Provider Services Representative jobs at Health Plan of San Joaquin - 915 jobs

CRM Senior Field Clinical Representative - San Fernando Valley, CA
Boston Scientific 4.7
Los Angeles, CA jobs
Additional Location(s): US-CA-Los Angeles; US-CA-Valencia Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance At Boston Scientific, we'll give you the opportunity to harness all that's within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we'll help you in advancing your skills and career. Here, you'll be supported in progressing - whatever your ambitions. About the role: At Boston Scientific, we're advancing the future of cardiac care. As part of our Cardiac Rhythm Management (CRM) division, you'll contribute to life-saving innovations that treat irregular heart rhythms, heart failure, and help prevent sudden cardiac arrest. Our mission is to improve patient outcomes and quality of life through less-invasive, cutting-edge therapies-including implantable cardioverter defibrillators (ICDs), insertable cardiac monitorization systems (ICMs), and cardiac resynchronization therapy (CRTs). With nearly two decades of innovation and clinical leadership, Boston Scientific is globally recognized as a trusted leader in Cardiac Rhythm Management (CRM). Join a team committed to making a meaningful difference in the lives of patients around the world. Role overview: In this dynamic and patient-centered role, you will be a key clinical and commercial contributor-supporting our technologies through hands-on education, sales support, and expert clinical guidance. You'll cover a defined territory, collaborating closely with hospitals and healthcare providers to ensure best-in-class outcomes and to drive the adoption of our innovative CRM solutions. Your responsibilities will include: Serving as the primary clinical expert during device implants, patient follow-ups, programming, and troubleshooting Delivering impactful education and training to healthcare professionals on product use and clinical benefits Attending procedures in hospital labs and operating rooms to support optimal patient outcomes Building strong relationships with physicians, nurses, and key hospital staff to foster trust and drive engagement Resolving customer needs efficiently, collaborating cross-functionally to ensure patient and clinician satisfaction Managing product inventory according to company guidelines, ensuring readiness and availability Participating in a rotational 24/7 on-call schedule to support patients and clinicians in real time Required qualifications: A minimum of a bachelor's degree in biomedical engineering, Science, Math, Business, Nursing preferred and/or equivalent technical work experience. A minimum of 3 years' relevant work experience. A minimum of 3 years in a Boston Scientific clinical position or minimum of 2 years with completed/passed IBHRE certification that is active. External equivalent is a minimum of 3 years competitive CRM clinical work experience OR minimum of 6 years cardiac-related clinical work experience OR minimum of 4 years with completed/passed NASPE/IBHRE certification. Ability to take rotational 24/7 call with a sales team involving holidays, weekends. Preferred qualifications: Previous experience working in an Electrophysiology (EP) Lab, device clinic and/or Cardiac Catheterization (Cath) Lab. Medical device sales, sales support, clinical education and/or clinical research experience. A self-starter with the ability to work independently, efficiently, and effectively where daily schedule varies by hours worked and tasks managed while remaining accountable to company, region and team goals. The ability to understand, communicate and train others in the use and understanding of complex medical device software algorithms as it pertains to device therapy and diverse disease states. Ability to communicate clearly and effectively with all levels of the medical community including patients. Demonstrated ability to work as part of a highly motivated team where flexibility and adaptability in a fast-paced, constantly changing work environment are paramount and urgency often dictates a dynamic work schedule. Requisition ID: 617301 The anticipated annualized base amount or range for this full time position will be $85,000 to $105,000, plus variable compensation governed by the Sales Incentive Compensation Plan (which includes certain annual non-discretionary incentives based on predetermined objectives) as well as the value of core and optional benefits offered at BSC, which can be reviewed at *************************** Actual compensation will be commensurate with demonstrable level of experience and training, pertinent education including licensure and certifications, and other relevant business or organizational needs. For MA positions: It is unlawful to require or administer a lie detector test for employment. Violators are subject to criminal penalties and civil liability. As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most - united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate. Now more than ever, we have a responsibility to apply those values to everything we do - as a global business and as a global corporate citizen. So, choosing a career with Boston Scientific (NYSE: BSX) isn't just business, it's personal. And if you're a natural problem-solver with the imagination, determination, and spirit to make a meaningful difference to people worldwide, we encourage you to apply and look forward to connecting with you! At Boston Scientific, we recognize that nurturing a diverse and inclusive workplace helps us be more innovative and it is important in our work of advancing science for life and improving patient health. That is why we stand for inclusion, equality, and opportunity for all. By embracing the richness of our unique backgrounds and perspectives, we create a better, more rewarding place for our employees to work and reflect the patients, customers, and communities we serve. Boston Scientific is proud to be an equal opportunity and affirmative action employer. Boston Scientific maintains a prohibited substance free workplace. Pursuant to Va. Code § 2.2-4312 (2000), Boston Scientific is providing notification that the unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana is prohibited in the workplace and that violations will result in disciplinary action up to and including termination. Please be advised that certain US based positions, including without limitation field sales and service positions that call on hospitals and/or health care centers, require acceptable proof of COVID-19 vaccination status. Candidates will be notified during the interview and selection process if the role(s) for which they have applied require proof of vaccination as a condition of employment. Boston Scientific continues to evaluate its policies and protocols regarding the COVID-19 vaccine and will comply with all applicable state and federal law and healthcare credentialing requirements. As employees of the Company, you will be expected to meet the ongoing requirements for your roles, including any new requirements, should the Company's policies or protocols change with regard to COVID-19 vaccination. Among other requirements, Boston Scientific maintains specific prohibited substance testing requirements for safety-sensitive positions. This role is deemed safety-sensitive and, as such, candidates will be subject to a drug test as a pre-employment requirement. The goal of the drug testing is to increase workplace safety in compliance with the applicable law. Nearest Major Market: Los Angeles Job Segment: Testing, Lab Technician, Cath Lab, Medical Lab, Biomedical Engineering, Technology, Healthcare, Engineering
$85k-105k yearly 2d ago

Looking for a job?

Let Zippia find it for you.

