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Medicare/Life/Annuities Sales Agent Remote Role 1099 Contract Role Commission-Only + Uncapped Commissions + Residuals Openings in: Indiana, Michigan, Arizona, New Mexico, Texas, Illinois, Ohio, Colorado, Florida, Kentucky, Tennesse Job Overview: Are you a driven and passionate sales professional looking to make a real impact? Advocate Financial is on the lookout for motivated Medicare Sales Agents to be part of our dynamic and growing team. This is your chance to step into a rewarding career where you'll help individuals navigate their Medicare options with confidence-while enjoying unlimited earning potential and exciting growth opportunities. In this role, you'll be the trusted advisor for clients, guiding them through Medicare plans with expert knowledge and personalized support. If you thrive on building meaningful relationships, delivering exceptional service, and achieving financial success, this is the opportunity you've been waiting for! Key Responsibilities: Client Consultation: Conduct thorough consultations with potential clients to assess their healthcare needs and determine eligibility for Medicare plans. Explain features, benefits, and coverage options of various Medicare plans to help clients make well-informed decisions. Sales Presentations: Develop and deliver compelling sales presentations that effectively highlight the advantages of specific Medicare plans. Address client questions and concerns with clear and concise information. Compliance: Stay up to date on changes in Medicare regulations and guidelines to ensure compliance with all applicable laws. Adhere to ethical standards and company policies in all sales activities. Lead Generation: Proactively generate leads through various channels, including referrals, community outreach, and networking. Utilize marketing materials and strategies to attract potential clients. Relationship Building: Establish and maintain strong relationships with clients to foster trust and long-term loyalty. Follow up with clients to address post-sales inquiries and ensure satisfaction. Documentation and Record Keeping: Accurately complete and submit all necessary paperwork for Medicare applications. Maintain detailed records of client interactions and transactions. Collaboration: Work collaboratively with internal teams, including underwriting and customer service, to ensure seamless processes for clients. Qualifications: Licensing: (License is required for the role) A health insurance license is not required to apply. Candidates can choose to obtain their license independently if desired. Medicare certification (AHIP) is highly desirable. Experience: Proven experience in Medicare, Life or Annuities sales or a related field is preferred. Communication Skills: Excellent verbal and written communication skills. Ability to explain complex information in a clear and understandable manner. Interpersonal Skills: Strong interpersonal skills with the ability to build rapport and trust with clients. Technology Proficiency: Proficient in using CRM software, Microsoft Office, and other relevant tools. Compensation: Job Types: Full-time & Part-time roles available Commission-only Uncapped earning potential + Residuals Benefits: Flexible schedule People with a criminal record are encouraged to apply Remote If you are passionate about helping individuals navigate their healthcare choices and have a strong sales acumen, we invite you to apply for this challenging and rewarding Medicare Sales Agent position with Advocate Financial. Join our team and contribute to improving the healthcare experience for our clients.

*** $20,000 sign-on bonus for external candidates! *** Uptown Psych, part of the Optum family of businesses is seeking a Clinical Medical Director / Psychiatrist to join our team in Chicago, IL. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Behavioral Care Team, you'll be an integral part of our vision to make healthcare better for everyone. Established in 2011, Uptown Psych is committed to bringing the best possible, evidence-based mental health services to the Chicago metropolitan area. As the Clinical Medical Director, you will work with clinicians at our centers in Illinois, Wisconsin, and Indiana while promoting a just culture and safe clinical environment for our patients and providers. You will maintain a clinical caseload (0.6 FTE) and provide clinical oversight (0.4 FTE ), allowing you to continue providing patient care while leveraging your expertise on a broader scale. You will collaborate with operational leadership to offer clinical insight into operational processes as needed. This 1.0 FTE position provides the flexibility of a hybrid work arrangement, combining time at our center located at 4753 N. Broadway St. in Chicago with the ability to work from home. This is a salaried position with quarterly bonus potential based on productivity after six months. Primary Responsibilities: Engage in clinical work, including patient care and clinical supervision Manage a team of psychiatrists and advanced practice clinicians (APCs) Serve as the collaborating physician and/or clinical supervisor of APCs Serve as a multi-state, dyadic partner to center operations leader Maintain quality assurance programs by participating in chart reviews and analyzing outcome metrics Contribute to initiatives for continuing education, including CMEs Champion patient safety through RLDatix reporting and reviews Benefits Include: Full medical, dental, and vision benefits Life and AD&D Insurance plus Short- and Long-Term Disability coverage 401(k) and Employee Stock Purchase Plan Generous PTO plus paid company holidays Reimbursement and time off allotment for CME activities Peloton and gym memberships discounts You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathic Medicine) Active, unrestricted Psychiatrist license in at least one of the following states: Illinois, Wisconsin, or Indiana. Must be willing to obtain licensures in remaining states within 90 days, if applicable Active Drug Enforcement Administration (DEA) license for prescribing controlled substances Board-certified by the American Board of Psychiatry and Neurology (ABPN) Basic Life Support (BLS) certification 3+ years of clinical work experience, post-residency Eligible to enroll as a Medicare provider or ability to terminate opt-out, if applicable Preferred Qualifications: Experience with clinical supervision / collaboration Experience working in an outpatient clinic setting Experience working with computers for professional communication and medical documentation - Excel, Outlook, Athena RMS or other Electronic Health Record systems (EHRs) Knowledge of Spravato or willing to be trained Knowledge of Transcranial Magnetic Stimulation (TMS) or willing to be trained Demonstrated leadership skills and/or experience; i.e., implementing strategic initiatives, leading/mentoring teams, managing projects, etc. *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Explore opportunities at Optum Behavioral Care. We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together. The salary range for this role is $214,000 to $382,000 annually based on full-time employment. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Employment Type:Part time Shift:Day ShiftDescription: RN Case Manager, Part-time (Day shift) Why Mount Carmel? With five hospitals, over 60 free-standing outpatient clinics, a college of nursing, a Medicare Advantage plan, and extensive outreach and community wellness programs, Mount Carmel Health System serves more than a million patients in central Ohio each year, and we've been a pillar of this community for more than 130 years. As a proud member of Trinity Health, one of the nation's largest Catholic healthcare delivery systems, our network of caring spans 22 states, 94 hospitals, and 133,000 colleagues nationwide. We know that exceptional patient care starts with taking care of our colleagues, so we invest in great people and all that we ask in return is that you come to work ready to make a difference and do the right thing. What we offer: Competitive compensation and benefits packages including medical, dental, and vision coverage Retirement savings account with employer match starting on day one Generous paid time off programs Employee recognition incentive program Tuition/professional development reimbursement Relocation assistance (geographic restrictions apply) Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing About the job: The RN Case Manager directs and coordinates the care of patients from admission to transfer or discharge. This is done with the intentions of cost effective utilization of hospital resources, minimizing out of pocket expenses for patients, providing customer support to our internal and external customers, appropriate utilization of resources and patient advocacy. Responsibilities Identifies discharge needs, determines the appropriate level of care that the patient can transition to, coordinates planning, and problem solves continuity issues to ensure seamless continuum of patient care and prevent the patient from having to readmit to the hospital. Assures all appropriate clinical information is provided to outside agencies. Communicates pertinent information to the appropriate members of the patient care team both effectively and professionally. Takes responsibility to identify and eliminate barriers to effective patient stay management and promotes improvements in work processes within department, hospital, and community. Responsible/accountable for professional development and maintaining licensure. Takes ownership for self-education. Advocates for patient legal, social, and ethical rights while balancing patient resources and hospital financial stewardship. Refers quality issues and poor utilization of services to the appropriate sources. Coordinates/facilitates patient/family education Requirements Associates degree from an accredited RN program Current license to practice as registered nurse in the State of Ohio Minimum of 3-5 years' recent clinical experience in an acute care setting. Must be able to work occasional weekend shifts, as needed. Mount Carmel and all its affiliates are proud to be equal opportunity employers. We do not discriminate on the basis of race, gender, religion, physical disability or any other classification protected under local, state or federal law. Our Commitment to Diversity and Inclusion Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity 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, status as a protected veteran, or any other status protected by law.

