Gold Coast Health Plan jobs - 4,975 jobs

is intended to start January 2026. The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in. Work Culture: GCHP strives to create an inclusive, highly collaborative work culture where our people are empowered to grow and thrive. This philosophy enables us to create the health plan of the future and do our best work - Together. GCHP promotes a flexible work environment. Employees may work from a home location or in the GCHP office for all or part of their regular workweek (see disclaimer). GCHP's focuses on 5 Core Values in the workplace: • Integrity • Accountability • Collaboration • Trust • Respect Disclaimers: • Flexible work schedule is based on job duties, department, organization, or business need. • Gold Coast Health Plan will not sponsor applicants for work visas. POSITION SUMMARY The RN, Quality Improvement (QI) will support the Quality Improvement and Health Services Programs, assisting the health plan to successfully achieve organizational objectives for clinical quality and patient safety. This position will be responsible for core clinical and regulatory compliance functions within the QI and Health Services arena, including Facility Site Review (FSR) Medical Record Review (MRR), Potential Quality Issue (PQI) investigation and reporting, and liaison with the team in designing and implementing clinical quality improvement strategies and interventions to support quality metrics and regulatory requirements. The RN, Quality Improvement I will work closely with the Health Services leadership team and the Chief Medical Officer to assess the Program's outcomes, identify areas of needed improvement, and institute actions to promote the delivery of high-quality care. This employee must be able to interpret the requirements of the Plan's regulatory bodies, and state and federal regulations, NCQA accreditation standards, and institute processes/programs to ensure compliance. Amount of Travel Required: 30-50% Reasonable Accommodations Statement To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions. ESSENTIAL FUNCTIONS Job Function & Responsibilities • Work closely with other departments of the Health Plan, Health Services and Ql team, and Chief Medical Officer to achieve the goals of the Quality Improvement and Health Equity Transformation (QIHET) Program by identifying issues and implementing corrective actions to ensure compliance with DHCS regulatory requirements and optimize GCHP quality performance. • Lead the timely investigation, processing, and reporting of identified potential quality issues (PQI following the Plan's procedures and timelines). • Track and trend PQI outcomes for the purpose of reporting and prioritization of improvement actions/interventions. • Annually review and edit relevant policies and procedures per APL updates, regulatory requirements, NCQA standards and/or required process changes. • Conduct facility site reviews (FSR), Medical Record Reviews (MRR), and/or Physical Accessibility Review Surveys (PARS) according to DHCS site survey requirements and maintain the FSR database for ongoing tracking of contracted sites and reporting purposes. • Ensure timely follow up on all FSR/MRR activities, including provider communication and corrective action plan documentation. • Lead and/or participate in quality improvement activities and audits, including but not limited to, focused medical record review (MRR), monitoring of Initial Health Appointment (IHA), blood lead screening in children, and other performance improvement projects. • Participate and/or provide clinical support to regulatory compliance activities, including but not limited to, DHCS Medical Audits, HEDIS compliance audits, and internal/external audits. • Support, as needed, the annual HEDIS project, including medical record abstraction and over-reads to determine compliance with HEDIS measures and optimize performance outcomes. • Utilize clinical expertise to create and/or revise policies and procedures per new APL requirements, regulatory requirements, and/or NCQA standards, establish QIHET work plan metrics and key performance indicators, implement provider training programs, and develop member and provider newsletter and website content. • Lead, facilitate and/or participate in relevant committees and work groups; prepare reports, data, or other materials for committee presentation. • Complete project-related communications, including job aides, member/physician communications, website content, work plans/action plans, graphical analyses, and agendas/minutes, as applicable. • Research best practices, and industry standards to help promulgate quality outcomes for the Plan. • Demonstrate strong critical thinking, collaboration, and work ethic, with the ability to foster teamwork and work effectively with providers and multi-disciplinary teams, and adapt quickly to changing priorities • Perform all other duties as assigned. MINIMUM QUALIFICATIONS Education & Experience: Required Education and Experience • Current CA Registered Nursing License - Unencumbered • Associate or bachelor's degree (two or four-year college or technical school) Required, Field of Study: Nursing • 1-2 years of clinical experience in Quality Improvement, Risk Management, Compliance, and/or Accreditation demonstrating increasing responsibility in clinical quality improvement. KNOWLEDGE, SKILLS & ABILITIES • Analytical and problem-solving acumen. • Critical thinking skills • Excellent verbal and written communication skills and ability to interact in a positive manner within the medical/clinic community. • Team player who builds effective working relationships within and across teams. • Ability to work independently. • Strong organizational skills • Ability to analyze, interpret, apply, and communicate policies, procedures and regulations. • Understanding and ability to perform data analysis, basic statistical skills including intermediate knowledge of Excel. • Proven experience with performance improvement methodologies required. PREFERRED QUALIFICATIONS • Public Health and/or ambulatory care/clinic setting background • Medicaid Health Plan experience • Certified Facility Site Reviewer or FSR experience • Knowledge of quality improvement processes and risk mitigation strategies in a managed care environment. • Knowledge of DHCS requirements, NCQA Accreditation standards, and HEDIS. Technology & Software Skills: • Highly competent in the MS Office products including proficiency in Word, Excel, PowerPoint, and databases. • Working knowledge with electronic health record systems including Cerner, NextGen, and Meditech. Certifications & Licenses: A valid and current Driver's License, Auto Insurance, and Current CA Registered Nurse licensure(s) Competency Statements • Business Acumen - Ability to grasp and understand business concepts and issues. • Decision Making - Ability to make critical decisions while following company procedures. • Goal Oriented - Ability to focus on a goal and obtain a pre-determined result. • Interpersonal - Ability to get along well with a variety of personalities and individuals. • Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type. • Time Management - Ability to utilize the available time to organize and complete work within given deadlines. • Consensus Building - Ability to bring about group solidarity to achieve a goal. • Relationship Building - Ability to effectively build relationships with customers and co-workers. • Presentation Skills - Ability to effectively present information publicly. • Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards. • Judgment - The ability to formulate a sound decision using the available information. • Communication, Oral - Ability to communicate effectively with others using the spoken word. • Communication, Written - Ability to communicate in writing clearly and concisely. • Problem Solving - Ability to find a solution for or to deal proactively with work-related problems.