Admissions Services Specialist Acute
Acadia Healthcare Inc. 4.0
Los Angeles, CA jobs
Acadia Healthcare is seeking remote Admissions Services Specialists to support our Acute Behavioral Health Facilities from coast to coast. is 100% remote. Highlights of this role include: Ability to verify benefits information for assigned facility. 1 weekend day shift Friday, Saturday, Sunday Experience monitoring and processing patient referrals (may include fax referrals). Respond to inquiries about facilities within policy timeframes. Support Acadia Healthcare admissions departments throughout the country. As one of the nation's leaders in treating individuals with acute co-occurring mood, addiction, and trauma, Acadia Healthcare places a strong emphasis on our admissions & intake functions to allow us to help every possible person in need. This person will be supporting Acadia Acute Admissions departments around the country in a remote capacity. ESSENTIAL FUNCTIONS: Manage Referral Management Portals Monitor all faxed referrals Monitor all webforms and call center handoffs/rollover referrals Utilize facility admissions/exclusionary criteria to process incoming types of referrals Respond to inquiries about the facility within facility policy timeframes. Document calls inside of Salesforce and follow-up as needed Complete Prior Authorization Pre-Admit the patients in billing system Coordinate with local admissions department regarding bed availability Facilitate intake, admissions, and utilization review process for incoming patients. Perform insurance benefit verifications, disseminating the information to appropriate internal staff. Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations for referrals. Coordinate admission and transfer between levels of care within the facility. Communicate projected admissions to designated internal representative in a timely manner. Ensure all medical admission documentation is gathered from external sources prior to patient admission and secure initial pre-authorization for treatment and admission. STANDARD EXPECTATIONS: * Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality. * Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team. EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: Bachelor's or Master's degree in Behavioral Science, Social Work, Sociology, Nursing, or a related field; in some states, RN, LVN/LPN Knowledge of admission/referral processes, techniques, and tools Familiarity with behavioral health issues and services Solid understanding of financial principles and insurance reimbursement practices Knowledge and proficiency with Salesforce.com (or other CRM application), Concur, and MS Office application. LICENSES/DESIGNATIONS/CERTIFICATIONS: * Licensure, as required for the area of clinical specialty, i.e., RN license, CAC or other clinical counseling or therapy license, as designated by the state in which the facility operates. SUPERVISORY REQUIREMENTS: This position is an Individual Contributor We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws. AHCORP LA
$32k-39k yearly est. 2d ago
Customer Care Representative I
Agendia 4.5
Irvine, CA jobs
The Customer Care Representative's 1 primary objective is to ensure all customers receive the best level of customer service throughout the entire customer experience when dealing with an Agendia representative. An RAR1 serves as an internal and external resource for all customer needs related to product information, patient related inquiries, client supplies, billing inquiries and as an internal support agent to the commercial team for prospective and existing client needs. The RAR1 shall treat all client interactions with the highest-level of professionalism, energetic and have excellent verbal and written communication skills. The RAR1 shall follow all regulatory guidelines according to Agendia's Quality Assurance program and HIPAA compliance since dealing with Patient Health Information (PHI). POSITION WITHIN THE ORGANIZATION 1. Reports to Regional Account Manager 2. Cooperates with all departments across the organization 3. Participates in: - Department meetings - Project meetings - Working groups - Project groups Requirements ESSENTIAL DUTIES AND RESPONSIBILITIES Ensure all Customer Care Policies and Procedures are followed as it relates to the Regional Account Representative I position. Ensure that all Agendia's health, HIPAA and safety Policies and Procedures are followed. Ensure that all customer interactions are handled with the best level of customer service at all times. Handle all external and internal client inquiries, requests and concerns timely and with the highest level of professionalism and ensure client needs are met. Accurately enter and maintain all required patient and customer data into the various systems utilized in the Customer Care department. Coordinate relationship with Customer Service department in Amsterdam Assist with Billing and Reimbursement inquiries. Responsible for in-bound and out-bound telephone calls and ensure all calls are handled within the Customer Care established performance metrics. Responsible for monitoring and resolving deficiencies within 2 working days. Ensure that all block requests are complete on a daily basis and escalate any delayed requests to lead and/or department Manager. Review Therapak (THP) orders on a daily basis and ensure all client supply orders are processed and shipped out timely. Participate in the "Meet and greet" and "Ride Along" program with Oncology Sales Specialists (OSS) when applicable. Tracking and monitoring of samples from pick-up to report delivery within the assigned territory. Responsible for timely retrieval of patient sample block requests from clients and OSS. Establish and maintain excellent communication with OSS's in your assigned territory and ensure OSSs' are informed of any potential client issues that may be encountered in a timely fashion. Coordinate with the OSS in your assigned territory a formal introduction to a new client within one week of first sample reported and establish relations with client. Submit block requests to path labs same working day as request are received. All block requests not completed same day, complete next working day. Direct contact with top Clients bi-monthly to follow up on issues or questions. Assist Commercial team with New Account set up in Sales Force. Assist Commercial team with Portal set up in Sales Force. Performs other related duties as required or assigned. The above listing represents the general duties considered essential functions of the job and is not to be considered a detailed description of all the work requirements that may be inherent in the position. KEY CONTACTS Internal * This position may interface with all departments within the company. External: * N/A EDUCATION AND EXPERIENCE REQUIREMENTS EDUCATION High School Diploma or equivalent 2 + years related experience Experience with Microsoft Office (especially Outlook, Word, and Excel) Experience with Windows Operating System environment and web applications KNOWLEDGE, SKILLS AND ABILITIES (KSA'S) Specific Knowledge Required: Understanding of general laboratory techniques. Knowledge: Comprehension of a body of information acquired by experience or study. Skill: A present, observable competence to perform a learned activity. Ability: Competence to perform an observable behavior. Punctual, able to be flexible with schedule. Professional phone demeanor. High level of accuracy and attention to detail. Ability to work with multiple systems (software). Ability to adapt to changing procedures, policies and work environment. Ability to work in a fast paced team environment. Effective written and verbal communication. Desired Skills: Bachelor's Degree (preferred). Knowledge of Customer Care principles within the healthcare/lab industry. Insurance and Billing principles within the medical industry. Supervisor Responsibilities: This position requires no supervisory responsibilities. PRIVACY NOTICE: To review the California privacy notice, click here: *********************************** Employees must not be classified as an excluded individual who is prohibited from participation in any Federal health care program. WORKING ENVIRONMENT Establishes ADA (Americans with Disabilities Act) requirements. ENVIRONMENT/SAFETY/WORK CONDITIONS General office environment. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Maintains a clean, neat, and orderly work area. Adheres to Department Specific Safety Guidelines. TRAVEL No travel is required. OTHER DUTIES Other duties as required.
$36k-44k yearly est. 2d ago
Navigation Center Representative (Temp)
Family Healthcare Network 4.2
Visalia, CA jobs
Primary Accountability The Navigation Center Representative plays an important role with patient access and is responsible for providing scheduling and navigation assistance to FHCN patients. Description of Primary Responsibilities * Provides scheduling and navigation assistance to FHCN patients. * Schedules, reschedules, confirms, and cancels appointments per established protocols and in adherence to scheduling guidelines, health center procedures, and quality customer service standards. * Verifies patient insurance and demographic information to appropriately complete pre-registration and health record updates. * Responds to patient scheduling needs retrieved from the patient portal. * As a PBX function, receives incoming calls and routes them to appropriate personnel network-wide. * As a patient advocate, provides patient education on diversified program services, sends coherent clinical messages regarding patient needs to appropriate health center staff, and performs call follow-ups and outreach as needed, including ER and recall outreach. * PBX responsible for uploading Triage Services reports to patient record. * Responsible for supporting streamlined patient flow coordination. * Scrubs schedules for appropriate visit types and helps to rectify scheduling conflicts to reduce patient wait-time and to maximize provider schedules. * Develops and sustains proficiency with electronic medical record system. * Maintains knowledge of program services to efficiently navigate patients. * Demonstrates knowledge of provider specializations to minimize appointment errors and to help providers achieve their scheduling quotas. * Monitors the Navigation Center queue to meet individual and collective performance metrics. * Performance metrics relate to the efficient management of calls presented and calls handled, as well as high quality standards. * Self-reported performance outcomes also required with some tasks. * Performs other duties as assigned. Description of Primary Attributes Professional & Technical Knowledge: * Must possess a high school diploma or General Educational Development (GED) certificate. * Job duties require specific knowledge of office or administrative processes and practices, typically learned on the job, or which may include a series of training sessions that would comprise a few weeks if done consecutively. * A minimum of one year experience in health care or call center environment preferred. Technical Skills: * Ability to prepare basic correspondence and simple reports in Microsoft Word. * Ability to use Microsoft Excel to create tables and simple displays or information. * Ability to create basic presentations in Microsoft PowerPoint. Licenses & Certifications: None required. Communications Skills: * Job duties require the employee to effectively communicate routine or non-technical information to co-workers and others. * Effectively communicates written information (including electronic correspondence) and verbal presentations. Physical Demands: The physical demands described here in this job description are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this position, the employee is regularly require to sit and use repetitive hand movement to type and grasp. The employee is frequently required to stand or walk; and occasionally lift and/or move up to 20 pounds. Pay Scale: Min Hourly Rate: $21.00 Max Hourly Rate: $28.60
$21-28.6 hourly Auto-Apply 2d ago
Navigation Center Representative
Community Health Centers of The Central Coast 4.2
Santa Maria, CA jobs