Remote Insurance Sales Representative - Full-time Flexible Hours, High Earnings, & Growth Potential Are you looking for a flexible, remote career that offers unlimited earning potential and career advancement? We are seeking motivated individuals to help protect families with life insurance and financial solutions, including Life, Annuities, Medicare, Health, Casualty, Accident and more. This 100% commission-based role allows you to be in control of your time while building a long-term financial legacy. No cold calling - we provide high-quality leads from individuals actively seeking coverage. You will meet with clients virtually or over the phone, offering solutions that fit their needs. What We Offer: ✅ Fully Remote, Work-From-Home Opportunity - Full-Time ✅ High Quality Leads Provided - No Cold Calling ✅ Competitive Commission Structure ✅ Excellent benefits package - Medical, Dental, and Prescription Coverage ✅ Life-Long Residuals, Long-Term Income Growth Opportunities ✅ Bonuses Opportunities ✅ Exceptional Training & Mentorship: One-on-one coaching and leadership development ✅ Career Growth: Advancement into management and leadership roles ✅ Work-Life Balance & Flexibility: You control your schedule Responsibilities: 🔹 Schedule and meet with pre-qualified clients via video or phone to discuss their insurance needs 🔹 Present and sell insurance and financial protection plans 🔹 Submit applications 🔹 Build long-term relationships with clients and provide excellent service 🔹 Maintain compliance with insurance industry regulations Qualifications: ✔️ Must reside in the USA or Canada (Work authorization required) ✔️ Insurance License Required (If you are not licensed, we'll help) ✔️ Self-Motivated & Goal-Oriented - You control your success! ✔️ Strong Communication & Customer Service Skills ✔️ Basic Computer Literacy & Access to a Laptop/Computer with a Camera ✔️ Coachability & Willingness to Learn - We provide top-tier training and mentorship Why Join Us? We offer an unparalleled support system, industry-leading training, and one of the best compensation plans in the industry. This Flexible full-time career is your opportunity to thrive in the insurance industry! 🚀 Ready to take control of your career? Apply today!

