CareFirst BlueCross BlueShield jobs - 272 jobs

A healthcare company is seeking an Associate General Counsel to provide a range of legal services focusing on regulatory, compliance, litigation, and employment law. The successful candidate will support management in complex legal matters, represent the company in regulatory issues, and work closely with cross-functional teams to navigate legal challenges. The role requires a Juris Doctor, bar admission within one year, and a background in healthcare law. A comprehensive benefits package is offered alongside a competitive salary range. #J-18808-Ljbffr

You could be the one who changes everything for our 28 million members as a Customer Care professional at Centene. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: We endeavor to craft a better human experience by transforming from a company perspective to a customer perspective. This Quality Assurance (QA) director will lead our monitoring teams in Member and Provider Services (MPS) and focus our contact center quality program on outcomes, statistical significance and the evaluation of competencies that drive resolution and customer satisfaction. This leader is responsible for programs that ensure high service standards across all customer interaction channels-these programs are designed to monitor customer service advocate performance, drive continuous improvement, align to business and departmental goals, and ensure regulatory compliance. Leads quality assurance team on performance, improvement, and career growth path consideration Oversees all the systems, processes, and initiatives that alleviate service quality issues Influences the quality assurance overall vision for service quality and ensures that achievable goals and milestones are set Cross-functionally collaborates to define, measure and continuously improve service quality Prioritizes identified service quality issues and/or risks to develop a remediation roadmap for the quality assurance team to ensure a consistent customer experience Regularly reviews key performance indicator (KPI) metrics to ensure accurate reporting, tracking performance, and to improve interactions and processes Develops the overall strategy for onboarding, hiring, and training new employees and performance and/or reward decisions within quality assurance department to ensure adequate training, adherence, and compliance Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires a Bachelor's degree and 7+ years of related experience, including prior management experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. 4+ years management experience preferred.Pay Range: $133,700.00 - $247,400.00 per year 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

Hi, we're Oscar. We're hiring a Specialist, Admin Complaints, Grievances & Appeals to join our Complaints, Grievances & Appeals team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: You will be responsible for the comprehensive management and resolution of complex administrative member and/or provider grievances and appeals. You will serve as a subject matter expert on non-clinical case resolution, focusing on sensitive member issues such as claims concerns, access barriers, benefits concerns and complex service inquiries. You will drive the resolution process to meet regulatory standards set by the health plan's governing bodies, while championing member satisfaction and retention. You will report into the Associate Director, Member & Provider Escalations. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The hourly rate for this role is: $24.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year. Responsibilities: Follow established workflows to acknowledge, log, and perform initial triage on complex or escalated administrative grievances from members and/or providers Conduct thorough, multi-faceted investigations by gathering and analyzing internal data, call logs, correspondence, etc. Use workflows to reconstruct complex event timelines involving prior authorizations, claims processing, and system-based adjudication edits to accurately determine the root cause of member and/or provider issues. Liaise with internal departments, such as Member Services, Eligibility & Benefits, and Claims, to obtain necessary information for complete case resolution. Based on investigative findings, determine a resolution strategy that is both fair and compliant with company and regulatory guidelines, utilizing established workflows. Escalate the issue to leadership for further guidance on resolution strategy, as needed Draft clear, accurate, complete resolution letters, ensuring all required regulatory elements are included Maintain meticulous and comprehensive case files in the case management system to ensure a clear and complete audit trail for each case Monitor and manage case timelines to ensure strict adherence to all federal and state mandated deadlines Compliance with all applicable laws and regulations Other duties as assigned Requirements: 1+ years of professional experience in a regulated industry, such as healthcare, insurance 1+ years of experience independently managing a demanding caseload with multi-step workflows, from initial intake through investigation, resolution, and final documentation, while meeting competing priorities. 1+ years of experience with directly managing escalated customer, member or provider cases 1+ years of experience with drafting and issuing formal written communication to member or providers 1+ years of experience working in a highly structured, workflow driven, environment Bonus points: Bilingual in Spanish (reading and writing) Bachelor's degree Experience in health care administration. Involvement in departmental or cross-functional process improvement or quality initiatives. This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