Job Description Job Title: Navigation Center Representative Department: Navigation Center Reports To: Navigation Center Supervisor FLSA Status: Non-Exempt Wage Range that the Company Expects to Pay: $21.00 - $23.15 per hour SUMMARY Under the general supervision of the Navigation Center Supervisor, the Navigation Center Representative will work to provide exceptional customer service to patients of Community Health Centers of the Central Coast (CHCCC). The position requires responding to a high volume of inbound calls for the purpose of scheduling appointments, appointment confirmations, cancellations, and rescheduling. The Navigation Center Representative will be responsible for performing insurance and financial class verification. The Navigation Center Representative processes patient inquires via phone, email, and Electronic Health Record (EHR) tasking. It is the primary purpose of CHCCC to provide the highest quality of total care possible to the patient population it serves. Such a level of quality depends ultimately on the staff's desire and ability to work together, individually, and as a team. The employee is expected to be professional, punctual, maintain regular attendance, cooperative, motivated, and organized at all times. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Additional duties may be assigned with or without prior notice. Provides an exceptional level of customer service to all patients and staff using AIDET Standards. Answers the telephone in a courteous, professional manner, and follow pre-designed scripts when handling patient calls. Handles high volume of inquiries from patients and internal/external customers, and deal with frequent changes, delay, or unexpected events. Receives incoming calls responsible for processing/directing them to the appropriate person or department when the Navigation Center is unable to assist the caller. Schedules, cancels, reschedules, and adheres to scheduling guidelines and frequency limitations. Provides directions to CHCCC locations to clientele upon request. Provides information to patients regarding clinical processes and answer questions as needed, including, but not limited to referral process, prescription refills, transportation services, financial programs, and other services. Verifies patient insurance in accordance with CHCCC guidelines and informs patients what information needs to be presented in order to apply for the various financial programs or health insurance options. Performs data entry, pre-registers, updates patient information, demographics, and insurance information. Ensures patient messages are properly documented in the patients EHR. Communicates with providers and other health center staff via electronic health record system. Responsible for contacting providers/professional staff and placing calls at the direction of the professional staff (such as doctor on call). May assist in completing appointment confirmation calls. Monitors the queue to ensure calls are answered in a timely appropriate manner. Executes department goals such as meeting the required number of calls per day. Completes Process Control Board (PCB) hourly. Updates Managed Daily Improvement (MDI) Board and Huddle metrics as needed. Assists in training, mentoring, and orientation of new and existing staff including other health center staff. Conducts patient outreach as needed or assigned and educates patients on CHCCC services. Promotes CHCCC Continuous Quality Improvement Program. Demonstrates adherence to and observes all safety policies and procedures, inclusive of infection control rules and regulations. Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served (infants, pediatrics, adolescents, adults or geriatrics). Demonstrates knowledge of domestic violence, child and dependent abuse protocols. Demonstrates culturally sensitivity and competence with patients. Maintains and adheres to HIPAA, employee confidentiality, and privileged communications (patient, employee, and corporation). SUPERVISORY RESPONSIBILITIES This job has no supervisory responsibilities. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or EXPERIENCE High school diploma or GED equivalent required. Minimum one year of customer service position preferably in a healthcare setting or completion of a Medical Assistant training program from an accredited school preferred. Must have excellent verbal and written communication skills. Knowledge of medical terminology is desirable. LANGUAGE SKILLS Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of patients or employees of organization. Bilingual - ability to read, speak and write in English and another language is desirable. MATHEMATICAL SKILLS Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratios, and percent, and to draw and interpret bar graphs. REASONING ABILITY Ability to apply sound judgment in understanding to carry out instructions in written or oral form. Ability to make appropriate job decisions following standard office policies and past precedents. COMPUTER SKILLS Intermediate computer literacy to comply with department needs (e.g. electronic medical record documentation). Experience with word processing, spreadsheets, email, and keyboarding required. Proficiency in Microsoft Office programs required. Minimum of typing at 35 wpm preferred. CERTIFICATES, LICENSES, REGISTRATIONS Certificate in Medical Assisting from an accredited school is preferred. Possession of current, valid and unrestricted California Driver's License (Class C) required. Current CPR (BLS-C) card preferred. OTHER REQUIREMENTS Required to pass a criminal history background check upon hire. Annual health examination; annual Tuberculosis skin test clearance or chest x-ray; proof of immunity to MMR, Varicella, and Hepatitis B; proof of Tdap vaccine; during current flu season, must provide proof of influenza vaccine or a signed declination form. If declined, a flu mask is mandatory during flu season. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to sit, stand and walk. The employee must regularly lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to work in a fast-paced environment consisting of high volume of inbound calls. Must be willing to have a flexible work schedule that may include evenings/weekends, and travel as needed.
$21-23.2 hourly 31d ago
Provider Relations Specialist IV
Kaiser Permanente 4.7
Sacramento, CA jobs
This role requires up to 50% travel As part of the Kaiser National Contracting Department, this position plays a key role in building and operationalizing a unified National Provider Relations structure and framework. The role partners closely with the National Provider Relations leader to standardize processes, strengthen communication pathways, and support the development of a scalable, enterprise-wide model that enhances provider engagement across all markets. It also provides in-person provider relations support, serving as a direct liaison to providers to reinforce relationships, address operational concerns, and ensure consistent delivery of the national strategy at the local level. Job Summary: In addition to the responsibilities listed below, this position is also responsible for planning, developing, and implementing provider satisfaction strategies to improve network relationships and enhance provider engagement; developing provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing media materials (e.g., articles and newsletters), publications, and manual updates to providers; ensuring providers adhere to regulatory and contractual requirements; escalating complex compliance issues to appropriate parties; supporting organizational responses to regulatory audits; and delivering provider education and/or onboarding. Essential Responsibilities: * Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome. * Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions. * Supports continuous improvement efforts by: utilizing provider, claims, and contracting data to identify and/or consult on continuous improvement across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); implementing process improvement initiatives to aid providers and business goals; participating in collaborations with internal and external partners to develop network strategies and implement improved access to care; and may also include conducting and/or collaborating on advanced modeling and analyses of provider and market data to develop recommendations, solutions, and action plans for improvement initiatives. * Ensures contract commitments are met by: gathering, validating, maintaining, summarizing, and/or analyzing provider and contract data of the day-to-day operation and management of services to consult on provider compliance; identifying and documenting provider activities and/or coordinating with alternate stakeholders to ensure compliance with contract terms and conditions; leveraging guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures; and consulting with Provider Systems Administration (PSA) or its equivalent as needed to ensure proper contract interpretation and operational readiness and supporting corrective actions as identified through contract performance. * Supports contract strategy development by: researching, developing, and assisting in the proposal and implementation of strategies that improve access to patient care while managing outside service costs; providing advanced consultation on local service delivery planning and delivery system leadership to aid in the achievement of provider priorities and strategies; may include engaging in collaborative cross-functional workgroups to ensure provider strategies meet the unique needs of diverse stakeholders; and may also include developing materials and/or conducting peer training for new hires and contingent workers(e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines). * Supports the growth of the Provider Network by: reviewing or identifying recommended/potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings; developing and maintaining trusted partnerships with providers to understand their unique service request needs and challenges; serving as a liaison between providers and KP by contributing to communication efforts (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by partnering with others to develop itineraries and agendas, gather credentialing materials, and/or initiate this process. * Contributes to provider satisfaction by: leveraging in-depth knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, other operational issues, and/or directories; ensuring requests for information, questions, and problems are identified, documented, and addressed in a timely manner; and in some instances, collaborating, creating, and/or delivering training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
$46k-67k yearly est. 6d ago
Provider Relations Specialist III
Kaiser Permanente 4.7
Sacramento, CA jobs
This role requires up to 50% travel As part of the Kaiser National Contracting Department, this position plays a key role in building and operationalizing a unified National Provider Relations structure and framework. The role partners closely with the National Provider Relations leader to standardize processes, strengthen communication pathways, and support the development of a scalable, enterprise-wide model that enhances provider engagement across all markets. It also provides in-person provider relations support, serving as a direct liaison to providers to reinforce relationships, address operational concerns, and ensure consistent delivery of the national strategy at the local level. Job Summary: In addition to the responsibilities listed below, this position is also responsible for aiding the planning and development of provider satisfaction strategies to improve network relationships and enhance provider engagement; supporting the development of provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing standard media materials (e.g., articles and newsletters) and publications to providers independently; ensuring providers adhere to regulatory and contractual requirements; escalating standard and nonstandard compliance issues to appropriate parties; gathering materials to support organizational responses to regulatory audits; and beginning to deliver provider education and/or onboarding. Essential Responsibilities: * Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome. * Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team. * Supports continuous improvement efforts by: organizing provider, claims, and contracting data to assist the team in identifying and/or consulting on continuous improvement opportunities across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); engaging in the implementation of process improvement initiatives to aid providers and business goals; and may also include supporting standard and non-standard analyses of provider and market data to develop recommendations for improvement initiatives. * Ensures contract commitments are met by: organizing provider data in appropriate data platforms and supporting the consultation of provider compliance; documenting provider activities and/or supporting the collaboration with alternate stakeholders to ensure compliance with contract terms and conditions; and following guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures. * Supports contract strategy development by: executing tasks to support strategies that improve access to patient care while managing outside service costs, with minimal supervision; collaborating with team members to provide consultation on local service delivery planning to aid in the achievement of provider priorities and strategies; engaging in collaborative cross-functional workgroups and/or executing on strategies to meet the unique needs of diverse stakeholders; and participating in and/or beginning to conduct peer training for new hires and contingent workers (e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines). * Supports the growth of the Provider Network by: researching and evaluating potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings; developing trusting relationships with providers to understand their role in the external network; serving as a liaison between providers and KP by completing communication tasks independently (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by organizing components of itineraries and agendas, gathering credentialing materials, and/or supporting the initiation of this process. * Contributes to provider satisfaction by: using comprehensive foundational knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, other operational issues, and/or directories; contributing to tasks to ensure requests for information, questions, and problems are identified, documented, and addressed in a timely manner; and creating training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
$46k-67k yearly est. 14d ago
Provider Relations Specialist IV
Kaiser Permanente 4.7
San Diego, CA jobs
