Navy Mutual jobs in Portland, OR

Health e Practices LLC, is excited to partner with The Portland Clinic to identify their next Chief Financial Officer. The following information is designed to outline the essential functions and position requirements of this job. It does not identify all tasks that may be expected, nor address the performance standards that must be maintained. Primary Function Responsible for partnering with staff and board leadership to ensure the financial success of The Portland Clinic. CFO oversees team of professionals who are responsible for the daily financial functions of the clinic. CFO analyzes current trends, proposes new tactics, measures results and recommends improvements. CFO works closely with CEO, CMO, COO, and other executives on execution of the clinic's strategic plan and is a key ex-officio member of the Executive Board of five Partner owners. Duties and Responsibilities: ( * Essential Functions) Analyze financial trends in all aspects of the clinic operation and present findings and recommendations to the executive leadership team for discernment and action.* Serve as an engaged participant on the Executive Chiefs Team, which guides the execution of The Portland Clinic Strategic Plan.* Prepare and offer timely, accurate and engaging presentations to all the Partners and Associates who attend the Quarterly Clinic Partnership meetings. Address physician questions, comments, and concerns in a timely manner.* Supervise team members as outlined in the TPC organizational chart. Ensure deadlines are met related to reporting, work queues, billing, and accuracy.* Maintain a positive team environment in these departments and conduct annual performance evaluations for all direct reports.* Serve as the clinic's chief liaison with critical contractors, including the clinic's primary bank, its outside accountant, cost reduction analysis personnel, etc.* Offer accurate, timely and insightful reports about the clinic finances to Executive Board. Also address all other issues related to finance that are on the agenda.* Supervise the preparation of the annual clinic budget. Collaborate with the controller and clinic supervisors on their portions of the budget.* Calculate and ensure the accuracy of provider compensation. Effectively communicate changes in compensation. Use the Partner/owner compensation formula to calculate pay and bonuses for all participants. Calculate quarterly the estimated retirement plan contributions for Partners.* Partner with team leaders on applications such as coverage for property, crime, D&O, Cyber, general liability, auto, and ASC.* Meet with associates interested in joining the partnership and calculate the impact of the partner formula and a comparison of their current status.* Invest monies regularly based on cash flow following the clinic's investment policy.* Collaborate closely with our outside auditors on the Clinic Annual Audit. Prepare necessary schedules and research all questions that they have based on their findings. Coordinate all tax filings with outside tax accountants.* Regularly evaluate financing options. Attend conferences and seminars that continually provide excellent information on the latest financial practices and where we can generate more revenue or save additional costs.* Regularly audit reports from health insurance plans related to risk pool settlements, to ensure their accuracy. Oversee Capital Budget requests and the process for approval, in working closely with Purchasing and the Value Analysis Team.* Oversee Portland Coordinated Care Association (PCCA). Assume projects given by the CEO or the Executive Board. Work in a cooperative manner with management/supervision, coworkers, customers, and vendors.* Abide by company policies.* Maintain regular, in person, work attendance and punctuality, as scheduled.* Other duties as assigned. Requirements: Minimum of 10 years of progressive financial management experience, ideally within a large physician-owned practice required. Minimum 2 years' experience in public accounting preferred. Bachelor's degree in healthcare administration, accounting, finance, or related field required. CPA or MBA strongly preferred. Experience/Qualifications/Skills Preferred: Experience managing finances in multi-specialty or equivalent health care business. Proven track record of producing accurate, timely, and insightful financial reporting. Strong leadership skills with experience managing and developing teams. Demonstrated ability to communicate complex financial concepts to non-financial stakeholders, particularly physician leaders or professional owners. Collaborative and strategic mindset with a commitment to teamwork and organizational success. Experience in using products such as: Microsoft Office(Excel, Work, PowerPoint, Access), Epicor Accounting Software with FRx report writer, EPIC (Electronic Health Record). Compassionate, patient, tactful, diplomatic, sociable, well organized, thorough, and independent. Planning, organizing, and delegation skills. Excellent communication skills, especially in presenting information to physicians and Executive Board. Skill in establishing and maintaining effective working relationships with Business Office, Executive Board, physicians, and other staff.

