Jobs at North East Medical Services (NEMS)

Lead and oversee nursing services across PACE sites, supervising clinical staff, managing staffing and training, coordinating care transitions and home health/SNF/hospice oversight, implementing quality improvement, ensuring regulatory compliance, participating in audits, and serving as Epic workflow expert.

Assess medical level-of-care eligibility for prospective PACE enrollees, perform comprehensive nursing and in-home evaluations, develop and coordinate individualized care plans with the Interdisciplinary Team, support and train family caregivers and home care staff, document changes in Epic, provide in-person/telehealth care, and may provide after-hours on-call support.

Coordinate and implement community health projects: develop plans and timelines, manage multiple initiatives, run meetings and presentations, gather healthcare data, support grant/budget/regulatory reporting, document workflows, and assist managers and physician leads.

Coordinate patient care and discharge planning, develop individualized care plans, facilitate interdisciplinary case conferences, perform home visits and medication reconciliation, manage patients across case management programs, collaborate with providers and community resources, document case activities, support quality improvement, and train new case managers.

Lead and execute organization-wide communications and PR strategy for NEMS. Manage media relations, draft press materials, own communications and social media calendars, coordinate press distribution, build media/influencer lists, monitor coverage and metrics, produce content to drive engagement and brand visibility, and present insights to leadership. Support stakeholder relationships and crisis or media inquiries. Bilingual English and Cantonese required.

Lead and execute integrated, multi-channel marketing strategies to drive enrollment, engagement, revenue, and brand visibility. Manage marketing staff and external partners, oversee content, CRM and analytics, allocate budget and resources, report performance to leadership, and ensure cross-departmental alignment and brand governance.

Provide primary, urgent, and specialty obstetric and gynecologic care at the NEMS clinic, including histories, exams, diagnoses, treatments, referrals, hospital admissions/attending care, on-call and Saturday coverage, patient counseling, prescribing, ordering/interpreting tests, electronic documentation, participation in quality assurance, training students and staff, and supervising mid-level providers.

Sell Medicare Advantage and Prescription Drug plans by identifying Medicare-eligible prospects, conducting needs analyses and presentations, enrolling members, meeting sales targets, maintaining stakeholder relationships, complying with CMS rules, and staying current on Medicare regulations and market trends.

Review and process referral and treatment authorization requests for inpatient and outpatient services, approve per authorization grid and clinical guidelines, meet productivity targets, research complex cases for Medical Director review, perform care coordination and customer service, stay current with DHCS and Health Plan requirements, and communicate decisions to members and providers.

Manage daily operations of ambulatory clinics, ensure compliance with PCMH and regulations, oversee staffing, budgets, audits, policies, quality metrics, staff development, and patient advocacy.

Entry-level Epic Application Analyst supporting implementation, configuration, testing, training, and first-level support for Epic Tapestry in managed care operations. Collaborates with cross-functional teams, troubleshoots issues, documents processes, and participates in upgrades and QA. May work after-hours and weekends as needed.

Manage provider credentialing and re-credentialing for a 1,000+ provider network, maintain accurate provider data, coordinate with health plans and internal teams, prepare audit files, support committee processes, monitor compliance, and handle credentialing-related complaints and appeals.

Provides nurse-led case management and discharge planning for a caseload of patients, developing individualized care plans, coordinating interdisciplinary teams and community resources, performing home visits and medication reconciliation, and monitoring outcomes for utilization and quality improvement.

Support Medicare and Medi-Cal value-based care programs by compiling and validating data, coordinating interventions, performing outreach, reporting outcomes, and collaborating with providers and health plans to drive quality improvement.

Lead and oversee managed care claims operations for Medi-Cal, Medicare Advantage, and PACE. Ensure regulatory compliance, optimize adjudication workflows, manage escalations and appeals, lead and train claims staff, collaborate with payers/providers/IT, analyze claims data, and report performance to senior management.

Provide outpatient psychiatric care including evaluations, diagnosis, medication management, psychotherapy, treatment planning, documentation in EHR, collaborate with multidisciplinary team, supervise psychiatric NP as needed, and meet productivity standards.

Reviews referral and treatment authorization requests, approves per authorization grid and clinical guidelines, leads and trains junior UM coordinators, prepares notices and reports, performs care coordination and transition-of-care, investigates appeals/complaints, communicates with providers and health plans, and ensures regulatory and contract compliance.

Provides primary, urgent, or specialty gastroenterology care at the NEMS clinic: evaluates patients, diagnoses, orders and interprets tests, prescribes treatment, hospitalizes and serves as attending when needed, participates in on-call and Saturday rotations, documents in the EHR, engages in quality assurance, training, and may supervise mid-level providers.

Lead implementation, configuration, maintenance, and support of Epic applications. Collaborate with clinicians and IT, manage projects, mentor junior staff, troubleshoot complex issues, perform QA on Epic configurations, and coordinate upgrades and optimizations. May work rotational after-hours and Saturdays.

Lead enterprise architecture across applications, data, integrations, infrastructure, security and cloud for a complex healthcare organization. Define standards, guide platform selection (EMR/CRM/PACS), design integration/API strategy (FHIR/HL7), govern data architecture, assess technical risk, and advise leadership on resilient, HIPAA-compliant solutions.