The Government Audit Supervisor is a full-time remote position working 8:00-5:00pm.What You'll Do: Performs supervisory review of all audit work papers completed by the team to ensure all work conforms to CMS and other government auditing standards. Performs supervisory review of all cost report acceptances and desk reviews to ensure timeliness requirements are met and all CMS standards are adhered to. Plans, monitors, and budgets all work assigned for the team, and evaluates and reports results. Performs supervisory review of all settlement packages ensuring product meets all CMS standards. Assists in developing the audit staff by providing on-the-job training as well as preparing and presenting formal staff training sessions. Researches issues and responds to provider and CMS requests in a timely manner. Required Education: Bachelor's in a job related field. Required Work Experience: 5 years auditing or accounting experience including 1 year in a leadership role or equivalent military experience in grade E4 or above. Required Skills and Abilities: Knowledge of cost accounting standards and Generally Accepted Accounting Principles. Knowledge and use of auditing standards and statistical sampling techniques. Good planning, organization, and human relations skills. Knowledge of the principles and practices of auditing. Ability to analyze and determine the applicability of financial data. Ability to gather information by examining records and documents and to interview individuals. Strong interpersonal skills. Ability to work professionally with persons at all levels. Ability to maintain effective working relationships. Ability to communicate clearly and effectively in oral and written form. Ability to handle sensitive matters on a confidential basis. Ability to make presentations and apply critical thinking skills. Knowledge of provider reimbursement review board. Ability to interpret and implement changes to Medicare program. Thorough understanding of Uniform Contractor Evaluation Program guidelines. Ability to adapt to changing environment. Strong planning skills with the ability to makes sound decisions. To qualify for this position, you will need: Required Software and Tools: Microsoft Office. Preferred Education: Bachelor's degree- any major Preferred Licenses and Certificates: Certified Public Accountant (CPA) or Certified Internal Auditor (CIA) or Certified Management Accountant (CMA) Work Environment: Typical office environment. Some travel between office buildings. Some out-of-town travel.Our Comprehensive Benefits Package Includes The Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits at the first of the month following 28 days of employment: Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Salary Range: Range Minimum$65,485.00 Range Midpoint$98,081.00 Range Maximum$130,677.00Equal Employment Opportunity Statement:BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.Some states have required notifications. Here's more information. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.

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 the design of internal communications and promotional products, as well as digital and print field marketing prospect-facing creative projects, Business Development projects, and others as appropriate. Also supports all creative projects involving multiple members of the Medicare Sales Operations department while partnering with Centene Corporate Marketing to ensure all brand standards are followed and implemented. ***PLEASE INCLUDE PORTFOLIO AND/OR LINK*** Supports all aspects of executive and internal communications, as well as external field marketing digital and print design projects. Follows vision, creative solutions, and delivers high quality designs for all assigned tasks. Follows production-based design, receiving and editing design files from various partners and vendors, as well as creation of new materials following the established brand guidelines. Supports the Medicare division and Sales Operations with creative project coordination and production, while ensuring projects are delivered on schedule. Complies with all company policies and brand standards. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's degree in Graphic Design, Marketing, Communications or related field. 1-2 years of related experience in graphic design, branding and identity design work.Pay Range: $27.02 - $48.55 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

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 REQUIRES 50% TRAVEL TO PROVIDERS OFFICES******CANDIDATE MUST RESIDE IN STATE OF INDIANA*** Position Purpose: Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding. Supports the development and implementation of quality improvement interventions and audits in relation to plan providers. Delivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements. Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure. Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters). Identifies specific practice needs where Centene can provide support. Develops, enhances and maintains provider clinical relationship across product lines. Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards. Ability to travel up to 50% of time to provider offices. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's Degree or equivalent required. 3+ years in HEDIS record collection and risk adjustment (coding) required Licenses/Certifications: One of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS For Managed Health Services - IN - No license/certification is required Pay Range: $26.50 - $47.59 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