Aflac is actively seeking motivated, entrepreneurial-minded individuals to join our team as a Benefits Advisor. In this independent role, you'll introduce businesses to Aflac's supplemental insurance plans and help policyholders gain added financial peace of mind. Whether you're launching a new career or looking to grow in a professional sales role, this opportunity offers flexibility, unlimited income potential, and the support of a trusted Fortune 500 brand. Advantages of working with us: - Enjoy a flexible schedule - no nights, weekends, or holidays - Unlimited earning potential (commissions, renewals, performance bonuses, stock) - Access to company-provided leads and digital sales tools - World-class sales training and ongoing professional development - Bonus opportunities available in your first 3 months* - Offer policyholders added-value services: telehealth, financial wellness, and healthcare navigation** Responsibilities & requirements: - Partner with business owners to provide benefits solutions for their employees - Build a pipeline through lead generation, networking, referrals, and cold outreach - Conduct product presentations and enrollments in person or virtually - Support clients with claims and provide ongoing customer service - Participate in team training, mentorship, and development sessions - Excellent communication, relationship-building, and presentation skills - Sales or customer service experience is a plus, but not required - Must be 18+ and legally authorized to work in the U.S. (no visa sponsorship available) - Positive, professional, and self-motivated attitude About Aflac: At Aflac, we work directly with employers to deliver voluntary benefits to their employees while helping to solve issues small businesses face. Our Benefits Advisors can play a vital role in helping people when they need it most - when they're injured or ill - by providing financial protection and peace of mind so they can focus on recovery, not bills. *This is not a salaried position, Aflac Benefits Advisors earn commissions, bonuses, residual income, and stock. **Aflac's affiliation with the Value-Added Service providers is limited only to a marketing alliance, and Aflac and the Value-Added Service providers are not under any sort of mutual ownership, joint venture, or are otherwise related. Aflac makes no representations or warranties regarding the Value-Added Service providers, and does not own or administer any of the products or services provided by the Value-Added Service providers. Each Value-Added Service provider offers its products and services subject to its own terms, limitations and exclusions. Services, Terms and conditions are subject to change and may be withdrawn at any time. The value-added services may not be available in all states, and benefits/services may vary by state. Aflac Benefits Advisors are independent contractors and are not employees of Aflac. Aflac family of insurers includes American Family Life Assurance of Columbus and American Family Life Assurance Company of New York. Aflac WWHQ | 1932 Wynnton Road | Columbus, GA 31999 Z2500301 EXP 5/26

Job Brief:Job Role - Desktop Support Technician Job Summary Desktop Technician will provide day to day local\remote desktop support, receive inbound calls, answer questions, troubleshoot and document steps performed to resolve challenges with hardware, software and application issues in a ticketing system. The candidate will also need to facilitate customer resolution for calls and engage their supervisors and managers to ensure operational consistency across all shifts within the IT Support Center. Desktop Support Engineer provides Break Fix, fault diagnosis and resolution. Providing fault analysis to customer's various core operating systems and platforms, as well be able to provide support and apply desktop fault resolution for the approved application suite. Ideal candidate should have relevant 2-3 years' experience in Windows Desktop support. a) Provide first/second level contact and problem resolution for customer issues. b) Work with Third Party Vendors to remediate complex AV issues as needed. c) Provide timely communication on issue status and resolution. d) Maintain ticket updates for all reported incidents. e) Install, upgrade, support and troubleshoot XP, Windows 7, Windows 8.1, Windows 10 and Microsoft Office 2010, Cisco Jabber, another authorized desktop application. f) Should have basic knowledge of Mac operating system, to support Apple pc users. g) Install, upgrade, support and troubleshoot for printers, computer hardware. h) Performs general preventative maintenance tasks on computers, laptops, printers. i) Performs remedial repairs on Desktops, laptops, printers and any other authorized peripheral equipment. j) Use diagnostic tools to troubleshoot problems associated with network connectivity, and workstation hardware/software. k) Broad experience of IT with basic understanding of Networks, Servers, Audio/Visual, Smart Devices and Telecoms. l) This position requires the ability to work in a project-based environment requiring flexibility and teamwork. Performs other duties as assigned. Candidate Required Minimum Qualifications and Skills a) Bachelor's Degree or equivalent in Computer Science or related field. b) CompTIA A+, Microsoft Certified Professional (MCP) or better. c) Minimum of 18 months years of IT experience. d) Windows 7-10, Microsoft Active Directory, utilization of GPOs, MS Office 365, PC hardware installation and troubleshooting, Enterprise anti-virus solutions, Helpdesk ticketing systems. e) Mobile device management including IOS and Android devices, Enterprise encryption solutions, Windows PC/laptop management via Active Directory. f) Proven analytical, troubleshooting and problem-solving skills. g) Proven ability to multi-task, effectively determine priorities and meet SLA's. h) Excellent communication relationship-building and internal customer service skills. i) Adaptable and flexible in a fast-changing industry and work environment. j) Willing to work off-hours and weekends when required for projects or emergency support. Responsibilities: Skills Required:

Experience more with a career at COUNTRY Financial! We're excited you're interested in a career at COUNTRY as we strive toward our vision - to enrich lives in the communities we serve. Our footprint spans coast to coast. But more important than where we operate, is the people who do the work. Apply today to help our organization grow and make a difference for our clients. About the role Serves as an advisor and strategic business partner to captive/exclusive COUNTRY agents to help them market, sell, and service COUNTRY products and services. Cultivates rep agency growth by advising individual agents in developing their business plans, including setting sales targets and providing partnership and guidance throughout the agent's business lifecycle. Serves as liaison between agents, the home office and other field operations. How does this role make an impact? * Advises agents on best practices for selling the full array of COUNTRY offerings and managing a successful agency, taking ownership in agents' success. * Acts as a consultant, working with individual agents to develop their annual business plans to achieve/exceed growth targets under the Sales Compensation Program framework; communicates expectations and conducts regular check-ins to review progress and offer support/counsel. * Formally welcomes, mentors and provides leadership to new agents by counseling them on business plans, marketing strategies, and retention campaigns. * Partners with Agency Recruiting in local strategic recruitment efforts to source, plan, grow and retain a high-performing sales force. * Communicates and reinforces centralized COUNTRY product-related training and conferences, as well as other critical information, such as corporate strategy, company performance, new program/system rollouts, priorities and campaigns. * Develops a high-performing culture, focused on establishing a network for agents to make connections and share ideas; establishes personal networks and participates in professional societies. * Coordinates with Marketing to help execute initiatives aimed at maximizing the rep marketing budget. Do you have what we're looking for? * 5 years of business-to-business sales or territory management experience or a combination of related experience, education and training, including management experience. * Property & Casualty, Life/Health licenses - must complete within 30 days of hire. * SIE, Series 6 and 63 licenses - must complete within 6 months of hire. * COUNTRY Financial Advisor Program certification - must complete within 9 months of hire. * Normal office environment. * Work may extend beyond normal business hours as business needs dictate. * Regular travel required, including some overnight. Base Pay Range: $100,000 - $137,000 The base pay range represents the typical range of potential salary offers for candidates hired. Factors used to determine your actual salary include your specific skills, qualifications and experience. Incentive Pay: In addition to base pay, this position is eligible for Agency Sales Incentive as well as a Short-Term Incentive plan. Relocation If you do not reside within the sales territory, you would be subject to the following relocation expectations: * Establish temporary residency within your sales territory within 60 days from your start date * Establish permanent residency within your sales territory within 180 days from your start date Why work with us? Our employees and representatives serve nearly one million households with our diverse range of personal and business insurance products as well as retirement and investment services. We build relationships and work together to create a stronger, more secure future for our clients and our communities. We're a big company, yet small enough you can make an impact and won't get lost in the shuffle. You'll have the opportunity to learn and grow throughout your career, either within this role or by exploring other areas of our business. You'll be able to take advantage of our benefits package, which includes insurance benefits (medical, dental, vision, disability, and life), 401(k) with company match. COUNTRY Financial is committed to providing equal opportunity in all areas of employment, and in providing employees with a work environment free of discrimination and harassment. Employment decisions are made without regard to race, color, religion, age, gender, sexual orientation, veteran status, national origin, disability, or any other status protected by applicable laws or regulations. Come join our team at COUNTRY today!