A leading insurance brokerage in San Francisco is seeking an experienced Account Executive in the Employee Benefits space. The role involves managing client relationships, delivering strategic benefit solutions, and collaborating with colleagues to exceed client expectations. Ideal candidates have a bachelor's degree and extensive client service experience in health insurance. This position offers a chance to thrive in a caring culture while making a significant impact in the industry. #J-18808-Ljbffr

Job Title: Event Coordinator Workplace Type: Onsite- 5 days Employment Type: Contract About the Role We are seeking a highly organized and proactive Event Coordinator to join our onsite Workplace team in San Francisco. This role is responsible for planning, coordinating, and executing a wide range of onsite events-from afternoon meet-ups to evening community gatherings-that help shape a welcoming, inclusive, and engaging workplace experience. The ideal candidate brings strong judgment, exceptional communication skills, and a passion for creating memorable events. This role requires flexibility, hands-on execution, and comfort working in a fast-paced, dynamic environment with frequent cross-functional collaboration. Note: This position requires onsite presence in San Francisco. Evening and occasional weekend availability is required to support events. Key Responsibilities Event Coordination & Operations Collaborate with internal teams to understand event goals, requirements, and logistics. Plan, coordinate, and execute onsite events, ensuring a seamless and positive attendee experience. Serve as the onsite facilities host during events, welcoming guests and ensuring comfort and safety. Oversee event setup and breakdown, coordinating logistics with Workplace, Security, IT/AV, and Facilities teams. Assist with vetting, scheduling, and coordinating event-related space usage and activities. Provide administrative support for pre-event planning and post-event wrap-ups, including documentation and follow-ups. Maintain onsite presence during evening and occasional weekend events to address real-time needs and ensure event success. Vendor & Stakeholder Management Coordinate with vendors and service providers (e.g., catering, furniture, supplies, AV). Manage vendor relationships to ensure timely delivery, quality service, and adherence to standards. Maintain clear, consistent communication with internal teams, vendors, and stakeholders throughout the event lifecycle. Collaborate cross-functionally to ensure all aspects of events are aligned and executed smoothly. Problem Solving & Decision Making Anticipate and proactively address issues or challenges during events. Exercise sound judgment when making onsite decisions and escalate concerns appropriately. Ensure compliance with workplace policies, safety standards, and crowd management best practices. Required Qualifications 2-5+ years of experience in event coordination, workplace experience, or office management. Experience managing event organizers, service providers, and facilities vendors. Proven ability to collaborate effectively with diverse stakeholders, including coordinators, security teams, visitors, leadership, and executive assistants. Strong customer service mindset with excellent written and verbal communication skills. Ability to manage multiple priorities, adapt quickly, and remain calm in a fast-paced environment. Demonstrated ability to exercise good judgment and make sound decisions independently. Working knowledge of event operations, crowd safety, and workplace standards. Preferred Qualifications Passion for creating welcoming, community-oriented workplace environments. Collaborative, proactive mindset with the ability to work across teams and functions. Interest in workplace experience, culture-building, and employee engagement initiatives. Typical Day in the Role A typical day may include: Meeting with internal partners to align on upcoming event objectives. Coordinating logistics with Workplace, Security, IT/AV, and Facilities teams. Managing vendor communications and confirming event resources. Hosting and supporting onsite events, including evening community gatherings. Troubleshooting real-time event issues and ensuring a high-quality attendee experience. Completing post-event follow-ups and administrative tasks. Why Join This Role? This role offers the opportunity to support high-visibility, culture-defining events that shape how employees, leaders, and guests experience the workplace. You'll gain hands-on exposure to event design, senior stakeholder engagement, and cross-functional collaboration within a values-driven, people-first organization. The position also provides strong mentorship and growth opportunities in workplace experience, events, and operations. If you like the position, please share your resume on ***************** Thank you :)

Job Details Position Type: Full Time Education Level: Bachelor's Degree Salary Range: $175,000.00 - $245,000.00 Salary/year Vice President, National Liability Practice Leader. This individual will be responsible for providing proactive strategic leadership for the development and growth. A strong background in leadership, developing sustainable business strategies, critical issue resolution, and creating new policies and procedures to drive quality, accuracy, and efficiency is required. Participate in the senior leadership group that will develop long term strategies for growth and profitability. Key Competencies: Self-Starter: Motivated and ambitious personality; desire to compete and succeed Intellectual Creativity: Ability to brainstorm outside of norm for creative solutions to success Exceptional relationship management skills Demonstrated consultative sales success Proven project management success Tenacity: Persistence and follow through Triple Threat: Intelligence, Personality and Drive! DUTIES AND RESPONSIBILITIES: Demonstrate a detailed understanding of TRISTAR businesses, objectives, products and services. Help ensure that our messaging resonates with our clients and brokers and speaks to our casualty solutions Strong technical understanding of all TRISTAR products and services and how they are best deployed for specific clients and/or carriers. Leverage cross-functional departments to maximize process efficiencies. Thorough knowledge of the client's industry and business drivers Work independently, collaboratively and in a leadership role with clients, brokers, carriers and TRISTAR team members Responsible for profit and loss, quality, human resources, product development and strategic relationships and policies and procedures. Lead a team of Property & Liability leaders, as well as their direct reports Identify opportunities for client program efficiencies, respond to questions or concerns, resolve problems in a timely and effective manner Develop strategic recommendations based on client's business needs and goals Lead projects and business planning meetings, working closely with C‑Suite level engagement to develop and influence long‑term strategy When appropriate prepare for and attend client and prospect meetings, industry events, broker & carrier partners Review and expand on vendor contracts to maximize profit share and delivery of quality standards Working with Carrier partners to expand service offerings Attend and present at Board of Directors meetings Assess market competition to evaluate new opportunities that can be developed to stay ahead of the industry. *Essential job function. EQUIPMENT OPERATED/USED: Computer, fax machine, copier, printer and other office equipment. SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire Qualifications Education / Experience Bachelor's Degree, or equivalent experience required; Masters degree or higher preferred. Minimum of ten years of successful TPA or other industry experience required. Knowledge of all auto and general liability and property programs. Proficient in use of Microsoft Office suite (MS Word, MS Excel, MS Outlook) Travel, as required. Excellent organizational and time management skills Knowledge, Skills and Abilities Prompt and regular attendance at assigned job locations Ability to work shifts exceeding 8 hours, 5 days per week Ability to interact with employees of all levels and clients in an appropriate manner Ability to concentrate and think strategically Availability onsite to confer with staff members with whom the incumbent must interact on a daily basis Ability to proficiently use a personal computer for tasks such as email and preparing reports using software Ability to review and analyze data and information. Ability to complete, or oversee the completion of, assigned tasks/projects in a timely manner. #J-18808-Ljbffr