Our Company: PharmaCord is a leading provider in pharmaceutical patient support services. Our services are sponsored by our pharmaceutical company clients. Together, we are committed to compassionately providing patients with support services during their journey on therapy. When you join the team as an Executive Case Manager, you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as part of their dedicated support team for helping them navigate the tricky process of getting access to their complex medication. You'll compassionately deliver an exceptional experience to many patients per day, always remembering that every prescription or document belongs to a real person who is looking for thorough and efficient management of their records. You'll adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records, your mastery of the program requirements, and ensuring their prescriptions or cases are handled in a timely manner. This role will include ownership of your patient journey from initiation to closure by using your critical thinking skills and your knowledge of the program and industry rules and standards. This includes completing benefit investigations, tracking prior authorizations/denial appeals, and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology, Lynk). This role requires a strong understanding of pharmacy and medical billing and coding, excellent communication skills, and the ability to navigate complex reimbursement processes. The Executive Case Manager provides expertise on insurance coverage and common access and reimbursement challenges affecting patients, healthcare providers and clients. The Executive Case Manager responsibilities include education on the access and reimbursement support tools available from PharmaCord and participating program, advising HCPs and/or patients and caregivers on the benefits and program eligibility for a specific patient, and educating HCP offices on Payor processes and procedures. A typical day in the life of an Executive Case Manager will include but not be limited to the following: Relationship Management Builds trusted relationships with patients, prescribers, and appropriate client stakeholders regarding reimbursement inquiries and challenges through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients. Manages all relationships in a manner that adheres to all relevant laws, regulations, program-specific operating procedures and industry standards related to access and affordability, including HIPAA and insurance guidelines. Managed through call/contact center structure, this role supports inbound and outbound calls to patients, caregivers, specialty pharmacies and healthcare professionals. Performs post Benefits Investigation calls to patients and/or physicians explaining coverage options and next steps in the access journey. Manages all client inquiries and as appropriate, such as case specific statuses. Manages HCP inquiries, as applicable, pursuant to business rules. All communications with the client's field teams will remain compliant and adhere to ways of working protocols outlined between PharmaCord and the client teams. Inbound Call Management Manages inbound calls as directed by the program-approved FAQs. Triage patients to internal or external resources as appropriate. Personalized Case Management Provides personalized case management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and patients to communicate benefit coverage and/or appropriately help drive next steps in obtaining coverage and/or access to prescribed medicine. All communications for case management will follow the guidelines set forth for the program and only provide information publicly available and/or outlined in the patient insert. Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed. Identifies and communicates patient's plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions. Serves as a subject matter expert to internal team as required and appropriate. Uses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow up on proper submission and/or outcome. Coordinates nurse teach with nurse educators, as applicable to program Supports adherence services as applicable to program. Identifies peer support resources for patients. Proactively communicates needs for reverification of prior authorization or re-enrollment. Identifies and reports adverse events, product complaints, special situation reports and/or medical inquiries received in accordance with program operating procedures and the Business Rules Documents all activities within the PharmaCord Lynk system, maintaining detailed records of reimbursement activities, including claims status, payments, and appeals. Generate reports and analysis as needed to identify trends and opportunities for improvement.in accordance with business requirements. Requirements: Completion of Bachelor's degree (or higher) required. Degree in healthcare administration, social science or similar related fields is strongly preferred. In lieu of a degree, five plus years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education is required. Two years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education is required. Minimum two years of experience in healthcare access delivery or management is strongly preferred. Will consider other certifications and five or more consecutive years of experience in relevant field. Certification examples include PACS (Prior Authorization Certified Specialist), CHES (Certified Health Education Specialist) or CCM in healthcare or social science (Certified Case Manager). Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes. Demonstrated examples of executing within guardrails recognizing urgency and consistently delivering patient centric results. Excellent attention to detail and organizational skills. Ability to prioritize tasks and work efficiently in a fast-paced environment. Effective written and verbal communication and interpersonal skills, with the ability to interact professionally with diverse stakeholders. Demonstrates the ability to think critically and issue resolution. Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines. Bi-lingual candidate welcomed We are located in Jeffersonville, IN. PharmaCord does reimburse for tolls if applicable, at the frequent user rate. This rate is applied after 40 trips per month (valued at $678.60 per year). Physical Demands & Work Environment: While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, use hands to type, handle or feel; and reach with hands and arms. Must be able to type 35 WPM with 97% accuracy. Ability to sit for extended periods of time. This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc. This position requires ability to work a standard 8.5-hour standard shifts between our business operating hours of 8am - 9pm Monday through Friday. A shift will be assigned and may change depending on business need. Once you land this position, you'll get to enjoy: Our Benefits & Perks Affordable Medical, Dental, and Vision benefits with no premium increases in 4 years 401(k) company match Wellness discounts on health premium HSA employer contribution Company paid Short-term Disability (STD) Company paid and voluntary Life Insurance options Voluntary Life, AD&D and Long-Term Disability Insurances Paid Parental Leave of Absence Wellness and Employee Assistance Programs PTO benefits, flex days and paid holidays Employee Referral Program Tuition reimbursement program A Career You'll Love Working for PharmaCord - voted Best Places to Work in Kentucky for 2019 and 2021. Voted Best Companies for Employee Happiness, Best Companies for Women and Culture by Comparably in 2023. Work for a company that values diversity and makes deliberate efforts to create in inclusive workplace. Opportunities for advancement with a company that supports personal and professional growth. Playing a crucial part in the lives of our patients, physicians, and pharmacies by enhancing the patient services experience. Any offer of employment is contingent on completion of a background check to company standard. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. At PharmaCord, we don't just accept difference - we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. PharmaCord is proud to be an equal opportunity employer. PharmaCord is unable to sponsor employees at this time. Want to learn more about us? Find us on LinkedIn, Glassdoor, Twitter & Facebook!

We are seeking a detail-oriented and knowledgeable Claims Specialist I to join our team. Under the direction of the Provider Claims Resolution & Recovery Supervisor, the Claims Specialist I - Provider Claims is responsible for evaluating professional, high dollar and outpatient/inpatient institutional claims while determining coverage and payment levels. Responsible for evaluating and resolving provider disputes & appeals, issuing resolution letters, and processing adjustment requests timely and accurately in accordance with standard procedures that ensure compliance with regulatory guidelines. Additional responsibilities include payment adjustment projects and complex claims as assigned. *Candidate will report to the Supervisor, Provider Claims Resolution and Recovery. * *This position is fully remote. Candidates must reside in California. No out of state candidates will be reviewed.* *Duties* * *Review and process provider dispute resolutions according to state and federal designated timeframes.* * *Research reported issues; adjust claims and determine the root cause of the dispute.* * *Draft written responses to providers in a professional manner within required timelines.* * *Independently review and price complex edits related to all claim types to determine the appropriate handling for each including payment or denial. * * *Complete the required number of weekly reviews deemed appropriate for this position. * * *Respond to provider inquiries regarding disputes that have been submitted.* * *Maintain, track, and prioritize assigned caseload through IEHP's provider dispute database to ensure timely completion. * * *Maintain knowledge of claims procedures and all appropriate reference materials; participate in ongoing training as needed.* * *Communicate with a variety of people, both verbally and in writing, to perform research, gather information related to the case that is under review. * * *Recommend opportunities for improvement identified through the trending and analysis of all incoming PDRs.* * *Coordinate with other departments as necessary to facilitate resolution of claim related issues. Identify and report claim related billing issues to various departments for provider education.* * *Any other duties as required to ensure Health Plan operations are successful.* *Requirements* Minimum of four (4) years of experience evaluating and processing institutional and professional medical claims. Proficiency in the following areas: Medical claims system, ICD-10 and CPT coding, reviewing medical authorizations, Provider contract rate interpretation, medical benefit coverage determination. Prior experience handling provider disputes, appeals and claim adjustments. *Experience preferably in HMO or Managed Care setting. Medicare and/or Medi-Cal experience, as well as managed care or government payer environment is helpful. * *Education Requirement* High School Diploma or GED required. *Skills* Strong analytical and problem-solving skills. Microsoft Office, Advanced Microsoft Excel. Written communication skills. Ability to analyze data and interpret regulatory requirements. Excellent communication and interpersonal skills, strong organizational skills, and skilled in data entry required. Typing a minimum of 45 wpm. Excellent oral and written communication skills. Billing experience will not be considered as actual claims processing or adjudicating experience. Job Type: Full-time Pay: $53,872.00 - $68,681.60 per year Benefits: * 401(k) * 401(k) matching * Dental insurance * Employee assistance program * Flexible spending account * Health insurance * Life insurance * On-site gym * Paid time off * Retirement plan * Tuition reimbursement * Vision insurance Schedule: * 8 hour shift * Day shift * Monday to Friday * No weekends Experience: * Medicare and Medi-Cal Claims processing: 4 years (Required) Work Location: Remote