This role requires up to 50% travel As part of the Kaiser National Contracting Department, this position plays a key role in building and operationalizing a unified National Provider Relations structure and framework. The role partners closely with the National Provider Relations leader to standardize processes, strengthen communication pathways, and support the development of a scalable, enterprise-wide model that enhances provider engagement across all markets. It also provides in-person provider relations support, serving as a direct liaison to providers to reinforce relationships, address operational concerns, and ensure consistent delivery of the national strategy at the local level. Job Summary: In addition to the responsibilities listed below, this position is also responsible for planning, developing, and implementing provider satisfaction strategies to improve network relationships and enhance provider engagement; developing provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing media materials (e.g., articles and newsletters), publications, and manual updates to providers; ensuring providers adhere to regulatory and contractual requirements; escalating complex compliance issues to appropriate parties; supporting organizational responses to regulatory audits; and delivering provider education and/or onboarding. Essential Responsibilities: * Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome. * Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions. * Supports continuous improvement efforts by: utilizing provider, claims, and contracting data to identify and/or consult on continuous improvement across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); implementing process improvement initiatives to aid providers and business goals; participating in collaborations with internal and external partners to develop network strategies and implement improved access to care; and may also include conducting and/or collaborating on advanced modeling and analyses of provider and market data to develop recommendations, solutions, and action plans for improvement initiatives. * Ensures contract commitments are met by: gathering, validating, maintaining, summarizing, and/or analyzing provider and contract data of the day-to-day operation and management of services to consult on provider compliance; identifying and documenting provider activities and/or coordinating with alternate stakeholders to ensure compliance with contract terms and conditions; leveraging guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures; and consulting with Provider Systems Administration (PSA) or its equivalent as needed to ensure proper contract interpretation and operational readiness and supporting corrective actions as identified through contract performance. * Supports contract strategy development by: researching, developing, and assisting in the proposal and implementation of strategies that improve access to patient care while managing outside service costs; providing advanced consultation on local service delivery planning and delivery system leadership to aid in the achievement of provider priorities and strategies; may include engaging in collaborative cross-functional workgroups to ensure provider strategies meet the unique needs of diverse stakeholders; and may also include developing materials and/or conducting peer training for new hires and contingent workers(e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines). * Supports the growth of the Provider Network by: reviewing or identifying recommended/potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings; developing and maintaining trusted partnerships with providers to understand their unique service request needs and challenges; serving as a liaison between providers and KP by contributing to communication efforts (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by partnering with others to develop itineraries and agendas, gather credentialing materials, and/or initiate this process. * Contributes to provider satisfaction by: leveraging in-depth knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, other operational issues, and/or directories; ensuring requests for information, questions, and problems are identified, documented, and addressed in a timely manner; and in some instances, collaborating, creating, and/or delivering training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
$45k-64k yearly est. 6d ago
Provider Relations Specialist III
Kaiser Permanente 4.7
San Diego, CA jobs
This role requires up to 50% travel As part of the Kaiser National Contracting Department, this position plays a key role in building and operationalizing a unified National Provider Relations structure and framework. The role partners closely with the National Provider Relations leader to standardize processes, strengthen communication pathways, and support the development of a scalable, enterprise-wide model that enhances provider engagement across all markets. It also provides in-person provider relations support, serving as a direct liaison to providers to reinforce relationships, address operational concerns, and ensure consistent delivery of the national strategy at the local level. Job Summary: In addition to the responsibilities listed below, this position is also responsible for aiding the planning and development of provider satisfaction strategies to improve network relationships and enhance provider engagement; supporting the development of provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing standard media materials (e.g., articles and newsletters) and publications to providers independently; ensuring providers adhere to regulatory and contractual requirements; escalating standard and nonstandard compliance issues to appropriate parties; gathering materials to support organizational responses to regulatory audits; and beginning to deliver provider education and/or onboarding. Essential Responsibilities: * Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome. * Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team. * Supports continuous improvement efforts by: organizing provider, claims, and contracting data to assist the team in identifying and/or consulting on continuous improvement opportunities across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); engaging in the implementation of process improvement initiatives to aid providers and business goals; and may also include supporting standard and non-standard analyses of provider and market data to develop recommendations for improvement initiatives. * Ensures contract commitments are met by: organizing provider data in appropriate data platforms and supporting the consultation of provider compliance; documenting provider activities and/or supporting the collaboration with alternate stakeholders to ensure compliance with contract terms and conditions; and following guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures. * Supports contract strategy development by: executing tasks to support strategies that improve access to patient care while managing outside service costs, with minimal supervision; collaborating with team members to provide consultation on local service delivery planning to aid in the achievement of provider priorities and strategies; engaging in collaborative cross-functional workgroups and/or executing on strategies to meet the unique needs of diverse stakeholders; and participating in and/or beginning to conduct peer training for new hires and contingent workers (e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines). * Supports the growth of the Provider Network by: researching and evaluating potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings; developing trusting relationships with providers to understand their role in the external network; serving as a liaison between providers and KP by completing communication tasks independently (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by organizing components of itineraries and agendas, gathering credentialing materials, and/or supporting the initiation of this process. * Contributes to provider satisfaction by: using comprehensive foundational knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, other operational issues, and/or directories; contributing to tasks to ensure requests for information, questions, and problems are identified, documented, and addressed in a timely manner; and creating training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
$45k-64k yearly est. 14d ago
Hospice Provider Relations (LVN)
Hope Hospice & Health Services 3.3
Pleasanton, CA jobs
We have been a trusted community resource since 1980. Our reputation has been built on consistency, responsiveness, and quality. As a non-profit, community-led agency, we are able to focus on providing quality care to patients and families when they need it most, rather than being driven by profit or financial demand. We are growing our hospice sales team and looking for a Licensed Vocational Nurse (LVN) with hospice experience, positivity, and a growth mindset! The LVN will share our vision with hospitals, facilities, and providers and to educate about the amazing benefit of community-focused not profit hospice This is an opportunity to join a local, well established not profit hospice organization with an excellent reputation! This role is focused on developing relationships, facilitating admissions, and being a contributing member of a dynamic and collaborative team! This is a full-time position offers competitive pay, generous benefits and a supportive work environment! Schedule: Monday - Friday; 8:30am - 5:00pm Location: Service areas include Walnut Creek, Concord, Pleasant Hill, Martinez, Brentwood, Pleasanton, Livermore, Hayward, San Lorenzo, Sunol, Union City, Fremont Hope Hospice follows all CDPH vaccine requirements for healthcare personnel. Essential Duties & Responsibilities include (but are not limited to): Develop relationships, maintain regular contact, and resolve issues with referral sources including physicians, hospitals, nursing facilities, residential care facilities for the elderly, senior housing, and community service agencies to ensure ongoing quality of care and referrals. Determine patient's eligibility for hospice care. Obtain informed consent(s) for service, inform patient/family of rights and responsibilities. Assist with the implementation and coordination of services required for the discharge of patients from hospitals into agency's hospice program. Education/Experience: Completion of a Licensed Vocational Nursing Education Program from an accredited school. Minimum of one year of LVN experience preferably in an acute care setting. Experience in a home health/ hospice setting preferred but not required. Certificates, Licenses, Registrations: Current Licensed Vocational Nurse certification from the California Board of Vocational Nurse and Psychiatric Technician Examiners. Valid California certification in Intravenous Therapy & Blood Withdrawal preferred. Current California Driver's License and automobile insurance that meets State of California requirements, if driving a car. Pay Range $95K - $100K annually Hope Hospice is proud to serve our community as an equal employment opportunity employer. Everyone is valued and welcome at Hope Hospice. Our organization is committed to diversity, equity and continues to build a culture of inclusion by recruiting, screening, hiring and retaining any qualified individual without regard to age, race, color, ethnicity, religion, gender, gender identity or expression, sexual orientation, disability, marital status, registered domestic partner status, citizenship, physical or mental disability, legally protected medical condition, family care status, military care status, veteran status or any other consideration made unlawful by Federal, state, or local laws.
$95k-100k yearly Auto-Apply 28d ago
Provider Relations Specialist IV
Kaiser Permanente 4.7
Oakland, CA jobs
This role requires up to 50% travel As part of the Kaiser National Contracting Department, this position plays a key role in building and operationalizing a unified National Provider Relations structure and framework. The role partners closely with the National Provider Relations leader to standardize processes, strengthen communication pathways, and support the development of a scalable, enterprise-wide model that enhances provider engagement across all markets. It also provides in-person provider relations support, serving as a direct liaison to providers to reinforce relationships, address operational concerns, and ensure consistent delivery of the national strategy at the local level. Job Summary: In addition to the responsibilities listed below, this position is also responsible for planning, developing, and implementing provider satisfaction strategies to improve network relationships and enhance provider engagement; developing provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing media materials (e.g., articles and newsletters), publications, and manual updates to providers; ensuring providers adhere to regulatory and contractual requirements; escalating complex compliance issues to appropriate parties; supporting organizational responses to regulatory audits; and delivering provider education and/or onboarding. Essential Responsibilities: * Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome. * Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions. * Supports continuous improvement efforts by: utilizing provider, claims, and contracting data to identify and/or consult on continuous improvement across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); implementing process improvement initiatives to aid providers and business goals; participating in collaborations with internal and external partners to develop network strategies and implement improved access to care; and may also include conducting and/or collaborating on advanced modeling and analyses of provider and market data to develop recommendations, solutions, and action plans for improvement initiatives. * Ensures contract commitments are met by: gathering, validating, maintaining, summarizing, and/or analyzing provider and contract data of the day-to-day operation and management of services to consult on provider compliance; identifying and documenting provider activities and/or coordinating with alternate stakeholders to ensure compliance with contract terms and conditions; leveraging guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures; and consulting with Provider Systems Administration (PSA) or its equivalent as needed to ensure proper contract interpretation and operational readiness and supporting corrective actions as identified through contract performance. * Supports contract strategy development by: researching, developing, and assisting in the proposal and implementation of strategies that improve access to patient care while managing outside service costs; providing advanced consultation on local service delivery planning and delivery system leadership to aid in the achievement of provider priorities and strategies; may include engaging in collaborative cross-functional workgroups to ensure provider strategies meet the unique needs of diverse stakeholders; and may also include developing materials and/or conducting peer training for new hires and contingent workers(e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines). * Supports the growth of the Provider Network by: reviewing or identifying recommended/potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings; developing and maintaining trusted partnerships with providers to understand their unique service request needs and challenges; serving as a liaison between providers and KP by contributing to communication efforts (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by partnering with others to develop itineraries and agendas, gather credentialing materials, and/or initiate this process. * Contributes to provider satisfaction by: leveraging in-depth knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, other operational issues, and/or directories; ensuring requests for information, questions, and problems are identified, documented, and addressed in a timely manner; and in some instances, collaborating, creating, and/or delivering training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