Back Provider Relations Specialist II #5675 Remote, Nebraska, United States Apply X Facebook LinkedIn Email Copy Position Locations Remote, Nebraska, United States Area of Interests Insurance Full-Time/Part Time Full-time Job Description The Provider Relations Specialist II serves as a liaison between the company and internal and external partners. This position develops and strengthens customer relationships by providing timely and accurate response to inquiries and conducting analysis to solve problems under limited supervision. This position may provide guidance, coaching, and training to associates. This position will be in-office for the first week for training and will then be remote (within Nebraska) and does not require regular in-office presence. What you do: Act as the main point of contact for dental providers regarding participation status, credentialing, and contract-related questions. Process new provider applications, credentialing requests, and changes to records Respond to provider and member inquiries via phone, email, and voice mail with professionalism and accuracy. Manage queue-based tasks including provider adds, terminations, fee schedule updates, and contract maintenance. Review and submit audits, ensuring documentation meets compliance and credentialing standards. Support assigned groups, handling all communications and requests. Collaborate with internal departments and network leasing partners to ensure data consistency and proper contract loading. Investigate and help resolve complaints from providers and members, coordinating with Compliance when necessary. Mentor peers and assist with training new hires on systems and procedures. Attend team meetings and stay current on internal processes, policies, and industry regulations. What you bring: S. Diploma or GED is required. Associate's degree or equivalent is preferred. 2-4 years of related experience is required. Previous experience in provider relations or similar role highly preferred. Insurance industry experience preferred. What we offer: A meaningful mission. Great benefits. A vibrant culture Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life. At Ameritas, you'll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don't: Ameritas Benefits For your money: * 401(k) Retirement Plan with company match and quarterly contribution. * Tuition Reimbursement and Assistance. * Incentive Program Bonuses. * Competitive Pay. For your time: * Flexible Hybrid work. * Thrive Days - Personal time off. * Paid time off (PTO). For your health and well-being: * Health Benefits: Medical, Dental, Vision. * Health Savings Account (HSA) with employer contribution. * Well-being programs with financial rewards. * Employee assistance program (EAP). For your professional growth: * Professional development programs. * Leadership development programs. * Employee resource groups. * StrengthsFinder Program. For your community: * Matching donations program. * Paid volunteer time- 8 hours per month. For your family: * Generous paid maternity leave and paternity leave. * Fertility, surrogacy, and adoption assistance. * Backup child, elder and pet care support. An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. Application Deadline This position will be open for a minimum of 3 business days or until filled. This position is not open to individuals who are temporarily authorized to work in the U.S. About this Position's Pay The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our Short-Term Incentive Plan with the annual target defined by the plan. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $18.32 - $29.31 / hour Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.

A leading insurance company is seeking a Staff Machine Learning Engineer to architect scalable AIML solutions and lead technical initiatives. The ideal candidate will have over 6 years of hands-on experience in machine learning and software engineering, deep programming proficiency, and a strong understanding of system architecture. This role offers a comprehensive rewards program, workplace flexibility, and opportunities for career advancement. #J-18808-Ljbffr

Back Sr DI Claims Examiner #5667 Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Apply X Facebook LinkedIn Email Copy Position Locations Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Area of Interests Insurance Full-Time/Part Time Full-time Job Description This position is remote (within the U.S.A.) and does not require regular in-office presence. What you do: Evaluates and authorizes disposition of complex claims. Obtains and analyzes medical records and financial documents. Initiates and monitors medical reviews, independent medical examinations, surveillance, and financial reviews. Corresponds with policyholders, attorneys, medical facilities, reinsurers, outside vendors, and insured's employer. Interacts with and requests formal written opinions from Legal and Medical/Underwriting departments. Makes decisions on evaluation of claims using judgment, experience, and collaboration with senior associates. Assists with recoveries from reinsurance carriers. Performs all claims processing support functions. What you bring: Bachelor's degree or equivalent experience is required. 1-3 years of related experience is required. What we offer: A meaningful mission. Great benefits. A vibrant culture Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life. At Ameritas, you'll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don't: Ameritas Benefits For your money: * 401(k) Retirement Plan with company match and quarterly contribution. * Tuition Reimbursement and Assistance. * Incentive Program Bonuses. * Competitive Pay. For your time: * Flexible Hybrid work. * Thrive Days - Personal time off. * Paid time off (PTO). For your health and well-being: * Health Benefits: Medical, Dental, Vision. * Health Savings Account (HSA) with employer contribution. * Well-being programs with financial rewards. * Employee assistance program (EAP). For your professional growth: * Professional development programs. * Leadership development programs. * Employee resource groups. * StrengthsFinder Program. For your community: * Matching donations program. * Paid volunteer time- 8 hours per month. For your family: * Generous paid maternity leave and paternity leave. * Fertility, surrogacy, and adoption assistance. * Backup child, elder and pet care support. An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. Application Deadline This position will be open for a minimum of 3 business days or until filled. This position is not open to individuals who are temporarily authorized to work in the U.S. About this Position's Pay The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our Short-Term Incentive Plan with the annual target defined by the plan. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $24.23 - $38.76 / hour Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.

GEICO . For more information, please .**Overview**: GEICO is on a multi-year journey to transform the insurance industry with Artificial Intelligence. **The Team****:** The AI Modeling and Research team is part of the AI Org, which is Geico's strategic investment with the mission to transform Geico into an AI-first company. AI org is led by Vice President, Head of AI. AI Org is in the Technology, Product and AI (TPA) org at Geico. TPA is led by the Chief Technology, Product and AI Officer, who reports to the CEO of Geico. **The Role Purpose**: We are looking for a highly experienced Distinguished Engineer who has deep insights into ML modeling for computer vision and can lead major technical decisions on how the company can build cutting-edge products powered by industry leading computer vision technologies. The candidate should build close partnerships with product, engineering and operation leadership across the company. This role will report directly to the Senior Director of AI Modeling and Research. **Responsibilities:** To be successful in this role, you will need: Continuously improving system performance, scalability, and user experience.**Qualifications****:** 15+ years of hands-on experience in AI/ML in a production environment.Successful leadership experience in leading the technical decisons for teams of size >= 15.Strong communication and collaboration skills across technical and non-technical teams.* Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being.* Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.* Access to additional benefits like mental healthcare as well as fertility and adoption assistance.* Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.At GEICO,we offer a rewarding career where your ambitions are met with endless possibilities.Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive on relentless innovation to exceed our customers' expectations while making a real impact on local communities nationwide.Founded in 1936, GEICO is a member of the Berkshire Hathaway family of companies and one of the largest auto insurers in the United States. #J-18808-Ljbffr