The Billing Specialist contributes to the billing functions and coordinates and manages the accounts receivable (AR) duties including accurate and timely completion and submission of the billing, collections, and management of the computer information system for billing of Medicare, Medicaid and other third party payers both electronically and on paper. PRIMARY RESPONSIBILITIES Accounts Receivable Accurately enters patient/client billing data, OASIS, visit charges, fee for service charges, and verifies discharge and admission data. Coordinates, reviews, and analyzes documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing. Coordinates, reviews and analyzes accounts receivable tracking tools and maintains accounts receivable files in order to ensure accurate and timely claim submission and to prevent lost revenue. Ensures patient eligibility is confirmed through insurance companies and the Medicare or Medicaid systems as appropriate, and that the necessary paperwork is accurate and submitted timely to prevent lost revenue. Maintains tracking tools and data to ensure that all necessary information is secured for timely accurate payment. This includes eligibility, insurance verification, authorizations, certification and recertification as well as state required documentation for Medicaid. Ensures that the appropriate payers have been identified and verified. This includes securing and reviewing the Medicare secondary payer questionnaire, verifying required authorizations are in place with the Medicaid MCOs, etc. Assists in the preparation of monthly accounts receivable review reports in order to ensure accuracy and timely processing of claims billed. Alerts appropriate management team members regarding late or missing documents required for billing. Works to rebill and collect old accounts receivable and claims that have been rejected for payment. Alerts the Billing Manager of seriously overdue accounts receivable. Oversee prebilling processes by including, but not limited to, reviewing invoices created to ensure accurate data, clearing and being the direct contact for non-billable partial visits and over-authorizations, and clearing information as necessary from the EVV Aggregator. General Guidelines Adheres to the agency's Code of Conduct, conducting all business activities in a professional and ethical manner. Interacts with all staff, patients/clients, payers, and other customers in a positive fashion supporting the agency's mission and vision. Complies with the agency's general orientation and to agency policies and procedures including confidentiality and HIPAA guidelines. Maintains the confidentiality of patient/client and agency information at all times. Ensures compliance with local, state and federal laws, and established agency policies and procedures. Participates in staff meetings, department meetings, team meetings, briefings, inservices, committees and other related activities as needed. Job Types: Full-time, Part-time Pay: $20.00 - $28.00 per hour Benefits: Dental insurance Flexible schedule Health insurance Paid sick time Paid time off Vision insurance Work from home Schedule: Monday to Friday Ability to Relocate: Bala-Cynwyd, PA 19004: Relocate before starting work (Required)

Account Manager/ Healthcare Managed Care Services Salary: 68-83K Chef2Home is seeking an experienced Sales Office Manager to support our Business Development Team providing Administrative, Engagement, Retention, and Growth expertise in a busy office setting. This position requires our applicants to have SOLID Managed Care expertise including government covered services, MCR/MCO and MCD. Additionally must have Marketing, Sales, Office Management skills, and SalesForce software experience. This role will be responsible for account and relationship management, retention & growth of the Ohio market. The AM will also maintain and track retention, growth activities, and travel expenses monthly to budgeted levels. Engagement, retention & growth volume goals will be developed and agreed upon between the VP of Business Development, CEO of Global Meals and the Division President of Home Delivered Meals (Global Meals Executive Team). Growth Activity The AM will focus on retention and expansion through OAA, Medicaid, Medicare Advantage, Hospital Programs, PACE programs and other non-traditional programs. The primary focus will be to develop, maintain and grow relationships with Global Meals contracted customers. The secondary focus will be on any new business brought on by the Business Development Team. Salesforce will be updated and maintained with customer data and information Salesforce and growth revenue tracking will be captured by CRM and finance weekly flash reports. Customer Engagement Customer Engagement expectations will include monthly/quarterly activities such as education programs, in-services, community events and business reviews. The engagement plan will be reviewed, and monthly activities will be reported to the Executive Team for Global Meals on a weekly or monthly basis. Retention and growth activities will include virtual meetings, in-services, pitch deck presentations, referral education, community support and C-Suite business reviews. Responsible for retention & expansion through OAA, Medicaid, Medicare Advantage, Hospital Programs, PACE programs, other non-traditional programs and leveraging existing relationships. Marketing Community and State Conferences Responsible for the coordination, exhibit management and speaking engagements at targeted conferences that support brand awareness for Global Meals. In-servicing Slide Decks and Account Marketing Will develop and provide input for all in-servicing decks to be customized to each partner as well as any necessary marketing tools Requirements: Relationship Management Experience Salesforce software MCO/MCR/MCD Understanding of OAA, Medicaid, Medicare Advantage, and similar managed care services Client Retention Marketing and Customer Engagement Stellar Communication Skills Office Administration including scheduling, reports, expense tracking Efficiency with standard Office Equipment Solid Microsoft Office Skills and the ability to learn new systems quickly

SPECIALTY CODER - REMOTE JOB IN TYLER *CHRISTUS Health System offers the Specialty Coder position as a remote opportunity. Candidate must reside in the states of Texas, Louisiana, Arkansas, New Mexico, or Georgia to further be considered for this position.* Responsible for maintaining current and high-quality ICD-10-CM and CPT coding of all professional services, including inpatient and outpatient Evaluation & Management (E/M), and operative/surgical procedures for multi-specialties. Via assigned work queues, verifies all charges and code assignments are correct. Accurately assigns appropriate modifiers to CPT codes. Communicates regularly with providers regarding coding concerns, missing/incomplete documentation, and coding policy updates. Responsible for assigned coding denial work queues. Requirements: · Minimum requirements: Completion of an AAPC or AHIMA approved Coding Certificate Program; High school diploma or GED · Minimum 2 years of multi-specialty physician operative and procedural services coding in an acute care hospital and/or outpatient clinic setting. *Specific experience in Cardiology, CV Surgery, Neurosurgery, or Urology is a plus. · Minimum 1 year of professional billing, claim denials, appeals, and/or revenue cycle work · Expert knowledge of CPT, ICD-10, HCPCS, and medical terminology · Strong knowledge of Medicare, Medicaid, and Commercial payers coding/billing guidelines and compliance regulations, including medical policy restrictions (LCDs and NCDs) · Exceptional written and verbal communication skills · Strong analytical and research skills, with extreme attention to detail · Proficient using multiple software applications, including: Excel, Word, and PowerPoint · Ability to prioritize assignments to meet deadlines · Ability to meet set productivity and quality standards · Able to work independently in a remote setting, as well as part of a team · EPIC and Meditech experience preferred · One of the following certifications is required: Certified Professional Coder (CPC) - AAPC Certified Coding Specialist (CCS) - AHIMA Certified Coding Associate (CCA) - AHIMA EEO is the law - click below for more information: ******************************************************************************************** We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at **************.

