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Remote Albion, NY jobs - 23 jobs

  • Speech Language Pathologist | $70/hr | remote or onsite |

    Amergis

    Remote job in Le Roy, NY

    SLP needed in Dansville $70/hr remote or onsite contact Laura at ******************** for more information The Speech-Language Pathologist is responsible for the implementation of speech/language pathology services. Minimum Requirements: Meets the education and experience requirements for a Certificate of Clinical Competence in speech-language pathology Must hold a degree from an accredited school of Speech-Language Pathology? Current licensure or certification as a Speech Language Pathologist in the state of assignment? One year of prior professional Speech Language Pathology experience preferred? Current CPR if applicable TB Questionnaire, PPD or chest x-ray if applicable Current Health certificate (per contract or state regulation) Must meet all federal, state and local requirements Must be at least 18 years of age Benefits At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits: Competitive pay & weekly paychecks Health, dental, vision, and life insurance 401(k) savings plan Awards and recognition programs *Benefit eligibility is dependent on employment status. About Amergis Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions. Amergis is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
    $70 hourly 4d ago
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  • Senior Customer Service Representative

    CVS Health 4.6company rating

    Remote job in Alabama, NY

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Requisition Job DescriptionPosition SummaryMeritain Health an Aetna/CVS affiliate has multiple openings for Sr. Customer Service Representatives in our permanent work from home role $19. 50/hr wage. This position handles customer service inquiries for our Fully Insured or High Profile role, they should be able to address problems via telephone, internet or written correspondence. Customer inquiries are of basic and routine nature. Handle incoming calls from members and providers regarding claims status, benefits and eligibility, PPO participation, etc Maintain department established performance metrics at a meets or exceeds expectations level Work together as a team and apply the Aetna Core Values in day-to-day operations Creating a Differentiated Service ExperienceDemonstrating Service DisciplineHandling Service ChallengesProviding Solutions to Constituent NeedsWorking Across BoundariesRequired Qualifications1+ years of customer service experience Experience in a metric based environment Proficiency with full suite of Microsoft ApplicationsComfortability utilizing search engines Excellent multi-tasking skills Ability to Effectively CommunicatePreferred QualificationsExperience working in a call center environment Medical terminology/insurance experience Results oriented and self-motivated Experience working remotely EducationHigh School diploma, G. E. D. or equivalent experience Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$18. 50 - $42. 35This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $18 hourly 2d ago
  • Care Manager II - Adult Health Homes - Livingston, Genesee, Orleans Counties

    Hillside Enterprises 4.1company rating

    Remote job in Batavia, NY

    The Care Manager II services youth and adults in their community setting with the goal of reducing and preventing emergency room visits, hospitalizations, and decreasing overall Medicaid costs as a lead member of the team responsible for the client. This role utilizes assessments, care planning, linkage to services and community resources, advocacy, and support to coordinate services for adults, youth, and families using person centered and family driven care strategies. This is a Monday-Friday, full-time (40 hours) position with a flexible schedule based on client/staff needs. After an initial training period, this role can be a hybrid mobile/on the road & remote/work from home blend. The area of coverage is Livingston, Genesee, and Orleans counties. Essential Job functions Responsible for, but not limited to comprehensive assessments, outreach and engagement, service and treatment linkage and coordination for assigned youth, adults and families. Partner with referral sources to engage youth, adults and families and build an interdisciplinary care team to support the member in meeting their needs. Facilitate monthly face-to-face visits with adults, youth, family, and their interdisciplinary care team, for assigned caseload. Conduct initial and ongoing assessments to assist with accomplishing member's goals and needs within program requirements. Create, implement, evaluate, and modify, as required and needed, individual service plans to meet assessed client's unique needs as a member of a multi-disciplinary team. Refer members to applicable agency services and community programs, such as outpatient counseling, dental provider, and primary care providers. Support members who transition between systems and services (i.e. hospitalizations, inpatient stays, residential settings, housing needs, etc.). Establish and maintain productive working relationships with community service providers to facilitate referrals and service evaluations. Maintain required contact with members, families, and the interdisciplinary team and facilitate team meetings. Serve as a liaison between the program and other internal and external resources, ensuring information is shared with the Care Team. Maintain and update all necessary records, forms, reports, and summaries in member files according to agency and funders standards. Travel across different counties within respective region to serve members, as required. While this job description covers many aspects of the role, employees may be required to perform other duties as assigned. Education & Experience Bachelor's degrees required. Minimum 2 years of experience working in a human services or related position supporting youth, adults and families required. SPECIAL REQUIREMENTS Unrestricted, valid NYS driver's license for minimum of 1 year with a clean driving record and minimum insurance coverage that meets agency standards. Children's Health Home only : Must receive CANS (Child and Adolescent Needs and Strengths Assessment) certification score of 70 within 3 months of hire and annually thereafter. Knowledge, Skills & Abilities In addition to demonstrating the Hillside Professional Competencies of Communicates Effectively, Personal Excellence, Cultural Competence, Builds and Leverages Relationships, and Optimizes Decision Making, the following occupational competencies must be demonstrated: Demonstrate the highest standards for ethical and professional conduct at all times Knowledge of all federal, state, and local statutes, regulatory agency standards and Hillside policies. Ability to manage multiple tasks and large caseloads simultaneously. Ability to manage scheduling visits with high volume caseload and complete tasks by funder deadlines. Ability to de-escalate and manage crisis situations both in-person and by phone. Physical Demands & Work Environment 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. Must be able to work a variable scheduling including evenings and weekends The following daily physical demands are required: Sitting (up to 6 hours) Occasional standing (up to 2 hour) Occasional walking (up to 2.5 hours) Driving (several times a week up to 6 hours) Continuous balancing (up to 8 hours) Occasional balancing, bending, stooping, climbing, kneeling, pushing, pulling, reaching forward or down, reaching overhead, running, and twisting (up to 2.5 hours) Weekly lifting up to 10-15 lbs. on a daily basis Manual dexterity is required, including the frequent ability to grasp in both hands and continuous use of fine manipulation skills in both hands (approximately 1-2.5 hrs.) Occasional exposure to dust, fumes, gases, chemicals, or smoke is apparent Ability to change positions as needed SPECIAL CONSIDERATIONS While Hillside is a restraint free environment, there may be times in a “life or limb” situation, that staff may be required to physically restrain clients weighing between 50 lbs. and 300 lbs. and guide them safely to the floor. In some circumstances, restraints can last up to 15 minutes and may require repetition as necessary. $21.40 Minimum pay rate, $31.00 Maximum pay rate, based on experience.
    $21.4-31 hourly Auto-Apply 56d ago
  • Sales Representative (South)

