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CorVel jobs in Fort Worth, TX

- 48 jobs
  • Senior CERIS Ops Manager

    Corvel 4.7company rating

    Corvel job in Fort Worth, TX

    The Senior CERIS Operations Manager is responsible for overseeing all aspects of the department including Personnel Hiring, Quality Assurance of Product, Workflow, Maintaining the tracking of and accountability of staff regarding production standards and department expectations. Works collaboratively with other department managers to achieve departmental requirements and goals. This is a hybrid role reporting to Fort Worth, TX. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: * Ensure timely and accurate communication of information, in written and electronic forms, that are directed to internal company contacts, clients and providers * Responsible for directing a designated group of employees in their day-to-day operations * Responsible for monitoring quality control of results per employee as well as the entire unit overall * Responsible for ensuring Metrics are in compliance daily * Responsible for tracking and reporting of department metrics to Director of Operations on a monthly basis or as required * Handles scheduling and monitoring of staff's attendance * Ensures timely distribution of claims to designated staff to meet Client SLA's * Responsible for human resources matters directly related to department supervised. I.e. Interviewing, Hiring, Training and addressing personnel issues. Reports any issues to Operations Manager when necessary * Responsible for ensuring evaluations are completely on time * Requires regular and consistent attendance in house * Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP) * Maintain HIPAA compliance policies * May be required to travel overnight and attend meetings * May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses * Additional duties as assigned KNOWLEDGE & SKILLS: * Must have good computer and analytical skills * Proficient in Microsoft Office suite, mainly Outlook, Excel, Word * Good organizational skills and ability to multitask * Detail Oriented * The ability to work independently, as well as, with a team * The ability to work in a fast paced/production based environment * Effective communication with others EDUCATION / EXPERIENCE: * Associates degree, national certification or equivalent * Minimum 5 years office experience * Previous Supervisory experience preferred PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $71,696 - $110,701 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CERIS: CERIS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid
    $71.7k-110.7k yearly 60d+ ago
  • Data Analyst

    Corvel Enterprise Claims, Inc. 4.7company rating

    Corvel Enterprise Claims, Inc. job in Dallas, TX

    Job Description The Data Analyst turns data into information, information into insight and insight into business decisions that may be best applied to profit. The Data Analyst identifies opportunities and challenges as well as their solutions across multiple departments, to support critical tactical and strategic decisions of CorVel. This is a hybrid position in Dallas, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides strategic and tactical support to the organization by analyzing and interpreting data to provide creative solutions Analyzes results of collected data using statistical techniques and provides ongoing reports Identifies, analyzes, and interprets trends or patterns in complex data sets Interfaces between various business and technical teams to understand context and business value in data Works closely with internal customers to build relationships; continuously gaining a deeper understanding of relevant data and processes to build solutions that meet business needs Using established protocols and resources, produces dynamic, meaningful, clear and informative reports and dashboards using standard business intelligence tools to help executive management solve highly complex problems Additional duties as assigned KNOWLEDGE & SKILLS: Mathematics, statistics and data analysis Excellent written and verbal communication skills Strong computer proficiency and technical aptitude Strong analytical skills with the ability to collect, organize, analyze and disseminate significant amounts of information with attention to detail and accuracy Strong interpersonal, time management, and organizational skills Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Bachelor's degree, preferably in a quantitative field 1-2 years of experience with analysis preferred Exposure to standard statistics and business intelligence tools (e.g. Excel, SPSS, SAS, Tableau, Chartio, etc.) PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $21.76 - $34.86 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. About CorVel: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid
    $21.8-34.9 hourly 14d ago
  • CareIQ Intake Specialist I

    Corvel Career Site 4.7company rating

    Corvel Career Site job in Fort Worth, TX

    The CareIQ Intake Specialist provides administrative customer service assistance to claimants, providers, and claims management by receiving and entering new ancillary healthcare referrals. Utilizing proprietary systems and knowledge from training, a CareIQ Intake Specialist will provide excellent telephonic and written customer service to both inbound and outbound customers. A CareIQ Intake Specialist operates with a high focus on accuracy and urgency to ensure that service orders are received quickly in alignment with the claimant and customer needs. This is a remote role however, for continuity of business, candidate must live and work in the Central or Eastern time zones and be willing to work 12PM - 8:30PM EST Monday - Friday. ESSENTIAL FUNCTIONS & RESPONSIBILITES: Provides quality and friendly telephonic customer service in an inbound and outbound high-volume call-center environment Completes accurate data entry and review Able to learn and operate corporate proprietary systems Enters assigned electronic (email/fax/data feed) orders into coordination system Ensures all case stakeholders are updated regularly Transcribes correspondence/reports from dictation Uses problem solving and critical thinking skills to ensure that daily scheduling challenges do not cause delays in securing appointments Meets departmental production and quality performance expectations Additional duties as assigned KNOWLEDGE & SKILLS: Ability to work on several concurrent tasks and prioritize workload to meet designated deadlines Excellent written and verbal communication skills Computer proficiency and technical aptitude with the ability to utilize Microsoft Office and Proprietary Systems Strong interpersonal, time management and organizational skills Ability to maintain a professional and courteous demeanor that sets tone for complex telephonic conversations Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: High School diploma Prior work experience in a detail-oriented customer service environment PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $15.26 - $23.28 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 3500 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
    $15.3-23.3 hourly 8d ago
  • Administrative Assistant

