Service Coordinator jobs at AmeriHealth Caritas - 96 jobs

AmeriHealth Caritas is seeking service-oriented, compassionate healthcare professionals to join our Long Term Services and Support (LTSS) team.Ideal candidates will have experience assessing those needingpersonal care services for instrumental daily living activities. As a Service Coordinator, you will assist participants who qualify for Medicaid in obtaining the long-term services and support they need as required by the Community Health Choices (CHC) agreement. You will contribute to the care coordination process by performing face-to-face assessments to identify, evaluate, coordinate, and manage participant's needs, including physical health, behavioral health, social services, and long-term services and support, as well as telephonic follow-up. **Work Arrangement** + This role is remote and will be community-facing + Qualified candidates must live in and be able to travel throughout Lawrence county in PA and surrounding areas. **Responsibilities** + Identify, coordinate, and assist participants in accessing needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports + Lead the participant-centered planning and service (PCPS) delivery process and oversee its implementation + Inform participants about available required needs assessments, the PCSP process, service alternatives, and service delivery options + Informs participants of their rights and assists with the complaint, grievance, and DHS Fair Hearing process + Collect additional necessary information, including participant preferences, strengths, and goals, to inform the development of the PCSP + Conducts reevaluation of level of care annually or more frequently as needed following CHC requirements + Works with the participant to complete activities necessary to maintain eligibility **Education and Experience** + Bachelor's Degree in social work, psychology, or related field is preferred + 3+ years of social service (in lieu of a Bachelor's degree) or related healthcare experience that required the following: + working with people who need personal care services + conducting face to face visits in the home or nursing facility focused on needs assessments and monitoring delivery of services + knowledge of the home and community-based service system and how to access/arrange for services + maintaining contact and relationships with healthcare professionals on a regular cadence, providing consistent and timely feedback to members' needs and requests + 2 to 3 years of Case management experience **Licensure** + Valid and current driver's license with reliable transportation with state-mandated minimum insurance **Skills & Abilities** + Must be computer proficient and have a working knowledge of MS Office specifically Excel + High speed internet + Dedicated home workspace free from distractions and conducive to HIPAA and Government compliance regulation AmeriHealth Caritas is a mission-driven organization with more than 40 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. We'd like to hear from you if you want to make a difference in people's lives. **Our Comprehensive Benefits Package** Flexible work solutions, including remote options and hybrid work schedules, Competitive pay, Paid time off, including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement, and more. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

The Year for Growth, Opportunity and Flexibility Are you ready for a career change in 2021? At American Income Life, we are searching for ambitious individuals who are ready to build a successful career while also having a positive impact on the communities around them. American Income Life currently provide supplemental insurance coverage to labor unions, credit unions and associations in 49 states, the District of Columbia, Canada and New Zealand. Why We Stand Out American Income Life provides supplemental insurance coverage to labor unions, credit unions and associations in 49 states, the District of Columbia, Canada and New Zealand. Requirements: Excellent communication skills Basic computer knowledge Work ethics Outgoing, fun & energetic with an upbeat personality Time management skills Pass a criminal background check Job Benefits: Full Benefits Paid weekly ($70,000 - $75,000 1st year average) Bonuses Health Insurance Reimbursement Life Insurance Flexible Schedule Retirement Plan American Income Life has served working class families since 1951 with life, accident, and supplemental health products to help protect members of labor unions, credit unions, associations, and their families. AIL representatives develop long-term relationships with clients and meet them where they are most comfortable: their homes Powered by JazzHR

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Supports community connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and supports the care team to identify member community support and provide health education as appropriate. This is a hybrid position must reside in Broward county for field visits to members homes to complete assessments. + Provides support to members to connect them to known community and care resources in a cost- effective manner + Supports the coordination of community outreach resources available to members and promotes awareness of care/services + Serves as support for members on community and care resource inquiries and opportunities available to members + Supports all member related correspondence and educational materials to assist in the facilitation of a successful community connection + Documents and maintains all community resources to ensure standards of practice and policies are in accordance with health plan requirements + Provide assistance to the clinical team of nurses and social workers. Activities include, but are not limited to outreach, community education, informal guidance and member support + Conduct non-clinical general health assessments in order to refer members to appropriate care/services, resolve concerns on member's behalf, and gather information for medical providers and staff working within the organization + Conduct non-medical assessments such as home safety, assessment of the community/environment resources, transportation, employment, and others to be able to refer to appropriate care/services, resolve concerns on member's behalf, and gather information for medical providers in staff working within our organization + Conduct telephonic and/or in-person outreach to locate individuals and families in the community who are hard to reach + May make visits to individual homes and/or community organizations + Working Knowledge of Social Determinants of Health (SDOH) barriers + Performs other duties as assigned + Complies with all policies and standards This is a hybrid position must reside in Broward county for field visits to members homes to complete assessments. **Education/Experience:** Requires a High School diploma or GED Requires 1 - 2 years of related experience Pay Range: $17.84 - $28.02 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