    Alteryx Inc. 4.0company rating

    Remote job in Alabama, NY

    We're looking for problem solvers, innovators, and dreamers who are searching for anything but business as usual. Like us, you're a high performer who's an expert at your craft, constantly challenging the status quo. You value inclusivity and want to join a culture that empowers you to show up as your authentic self. You know that success hinges on commitment, that our differences make us stronger, and that the finish line is always sweeter when the whole team crosses together. The Alteryx Digital Representative is an account management role that overlays either Strategic AEs or Enterprise AEs, supporting day to day business, directing small to medium expansion and renewal opportunities, and facilitating overall account strategies. This role is expected to regularly exercise independent discretion and judgment, and make recommendations to the business and management thereof on matters of significance. Responsibilities: Account Management * Directing and managing day to day administration required to solve customer issues, increase sales momentum for Alteryx and conduct ongoing business with the account. * Gain a deep understanding of the customer's processes and problems. Ensure the right questions are being asked and answered. Bring unique value to every interaction. Develop relationships with multiple buying personas within the prospect account * Connect prospect's business objectives (both functional and corporate) with Alteryx solutions. Deploy a customer-centric approach in understanding how Alteryx can do so * Establish positive relationships based on knowledge of customer requirements and dedication to value (value of counsel and expertise, value of solutions, value of implementation expertise) * Identify opportunities to increase adoption and expand Alteryx's footprint at the account utilizing data, metrics, and discovery * Partner with Customer Success (where applicable) to ensure customers achieve outcomes and are positioned for successful renewals and strategize regarding best practices for the AE in conjunction with large and complex accounts. Help accelerate customer time-to-value to support future expansion. Renewal & Expansion ($100K-$250K ATR Segment) * Own renewals for assigned customers with ATR between $100K-$250K * Drive independent expansion opportunities under 50K * Establish new foot holds for Alteryx within the accounts in the assigned territories. * Run customer calls, product conversations, and commercial negotiations with autonomy to reinforce value, mitigate risk, ensure commercial alignment, and facilitate close. * Maintain rigorous Salesforce hygiene. Territory Overlay & Partnership * Align tightly with assigned Strategic or Enterprise AEs to support overall account coverage with strategy and business operations. Prioritize issues within the account, identify key trends, and make business recommendations * Collaborating on broader account strategy and whitespace planning with internal teams * Use structured digital plays to activate new opportunities and drive velocity across the territory. Cross-Functional Collaboration * Partner with SEs, Marketing, Customer Success, Renewals, and Partners to support evaluations and adoption. * Navigate deal desk, legal, and discounting guardrails efficiently. * Ensure smooth handoffs and alignment on customer objectives across functions, and make recommendations on customer objections. Qualifications * 2-5 years of quota-carrying SaaS sales experience (Digital AE, RM, SMB/MM AE, ISR) * Strong negotiation, objection handling, and closing skills. * Experience with Salesforce and sales engagement tools. * Ability to travel 10-25% as needed. * Competitive, coachable, resilient, and driven by performance in a high-growth GTM environment. Compensation Alteryx is committed to fair, equitable, and transparent compensation. Final compensation is determined by several factors, including but not limited to relevant work experience, education, certifications, skills, and geographic location. The base salary range for this role in the United States is $81,000-$90,000 with On-Target-Earnings range of $135,000-$150,000. In addition to base pay and commission eligibility, this role includes clear forms of additional compensation, such as: * A monthly Connectivity Plus stipend of $150 to support remote work-related expenses * An annual $200 home office reimbursement Alteryx offers a comprehensive benefits package designed to support your health, financial security, and overall well-being, including: * Medical, dental, and vision coverage * 401(k) with company match * Paid parental leave, caregiver leave, and flexible time off * Mental health support and wellness reimbursement * Career development and education assistance #LI-JS1 #LI-REMOTE Find yourself checking a lot of these boxes but doubting whether you should apply? At Alteryx, we support a growth mindset for our associates through all stages of their careers. If you meet some of the requirements and you share our values, we encourage you to apply. As part of our ongoing commitment to a diverse, equitable, and inclusive workplace, we're invested in building teams with a wide variety of backgrounds, identities, and experiences. Benefits & Perks: Alteryx has amazing benefits for all Associates which can be viewed here. For roles in San Francisco and Los Angeles: Pursuant to the San Francisco Fair Chance Ordinance and the Los Angeles Fair Chance Initiative for Hiring, Alteryx will consider for employment qualified applicants with arrest and conviction records. This position involves access to software/technology that is subject to U.S. export controls. Any job offer made will be contingent upon the applicant's capacity to serve in compliance with U.S. export controls.
    $135k-150k yearly Auto-Apply 17d ago
  • (Remote) Corporate Development Outreach Specialist

    Harris Computer Systems 4.4company rating

    Remote job in Alabama, NY

    Harris is expanding its Corporate Development & M&A team and is seeking a highly driven Corporate Development Outreach Representative to fuel top-of-funnel acquisition sourcing. This role is designed for someone who thrives on outbound activity, enjoys making high-volume phone calls, and brings creativity, persistence, and grit to opening doors with founders, CEOs, and senior executives. This remote role welcomes candidates anywhere in Canada and the US in the EST timezone. Minimal travel requirements, but will require some travel 2-3 times per year for learning development in North America. A valid passport/visa is required for travel. Salary: 70K-75K What your impact will be: * Proactively source acquisition opportunities through high-volume outbound outreach (cold calling, email, LinkedIn, events follow-up). * Identify, research, and engage founders, CEOs, and owners of software and technology-enabled businesses. * Execute structured, multi-step outreach cadences and continuously refine messaging through testing and feedback. * Initiate and qualify early-stage conversations and book introductory and discovery meetings for senior M&A and Business Development leaders. * Conduct market, account, and industry research to personalize outreach and identify strategic fit. * Build long-term relationships with executives, entrepreneurs, advisors, and intermediaries. * Maintain exceptional CRM hygiene in Salesforce, including notes, activity tracking, pipeline stages, and dispositions. * Meet or exceed weekly and monthly KPIs tied to outreach volume, conversations, meetings booked, and qualified targets added. * Support transaction progression by coordinating meetings, site visits, and information flow as opportunities advance. What We're Looking For * Competitive and energized by outbound prospecting and initial outreach. * 1-3 years of experience in business development, sales, M&A origination, or high-volume outbound roles. * Proven comfort engaging senior decision-makers and handling objections with confidence. * Strong interest in M&A, corporate development, and software or SaaS businesses. * Creative, resourceful, and persistent in finding new ways to engage prospects. * Excellent verbal and written communication skills. * Highly organized with strong attention to detail and urgency. * Self-starter who thrives in fast-paced, ambiguous environments and consistently exceeds goals. * Experience using CRM tools (Salesforce preferred), LinkedIn, AI, and outbound sequencing tools. * Business acumen and problem-solving mindset; financial literacy is a plus. * Willingness to travel occasionally for conferences, events, or founder meetings. Measures of Success * Consistent flow of new conversations and qualified acquisition targets. * Strong conversion rates from outreach to meetings and qualified opportunities. * High-quality executive relationships built over time. * Accurate, disciplined CRM reporting and pipeline management. What we can offer: * 3 weeks' vacation and 5 personal days * Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment * Employee stock ownership and RRSP/401k matching programs * Lifestyle rewards * Remote work and more! About Harris: Harris is a leading provider of mission critical software to the public sector in North America. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals. Our success has been realized through investments in our proprietary software and market expertise. This focus, combined with acquiring businesses that build upon or complement our offerings, has helped drive our success. Harris will continue to growth through reinvestment - both in the people and products that we offer and making investments in acquiring new businesses. #LI-remote
    $43k-59k yearly est. Auto-Apply 6d ago
  • Manufacturing Engineering Director