Ciena Healthcare is recruiting for the key position of Admissions Director based out of our corporate central intake team. This role involves multi-facility referral management and will cover our Central, Ohio facilities. The role needs someone with prior experience in admissions, marketing or as a hospital liaison. This is a Monday - Friday position. Benefits: Competitive pay. Medical, dental, and vision insurance. 401K with matching funds. Life Insurance. Employee discounts. Tuition Reimbursement. Student Loan Reimbursement. Responsibilities: Drive the central intake / admissions process and support census growth for facilities in the Columbus area. Works closely with our external marketing and hospital liaisons. Provide clients (prospective residents, their families, and referral sources) with facility and program specific information. Evaluate and assess potential patients for clinical appropriateness and placements into one of our skilled nursing facilities Help to manage the admissions process at the building level and ensure proper admission documentation. Participate in the facility specific sales and marketing team events and plans as needed. Requirements: Prior experience in a Skilled Nursing Facility (SNF) preferred. Associates degree or higher is preferred. Prior experience in admissions, marketing, central intake or as a hospital liaison is required. Solid computer skills, including Microsoft Office products and Point Click Care (PCC). Working knowledge of federal & state regulations and reimbursement (Managed Care, Medicare, and HMOs). Ciena Healthcare: We are a provider of skilled nursing, subacute, rehabilitative, and assisted living services dedicated to achieving the highest standards of care in five states including Michigan, Ohio, Virginia, North Carolina, and Indiana. We serve our residents with compassion, concern, and excellence, believing that every one of them is a unique person who deserves our best each day that we care for them. If you have a passion for improving the lives of those around you and working with others who feel the same way. IND123

Tandym Group has several immediate opportunities for A/R Collections Specialists with a client in Texas. These contracts will be 100% remote. These resources will be focused on A/R, billing, collections, follow-up, appeals, and denials, specifically working with Epic and Meditech systems. Required Experience: 5 years of revenue cycle experience focused on A/R, Billing, Collections, & Follow-Up. Experience with billing, claim edits and billing edits (including RTP - Return to Provider, and clearinghouse bounce-back corrections). Experience with lifecycle billing, including initial claims, claim edits, resubmitted claims, and denial management. Experience working denials from start to resolution. Experience working with appeals, including creating appeals letters, and following through to resolution. 3+ years' experience with billing, working claims, doing collections/follow-up using Epic HB software. 2+ years' experience with Meditech software. Experience with commercial and government collections (Medicare, Medicaid, etc.). Preferred Experience: Experience with SSI and handling bounce-backs from the clearinghouse or scrubber. Excellent customer service skills and the ability to maintain positive relationships with clients. Proactive and metrics-driven approach to efficiently working collections. Understanding of most effective ways to handle work-queues and prioritize tasks. Proven ability to handle 40-60 accounts per day efficiently.

Join Our Team of California Mental Health Providers! Foresight is an outpatient mental health company that offers virtual and in-person therapy across California. Our purpose is to increase access to high-quality mental health care. We are actively hiring therapists in the Oakland area for both remote and hybrid roles at our office in Berkeley. Our office provides a modern, professional space for in-person sessions. Whether you prefer the flexibility of remote work or the option to see clients in person, we support your ideal work environment. As a Foresight Therapist, You'll Enjoy: Flexible scheduling for full-time and part-time Work remote or in a hybrid setting in one of our offices Freedom to use modalities aligned with your strengths and client needs Easy documentation through a streamlined EHR Professional development, consultation groups, and a dedicated support team for building caseloads, credentialing, and billing Free in-house Continuing Education and Therapy Certification programs Collaboration with an interdisciplinary team, including psychiatrists, mental health nurse practitioners, and registered dieticians What You'll Do: Provide psychotherapy to individuals, couples, and families (virtually or in-person) Conduct assessments, diagnose, and develop treatment plans Complete timely electronic documentation (within 72 hrs) Manage your caseload and maintain a consistent schedule Compensation & Benefits: Sign-on Bonus: $3,500 for full-time roles (paid over 9 months) Competitive Salaries: Full-time: $70,000-$110,000/year (based on caseload, minimum of 25 clients/week) Part-time clinicians see between 10-24 clients per week (minimum 12 hours per week of availability required) - hourly rate of 50 USD (part-time) Comprehensive Benefits for full-time employees: Medical, dental, vision insurance; 4 weeks PTO; paid holidays; 401(k) match, HSA/FSA, company-paid life insurance, and more! What We're Looking For: Foresight seeks California Licensed Clinical Social Workers (LCSWs), Marriage and Family Therapists (LMFTs), Professional Clinical Counselors (LPCCs), and or Clinical Psychologists who reside in California or within a state in which we operate (CA residency required for hybrid roles). We seek clinicians who are committed to client-centered care using trauma-informed and evidence-based practices. They should be well-versed in mental health counseling practices, including initial triage, risk assessment/management, crisis interventions, ICD-10 codes, and treatment planning, and proficient with technology, including EHR systems, Zoom, and Google Suite. Must not be opted out of Medicare Apply today! Take the next step in your career, and help to transform lives working in a supportive professional community. #INDCA Thanks for your interest in working with Foresight If you are a California resident, please read our California Candidate Privacy Notice here. Foresight is an equal opportunity employer. We're committed to providing reasonable accommodations and will work with you to meet your needs. If you're a person with a disability and require assistance during the application process, please don't hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