AmeriHealth Caritas is seeking service-oriented, compassionate healthcare professionals to join our Long Term Services and Support (LTSS) team. Ideal candidates will have experience assessing those needing personal care services for instrumental daily living activities. As a Service Coordinator, you will assist participants who qualify for Medicaid in obtaining the long-term services and support they need as required by the Community Health Choices (CHC) agreement. You will contribute to the care coordination process by performing face-to-face assessments to identify, evaluate, coordinate, and manage participant's needs, including physical health, behavioral health, social services, and long-term services and support, as well as telephonic follow-up. Work Arrangement * This role is remote and will be community-facing * Qualified candidates must live in and be able to travel throughout Lawrence county in PA and surrounding areas. Responsibilities Identify, coordinate, and assist participants in accessing needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports Lead the participant-centered planning and service (PCPS) delivery process and oversee its implementation Inform participants about available required needs assessments, the PCSP process, service alternatives, and service delivery options Informs participants of their rights and assists with the complaint, grievance, and DHS Fair Hearing process Collect additional necessary information, including participant preferences, strengths, and goals, to inform the development of the PCSP Conducts reevaluation of level of care annually or more frequently as needed following CHC requirements Works with the participant to complete activities necessary to maintain eligibility Education and Experience Bachelor's Degree in social work, psychology, or related field is preferred 3+ years of social service (in lieu of a Bachelor's degree) or related healthcare experience that required the following: working with people who need personal care services conducting face to face visits in the home or nursing facility focused on needs assessments and monitoring delivery of services knowledge of the home and community-based service system and how to access/arrange for services maintaining contact and relationships with healthcare professionals on a regular cadence, providing consistent and timely feedback to members' needs and requests * 2 to 3 years of Case management experience Licensure * Valid and current driver's license with reliable transportation with state-mandated minimum insurance Skills & Abilities Must be computer proficient and have a working knowledge of MS Office specifically Excel High speed internet Dedicated home workspace free from distractions and conducive to HIPAA and Government compliance regulation AmeriHealth Caritas is a mission-driven organization with more than 40 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. We'd like to hear from you if you want to make a difference in people's lives. Our Comprehensive Benefits Package Flexible work solutions, including remote options and hybrid work schedules, Competitive pay, Paid time off, including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement, and more.

AmeriHealth Caritas is seeking service-oriented, compassionate healthcare professionals to join our Long Term Services and Support (LTSS) team.Ideal candidates will have experience assessing those needingpersonal care services for instrumental daily living activities. As a Service Coordinator, you will assist participants who qualify for Medicaid in obtaining the long-term services and support they need as required by the Community Health Choices (CHC) agreement. You will contribute to the care coordination process by performing face-to-face assessments to identify, evaluate, coordinate, and manage participant's needs, including physical health, behavioral health, social services, and long-term services and support, as well as telephonic follow-up. **Work Arrangement** + This role is remote and will be community-facing + Qualified candidates must live in and be able to travel through Westmoreland and Fayette counties in PA. **Responsibilities** + Identify, coordinate, and assist participants in accessing needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports + Lead the participant-centered planning and service (PCPS) delivery process and oversee its implementation + Inform participants about available required needs assessments, the PCSP process, service alternatives, and service delivery options + Informs participants of their rights and assists with the complaint, grievance, and DHS Fair Hearing process + Collect additional necessary information, including participant preferences, strengths, and goals, to inform the development of the PCSP + Conducts reevaluation of level of care annually or more frequently as needed following CHC requirements + Works with the participant to complete activities necessary to maintain eligibility **Education and Experience** + Bachelor's Degree in social work, psychology, or related field is preferred + 3+ years of social service (in lieu of a Bachelor's degree) or related healthcare experience that required the following: + working with people who need personal care services + conducting face to face visits in the home or nursing facility focused on needs assessments and monitoring delivery of services + knowledge of the home and community-based service system and how to access/arrange for services + maintaining contact and relationships with healthcare professionals on a regular cadence, providing consistent and timely feedback to members' needs and requests + 2 to 3 years of Case management experience **Licensure** + Valid and current driver's license with reliable transportation with state-mandated minimum insurance **Skills & Abilities** + Must be computer proficient and have a working knowledge of MS Office specifically Excel + High speed internet + Dedicated home workspace free from distractions and conducive to HIPAA and Government compliance regulation AmeriHealth Caritas is a mission-driven organization with more than 40 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. We'd like to hear from you if you want to make a difference in people's lives. **Our Comprehensive Benefits Package** Flexible work solutions, including remote options and hybrid work schedules, Competitive pay, Paid time off, including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement, and more. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