    Winland Foods

    Remote job in Medina, NY

    Winland Foods is a leading manufacturer of high-quality food products trusted by households and foodservice partners across North America. Grounded in our values and driven by our One Winland mindset, we are transforming how we operate-from the plant floor to the executive level-to deliver exceptional value to our customers, our employees, and the communities we serve. We take pride in fostering a culture of continuous improvement, accountability, and innovation. If you're energized by building high-performing teams, creating sustainable systems, and shaping the future of manufacturing excellence, we'd love to meet you. The Director of Engineering will lead the development and execution of Winland Foods' manufacturing engineering strategy, driving capital investment and process optimization across our network of our 11 pasta/dry dinners manufacturing facilities. This leader will guide a team of engineers and collaborate deeply with Operations, Supply Chain, Maintenance, Quality, EHS, and Finance to ensure best-in-class performance in safety, cost per pound, service, quality, and sustainability. **Employee Type:** Full time **Location:** US Works from Home **Job Type:** Engineering **Job Posting Title:** Manufacturing Engineering Director **Job Description:** **Schedule:** Remote with Travel up to 75% **Work Location:** Remote and must reside in one of the states where our manufacturing facilities are located. (AZ, MO, KY, TX, IL, NY, SC, WI, PA, ND) **Benefits:** Medical, Dental, Vision, 401(k) with match, STD/LTD/AD&D/Life, HSA, FSA, EAP, Hospital indemnity, Accident Insurance, Identity and Fraud Protection Plan, Legal, and Critical Illness. **Salary, based on experience and other qualifications:** $136k to $238k Annually with additional bonus potential We are seeking a transformative leader - someone who is as passionate about coaching and developing talent as they are about technical rigor and data-driven problem solving. **Key Responsibilities** **Strategic Leadership** + Define and execute the engineering strategy aligned to business objectives. + Advance a continuous improvement culture to improve cost per pound and productivity while enhancing quality and service. + Drive standardization of processes and best practices across sites. **Capital Management & Innovation** + Lead capital planning and execution to optimize capacity, technology upgrades, cost savings, and facility expansions. + Develop and manage the 3 year CAPEX plan for the Pasta Plant network. + Lead and support project development and the presentation of capital authorization documents that are complete, concise, and reflect thorough due diligence to ensure project success. + Evaluate emerging technologies that enhance automation, sustainability, and throughput. + Partner with procurement and vendors to manage equipment selection, installation, commissioning, and training. Drive capital supplier negotiations to optimize cost-benefits. + Lead and support projects through ideation and stage gating, scoping, approval, final engineering/design, equipment selection and procurement, construction, and commissioning, qualification, and validation. + Develops Business Case Screening scopes and cost estimates to give the business team a directional view of a project and the robustness of the business case. **Team & People Development** + Build, mentor, and inspire a high-performing, diverse engineering team. + Foster a culture of curiosity, collaboration, and accountability. + Directly engage with plant teams to support capability-building and performance coaching. **Operations & Process Excellence** + Lead engineering efforts related to processing, packaging, and automation to improve efficiency and reliability. + Partner closely with Operations, Quality and Maintenance to reduce downtime and improve equipment life cycles. + Ensure safety-employee and food safety-remains a non-negotiable priority in all engineering work. + Provide leadership, resources, and on-site troubleshooting to support resolution of plant related technical issues. **What Great Looks Like** + A proactive, visible leader who builds trust and alignment across teams. + A strategic thinker who also loves rolling up their sleeves on the plant floor. Travel of ~50% to 65% is expected. + Compelled by measurable results, sustainable standard work, and continuous improvement. + Strong communicator who energizes others and champions Winland Values across functions. **Qualifications** **Required** + Bachelor's degree in Engineering (Mechanical, Industrial, Chemical, or related). + 10+ years of manufacturing engineering experience; with at least 5 years in a multi-site environment. + Proven track record in capital planning and execution and project management. + Demonstrated leadership by building and developing high-performing engineering teams. + Strong ability to collaborate cross-functionally and influence at all organizational levels. + Working knowledge of sanitary equipment design, Good Manufacturing Practices and Government regulations as they apply to food manufacturing operations (i.e. OSHA, EPA, FDA). + Proficiency in MS 365, and MS Project. **Preferred** + Food or consumer packaged goods (CPG) experience strongly preferred. + Experience with AutoCAD and SAP. + Experience with automation, industrial control systems, and IIoT technologies. + Formal project management training or certification. **Winland Values & Culture** + We Put People First + We Deliver Excellence + We Act with Integrity + We Win Together - One Winland ** ** The Engineering Director will be a visible culture carrier-working shoulder to shoulder with plant teams to foster continuous improvement, empowerment, and operational excellence. **Why Join Winland Foods** + High-impact leadership role with direct influence on enterprise transformation. + Opportunity to shape engineering strategy and build a best-in-class technical organization. + A culture committed to career development, collaboration, and innovation. + Competitive compensation, benefits, and growth opportunities. Play a critical role in shaping the future of Winland Foods-where your ideas, expertise, and leadership will help drive breakthrough performance. **Join us. Let's build something exceptional-together.** **EEO Statement:** Winland Foods seeks to recruit, develop, and retain the most talented people from a diverse candidate pool, and as a global company we believe our success is enhanced by fostering equity and inclusion in the workplace. Therefore, Winland Foods is committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates without regard to race, color, religion, sex, pregnancy, national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, genetic information, military or veteran status, and any other characteristic protected by applicable law. **About Us** At Winland Foods, we're passionate about creating exceptional food experiences that bring people together. We are a dynamic and growing company specializing in meal preparation products-from pasta and sauces to plant-based proteins and more. Our portfolio includes beloved consumer brands and custom private-label solutions for retail and foodservice channels. **Why Work With Us?** We believe in being exceptional **from the land to the table** . That means: + **Commitment to Quality:** We consistently exceed industry standards across our value chain. + **Sustainability & Responsibility:** We prioritize environmental stewardship and make a positive impact on the world around us. + **People First:** The safety, well-being, and growth of our employees are at the heart of everything we do. **Our Culture** We're a team of food enthusiasts who value collaboration, innovation, and integrity. At Winland Foods, you'll find an environment where your ideas matter, your contributions are recognized, and your career can thrive. **Explore Opportunities** At Winland Foods, you'll find opportunities across operations, supply chain, marketing, and product development-roles where your work truly makes an impact. By joining our team, you become part of a forward-thinking organization that values passion, collaboration, and shared success with our customers. Together, we're shaping the future of food. **To All Recruitment Agencies** Winland Foods does not accept unsolicited agency resumes/CVs. Please do not forward resumes/CVs to Winland Foods employees, or any company location(s). Winland Foods is not responsible for any fees related to unsolicited resumes/CVs.
    $132k-188k yearly est. 60d+ ago
  • Remote Part Time Data Entry Jobs

    Remote Jobs Solutions

    Remote job in Akron, NY

    About the job Remote Part Time Data Entry Jobs - $1900/ Weekly Remote Part Time Data Entry Jobs - $1900/ Weekly This is your opportunity to start a long-lasting career with endless opportunity. Discover the freedom you've been searching for by taking a moment to complete our online application. Benefits: Excellent weekly pay Safe workplace Multiple shifts are offered from morning to night and no experience is required. You will have ample opportunity for growth Part-time offered - choose the days you want to work A commitment to promote from within Responsibilities: Must have the ability to carry out tasks with or without sensible accommodation Perform all other duties as appointed Assist in creating a favorable, professional and safe work environment Qualifications: No experience, Willing to train Ability to work within established turnaround times Must have excellent social skills and the ability to organize simultaneous tasks Ability to analyze and apply company policies and procedures Excellent verbal and written communication abilities Ability to work both individually and within a team environment Ability to remain organized, regard to detail, follow guidelines and multi-task in a professional and efficient way
    $30k-37k yearly est. 60d+ ago
  • Utilization Management Nurse Consultant

    CVS Health 4.6company rating

    Remote job in Alabama, NY

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. SummaryAssesses and monitors patient health, administering medications and treatments, performing medical procedures, and collaborating with physicians and other healthcare professionals to develop and implement patient care plans. Educates patients and their families about healthcare management and assists in maintaining a safe and supportive healthcare environment. Primary Job Duties & ResponsibilitiesDrives effective utilization management practices by ensuring appropriate and cost-effective allocation of healthcare resources and facilitating appropriate healthcare services/benefits for members. Conducts routine utilization reviews and assessments, applying evidence-based criteria and clinical knowledge to evaluate the medical necessity and appropriateness of requested healthcare services. Collaborates with healthcare providers, multidisciplinary teams, and payers to develop and implement care plans that optimize patient outcomes while considering the efficient use of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare professionals by promoting effective utilization management strategies. Reviews and analyzes medical records, treatment plans, and documentation to ensure compliance with guidelines, policies, and regulatory requirements, subsequently providing recommendations for care coordination and resource optimization. Consults with and provides expertise to other internal and external constituents throughout the coordination and administration of the utilization/benefit management function. Communicates regularly with internal and external stakeholders to facilitate effective care coordination, address utilization management inquiries, and ensure optimal patient outcomes. Provides IC-related coaching and guidance to nursing staff and other healthcare professionals, sharing knowledge and expertise to enhance their understanding of utilization management principles and improve their clinical decision-making. Contributes to the development and implementation of utilization management strategies, policies, and procedures that aim to improve patient care quality, cost-effectiveness, and overall healthcare system performance. EducationBachelor's degree preferred/specialized training/relevant professional qualification. Prior Relevant Work Experience3-5 years Essential QualificationsWorking knowledge of problem solving and decision making skills. Working knowledge of medical terminology. Working knowledge of digital literacy skills. Ability to deal tactfully with customers and community. Ability to handle sensitive information ethically and responsibly. Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option. Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients. Registered Nurse (RN) required. Licensed Clinical Social Worker (LCSW) preferred. Requisition Job DescriptionPosition SummaryThis Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in any state. Normal Working Hours: Monday through Friday 8:30am-5:00pm in the time zone of residence. Shift times may vary occasionally per the need of the department. Rotational late shift 9:30-6CST. No travel is required. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. You would be responsible for ensuring the member is receiving the appropriate care at the appropriate time and at the appropriate location, while adhering to federal and state regulated turn-around times. This includes reviewing written clinical records. The UM Nurse Consultant job duties include (not all encompassing):Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the complex needs of the member. Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure, and clinical judgment to render coverage determination/recommendation along the continuum of care Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Required QualificationsRN with active and unrestricted state licensure in their state of residence2+ years of acute hospital clinical experience as an RN with preference for medical-surgical and ICU experience (team is not accepting applicants whose only acute care experience is in behavioral health) Preferred Qualifications1+ years' experience Utilization Review experience1+ years' experience Managed Care Strong telephonic communication skills1+ years' experience with Microsoft Office Suite (PowerPoint, Word, Excel, Outlook) Experience with computers toggling between screens while using a keyboard and speaking to customers. Ability to exercise independent and sound judgment, strong decision-making skills, and well-developed interpersonal skills Ability to manage multiple priorities, effective organizational and time management skills required Ability use a computer station and sit for extended periods of time EducationAssociate Degree in Nursing is minimum required, BSN preferred. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$29. 10 - $62. 32This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/03/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $29 hourly 2d ago
  • WIC Breastfeeding Peer Counselor