    Humana 4.8company rating

    Frisco, TX job

    Become a part of our caring community and help us put health first The Administrative Assistant provides advanced administrative support to executives, managers, or departments. This role performs a variety of complex administrative tasks requiring discretion, independent judgment, and thorough knowledge of organizational policies and procedures. The Administrative Assistant coordinates internal and external meetings which may involve scheduling meeting times, making travel arrangements for attendees, and ensuring that various meeting amenities are available. Manages the appointments and schedules of applicable staff. Uses office equipment such as photocopiers, faxes, and printers. Key Responsibilities: Manage calendars, schedule appointments, and coordinate meetings and travel arrangements for assigned leaders. Prepare correspondence, reports, presentations, and other documents with a high degree of accuracy and professionalism. Assist with the preparation and reconciliation of expense reports and purchase requisitions. Coordinate logistics for meetings, including room reservations, materials preparation, and catering. Maintain confidential files and records, ensuring compliance with company policies. Support project coordination, track deadlines, and follow up on action items, as needed Ability to balance multiple initiatives and prioritize workload Serve as a point of contact for internal and external stakeholders. Perform other duties as assigned to ensure efficient office operations. Additional responsibilities may include distributing incoming mail, preparing outgoing mail, filing, maintaining office supplies or other inventory. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge. Use your skills to make an impact Required Qualifications: Minimum of 3-5 years of administrative support experience, preferably supporting management or executive-level staff. Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and other relevant software. Excellent written and verbal communication skills. Strong organizational skills and attention to detail. Ability to handle confidential information with discretion. Demonstrated ability to work independently and as part of a team. Preferred Qualifications: Associate's or Bachelor's degree Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,100 - $72,500 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $53.1k-72.5k yearly Auto-Apply 1d ago
  • CERIS Certified Coder I

    Corvel Career Site 4.7company rating

    Corvel Career Site job in Fort Worth, TX

    CERIS is seeking a Certified Coder. The CERIS Certified Coder reverse code previously coded medical bills to determine coding accuracy. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim and processes based on state rules and regulations Determine validity and compensability of the claim using CorVel proprietary programs Make recommendations to referring office Communicate claim status with referring office Read and comprehend all medical reports Adhere to client and carrier guidelines and participate in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as, maintain HIPAA compliance KNOWLEDGE & SKILLS: Ability to learn rapidly to develop knowledge and understanding of claims practice Strong organizational skills Ability to meet or exceed performance competencies Effective and professional communication skills Ability to handle stressful situations, and use critical and strategic thinking Demonstrated outstanding leadership, problem solving, and analytical skills Ability to think and work independently, while working in an overall team environment Proficient in Microsoft Office Suite, especially Excel and Outlook EDUCTION & EXPERIENCE: High School diploma, or equivalent Current AAPC certification (which must be maintained throughout employment as current and active status) Certification as CPC with the AAPC for more than 2 years (w/ surgical or office experience) Current or recent orthopedic billing/coding experience E/M coding/down-coding experience EncoderPro software experience Texas workers compensation experience is preferred Pain Management/Anesthesia/General Surgery coding experience is preferred PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $42,899 - $64,162 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CERIS: CERIS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
    $42.9k-64.2k yearly 60d+ ago
  • Payment Integrity Analyst II