As a Service Coordinator, you will assist participants who qualify for Medicaid in obtaining the long-term services and support they need as required by the Community Health Choices (CHC) agreement. You will contribute to the care coordination process by performing face-to-face assessments to identify, evaluate, coordinate, and manage participant's needs, including physical health, behavioral health, social services, and long-term services and support, as well as telephonic follow-up. Work Arrangement * Remote * Must be able to travel up to 90 minutes from your home to Chester, Bucks, Montgomery, Delaware, and Philadelphia Pennsylvania counties Responsibilities Identify, coordinate, and assist participants in accessing needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports Lead the participant-centered planning and service (PCPS) delivery process and oversee its implementation Inform participants about available required needs assessments, the PCSP process, service alternatives, and service delivery options Informs participants of their rights and assists with the complaint, grievance, and DHS Fair Hearing process Collect additional necessary information, including participant preferences, strengths, and goals, to inform the development of the PCSP Conducts reevaluation of level of care annually or more frequently as needed following CHC requirements Works with the participant to complete activities necessary to maintain eligibility Education and Experience Bachelor's Degree in social work, psychology, or related field is preferred 3+ years of social service (in lieu of a Bachelor's degree) or related healthcare experience that required the following: working with people who need personal care services, conducting face to face visits in the home or nursing facility focused on needs assessments and monitoring delivery of services knowledge of the home and community-based service system and how to access/arrange for services maintaining contact and relationships with healthcare professionals on a regular cadence, providing consistent and timely feedback to members' needs and requests. * 2 to 3 years of Case management experience Licensure * Valid and current driver's license Skills & Abilities Must be computer proficient and have a working knowledge of MS Office specifically Excel High speed internet Dedicated home workspace free from distractions and conducive to HIPAA and Government compliance regulations AmeriHealth Caritas is seeking service-oriented, compassionate healthcare professionals to join our Long Term Services and Support (LTSS) team. Ideal candidates will have experience assessing those needing personal care services for instrumental daily living activities AmeriHealth Caritas is a mission-driven organization with more than 40 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. We'd like to hear from you if you want to make a difference in people's lives. Our Comprehensive Benefits Package Flexible work solutions, including remote options and hybrid work schedules, Competitive pay, Paid time off, including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement, and more.

As a Service Coordinator, you will assist participants who qualify for Medicaid in obtaining the long-term services and support they need as required by the Community Health Choices (CHC) agreement. ;You will contribute to the care coordination process by performing face-to-face assessments to identify, evaluate, coordinate, and manage participant's needs, including physical health, behavioral health, social services, and long-term services and support, as well as telephonic follow-up. **Work Arrangement** + Remote + Must be able to travel up to 90 minutes from your home to Chester, Bucks, Montgomery, Delaware, and Philadelphia Pennsylvania counties **Responsibilities;** + Identify, coordinate, and assist participants in accessing needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports + Lead the participant-centered planning and service (PCPS) delivery process and oversee its implementation + Inform participants about available required needs assessments, the PCSP process, service alternatives, and service delivery options + Informs participants of their rights and assists with the complaint, grievance, and DHS Fair Hearing process + Collect additional necessary information, including participant preferences, strengths, and goals, to inform the development of the PCSP + Conducts reevaluation of level of care annually or more frequently as needed following CHC requirements + Works with the participant to complete activities necessary to maintain eligibility **Education and Experience** + Bachelor's Degree in social work, psychology, or related field is preferred + 3+ years of social service (in lieu of a Bachelor's degree) or related healthcare experience that required the following: + working with people who need personal care services, + conducting face to face visits in the home or nursing facility focused on needs assessments and monitoring delivery of services + knowledge of the home and community-based service system and how to access/arrange for services + maintaining contact and relationships with healthcare professionals on a regular cadence, providing consistent and timely feedback to members' needs and requests. + 2 to 3 years of Case management experience **Licensure** + Valid and current driver's license **Skills & Abilities** + Must be computer proficient and have a working knowledge of MS Office specifically Excel + High speed internet + Dedicated home workspace free from distractions and conducive to HIPAA and Government compliance regulations ; AmeriHealth Caritas is seeking service-oriented, compassionate healthcare professionals to join our Long Term Services and Support (LTSS) team.;Ideal candidates will have experience assessing those needing;personal care services for instrumental daily living activities AmeriHealth Caritas is a mission-driven organization with more than 40 years of experience delivering comprehensive, outcomes-driven care to those who need it most. We are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs.; We'd like to hear from you if you want to make a difference in people's lives. **Our Comprehensive Benefits Package** Flexible work solutions, including remote options and hybrid work schedules, Competitive pay, Paid time off, including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement, and more. ; As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. We want to connect with you if you're going to make a difference. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at *************************** Responsibilities: The Service Coordination Supervisor is responsible for overseeing the operational functions of the LTSS Service Coordination team using the AmeriHealth Caritas Pennsylvania Community Health Choices model of care. Oversees the day to day operations of the LTSS department, including the development of Person-Centered Service Plans, authorization and approval of services and the coordination of benefits for all LTSS Participants. Serves as a subject matter expert for LTSS training for internal care teams and external audiences. Supports coordination of LTSS with other clinical and social services across the continuum of care, striving to enhance the quality of Participant care and services. Maintains operational processes, policies, and procedures to support LTSS care delivery Ensure quality and performance metrics are consistently met regarding LTSS, as specified in the agreement. Education/Experience: Bachelor's degree required. Pennsylvania licensed RN, LSW, or LPC required. 1 to 3 years of leadership and/or supervisory experience. 3 years working in social service or healthcare-related field. Experience working with people with disabilities or seniors in need of LTSS. Knowledge of the home and community-based service system and how to access and arrange for services. Experience conducting LTSS needs assessments and monitoring LTSS delivery. Ability to provide informed advocacy. Ability to interact with health care professionals professionally. Our Comprehensive Benefits Package Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.

Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. We want to connect with you if you're going to make a difference. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at *************************** **Responsibilities:** The Service Coordination Supervisor is responsible for overseeing the operational functions of the LTSS Service Coordination team using the AmeriHealth Caritas Pennsylvania Community Health Choices model of care. + Oversees the day to day operations of the LTSS department, including the development of Person-Centered Service Plans, authorization and approval of services and the coordination of benefits for all LTSS Participants. + Serves as a subject matter expert for LTSS training for internal care teams and external audiences. + Supports coordination of LTSS with other clinical and social services across the continuum of care, striving to enhance the quality of Participant care and services. + Maintains operational processes, policies, and procedures to support LTSS care delivery + Ensure quality and performance metrics are consistently met regarding LTSS, as specified in the agreement. **Education/Experience:** + Bachelor's degree required. + Pennsylvania licensed RN, LSW, or LPC required. + 1 to 3 years of leadership and/or supervisory experience. + 3 years working in social service or healthcare-related field. + Experience working with people with disabilities or seniors in need of LTSS. + Knowledge of the home and community-based service system and how to access and arrange for services. + Experience conducting LTSS needs assessments and monitoring LTSS delivery. + Ability to provide informed advocacy. + Ability to interact with health care professionals professionally. **Our Comprehensive Benefits Package** Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. This is a field-based position with a home-based office in Eastern Shore, VA Market. The Field Care Coordinator is responsible for facilitating, promoting, and advocating for the enrollees' ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients. Additionally, the care coordinator is responsible for assessing the availability of natural supports such as the enrollee's representative or family members to ensure the ongoing mental and physical health of those natural supports. The Field Care Coordinator collaborates with the Interdisciplinary Team to coordinate the delivery of comprehensive, efficient, cost-effective patient care. The Field Care Coordinator will be traveling into enrollees' homes, nursing facilities, Adult Day Health, and Adult Living Facilities (ALF) to conduct in-depth assessments and develop the plan of care. The Field Care Coordinator actively assists enrollees with care transitions in collaboration with the Interdisciplinary Team and the acute or skilled facility staff, and the enrollees and / or the enrollees' representatives. Field Care Coordinators act as liaison between the Health Plan, the Commonwealth, enrollees, and their families. Field Care Coordinators follow established professional standards of care, Commonwealth guidelines and policy and procedures. If you are located in commutable distance of Eastern Shore, VA Market, you will have the flexibility to work remotely* as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current and unrestricted Licensed Practical Nurse in the state of Virginia OR Social Work or Human Services (or related field) with a 4-year degree 3+ years of care coordination or behavioral health experience and/or work in a healthcare environment 1+ years of experience with MS Office, including Word, Excel, and Outlook Experience working with members who have medical needs, the elderly, individuals with physical disabilities and / or those who may have communication barriers Driver's license and reliable transportation and the ability to travel within assigned territory to meet with members and providers Preferred Qualifications: CCM certification Experience working with Medicaid / Medicare population Experience working in team-based care Long term care / geriatric experience Background in Managed Care Physical Requirements: Ability to transition from office to field locations multiple times per day Ability to navigate multiple locations/terrains to visit employees, members and/or providers Ability to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.) Ability to remain stationary for long periods of time to complete computer or tablet work duties *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 to $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts on the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Field Care Coordinator- HIDE SNP is an essential element of an Integrated Care Model and is responsible for establishing a set of person-centered goal-oriented, culturally relevant, and logical steps to ensure that the person receiving LTSS receives services in a supportive, effective, efficient, timely and cost-effective manner. Care coordination includes case management, disease management, discharge planning, transition planning, and addressing social determinants of health and integration into the community. This position is Field Based with a Home-Based office. The expected travel time for member home visits is typically 75% within a 50-mile radius and/or 50-minute drive from your home pending business needs. If you reside in or near Saint Joseph County, MI or surrounding area, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Develop and implement care plan interventions throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for persons and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team Assess, plan, and implement care strategies that are individualized by the individual and directed toward the most appropriate, least restrictive level of care Identifies problems/barriers to care and provide appropriate care management interventions Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Provides resource support to members for local resources for services (e.g., Children with Special Health Care Services (CSHCS), employment, housing, independent living, foster care) based on service assessment and plans, as appropriate Manage the person-centered service/support plan throughout the continuum of care Conduct home visits in coordination with the person and care team Conduct in-person visits, which may include nursing homes, assisted living, hospital or home Gathers, documents, and maintains all member information and care management activities to ensure compliance with current state and federal guidelines