    Oak Orchard Community Health Center 4.3company rating

    Remote job in Brockport, NY

    Job DescriptionDescription: A paraprofessional support position providing basic breastfeeding information and encouragement to pregnant and breastfeeding enrolled WIC participants. Job Responsibilities: • Attends breastfeeding training classes to become a peer counselor. • Receives a caseload of WIC mothers and makes routine periodic contacts with all mothers assigned as outlined by WIC Breastfeeding Coordinator. • Gives basic breastfeeding information and support to new mothers, including telling them about the benefits of breastfeeding, overcoming common barriers, and getting a good start with breastfeeding. She also helps mothers prevent and handle common breastfeeding concerns. • Counsels WIC prenatal and breastfeeding mothers in the WIC clinic, by telephone, and/or hospital visits at scheduled intervals determined by the WIC Program. Can make these contacts outside the normal WIC office hours as needed. • Responds to WIC mothers who contact her as soon as possible, within 24 hours at most, utilizing the cell phone or office phone provided by the employer. • Respects each mother by keeping her information strictly confidential. • Keeps accurate records of all contacts made with WIC mothers. • Adheres to all organizational policies and procedures relative to exposure control. • Refers non scope-of-practice inquiries to: o WIC Nutritionist or Breastfeeding Coordinator o Lactation consultant o Healthcare providers o Community agencies and programs • Attends and assists with prenatal classes, facilitated group discussions, hospital visits, and breastfeeding support groups as offered. • Attends monthly staff meetings and breastfeeding conferences and workshops as appropriate. • Reads assigned books and materials on breastfeeding that are provided by Breastfeeding Coordinator. • May assist WIC staff in promoting breastfeeding peer counseling through special projects and duties as assigned. • May deliver and educate on breast pumps, after assessment by Breastfeeding Coordinator, a Qualified Nutritionist or Competent Professional Authority and provide education and follow-up under the guidance of the Breastfeeding Coordinator. • Complete mandatory trainings and read mandatory policies as required by Oak Orchard Health. • May participate in outreach and public health detailing as assigned. • Complies with all New York State WIC Program and Oak Orchard Health policies. • Any other reasonable requests from management. Requirements: Skills/Qualifications: · Has breastfed at least one baby (does not have to be currently breastfeeding) and within the target WIC population. · Is enthusiastic about breastfeeding and wants to help other mothers enjoy a positive experience. · Can work between 10-15 hours per week based on caseload needs. This is a per diem position and requires flexibility in schedule. Some evenings and weekends may be required. · Must be available to work in office and work from home available as determined by supervisor. · Has reliable transportation. Car and valid Driver's license required. Must maintain vehicle insurance. Car must be registered in New York State and maintain minimum requirement, by law, to have liability insurance. · Has good organizational skills, enabling her to manage her assigned caseload, keep track of her scheduled clinic hours, meetings, and trainings, and meet deadlines. · Current or previous WIC participants are preferred. · Is committed to creating a positive team environment and being a good team member. · Optional: Bilingual in English and another relevant language. Required Education and Experience: · High school diploma or equivalent. · Attends a series of breastfeeding classes based on New York State Peer counseling Curriculum. · Observes other peer counselors or breastfeeding experts helping mothers breastfeed. · Reads assigned books or materials about breastfeeding.
    $30k-40k yearly est. 13d ago
  • (Remote) Customer Success Analyst

    Harris Computer Systems 4.4company rating

    Remote job in Alabama, NY

    NorthStar is seeking a Customer Success Analyst to join our growing support team. As a successful candidate you will oversee customer tickets and ensure that customers receive timely responses and updates. You will investigate, manage, track and close client support issues. You will be responsible for contributing to a knowledge base and responding to customers through CHAT. You must have the ability to assess priorities and respond to issues accordingly seeing them through to resolution. In this role, you will report to Manager, Customer Success and you will be supported by a great team in providing exceptional, proactive customer service. This remote role welcomes candidates anywhere in Canada and the USA. Up to 10% travel may be required. A valid passport will be required to travel across Canada, USA, and the Caribbean. Salary: 65K-85K CAD based on experience. What your impact will be: * Deliver first line Customer support Operate as primary support liaison between NorthStar and our clients. Effectively respond to and resolve inquiries of both a product and technical nature received by telephone, electronically submitted tickets or through CHAT. * Assess various situations, reviewing software configuration, set-up and software code while identifying the correct resolution or escalation according to NorthStar Support guidelines. * Report detailed information within the client tracking system and document processes, routines, and programs by following the defined guidelines and team goals & objectives. * Regularly review the database of submitted items and proactively follow up with internal and external clients to ensure that their inquiries and/or issues have been satisfactorily resolved. * Work closely with other team members as part of a cohesive group exchanging knowledge through peer-to-peer interaction training sessions. * Maximize and maintain current knowledge and awareness of applications and related technologies. * Develop, monitor, document and maintain best practices. What we are looking for: * Preference would be given to any candidates with utility experience. * Proven work experience in Software Support role. * Strong interpersonal and communication skills. * Excellent analytical, research and problem-solving skills with a strong ability to prioritize work effectively. * Exceptional attention to detail and the ability to grasp concepts quickly. What we can offer: * 3 weeks' vacation and 5 personal days * Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment * Employee stock ownership and RRSP/401k matching programs * Lifestyle rewards * Remote work and more! About Harris: Harris is a leading provider of mission critical software to the public sector in North America. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals. Our success has been realized through investments in our proprietary software and market expertise. This focus, combined with acquiring businesses that build upon or complement our offerings, has helped drive our success. Harris will continue to growth through reinvestment - both in the people and products that we offer and making investments in acquiring new businesses. About Northstar: NorthStar Utilities Solutions is a unique company that has served the utility community in North America and the Caribbean for 50 years. Our team members have enabled us to have continuous growth and innovation. We pride ourselves on delivering impressive customer service and standing apart as an industry leader. We are looking for people who are avid problem solvers, crave challenges, embrace technology and grasp complex ideas. Click here to learn more about NorthStar Utilities Solutions. #LI-remote
    $64k-90k yearly est. Auto-Apply 2d ago
  • Work from Home Inbound Customer Service (State of Alabama)