You could be the one who changes everything for our 28 million members by using technology to improve health outcomes around the world. As a diversified, national organization, Centene's technology professionals have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: In charge of the prioritization of projects, auditing project alignment with overall technical or business strategy, guiding resource allocation, and supporting the development of project or program execution plans. Manages Agile / Lean portfolios and supports overall strategy, investment funding, Agile portfolio operations, and Lean governance. Applies the concept of lean thinking to program and product and coaches stakeholders on these concepts to achieve objectives. Facilitates the portfolio management processes to ensure strategic alignment on technologies and goals Develops and monitors reporting metrics and portfolio dashboards to allow for repeatable and predictable project or product release success. Creates visibility into areas struggling with scope, schedule, resources, or budget Contributes to the development, management and optimization of portfolio, program, and project management methodologies and disciplines Facilitates resource and budget planning with the IT teams on new demands and contributes to the sequencing of projects into the portfolio Identifies dependencies and critical paths, and aids stakeholders in managing them Improves and streamlines the portfolio and project lifecycle, by working closely with business units, user base, and tool teams Identifies and resolves problems often anticipating issues before they occur or before they escalate; develop and evaluate options and implements solutions Analyzes project risk profile and balance at the portfolio level Contributes to capacity planning for initial and ongoing identification of resource needs and scheduling that will be used for making critical portfolio decisions Develop and maintain processes to facilitate integrated project scoping between various workgroups and identifies operational impacts and dependencies Maintain departmental work process for IT controls Analyze demand data to identify and report on trends Identify key leading and lagging risk factors Ensure compliance to all policies and procedures Drive portfolio planning and operations for assigned portfolio Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires a Bachelor's degree and 5 - 7 years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Technical Skills: One or ore of the following skills are desired. Experience with Other: ServiceNow, Flexera, and/or BDNA Experience with Data Analysis Knowledge of Other: IT hardware/software assets as well as knowledge of applications and application platforms Knowledge of JIRA Soft Skills: Seeks to acquire knowledge in area of specialty Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions Ability to work independently Demonstrated analytical skills Demonstrated project management skills Demonstrates a high level of accuracy, even under pressure Demonstrates excellent judgment and decision making skills Ability to communicate and make recommendations to upper management Ability to drive multiple projects to successful completion License/Certification: Certified Project Management Professional (PMP)-PMI required Certified Workforce Planning Professional preferred Certified in Governance of Enterprise IT (CGEIT) preferred Pay Range: $119,100.00 - $220,500.00 per year 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

Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions. You will report into the Supervisor, Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Texas, Georgia, Arizona, and Florida. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year. Responsibilities: Complete medical necessity reviews and level of care reviews for requested services using clinical judgment and Oscar Clinical Guidelines, Milliman Care Guidelines Obtain the information necessary (via telephone and fax) to assess a member's clinical condition, and apply the appropriate evidence-based guidelines Meet required decision-making SLAs Refer members for further care engagement when needed Compliance with all applicable laws and regulations Other duties as assigned Requirements: Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) Associate Degree or Bachelors Degree - Nursing or Graduate of Accredited School of Nursing MCG or InterQual tooling experience Ability to obtain additional state licenses to meet business needs 1+ year of utilization review experience in a managed care setting 1+ years of clinical experience (including at least 1+ year clinical practice in an acute care setting, i.e., ER or hospital) Bonus points: BSN Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Hi, we're Oscar. We're hiring a Claims Processor to join our Claims Production team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role You will process incoming work associated with Claims operations following standard operating procedures. You will report to the Claims Production Team Lead. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $19.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year Responsibilities Develop an excellent grasp of the Administrative Operations system and overall workflows. Develop a comprehensive understanding of the current review processes that exist and additional processes needed to improve consistency and quality of review. Contribute to the reduction of the daily inventory. Form relationships with all partners. Take ownership of monitoring, tracking, and providing a status on the health of all work-in-progress issues. Manage the escalation and resolution process with external vendors to ensure appropriate turnaround times (where applicable). Contribute to team-wide goals that support the success of Claims Productions daily operations. Compliance with all applicable laws and regulations Other responsibilities as assigned Qualifications 1+ years previous work experience in claims processing 1+ years quantitative analysis skills demonstrated through the use of Excel or Google Sheets Bonus Points A bachelor's degree in Business, Accounting, Finance, Economics, Healthcare, Public Policy, Technology or Math In-depth knowledge of general Insurance or Health Insurance operations processing protocols and payment schemes. Experience manipulating and entering accurate data in a production environment. Experience handling Personal Health Information (PHI). Ability to balance competing priorities and continue to accomplish projects. This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