What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Must possess one of the following: Current, unrestricted independent licensure as a Registered Nurse (RN) in state of Michigan Master's degree and current, unrestricted independent licensure as a Social Worker (e.g., LMSW, LCSW, LLMSW) Bachelor's degree and current, unrestricted independent licensure as a Social Worker (e.g. LLBSW, LBSW) 2+ years of experience working within the community health setting in a healthcare role 1+ years of experience with local behavioral health providers and community support organizations addressing SDoH (e.g., food banks, non-emergent transportation, utility assistance, housing/rapid re-housing assistance, etc.) 1+ years of experience working with persons with long-term care needs and/or home and community-based services 1+ years of experience working in electronic documentation systems and with MS Office (Outlook, Excel, Word) Access to reliable transportation and the ability to travel within assigned territory to meet with members and providers up to 75% of the time depending on member and business needs Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Ability to travel to Southfield, MI office for quarterly team meetings Must reside within the state of Michigan Preferred Qualifications: RN or LMSW, LLMSW, LCSW 1+ years of medical case management experience Demonstrated experience/additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders) Experience with MI Health Link (MMP) Experience working in Managed Care Working knowledge of NCQA documentation standards *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. **PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #RED

Job DescriptionJob Title: Employer Services CoordinatorReports To: Director of Customer ExperienceExempt/Non-Exempt: Non-Exempt The Employer Services Coordinator's main responsibility is to support clients and brokers primarily via phone and email correspondence on inquiries or issues that arise. This position is expected to deliver excellent customer service by researching and responding to client and broker inquires in a timely manner. Key Responsibilities:- Provide primary support for SIHO clients and brokers on day to day inquiries and issue resolution- Create, update, and distribute appropriate documents that assist in improving SIHO's service to customers.- Assist with new account implementations, client orientations, open enrollment sessions and quarterly reviews, as needed- Identify and communicate process improvement opportunities to prevent repeat calls on the same topic.- Actively engage in tasks that continuously reduce repeat calls to all departments and escalated calls to Employer Services Team.- Assist in the development of and the implementation of internal controls and procedures. Minimum Skills Requirement:- Possess a passion for customer service- Two years experience in customer service or related environment- Knowledge of the managed health care industry preferred- Demonstrated ability to solve complex benefits problems- Excellent writing and speaking skills- Computer literate in Microsoft Excel and Word. (Experience in Publisher and Access helpful) Ability to work at a self-directed pace in a changing, multi-task environment- Professional appearance and presence- Must be able to travel to other locations and at times may require an overnight stay- Bachelors Degree preferred or equivalent work experience Other: (internal candidates) Current PMAS performance evaluation of “3” or higher We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

An ECM Coordinator supports department staff with administrative tasks related to a member's medical condition(s), department case work, communication with internal and external stakeholders, and manage audits. This role will engage with members to offer support and resources related to their medical condition(s) through Allied Care. ESSENTIAL FUNCTIONS Facilitate reviews, referrals, and outreach for referral-based proprietary strategies as well as engaging with members across Medical Management products Document all engagement accurately and concisely within the Microsoft Customer Relationship Management (CRM) system Manage escalated and time sensitive case management questions received from members, broker relationships, and internal and external Allied stakeholders Collaborate with strategic vendor partners to provide supportive services and support to members Lead and facilitate claims auditing in conjunction with ECM Coordinators. Complete department auditing related to daily tasks to ensure accuracy and identify escalations Identify impactful scenarios through appropriate closing summaries in timely fashion. Share impactful scenarios with the department's leadership team to deliver to internal departments, such as Sales, Operations, and Executive leadership Identifying escalations for department leadership team, as appropriate Other duties as assigned EDUCATION Bachelor's Degree or equivalent work experience, required EXPERIENCE AND SKILLS At least 3-5 years of administrative support experience required. Focus on patient-provider engagement, needs assessments, coordination of care, and or patient treatment adherence within the healthcare or social service industry preferred Understanding of intermittent medical terminology such as CPT, HCPC, and diagnostic codes Understanding of basic benefit plan design terminology such as deductible, out-of-pocket, prescription drugs, physical medicine services, etc. Strong verbal and written communication skills Strong analytical and problem-solving skills COMPETENCIES Communication Customer Focus Accountability Functional/Technical Job Skills PHYSICAL DEMANDS This is a standard desk role - long periods of sitting and working on a computer are required. WORK ENVIROMENT Remote Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role. Protect Yourself from Hiring Scams Important Notice About Our Hiring Process To keep your experience safe and transparent, please note: All interviews are conducted via video. No job offer will ever be made without a video interview with Human Resources and/or the Hiring Manager. If someone contacts you claiming to represent us and offers a position without a video interview, it is not legitimate. We never ask for payment or personal financial information during the hiring process. For your security, please verify all job opportunities through our official careers page: Current Career Opportunities at Allied Benefit Systems Your security matters to us-thank you for helping us maintain a fair and trustworthy process!