Bad software is everywhere, and we're tired of it. Sentry is on a mission to help developers write better software faster so we can get back to enjoying technology. With more than $217 million in funding and 100,000+ organizations that believe we're on to something, we're building performance and error monitoring tools that help companies like Disney, Microsoft, and Atlassian spend less time fixing bugs and more time building products. Sentry embraces a hybrid work model, with Mondays, Tuesdays, and Thursdays set as in-office anchor days to encourage meaningful collaboration. If you like to selfishly build things that make your digital life better, come help us build the next generation of software monitoring tools. Are you a dynamic Senior Field Marketing Manager ready to make a significant impact? Sentry is seeking a driven leader to not only spearhead our regional event strategy, including our impactful startup program, but also to play a key role in building out and expanding our overall field marketing capabilities. If you're passionate about creating engaging experiences that drive pipeline and eager for the autonomy to shape our regional presence, this is your opportunity. Reporting to the Events and Field Marketing Lead, you will be responsible for strategically planning and executing a diverse range of hosted, sponsored, and partner events, while contributing directly to pipeline creation and the growth of Sentry's regional presence. In this role you will Plan and execute impactful regional field marketing events that generate qualified leads, accelerate sales opportunities, and strengthen customer relationships Own end-to-end trade show and conference logistics, including vendor coordination, budgeting, staffing, metrics tracking, and on-site execution, ensuring high-quality experiences Collaborate closely with sales teams to identify key accounts and develop tailored marketing strategies that engage prospects effectively Provide consistent and clear communication of events programs to all stakeholders, including preparing and maintaining internal and external event planning documents, checklists, on-site schedules, timelines, recommendations, and budget. Track and report on event performance metrics and ROI, partnering with internal sales and MOPs teams to optimize future marketing activities Support the creation of compelling event content and messaging in collaboration with Product Marketing Build and maintain strong relationships with local companies, community organizations, influencers, and other key stakeholders Work effectively with go-to-market, Developer Relations, Product Marketing, engineering, and product teams to ensure cohesive campaign execution Track all marketing activities and leads diligently in Salesforce Contribute to quarterly planning and alignment with sales targets and business objectives Identify opportunities to improve field marketing processes and tactics. You'll have the autonomy to propose and build new program ideas based on data, market insights, and stakeholder feedback to improve pipeline contribution and ROI for Sentry Ensure every regional experience reflects Sentry's mission and brand, creating meaningful and targeted touch points You'll love this job if you Pay attention to the little things and keep things running smoothly with great organization and time management Get excited about hitting goals and seeing real results from your work Can roll with the punches and stay flexible when things move fast or priorities shift Enjoy thinking on your feet and finding creative solutions when challenges pop up Qualifications 8+ years of experience in B2B field or event marketing, preferably in the technology sector A self-starter who can work independently while also being a collaborative team player Comfortable engaging directly with executives, sales leaders, prospects, and customers to shape messaging, gather insights, and drive pipeline impact Customer-focused with an understanding of how to create valuable experiences across in-person and digital touch points Budget Management skills to forecast, manage, and summarize event spend with internal teams and vendors; analytical skills to measure event ROI Proficiency working in Salesforce, Marketo, Jira and Google Suite Strong communicator with the ability to align cross-functional stakeholders and articulate campaign impact to leadership You know San Francisco like the back of your hand-especially the off-the-radar places that make people go “wow.” It's not just about fancy dinners; you have an eye for experiences that are stylish, thoughtful, and genuinely fun Treat every event like a fresh experience, not a rinse-and-repeat The base salary range (or hourly wage range, if applicable) that Sentry reasonably expects to pay for this position is $150,000 to $165,000. A successful candidate's actual base salary (or hourly wage) amount will be determined by a variety of relevant factors including, without limitation, the candidate's work location, education, work and other relevant experience, skills, and job-related knowledge. A successful candidate will be eligible to participate in Sentry's employee benefit plans/programs applicable to the candidate's position (including incentive compensation, equity grants, paid time off, and group health insurance coverage). See Sentry Benefits for more details about the Company's benefit plans/programs. Equal Opportunity at Sentry Sentry is committed to providing equal employment opportunities to its employees and candidates for employment regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, veteran status, or other legally-protected characteristic. This commitment includes the provision of reasonable accommodations to employees and candidates for employment with physical or mental disabilities who require such accommodations in order to (a) perform the essential functions of their jobs, or (b) seek employment with Sentry. We strive to build a diverse team, with an inclusive culture where every teammate can thrive. Sentry is an open-source company because we believe that everyone, everywhere, should have the ability and tools to make great software. Software should be accessible. That starts with making our industry accessible. #J-18808-Ljbffr

Back Data Analytics Intern - Business Intelligence #5406 Multiple Locations Apply X Facebook LinkedIn Email Copy Position Locations Remote, Nebraska, United StatesRemote, Ohio, United States Area of Interests Intern Full-Time/Part Time Part-time Job Description Ameritas Life Insurance Corp is looking for a Data Analytics - Business Intelligence Intern to drive the business by providing internal business stakeholders with valuable data analytics and dashboards to better enable them to meet business needs. At Ameritas, our mission is Fulfilling Life. We do that in many ways, but especially by helping people invest in themselves by offering trusted financial products and advice. Because we believe everyone should be happy, healthy, and financially secure, we work hard to provide trusted financial products and valued guidance, including individual life and disability insurance, employee benefits, retirement planning, investments, and wealth management services. This internship will start in January 2026. This is a hybrid role offered in either Lincoln, NE or Cincinnati, OH. What you do: Process and analyze datasets to support business stakeholders. Develop and maintain reports and dashboards using Business intelligence tools like Power BI and Cognos Collaborate with cross-functional teams to understand data needs, use cases and propose solutions. Troubleshoot and resolve data issues as they arise. Collaborate with Data Engineering and IT admin teams as needed to ensure data and reporting tasks are completed on time. Contribute to the documentation of processes and procedures. What you bring: Must be enrolled in a college program at least half-time as defined by your institution for the entire duration of the internship studying computer science, data science, data analytics or related field. Able to commit to a long-term internship working full-time in the summer and part-time during the school year. Full-time hours: 30-40 hours per week Part-time hours: 15-20 hours per week Consistently demonstrates initiative and a professional, self-directed approach to responsibilities and an ability to meet deadlines. Has taken coursework related to data management, databases, AI/Machine Learning, and similar subject matter. Approaches situations with a natural curiosity and has a willingness to learn new tools and technologies. Excellent verbal and written communication and presentation skills. Keen analytical skills and problem-solving skills. Extremely strong PC and Excel skills. Intermediate to advanced experience with SQL is a plus, but not a requirement. What we offer: Our company motto is "Fulfilling Life" and we take that job seriously, with a heavy commitment to volunteering and community support, employee well-being, and providing quality products and services that help our customers create a brighter future. Being a mutual-based organization, the return on our investment goes back into the company, to benefit our members/customers. We're committed to professional development, opportunity, inclusion, and diversity. Team building and collaboration are also priorities. An Equal Opportnity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. About this Position's Pay The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, work location, skill set, and candidate level of experience to ensure pay equity within the organization. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $13.33 - $26.67 / hour Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.