    Corvel 4.7company rating

    Corvel job in Fort Worth, TX

    The Payment Integrity Analyst is responsible for accurately reviewing pre and post pay claim audits based on client, policy, industry standards and/or CMS guidelines. . ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: * Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication. * Ability to use clinical judgement and analytical skills to appropriately review documentation submitted for claim audits. * Utilize clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits. * Utilize applicable tools and resources to complete internal audits and/or appeals. * Timely completion of internal audits and/or appeals. * Attends Clinical Team Meetings, All Company Meetings, Education Opportunities, Trainings, and other potential meetings * Additional duties as assigned. KNOWLEDGE & SKILLS: * Ability to demonstrate understanding of CMS and commercial payer policy in written and verbal format * Strong understanding of claims processing, ICD-10 Coding, DRG Validation, Coordination of Benefits * Strong understanding of healthcare revenue cycle and claims reimbursement * Proficient in Microsoft Office including Pivot Tables and Database Management * Comfortable interfacing with clients and the C-Suite * Demonstrate ability to manage multiple projects, set priorities and adhere to committed schedule * Strong interpersonal skills and adaptive communication style, complex problem solving skills, drive for results, innovative * Excellent written and verbal communication skills * Proven track record of delivering concrete results in strategic projects/programs * Strong analytical and modeling ability and distilling data into actionable results * Superb attention to detail and ability to deliver results in a fast paced and dynamic environment EDUCATION/EXPERIENCE: * Must maintain a current LPN, LVN and/or RN licensure * Preferred experience with health insurance denials and/or appeals, payer audits, or vendor audits * Previous experience in one or more of the following areas required: * Medical bill auditing * Experience in the acute clinical areas of facilities in O.R., I.C.U., C.C.U., E.R., Telemetry, Medical/Surgical, OB or L&D, Geriatrics and Orthopedics * Knowledge of worker's compensation claims process * Prospective, concurrent and retrospective utilization review * Bachelor's degree in healthcare or related field preferred * 1+ years healthcare revenue cycle * 1+ years of relevant experience or equivalent combination of education and work experience * 1+ years hospital bill audit PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $63,902 - $96,662 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. About CERIS CERIS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
    $63.9k-96.7k yearly 60d+ ago
  • CERIS Ops Supervisor

    Corvel Career Site 4.7company rating

    Corvel Career Site job in Dallas, TX

    The CERIS Operations Supervisor is responsible for managing daily production for the department, which may include one or more of the following functions: human resources, customer service, and promoting positive influence over the Analysts. This is an onsite position in Dallas, TX. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Approve Electronic time cards for employees Assist Manager in establishing employee schedules Oversee Quality Control and tracking or error rates Maintaining HIPAA compliance in all aspects of communications Requires regular and consistent attendance Oversee production while developing, tracking, and enforcing Quota Track all protocol changes made by clients and communicating those changes with the team Perform timely and accurate employee evaluations Assist manager in the hiring process, help conduct interviews Other duties as assigned by manager KNOWLEDGE & SKILLS: Must have good computer and analytical skills Proficient in Microsoft Office suite, mainly Outlook, Excel, Word Good organizational skills and ability to multitask Detail Oriented The ability to work independently, as well as, with a team The ability to work in a fast paced/production based environment Effective communication with others EDUCATION / EXPERIENCE: High school diploma or equivalent Minimum of 1 year office experience Minimum 1 year as closing analyst Previous Supervisory experience preferred PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $17.93 - $26.79 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CERIS: CERIS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Onsite
    $17.9-26.8 hourly 48d ago
  • Home Health Sales Executive

    Humana Inc. 4.8company rating

    Plano, TX job

    Become a part of our caring community and help us put health first As a Home Health Specialist, you will: * Call on physicians, hospitals, skilled nursing facilities' management, discharge planners, and case managers within an assigned territory to promote our homecare services. * Build and maintain client relationships. * Prepare business plans and maintain target lists. Prioritize accounts in accordance with the market sales plan. * Gather and organize account-related information and provide input on key customer opportunities, service line extensions and proposal or contract pricing. Use your skills to make an impact Required Experience/Skills: * Previous health care sales experience, such as selling in skilled nursing facilities (SNF), DME, Ortho, Cardio, Infusion, Imaging, Laboratory, preferred. * Bachelor's degree in Marketing, Business, or a health related science (e.g., nursing, pharmacy, etc.) preferred. * Excellent selling, organization, problem-solving skills and the ability to appropriately represent the Company service capabilities to the targeted referral source audience is required. * Excellent interpersonal communication and presentation skills required. * Ability to travel within assigned territory and to sales meetings as required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $58,700 - $78,500 per year This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $58.7k-78.5k yearly 8d ago
  • Medical Assistant Float