Answers phone in dietary office; greets and assists patients in selection of regular and modified diets; enters meal selections into computer for printout in kitchen; and monitors diabetic, renal and other modified diets. Educates patient on menu selections allowed within diet prescription and maintains and updates diet orders. Functions as work leader during assigned shifts. This Full time position is dayshift Rotations: Every other weekend

Answers phone in dietary office; greets and assists patients in selection of regular and modified diets; enters meal selections into computer for printout in kitchen; and monitors diabetic, renal and other modified diets. Educates patient on menu selections allowed within diet prescription and maintains and updates diet orders. Functions as work leader during assigned shifts. This part-time position works a variable shift and can include: 5:30 am - 2:00 pm 1:00 pm - 7:30 pm Every other weekend 16-20 hours per week

Company name: PCA Care Connections Service Coordinator I Full Time Pay range: $43,899.00-$50,818.58 based on experience. "PCA Care Connections is a NCQA accredited non-profit agency that currently provides two types of services: Service Coordinator for Community Health Choices (CHC) participants enrolled with Pennsylvania Health and Wellness and Nursing Home Transition Services for participants enrolled with Pennsylvania Health and Wellness or Keystone First. We currently serve participants throughout the Greater Philadelphia region, including Philadelphia, Delaware, Montgomery, Bucks and Chester counties. " The mission of PCA Care Connections is “provide high quality, person-centered and cost effective Service Coordination for older adults and persons with disabilities in partnerships with managed care organizations and integrated health systems and practices. Our goals are to promote quality of life, independence, dignity, and optimal health and well-being.” Medical, prescription drug, vision, and dental coverage Flexible spending plan (health and dependent care) EAP, life insurance, short- and long-term disability insurance Pre-tax commuting, and parking benefits Annual paid time off and vacation are based depending on tenure. Requirements DESCRIPTION: Reporting to a Supervisor, this position facilitates and coordinates long-term services and supports, utilizing a person-centered approach to improve psychosocial and health outcomes. In accordance with procedures and requirements of Community Health Choices (CHC) Managed Care Organization (MCO), the Service Coordinator has responsibility for ongoing assessment, service planning, service coordination, monitoring, follow-up, and evaluation for persons with disabilities and/or older adults. The SC works within a collaborative team approach to identify and address participants' needs, preferences, and goals related to physical health, behavioral health, social services, and long-term services and supports. SCs work primarily remotely when not in the field but do have access to the office, as needed. All SCs are provided with a tablet and mobile phone to fulfill work duties. Qualifications: Associate's degree in social work, psychology, or related fields with 3 years of employment in social service or health care related setting or Bachelor's degree in social work, psychology, or related fields with at least 1 year of employment in a social service or health care related setting, preferred. Professional Characteristics: High energy level; able to manage a variety of tasks simultaneously. Excellent interpersonal and communication skills. Well organized. High level of flexibility Utilizes critical thinking Strong computer skills Cultural competency Duties and Functions: a. Conducts comprehensive person-centered assessments utilizing the InterRAI and Person-Centered Planning Tool (PCSP) tools to determine participants' needs, strengths, preferences, and goals. Inter RAI and PCSP are completed annually or whenever there is a significant change. b. Works with participant, his/her family, and/or caregiver, to develop an individualized service plan, making use of consultation with other disciplines as indicated. c. Identifies, mobilizes, and arranges informal and formal resources to meet participants' needs including LTSS services, other covered services, and non-covered community services and supports. d. Facilitates participant choice of providers and SCs. e. Adheres to all MCO required timeframes. f. Adheres to all documentation and reporting requirements. g. Participates/Conducts Interdisciplinary Team meetings h. Conducts home visits and telephone contacts per MCO standards to monitor adequacy and continued appropriateness of service plan as well as goal achievement. i. Facilitates care transitions j. Provides coordination with behavioral health services k. Monitors participant satisfaction to ensure quality of services provided. l. Supports participants with maintaining their CHC eligibility. m. Completes critical incidents and associated root cause analysis (RCA) as needed. n. Notifies participants of their rights and assists with complaint, grievance, and Fair Hearing processes o. Adheres to the Health Insurance Portability and Accountability Act (HIPAA) p. Utilizes tablet in the field. Completes all necessary forms and data entry for participants' record, other management information, and other written reports as required, such as critical incidents. q. Participates in quality improvement activities r. Participates in orientation and training and attends regularly scheduled supervision and staff meetings. Seeks opportunities for professional development. s. Other duties as assigned. Additional Requirements: Must have a valid driver's license, good driving record, and continuous access to a fully-insured car Drug testing required Pre-employment physical Second language abilities preferred For information on PCA Care Connections, including