We are seeking a dynamic leader to drive excellence in provider, member, and business partner interactions while fostering strong, productive relationships. This role partners with stakeholder leadership to shape business strategies that support operational efficiency and deliver an exceptional member experience. As the Manager, Contact Center, you will provide vision, direction, and leadership to a high-performing, customer-facing team. You will oversee strategic functions that ensure compliance with state, federal, and BCBSA standards, while empowering team members to achieve peak performance. Success in this role requires building collaborative relationships across the organization and inspiring a culture of accountability, innovation, and service. What You'll Do People Management Develop performance goals and track performance against established goals. Handle complex employee issues. Conduct random audits of teams work. Review audit results with staff and create performance improvement plans as necessary. Develop and implement training plans to ensure growth and development for staff. Develop staff provider relation skills and provider communication through formal and informal training, coaching, and feedback. Interpret and analyze complex data from staffing models and other sources to identify issues and make recommendations for effective solutions. Develop resource allocation strategies to meet changing business demands. Stakeholder Engagement Represent BCBSNC in stakeholder meetings to address stakeholder inefficiencies and to ensure contractual compliance. Plan all on-site visits to stakeholders to educate on BCBSNC medical or administrative policies and procedures. Address stakeholder concerns and non-compliance contract/administrative issues. Coordinate the required corrective actions. Partner with assigned stakeholders to understand their processes, procedures and systems as they relate to the way they conduct business with BCBSNC. Develop and maintain extensive knowledge of key stakeholders and/or regional territories. Leverage knowledge base to forward Enterprise relationships with stakeholders. Track stakeholder issues for root-cause analysis, escalation, and closure. Document issue resolution using issue resolution protocol. Comply with state, federal and BCBSA regulations governing stakeholders and suggests implementation of any product, process, or system modifications to ensure compliance. Identify opportunities to control medical expense and deploy action plans to accomplish stakeholder-specific or regional medical expense goals. Participate in negotiations with stakeholders as needed. Project/Program and Operations Support Manage day-to-day consultative activities for a high-profile healthcare system. Participate in and support negotiations as needed. Assist in the analysis of all products, identify any deficiencies and make recommendations for improvement. Provide analysis and feedback for technologies, trends, best practices and service offerings to incorporate them into overall stakeholder business solutions. Lead team of onsite coordinators in identifying, analyzing, and resolving complex operational issues impacting the healthcare system. Act as technical resource for the team providing assistance on system issues, work processes, and procedures. Represent the department on corporate projects that require independent, sound decision making and broad-based understanding of the effects on the department as a whole. Develop and recommend short- and long-term service objectives and methods, implement these methods when approved. Respond quickly and accurately to escalated issues from clients and customers. Review customer needs and delivery commitments and review with team members. Identify, analyze and resolve complex high dollar operational issues impacting the healthcare system they are responsible for or the members and groups that they serve. Use the appropriate Stakeholder Service Model to increase customer satisfaction and reduce administrative costs. What You Bring Bachelor's degree or advanced degree (where required) 8+ years of experience in related field. In lieu of degree, 10+ years of experience in related field LEAN certification advanced within 12 months of hire. Bonus Points Experience in provider interactions with institutional, professional and ancillary providers. Experience in claims, customer service, membership, enrollment or a call center environment. Experience managing a project Ability to interpret policy provisions Make sound and independent business decisions in high pressure situations Excellent interpersonal and relationship building skills Strong data analysis and problem-solving skills Knowledge of institutional and ancillary pricing, health care finance, hospital and ancillary payments Strong negotiation skills Ability to effectively manage multiple high priority and high-profile tasks/provider relationships What You'll Get The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community. Work-life balance, flexibility, and the autonomy to do great work. Medical, dental, and vision coverage along with numerous health and wellness programs. Parental leave and support plus adoption and surrogacy assistance. Career development programs and tuition reimbursement for continued education. 401k match including an annual company contribution Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $73,698.00 - $117,917.00 Skills Action Planning, Business, Business Strategies, Coaching, Customer Satisfaction, Decision Making, Leadership, People Management, Performance Improvements, Problem Resolution, Problem Solving, Relationship Building