A tech-enabled insurance advisory is seeking a knowledgeable Insurance Advisor to enhance client satisfaction during the sales and onboarding phase. The role requires 2+ years in a client-facing capacity, as well as a property and casualty license. Ideal candidates should be adaptable and possess excellent communication skills. The position is based in New York with a hybrid work model requiring in-office attendance three days a week. Competitive salary package, including equity options, is offered. #J-18808-Ljbffr

GEICO . For more information, please GEICO is seeking an experienced software engineer with a passion for building high-performance, low maintenance, zero-downtime platforms, and applications. You will help drive our insurance business transformation as we transition from a traditional IT model to a tech organization with engineering excellence as its mission, while co-creating the culture of psychological safety and continuous improvement.**Position Description** Our Staff Software Engineer works with the team and the broader org to innovate and build new systems, improve, and enhance existing systems and identify new opportunities to apply your knowledge to solve critical problems. You will lead and own the strategy and execution of a technical roadmap that will increase the velocity of delivering products and unlock new engineering capabilities. The ideal candidate has a deep understanding of technology, risk management, site reliability engineering principles, and strategic planning to design and implement resilient systems that safeguard our business from potential threats.**Position Responsibilities** As a Staff Software Engineer, you will: Be a role model and mentor, helping to coach and strengthen the technical expertise and know-how of our engineering and product community. Influence and educate executives Determine and support resource requirements, evaluate operational processes, measure outcomes to ensure desired results, and demonstrate adaptability and sponsoring continuous learning**Qualifications** Deep knowledge of SRE practices, methodologies, and principles, along with a solid understanding of on prem and public cloud-based network, compute, and storage technologies In-depth knowledge of hybrid cloud architecture, IaaS and PaaS technologies, container orchestration platforms (e.g., Kubernetes), cloud efficiency and observability, etc.Ability to create incident response playbooks, runbooks, incident triaging strategies, and post-incident analysis to drive continuous improvement in system reliability and availability Experience with open-source management and monitoring tools Experience with infrastructure automation, tooling, and configuration management frameworks (e.g., Puppet, Chef, Ansible, Pulumi, Terraform, etc.) Familiarity with cloud security best practices and compliance standards Excellent leadership skills with a passion for mentoring and fostering professional growth Strong problem-solving and analytical abilities, with a keen eye for detail and a passion for driving operational excellence Visionary thinker with the ability to anticipate future challenges and opportunities Exceptional leadership and communication skills **Experience** 8+ years of professional experience in software development6+ years of experience with architecture and design and working on open-source frameworks4+ years of experience with AWS, GCP, Azure, or another cloud service **Education** Bachelor's degree in computer science or related field, or equivalent experience* Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being.* Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance.* Access to additional benefits like mental healthcare as well as fertility and adoption assistance.* Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.For more than 75 years, GEICO has stood out from the rest of the insurance industry! We are one of the nation's largest and fastest-growing auto insurers thanks to our low rates, outstanding service and clever marketing. We're an industry leader employing thousands of dedicated and hard-working associates. As a wholly owned subsidiary of Berkshire Hathaway, we offer associates training and career advancement in a financially stable and rewarding workplace. #J-18808-Ljbffr

Health Plan of San Mateo Fellowship Program 2026 Application Due by March 2, 2026 Make a difference in your community The Health Plan of San Mateo (HPSM) is a local non-profit health plan that offers health coverage to San Mateo County's underserved population. We currently serve more than 150,000 county residents through several programs, with most of our members qualifying for coverage through Medi-Cal, the state's Medicaid program. HPSM has more than 300 employees and partners closely with clinicians and community organizations throughout the region. Objective Health Plan of San Mateo's Fellowship Program supports the recruitment, skill development, career growth, and retention of emerging managed care leaders by fostering a positive work environment with thoughtful and dedicated mentorship. The Fellowship Program is a paid opportunity to contribute meaningfully to HPSM's organizational focus areas. Fellowship Scope This opportunity will provide the fellow with: Knowledge and experience in the operation of a non-profit community-based health plan. Knowledge and experience in the development of programs and services that benefit our diverse membership. Professional experience working on a specific project important to HPSM and a chance to present recommendations through a final paper and/or presentation to HPSM leadership. Fellowship Logistics · Start date: June 22, 2026 (flexible based on applicant schedule) Work Type: Hybrid (Will work at the South San Francisco office) Applicants must have a California residence Type Duration Total Hours Compensation Experience Level Fellow 4 - 6 months 24 - 29 hrs/week Up to 1000 hours Between $24 - $26/hour, depending upon experience Good fit for recent college graduates, graduate students, and career professionals with previous related experience who are interested in working on multiple projects under an overarching focus area Required Skills & Knowledge These are the qualifications typically needed to succeed in this position. However, you do not need to meet every requirement to apply. Currently enrolled or recent graduate of an undergraduate or graduate degree program in public health, public policy, business administration, social work, social sciences, communications, or related disciplines. Minimum 3.0 GPA. Experience and/or skills that align with one of the projects listed below. Solid written and verbal communication skills. Intermediate proficiency with Microsoft Office (Word, Excel, Outlook, and PowerPoint). Project Information Working collaboratively with the HPSM sponsor, the fellow will be provided with the opportunity to work on the following projects during the fellowship. Project Description Provider Learning Fellow HPSM's Learning and Development and Provider Services department is seeking a fellow that will support the Learning and Development and Provider Services teams with new provider and staff training content. The fellow will project manage the development of the 2027 Provider Manual, update the provider onboarding video series, assist with provider notifications, and other regulatory provider learning content, and more. The fellow will also assist with some all-staff-related trainings and communications. Project Key Deliverables 2027 Provider Manual (Project management and development) Update provider onboarding video series Provider notifications/newsletter articles Required provider training content updates/creation All-staff training support and learning development communications *HPSM will also work with students to tailor this experience to meet requirements of a Master of Public Health field study, practicum, or capstone projects. We have experienced MPH professionals to serve as preceptors. Applicants must have completed 1 year of their MPH program studies. It is HPSM's policy to provide equal employment opportunities for all applicants and employees. HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law. HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.