more information on our company culture, visit our website at *********************************** All applicants will receive an acknowledgement that their application has been. Those candidates selected for further consideration will be contacted. PCA Care Connections is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job Description Company name: PCA Care Connections Service Coordinator Trainee Full Time Pay range: $37,605.84-$43,533.46 varies based on experience. DESCRIPTION: Reporting to a Supervisor, this position facilitates and coordinates long-term services and supports, utilizing a person-centered approach to improve psychosocial and health outcomes. In accordance with procedures and requirements of Community Health Choices (CHC) Managed Care Organization (MCO), the Service Coordinator (SC) has responsibility for ongoing assessment, service planning, service coordination, monitoring, follow-up, and evaluation for persons with disabilities and/or older adults. The SC works within a collaborative team approach to identify and address participants' needs, preferences, and goals related to physical health, behavioral health, social services, and long-term services and supports. SCs work primarily remotely when not in the field but do have access to the office, as needed. All SCs are provided with a tablet and mobile phone to fulfill work duties. Requirements Qualifications: Education: High School Diploma or equivalent. Experience: Minimum of three years of employment in a social service or health care related setting. Professional Characteristics: High energy level; able to manage a variety of tasks simultaneously. Excellent interpersonal and communication skills. Well organized. High level of flexibility Utilizes critical thinking Strong computer skills Cultural competency Duties and Functions: a. Conducts comprehensive person-centered assessments utilizing the InterRAI and Person-Centered Planning Tool (PCSP) tools to determine participants' needs, strengths, preferences, and goals. Inter RAI and PCSP are completed annually or whenever there is a significant change. b. Works with participant, his/her family, and/or caregiver, to develop an individualized service plan, making use of consultation with other disciplines as indicated. c. Identifies, mobilizes, and arranges informal and formal resources to meet participants' needs including LTSS services, other covered services, and non-covered community services and supports. d. Facilitates participant choice of providers and SCs. e. Adheres to all MCO required timeframes. f. Adheres to all documentation and reporting requirements. g. Participates/Conducts Interdisciplinary Team meetings h. Conducts home visits and telephone contacts per MCO standards to monitor adequacy and continued appropriateness of service plan as well as goal achievement. i. Facilitates care transitions j. Provides coordination with behavioral health services k. Monitors participant satisfaction to ensure quality of services provided. l. Supports participants with maintaining their CHC eligibility. m. Completes critical incidents and associated root cause analysis (RCA) as needed. n. Notifies participants of their rights and assists with complaint, grievance, and Fair Hearing processes o. Adheres to the Health Insurance Portability and Accountability Act (HIPAA) p. Utilizes tablet in the field. Completes all necessary forms and data entry for participants' record, other management information, and other written reports as required, such as critical incidents. q. Participates in quality improvement activities r. Participates in orientation and training and attends regularly scheduled supervision and staff meetings. Seeks opportunities for professional development. s. Other duties as assigned. Additional Requirements: Must have a valid driver's license, good driving record, and continuous access to a fully-insured car Drug testing required Pre-employment physical Second language abilities preferred For information on PCA Care Connections, including more information on our company culture, visit our website at ********************************** All applicants will receive an acknowledgement that their application has been. Those candidates selected for further consideration will be contacted. PCA Care Connections is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job DescriptionClient Care Coordinator Department: Boca Health Marketing Reports to: National Director of Strategic Development Salary: Competitive based on education and experience. About Boca Recovery Center Founded in 2016, Boca Recovery Center is a nationally recognized addiction treatment provider specializing in substance use disorders and co-occurring mental health conditions. With locations in Florida, New Jersey, Indiana, and Massachusetts, we deliver evidence-based clinical care in a supportive, structured environment. Our team is committed to providing trauma-informed, client-centered services that promote lasting recovery. Position Overview We are seeking a dedicated and compassionate Client Care Coordinator to support clients through their treatment journey and ensure a successful transition into aftercare services. This role manages client care from admission through discharge, with a strong focus on aftercare planning, engagement, group facilitation, and collaboration with outreach, clinical, operations, and alumni teams. The Client Care Coordinator also provides support in AMA prevention and case management tasks such as FMLA and short-term disability processes. Key ResponsibilitiesAftercare & Discharge Planning Develop and implement individualized aftercare plans in coordination with clients, families, and clinical staff. Facilitate referrals and placements into outpatient programs, sober living, and recovery housing. Document and communicate all discharge planning details with the treatment team and referral sources. Client Engagement & Support Assist clients in navigating legal, family, or logistical barriers to treatment and recovery. Participate in AMA blocking efforts, providing motivational support and involving family/support systems. Maintain consistent, supportive communication with clients during treatment and facilitate smooth post-discharge transitions. Group Facilitation Lead engaging group sessions focused on relapse prevention, life skills, recovery maintenance, and aftercare education. Encourage active participation and provide resources for continued care and long-term recovery. Case Management Support Support clients in completing FMLA, short-term disability, and related medical leave documentation. Coordinate with employers, EAPs, and insurance providers to ensure continuity of care. Provide assistance with housing, transportation, and employment resources during the discharge process. Team Coordination & Communication Serve as liaison between Clinical, Outreach, Alumni, and operational teams to ensure seamless care coordination. Actively participate in interdisciplinary team meetings and case conferences. Maintain accurate and timely documentation within the Electronic Health Records (EHR) system. Key Performance Indicators (KPIs) Aftercare Placement Rate: 90% of eligible clients discharged with confirmed aftercare plan and placement. Timeliness of Aftercare Planning: Initial plan started within 5 days of admission; finalized at least 72 hours before discharge. AMA Intervention Success Rate: 60% of clients receiving intervention remain in treatment for at least 72 additional hours. Client Satisfaction: 85% positive feedback on aftercare planning and support from client satisfaction surveys. Requirements Associate's Degree in Psychology, Social Work, Counseling, or related field (required) 1-2 years of experience in behavioral health or substance use treatment setting Familiarity with aftercare planning, FMLA/disability documentation, and case management preferred Strong interpersonal, communication, and documentation skills Ability to work both independently and collaboratively within a multidisciplinary team Knowledge of community resources and treatment continuum Experience using Electronic Health Records (EHR) preferred Group facilitation experience is a plus Benefits Boca Recovery Center offers a comprehensive benefits package, including: Health Insurance Retirement Plans Disability Coverage Paid Time Off Continuing Education & Professional Development Opportunities Join Boca Recovery Center and make a meaningful impact through expert, compassionate care in a mission-driven environment focused on recovery and wellness.

In an environment of continuous quality improvement, the Denials Management Coordinator is responsible for reviewing all denials to determine patterns in errors, payors, and internal processes to improve our denial rate. Exhibits the MHS Standards of Excellence and exercises strict confidentiality at all times. Job Functions: Analyzes all denials for patterns. Works with front line staff and educate on proper processes. Ability to verbalize to insurance carriers and write appeal details to support additional payment on denied claims. Accurately and consistently documents the results of all denial reviews in the hospital information system. Prepares reports as required by management regarding audit results, process improvement recommendations and systemic payment errors. Makes monthly observations and recommendations to prevent future denials. Assumes all other duties and responsibilities as necessary. Qualifications Minimum Education/Experience Required: High School Diploma or GED required. Minimum of two years of previous experience in a healthcare-related position required. Experience in coding, medical necessity, registration, insurances, and precertification processes and/or denials preferred. Minimum of 2 years of experience or formal education in basic ICD10 coding, medical terminology, Anatomy/pathophysiology, and disease process preferred. Depending on healthcare-related experience, may require coding certification within 2 years of date of hire. Experience reviewing ambulatory claim denials preferred. Special Knowledge, Skills, Training: Computer skills (word processing, spreadsheet, graphics, and database software applications). Strong quantitative, analytical and organization skills. Strong negotiation skills. Proficient in payment review systems, hospital information systems and coding methodologies. Ability to understand medical records, hospital bills, and the charge master. Ability to understand all ancillary department functions for the facility. Ability to understand complex insurance terms and payment methodologies. Ability to effectively negotiate with insurance carriers and customers. Ability to utilize and understand computer technology. Ability to communicate orally and in written form. Team-orientated with strong interpersonal skills. Compensation Details: Education, experience, and tenure may be considered along with internal equity when job offers are extended. Benefits: Memorial Health System is proud to offer an affordable, comprehensive benefit package to all full time and flex time employees. To learn more about the many benefits we offer, please visit our website at ************************** Bonus Eligibility: Available to qualifying full or flex time employees. Eligibility will be determined upon offer. Memorial Health System is an equal opportunity provider and employer. If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at ******************************************* or at any USDA office, or call ************** to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Stop 9410, Washington, D.C. 20250-9410, by fax ************** or email at ***********************. * Memorial Health System is a federal drug-free workplace. This policy prohibits marijuana use by employees.