    Humana Inc. 4.8company rating

    Fort Worth, TX job

    Become a part of our caring community and help us put health first The Medical Assistant is the first point of contact for patient care. Responsible for administrative duties in addition to patient care. The Medical Assistant performs advanced administrative, operational, customer support duties that require independent initiative and judgment. The Medical Assistant performs clinical duties such as discussing symptoms, obtaining vital signs, medication/vaccine administration, phlebotomy, collecting specimens, performing diagnostic screening tests, sterilizing/cleaning equipment, maintaining examination rooms, and documenting information into the electronic medical records system. Collaborates closely with Physicians and Advanced Practice Providers. Delivers direct patient care dependent on what active certification allows. Decisions typically focus on methods, tactics, and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes, and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge. The Medical Assistant 3 possesses advanced skills and knowledge, contributes to process improvement, delivers in-depth education/training, and provides advanced guidance/mentoring to other Medical Assistants. The Medical Assistant Float position will require travel / float to 5 clinics in the DFW Market (CenterWell North Buckner, Redbird, South Garland, NW Dallas, and Richardson). Mileage will be reimbursed for all travel. Use your skills to make an impact Required * Certified or Registered * Phlebotomy experience * Travel / Float to to 5 clinics in the DFW Market (CenterWell North Buckner, Redbird, South Garland, NW Dallas, and Richardson). * Medication/vaccine administration experience * 1+ years MA experience * High school diploma or equivalent * CPR Certified * This role is considered patient facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB Preferred * 1+ years MA experience in PCO center * Value Based Care experience including knowledge of HEDIS, CPT/ICD coding, and CAHPS/HOS Patient Experience * Bilingual proficiency in English and Spanish - must pass proficiency exam prior to foreign language communication Additional Information: This role is considered patient-facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Interview Format: HireVue: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Benefits: Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: * Health benefits effective day 1 * Paid time off, holidays, volunteer time and jury duty pay * Recognition pay * 401(k) retirement savings plan with employer match * Tuition assistance * Scholarships for eligible dependents * Parental and caregiver leave * Employee charity matching program * Network Resource Groups (NRGs) * Career development opportunities #LI-BL1 Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $44,900 - $60,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $44.9k-60.2k yearly Easy Apply 60d+ ago
  • Claims Specialist

    Corvel Career Site 4.7company rating

    Corvel Career Site job in Dallas, TX

    The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a hybrid position in Dallas, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills Ability to learn rapidly to develop knowledge and understanding of claims practice Ability to identify, analyze and solve problems Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets Strong interpersonal, time management and organizational skills Ability to meet or exceed performance competencies Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Bachelor's degree or a combination of education and related experience Minimum of 1 year of industry experience and claims management preferred State Certification as an Experienced Examiner PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $51,807 - $83,551 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Hybrid
    $51.8k-83.6k yearly 34d ago
  • Broker Relationship Manager

    Humana Inc. 4.8company rating

    Arlington, TX job

    Become a part of our caring community and help us put health first The Broker Relationship Manager will be responsible for cultivating and maintaining strategic partnerships with brokers to drive new patient growth and expand our presence within the market. The ideal candidate will possess strong industry knowledge, exceptional relationship-building skills, and a proven track record of success. This position will play a pivotal role in advancing our mission to deliver high-quality, value-based care to seniors across the nation. Travel across the Dallas Ft Worth Metroplex is required Responsibilities: * Develop and nurture relationships with brokers and intermediaries specializing in senior healthcare, Medicare Advantage, and value-based care models. * Identify and pursue new broker partnerships and business opportunities aligned to our strategic objectives to increase patient enrollment and revenue growth. * Serve as the primary point of contact for brokers, providing them with the necessary tools, resources, and support. * Conduct training sessions, webinars, and presentations for brokers to educate them about value-based care, our care-model, service offerings, and the benefits of partnering with our organization. * Collaborate closely with internal teams, including sales, marketing, operations, and care team to align broker initiatives with overall business objectives and ensure seamless execution of broker-driven sales strategies. * Collaborate with brokers on events and marketing campaigns. * Stay informed about market trends, competitor activities, regulatory changes, and emerging opportunities within the senior healthcare landscape to inform broker engagement strategies and maximize market penetration. Use your skills to make an impact Required Qualifications: * Bachelor's degree in business administration or marketing and/or minimum of 5+ years' experience in related field. * Proven track record of success in broker relationship management or sales within the healthcare industry, with a focus on senior healthcare and value-based care models. * Deep understanding of Original Medicare, Medicare Advantage, and other senior healthcare insurance products. * Excellent interpersonal and communication skills, with the ability to build rapport, negotiate effectively, and influence decision makers at all levels. * Strong business acumen and analytical skills, with the ability to analyze market data, identify trends, and develop actionable insights to drive business growth. * Results-driven mindset with a demonstrated ability to meet or exceed sales targets and drive growth through broker partnerships. * Ability to work independently and collaboratively in a fast-paced, team-oriented environment. * Strong proficiency in CRM software (Salesforce) and Microsoft Office suite. * This role is part of Humana's Driver safety program and, therefore, requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits. * This is a field sales position, not work from home, and may require evening or weekend hours. Preferred Qualifications: * Bilingual Spanish Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,000 - $105,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $77k-105.1k yearly 3d ago
  • Claims Assistant