A leading software monitoring company in San Francisco is seeking an experienced Engineering Manager to lead the Event Streaming team. The role focuses on overseeing a globally distributed team, driving system architecture, and fostering a high-performing team culture. The ideal candidate has over 10 years of experience in software engineering, with substantial expertise in backend development and distributed systems. This position offers a competitive salary in a hybrid work environment. #J-18808-Ljbffr

This is an on site and in the field position. This role requires the ability to reliably commute to South San Francisco and surrounding bay area cities. General Description The Pediatric Community Health Worker (CHW) will provide care coordination, health education and navigation, and resource referral services that are medically necessary for HPSM's infant and toddler members, as well as family members. This includes connecting members to primary care providers, addressing social determinants of health (SDOH), and providing or coordinating access to other needed services to improve members' physical and mental health. The CHW will act as a liaison collaborating directly with primary care offices, social services, and the community to facilitate access to services and improve the quality, health equity, and cultural competence of service delivery. The CHW will play a critical role in improving the health and well-being of members by using their knowledge of the member's community and common lived experiences. This is an in-person, field-based position that requires employees to travel from the HPSM office to member's homes and other locations (e.g., medical office, county offices, etc.) mostly within San Mateo County. Qualifications The following represents the typical way to achieve the necessary skills, knowledge and ability to qualify for this position: Education and Experience CHW certification or experience pathway (at least 2,000 working hours as CHW or case manager). If experience pathway, candidate must obtain CHW certification within eighteen (18) months of hire. Associate or bachelor's degree in justice or social services (e.g. public health, psychology, social work, sociology) with at least 1 year providing direct services to a Medi-Cal population, families, or in a field-based setting required. Must have relevant lived experience that connects the CHW to the served population. This includes, but is not limited to, incarceration, military service, pregnancy, disability, foster care, homelessness, mental health conditions, substance use disorders or surviving domestic or intimate partner violence and exploitation. Lived experience may encompass shared race, ethnicity, sexual orientation, gender identity, language, or cultural background with one or more groups in the community for which the CHW is providing services. A valid CHW certificate must include completion of a curriculum that attests to demonstrated skills and/or practical training in the following areas: communication, interpersonal and relationship building, service coordination and navigation, capacity building, advocacy, education and facilitation, individual and community assessment, professional skills and conduct, outreach, evaluation and research, and basic knowledge in public health principles and social drivers of health (SDOH), as determined by the Supervising Provider. Certificate programs must also include field experience as a requirement. Skills Bilingual fluency in Spanish is required to effectively communicate with our diverse member population. Intermediate proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, and PowerPoint and use of computers. Advanced motivational interviewing skills. Knowledge Extensive knowledge of Medi-Cal benefits and the managed care CHW benefit. Working knowledge of San Mateo County or other community resources available to Medi-Cal members. Extensive knowledge of Personal Health Information (PHI) privacy and security requirements and best practices for maintaining confidentiality of health information. Abilities Ability to synthesize important information shared during in-person or virtual visits into a standardized note format. Ability to navigate complex systems of care and simplify steps for referrals and follow-ups. Ability to encourage member autonomy via the teach back method to gauge understanding. Licensure/Certifications A valid CHW certification is required or the ability to obtain CHW certification within 18 months of employment is required. Driving Verifiable, clean DMV record and ability to travel to various locations throughout California up to 85% of the time. Must have reliable and insured transportation and use own vehicle for job-related duties. Duties & Responsibilities Essential Functions Case Management Maintain a caseload of members and their families with varying needs. Function as a liaison between members and providers, coordinating services among multiple providers and community agencies on behalf of member's and their families. Provide Health Education and outreach to members, promoting wellness and prevention. This may include providing information, instruction, coaching and goal setting to improve a member's physical and mental health, address barriers and/or ability to self-manage health conditions. Function as a health navigator providing members with information, training, referrals, advocacy on their behalf, or other assistance to help members receive services related to perinatal care, sexual and reproductive health, environmental and climate-sensitive health issues, oral health, aging, injury, domestic violence and other violence prevention services. Care Plan Implementation Administer Mini Risk assessments and other assessment tools to members at regular intervals. Assist members in identifying their goals (health, behavioral, social, etc.) and supporting them in achieving these goals. Independently conduct in-person/in-home/in-facility assessments for those enrolled in the Baby Bonus program and assess needs related to: physical or behavioral health, Activities of Daily Living (ADLs) / Instrumental Activities of Daily Living (IADLs), Safety, Behavioral Health, SDOH and other needs for community resources or services. Assist members in identifying their strengths and barriers to successfully meet their care plan goals, while focusing on member-centric health choices. Collaborate with community providers/partners to ensure services are coordinated effectively. Community Liaison Complete follow-up visits either in person or via telecommunication as outlined in the visit guide. Conduct in-home/in-facility visits and assess any safety concerns; provide follow-ups to resources and consult with supervisor, as appropriate. Facilitate interdisciplinary communication and hand offs to other team members. Provide members and families with information about HPSM benefits, programs, and processes, staying up to date on this information as there are changes. Data & Reporting Maintain required and complete documentation within two (2) business days for all activities in the plan's care management system, MHK, or other appropriate HPSM systems. Maintain required fiduciary code tracking in shared spreadsheet within 1 business day. Track high acuity members on the caseload, create a summary of the case, and report to the team on a weekly basis. Add new member data into MHK system, and other systems upon enrollment and disenrollment. Secondary Functions Maintain a valid CHW certification. Maintain a valid CA driver's license and a satisfactory driving record. Maintain reliable and insured transportation. Maintain language fluency in the required language(s) indicated above. Act as an SME to colleagues and partners regarding community resources and programs. Participate in continuous quality improvement activities. Perform other duties as assigned.