    Colony Brands, Inc. 4.4company rating

    Remote job in Alabama, NY

    SC Data Center, Inc. participates in the Department of Homeland Security U.S. Citizenship and Immigration Services' E-Verify program * This position is only open to candidates 18 years or older living in Alabama, Arkansas, Georgia, Iowa, Kansas, Louisiana, Mississippi, Missouri, North Carolina, or Wisconsin.* Work at Home! You can apply online at ***************************************************** Please call us at ************ if you have additional questions! Join our team! Are you looking for a flexible part-time, seasonal job that fits your schedule? Start at $14.00 per hour and earn upsell commission on top! Choose your own availability and work around your existing commitments, making this the perfect role for those looking to earn extra cash before the holidays or as a seasonal second job. Join a supportive team that values your time and effort. As a Work at Home Inbound Customer Service Representative you are responsible for maintaining positive customer relations by addressing all types of product related concerns, including: taking orders, verifying information, tracking packages, and answering customer questions. Working from home entails a high level of computer knowledge as you will be required to navigate through multiple systems and enter information using your keyboard including function keys while speaking with customers on the phone. SC Data Center Inc., offers flexible schedules, paid training, employee discounts up to 50%, and Booster Discount Certificates that allow employees to purchase company products for free. As a Home Agent you will be able to work from the ease of your own home provided that your computer meets our minimum technical requirements (see below). Your next opportunity is just a few clicks away! Preferred Computer Requirements A PC or Laptop with: * Current and supported MS Windows 11 Operating System (No Mac, Vista, Chromebook, or XP) * Processor * AMD Ryzen 2nd Generation or newer OR * INTEL i-series 8th Generation or newer with 4 or more cores and must be 2018 or newer * 8GB RAM or installed memory * 10GB of Free Hard Disk Space Dedicated High Speed Internet: * Internet Download Speed: 10.0 MBPS * Internet Upload Speed: 5.0 MBPS * Wired Internet with a cable connection (Dial-up, Wi-Fi, Hotspots, and Satellite are not allowed) Minimum Computer Requirements A PC or Laptop with: * Current and supported MS Windows 11 Operating System (No Mac, Vista, Chromebook, or XP) * Processor * AMD 2.1GHZ or higher OR * INTEL 1.8GHZ or higher, OR * INTEL 1.7GHZ or lower; must be i3, i5, i7, or Pentium with 4 or more cores and be 2016 or newer * 4GB RAM or installed memory * 10GB of Free Hard Disk Space Dedicated High Speed Internet: * Internet Download Speed: 4.0 MBPS * Internet Upload Speed: 2.0 MBPS * Wired Internet with a cable connection (Dial-up, Wi-Fi, Hotspots, and Satellite are not allowed) Other Requirements * Keyboard: Function Keys (F-Keys) * Wired USB Headset * Webcams are recommended (not required) * Dual monitors recommended (not required) * Minimum monitor size of 17+ inches recommended (not required) * External mouse recommended (not required) Training Requirements (Mandatory): * 1st Shift Training - 2 weeks (M-F), 8:30am-3:30pm CST * 2nd Shift Training - 2 weeks (M-F), 5:00pm-11:00pm CST * Weekend Training - 3 weekends (Sa-Su), 8:00am-4:00pm CST Most communication throughout the hiring process will be conducted via email. Please ensure you enter a valid email address that you check regularly when completing the application. You can expect emails from **************************** and **************************. To prevent these emails from ending up in your junk/spam folders, we ask that you set your email filter to unblock, whitelist, or accept emails from these addresses. Benefits Details Temporary/Part-Time Employee Benefits/Perks: Performance Based Pay/Incentives - We provide job performance pay and incentive based pay for the majority of our Temporary/Part-Time roles Shift Premium pay for 2nd, 3rd, and Weekend shifts Holiday Pay for employees returning for their fifth consecutive season Safety and Attendance Incentives Employee Discounts - Our employee sales program offers employee discounts on items ordered from our catalogs and selected Outlet Store. Discounts range from 45% to 50% off.Employee Mini Stores - Discounted product offered at our multiple Employee Only StoresFlexible Work Schedules
    $14 hourly Easy Apply 27d ago
  • US Seasonal Tax-Financial Services Organization-Private Tax- Manager

    About EY-Parthenon

    Remote job in Akron, NY

    At EY, we're all in to shape your future with confidence. We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world. Seasonal Tax Manager - FSO-PCS Financial Services Organization Private Client Services (PCS) is a growing practice within EY, and you'll see that growth reflected in our career opportunities. The team has a dedicated focus toward serving privately held companies and their owners and their families. These clients span from family-owned businesses to private equity owned companies. One thing they all have in common is they are high growth private companies. As many companies choose to no longer go public, this is an ever increasing and exciting group of companies from start-up companies all the way to multibillion-dollar global private enterprises. With a diverse portfolio of interesting and challenging work, you'll make an impact on some of the most technically demanding tax planning and compliance projects around. You'll be part of a growing global team, acting as a key point of contact for a wide range of clients and colleagues. In return, you can expect plenty of support designed with your own personal skills and experience. EY is a dynamic place to develop not only your technical tax knowledge, but also your professional leadership and business acumen. The opportunity EY is currently seeking experienced seasonal tax professionals for our tax season. You'll join the team at a critical time, leveraging your expertise to help support our clients. In return, you can expect the support of some of the most engaging colleagues around. You'll receive hourly, over-time eligible pay, and a unique opportunity to enhance or refine your skills within one of our high performing tax teams. Your key responsibilities As a seasonal tax manager your main priority includes reviewing complex individual tax returns for our Private Tax clients. In this role you'll be able to work remotely from within the United States. Skills and attributes for success A strategic eye toward prioritizing when working on multiple complex projects Experience performing high quality review of complex tax returns Knowledge/experience in handling Individual, Gift, Trust, and Estate Tax Returns- 1040, 1041, 706, 709 Comfort with working remotely in a virtual team environment including working with an offshore shared services center To qualify for the role you must have Valid US Certified Public Accountant (CPA) license or Enrolled Agent (EA) or active state bar membership A bachelor's degree in Accounting, Finance, Business, or a related discipline A minimum of 5 years of relevant experience in tax compliance for private client individuals in financial services Strong analytical skills, written/verbal communication skills, interpersonal; problem-solving ability and attention to detail Ideally, you'll also have A proven record of excellence in tax accounting for financial statements with a top or mid-tier firm What we look for We're interested in strong team players who support their colleagues in reaching their goals while also considering their own workload and deliverables. We're looking for people with a genuine passion for tax, and the future of tax, and are inspired to help our clients meet complex tax obligations. If you have a strong quality focus, the desire to develop meaningful relationships, and the ambition to deliver above and beyond expectations, this role is for you. What we offer you At EY, we'll develop you with future-focused skills and equip you with world-class experiences. We'll empower you in a flexible environment, and fuel you and your extraordinary talents in a diverse and inclusive culture of globally connected teams. Learn more. The salary range for this job in all geographic locations in the US is $90/hr to $120/hr. Individual salaries within those ranges are determined through a wide variety of factors including but not limited to education, experience, knowledge, skills and geography. Are you ready to shape your future with confidence? Apply today. EY accepts applications for this position on an on-going basis. For those living in California, please click here for additional information. EY focuses on high-ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities. EY | Building a better working world EY is building a better working world by creating new value for clients, people, society and the planet, while building trust in capital markets. Enabled by data, AI and advanced technology, EY teams help clients shape the future with confidence and develop answers for the most pressing issues of today and tomorrow. EY teams work across a full spectrum of services in assurance, consulting, tax, strategy and transactions. Fueled by sector insights, a globally connected, multi-disciplinary network and diverse ecosystem partners, EY teams can provide services in more than 150 countries and territories. EY provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, genetic information, national origin, protected veteran status, disability status, or any other legally protected basis, including arrest and conviction records, in accordance with applicable law. EY is committed to providing reasonable accommodation to qualified individuals with disabilities including veterans with disabilities. If you have a disability and either need assistance applying online or need to request an accommodation during any part of the application process, please call 1-800-EY-HELP3, select Option 2 for candidate related inquiries, then select Option 1 for candidate queries and finally select Option 2 for candidates with an inquiry which will route you to EY's Talent Shared Services Team (TSS) or email the TSS at **************************.
    $90-120 hourly 60d+ ago
  • Virtual Data Collection Agent (Work-at-Home)

    Focusgrouppanel

    Remote job in Chili, NY

    We appreciate you checking us out! Work At Home Data Entry Research Panelist Jobs - Part Time, Full Time This work-from-home position is ideal for anyone with a diverse professional background, including administrative assistants, data entry clerks and typists, customer service reps or drivers. Unleash your skillset within an accommodating role that can be managed from any location! Are you searching for a new way to make money? Look no further - we are seeking individuals now who can work remotely from their own homes! Whether it's part-time or full-time, discover an opportunity that works best with your schedule. You will find both full-time and part-time remote opportunities in a variety of career fields. To secure a legitimate work from home data entry position, expertise in that field isn't an absolute must. Companies providing these jobs offer comprehensive training to the successful applicant so they can excel at their role! JOB REQUIREMENTS Computer with internet access Quiet work space away from distractions Must be able and comfortable to working in an environment without immediate supervision Ability to read, understand, and follow oral and written instructions. Data entry or administrative assistant experience is not needed but can be a bonus We are recruiting those who have a background in health care, warehouse worker, delivery drivers, customer service, etc - we welcome all backgrounds so long as you're ready to learn JOB PAY up to $250hr. (single session research studies) up to $3,000 (multi-session research studies) Applying on our website is necessary to ensure you receive important updates from us. Keep an eye out for emails with further instructions! To get started, these are the essential elements you'll need! LapTop. You may be asked to use your webcam. These types of studies typically pay more. You'll need a stable internet connection. You may be asked to conduct a study using your SmartPhone. Data entry skills. All studies require that you be able to read, write and take direction as well as type a minimum of 25 words per minute. Backgrounds in Customer Service, Administrative Assisting, Sales and Sales Support helpful but not mandatory We're eager to collaborate with you! Take the next step and reach out via email--apply now for a position today! Take control of your work schedule with our flexible position that allows for remote or in-person participation. With no minimum hours, you can choose to tackle this role part time or full time from the comfort of home. Plus, gain exclusive access to complimentary samples from sponsors and partners as a reward for offering valuable feedback on their products! Act now by clicking 'Apply' and launch into an exciting new work at home job today! This position is open to anyone looking for short-term, work at home, part-time or full-time job. Do you want to add an extra stream of income? Let us help! By participating in our paid market survey, people from all walks of life can earn some money. No prior experience is needed and the hours are flexible-perfect for those looking for a part-time job they can do remotely. Roles include data entry clerk, customer service agent, nurse or medical assistant - just choose what suits your skills best and start earning!
    $31k-56k yearly est. Auto-Apply 58d ago
  • Lead Director, Product Management and Development Remote

    CVS Health 4.6company rating

    Remote job in Alabama, NY

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position SummaryThe Lead Director, Product Standards Management provides strategic leadership to a team of approximately seven colleagues responsible for enterprise‑wide product standards, compliance oversight, and execution of complex cross‑functional initiatives. The role ensures that Commercial Product offerings align with regulatory requirements, organizational standards, competitive positioning, and operational feasibility. This leader cultivates a high‑performing culture, develops future talent, and serves as a trusted advisor to senior and executive leadership. The Lead Director drives operational excellence, establishes governance frameworks, anticipates risk, and ensures consistency and quality across Product Standards functions. Primary Responsibilities:Strategic Leadership & VisionSet strategic direction for Product Standards, ensuring alignment with enterprise objectives and Commercial Product goals. Translate complex regulatory, policy, and market insights into actionable product standards and operational guidance. Serve as a subject‑matter expert and advisor to senior leaders on product compliance, risk, and strategy. People Leadership & Talent DevelopmentLead and develop a team of seven professionals, driving a culture of accountability, high performance, growth, and engagement. Provide coaching, mentorship, and development planning that strengthens organizational capability and builds future leaders. Program & Standards GovernanceOversee large‑scale, enterprise initiatives focused on product standards, regulatory alignment, and compliance execution. Lead or oversee governance forums, regulatory review processes, cross‑functional consultation, and enterprise standard‑setting. Ensure consistent implementation of standards across teams, functions, and market segments. Operational Excellence & Risk ManagementEstablish, standardize, and continuously improve processes that enhance consistency, scalability, and compliance. Anticipate operational, regulatory, and cross‑functional risks; design and implement mitigation strategies. Partner with Product, Compliance, Legal, Actuarial, and Operational leadership to ensure end‑to‑end alignment. Cross‑Functional Partnership & CommunicationSynthesize complex information from regulatory, market, and legislative sources and communicate implications clearly. Deliver high‑impact presentations and recommendations to senior and executive stakeholders. Align product standards and compliance strategies across stakeholders and business units. Required Qualifications:8+ years of experience in product, benefit configuration, compliance, legislation, or related discipline. Deep understanding of healthcare products, benefits, regulatory policy, and industry dynamics. Proven experience leading complex cross‑functional projects and initiatives. Demonstrated leadership experience developing people, coaching teams, and building high‑performing cultures. Advanced strategic thinking with the ability to interpret legislation, assess business impact, and guide compliant decisions. Strong executive communication and influencing skills; ability to translate complex information for senior leaders. High proficiency in data analysis, desktop tools, and structured problem‑solving. Preferred Qualifications:Experience leading organizational change and continuous improvement initiatives. Track record of developing talent pipelines and building leadership capability. Experience in governance forums, regulatory review, or enterprise standard‑setting within a regulated environment. Ability to identify multi‑level risks and cross‑functional dependencies and design scalable mitigation strategies. Education:bachelor's degree preferred/specialized training/relevant professional qualification. Pay RangeThe typical pay range for this role is:$100,000. 00 - $231,540. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 02/13/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $100k-231.5k yearly 3d ago
  • NON-COMPACT STATE - PT Remote CCM/RTM Care Management Nurse (CA)

    Harris Computer Systems 4.4company rating

    Remote job in Alabama, NY

    Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing problems before they happen for patients with two or more chronic conditions. We believe every patient with chronic disease deserves consistent check-ins, follow-up, and support. The position of the Nurse Chronic Care Coordinator, Remote will perform telephonic encounters with patients on behalf of our partners each month and develops detailed care plans within our care plan templates in the electronic health record. This begins as an Independent 1099 Contractor position but offers the potential to reach full-time W2 employment (with employee benefits). Esrun Health is seeking Nurses to work part-time from their home office while complying with HIPAA privacy laws. You will set your own hours and will not be held to a daily work hour schedule. You will be contracted to work a minimum of 20hrs/wk. Esrun Health wants its team members to have the flexibility to balance their work-life with their home life. Part-time team members will typically need to dedicate an average of 20-30 hours per week to care for their assigned patients. This unique business model allows you to choose what days and what hours of the day you dedicate to care for your patients. The Care Coordinator will be assigned a patient panel based on skill and efficiency level and is expected to carry a patient panel of a minimum of 100 patients per calendar month. Care Coordinators will be expected to complete encounters on 90 percent of the patients they are assigned. Esrun Health utilizes a productivity-based pay structure and pays $10.00 per completed patient encounter up to 99 encounters/month, $10.25/encounter from 100-149 encounters/month, $12/encounter from 150-199 encounters/month, $14/encounter from 200-249 encounters/month, and $16/encounter for >250 encounters/month. Payment tier increases require 2 months consistency to achieve. A patient encounter will take a minimum of 20 minutes (time is cumulative including chart review, call times/attempts/texts, care plan development, care coordination, and documentation time). What your impact will be: * The role of the Care Coordinator is to abide by the plan of care and orders of the practice. * Ability to provide prevention and intervention for multiple disease conditions through motivational coaching. * Develops a positive interaction with patients on behalf of our practices. * Improve revenue by creating billable CCM episodes, increasing visits for management of chronic conditions. * Develops detailed care plans for both the doctors and patients. The care plans exist for prevention and intervention purposes. * Understand health care goals associated with chronic disease management provided by the practice. * Attend regularly scheduled meetings (i.e., Bi-Monthly Staff Meetings, monthly one on one's, etc.). These "mandatory" meetings will be important to define the current scope of work. What we are looking for: * Graduate from an accredited School of Nursing. (LPN, LVN, RN, BSN, etc.) * Current license to practice as an RN/ LVN/LPN with no disciplinary actions noted * A minimum of two (2) years of clinical experience in a Med/Surg, Case Management, and/or home health care. * Hands-on experience with Electronic Medical Records as well as an understanding of Windows desktop and applications (Microsoft Office 365, Teams, Excel, etc.), also while being in a HIPAA compliant area in home to conduct Chronic Care Management duties. * Ability to exercise initiative, judgment, organization, time-management, problem-solving, and decision-making skills. * Skilled in using various computer programs (If you don't love computers, you won't love this position!) * High Speed Internet and Desktop or Laptop computer (Has to be operation system of Windows 10 or higher or Mac) NO Chromebooks and no iPad. * Excellent verbal, written and listening skills are a must. What will make you stand out: * Quickly recognize condition-related warning signs. * Organized, thorough documentation skills. * Self-directed. Ability to prioritize responsibilities. Demonstrated time management skills. * Clear diction. Applies exemplary phone etiquette to every call. * Committed to excellence in patient care and customer service. What we offer: * Contract position with opportunity to become a full-time position, to include benefit options (Medical, Dental, Vision, 401K, Life). * Streamline designed technology for your Chronic Care operations. * Established and secure company since 1976, providing critical software solutions for many verticals in countries ranging from North America, Europe, Asia, and Australia * Core Values that unite and guide us. * Autonomous and Flexible Work Environments * Opportunities to learn and grow. * Community Involvement and Social Responsibility About us: Esrun Health, a division of Harris Computer, is on a mission to redefine remote care. Our program offers a customized model of remote care services that blends Chronic Care Management (CCM), Remote Therapeutic Monitoring (RTM), Remote Physiologic Monitoring (RPM), Behavioral Health Integration (BHI), and/or Transitional Care Management (TCM) for each client based on their specific practice needs. As a Harris healthcare business, we are able to maintain a people-focused, small company experience with the financial security of a large organization.
    $10 hourly Auto-Apply 15d ago
  • Counselor for School Based Services