    Corvel Career Site 4.7company rating

    Corvel Career Site job in Dallas, TX

    The Claims Assistant will support the claims staff in the set-up and administration of workers' compensation claims/case management and other tasks depending on the specific customer needs. in Dallas, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless), and input notes/diary entries in the claims system Process payments, as needed Process form letters, state forms and reports Assist claims examiners with telephone calls including provider, claimant and customer calls Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills PC literate, including Microsoft Office (Word, Excel) Ability to work independently and in a team environment Strong organizational skills EDUCATION & EXPERIENCE: High school diploma, college degree preferred Six (6) months of service oriented office experience preferred PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $13.08 - $22.89 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
    $13.1-22.9 hourly 20d ago
  • Itemization Review Nurse II

    Corvel 4.7company rating

    Corvel job in Fort Worth, TX

    The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Collects supporting data and analyzes information to make decisions regarding accuracy of billing * Appropriately documents work and final conclusions in designated computer program * Understanding of Surgical Implants * Meets department's expectations and standards * Additional duties as assigned KNOWLEDGE & SKILLS: * Understanding of Itemization Review for designated clients * Understanding of CERIS systems and Data Base informatics * Understanding of HIPAA regulations * Exceptional organizational skills with the ability to handle stressful situations and adapt accordingly * Demonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environment * Strategic problem solving, analytical, and critical thinking skills * Effective written and verbal communication skills * Ability to work independently and within a team environment * Proficiency with Microsoft Office Suite, including Excel, Outlook, Teams EDUCATION & EXPERIENCE: * Must maintain current licensure as a Registered Nurse in the state of employment * Must have a minimum of 5 years' experience in the O.R., ICU, or E.R. as an R.N. * Associate Degree in Nursing or higher * Experience in medical bill auditing preferred but not mandatory PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $59,681 - $96,123 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CERIS: CERIS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
    $59.7k-96.1k yearly 35d ago
  • Medicare Sales Field Agent - Denton County, TX

    Humana 4.8company rating

    Denton, TX job

    **Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll help bring Humana's strategy to life: Deliver on the fundamentals, differentiate through exceptional service, and grow by expanding our reach and impact. **What You'll Do in This FIELD Based Role:** + **Deliver** : Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental, Vision, and Prescription coverage. + **Differentiate** : Create meaningful, face-to-face connections through grassroots marketing, community events, and in-home visits-providing a personalized experience that sets Humana apart. + **Grow** : Drive self-generated sales, meet performance goals, and expand Humana's presence in the market by becoming a valued resource in your community. You'll engage with customers in the **FIELD** through a mix of in-person, virtual, and phone interactions. **Face-to-face visits in prospective members' homes are a key part of this role.** **Why Join Humana?** + **People-first culture** that supports your personal and professional growth. + **Inclusive and diverse environment** that values multilingual talent and cultural understanding. + **Autonomy and flexibility** to manage your schedule and success. + **Purpose-driven mission** to help people achieve their best health-and transform healthcare along the way. **Benefits include:** + Medical, Dental, Vision, and a variety of other supplemental insurances + Paid Time Off (PTO) and Paid Holidays + 401(k) retirement savings plan with a competitive match + Tuition reimbursement and/or scholarships for qualifying dependent children + **And much more!** **Use your skills to make an impact** **Required Qualifications** + **Active Health Insurance License** or ability to obtain. + Must reside in **the designated local territory** to effectively serve the community. + Comfortable with **daily face-to-face interactions** in prospective members' homes and engaging with the community through service, organizations, volunteer work, or local events.. + Valid state **driver's license** and **proof of personal vehicle liability insurance** meeting at least 25/25/10 coverage limits (or higher, based on state requirements). **Preferred Qualifications** + **Active Life and Variable Annuity Insurance License** . + Prior experience **selling Medicare products** . + Experience in **public speaking or delivering presentations** to groups. + Associate's or Bachelor's degree. + Experience using Microsoft Office tools such as **Teams, Excel, Word, and PowerPoint** . + **Bilingual** in English and Spanish, with the ability to speak, read, and write fluently in both languages. **Additional Information** + This position is in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and MVR review. + Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. + Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Schedule** **:** Meeting with members requires appointments and/or event times that may vary on nights and weekends. Flexibility is essential to your success. **Training:** The first five weeks of employment and attendance is mandatory. **Interview Format:** As part of our hiring process for this opportunity, we are using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward in the process, you will receive a text message inviting you to participate in a HireVue prescreen. In this prescreen, you will receive a set of questions via text and given the opportunity to respond to each question. You should anticipate this prescreen taking about 15 minutes. Your responses will be reviewed and if selected to move forward, you will be contacted with additional details involving the next step in the process. **Pay Range** The range below reflects a good faith estimate of total compensation for full time (40 hours per week) employment at the time of posting. This compensation package includes both base pay and commission with guarantee. The pay range may be higher or lower based on geographic location. Actual earnings will vary based on individual performance, with the base salary and commission structure aligned to company policies and applicable pay transparency requirements. $80,000 - $125,000 per year \#medicaresalesrep Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $28k-36k yearly est. Easy Apply 56d ago
  • CERIS IT Compliance Analyst