Hi, we're Oscar. We're hiring a Provider Data Representative to join our Provider Operations team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: The Provider Data Representative is responsible for the accurate management and maintenance of provider data at Oscar. Key responsibilities include processing provider and facility rosters, reformatting data, and supporting updates to provider records. This role involves regular communication with providers via email to confirm request completion, obtain additional information, and address follow-up inquiries. The Provider Data Representative also collaborates with internal teams by triaging and escalating requests as necessary to ensure timely and effective resolution. You will report into the Provider Operations Lead. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $19 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year. Responsibilities: Manage ingestion of provider data while maintaining service delivery, productivity, and quality expectations Develop a comprehensive understanding of Provider Demographic data and downstream impacts Form working relationships with internal and external stakeholders Support the leadership team by identifying issues through established escalation pathways Be accountable for monitoring and tracking the health of all assigned work-in-progress issues. Escalate and resolve provider data issues to ensure appropriate turnaround times Be an active participant in process improvement initiatives Compliance with all applicable laws and regulations Other duties as assigned Requirements: High school diploma or GED 1+ years of experience in a fast-paced, volume-based or customer service-oriented environment Experience with Provider Data 1+ years Excel/Google sheet proficiency Bonus points: Strong verbal and written communication skills Strong quantitative or analytical skills focused on proactively identifying or solving problems In-depth knowledge of health insurance Experience manipulating and entering accurate data in a production driven environment Advanced Google Suite or Microsoft Office capabilities or willingness to learn This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This role supports a 24 hour/365 day crisis call center. Applicants must reside in Louisiana. Position Purpose: Work in collaboration with schools of higher education, county first responders, law enforcement, emergency departments, providers, crisis mobile teams and the Cenpatico Crisis Line provider to support the delivery of coordinated and effective crisis services. Develop relationship with all local schools of higher education and coordinate crisis prevention and disaster recovery efforts Verify crisis provider services are delivered in accordance to contract expectations Facilitate the issuing of Corrective Action letters to providers for non-compliance to contract requirements Verify follow-up occurs after crisis interventions to effectively coordinate care Educate local schools of higher education about how to identify the early warning signs of mental illness and what actions to take to safeguard students, faculty and the community Support the Crisis System Plan and the development of provider crisis programs and services within the Provider Network. Monitor the performance of the Crisis Line provider, Crisis Mobile Teams and other providers of crisis services Support the development of Crisis Response Center processes to verify effective coordination of care with other providers Establish baseline data; collect, analyze and report outcomes and progress in reaching program goals. Support the coordination of crisis system processes among system partners, including schools of higher education, crisis providers, intake agencies, emergency rooms, police and fire Conduct root causes analyses, conduct rapid cycle improvement processes Conduct cross departmental and cross system collaborative meetings to execute initiatives and resolve system issues Receive and respond to external system partner related issues in a timely manner Troubleshoot service delivery and coordination issues on behalf of system partners Educate system partners regarding policies and procedures related to referrals, website education, and problem solving Implement and monitor project plans to meet goals and timelines Request corrective action plans from providers that are non-compliant and/or fail to meet contract requirements Develop training modules and train appropriate users Support the involvement of Peer and Family Support Services, and wrap around and community based services to both stabilize and reduce crisis in the community. Provide on-call telephonic coverage 24 hours a day, in rotation as assigned, to provide consultation Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in Behavioral Health or equivalent experience. 5+ years of related experience. Master's degree in Behavioral Health or Social Science preferred. License/Certificates: Licensed Independent Substance Abuse Counselor (LISAC), Licensed Master Social Worker (LMSW), Licensed Bachelor Social Worker (LBSW), Certified Employee Assistance Professional (CEAP) or Licensed Marriage & Family Therapist (LMFT) preferred. For LA Healthcare Connections plan only: One of the following licenses is required: Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), or Licensed Addiction Counselor (LAC) Pay Range: $55,100.00 - $99,000.00 per year 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

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. Supports Long Term Services & Support (LTSS) network providers with recruitment and retention of direct care staff. Promotes self-determination and self-direction options with our membership. Partners with LTSS providers and account management to monitor staffing levels and engage providers and offer assistance with staffing gaps when indicated Conducts virtual and in-person job fairs to assist with recruitment Develops and maintains collaborative partnerships with local colleges and universities, the state workforce commission, agency networks and community groups Provides assistance to members through the following methods: Education and assistance with accessing Employment Assistance and Supported Employment benefits Referrals to the workforce commission and community organizations that link members to employment opportunities Provides support for individuals who self-direct, assist with back-up plan development (as needed) and provide webinars and forums on self-direction Monitors and expands alternative payment models with LTSS providers to provide financial incentive paid to direct care staff for high quality work Education/Experience: Bachelor's degree in Human Resources, Health Care, Sociology or related field or equivalent experience. 3+ years of related, employment specialist, workforce development, job coach, HR, client services, community relations, preferably in a managed care or Medicaid environment or other related experience. Community Health Worker Certification preferred. Candidates must be in one of the following Texas counties to be considered for this role: McMullen County, Texas, Jim Hogg County, Texas, Zapata County, Texas, Duval County, Texas, Maverick County, Texas, Webb County, Texas . This is a remote role that requires occasional local travel for internal and provider/member-facing meetings. Pay Range: $27.02 - $48.55 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

Hi, we're Oscar. We're hiring a Team Lead, Claims Production to join our Claims Production team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role The Lead, Claims Production is responsible for managing the success of multiple Claims Production teams by driving performance, effectiveness, and operational improvements to daily workflows and strategies. You will report to the Manager, Claims Production. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is $51,120 - $67,095 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities Guide your team's metrics, including member and provider satisfaction, quality of care (daily benchmark production) and employee satisfaction Coach direct reports through a culture of feedback and development to provide the best member/provider experience and care possible. Serve as a central communicator -- leading team huddles, promoting vision, strategy, company values, and providing feedback to team members and other company associates. Manage the daily needs of your team, including hiring, training, inventory levels, and scheduling to ensure an efficient operation Compliance with all applicable laws and regulations Other duties as assigned Qualifications 3+ years of experience leading and supporting a Claims Production team 2+ years reading and using claims data to identify trends; including inventory management Demonstrated capacity to balance competing priorities and continue to execute projects with excellence Bonus Points Prior healthcare or service experience Bachelor's Degree Proficiency navigating Excel, JIRA, and SQL This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

