred
  • Data entry experience required. Must be computer literate
  • Excellent communication skills and organizational ability is required. Must be self-motivated and willing to learn multiple tasks. Must be well organized and able to prioritize tasks
  • Must demonstrate accuracy in spelling and documentation. Proficiency in a second language is highly desirable
  • Ability to perform job functions with autonomy and be a self-starter
  • Must possess excellent interpersonal skills, telephone etiquette and maintain positive communication at all times
  • Must have commitment to excellence in customer service
Job Location:
  • Plymouth Meeting, PA





Send resume AND salary history to:
HR Department, ProgenyHealth
Email: jobs@progenyhealth.com
Fax: 484-362-6558
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Medical Informatics Analyst

Job Description:

The Medical Informatics Analyst will report to the CFO and assist the Finance, Operations and Senior Leadership team in the development of enterprise-wide and client focused claims reports as well as data requests and data initiatives based on the specific needs of our internal/external clientele. He/she will also support sales efforts by reviewing, analyzing and assessing data reports required to engage/retain clients.

Job Responsibilities:
  • Support all claims analysis reporting requests, reviews etc. and coordinate data pulls from client systems
  • Analyze data and trends and create documentation supporting all the reports as needed.
  • Prepare summaries and analysis results using graphical representations and professional formatting
  • Maintain data integrity and ongoing quality control of delivered reports
  • Develop, measure and communicate baseline data analyses, performance measures and ROI analyses for new and existing clients.
  • Assist CFO with the evaluation of claims data and related ROI communication strategy in line with the company vision.
  • Interface with prospective clients to understand their contracts, payment methodologies, state requirements, etc. to prepare credible pre-program data analysis.
  • Maintain knowledge of changes in payment methodologies and apply updated learnings into semi-annual and year-end analyses.
  • Work with client services to request health plan data files to validate our ROI for annual reviews.
  • Assist with other ad hoc reporting and analytical efforts
Job Requirements:
  • A minimum of 5 years’ progressive experience generating and analyzing data is required.
  • Managed care experience preferred.
  • Experience in healthcare and/or disease management industry preferred.
  • Bachelor’s degree required
  • Intermediate level of programming knowledge of relational databases, database structures and design, data management, data warehouse utilization.
  • Adept at reviewing client inpatient/outpatient data, including both authorization and paid claims data.
  • Experience with SQL Server reporting capabilities and related SQL queries is a plus.
  • Must be able to speak and write in English fluently.
  • Ability to interact effectively with different business units, team members, and external client at all levels.
  • Ability to deal with ambiguity and drive results.
  • Desire to make an impact, manage multiple tasks and shift priorities quickly.
  • Must be self-motivated and willing to learn multiple tasks.
  • Must be well organized and able to prioritize tasks.
  • Must demonstrate accuracy in writing and documentation.
Job Location:
  • Plymouth Meeting, PA




Send resume AND salary history to:
HR Department, ProgenyHealth
Email: jobs@progenyhealth.com
Fax: 484-362-6558
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Director of Healthcare Sales

Job Description:

ProgenyHealth has an exciting opportunity for a Director focused in Healthcare Sales. You must be ready to make an impact, leverage relationships and produce significant revenue results. This Director must understand complex sales and be highly motivated and determined to identify, and close new business opportunities driving pipeline growth.

Job Responsibilities:
  • Expand our footprint through a variety of direct and indirect engagement strategies, including direct sales & working with client managers to showcase our broad range of products and services.
  • Will be responsible for conducting full life cycle sales activities from identifying, prospecting, qualifying, pricing, demonstrating value, negotiating and closing sales opportunities.
  • Develop and prepare responses to all prospect RFP’s.
  • Represent Progeny at industry events, trade shows, thought leadership activities, including presentations as needed.
  • Bachelor’s degree in health, business, or public service.
  • Master’s degree preferred.
  • Analyze sales activities. Identify and recommend strategies to improve sales performance and ensure Progeny is competitive in the market.
  • Provide regular sales reports, forecasts and other related communications as requested.
Job Requirements:
  • A minimum of 10 years of experience conducting full life cycle sales activities from identifying, prospecting, qualifying, pricing, demonstrating value, negotiating and closing sales opportunities.
  • Comfortable and well versed in all aspects of selling, from lead generation and cold calling to handling sophisticated business development meetings with C-Suite level clients.
  • Exemplary interpersonal and relationship building skills, and professional presence to sell to clients at all levels.
  • Proven negotiation and closing skills in a challenging and competitive environment, managed care preferred.
  • Strong experience in developing sales strategies and performance metrics.
  • Strong understanding of networking via social media.
  • Strong ability to be collaborative and willingness to embrace new challenges in a growing and dynamic environment.
  • Ability to travel up to 60%.
Job Location:
  • Plymouth Meeting, PA

 

 





Send resume AND salary history to:
HR Department, ProgenyHealth
Email: jobs@progenyhealth.com
Fax: 484-362-6558
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RN – Case Manager – 100% Virtual

Must live in the State of MO with previous health plan experience

Job Description:

The Case Manager will focus on empowering the members’ family to support optimal wellness while advocating for the necessary medical services across the health care continuum. The Case Manager works in a telephonic managed care setting combining strong clinical knowledge and critical thinking to facilitate a plan of care that will ensure quality medical care for the high risk member population serviced by ProgenyHealth Inc. based on the CMSA national standards for case management practice.