    Bestself Behavioral Health 4.0company rating

    Remote job in Akron, NY

    Newly hired Counselors in certain clinics/programs will be eligible for up to $5,000 in a sign-on/retention bonus! Further details regarding eligibility & payments will be provided in the hiring process. Are you a committed, enthusiastic, caring, and licensed counselor ready to make a meaningful impact on the lives of others? We're inviting talented professionals like you submit an application to join our passionate team. At BestSelf Behavioral Health, our mission is to empower everyone to become their BestSelf and that absolutely includes our employees! We have a variety of schedules available. Part time includes any hours between 18-34 hours per week) & full time includes 35, 37.5, or 40 hours per week. Schedule may vary based on program but are typically Monday-Friday. Some programs may require evening and weekend availability (if that interests you, please let us know when we contact you!). Hybrid between in office and remote work may be an option for many of our programs. Have you heard about us? At BestSelf Behavioral Health, we're redefining the world of mental health and wellness with our pioneering and comprehensive services. We're not just a mental health provider; we're mental health innovators. We believe in reimagining mental health and wellness solutions to provide the best care to our communities. Join us on a journey of personal and professional growth, where your passion for making a difference can truly shine and your expertise will play a pivotal role in creating more innovative, evidence-based strategies for well-being. One in four adults faces mental health challenges annually. BestSelf Behavioral Health provides comprehensive services, including Individual and Group Therapy Medication Management, Peer Support, Psychiatric Rehabilitation, and Targeted Case Management. Through several comprehensive and integrated therapy techniques, we will address various needs such as anxiety, depression, stress, and major life changes. Additionally, we will provide Dialectical Behavior Therapy to support those impacted by substance use or gambling addiction. How will you inspire others to become their BestSelf? A Counselor at BestSelf Behavioral Health works directly with individuals facing various mental health, substance use, or co-occurring challenges, employing evidence-based & trauma informed care practices. The Counselor will provide individual and group therapy, support services for families, and crisis counseling. They collaborate with interdisciplinary teams to perform comprehensive assessments, diagnosis, treatment planning, discharges, and appropriate client referrals. In times of crisis, Counselors respond promptly and expertly, developing safety plans to ensure clients' well-being. Counselors will also embrace a harm reduction model to promote healthier choices and behaviors, fostering recovery, and growth. A Counselor at BestSelf can expect a workday that is dynamic, inspiring, and extremely rewarding. If you meet the following criteria, apply today! * Minimum Master's degree in Social Work, Mental Health Counseling, Marriage & Family Therapy, or CASAC-T/CASAC-P required. * Professional licensure: LMSW, LMFT, MHC-P, CASAC, CRC, LMHC, LCSW preferred. * Must have knowledge of a variety of common intervention techniques, common mental health diagnoses, substance use interventions and resources. * Excellent communication skills. * Must be familiar with community resources to be able to appropriately link clients. * Minimum proficiency with Windows based software applications is required. * Must have experience with Electronic Medical Records databases and basic computer skills. * Must appreciate cultural diversity and be aware of cross cultural counseling issues. * Valid Drivers License, vehicle in working condition (with valid inspection, registration, and insurance), ability to travel between sites, & Defensive Driving Course (only applicable for some of our community & mobile programs). Some things you can look forward to: * Welcoming, team environment, that inspires you to thrive and be your BestSelf! * Rewarding work experience! * Generous paid time off * Flexible schedule * Up to $5,000 sign on bonus* (further details regarding eligibility & payments will be provided in the hiring process) * Opportunity to increase leadership development by coaching & developing interns * Intern supervisors eligible for stipends at the conclusion of each semester * Quarterly productivity bonus up to $6,220 per year (with a potential to go even higher) * Community stipend per pay (applicable to our defined community & mobile programs) * Language stipend per pay (if fluent in another language that supports our clients) * Shift stipend (applicable to our residential programs) * Various student loan forgiveness programs * Multiple and diverse health insurance options * Many other unique lifestyle & personal insurance options * Tuition reimbursement * CASAC certification tuition support * Professional license/certification renewal reimbursement * Defensive driving course reimbursement (if required for position) * Career growth and advancement opportunities * We look forward to telling you more! Locations * Schools in Alden, NY, Akron, NY, Lockport, NY, Niagara Falls, NY, North Tonawanda, NY Salary Range * Determined based on education, level of licensure/certification, and experience. * Increases given when new licensure obtained. Unlicensed Counselors: * 35 hours per week: $43,500-$51,986.53 per year full time or $23.91-$28.57 per hour part time * 37.5 hours per week: $46,607.14-$55,699.85 per year full time or $23.91-$28.57 per hour part time * 40 hours per week: $49,714.28-$59,413.17 per year full time or $23.91-$28.57 per hour part time Licensed Counselors: * 35 hours per week: $45,500-$57,961.99 per year full time or $25-$31.85 per hour part time * 37.5 hours per week: $48,750-$62,102.13 per year full time or $25-$31.85 per hour part time * 40 hours per week: $52,000-$66,242.27 per year full time or $25-$31.85 per hour part time
    $49.7k-59.4k yearly 60d+ ago
  • Medical Director (Medical Policy & Operations)

    CVS Health 4.6company rating

    Remote job in Alabama, NY

    At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryAetna, a CVS Health company, has an outstanding opportunity for a Medical Director. Ready to take your career to the next level with a Fortune 6 company?This is a remote Work at Home position and can be located anywhere in the United States. In this role as Medical Director MPO (Medical Policy & Operations) you will be responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. This Medical Director provides subject matter expertise to provide clinical support and business direction in these areas. Knowledge of Aetna clinical and coding policy and experience with appeals, claim review, reimbursement issues, and coding is preferable, but a willingness to learn is essential. The Primary Responsibilities of this Medical Director role include support of the appeal process, clinical claim review process, pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise in clinical and payment policy to provide clinical support and business direction in these areas. In this role you will:Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services. Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna policies and practices to service and payment requests. Proactively use data analysis to identify opportunities for quality improvement and positively influence the effective delivery of quality care services. Be a subject matter expert, internal consultant and payment policy contributor subject matter expertise and internal consultant. Demonstrate the ability to work within and lead as necessary teams comprised of a diverse group of health delivery professionals in order to manage the business objectives of the company. Work Collaboratively with the functional areas. Required Qualifications*Five (5) or more years of experience in Health Care Delivery System e. g. , Clinical Practice and Health Care Industry. *Active and current state medical license without encumbrances. *M. D. or D. O. , Board Certification in an ABMS recognized specialty including post-graduate direct patient care experience Preferred Qualifications* Health plan/payor experience. * Foundational baseline skills in Medicine, Health Policy, Coding: HCPCS / CPT, Clinical Policy, Reimbursement and Health Care Systems. * Strong communication skills both written and verbal. Education* M. D. or D. O. , Board Certification in an ABMS recognized specialty including post-graduate direct patient care experience Pay RangeThe typical pay range for this role is:$174,070. 00 - $374,920. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/30/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $174.1k-374.9k yearly 43d ago
  • (Remote) Account Manager, Install Base Sales