To learn more about this role, watch our field merchandisers in action. As a Field Merchandiser, you'll have the opportunity to work independently to showcase your organization and time management skills, your ability to establish retailer relationships, while being the face of Hallmark. You will collaborate with local store teams to optimize product placement and maintain inventory levels as well as support fellow team members with seasonal resets and installations, when needed. On occasion you may have the opportunity to work with other products from other companies in the stores that you service. SALARY AND SCHEDULE DETAILS * Your starting hourly pay rate will be $15.00-$17.00 depending on your skills and experience. * Eligible Employees receive annual pay increases. * This is a Part-Time position with a variable schedule during the work week. * Average weekly hours for this position are between 6-8 hours per week. * Availability the week before and after major holidays, which may include weekends is required. YOUR ROLE AND RESPONSIBILITIES WILL INCLUDE You'll perform service work in the Hallmark department of various retail stores such as grocery stores, drug stores, department stores, and mass retailers. The retail merchandiser position consists of three major components: * Day-to-day engagement: Utilizing a mobile device provided by Hallmark, you'll restock, organize, and monitor the inventory of Hallmark products within and outside the Hallmark department. The use of technology is critical in this role, for the day-to-day work as well as communication with your supervisor, reporting time, providing feedback, and answering surveys for required merchandising activities. Professional and courteous interaction with store employees, management, and customers is also vital for success in this role. You are responsible for the entire Hallmark product display at your assigned stores. * Holiday support: Hallmark's operations revolve around seasonal demand. Leading up to and following holidays such as Valentine's Day, Easter, Mother's Day, Father's Day, Halloween, Thanksgiving, and Christmas, you can expect additional days and extended hours during the work week. On occasions like Valentine's Day, Mother's Day, and Father's Day, you may be required to work on the actual holiday itself, which may include the weekend. * Department Resets: At times, you may be part of a team responsible for installations and various tasks like building and installing Hallmark fixtures, relocating card departments and products, as well as resetting card sections. Typically, you will be notified two weeks in advance for remodel assignments. This could include evenings or weekend. * One Team Vision: As part of Hallmark's field organization, you are part of a network of merchandisers professionals that often times will support other team members as needed in their territories. PHYSICAL REQUIREMENTS This is a physically demanding job that requires a high level of energy and a sense of urgency. You will be working on the selling floor as well as in back stockrooms. You must be able to consistently push, pull, lift, and carry cartons, merchandise, and display fixtures up to 30 pounds throughout the workday and up to 50 pounds on occasion. You will also be required to kneel, squat, walk, and stand throughout your workday, and you may be required to climb stairs and step ladders. BASIC QUALIFICATIONS * You're at least 18 years of age. * You're able to read, write and understand English. * You have the ability to grasp, pull, lift, and carry products up to 30 pounds frequently and 50 pounds occasionally. * Able to operate a digital hand-held device to open and read documents and interpret information. * You have access to a Wi-Fi network and the internet. * You have access to consistent transportation to travel to and between assigned stores as scheduled. Part-time employees with a work schedule less than 30 hours have access to a variety of voluntary benefits through Voluntary Benefits including dental, vision, critical illness, accident insurance, hospital indemnity and minimum essential coverage (preventive care). Prior to applying, watch our field merchandisers in action. Now's your chance to Make Your Mark-just follow the instructions below to apply. You must show how you meet the basic qualifications in a resume or document you upload, or by completing the work experience and education application fields. Accepted file types are DOCX and PDF. Part-time employees with a work schedule less than 30 hours have access to a variety of voluntary benefits through Voluntary Benefits including dental, vision, critical illness, accident insurance, hospital indemnity and minimum essential coverage (preventive care). In compliance with the Immigration Reform and Control Act of 1986, Hallmark Cards, Inc. and its subsidiary companies will hire only individuals lawfully authorized to work in the United States. Hallmark does not generally provide sponsorship for employment. Employment by Hallmark is contingent upon the signing of the Employment Agreement, signing of an agreement to arbitrate in connection with the Hallmark Dispute Resolution Program, completing Form I-9 Employment Eligibility Verification, and successfully pass pre-employment (post offer) background check. Hallmark is an equal opportunity employer. All qualified applicants will be considered for employment without regard to race, color, religion, sex, age, pregnancy, national origin, physical or mental disability, genetics, sexual orientation, gender identity, veteran status, or any other legally-protected status. Principals only please. HALLMARK - Because Connecting With Each Other Has Never Been More Important For over 100 years, Hallmark has helped people connect and strengthen the relationships that matter most. Today, we're building the next century of connection- blending the warmth of in-store experiences with the ease of digital innovation. We're looking for empathetic learners, strategic thinkers, and enthusiastic visionaries from all backgrounds to help shape what's next. If you're ready to bring fresh ideas and energy, we'd love to have you on the team! At Hallmark, you'll feel welcomed from day one- whether you're remote, hybrid, or in-office. We'll tap into your strengths, offer leadership opportunities, and support your growth every step of the way. Our culture is rooted in care and inclusion. We celebrate diverse perspectives and actively seek out new voices- like yours- to help us grow and evolve. Let's imagine the future of Hallmark together!