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Maintain and enhance the Workday platform, ensuring efficient workflows, process improvement, and organizational compliance. Responsible for data integrity, workflows, system configuration, administrative system requests, issue resolution, security, reporting and data analysis and processing. Use strong HR experiences and knowledge to ensure Workday and ancillary systems are easy to use, apply best practices and meet the needs of employees, supervisors, and the organization. Maintain an extremely high level of confidentiality, accuracy, and integrity. Essential Responsibilities: As a member of the Workday team, manage and maintain HRs existing Workday modules and stay current on new functionality and modules to address future needs. Configure and update business processes, security roles, and integrations as needed. Prepare, test and execute annual Workday projects and tasks, including but not limited to, objective setting, mid- year and annual review processes. 9-boxing, bonus and merit processes, employee engagement, data integrity project, open enrollment, etc. Ensure timely and successful completion. Analyze, validate, and audit system data, ensuring data accuracy, and legal compliance. Develop custom reports and dashboards to provide meaningful data analysis. Maintain custom reports scheduled for automatic delivery. Import large scale data changes from spreadsheets or other applications to the HR system. Maintain working knowledge of HR areas to understand HR's software/data/reporting needs. Partner with HR Business Partners, SMEs, and business leaders to ensure the design and development of Workday functionality to meet the evolving needs of the business. Provide leadership, coaching and training support to all other staff across the organization that have Workday in their roles and responsibilities (i.e. super-users, HRBP's). Setup and maintain system configurations, automated business processes, system security; as well as integrations. Ensure compliance of design and system integration protocol/guidelines such that they meet internal standards. Provide direction and feedback to end users on issue resolution and affect change management, as well as guidance towards proper administrative and technical standards. Create training documents, videos and/or conduct training sessions with end-users, as necessary. Review and process various Workday HR Administrator tasks, including final approval on hires; job, data and location changes; manage delegation changes, cancel/rescind tasks; security changes, etc. Perform HR system testing for system implementations, upgrades, patches, and enhancements. Participate in Workday user-group meetings, trainings and conferences. Research and troubleshoot non-routine HR system issues, including creating and monitoring service requests with software vendors and consultants, as required. Proactively prepare for the bi-annual Workday release cycle. Research new functionality to be released and functionality to be deprecated. Collaborate with the Workday team and SMEs to share release details, establish a testing plan and ensure their testing is completed. Complete testing and ensure all general functionality, reports, integrations, etc. functions and make changes to business processes, fields, etc. as required. Manage multiple projects with competing priorities to ensure all requests are handled in a timely manner. Serve as liaison between HR, IT, external vendors, and other stakeholders for HRIS projects. Organize and oversee HR systems related projects. Build project plans and ensure adherence to schedule and other specifications. Oversee the completion of the annual Affirmative Action Plans as well as providing education to HR team members on the plan, requirements, results, etc. Oversee the completion of required federal and state reporting requirements such as EEO, Vets, etc. Perform other related duties as assigned. Supporting Responsibilities: Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. SUCCESS PROFILE Work Experience: Minimum of 7 years of experience working in Human Resources required. Prior HR-system experience including implementation, administration, configuration, testing, troubleshooting, and/or providing technical support required. Prior experience with Workday strongly preferred. Experience leading and executing projects from start to finish required. Education, Certificates, Licenses: Bachelor's degree required. Candidates with an associate's degree and 2 years of relevant experience, or a high school diploma and 4 years of relevant experience, in addition to the required minimum years of Work Experience will also be considered. Preferred area of focus: Human Resources Management, Business Administration, or related field. Knowledge: Strong understanding of HR workflows and system dependencies. Ability to work well under changing priorities and deadlines, with frequent interruptions, while maintaining a high customer service standard. Ability to work independently and manage multiple projects simultaneously while remaining organized and meeting project timelines. Ability to manage multiple complex projects simultaneously. Ability to guide internal customers through the design and delivery of new functionality through a thorough understanding of data and the organization structure. Experience performing analysis of data to meet the needs of customers (HR Business Partners, Business or Functional Leaders, Legal team, external parties) and to aid in decision making. Experience working cross functionally with teams to gather information/data needed to conduct business needs analysis, drive and deliver consensus, move updates forward and provide project results to senior management. Ability to interact with and present to all levels of leadership across the company. Ability to anticipate future consequences and trends and use good judgment about which ideas and suggestions will work and can facilitate effective brainstorming. Ability to quickly zero in on the highest priorities that add the most value. Eliminate roadblocks and quickly sense what will help or hinder accomplishing a goal. Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Collaborate closely with physicians, nurses, social workers and a wide range of medical and non-medical professionals to coordinate delivery of healthcare services. Assess the member's specific health plan benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services which promote quality, cost-effective outcomes by helping member populations achieve effective utilization of healthcare services. Facilitate outstanding member care using fiscally responsible strategies. Essential Responsibilities: Collect and assess member information pertinent to member's history, condition, and functional abilities in order to promote wellness, appropriate utilization, and cost-effective care and services. Coordinate necessary resources to achieve member outcome goals and objectives. Accurately document case notes and letters of explanation which may become part of legal records. Perform concurrent review of members admitted to inpatient facilities, residential treatment centers, and partial hospitalization programs. Maintain contact with the inpatient facility utilization review personnel to assure appropriateness of continued stay and level of care. Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions. Review referral and preauthorization requests for appropriateness of care within established evidence-based criteria sets. When applicable, identify and negotiate with appropriate vendors to provide services. When appropriate, negotiate discounts with non-contracted providers and/or refer such providers to Provider Network Department for contract development. Work with multidisciplinary teams utilizing an integrated team-based approach to best support members, which may include working together on network not available (NNA), out of network exceptions (OONE), and one-time agreements (OTA). Serve as primary resource to member and family members for questions and concerns related to the health plan and in navigating through the health systems issues. Interact with other PacificSource personnel to assure quality customer service is provided. Act as an internal resource by answering questions requiring medical or contract interpretation that are referred from other departments, as well as physicians and providers of medical services and supplies. Assist employers and agents with questions regarding healthcare resources and procedures for their employees and clients. Identify high cost utilization and refer to Large Case Reinsurance RN and Care Management team as appropriate. Assist Medical Director in developing guidelines and procedures for Health Services Department. Supporting Responsibilities: Act as backup and be a resource for other Health Services Department staff and functions as needed. Serve on designated committees, teams, and task groups, as directed. Represent the Heath Services Department, both internally and externally, as requested by Medical Director. Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. SUCCESS PROFILE Work Experience: Minimum of three (3) years of nursing or behavioral health experience with varied medical and/or behavioral health exposure and capability required. Experience in acute care, case management, including cases that require rehabilitation, home health, behavioral health and hospice treatment strongly preferred. Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Registered Nurse or a clinically licensed behavioral health practitioner with current unrestricted state license. Within six (6) months of hire licensure may need to include Oregon, Montana, Idaho and/or other states as needed. Case Manager Certification as accredited by CCMC preferred. Knowledge: Thorough knowledge and understanding of medical and behavioral health processes, diagnoses, care modalities, procedure codes including ICD and CPT Codes, health insurance and state-mandated benefits. Understanding of contractual benefits and options available outside contractual benefits. Working knowledge of community services, providers, vendors and facilities available to assist members. Understanding of appropriate case management plans. Ability to use computerized systems for data recording and retrieval. Assures patient confidentiality, privacy, and health records security. Establishes and maintains relationships with community services and providers. Maintains current clinical knowledge base and certification. Ability to work independently with minimal supervision. Must be able to function as part of a collaborative, cohesive community. Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Accountable for the effective management of appeals clinical staff. Responsible for hiring, training, coaching, counseling, and evaluating team member performance. May be called upon to perform routine day-to-day program functions. Actively participate in program development and implementation. Supervise and provide guidance to direct reports and other department staff regarding company policies, procedures, and operations. Manage the quality and productivity of team tasks and workflow as they relate to both assigned functions and the overall effectiveness of the Health Services team. Work to resolve issues and improve processes and outcomes. Essential Responsibilities: Take a leadership role in the development, implementation, and ongoing operation and maintenance of assigned programs, services, or functions. Improve the performance of the department through effective oversight and coaching of team members, managing team performance and improving processes and outcomes. Monitor daily workflow and caseloads and other work processes of team to assure appropriate distribution and processing of tasks. Responsible for the orientation and training of new hires. Provide ongoing supervision, training, evaluation, and leadership to assigned team members. This may include annual reviews, involvement in promotions and/or terminations of employees. Participate in hiring decisions in concert with Appeals and Grievance Director and HR. Monitor and evaluate team assignments relating to volumes, timelines, accuracy, customer service, and other quality and performance measures, and take actions as appropriate. Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize LEAN methodologies for continuous improvement. Monitor key performance indicators and identify improvement opportunities. Serve as liaison with other PacificSource departments or community partners to coordinate optimal provision of service and information. Serve on various internal and external committees as required or designated. Document and report any pertinent communications back to the team or department. Utilize and promote use of evidence-based medical criteria. Maintain modified caseload consistent with assigned responsibilities. Facilitate investigation and resolution of process-related issues as needed. Facilitate conflict resolution, including interfacing with affected departments and individuals, as appropriate. Oversee and assist in providing exceptional service and information to members, providers, employers, agents, and other external and internal customers. Provide backup to other departmental teams or management staff, as needed. Supporting Responsibilities: Meet department and company performance and attendance expectations. Relate new or revised policies, procedures and/or processes to team members to ensure they have the most up‐to‐date and current information. Facilitate team operations by discussions through the sharing of information and knowledge, identification of teamwork issues, development of problem‐solving recommendations, and recommendations of standardizing Health Services operations. Represent the Appeals and Grievance Department, both internally and externally, as requested by Appeals and Grievance Manager and/or Director. Perform other duties as assigned. Work Experience: A minimum of five years clinical experience required. Minimum of three years direct health plan experience in the following areas: utilization management, grievance and appeal, or claims review strongly preferred. Prior supervisory experience preferred. Education, Certificates, Licenses: Registered Nurse/Licensed Social Worker with current appropriate unrestricted state license. Within 6 months of hire licensure may need to include Oregon, Montana, Idaho, Washington and/or other states as needed. Knowledge: Knowledge of health insurance and state mandated benefits. Thorough knowledge and understanding of medical procedures, diagnoses, care modalities, procedure codes (including ICD-10, HCPC CPT codes). Effective adult education/teaching and/or group leadership skills. Ability to deal effectively with people who have various health issues and concerns. Strong analytical and organizational skills with experience in using information systems and computer applications. Flexible to meet the departments changing needs Ability to develop, review, and evaluate utilization and case management reports. Good computer skills including experience with Word, Excel, and PowerPoint. Ability to use audio-visual equipment. Ability to work independently with minimal supervision. Competencies Building Trust Building a Successful Team Aligning Performance for Success Building Customer Loyalty Building Strategic Work Relationships Continuous Improvement Decision Making Facilitating Change Leveraging Diversity Driving for Results Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Iron Horse Studio is hiring a Senior Webflow Design Lead to push the creative bar for B2B brands. You will shape concepts, art direct visual systems, and translate brand stories into elegant, performant Webflow experiences. From motion and microinteractions to componentized libraries in Figma and Webflow, you will craft work that feels awesome and moves the needle on KPIs. You will mentor designers, lead critiques, and partner with content, engineering, and analytics to ship work that is imaginative and measurable. You're a good fit for Iron Horse if: You are a designer first, with a portfolio that shows award-caliber creative across web, motion, and brand You turn business goals into creative concepts and clear narratives You use animation and micro interactions to enhance clarity and delight You believe constraints like accessibility, performance, and SEO sharpen the idea We're a good fit for you if: You want to lead a Webflow practice serving B2B brands You like fast cycles: concept → prototype → ship → learn You value tasteful motion, tight typography, and polished details You pair creative exploration with analytics and CRO What you'll do. Lead Webflow design and development, architecting modular design systems that scale creativity and maintainability Elevate design quality by defining standards for UX, accessibility, performance, and editorial voice and by enforcing quality gates and documentation Create concept to launch workflows that include prototypes, motion language, and micro interactions consistent with brand stories Infuse AI and analytics into delivery using research synthesis, generative exploration, automated QA, and experiment design to validate lift Support CMS