Salary Range: $153,481 - $237,896 The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change. FLSA Status: Exempt Department: Information Technology Reports To: Director, Application and Product Development GENERAL DESCRIPTION OF POSITION The Manager of Application Development is responsible for the supervision of the application development staff in the design, development, implementation and support of in-house and vendor applications and interfaces, including the accurate data exchange between trading partners in accordance with state and federal regulatory and contractual requirements and SCFHP policies and procedures as set forth for all lines of business. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily. Supervise and mentor personnel performing design, development, implementation, maintenance, and reporting from application databases, data warehouse and data cube environments. Oversee the design, development, implementation, and maintenance of electronic data exchange in multiple formats, including EDI X 12 transaction sets specific to healthcare transactions. Oversee the development and maintenance of enterprise data warehouse. Exercise staff oversight to ensure new operations plans, policies, procedures and transition/migration plans are consistent with the overall company goals and objectives. Define and modify IT development standards, policies and procedures to ensure they remain current with business and regulatory needs. Participate in the project approval and prioritization process with other IT management and business leaders. Contribute and participate in the strategic planning process and share in the development of SCFHP vision, goals and initiatives. Develop positive relationships with managers, directors and leaders by understanding business priorities and information technology enablers. Perform other related duties as required or assigned. SUPERVISORY/MANAGEMENT RESPONSBILITIES Carries out supervisory/management responsibilities in accordance with SCFHP's policies, procedures, applicable regulations and laws. Responsibilities include: Recruiting, interviewing, and hiring. Developing a high performing department culture and staff. This includes setting the standard for staff/peers and motivating employees to maximize organizational goals and objectives. Effectively assimilating, training and mentoring staff and (when appropriate), cross training existing staff and initiating retraining. This includes coaching to help increase skills, knowledge and (if applicable) improve performance. Setting goals and planning, assigning, and directing work consistent with said goals. This includes responding to employees' needs, ensuring they have the necessary resources to do their work. Appraising performance, rewarding and disciplining employees, addressing complaints and resolving issues. This includes providing regular and effective feedback to employees and completing timely and objective performance reviews. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. Bachelor's Degree in Business Administration, Computer Science, Public Health, or related field, or equivalent training/experience. (R) Minimum five years of experience in a lead or supervisory capacity. (R) Minimum ten years of experience in application development. (R) Minimum ten years of experience, with SQL programming, MS SQL database development, and T-SQL query generation. (R) Minimum five years of experience with MS SQL Business Intelligence tools (SSRS, SSIS, SSAS) or other enterprise business intelligence software. (R) Minimum five years of programming background in any of the following applicable languages/platforms; .NET, PERL, Java, SAS, VB, C++, C#, or other modern programming language or related software. (R) Demonstrated knowledge of software development life cycle (SDLC), coding standardization, peer review and user acceptance testing. (R) The ability to effectively manage multiple projects across multiple team members, including direct reports and other IT staff members. (R) Excellent data analysis skills. (R) Knowledge of and experience with healthcare management information systems. (R) Good working knowledge of BizTalk, Sharepoint, ActiveBatch and other core integration tools and services. (D) Working knowledge of and the ability to efficiently operate all applicable computer software including a working knowledge of computer applications such as Outlook, Word and Excel. (R) Ability to use a keyboard with moderate speed and a high level of accuracy. (R) Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, providers and outside entities over the telephone, in person or in writing. (R) Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R) Ability to maintain confidentiality. (R) Ability to comply with SCFHP's policies and procedures. (R) Ability to perform the job safely with respect to others, to property, and to individual safety. (R) WORKING CONDITIONS Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to regular contact with co-workers, managers, external partners, and vendors in person, by telephone and via work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R) Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels. EOE (function () { 'use strict'; social Share.init(); })();

I am working with a GC to hire Assistant Project Managers and Project Managers for the Riverwalk Project (Riverwalk San Diego - Restoring the River. Creating a Neighborhood.) in San Diego. The project transforms the Riverwalk Golf Course into a vibrant, walkable community with 4,300 homes, 150,000+ sq. ft. of retail, up to 1 million sq. ft. of office space, and extensive parks and restored river habitat Open positions: Office engineer Project Engineer Assistant Project Manager Project Manager Senior Project Manager To be considered for any of these positions you must have Multifamily Construction experience. This could be with either a GC or an Owner Builder. If you're interested in contributing to a high-profile project or know someone who might be, let me know

General Description Act as the primary point of contact for members of CareAdvantage D-SNP and CareAdvantage CMC and assist members with all aspects of plan benefits. Duties & Responsibilities Essential Functions: Provide customer service to CareAdvantage members primarily on the phone. Answer member questions about CareAdvantage health and prescription drug benefits, eligibility, and provider network. Make New Member Welcome Calls. Resolve problems that members have accessing CareAdvantage-covered services, including but not limited to health care services and prescription medications. Ensure that assigned members retain CareAdvantage enrollment by investigating and contacting members and partnering agencies. Clearly document any member's complaints, including grievances and appeals. Follow through with proactive solutions to resolve member issues. Prepare and submit requests for services made directly by a member to HPSM Health Services. Prepare and submit member requests for continuity of care with non-contracted providers to the Provider Services Department. Refer members to appropriate community partner agencies depending on specific circumstances including but not limited to: Behavioral Health and Recovery Services, Aging and Adult Services, Legal Aid and/or HICAP when appropriate. Relay pertinent health information to HPSM clinical staff to facilitate care coordination and/or receipt of medical services including prescriptions. Participate in and professionally represent HPSM at health fairs, community partnerships, meetings, committees, and coalitions as requested by the Manager or Supervisor. Secondary Functions: Perform other duties as assigned. Qualifications The following represents the typical way to achieve the necessary skills, knowledge and ability to qualify for this position: Education and experience equivalent to: Equivalent to a high school diploma or GED required. Two (2) to three (3) years' experience performing customer service preferably in a health plan environment. Previous experience working with seniors or people with disabilities and/ in a medically related field such as medical assisting. Knowledge of: Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access, and PowerPoint. Health Insurance programs preferred. Customer service principles and practices. Abilities: Work cooperatively with others. Work as part of a team and support team decisions. Communicate effectively, both verbally and in writing. Adapt to changes in requirements/priorities for daily and specialized tasks. Demonstrate excellent oral and written communication skills with various audiences and individuals of diverse backgrounds. Perform problem research, use analytical skills, and effectively influence positive outcomes. Develop and maintain strong professional relationships with a diverse range of people. Utilize a personal computer, including the range of Microsoft Office products (Word, Excel, PowerPoint, Access, and Outlook). Desirable skills: Bilingual skills in Spanish. Salary and benefits The starting salary range is $25.78 - $32.61 per hour, depending on the candidate's work experience. Excellent benefits package includes: HPSM-paid premiums for employees' medical, dental and vision coverage (employee pays 10% of each dependent's premiums) Fully paid life, AD&D and LTD insurance Retirement plan (HPSM contributes the equivalent of 10% annual compensation) 12 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year Tuition reimbursement plan. Employee wellness program It is HPSM's policy to provide equal employment opportunities for all applicants and employees. HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law. HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.