    Corvel Career Site 4.7company rating

    Corvel Career Site job in Fort Worth, TX

    The IT Compliance Analyst supports the organization's compliance and risk management programs by coordinating assessments, audits, and certifications across frameworks such as HITRUST, SOC, HIPAA, and NIST. This role helps maintain a strong IT compliance posture by managing evidence, monitoring control performance, maintaining documentation, and partnering closely with IT, Security, Privacy, Legal and external auditors. The Analyst also contributes to continuous improvement efforts, compliance automation initiatives, and reporting that supports leadership visibility and informed decision-making. Key Responsibilities Assessment & Audit Support Coordinate internal and external compliance assessments, audits and certifications. Prepare, organize, and manage evidence to meet control and audit requirements. Track remediation activities and ensure timely closure of identified gaps. Maintain audit-ready documentation and support readiness reviews. Additional duties as assigned Compliance Program Management Support development and maintenance of compliance frameworks, policies, and procedures. Monitor regulatory and framework changes, updating controls and documentation as needed. Participate in risk assessments and control evaluations to identify opportunities for efficiency, automation and continuous improvement. Conduct and/or support periodic control testing and continuous monitoring to validate control effectiveness and compliance readiness. Contribute to compliance metrics, dashboards and trend reporting for leadership visibility. Collaboration & Communication Partner with IT, Security, Privacy, Legal and Operations to ensure consistent compliance practices. Collaborate with Privacy and Data Governance teams to ensure alignment with HIPAA, CCPA, GDPR and other data protection regulations. Communicate compliance requirements, audit findings and remediation progress clearly to stakeholders at all levels. Support awareness and training initiatives promoting compliance and data protection. Promote a culture of accountability and continuous improvement. Qualifications Bachelor's degree in Business Administration, Risk Management, Healthcare Administration, Legal/Paralegal Studies, Information Security or related field (or equivalent experience). 2-5 years of experience in compliance, audit, or information security. Working knowledge of regulatory frameworks (HITRUST CSF, SOC, HIPAA). Familiarity with healthcare regulatory authorities and governance areas (CMS, HHS, OCR, OIG). Experience coordinating audits and managing evidence requests across diverse teams. Strong organizational, analytical, and communication skills; detail-oriented and adaptable. Preferred Skills Experience supporting HITRUST certification or readiness assessments. Collaboration with legal teams and practices including regulations, policies and contracts. Familiarity with GRC tools (e.g., Archer, ServiceNow GRC, ProcessUnity, OneTrust). Utilization of compliance automation tools (e.g., Conveyor, Drata, Vanta, Winify AI). Certifications such as HITRUST CCSFP, CISA, CISM, CRISC, CGEIT, or CISSP. PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $59,681 - $96,123 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. About CERIS CERIS Inc., a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
    $59.7k-96.1k yearly 24d ago
  • DRG Clinical Payment Integrity Manager

    Corvel Career Site 4.7company rating

    Corvel Career Site job in Fort Worth, TX

    The Policy and Payment Integrity Manager oversees the PPI team and assists with implementation of policies to perform reviews conducted by CERIS, including but not limited to itemized bill review, professional review, hospital outpatient and DRG validation. This role manages members of the PPI team, developing team strengths and improving weaknesses, identifying team goals, and evaluating team progress. The Policy and Payment Integrity Manager provides trend analysis of internal auditing of claims for accuracy related to pre- and post-payment claims, targeted claims, high dollar claims, and any other claim or record that requires quality review. The role assists with development of internal quality assurance measures based on client policy and industry guidelines. The manager also aids in researching and implementing best practices related to (CMS) payment policies, healthcare policies, client, state, and/or policy initiatives. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Assists with development and modification of standard operating procedures for PPI team Utilizes healthcare and auditing experience to design, develop and implement audit criteria that are relevant and necessary for the continuous development services performed by CERIS Exercises good judgment to resolve complex claim and appeal issues and makes sound decisions in the absence of detailed instructions or during escalations Participates in discussions with internal and external stakeholders in regards to reviews conducted by CERIS, including but not limited to itemized bill review, professional review, hospital outpatient and DRG validation Researches, interprets, communicates, and applies CMS, Federal, State and client policies to claims review Works with operational leaders within the business to recommend opportunities for process improvements Acts as a resource and liaison for internal departments, account management, senior management and clients, as needed Additional duties as assigned KNOWLEDGE & SKILLS: Strong interpersonal skills and adaptive communication style, complex problem solving skills, drive for innovation and results Ability to manage multiple projects, set priorities and adhere to predetermined schedule Strong knowledge of itemized bill review, ASC, and outpatient claim review Understanding of CMS and commercial payer policy Strong understanding of claims processing, ICD-10 Coding, DRG Validation, and Coordination of Benefits Strong understanding of healthcare revenue cycle and claims reimbursement Proficient in Microsoft Office, including Pivot Tables and Database Management Comfortable interfacing with clients and the C-Suite Excellent written and verbal communication skills Proven track record of delivering concrete results in strategic projects/programs Strong analytical skills and data-driven decision-making Superb attention to detail and ability to deliver results in a fast paced and dynamic environment EDUCATION & EXPERIENCE: Must maintain a current RN licensure in the state of employment Must maintain a current coding license (CPC, CCS, RHIT, etc.) 3+ years of management experience Minimum of 5 years' experience in Operating Room, either as a circulating RN or scrub RN, as well as 2 years' clinical experience in an acute care facility Knowledge of worker's compensation claims process Prospective, concurrent and retrospective utilization review 5+ years of relevant experience or equivalent combination of education and work experience 3+ years hospital bill audit Bachelor's degree in healthcare or related field Previous experience in the following areas preferred: Medical bill coding and auditing DRG and Clinical Validation Experience in the acute clinical areas of facilities in O.R., I.C.U., C.C.U., E.R., Telemetry, Medical/Surgical, OB or L&D, Geriatrics and Orthopedics PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $80,718 - $124,624 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. About CERIS CERIS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
    $80.7k-124.6k yearly 60d+ ago
  • Procurement Supervisor

    Corvel 4.7company rating

    Corvel job in Dallas, TX

    The Procurement Supervisor is responsible for managing daily production (file flow) of designated department, which may include one or more of the following functions: human resources, customer service, and promoting positive influence over Procurement Analysts. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Responsible for directing a designated group of employees in their day-to-day operations * Responsible for quality of service provided * Responsible for human resources matters directly related to department supervised * Requires regular and consistent attendance * Responsible for training of new employees and/or implementing protocols as they change and sending those changes out to the units * Comply with all safety rules and regulations during work hours in conjunction with the Injury Illness Prevention Program (IIPP) * Additional duties as required * Must be willing and able to work overtime as required * May be required to travel overnight and attend meetings * May perform managerial responsibilities in managers' absence * May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses KNOWLEDGE & SKILLS: * Exceptional organizational skills * Ability to work independently, while being available to others * Effective and professional communication skills * Ability to provide correct answers to questions from various sources in a timely manner * Demonstrated problem solving skills and analytical skill * Ability to demonstrate leadership abilities, independent thinking * Proficient in Microsoft Office applications * The ability to work in a fast paced/production environment EDUCATION & EXPERIENCE: * High school diploma or equivalent * 2 to 3 years' experience in a professional office environment * Supervisory experience is a plus PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $16.36 - $26.31 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. About CERIS CERIS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Onsite
    $16.4-26.3 hourly 60d+ ago
  • Procurement Team Lead

    Corvel 4.7company rating

    Corvel job in Dallas, TX

    The Procurement Team Lead position is 50% production and 50% assisting and supporting direct supervisor with ensuring their team meets protocol, as well as, performing supervisor duties if and when the supervisor is out. . ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Monitor/Audit and report Both Aging Reports for Procurement and Humana * Monitor/Audit files in Procurement staffs individual Queues via Management Console Tool for accuracy and timely claim processing * Work through Procurement QC Queue assisting to maintain when Queue is over 2 pages * Assist Reps with all questions and concerns * Answer emails from both Procurement and other internal departments and also externally from Clients/Providers in reference to any concerns to complete the processing of claims * Answer phone calls from both internal departments and externally from Providers in reference to any concerns to complete the processing of claims * Requires regular and consistent attendance, complying with the company Employee handbook requirements for attendance * Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP) * Additional duties as required by manager or supervisor KNOWLEDGE & SKILLS: * Exceptional organizational skills * Ability to work independently * Ability to work in a fast paced/production environment * Provide QC to handles claims within the dept. / correct when applicable * Effective and professional communication skills * Ability to search / find answers * Demonstrated problem solving skills and analytical skill * Ability to demonstrate leadership abilities, independent thinking * Proficient in Microsoft Office applications * The ability to work in a fast paced/production environment EDUCATION & EXPERIENCE: * High school diploma or equivalent * 6 months to 1 year office experience * Minimum one year as Procurement Analyst PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $15.26 - $23.28 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. About CERIS CERIS, a division of CorVel Corporation, a certified Great Place to Work Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Onsite
    $15.3-23.3 hourly 60d+ ago
  • Licensed Vocational Nurse, Home Health