migrations to Webflow Enterprise, shaping content models, collections, redirects, and SEO hygiene in collaboration with strategy, content and engineering Mentor and inspire designers through critiques, coaching, playbooks, and portfolio development Collaborate cross-functionally with account, content, engineering, analytics, and strategy to deliver on time and on budget and to measurable outcomes Champion studio innovation through thought leadership, showcases, and repeatable best practices What we're looking for. Experience and skills 6-10+ years in B2B UX/UI/web design, including 4+ years of commercial Webflow work; Mastery of Figma + Webflow with strong component libraries and design system documentation. Portfolio that demonstrates systems thinking, tasteful motion, and campaign-level craft applied to marketing sites Proven migration experience delivering performance and SEO aware builds with confidence in analytics, CRO led experimentation, and structured QA Proficiency with Mast, Finsweet Client-First, GSAP, Javascript, and semantic HTML/CSS. Ability to manage multiple projects and priorities in a fast-paced, collaborative environment Mindset and traits Art direction combined with pragmatic systems thinking Clear communicator capable of simplifying choices and aligning teams. Mentor who raises the bar while moving quickly and protecting quality Why join us? Join a values driven, ego-less team with real ownership and access to leadership Enjoy flexible remote, hybrid, and on-site options with a healthy work-life balance Get strong benefits, including medical, dental, vision, parental leave, mental health resources, and generous PTO, including your birthday Grow through team events, learning programs, and cross-functional collaboration Work where diversity is celebrated and inclusion is a commitment, not a slogan Additional details. This position is open only to candidates who reside in the United States and are already legally authorized to work here on a full-time basis. This position is remote but requires availability during standard U.S. business hours (typically 9:00 a.m. to 5:00 p.m. in your designated time zone). Occasional flexibility may be needed based and periodic travel may be required. This role is eligible for a discretionary annual bonus and a comprehensive benefits package, including medical, dental, vision insurance, paid time off, 401(k), basic life insurance, Flexible Savings Account, and long- and short-term disability insurance. About Iron Horse Studio Iron Horse Studio is the Webflow Enterprise practice inside Iron Horse, where design craft and demand generation live together. We embrace AI-forward thinking, rapid experimentation, and outcome-focused strategies to help brands innovate with speed and precision. Join a passionate team committed to exploring what's next-where advanced tools, collaborative culture, and the art of making converge for real business impact.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. The Senior Director, Product and Regulatory Management is responsible for leading teams in three key domains: 1) the development, implementation, and management of the end-to-end product lifecycle for Medicare and commercial lines of business; 2) efficient and effective commercial business administration; and 3) compliant and effective regulatory communications. Working with company leadership, the Senior Director is responsible for developing and implementing products that achieve membership and profitability targets. In support of strategic business plans developed by the leaders responsible for profit and loss of the lines of business, this position ensures the product lifecycles, annual roadmaps, filings, and communications meet business needs. The Senior Director ensures the organization complies with product, filing, and communication-related processes and timelines, as well as manages major milestones, risk and mitigation planning, tracking and reporting, and communication across the organization. The Senior Director leads product strategy, development, the annual bid process, and corresponding initiatives. The product portfolio includes Medicare Advantage, Dual Special Needs Plan (DSNP), fully insured group business, and Individual offerings, on and off exchange, as well as corresponding regulated filings and materials. The communications portfolio supports regulated communications, predominantly for Medicare Advantage, DSNP, and Medicaid plans. The Senior Director manages a leadership team to deliver on this critical work. Essential Responsibilities: Lead the product portfolio development and execution strategy across segments and multiple plan years. Direct the Medicare and Commercial product strategy and portfolio management to ensure profitable growth consistent with business plans. Oversee each step of the work from development to assessment and implementation. Lead, coordinate, and communicate product and lifecycle activities with others in the organization. Oversee successful and timely annual bids, filings, related regulatory submissions, and go-to-market activities. Oversee development and deployment of regulatory communication materials and processes, including Annual Notice of Change, directories, Evidence of Coverage, handbooks, formulary materials, forms, letters, and other regulated materials. Oversee the preparation of all filings and compliant regulatory documents across the product portfolio, including health contracts, self-funded materials, and related documents. Oversee implementation of state and federal benefit mandates, including benefit changes and member communication requirements. Provide strategic advice for PacificSource teams to ensure plan information is accurate and available timely within required timeframes. Ensure proactive