$46k-67k yearly est. 6d ago
Provider Relations Specialist III
Kaiser Permanente 4.7
Oakland, CA jobs
This role requires up to 50% travel As part of the Kaiser National Contracting Department, this position plays a key role in building and operationalizing a unified National Provider Relations structure and framework. The role partners closely with the National Provider Relations leader to standardize processes, strengthen communication pathways, and support the development of a scalable, enterprise-wide model that enhances provider engagement across all markets. It also provides in-person provider relations support, serving as a direct liaison to providers to reinforce relationships, address operational concerns, and ensure consistent delivery of the national strategy at the local level. Job Summary: In addition to the responsibilities listed below, this position is also responsible for aiding the planning and development of provider satisfaction strategies to improve network relationships and enhance provider engagement; supporting the development of provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing standard media materials (e.g., articles and newsletters) and publications to providers independently; ensuring providers adhere to regulatory and contractual requirements; escalating standard and nonstandard compliance issues to appropriate parties; gathering materials to support organizational responses to regulatory audits; and beginning to deliver provider education and/or onboarding. Essential Responsibilities: * Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome. * Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team. * Supports continuous improvement efforts by: organizing provider, claims, and contracting data to assist the team in identifying and/or consulting on continuous improvement opportunities across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); engaging in the implementation of process improvement initiatives to aid providers and business goals; and may also include supporting standard and non-standard analyses of provider and market data to develop recommendations for improvement initiatives. * Ensures contract commitments are met by: organizing provider data in appropriate data platforms and supporting the consultation of provider compliance; documenting provider activities and/or supporting the collaboration with alternate stakeholders to ensure compliance with contract terms and conditions; and following guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures. * Supports contract strategy development by: executing tasks to support strategies that improve access to patient care while managing outside service costs, with minimal supervision; collaborating with team members to provide consultation on local service delivery planning to aid in the achievement of provider priorities and strategies; engaging in collaborative cross-functional workgroups and/or executing on strategies to meet the unique needs of diverse stakeholders; and participating in and/or beginning to conduct peer training for new hires and contingent workers (e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines). * Supports the growth of the Provider Network by: researching and evaluating potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings; developing trusting relationships with providers to understand their role in the external network; serving as a liaison between providers and KP by completing communication tasks independently (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by organizing components of itineraries and agendas, gathering credentialing materials, and/or supporting the initiation of this process. * Contributes to provider satisfaction by: using comprehensive foundational knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, other operational issues, and/or directories; contributing to tasks to ensure requests for information, questions, and problems are identified, documented, and addressed in a timely manner; and creating training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
$46k-67k yearly est. 14d ago
Member Service Center Representative (Call Center)
Theresa Allison Md 3.4
Napa, CA jobs
Redwood Credit Union is looking for a Part Time (24 to 25 hours per week) Member Service Center Representative, with experience working in a Call Center Environment and that have a strong focus of providing outstanding Member Service by performing a variety of Member Service duties. These duties are associated with teller transactions, opening new accounts, loan transactions and cross selling Redwood Credit Union products and services. Key ResponsibilitiesService:o Answer the telephone within established performance and service guidelines.o Complete phone transactions accurately and efficiently.o Disseminate and provide education of lending, CUSO and membership information to callers.o Ensure problem ownership in an effort to protect the Member experience by researching Member problems, complaints and questions. Responding with thorough, and accurate information through oral and/ or written communication, or by directing them to the appropriate department or person for assistanceo Provide basic level technical support of our online and Mobile banking platformso Deliver excellent Member service by implementing Credit Union policy and departmental procedures and following RCU service philosophy and standards.Sales & Efficiency:o Attain individual and departmental goals and objectives as established in the MSC performance standards.o Cross-sells Credit Union products and services.o Demonstrate efficiency by maintaining professional control of member conversation, and follow accurate procedures.Support:o Post and balance daily work and maintain proper documentation.o Utilize online manuals and knowledge repository as a resourceo Complete departmental and back-office tasks as assigned including typing routine letters and/or documents.o Compile data and complete work related to departmental reports.o Maintain files, post records, make and check routine calculationso Perform all functions in a security conscientious manner. Join us and discover why you'll love working at Redwood Credit Union! ABOUT REDWOOD CREDIT UNION (RCU):At Redwood Credit Union, our mission is to passionately serve the best interests of our Members and communities. Since 1950, we have been dedicated to supporting the financial well-being of our Members through better rates, low or no fees, and best-in-class customer service. Our purpose is to inspire hope and elevate the financial well-being of our communities one person at a time, through good times and bad. As a not-for-profit financial institution, we are committed to a people-first approach, which is reflected not only in how we serve our Members, but also in how we treat our employees. Our leadership team is deeply focused on fostering a culture of heart and empathy, integrity, passion, inclusion, meaningful relationships, excellence, and ensuring financial well-being for all. Why work for Redwood Credit Union?• 28th largest credit union in the U.S. and the largest financial institution based in the North Bay • Awarded a 5-Star Rating based on 6/30/24 financial data by Bauer Financial• Recognized by Newsweek as one of "America's Greatest Midsize Workplaces 2025"• Recognized by Newsweek as one of "America's Best Credit Unions 2025"• Top Corporate Philanthropists (#24) - San Francisco Business Times• Voted Best Places to Work in the North Bay 20 years in a row• World-class Employee Engagement scores• Rated Superior in Service by more than 90% of Members, surveyed by SF Gate• Industry leading Net Promoter Scores across the U.S. Minimum Qualifications: Knowledge, Skills and Abilities Knowledge of modern office methods, practices and procedures. Skilled in operations of personal computer with Internet and Intranet access in a Windows environment. Demonstrated Member service skills. Ability to cross-sell products and services to meet Member needs. Ability to make mathematical computations. Ability to type 40 words per minute. Ability to communicate effectively both verbally and in writing. Ability to establish and maintain effective working relationships with a diverse group of people. Must be able to work on Saturdays The Ideal candidate has a combination of education and experience equivalent to a high school diploma or closely related field and two years call center, retail or clerical experience in a customer service environment. Compensation: Base starting range: $23.00 to $31.00 per hour commensurate with experience. (This position is also eligible for an 8% call center differential) Our base salary starting range is based on scope and responsibilities of the position, candidate's work experience, education/training, key skills, and internal peer equity. We offer a competitive total rewards package including a wide range of medical, dental, vision, financial, and other benefits. Redwood Credit Union offers a robust benefits package to our eligible employees including:• Competitive medical, dental, and vision insurance, mental health offerings• Employee performance incentive plan• Salary Advancement- Merit increase based on performance• 401(k) program with employer match• Time Off- Competitive PTO accrual plus 11 paid company holidays and your birthday off! RCU Discounts and Perks:• RCU employees are eligible for a .75% discount off RCU standard collateral auto loans• RCU employees are eligible for a 1% discount on all recreational or boat loan products• 2% discount off Visas and LOC Loans through RCU• 0% interest loan to support employees with various immigration related expenses such as visa application fees and relocation costs. Loan amount up to $1,000.• 0% interest loan to support employees with expenses associated with the naturalization process. Loan amount up to $15,000.• 0% interest on garment, fitness, or home office equipment loan of up to $500• 100% financing for employee purchased homes! Physical Requirements:• Ability to talk on the phone• Ability to stand, bend, stoop, sit, walk, twist and turn.• Ability to lift up to 15 pounds.• Ability to use a computer keyboard and calculator.•Work environment is indoors; majority of the time is spent sitting at a desk. *Redwood Credit Union is not offering Visa transfers and/or sponsorships for this position. Internal Team Members: If you are a current Team Member, please apply through the internal careers page located in RCUNET. We are an Equal Opportunity Employer
$23-31 hourly Auto-Apply 1d ago
Member Service Center Representative (Call Center)
Redwood Credit Union 3.4
Napa, CA jobs
Job DescriptionRedwood Credit Union is looking for a Part Time (24 to 25 hours per week) Member Service Center Representative, with experience working in a Call Center Environment and that have a strong focus of providing outstanding Member Service by performing a variety of Member Service duties. These duties are associated with teller transactions, opening new accounts, loan transactions and cross selling Redwood Credit Union products and services. Key ResponsibilitiesService:o Answer the telephone within established performance and service guidelines.o Complete phone transactions accurately and efficiently.o Disseminate and provide education of lending, CUSO and membership information to callers.o Ensure problem ownership in an effort to protect the Member experience by researching Member problems, complaints and questions. Responding with thorough, and accurate information through oral and/ or written communication, or by directing them to the appropriate department or person for assistanceo Provide basic level technical support of our online and Mobile banking platformso Deliver excellent Member service by implementing Credit Union policy and departmental procedures and following RCU service philosophy and standards.Sales & Efficiency:o Attain individual and departmental goals and objectives as established in the MSC performance standards.o Cross-sells Credit Union products and services.o Demonstrate efficiency by maintaining professional control of member conversation, and follow accurate procedures.Support:o Post and balance daily work and maintain proper documentation.o Utilize online manuals and knowledge repository as a resourceo Complete departmental and back-office tasks as assigned including typing routine letters and/or documents.o Compile data and complete work related to departmental reports.o Maintain files, post records, make and check routine calculationso Perform all functions in a security conscientious manner. Join us and discover why you'll love working at Redwood Credit Union! ABOUT REDWOOD CREDIT UNION (RCU):At Redwood Credit Union, our mission is to passionately serve the best interests of our Members and communities. Since 1950, we have been dedicated to supporting the financial well-being of our Members through better rates, low or no fees, and best-in-class customer service. Our purpose is to inspire hope and elevate the financial well-being of our communities one person at a time, through good times and bad. As a not-for-profit financial institution, we are committed to a people-first approach, which is reflected not only in how we serve our Members, but also in how we treat our employees. Our leadership team is deeply focused on fostering a culture of heart and empathy, integrity, passion, inclusion, meaningful relationships, excellence, and ensuring financial well-being for all. Why work for Redwood Credit Union?• 28th largest credit union in the U.S. and the largest financial institution based in the North Bay • Awarded a 5-Star Rating based on 6/30/24 financial data by Bauer Financial• Recognized by Newsweek as one of "America's Greatest Midsize Workplaces 2025"• Recognized by Newsweek as one of "America's Best Credit Unions 2025"• Top Corporate Philanthropists (#24) - San Francisco Business Times• Voted Best Places to Work in the North Bay 20 years in a row• World-class Employee Engagement scores• Rated Superior in Service by more than 90% of Members, surveyed by SF Gate• Industry leading Net Promoter Scores across the U.S. Minimum Qualifications: Knowledge, Skills and Abilities Knowledge of modern office methods, practices and procedures. Skilled in operations of personal computer with Internet and Intranet access in a Windows environment. Demonstrated Member service skills. Ability to cross-sell products and services to meet Member needs. Ability to make mathematical computations. Ability to type 40 words per minute. Ability to communicate effectively both verbally and in writing. Ability to establish and maintain effective working relationships with a diverse group of people. Must be able to work on Saturdays The Ideal candidate has a combination of education and experience equivalent to a high school diploma or closely related field and two years call center, retail or clerical experience in a customer service environment. Compensation: Base starting range: $23.00 to $31.00 per hour commensurate with experience. (This position is also eligible for an 8% call center differential) Our base salary starting range is based on scope and responsibilities of the position, candidate's work experience, education/training, key skills, and internal peer equity. We offer a competitive total rewards package including a wide range of medical, dental, vision, financial, and other benefits. Redwood Credit Union offers a robust benefits package to our eligible employees including:• Competitive medical, dental, and vision insurance, mental health offerings• Employee performance incentive plan• Salary Advancement- Merit increase based on performance• 401(k) program with employer match• Time Off- Competitive PTO accrual plus 11 paid company holidays and your birthday off! RCU Discounts and Perks:• RCU employees are eligible for a .75% discount off RCU standard collateral auto loans• RCU employees are eligible for a 1% discount on all recreational or boat loan products• 2% discount off Visas and LOC Loans through RCU• 0% interest loan to support employees with various immigration related expenses such as visa application fees and relocation costs. Loan amount up to $1,000.• 0% interest loan to support employees with expenses associated with the naturalization process. Loan amount up to $15,000.• 0% interest on garment, fitness, or home office equipment loan of up to $500• 100% financing for employee purchased homes! Physical Requirements:• Ability to talk on the phone• Ability to stand, bend, stoop, sit, walk, twist and turn.• Ability to lift up to 15 pounds.• Ability to use a computer keyboard and calculator.•Work environment is indoors; majority of the time is spent sitting at a desk. *Redwood Credit Union is not offering Visa transfers and/or sponsorships for this position. Internal Team Members: If you are a current Team Member, please apply through the internal careers page located in RCUNET. We are an Equal Opportunity Employer We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us at *********************.
$23-31 hourly Easy Apply 2d ago
Provider Relations Specialist IV
Kaiser Permanente 4.7
Pasadena, CA jobs
This role requires up to 50% travel As part of the Kaiser National Contracting Department, this position plays a key role in building and operationalizing a unified National Provider Relations structure and framework. The role partners closely with the National Provider Relations leader to standardize processes, strengthen communication pathways, and support the development of a scalable, enterprise-wide model that enhances provider engagement across all markets. It also provides in-person provider relations support, serving as a direct liaison to providers to reinforce relationships, address operational concerns, and ensure consistent delivery of the national strategy at the local level. Job Summary: In addition to the responsibilities listed below, this position is also responsible for planning, developing, and implementing provider satisfaction strategies to improve network relationships and enhance provider engagement; developing provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing media materials (e.g., articles and newsletters), publications, and manual updates to providers; ensuring providers adhere to regulatory and contractual requirements; escalating complex compliance issues to appropriate parties; supporting organizational responses to regulatory audits; and delivering provider education and/or onboarding. Essential Responsibilities: * Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome. * Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions. * Supports continuous improvement efforts by: utilizing provider, claims, and contracting data to identify and/or consult on continuous improvement across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); implementing process improvement initiatives to aid providers and business goals; participating in collaborations with internal and external partners to develop network strategies and implement improved access to care; and may also include conducting and/or collaborating on advanced modeling and analyses of provider and market data to develop recommendations, solutions, and action plans for improvement initiatives. * Ensures contract commitments are met by: gathering, validating, maintaining, summarizing, and/or analyzing provider and contract data of the day-to-day operation and management of services to consult on provider compliance; identifying and documenting provider activities and/or coordinating with alternate stakeholders to ensure compliance with contract terms and conditions; leveraging guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures; and consulting with Provider Systems Administration (PSA) or its equivalent as needed to ensure proper contract interpretation and operational readiness and supporting corrective actions as identified through contract performance. * Supports contract strategy development by: researching, developing, and assisting in the proposal and implementation of strategies that improve access to patient care while managing outside service costs; providing advanced consultation on local service delivery planning and delivery system leadership to aid in the achievement of provider priorities and strategies; may include engaging in collaborative cross-functional workgroups to ensure provider strategies meet the unique needs of diverse stakeholders; and may also include developing materials and/or conducting peer training for new hires and contingent workers(e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines). * Supports the growth of the Provider Network by: reviewing or identifying recommended/potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings; developing and maintaining trusted partnerships with providers to understand their unique service request needs and challenges; serving as a liaison between providers and KP by contributing to communication efforts (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by partnering with others to develop itineraries and agendas, gather credentialing materials, and/or initiate this process. * Contributes to provider satisfaction by: leveraging in-depth knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, other operational issues, and/or directories; ensuring requests for information, questions, and problems are identified, documented, and addressed in a timely manner; and in some instances, collaborating, creating, and/or delivering training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
$45k-65k yearly est. 6d ago
Provider Relations Specialist III
Kaiser Permanente 4.7
Pasadena, CA jobs
This role requires up to 50% travel As part of the Kaiser National Contracting Department, this position plays a key role in building and operationalizing a unified National Provider Relations structure and framework. The role partners closely with the National Provider Relations leader to standardize processes, strengthen communication pathways, and support the development of a scalable, enterprise-wide model that enhances provider engagement across all markets. It also provides in-person provider relations support, serving as a direct liaison to providers to reinforce relationships, address operational concerns, and ensure consistent delivery of the national strategy at the local level. Job Summary: In addition to the responsibilities listed below, this position is also responsible for aiding the planning and development of provider satisfaction strategies to improve network relationships and enhance provider engagement; supporting the development of provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing standard media materials (e.g., articles and newsletters) and publications to providers independently; ensuring providers adhere to regulatory and contractual requirements; escalating standard and nonstandard compliance issues to appropriate parties; gathering materials to support organizational responses to regulatory audits; and beginning to deliver provider education and/or onboarding. Essential Responsibilities: * Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome. * Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team. * Supports continuous improvement efforts by: organizing provider, claims, and contracting data to assist the team in identifying and/or consulting on continuous improvement opportunities across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); engaging in the implementation of process improvement initiatives to aid providers and business goals; and may also include supporting standard and non-standard analyses of provider and market data to develop recommendations for improvement initiatives. * Ensures contract commitments are met by: organizing provider data in appropriate data platforms and supporting the consultation of provider compliance; documenting provider activities and/or supporting the collaboration with alternate stakeholders to ensure compliance with contract terms and conditions; and following guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures. * Supports contract strategy development by: executing tasks to support strategies that improve access to patient care while managing outside service costs, with minimal supervision; collaborating with team members to provide consultation on local service delivery planning to aid in the achievement of provider priorities and strategies; engaging in collaborative cross-functional workgroups and/or executing on strategies to meet the unique needs of diverse stakeholders; and participating in and/or beginning to conduct peer training for new hires and contingent workers (e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines). * Supports the growth of the Provider Network by: researching and evaluating potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings; developing trusting relationships with providers to understand their role in the external network; serving as a liaison between providers and KP by completing communication tasks independently (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by organizing components of itineraries and agendas, gathering credentialing materials, and/or supporting the initiation of this process. * Contributes to provider satisfaction by: using comprehensive foundational knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, other operational issues, and/or directories; contributing to tasks to ensure requests for information, questions, and problems are identified, documented, and addressed in a timely manner; and creating training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
$45k-65k yearly est. 14d ago
Early Childhood Enrollment Representative
Family Bridges, Inc. 3.8
Oakland, CA jobs
Job DescriptionJOB ANNOUNCEMENT POSITION: Early Childhood Enrollment Representative (Part-Time) RESPONSIBLE TO: Chief Financial Officer COMMITMENT: Part-Time Position (20 hours per week) STATUS: Regular, Non-Exempt Application Deadline: Open Until Filled JOB SUMMARY: The Early Childhood Enrollment Representative supports the growth of our early childhood center by engaging with families, promoting programs, and guiding parents through the enrollment process for PreK-K. This role focuses on family outreach, community engagement, and culturally responsive communication with Oakland and nearby Bay Area families. MAJOR DUTIES and RESPONSIBILITIES: Family Outreach & Recruitment Connect with East Bay families, especially Chinese-speaking communities. Attend community events, fairs, and family programs as a program representative. Respond to prospective family inquiries in English and Chinese. Support families from first contact through enrollment. Marketing & Communications Assist with simple outreach materials (flyers, social posts, emails). Provide Chinese translations for promotional content. Support social media and digital outreach to increase program visibility. Community Engagement Build relationships with local organizations, childcare centers, and parent groups. Participate in tours, open houses, and community events. Administrative & Enrollment Support Track inquiries and enrollment progress. Assist with scheduling, data entry, and event logistics. Support family information sessions and follow-up communication. Qualifications Bilingual: Mandarin and/or Cantonese + English (required). Experience in outreach, community engagement, admissions, or early childhood settings. Knowledge of Oakland/Bay Area early childhood family needs. Strong interpersonal and culturally sensitive communication skills. Ability to work independently and occasionally during evenings/weekends. Basic skills in social media, Canva, and email communication tools. Compensation & Schedule Part-time position at 20 hours per week. Compensation commensurate with experience. ADA ACCOMADATIONS: Ability to communicate clearly with others. Ability to see and hear to interact with others. Ability to work outdoors for extended periods of time. Ability to use a computer as well as a smartphone. Must possess a valid driver's license and have access to a reliable personal vehicle for work-related travel throughout Alameda and nearyby counties To lift a minimum of 20 lbs. Vision 20/20 with correction. SALARY: The target hourly rate for this position is $25.00-$29.60, with benefits, and final compensation will be determined based on the selected candidate's experience, qualifications, education, and skill set, in alignment with internal pay practices. TO APPLY: Submit cover letter and resume to Human Resources, Family Bridges, Inc., 168-11th Street, Oakland, CA 94607 | E-mail: ******************** Family Bridges, Inc. is a non-profit multi-services community-based organization that has been serving the Asian American communities in the East Bay for more than 55 years. Family Bridges, Inc. is an equal opportunity employer regardless of race, color, religion, sex, national origin, marital status, sexual orientation, age, or disability. Powered by JazzHR J03IXuwUaB
$25-29.6 hourly Easy Apply 21d ago
Early Childhood Enrollment Representative
Family Bridges 3.8
Oakland, CA jobs
JOB ANNOUNCEMENT POSITION: Early Childhood Enrollment Representative (Part-Time) RESPONSIBLE TO: Chief Financial Officer COMMITMENT: Part-Time Position (20 hours per week) STATUS: Regular, Non-Exempt Application Deadline: Open Until Filled JOB SUMMARY: The Early Childhood Enrollment Representative supports the growth of our early childhood center by engaging with families, promoting programs, and guiding parents through the enrollment process for PreK-K. This role focuses on family outreach, community engagement, and culturally responsive communication with Oakland and nearby Bay Area families. MAJOR DUTIES and RESPONSIBILITIES: Family Outreach & Recruitment Connect with East Bay families, especially Chinese-speaking communities. Attend community events, fairs, and family programs as a program representative. Respond to prospective family inquiries in English and Chinese. Support families from first contact through enrollment. Marketing & Communications Assist with simple outreach materials (flyers, social posts, emails). Provide Chinese translations for promotional content. Support social media and digital outreach to increase program visibility. Community Engagement Build relationships with local organizations, childcare centers, and parent groups. Participate in tours, open houses, and community events. Administrative & Enrollment Support Track inquiries and enrollment progress. Assist with scheduling, data entry, and event logistics. Support family information sessions and follow-up communication. Qualifications Bilingual: Mandarin and/or Cantonese + English (required). Experience in outreach, community engagement, admissions, or early childhood settings. Knowledge of Oakland/Bay Area early childhood family needs. Strong interpersonal and culturally sensitive communication skills. Ability to work independently and occasionally during evenings/weekends. Basic skills in social media, Canva, and email communication tools. Compensation & Schedule Part-time position at 20 hours per week. Compensation commensurate with experience. ADA ACCOMADATIONS: Ability to communicate clearly with others. Ability to see and hear to interact with others. Ability to work outdoors for extended periods of time. Ability to use a computer as well as a smartphone. Must possess a valid driver's license and have access to a reliable personal vehicle for work-related travel throughout Alameda and nearyby counties To lift a minimum of 20 lbs. Vision 20/20 with correction. SALARY: The target hourly rate for this position is $25.00-$29.60, with benefits, and final compensation will be determined based on the selected candidate's experience, qualifications, education, and skill set, in alignment with internal pay practices. TO APPLY: Submit cover letter and resume to Human Resources, Family Bridges, Inc., 168-11 th Street, Oakland, CA 94607 | E-mail: [email protected] Family Bridges, Inc. is a non-profit multi-services community-based organization that has been serving the Asian American communities in the East Bay for more than 55 years. Family Bridges, Inc. is an equal opportunity employer regardless of race, color, religion, sex, national origin, marital status, sexual orientation, age, or disability.
$25-29.6 hourly Auto-Apply 50d ago
Collection Rep / Billing/Collections / Full-time / Days
Childrens Hospital Los Angeles 4.7
Glendale, CA jobs
NATIONAL LEADERS IN PEDIATRIC CARE Ranked among the top 10 pediatric hospitals in the nation, Children's Hospital Los Angeles (CHLA) provides the best care for kids in California. Here world-class experts in medicine, education and research work together to deliver family-centered care half a million times each year. From primary to complex critical care, more than 350 programs and services are offered, each one specially designed for children. The CHLA of the future is brighter than can be imagined. Investments in technology, research and innovation will create care that is personal, convenient and empowering. Our scientists will work with clinical experts to take laboratory discoveries and create treatments that are a perfect match for every patient. And together, CHLA team members will turn health care into health transformation. Join a hospital where the work you do will matter-to you, to your colleagues, and above all, to our patients and families. The work will be challenging, but always rewarding. It's Work That Matters. Overview Schedule: Day Shift: 1 day on-site, 4 days remote Purpose Statement/Position Summary: The Collection Representative is responsible for the billing and follow-up related to HMO's, PPO's, Medi-Cal, CCS, GHPP, PCCM's Managed Care and outside organizations. Responds to inquiries and resolves problems regarding billing and collection matters. Minimum Qualifications/Work Experience: 1 year experience of hospital Billing and Collections required, including insurance and government payers. Previous experience with facility claims for inpatient and or outpatient billing for commercial and managed care payers. Familiarity with medical billing processes, insurance claims, and understanding of medical coding (such as ICD-10, CPT) is essential. Experience with electronic health record (EHR) systems and billing software is also beneficial. Knowledge of CCS, Medi-Cal, GHPP. The ability to analyze financial documents, identify discrepancies, and resolve billing issues is essential. Strong problem-solving skills help in effectively managing accounts and ensuring timely collections. Meticulous attention to detail is necessary to ensure accuracy in billing and collections. Strong organizational skills are required to manage multiple accounts, prioritize tasks, and meet deadlines efficiently. Education/Licensure/Certification: High school diploma or equivalent. Certificate or degree in healthcare background preferred. Pay Scale Information $43,680.00-$65,062.00 CHLA values the contribution each Team Member brings to our organization. Final determination of a successful candidate's starting pay will vary based on a number of factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this specific job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs. CHLA looks forward to introducing you to our world-class organization where we create hope and build healthier futures. Children's Hospital Los Angeles (CHLA) is a leader in pediatric and adolescent health both here and across the globe. As a premier Magnet teaching hospital, you'll find an environment that's alive with learning, rooted in care and compassion, and home to thought leadership and unwavering support. CHLA is dedicated to creating hope and building healthier futures - for our patients, as well as for you and your career! CHLA has been affiliated with the Keck School of Medicine of the University of Southern California since 1932. At Children's Hospital Los Angeles, our work matters. And so do each and every one of our valued team members. CHLA is an Equal Employment Opportunity employer. We consider qualified applicants for all positions without regard to race, color, religion, creed, national origin, sex, gender identity, age, physical or mental disability, sexual orientation, marital status, veteran or military status, genetic information or any other legally protected basis under federal, state or local laws, regulations or ordinances. We will also consider for employment qualified applicants with criminal history, in a manner consistent with the requirements of state and local laws, including the LA City Fair Chance Ordinance and SF Fair Chance Ordinance. Qualified Applicants with disabilities are entitled to reasonable accommodation under the California Fair Employment and Housing Act and the Americans with Disabilities Act. Please contact CHLA Human Resources if you need assistance completing the application process. Our various experiences, perspectives and backgrounds allow us to better serve our patients and create a strong community at CHLA. Billing/Collections
$43.7k-65.1k yearly 30d ago
Collection Rep / Billing/Collections / Full-time / Days
Children's Hospital Los Angeles 4.7
Glendale, CA jobs
**NATIONAL LEADERS IN PEDIATRIC CARE** Ranked among the top 10 pediatric hospitals in the nation, Children's Hospital Los Angeles (CHLA) provides the best care for kids in California. Here world-class experts in medicine, education and research work together to deliver family-centered care half a million times each year. From primary to complex critical care, more than 350 programs and services are offered, each one specially designed for children. The CHLA of the future is brighter than can be imagined. Investments in technology, research and innovation will create care that is personal, convenient and empowering. Our scientists will work with clinical experts to take laboratory discoveries and create treatments that are a perfect match for every patient. And together, CHLA team members will turn health care into health transformation. Join a hospital where the work you do will matter-to you, to your colleagues, and above all, to our patients and families. The work will be challenging, but always rewarding. **It's Work That Matters.** **Overview** **Schedule:** Day Shift: 1 day on-site, 4 days remote **Purpose Statement/Position Summary:** The Collection Representative is responsible for the billing and follow-up related to HMO's, PPO's, Medi-Cal, CCS, GHPP, PCCM's Managed Care and outside organizations. Responds to inquiries and resolves problems regarding billing and collection matters. **Minimum Qualifications/Work Experience:** 1 year experience of hospital Billing and Collections required, including insurance and government payers. Previous experience with facility claims for inpatient and or outpatient billing for commercial and managed care payers. Familiarity with medical billing processes, insurance claims, and understanding of medical coding (such as ICD-10, CPT) is essential. Experience with electronic health record (EHR) systems and billing software is also beneficial. Knowledge of CCS, Medi-Cal, GHPP. The ability to analyze financial documents, identify discrepancies, and resolve billing issues is essential. Strong problem-solving skills help in effectively managing accounts and ensuring timely collections. Meticulous attention to detail is necessary to ensure accuracy in billing and collections. Strong organizational skills are required to manage multiple accounts, prioritize tasks, and meet deadlines efficiently. **Education/Licensure/Certification:** High school diploma or equivalent. Certificate or degree in healthcare background preferred. **Pay Scale Information** $43,680.00-$65,062.00 CHLA values the contribution each Team Member brings to our organization. Final determination of a successful candidate's starting pay will vary based on a number of factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this specific job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs. CHLA looks forward to introducing you to our world-class organization where we create hope and build healthier futures. Children's Hospital Los Angeles (CHLA) is a leader in pediatric and adolescent health both here and across the globe. As a premier Magnet teaching hospital, you'll find an environment that's alive with learning, rooted in care and compassion, and home to thought leadership and unwavering support. CHLA is dedicated to creating hope and building healthier futures - for our patients, as well as for you and your career! CHLA has been affiliated with the Keck School of Medicine of the University of Southern California since 1932. At Children's Hospital Los Angeles, our work matters. And so do each and every one of our valued team members. CHLA is an Equal Employment Opportunity employer. We consider qualified applicants for all positions without regard to race, color, religion, creed, national origin, sex, gender identity, age, physical or mental disability, sexual orientation, marital status, veteran or military status, genetic information or any other legally protected basis under federal, state or local laws, regulations or ordinances. We will also consider for employment qualified applicants with criminal history, in a manner consistent with the requirements of state and local laws, including the LA City Fair Chance Ordinance and SF Fair Chance Ordinance. Qualified Applicants with disabilities are entitled to reasonable accommodation under the California Fair Employment and Housing Act and the Americans with Disabilities Act. Please contact CHLA Human Resources if you need assistance completing the application process. Our various experiences, perspectives and backgrounds allow us to better serve our patients and create a strong community at CHLA. Billing/Collections
$43.7k-65.1k yearly 60d+ ago

Learn more about Health Plan of San Joaquin jobs

Overview
Reviews

Most common jobs at Health Plan of San Joaquin

Coordinator Health Plan of San Joaquin jobs

Provider services representative Health Plan of San Joaquin jobs

Most in demand jobs

Zippia Careers
Office and Administrative Industry
Provider Services Representative Jobs
Health Plan of San Joaquin Jobs
Health Plan of San Joaquin Provider Services Representative Jobs

Updated January 28, 2026

Provider Services Representative jobs at Health Plan of San Joaquin - 915 jobs

CRM Senior Field Clinical Representative - San Fernando Valley, CA

Admissions Services Specialist Acute

Customer Care Representative I

Navigation Center Representative (Temp)

Navigation Center Representative

Provider Relations Specialist IV

Provider Relations Specialist III

Provider Relations Specialist IV

Provider Relations Specialist III

Hospice Provider Relations (LVN)

Provider Relations Specialist IV

Provider Relations Specialist III

Member Service Center Representative (Call Center)

Member Service Center Representative (Call Center)

Provider Relations Specialist IV

Provider Relations Specialist III

Early Childhood Enrollment Representative

Early Childhood Enrollment Representative

Collection Rep / Billing/Collections / Full-time / Days

Collection Rep / Billing/Collections / Full-time / Days

Learn more about Health Plan of San Joaquin jobs

Most common jobs at Health Plan of San Joaquin

Most in demand jobs