Columbus Healthcare Center, a member of the CommuniCare Family of Companies, is currently recruiting an RN MDS Nurse to join our team. At CommuniCare, MDS Nurses are treated as key members of our Operations team. We appreciate your contribution to our facility's success! WHAT WE OFFER Beyond our competitive wages and Paid Time Off, we offer all full-time employees a variety of benefit options including: Life LTD/STD Medical, Dental, and Vision 401(k) Employer Match with Flexible Spending Accounts CATCH THE SPIRIT! When you join the CommuniCare family, you'll quickly catch the team spirit. Coworkers and residents become family, the workplace becomes a home, and a touch of spontaneity and fun keeps everyone smiling. Our core values promote an environment of respect, courtesy, and professional excellence where you can dedicate yourself to a career you love. Do you have what it takes to be an RN MDS Nurse with CommuniCare? QUALIFICATIONS & EXPERIENCE REQUIREMENTS Graduate of an accredited school of nursing; RN Valid RN license in the state employed Three years of experience in a long term care environment preferred Experience with the MDS/RAI process and/or case management preferred JOB RESPONSIBILITIES The MDS Nurse RAC (Resident Assessment Coordinator) reports to the Executive Director and is responsible for accurate and timely completion of mds assessments and coordination of the RAI process. Provides Medicare, Medicaid (case mix), and managed care oversight to ensure appropriate clinical services are provided and appropriate reimbursement is received for each resident. This includes ensuring that the centers are in compliance with federal and state regulations as well as the CommuniCare Family of Companies' guidelines and policies and procedures. This role serves as a key member of the facility's management team in helping the facility obtain/maintain quality outcomes. THE COMMUNICARE COMMITMENT A family-owned company, we have grown to become one of the nation's largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients, and family members care for and about one another.

We are currently hiring for a RN Quality Improvement Policy Coordinator to join BlueCross BlueShield of South Carolina. This individual will perform vendor audits and oversight. They will provide reporting to the vendors, Governance Committee, the executive team, and other stakeholders using Excel and PowerPoint. They must be able to communicate the results and their impact to the various groups. They will write and update policies and manage vendors. They will also collaborate with the Governance Committee and oversight teams on audits and reporting. Strong auditing, policy writing and vendor management will assist in being successful in this role. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future. Description Logistics: This position is full time (40 hours/week) Monday-Friday and is a hybrid position. To work from home, you must have high-speed internet and a private home office. You cannot have satellite internet. Candidate must reside in the state of South Carolina. Location: It will be mainly work from home with working onsite at 17 Technology Circle, Columbia, S.C., 29203 a few times per month. Position Purpose: Monitors/implements quality improvement/management activities. Conducts specific medical reviews as necessary, analyzes findings, makes recommendations for corrective actions, and prepares formal documentation for compliance with applicable standards/regulations. Performs Health Plan Employer Data Information Set data collection (HEDIS), and National Committee for Quality Assurance (NCQA) accreditation activities. What You'll Do: Performs quality improvement activities to monitor/maintain compliance with applicable standards/regulations. Analyzes/documents/presents findings of quality improvement activities. Recommends corrective action and improvement when necessary. Conducts quality medical record reviews to monitor quality of care and service provided. Tracks/trends/investigates quality concerns and complaints. Coordinates HEDIS data collection. To Qualify for This Position, You'll Need the Following: Education: Associates in a job-related field. Nursing Experience: Four years clinical OR Behavioral Health to include two-years Quality Management experience. Skills/Abilities: Excellent verbal and written communication, customer service, organizational, presentation, problem solving, and analytical and critical thinking skills. Proficient spelling, grammar, punctuation, and basic business math. Ability to handle confidential or sensitive information with discretion. Demonstrated ability to identify the need for and implement corrective actions. Strong understanding of managed care. License: Active, unrestricted licensure in Behavioral Health from the United States and in the state of hire, OR active, unrestricted RN licensure from the United States and in the state of hire, OR active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), OR Registered Health Information Administrator (RHIA). Software: Microsoft Office. We Prefer That You Have the Following: Experience: Policy Writing and auditing experience in a state or government oversight capacity is strongly preferred. Vendor Management experience. Medicare experience a plus. Skills/Abilities: Able to effectively communicate audit results with various stakeholders. Strong attention to detail, very well organized. Software: Intermediate Excel and PowerPoint skills experience needed. What We Can Do for You: 401(k) retirement savings plan with company match. Subsidized health plans and free vision coverage. Life insurance. Paid annual leave - the longer you work here, the more you earn. Nine paid holidays. On-site cafeterias and fitness centers in major locations. Wellness programs and healthy lifestyle premium discount. Tuition assistance. Service recognition. Incentive Plan. Merit Plan. Continuing education funds for additional certifications and certification renewal. What to Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with the most qualified candidates. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Some states have required notifications. Here's more information. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please e-mail ************************ or call **************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Medicare Star Provider Relations Specialist is responsible for providing Medicare Star/ Healthcare Effectiveness Data and Information Set (HEDIS) support and training for direct providers and contracted provider groups. This position serves as a liaison between Alignment Health plan and IPA/MSO partners. Functions as the single point-of-contact for all on-going Medicare Star, HEDIS, and Consumer Assessment of Healthcare Providers and Systems (CAHPS) issues as needed by providers and is responsible for timely and professional interaction with internal and external customers. GENERAL DUTIES/RESPONSIBILITIES : 1. Facilitates IPA and MSO education and training in order to increase their familiarity and satisfaction with Alignment's systems and strategies, including training and education on Star including: HEDIS, HEDIS data submission, CAHPS and clinical initiatives. 2. Facilitates provider and office staff education and training to increase their familiarity and satisfaction with Alignment's systems and strategies, including training and education on CAHPS, HEDIS, and HOS as well as Star and clinical initiatives. 3. Sets targets and priorities to meet national HEDIS/Star and market-specific Medicare Star Program needs. Researches issues related to measures not meeting benchmark and drive internal resolution. 4. Connects meaningfully internal departments to build emotional engagement and customer advocacy. Simplifies complexity and integrates internal efforts to deliver an optimal HEDIS/Star performance organizationally. 5. Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints. 6. Engages others by gathering multiple views and being open to diverse perspectives. 7. Assess IPA and MSO performance and provide actionable items to increase performance in underperforming areas. 8. Maintains and builds meaningful relationships with IPA and MSO partners to facilitate cooperation and collaboration. 9. Implements performance related campaigns throughout the year that target specific areas of STAR performance. 10. Serves as primary point of contact for IPA and MSO data exchange communication and manages quick resolutions to ensure quality of internal data. 11. Researches any supplemental data exchange issues and correct them in a timely manner with IPA/MSO. 12. Other duties as assigned. Minimum Requirements: Experience: • Required: Minimum 2+ years of HEDIS and Medicare Star program. Minimum 2 years of experience reconciling data discrepancies, and encounter submission errors between provider and healthcare plan. • Preferred: 4+ years HEDIS and Medicare Star program experience Education: • Required: Bachelor's degree Specialized Skills: • Required: Working knowledge of healthcare provider business operations Knowledge of healthcare, managed care, Medicare Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. Report Analysis Skills: Comprehend and analyze statistical reports. Licensure: • Required: Valid Drivers license and automobile insurance Other: • Required: Office Hours: Monday-Friday, 8am to 5pm. Extended work hours, as needed. Up to 60% of travel by car routinely required. Travel by plane required as needed to support provider services needs in other geographies. Maintain reliable means of transportation. If driving, must have a valid driver's license and automobile insurance. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: $58,531.00 - $87,797.00 Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at ******************************* If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email ******************.