    Harris Computer Systems 4.4company rating

    Remote job in Alabama, NY

    A division of Harris, Advanced is seeking a dedicated and results-driven Account Manager to join our dynamic team in the utility billing sector. In this pivotal role, you will focus exclusively on supporting the install base sales team, driving growth by developing and executing targeted account strategies in partnership with Regional Sales Directors. You will play a critical role in identifying and advancing cross-sell and up-sell opportunities across interoperable Harris platforms and preferred third-party partner solutions within the surrounding utility ecosystem. If you possess strong strategic thinking, relationship-building skills, and a solid understanding of utility operations and enterprise software, this is an excellent opportunity to contribute directly to the company's growth and customer success. This remote role welcomes candidates anywhere in Canada and the US. Up to 50% of travel within North America is required for this role. A valid passport/visa is required for travel. Salary: 80-100K What your impact will be: Strategic Account Planning * Collaborate closely with Regional Sales Directors to develop and execute target account sales strategies that expand solution adoption within existing utility customers. * Leverage data and insights from Salesforce (SF.com) and other corporate systems to prioritize opportunities, identify whitespace, and drive account-based sales strategies with precision and discipline. * Identify cross-sell and up-sell opportunities within the broader utility ecosystem, including Harris solutions and third-party preferred partners. Sales Enablement & Partner Collaboration * Work with internal and external solution partners to develop compelling, tailored proposals and solution recommendations. * Coordinate and support customer-facing webinars, thought leadership sessions, and joint partner campaigns to drive awareness and pipeline growth. Sales Execution Support * Prepare meeting materials, solution overviews, and supporting documentation for onsite and virtual customer engagements. * Participate in select onsite customer meetings, supporting Regional Sales Directors during presentations, demonstrations, and follow-up activities. * Ensure timely and high-quality post-meeting follow-up to advance opportunities through the sales cycle. Event & Conference Support * Serve as a key support function for regional, industry, and corporate conferences, helping coordinate booth activity, customer engagement schedules, and follow-up actions. * Represent the company professionally to strengthen relationships with existing customers and ecosystem partners. Market & Product Insight * Stay current on Harris and partner solution capabilities, competitive offerings, and industry trends to effectively position the value of integrated solutions. * Provide feedback from customer interactions to internal stakeholders to help refine sales strategies and product roadmaps. What we are looking for: * Bachelor's degree in business, Computer Science, or a related experience. * Proven experience in enterprise sales, account management, or business development, ideally in the utility billing or enterprise software sector. * A foundational understanding of utility operations and meter-to-cash processes. * Demonstrated success in cross-selling, upselling, or expanding footprint within existing accounts. * Experience collaborating with cross-functional teams and external solution partners to develop joint proposals. * Proficiency with Salesforce and corporate CRM tools, with a data-driven approach to managing opportunities, forecasting, and account planning. * A curiosity about Artificial Intelligence (AI) and a willingness to explore ways to leverage AI to drive sales automation, operational efficiency, and process improvement within the team. * Willingness to travel for customer meetings and industry events as required (up to 50%). What we can offer: * 3 weeks' vacation and 5 personal days * Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment * Employee stock ownership and RRSP/401k matching programs * Lifestyle rewards * Remote work and more! About Harris: Harris is a leading provider of mission critical software to the public sector in North America. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals. Our success has been realized through investments in our proprietary software and market expertise. This focus, combined with acquiring businesses that build upon or complement our offerings, has helped drive our success. Harris will continue to growth through reinvestment - both in the people and products that we offer and making investments in acquiring new businesses. About Advanced Utility Systems: Advanced Utility Systems was established in 1997 to provide Customer Information and Billing solutions exclusively to municipal, investor owned and cooperative utilities. With more than 150 successful customer deployments across North America, Central America, South America and the Caribbean, Advanced has the experience required to deliver a successful implementation of your mission critical CIS. #LI-remote
    $61k-82k yearly est. Auto-Apply 17d ago
  • Care Manager II - Adult Health Homes - Livingston, Genesee, Orleans Counties

    Hillside Childrens Center 4.0company rating

    Remote job in Batavia, NY

    The Care Manager II services youth and adults in their community setting with the goal of reducing and preventing emergency room visits, hospitalizations, and decreasing overall Medicaid costs as a lead member of the team responsible for the client. This role utilizes assessments, care planning, linkage to services and community resources, advocacy, and support to coordinate services for adults, youth, and families using person centered and family driven care strategies. This is a Monday-Friday, full-time (40 hours) position with a flexible schedule based on client/staff needs. After an initial training period, this role can be a hybrid mobile/on the road & remote/work from home blend. The area of coverage is Livingston, Genesee, and Orleans counties. Essential Job functions Responsible for, but not limited to comprehensive assessments, outreach and engagement, service and treatment linkage and coordination for assigned youth, adults and families. Partner with referral sources to engage youth, adults and families and build an interdisciplinary care team to support the member in meeting their needs. Facilitate monthly face-to-face visits with adults, youth, family, and their interdisciplinary care team, for assigned caseload. Conduct initial and ongoing assessments to assist with accomplishing member's goals and needs within program requirements. Create, implement, evaluate, and modify, as required and needed, individual service plans to meet assessed client's unique needs as a member of a multi-disciplinary team. Refer members to applicable agency services and community programs, such as outpatient counseling, dental provider, and primary care providers. Support members who transition between systems and services (i.e. hospitalizations, inpatient stays, residential settings, housing needs, etc.). Establish and maintain productive working relationships with community service providers to facilitate referrals and service evaluations. Maintain required contact with members, families, and the interdisciplinary team and facilitate team meetings. Serve as a liaison between the program and other internal and external resources, ensuring information is shared with the Care Team. Maintain and update all necessary records, forms, reports, and summaries in member files according to agency and funders standards. Travel across different counties within respective region to serve members, as required. While this job description covers many aspects of the role, employees may be required to perform other duties as assigned. Education & Experience Bachelor's degrees required. Minimum 2 years of experience working in a human services or related position supporting youth, adults and families required. SPECIAL REQUIREMENTS Unrestricted, valid NYS driver's license for minimum of 1 year with a clean driving record and minimum insurance coverage that meets agency standards. Children's Health Home only : Must receive CANS (Child and Adolescent Needs and Strengths Assessment) certification score of 70 within 3 months of hire and annually thereafter. Knowledge, Skills & Abilities In addition to demonstrating the Hillside Professional Competencies of Communicates Effectively, Personal Excellence, Cultural Competence, Builds and Leverages Relationships, and Optimizes Decision Making, the following occupational competencies must be demonstrated: Demonstrate the highest standards for ethical and professional conduct at all times Knowledge of all federal, state, and local statutes, regulatory agency standards and Hillside policies. Ability to manage multiple tasks and large caseloads simultaneously. Ability to manage scheduling visits with high volume caseload and complete tasks by funder deadlines. Ability to de-escalate and manage crisis situations both in-person and by phone. Physical Demands & Work Environment 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. Must be able to work a variable scheduling including evenings and weekends The following daily physical demands are required: Sitting (up to 6 hours) Occasional standing (up to 2 hour) Occasional walking (up to 2.5 hours) Driving (several times a week up to 6 hours) Continuous balancing (up to 8 hours) Occasional balancing, bending, stooping, climbing, kneeling, pushing, pulling, reaching forward or down, reaching overhead, running, and twisting (up to 2.5 hours) Weekly lifting up to 10-15 lbs. on a daily basis Manual dexterity is required, including the frequent ability to grasp in both hands and continuous use of fine manipulation skills in both hands (approximately 1-2.5 hrs.) Occasional exposure to dust, fumes, gases, chemicals, or smoke is apparent Ability to change positions as needed SPECIAL CONSIDERATIONS While Hillside is a restraint free environment, there may be times in a “life or limb” situation, that staff may be required to physically restrain clients weighing between 50 lbs. and 300 lbs. and guide them safely to the floor. In some circumstances, restraints can last up to 15 minutes and may require repetition as necessary. $21.40 Minimum pay rate, $31.00 Maximum pay rate, based on experience.
    $21.4-31 hourly Auto-Apply 56d ago
  • Utilization Management Nurse Consultant

    CVS Health 4.6company rating

    Remote job in Alabama, NY

    We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Regular business hours are 8:00 am-8:00 pm EST. Must be available to work any 8 hour shift within this timeframe with start times ranging from 8:00 am-11:30am EST. About Us American Health Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care management solutions that promote high-quality healthcare for members. Position SummaryJoin our Utilization Management team as a Nurse Consultant, where you'll apply clinical judgment and evidence-based criteria to review inpatient and outpatient services. You'll collaborate with providers, authorize care, and escalate cases when needed, all while navigating multiple systems and maintaining accurate documentation. This role suits nurses who thrive in fast-paced environments, are highly organized, and comfortable with computer-based work. Key ResponsibilitiesApply critical thinking and evidence-based clinical criteria to evaluate outpatient and inpatient services requiring precertification and concurrent review. Conduct clinical reviews via phone and electronic documentation, collaborating with healthcare providers to gather necessary information. Use established guidelines to authorize services or escalate to Medical Directors as needed. Navigate multiple computer systems efficiently while maintaining accurate documentation. Thrive in a fast-paced, high-volume environment with strong organizational, multitasking, and prioritization skills. Perform sedentary work that primarily involves extended periods of sitting, as well as frequent talking, listening, and use of a computer. Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring continuity of care and operational support. Participate in occasional on-call rotations, including some weekends and holidays, per URAC and client requirements. Remote Work ExpectationsThis is a 100% remote role; candidates must have a dedicated workspace free of interruptions. Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted. Required QualificationsActive unrestricted state Registered Nurse licensure in state of residence required. Minimum 5 years of relevant experience in Nursing. At least 1 year of Utilization Management experience in concurrent review or prior authorization. Strong decision-making skills and clinical judgment in independent scenarios. Proficient with phone systems, clinical documentation tools, and navigating multiple digital platforms. Commitment to attend a mandatory 3-week training (Monday-Friday, 8:30am-5:00pm EST) with 100% participation. Preferred Qualifications1+ year of experience in a managed care organization (MCO). Experience in a high-volume clinical call center or prior remote work environment. EducationAssociate's degree in nursing (RN) required, BSN preferred. Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$29. 10 - $62. 32This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $29 hourly 11d ago

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