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: Lead, negotiate, and manage multiple hospital, large medical group, physician, school and/or ancillary contracting activities in accordance with Corporate, health plan, and state guidelines. Oversee all activities of the contracting department Develop and implement a network development plan for an assigned region and set of providers and identify and initiate contact with potential providers Negotiate contracts with interested providers utilizing model provider agreements, and follow up on contracts Lead negotiations, rate modeling, implementation and ongoing monitoring of assigned group of providers to maximize business relationships and opportunities Oversee provider set-up and contract configuration to ensure accurate claims adjudication and facilitate the organization of provider focus groups Evaluate and monitor providers' performance standards and financial performance of contracts Ensures compliance with national contracting standards, reimbursement standards, provider set-up rules, exception process and use of model contract language Perform financial analyses to identify medical cost improvement opportunities and develop and execute contracting action plans to achieve results Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in Healthcare Administration, Business Administration, Marketing, related field or equivalent experience. 4+ years of provider relations/contracting experience in a healthcare and/or managed care environment. Working knowledge of contracting language and the principles of negotiation. Familiarity with managed care, State and/or Federal health care programs. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff. License/Certification: Valid driver's license. Candidates must be in the state of Michigan to be considered for this role. This is a remote position, but it may require occasional travel for meetings in Detroit, MI. Pay Range: $87,700.00 - $157,800.00 per year 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

Hi, we're Oscar Medical Group. We're hiring a Physician Assistant to join our Virtual Health Assessment team. At Oscar Medical Group, we are refactoring healthcare. We want to help each of our members achieve their healthcare goals in a personalized way. To help us achieve that goal we are looking for innovative leaders who think big and push boundaries to refactor healthcare and the healthcare delivery system. About the role: Oscar Medical Group runs a Virtual Health Assessment (VHA) program that outreaches and virtually engages Oscar Health Insurance members in an evaluation and management visit. You will also help to support teams across Oscar Medical Group, including Virtual Primary Care and Virtual Urgent Care when needed. You will report into the Director, Virtual Health Assessment. Clinic Hours: 8a-8p EST Monday - Thursday 8a-6p EST Friday & Saturday 8hr or 10hr shifts 1 late day (working shift ending at 8p EST) is required per week 2 Saturday shifts required per quarter Work Location: This is a remote position, open to candidates who reside in: Alabama; Arizona; Arkansas; Colorado; Connecticut; District of Columbia; Florida; Georgia; Idaho; Illinois; Indiana; Iowa; Kansas; Kentucky; Maine; Maryland; Massachusetts; Michigan; Minnesota; Missouri; Nevada; New Hampshire; New Jersey; New Mexico; North Carolina; Ohio; Oregon; Pennsylvania; Rhode Island; South Carolina; Tennessee; Texas; Utah; Vermont; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $104,000 - $136,500 per year. You are also eligible for employee benefits, annual vacation grant of up to 18 days per year, and annual performance bonuses. Responsibilities: Perform preventative care screenings, complete medication reconciliation, diagnose medical conditions and provide health coaching, referrals and treatment when clinically appropriate. Outreach members who are more chronically ill based on historical and suspected health information. Engage members who have a lower probability of seeing their PCP. Identify areas in the member's medical journey that can be improved by increasing their access to care with a licensed provider. Cross-train into urgent care and/or virtual primary care service line Interact with members virtually, including virtual assessment, diagnosis and treatment. Compliance with all applicable laws and regulations Other duties as assigned Requirements: PA from accredited program Board Certification (NCCPA) Experience with Clinical Documentation Improvement and/or managing HEDIS quality measures Licensed in Georgia and one of the following states: Florida, Texas, or Ohio Bilingual - Spanish fluency (read, write, & speak) Ability to obtain licensure in additional states 3+ years experience in outpatient Family Medicine, Internal Medicine, or Primary Care This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