$10,000 Sign-On Bonus Are you looking for a nursing leadership opportunity with a growing organization? We have an exceptional opportunity for a Director of Nursing (DON) to join our team. As the Director of Nursing (DON), you will plan, coordinate and manage the nursing department. You will be responsible for the overall direction and evaluation of nursing care and services provided to the residents. You will supervise nursing care provided by RNs, LPNs and STNAs. Responsibilities: Schedule and perform resident rounds to monitor and evaluate the quality and appropriateness of nursing care. Insure proper charting and documentation of care and of medications and treatments. Recommend to the administrator the number and levels of nursing personnel to be employed. Participate in the budget process of the facility and maintains the nursing supply, equipment and nurse staffing budgets. Maintain current knowledge of applicable managed care, Medicare and state Medicaid regulations, reimbursement systems and methodology. Participate in the Quality Assurance Performance Improvement program, making necessary improvement to processes based on quality assurance data. Requirements: RN license in the state. Director of Nursing, management or supervisor experience in long-term care, restorative or geriatric nursing. Current CPR certification. Additional certification in nursing specialty desired. Ciena Healthcare: We are a national organization of skilled nursing, subacute, rehabilitative, and assisted living providers dedicated to achieving the highest standards of care in five states including Michigan, Ohio, Virginia, North Carolina, and Indiana. We serve our residents with compassion, concern, and excellence, believing that every one of them is a unique person who deserves our best each day that we care for them. If you have a passion for improving the lives of those around you and working with others who feel the same way. IND123

BerryDunn is seeking a Medicaid Pharmacy Subject Matter Expert who will provide subject matter expertise and project management skills to support our State Medicaid agencies' delivery of pharmacy benefits. Duties will include, but not be limited to, working with business and technical subject matters who manage the day-to-day operations of pharmacy benefits for our clients; supporting systems procurements and implementations that help ensure Centers for Medicare & Medicaid Services (CMS) outcomes are met; and contributing knowledgeable content to support requirements development and performance measures. This role will support the drafting of requests for proposals (RFPs); vendor procurements; vendor management; developing, executing and validating testing; risk management; and creating and facilitating training. The Medicaid Pharmacy Subject Matter Expert will work closely with BerryDunn team members, internal business leads and vendors to support proposed project plans and implementation strategies; and to support requirement validation sessions. The Medicaid Pharmacy Subject Matter Expert will support core team tasked with leading and supporting the delivery of services to clients on time, within scope, and within budget. This position can be based remote or at one of the BerryDunn's offices in West Virginia, Maine, Connecticut, Massachusetts, or New Hampshire. Travel Expectations: Willingness to travel 30 to 50%. You Will Provide subject matter expertise to support client projects and/or initiatives related to the procurement and implementation Medicaid enterprise systems that support the delivery of pharmacy benefits to Medicaid members. Provide subject matter expertise related to drug rebates, drug utilization review, pharmacy point of sale systems and/or pharmacy claims adjudication Help facilitate meetings and interviews with client stakeholders, including development of presentations and other materials to support meetings. Conduct project management tasks such as tracking and reporting project progress, maintaining a project document repository, and reviewing deliverables for quality assurance. Lead the development of concise summaries, reports, and presentations of complex data and information for client leadership. Provide functionality and/or technical expertise in resolving inquiries from other teams about solutions within their area of specialization. Analyze, review, and manage vendor supplied documentation. Provide subject matter expertise to support Medicaid clients for project activities, including, but not limited to: Analyzing risks and opportunities. Scheduling, facilitating and/or attending meetings with clients and vendors. Assisting in stakeholder management and engagement. Researching, reviewing and/or proposing potential program changes. You Have Bachelor's degree (master's preferred). Demonstrated written and verbal communications skills. Demonstrated ability to adapt and be resourceful to changing needs of the project and client(s). Demonstrated ability to excel in a team setting. Excellence in the areas of time management, flexibility, critical thinking, and attention to detail. Preferred qualifications/experience Experience supporting initiative focused on commercial over the shelf (COTS) solutions, and/or familiarity with software as a service (SaaS) models, and/or cloud applications. At least 3 years in a project manager or technical lead role for pharmacy or pharmacy-related services in fee for service or managed care applications. Experience working at a national or regional consulting firm, state health and human services/Medicaid agency, a pharmacy benefits vendor, and/or technology vendors that supports the delivery of state Medicaid pharmacy benefits. Project Management Institute (PMI) Project Management Professional (PMP) certification, and/or other industry recognized project management credential. Compensation Details The base salary range targeted for this role is $110,000 - $130,000. This salary range represents BerryDunn's good faith and reasonable estimate of the range of possible compensation at the time of posting. If an applicant possesses experience, education, or other qualifications in excess of the minimum requirements for this posting, that applicant is encouraged to apply and a final salary range may then be based on those additional qualifications; compensation decisions are dependent on the facts and circumstances of each case. The salary of the finalist selected for this role will be based on a variety of factors, including but not limited to, years of experience, depth of experience, seniority, merit, education, training, amount of travel, and other relevant business considerations. BerryDunn Benefits & Culture Our people are what make BerryDunn special, and in return we strive to support our employees and help them thrive. Eligible employees have access to benefits that go beyond what's expected to support their physical, mental, career, social, and financial well-being. Visit our website for a complete list of benefits and a look into our culture: Experience BerryDunn. We will ensure that individuals are provided reasonable accommodation to participate in the job application or interview process or perform essential job functions. Please contact ********************* to request an accommodation. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. About BerryDunn BerryDunn is a client-centered, people-first professional services firm with a mission to empower the meaningful growth of our people, clients, and communities. Led by CEO Sarah Belliveau, the firm has been recognized for its efforts in creating a diverse and inclusive workplace culture, and for its focus on learning, development, and well-being. Learn more at berrydunn.com. BerryDunn is the brand name under which Berry, Dunn, McNeil & Parker, LLC and BDMP Assurance, LLP, independently owned entities, provide services. Since 1974, BerryDunn has helped businesses, nonprofits, and government agencies throughout the US and its territories solve their greatest challenges. The firm's tax, advisory, and consulting services are provided by Berry, Dunn, McNeil & Parker, LLC, and its attest services are provided by BDMP Assurance, LLP, a licensed CPA firm. “BerryDunn” is the brand name under which Berry, Dunn, McNeil & Parker, LLC and BDMP Assurance, LLP practice in an alternative practice structure in accordance with the AICPA Code of Professional Conduct and applicable law, regulations and professional standards. BDMP Assurance, LLP is a licensed independent CPA firm that provides attest services to its clients, and Berry, Dunn, McNeil & Parker, LLC and its subsidiary entities provide tax, advisory, and consulting services to their clients. #BD_CT #LI-Remote Don't See A Match For You At This Time? We invite you to join our Talent Connection and let's stay in touch