Job Responsibilities:
  • Utilizes the case management process of engaging, assessing, planning, implementing, monitoring, and, evaluating the needs of the high risk neonatal population
  • Initiating engagement with member’s caregiver during inpatient stay in order to support the treatment plan and discharge planning process.• Acting as a member advocate by the appropriate selection of services, based upon member’s benefits, for appropriate utilization of resources, and providing an ongoing evaluation of member outcomes
  • Referring members’ caregivers to community resources when appropriate and based upon client specific requirements
  • Working in a telephonic managed care setting, combining strong clinical knowledge and critical thinking to facilitate a plan of care that will ensure quality medical care for the high risk member population serviced by ProgenyHealth Inc.
  • Developing care plans individualized to the needs of each infant and his/her family
  • Participating in case management rounds with ProgenyHealth and client teams to discuss barriers and opportunities to improve health outcomes
  • Collaborating with other ProgenyHealth staff, families, facility staff, community agencies, primary care and specialist offices to ensure that evidence-based protocols are utilized in treatment plan
  • Utilizing motivational interview skills to maintain caregiver engagement through the first year of member’s life.
Job Requirements:
  • Registered Nurse (RN) with a current, unrestricted license is required – Must live in the State of MO.
  • Three or more years of clinical experience as a Pediatric/NICU nurse or Adult ICU* is required.
  • * If clinical experience is Adult ICU, candidate must have experience working in a health plan in a CM or discharge planning role.
  • NICU or Pediatric Intensive Care nurse preferred.
  • Two or more years of managed care experience in a health plan in a discharge planning role or case management role is required.
  • Experience with Data entry into a database or EHR required. Must have strong computer skills.
  • Excellent communication skills and organizational ability is required. Must be self-motivated and willing to learn multiple tasks. Must be well organized and able to prioritize tasks
  • CCM certification highly desirable and is required after two years of employment
  • Ability to perform job functions with autonomy and be a self-starter
  • Must possess excellent interpersonal skills, telephone etiquette and maintain positive communication at all times
  • Must have commitment to excellence in customer service




Send resume AND salary history to:
HR Department, ProgenyHealth
Email: jobs@progenyhealth.com
Fax: 484-362-6558
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Concurrent Review Nurse/Utilization Review – 100% Virtual

Must live in the State of MO with Previous HealthPlan Experience

Job Description:

Clinical care nurses coordinate overall member care, from pre-admission, continued stay (concurrent review) and any outpatient services utilizing a pro-active, evidence-based decision making process that is physician sensitive and attaining quality outcomes for the members. The clinical care nurse serves as a nurse reviewer for admissions, lengths of stay and a facilitator for discharge planning. This position functions as a liaison between the providers, hospitals and health plans. Responsible for the implementation of client-specific contracted polices, managed care policies and must be very knowledgeable about benefits, criteria and guidelines used for reviews. Must be adept at identifying and referring potential quality of care issues to the Medical Director, client and/or appropriate staff.

Job Responsibilities:
  • Initiating the continuum of care process for neonatal admissions.
  • Interacting telephonically and in writing with hospital staff to collect clinical information for newborns in intensive care nurseries in order to facilitate medical necessity determinations.
  • Coordinating discharge planning needs for newborns being discharged from intensive care nurseries.
  • Authorization of all services requiring prior authorization, based upon health plan specific service agreements
  • Review of all services (readmissions and elective procedures) for first year of life
  • Documenting all activities in the electronic medical record.
Job Requirements:
  • Must live in the state of MO
  • Registered Nurse (RN) with a current, unrestricted license is required
  • Three or more years of clinical experience as a Pediatric/NICU nurse or Adult ICU nurse is required.
  • Experience with InterQual and/MCG preferred.
  • Experience with URAC or NCQA standards preferred
  • Data entry skills required.
  • Must be comfortable with and have good computer skills.
  • Excellent communication skills and organizational ability is required.
  • Must be self-motivated and willing to learn multiple tasks. Must be well organized and able to prioritize tasks.
  • Must demonstrate accuracy in spelling and documentation. Ability to perform job functions with autonomy and be a self starter. Must possess excellent interpersonal skills, telephone etiquette and maintain positive communication at all times.
  • Must have commitment to excellence in customer service.