You could be the one who changes everything for our 28 million members by using technology to improve health outcomes around the world. As a diversified, national organization, Centene's technology professionals have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Provides leadership and direction in planning, developing, and maintaining Centene's IT service operations function. Provides oversight to the major enterprise system management and event management tools, and their respective maintenance. Leads ITSM strategies, including collaborating with disaster recovery and business continuity teams. Also manages the overall performance and reliability of the ITSM team by establishing and implementing technical and operational performance standards as defined for core functions that are essential to supporting Centene's established IT strategic objectives. Develops strategy and plan for the implementation and development of policies and procedures to ensure consistently high levels of quality and availability Defines and maintains service operations key performance indicators (KPI) metrics Oversees the planning, hosting, and deployment of key operational activities for IT service and support teams to reduce service volume activity, decrease unexpected network impact activity and ensure consistent response practices Oversees operational activities per standard operating procedures such as batch processing, backup/recovery jobs, system health checks, system reboots, user account management, system patching, etc. Oversees enterprise event management tools and their respective maintenance, configuration, integration, and strategies Manages the hiring and training of new and existing staff, conduct performance reviews, provide leadership, technical guidance and coaching to IT Service team members Leads team to help ensure the stable operation of ITSM activities Shares knowledge and develop staff capabilities to strengthen understanding of service operations, business issues and best practices; evaluate and define implications to IT Manages the budget for service operations, support reporting and forecasting activities Mentors and guides staff Manages the hiring and training of new and existing staff, conducts performance reviews, and provides leadership, technical guidance and coaching Shares knowledge and develops staff capabilities to strengthen understanding of business issues and best practices Develops and communicates organizational objectives; inspires and motivates team members to achieve results Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires a Bachelor's degree and 5+ years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Technical Skills: One or more of the following skills are desired. Experience with Other: Windows Server, Active directory, UNIX/Linux, Data Domain Storage, NetBackup and their uses in application hosting architecture, tools such as SolarWinds, Microsoft System Center or equivalent, current networking systems, ITIL framework and practices Soft Skills: - Ability to lead/manage others - Collaboration and team building skills - Effectively coaches and delivers constructive feedback - Instills commitment to organizational goals - Ability to communicate and make recommendations to upper management - Effective conflict management skills - Develops and delivers effective presentations - Demonstrated negotiation skills Pay Range: $102,900.00 - $190,500.00 per year 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

Resp & Qualifications Purpose The Associate General Counsel provides a complete range of legal services in support of the Assistant General Counsel, Litigation General Counsel, and the Division(s), Department(s), and/or specialized areas of legal practice to which the position is assigned with a focus on regulatory, compliance, litigation, and employment law. Essential Functions Provides advice and counsel to management and/or their designees in complex and rapidly evolving areas of the law; evaluates divisional and departmental initiatives and represents the corporation's legal interests on intercompany management committees; researches, analyzes and writes legal memoranda and provides legal guidance on a wide variety of legal, regulatory, contractual, compliance, corporate governance and operational matters, including the interpretation and implementation of legislation; assists with and/or supports representation of the corporation's legal interests by interfacing with opposing counsel and regulatory agencies on issues having significant impact on company operations and/or finances. Responsible for representing the company before regulators including, but not limited to the EEOC, MCCR, DCOHR or other state or local equivalent, the NLRB, MIA and OAH. Support Litigation General Counsel and employment counsel, as necessary. Reviews subpoenas, garnishments, and other court issued documents for legal sufficiency and provides direction to legal support staff to ensure that the corporation's responses are in an appropriate manner. Oversees the filing of proofs of claim in bankruptcy matters to ensure that the corporation's financial interests are adequately protected, as well as supports Assistant General Counsel by analyzing business operations and recommending and implementing processes to maximize effectiveness of legal resources. Provides guidance to Paralegals and Legal Assistants with respect to legal research projects and drafting of memoranda. Qualifications Education Level: Juris Doctor Licenses/Certifications Required: Bar Admission to the MD or DC Bar within 1 Year Experience: 1 year experience in the legal field. Healthcare, regulatory, or another relevant base of experience is required. Preferred Qualifications: 1+ year of regulatory experience; minimum of 1 year in ERISA/health/managed care issues and experience in bankruptcy, employment law, litigation and/or arbitration preferred. Knowledge, Skills and Abilities (KSAs): Strong analytical, interpersonal, and written and verbal communications skills. Ability to follow instructions, to be flexible/versatile, and to work independently. Salary Range $123,440 - $220,649 Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401(k) contribution programs/plans (all benefits/incentives are subject to eligibility requirements). Department Office of Corporate Counsel I Equal Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: ************************* Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. Physical Demands The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship #LI-LJ1 #J-18808-Ljbffr