    Humana Inc. 4.8company rating

    Plano, TX job

    Become a part of our caring community and help us put health first Make a meaningful impact every day as a CenterWell Home Health nurse. You'll provide personalized, one-on-one care that helps patients regain independence in the comfort of their homes. Working closely with a dedicated team of physicians and clinicians, you'll develop and manage care plans that support recovery and help patients get back to the life they love. As a Home Health LVN, you will: * Provide professional nursing services under the direction of a RN in compliance with the state's Nurse Practice Act, any applicable licensure/certification requirement, applicable healthcare standards, governmental laws and regulations, and CenterWell Home Health policies and procedures. * Provide skilled nursing interventions in the treatment of the patient/clients illness, rehabilitative needs and preventative care. Utilize a holistic approach in the provision of problem specific therapeutic interventions, teaching and training activities in accordance with the plan of care. * Apply knowledge and skills in accordance with accepted standards of clinical practice to facilitate problem resolution and achieve individualized patient goals and outcomes. * Confer with the RN Supervisor regarding needed changes in the Plan of Treatment. Accept verbal orders from physician were permitted by state law/regulations/Nurse Practice Act and communicate these orders to the RN Supervisor. * Utilize a systematic, individualized goal/outcome driven approach in implementing the nursing plan of care. * Maintain contact with patients, physicians, clinical manager(s), other members of the healthcare team in a timely manner regarding patient/family needs and status changes. Participate in care coordination activities and discharge planning as appropriate. * Maintain the highest standards of professional conduct in relation to information that is confidential in nature. Share information only when the recipient's right to access is clearly established and the sharing of such information is dearly in the best interests of the patient. * Appropriately communicate to ensure adherence to professional standards in the provision of and availability of supplies, materials and equipment needed to safely and effectively implement the plan of care. * Prepare, submit and maintain documentation as required by the Company and/or facility. Visit/shift notes documented on day services are rendered. Use your skills to make an impact Required Experience/Skills: * Graduate of an accredited Licensed Practical Nursing Program or accredited School of Vocational Nursing. * Current nursing license in the practicing state. * Valid drivers license, auto insurance and reliable transportation. * Current CPR certification. * Two years experience as an LPN/LVN in a clinical setting, preferably in a home health or hospice setting. Pay Range * $28.00 - $40.00 - pay per visit/unit * $44,600 - $61,400 per year base pay Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,000 - $73,000 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $53k-73k yearly 60d+ ago
  • Clinical Manager, Home Health

    Humana Inc. 4.8company rating

    Cleburne, TX job

    Become a part of our caring community and help us put health first Work Schedule: Full-time/40 Hours On-site * $10K Sign-On Bonus* * This position is eligible for relocation assistance. The specific package offered will vary based on individual circumstances and company policy. This position comes with a $10K sign-on bonus. * The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. * Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. * Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies. * Manages the assignment of caregivers. * Responsible for and oversees the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission criteria and make the decision to admit patients to service. Assigns appropriate clinicians to a case, as needed. * Instructs and guides clinicians to promote more effective performance and delivery of quality home care services, and is available at all times during operating hours to assist clinicians as appropriate. * Assists clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing patient Plan of Care (POC). * Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. * Coordinates communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning. * Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. * Participates in sales and marketing initiatives. * Supervises all clinical employees assigned to a specific location. Responsible for the overall direction, coordination, and evaluation of the location. Carries out supervisory responsibilities in accordance with Company policies and procedures. * Handles necessary employee corrective action and discipline issues fairly and objectively, in consultation with the Human Resources Department and the Executive Director/Director of Operations. * Participates in the interviewing, hiring, training, and development of direct care clinicians. Evaluates their performance relative to job goals and requirements. Coaches staff and recommends in-service education programs, when needed. Ensures adherence to internal policies and standards. * Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed. * Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through the utilization of Performance Improvement principles. * Responsible for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, for appropriateness of care, delivery, and documentation requirements. * Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. Competently performs patient care assignments and staff management activities. * Provides direct patient care on an infrequent basis and only in times of emergency. * Acts as Branch Director in his/her absence. * Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical documentation meets internal standards. * Participates in performance improvement activities, maintains ongoing clinical knowledge through internal and external training programs. Provides interpretation of knowledge and direction to staff. * Maintains relationships with referral/community sources. Participates in professional organizations and conducts care-related programs. * Performs other related duties as assigned or requested. Use your skills to make an impact * Graduate of an accredited School of Nursing. * Current state license as a Registered Nurse. * Proof of current CPR. * Valid driver's license, auto insurance and reliable transportation. * Two years as a Registered Nurse in a home care, with at least one-year of management experience preferred. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,200 - $106,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $77.2k-106.2k yearly 11d ago

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