is intended to start January 2026. The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in. Work Culture: GCHP strives to create an inclusive, highly collaborative work culture where our people are empowered to grow and thrive. This philosophy enables us to create the health plan of the future and do our best work - Together. GCHP promotes a flexible work environment. Employees may work from a home location or in the GCHP office for all or part of their regular workweek (see disclaimer). GCHP's focuses on 5 Core Values in the workplace: • Integrity • Accountability • Collaboration • Trust • Respect Disclaimers: • Flexible work schedule is based on job duties, department, organization, or business need. • Gold Coast Health Plan will not sponsor applicants for work visas. POSITION SUMMARY The Provider Relations Representative-External is a field-based position is responsible for ensuring effective communication, compliance, and support for network providers, dedicating a minimum of 75% of time to provider visits, community engagements, and on-site activities. As the primary liaison between providers and the organization, the representative is tasked with resolving inquiries, facilitating onboarding processes, and delivering targeted education on policies, regulatory requirements, and reimbursement methodologies. Through proactive collaboration with internal departments, the representative ensures seamless coordination for claims resolution, contracting questions, and data management. Amount of Travel Required: 75% Reasonable Accommodations Statement To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions. ESSENTIAL FUNCTIONS • Initiate and maintain effective channels of communication with GCHP network providers. • Provide the onboarding of new GCHP network providers to ensure full compliance with regulatory requirements. • Travel to provider offices at a minimum of 4 working days per week. • Build and nurture relationships with healthcare providers, community-based organizations, and other key stakeholders in the designated region to promote the health plan's goals and ensure robust network participation. • Act as a primary external point of contact for provider inquiries, resolving issues promptly. Educate providers on health plan policies, procedures, and compliance requirements to enhance efficiency and service delivery. • Represent the health plan at local events, health fairs, and professional gatherings. Develop and deliver presentations to increase awareness and advocate for the organization's services within the community. • Conduct regular provider visits to gather data, identify trends, and assess provider performance. Provide actionable insights and detailed reports to internal teams to support strategic decision-making. • Work closely with cross-functional teams, including internal provider relations teams, operations, and customer service, to align provider activities with GCHP goals and improve the overall provider experience. • When required, assist departmental operations with investigating contracting questions, including interpretation of contract language as it pertains to the roles and responsibilities of a GCHP network provider, coding and reimbursement methodology. • Manage and maintain GCHP network provider data and rosters to ensure additions and terminations of participating providers, address/demographic changes, name changes, TIN, NPI updates and provider practice information changes are timely and accurately submitted to all applicable operational systems. • Facilitate first call resolution, when appropriate, for GCHP provider questions and concerns. • Drive the resolution of escalated questions and concerns efficiently by actively engaging with providers, claims, contracting, and health services departments, ensuring clear and effective communication across all parties. • Gather, review, and submit relevant documentation needed for to help resolve complex claims inquiries and/or claims processing. • Educate healthcare providers about Medicare Risk Adjustment (MRA) including but not limited to accurate documentation, coding. • Educate healthcare providers on CMS guidelines, compliance requirements and risk adjustment audits and reviews. • Coordinate prompt claims resolution through direct communications with providers, claims, contracting and health services departments. • Be proficient and maintain knowledge of basic claims processing, components of claims submission, processing, payment and reimbursement methodologies and issues resolution. • Organize, schedule, and develop training sessions for joint operation meetings, individual provider trainings, and group provider trainings. • Provide documentation and reports for internal GCHP committees, detailing provider trainings, contacts, and follow-ups. • Consistently monitor and manage the provider roster, ensuring timely follow-ups and oversight. • Maintain understanding of applicable federal, state, and local laws and regulations regarding healthcare with a focus on Medicaid and Medicare. • Notify departmental colleagues and/or leadership of potential issues, shortfalls, and trends in GCHP provider network to help initiate improvement opportunities. • Assist departmental colleagues on training of contract inquiries and/or contract issues that impact GCHP network providers' roles and responsibilities. • Manage disputes diplomatically to find mutually beneficial solutions. • Articulate information, updates and policies to ensure providers understand expectations and requirements. MINIMUM QUALIFICATIONS Education & Experience: Please identify the nature of education and experience such as: Associates, Bachelor's and/or Master's degree (four-year college or technical school) and list any applicable specialty or field of study. • High School Degree • Minimum 5+ years health care/managed care experience to include: Experience in provider relations, healthcare administration, health related customer service or a related field. • Proficient knowledge of governmental lines of business (Medicare and Medicaid) KNOWLEDGE, SKILLS & ABILITIES Preferred Qualifications: • Bachelor's Degree (four-year college) • Understanding with claims processing, reimbursement methodologies, and healthcare regulations. • Proven track record of building and maintaining relationships with healthcare providers or clients. • Experience in training, onboarding, or educating providers on policies, procedures, and compliance requirements. Technology & Software Skills: Advanced computer skills included in the MS Office products, specifically Word, Excel, PowerPoint, Teams and Outlook Certifications & Licenses: A valid and current Driver's License, Auto Insurance Professional licensure: N/A Competency Statements • Management Skills - Ability to organize and direct oneself. • Initiative - Ability to make decisions or take actions to solve a problem or reach a goal. • Customer Oriented - Ability to take care of customer needs while following company procedures. • Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type. • Interpersonal - Ability to get along well with a variety of personalities and individuals. • Time Management - Ability to utilize the available time to organize and complete work within given deadlines.