To provide client service support to the Account Management teams. Collect medical documentation and information to setup new clients of 180 Medical. Key Responsibilities: Contact clients to set up medical supply orders Handle incoming phone calls from clients regarding orders & customer service issues Request Medicare documentation on Medicare clients Contact medical facilities to obtain cultures and UAs on potential clients Make entries as appropriate in Medtrack an internal Microsoft Access database Place orders and/or change orders in Medtrack Support Team Leader on miscellaneous projects Scanning and faxing all types of documentation to medical facilities Verifying insurance for existing customer insurance changes Performs follow up phone calls to clients after the initial shipment Verifies that client files are complete and all necessary documentation is in place All other duties as assigned. Qualifications/Education: Must have a high school diploma; college degree preferred, not required. Six months to one year related experience and/or training; or equivalent combination of education and experience. Typing: 35-40 wpm with 40 (adjusted) highly recommended Possess medical administrative skills Good communication skills with professionals in clinics and hospitals Sales experience preferred Ability to reason, problem solve and think outside the box Multi-task a variety of issues Good organization skills and can prioritize tasks Proficient in Microsoft Office programs Good attention to detail Reliable/dependable Flexible and adaptable to changes in environment and industry Team Player; work well with others Dimensions: Physical Demands Regularly required to sit, stand, walk, and occasionally bend and move about the facility. Infrequent light physical effort required. Occasional lifting up to 10 lbs. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Working Conditions Work performed in an office environment, Special Factors This role can be performed remotely. Beware of scams online or from individuals claiming to represent Convatec A formal recruitment process is required for all our opportunities prior to any offer of employment. This will include an interview confirmed by an official Convatec email address. If you receive a suspicious approach over social media, text message, email or phone call about recruitment at Convatec, do not disclose any personal information or pay any fees whatsoever. If you're unsure, please contact us at ********************. Equal opportunities Convatec provides equal employment opportunities for all current employees and applicants for employment. This policy means that no one will be discriminated against because of race, religion, creed, color, national origin, nationality, citizenship, ancestry, sex, age, marital status, physical or mental disability, affectional or sexual orientation, gender identity, military or veteran status, genetic predisposing characteristics or any other basis prohibited by law. Notice to Agency and Search Firm Representatives Convatec is not accepting unsolicited resumes from agencies and/or search firms for this job posting. Resumes submitted to any Convatec employee by a third party agency and/or search firm without a valid written and signed search agreement, will become the sole property of Convatec. No fee will be paid if a candidate is hired for this position as a result of an unsolicited agency or search firm referral. Thank you. Already a Convatec employee? If you are an active employee at Convatec, please do not apply here. Go to the Career Worklet on your Workday home page and View "Convatec Internal Career Site - Find Jobs". Thank you!

The Health Data Analyst provides information, analyses, and consultation to internal and external stakeholders. This position assesses the performance of pharmacy benefits and/or networks and develops recommendations for improvements or enhancement to support departmental and organizational objectives. This position will participate in the development of new reports, analytical models, and products/benefit programs that align with strategic imperatives. Responsibilities Assumes responsibility for moderately complex analytic and consultative work such as analyzing and interpreting client pharmacy benefit data, trends and reports and partnering with analytics team to deliver recommendations or project status updates to internal and external stakeholders; investigates follow up items or questions regarding project and/or request scope Investigates key drivers of benefit performance Create new queries using Alteryx including multiple table joins, understanding of table structures, creation of detailed formulas Participates in development of analytic methodologies, models, reports and new products May be responsible for Centers for Medicaid/Medicare Services reporting and analysis, including the management of directories and bid support Other duties as assigned Minimum Qualifications Bachelors degree in Mathematics, Finance, or related field, or the equivalent combination of education and/or relevant work experience; HS diploma or GED is required 2 years of experience in pharmacy benefits management, reporting & analytics, benefits consulting, healthcare, financial services or related field Must be eligible to work in the United States without need for work visa or residency sponsorship Additional Qualifications Advanced Microsoft Excel skills ability to create complete formulas and efficient data manipulation. Intermediate troubleshooting skills, including in-depth client data research, which may involve research and drivers of utilization; understands resources needed and steps/processes on how to complete the problem; able to understand when an issue arises how-to navigate to a resolution Strong PBM industry knowledge; able to articulate the industry trends to clients and the impact of trends and changes to client financials Ability to establish rapport and effectively influence at all levels within an organization Ability to communicate effectively and present complex data to a wide variety of audiences Preferred Qualifications Knowledge of the PBM (Pharmacy Benefit Management) industry and PBM data; understands key PBM metrics (such as PMPM, generic utilization) Experience working with large sets of pharmacy, claims, medical, and/or financial data Previous experience in a client facing or consultative role Extensive experience using analytic tools; familiarity with Alteryx Minimum Physical Job Requirements Constantly required to sit, use hands to handle or feel, talk and hear Frequently required to reach with hands and arms Occasionally required to stand, walk and stoop, kneel, and crouch Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus