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Patient Service Coordinator jobs at Humana - 25 jobs
Pre-Service Coordinator
Humana
Patient service coordinator job at Humana
Become a part of our caring community and help us put health first The Pre-Service Coordinator is responsible for all aspects of referral management and accurately process incoming requests for homecare, DME/supplies and pharmacy/infusion services meeting the timeline expectations as outlined in the Health Plan contractual agreements. The Pre-Service Coordinator will review inbound referrals and correspondence for processing, fulfilment or resolution utilizing all appropriate software systems and resources. Screen physician's orders and documentation to identify that all qualifying medical documentation and required information is included. When necessary, request additional applicable information from referring entity. Perform verification of benefits coverage and eligibility for services per Health Plan contract. Review referral data matching it against specified medical terms and diagnoses or procedure codes and follow established procedures for approving request or referring request for further review. Provide referral management education to members and providers regarding medical benefits, referral status and prior authorizations. Communicate with patient to confirm demographics and explain the details of the services/care requested. Coordinate the timely delivery of care and services with providers. Also communicate with referring entities, providers, and members regarding final referral determination while maintaining detailed documentation to record patient, physician, referral source and provider interactions and communications. Work with Pre-Authorization, Utilization Management, Billing, Pharmacy, Home Care and DME regarding referred services. Maintain working knowledge of applicable CPT, HCPC, ICD-10 codes, and all insurance contracts. Understand Medicare/Medicaid criteria and Health Plan policies to ensure the referral meets all requirements and guidelines. Maintain knowledgeable of, and adhere to applicable federal/state regulations, laws related to patient confidentiality, release of information, and HIPAA. Always preserve the security and confidentiality of patients' personal information. Report ongoing issues with referring entities or providers that delay service delivery to manager. Provides excellent internal and external customer service by ensuring work meets quality standard. Use your skills to make an impact Required Qualifications 1-3 years of Home Health, DME (Durable Medical Equipment), or Infusion Pharmacy experience is required. Wound care/Ostomy supplies experience is preferred. Microsoft Office technical experience with Word, Outlook, and Excel is preferred. Knowledge of Medicare/Medicaid & commercial insurance is required. Experienced with medical authorizations is required. Knowledge of medical billing is preferred. Must be passionate about contributing to an organization focused on continuously improving consumer experiences Excellent customer service and communication skills. Additional Information Remote (Subject to potential future adjustments based on evolving business requirements) Required shifts: 12:30p - 9:00p (no weekends) or 9:00a - 6:00p (with rotating weekends) Overtime: As needed Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $39,000 - $49,400 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.$39k-49.4k yearly Auto-Apply 25d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare
Columbus, OH jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.$21.7-28.8 hourly 17d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare Inc.
Columbus, OH jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.$21.7-28.8 hourly 13d agoLead Practice Coordinator
Tenet Healthcare
Remote
The Medical Office Coordinator is responsible for greeting patients, answering phones and scheduling appointments. The collection of accurate patient demographics, insurance verification, referral processing, and various other areas of data entry. Coordinates the daily operations of the physician office, including the medical records process, patient and physician scheduling, overseeing the front desk, confirming appointments, and ordering office supplies. Will be responsible for charge entry and patient balance processing and the daily reconciliation of charges and payments. High School Diploma/GED 5 years of experience in a Physician Practice preferred Completion of Medical Office Assistant program preferred Healthcare management/administration certification preferred EMR/EHR experience preferred, NextGen or Athena experience preferred Proficiency in a windows environment with a working knowledge of Word, Outlook, and the Internet is required Willingness to be flexible and adaptable in a complex, matrix environment Greeting patients, answering phones and scheduling appointments Collection of accurate patient demographics Answers telephones in a prompt and courteous manner Insurance verification Referral processing Will be responsible for charge entry and patient balance processing and the daily reconciliation of charges and payments Displays concern and provides assistance or explains procedures as appropriate to callers or in face-to-face situations Ensures that all contacts with patients, the public, physicians and other personnel are carried out in a friendly, courteous, helpful and considerate manner Manage, copy, and review medical records to ensure accuracy Coordinates the daily operations of the physician office, including the medical records process, patient and physician scheduling, overseeing the front desk, confirming appointments, and ordering office supplies$47k-60k yearly est. Auto-Apply 37d agoInsurance Verification Representative-Remote
Community Health Systems
Franklin, TN jobs
The Insurance Verification Representative is responsible for verifying insurance benefits, eligibility, and authorization requirements to ensure accurate billing and reimbursement for procedures and services. This role interacts with physician offices, patients, and internal departments to coordinate insurance approvals, obtain necessary referrals and authorizations, and communicate patient financial responsibilities. The Insurance Verification Representative ensures compliance with payer guidelines and facilitates a smooth scheduling and billing process for patients. **This is a REMOTE position** **Essential Functions** + Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients to ensure coverage and minimize claim denials. + Confirms that the correct insurance package has been loaded into the patient's chart and updates records as needed. + Reviews provider schedules in the electronic medical record system to obtain referrals for HMO patients and authorizations for procedures and radiology testing. + Works with hospital radiology and scheduling teams to ensure all necessary authorizations are secured for upcoming procedures. + Reviews the authorization/referral list in the patient financial system (e.g., Athena) and attaches required authorizations and referrals to pending appointments. + Utilizes financial and scheduling systems to generate authorizations, verify patient coverage, and ensure all necessary approvals are documented. + Tracks and monitors authorizations and referrals, ensuring compliance with benchmark data and payer requirements. + Coordinates with physician offices to resolve issues related to pre-determinations and authorization delays. + Contacts patients in advance of procedures to notify them of estimated financial responsibility and available payment options. + Assists and provides backup support for other business office positions as needed. + Performs other duties as assigned. + Maintains regular and reliable attendance. + Complies with all policies and standards. **Qualifications** + H.S. Diploma or GED required + Associate Degree in Healthcare Administration, Business, or a related field preferred + 1-2 years of experience in insurance verification, patient access, medical billing, or healthcare financial services required + Experience working with electronic medical records (EMR), patient scheduling systems, and insurance payer portals. preferred **Knowledge, Skills and Abilities** + Strong understanding of insurance verification processes, medical benefit plans, and payer authorization requirements. + Knowledge of healthcare reimbursement practices, including prior authorization and referral processes. + Proficiency in electronic medical records (EMR), financial systems, and patient scheduling software. + Excellent communication and customer service skills to interact professionally with patients, physician offices, and payers. + Strong attention to detail to ensure accuracy in insurance verification and documentation. + Ability to work independently and prioritize tasks in a fast-paced environment. + Knowledge of HIPAA regulations and patient confidentiality requirements. Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to ************************************************* to obtain the main telephone number of the facility and ask for Human Resources.$28k-31k yearly est. 4d agoInsurance Verification Representative
Community Health Systems
Remote
The Insurance Verification Representative is responsible for verifying insurance benefits, eligibility, and authorization requirements to ensure accurate billing and reimbursement for procedures and services. This role interacts with physician offices, patients, and internal departments to coordinate insurance approvals, obtain necessary referrals and authorizations, and communicate patient financial responsibilities. The Insurance Verification Representative ensures compliance with payer guidelines and facilitates a smooth scheduling and billing process for patients. Essential Functions Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients to ensure coverage and minimize claim denials. Confirms that the correct insurance package has been loaded into the patient's chart and updates records as needed. Reviews provider schedules in the electronic medical record system to obtain referrals for HMO patients and authorizations for procedures and radiology testing. Works with hospital radiology and scheduling teams to ensure all necessary authorizations are secured for upcoming procedures. Reviews the authorization/referral list in the patient financial system (e.g., Athena) and attaches required authorizations and referrals to pending appointments. Utilizes financial and scheduling systems to generate authorizations, verify patient coverage, and ensure all necessary approvals are documented. Tracks and monitors authorizations and referrals, ensuring compliance with benchmark data and payer requirements. Coordinates with physician offices to resolve issues related to pre-determinations and authorization delays. Contacts patients in advance of procedures to notify them of estimated financial responsibility and available payment options. Assists and provides backup support for other business office positions as needed. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications H.S. Diploma or GED required Associate Degree in Healthcare Administration, Business, or a related field preferred 1-2 years of experience in insurance verification, patient access, medical billing, or healthcare financial services required Experience working with electronic medical records (EMR), patient scheduling systems, and insurance payer portals. preferred Knowledge, Skills and Abilities Strong understanding of insurance verification processes, medical benefit plans, and payer authorization requirements. Knowledge of healthcare reimbursement practices, including prior authorization and referral processes. Proficiency in electronic medical records (EMR), financial systems, and patient scheduling software. Excellent communication and customer service skills to interact professionally with patients, physician offices, and payers. Strong attention to detail to ensure accuracy in insurance verification and documentation. Ability to work independently and prioritize tasks in a fast-paced environment. Knowledge of HIPAA regulations and patient confidentiality requirements.$28k-32k yearly est. Auto-Apply 5d agoInsurance Verification Representative-Remote
Community Health System
Remote
The Insurance Verification Representative is responsible for verifying insurance benefits, eligibility, and authorization requirements to ensure accurate billing and reimbursement for procedures and services. This role interacts with physician offices, patients, and internal departments to coordinate insurance approvals, obtain necessary referrals and authorizations, and communicate patient financial responsibilities. The Insurance Verification Representative ensures compliance with payer guidelines and facilitates a smooth scheduling and billing process for patients. This is a REMOTE position Essential Functions * Verifies insurance benefits, eligibility, and pre-determination requirements for all scheduled patients to ensure coverage and minimize claim denials. * Confirms that the correct insurance package has been loaded into the patient's chart and updates records as needed. * Reviews provider schedules in the electronic medical record system to obtain referrals for HMO patients and authorizations for procedures and radiology testing. * Works with hospital radiology and scheduling teams to ensure all necessary authorizations are secured for upcoming procedures. * Reviews the authorization/referral list in the patient financial system (e.g., Athena) and attaches required authorizations and referrals to pending appointments. * Utilizes financial and scheduling systems to generate authorizations, verify patient coverage, and ensure all necessary approvals are documented. * Tracks and monitors authorizations and referrals, ensuring compliance with benchmark data and payer requirements. * Coordinates with physician offices to resolve issues related to pre-determinations and authorization delays. * Contacts patients in advance of procedures to notify them of estimated financial responsibility and available payment options. * Assists and provides backup support for other business office positions as needed. * Performs other duties as assigned. * Maintains regular and reliable attendance. * Complies with all policies and standards. Qualifications * H.S. Diploma or GED required * Associate Degree in Healthcare Administration, Business, or a related field preferred * 1-2 years of experience in insurance verification, patient access, medical billing, or healthcare financial services required * Experience working with electronic medical records (EMR), patient scheduling systems, and insurance payer portals. preferred Knowledge, Skills and Abilities * Strong understanding of insurance verification processes, medical benefit plans, and payer authorization requirements. * Knowledge of healthcare reimbursement practices, including prior authorization and referral processes. * Proficiency in electronic medical records (EMR), financial systems, and patient scheduling software. * Excellent communication and customer service skills to interact professionally with patients, physician offices, and payers. * Strong attention to detail to ensure accuracy in insurance verification and documentation. * Ability to work independently and prioritize tasks in a fast-paced environment. * Knowledge of HIPAA regulations and patient confidentiality requirements.$28k-32k yearly est. 4d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare
Cleveland, OH jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.$21.7-28.8 hourly 17d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare
Akron, OH jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.$21.7-28.8 hourly 17d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare
Cincinnati, OH jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.$21.7-28.8 hourly 17d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare Inc.
Cincinnati, OH jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.$21.7-28.8 hourly 13d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare Inc.
Akron, OH jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.$21.7-28.8 hourly 13d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare
Dayton, OH jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.$21.7-28.8 hourly 17d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare Inc.
Dayton, OH jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.$21.7-28.8 hourly 13d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare
Ohio jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: 10-6:30 PM MST** **Essential Job Duties** - Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. - Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. - Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. - Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. - Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. - Utilizes appropriate resources to ensure member contact information is current and up-to-date. - Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. - Interacts with appropriate primary care providers to ensure member registry is current and accurate. - Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. - Proactively identifies ways to improve member relations. - Supports goal to achieve and maintain industry-leading Medicare STAR ratings. **Required Qualifications** - At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. - Excellent customer service skills. - Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. - Ability to multi-task applications while speaking with members. - Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. - Ability to meet established deadlines. - Ability to function independently and manage multiple projects. - Excellent verbal and written communication skills, including excellent phone etiquette. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Health care industry experience. - Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.$21.7-28.8 hourly 17d agoRepresentative, Medication Therapy Management Services (Bilingual preferred)
Molina Healthcare Inc.
Ohio jobs
Provides customer service support for inbound/outbound Medication Therapy Management (MTM) pharmacy calls from members, providers, and pharmacies. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Shift: 10-6:30 PM MST Essential Job Duties * Handles and records inbound/outbound pharmacy calls with members, providers, pharmacists, pharmacies and technicians - ensuring departmental and Centers for Medicare and Medicaid Services (CMS) standards are met. * Educates Molina members on the urgency, positive impacts, and importance of completing an annual comprehensive medication review with pharmacists, and maintaining good medication adherence. * Enforces Health Insurance Portability and Accountability Act (HIPAA) compliance standards and regulations. * Provides clerical services and support to pharmacists and technician staff, and support for day-to-day pharmacy operations as delegated. * Adheres to pharmacy policies and procedures related to appropriate call resolution/transfer to internal departments as required. * Utilizes appropriate resources to ensure member contact information is current and up-to-date. * Effectively communicates general Medicare and Medicaid plan benefits to existing pharmacy members. * Interacts with appropriate primary care providers to ensure member registry is current and accurate. * Supports pharmacists with completion of comprehensive medication reviews through pre-work up to case preparation. * Proactively identifies ways to improve member relations. * Supports goal to achieve and maintain industry-leading Medicare STAR ratings. Required Qualifications * At least 1 year of related experience, including call center or customer service experience, or equivalent experience combination of relevant education and experience. * Excellent customer service skills. * Ability to work independently when assigned special projects, such as pill box requests, care management referrals, over the counter (OTC) requests, etc. * Ability to multi-task applications while speaking with members. * Ability to develop and maintain positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors. * Ability to meet established deadlines. * Ability to function independently and manage multiple projects. * Excellent verbal and written communication skills, including excellent phone etiquette. * Microsoft Office suite, and applicable software program(s) proficiency. Preferred Qualifications * Health care industry experience. * Pharmacy related experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $28.82 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.$21.7-28.8 hourly 13d agoSchedule Specialist, Home Health - Remote - CHRISTUS Homecare
Unitedhealth Group
Tyler, TX jobs
Explore opportunities with Christus Homecare, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As the Scheduling Specialist you will managing patient referrals and visit schedules. Assigns patient assessments and other visits as ordered by the physician using an online scheduling system. Collaborate with the Team Leader to identify clinicians with the appropriate experience and skill set to match patient needs. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Utilizes an automated scheduling system to maintain a calendar of services for both episodic and per visit customers + Processes workflow for requested scheduled, missed, rescheduled, reassigned, declined, and delivered visits + Monitors pending referrals daily and assigns licensed professional and case manager for all start of care visits + Communicates daily with field staff regarding any visits unaddressed in late, pending, or incomplete status for resolution as appropriate You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in **Required Qualifications:** + High school education or equivalent experience **Preferred Qualifications:** + 1+ years of scheduling experience in a health care setting using an online scheduling system + Exceptional organizational, customer service, communication, and decision-making skills + Working knowledge of state and federal regulations governing OASIS visits, supervisory, and reassessment visits *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $14.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._$14-27.7 hourly 39d agoSchedule Specialist, Home Health - Remote - CHRISTUS Homecare
Unitedhealth Group Inc.
Tyler, TX jobs
Explore opportunities with Christus Homecare, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Scheduling Specialist you will managing patient referrals and visit schedules. Assigns patient assessments and other visits as ordered by the physician using an online scheduling system. Collaborate with the Team Leader to identify clinicians with the appropriate experience and skill set to match patient needs. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Utilizes an automated scheduling system to maintain a calendar of services for both episodic and per visit customers * Processes workflow for requested scheduled, missed, rescheduled, reassigned, declined, and delivered visits * Monitors pending referrals daily and assigns licensed professional and case manager for all start of care visits * Communicates daily with field staff regarding any visits unaddressed in late, pending, or incomplete status for resolution as appropriate You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in Required Qualifications: * High school education or equivalent experience Preferred Qualifications: * 1+ years of scheduling experience in a health care setting using an online scheduling system * Exceptional organizational, customer service, communication, and decision-making skills * Working knowledge of state and federal regulations governing OASIS visits, supervisory, and reassessment visits * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $14.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.$14-27.7 hourly 1d agoPatient Care Coordinator- Evernorth
Cigna
Pittsburgh, PA jobs
As a Patient Care Coordinator, you will support patients throughout their specialty therapy journey by coordinating refill activities, communicating with caregivers and healthcare providers, and ensuring timely, accurate delivery of medications. You will help create a supportive, service‑oriented experience while contributing to reliable pharmacy operations. Responsibilities * Communicate with patients, caregivers, and medical staff to coordinate medication deliveries and follow‑up needs. * Make outbound and receive inbound calls, documenting all interactions accurately. * Support pharmacy operations by evaluating product usage, documenting inventory, completing verbal assessments, and setting up medication orders under pharmacist supervision. * Update patient profiles, complete assessments, and assist with refill setup while maintaining accurate records. * Meet or exceed call productivity and quality metrics. * Provide exceptional customer service and maintain a professional, positive image. * Serve as an information conduit between pharmacy operations and patients, caregivers, or medical professionals. * Maintain compliance with organizational behaviors and competencies. * Perform additional tasks as assigned to support patient care and operational needs. Required Qualifications * High school diploma or GED. * Proficiency in Microsoft Office. Preferred Qualifications * Pharmacy technician certification. * Prior specialty healthcare experience. * Strong communication, organization, and customer service skills. * Ability to manage time effectively and work both independently and collaboratively. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.$29k-37k yearly est. Auto-Apply 22d agoSupervisor, Patient Care Coordinator- Evernorth
Cigna
Pittsburgh, PA jobs
As the Supervisor of Patient Care Coordinators, you will guide a dedicated team that supports patients throughout their specialty therapy journey. You will oversee daily workflows, foster a culture of collaboration and service, and ensure high‑quality, patient‑centered communication. Your leadership will help strengthen operational performance, enhance the care experience, and support continuous improvement across the department. Responsibilities * Supervise daily operations by assigning tasks, supporting staff, monitoring workflow outcomes, and reporting key updates to leadership. * Maintain expertise across functional areas including onboarding, insurance verification, patient care coordination, patient advocacy, and support services. * Develop work schedules, implement departmental guidelines, lead staff meetings, and communicate updates on internal processes and contracts. * Lead recruitment, hiring, onboarding, training, and competency development to maintain a skilled and engaged workforce. * Evaluate employee performance, provide coaching, conduct performance reviews, and recommend corrective actions when necessary. * Ensure productivity standards, regulatory requirements, and accreditation expectations are consistently achieved. * Serve as a resource for staff, supporting problem resolution and addressing questions related to intake workflows. * Model organizational competencies and behaviors in all leadership activities. * Perform other duties as assigned to support patient care and operational efficiency. Required Qualifications * High school diploma or GED. * Strong leadership, communication, and organizational skills. * Ability to manage competing priorities and support team performance in a fast‑paced environment. Preferred Qualifications * Bachelor's degree or equivalent experience. * One year of leadership experience in a healthcare or professional environment. * Proficiency with Microsoft Office and related systems. * Strong decision‑making, time‑management, and conflict‑resolution skills. * Knowledge of medical terminology. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.$29k-37k yearly est. Auto-Apply 22d ago
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