communication of new and revised plan designs and benefits to internal stakeholders. Develop and improve processes, driving administrative efficiencies and cost savings, including leading in a matrixed environment and emphasizing execution, market positioning, and operational tactics. Drive operational excellence, sustainability, and profitable growth. Generate local competitive market insights to drive innovation and decision making. Conduct market research, competitive analysis, and financial assessments to evaluate improvement opportunities and business strategies in concert with PacificSource's enterprise strategy. Implement strategies across segments and markets. Develop structures and processes to ensure compliance, including leading cross-functional teams. Collaborate with Marketing, Sales, Operations, Health Services, and Compliance. Develop strategic business partnerships with internal departments and leaders to ensure strong operating performance, high member satisfaction and quality performance, access, compliance and audit readiness, and sound financial performance. Work closely with Compliance and others to ensure policies, procedures, workflows, lifecycle strategies, product offerings, and success initiatives comply with state and federal regulations. Participate in compliance audits, activities, and planning. Negotiate business relationships with vendors and oversee the execution, implementation, and oversight of the contracts. Develop and monitor departmental budgets and take corrective action as necessary. Provide leadership and mentoring to the enterprise product team, the business administration team, and the regulatory communications team. Foster leadership development and advancement. Develop succession plans. Manage, coach, motivate, and guide employees. Support the organization's commitment to diversity, equity, inclusion, and belonging by fostering a culture of dignity, cultural awareness, compassion, and respect. Supporting Responsibilities: Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy HIPAA laws, and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. SUCCESS PROFILE Work Experience: Minimum of eight years of experience in product, portfolio, lifecycle management, and regulated communications, or substantially equivalent work in highly regulated functions. Exemplary work history with a proven record of success in positions of progressively greater responsibility managing people and achieving business goals and objectives. A solid grasp of the managed care field and insurance regulations is crucial for this role. Experience with strategic planning, communications, sales, product development, regulatory filings, and managing teams required. Leadership experience in a managed care organization requiring advanced knowledge of products, regulatory filings, and regulated communications. Experience with end-to-end product development and lifecycle management of Medicare Advantage, Individual, and group segments, on and off exchange. Experience providing oversight to ensure the successful regulatory filing of all required product materials. Demonstrated success working in a matrixed environment with the ability to set a path and inspire others to follow. Proven record of accomplishment as a driver of process improvement and identifier of efficiency opportunities and ability to lead change. Experience with federal and state regulatory compliance for health insurance plans. Proven ability to quickly assimilate information and make informed decisions; logical, analytical thinker with great influencing abilities; and ability to handle multiple priorities and deal with ambiguity. Education, Certificates, Licenses: Bachelor's degree required with a focus in health care administration, business, public policy, public health, or a related field. Master's degree or other advanced degree preferred. Knowledge: Advanced knowledge of Medicare Advantage, DSNP, fully insured group business, and Individual, on and off exchange, along with a deep understanding of the key attributes, competencies, and strategies for success. Advanced knowledge of state and federal regulations. Knowledge of self-funding arrangements is preferred but not required. Strong understanding of managed care and publicly financed or subsidized health care, including the intersection between retail Medicare Advantage, DSNP, and Medicaid. Demonstrated experience and success in working collaboratively in defining and achieving common goals. Ability to communicate, persuade, influence, and negotiate effectively. Comprehensive knowledge of business principles and administration, organization, and management activities, including knowledge of infrastructure and operational requirements needed to comply with regulatory mandates. Excellent verbal and written communication skills. Solid organizational and problem-solving skills with a keen eye for detail. Proficiency in analyzing market trends, conducting competitive research, and developing strategic product and portfolio roadmaps is essential for success. The ability to multitask, prioritize competing demands, and adapt to a changing regulatory environment is key. Competencies Authenticity Establishing strategic direction Customer focus Leading change Empowerment/delegation Building organizational talent Coaching and developing others Passion for results Cultivating networks Emotional intelligence Optimizing diversity Environment: Work remotely and inside in a general office setting with ergonomically configured equipment. Travel is required approximately 20% of the time. Skills: Accountable leadership, Business & financial acumen, Empowerment, Influential Communications, Situational Leadership, Strategic Planning Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Develop, coordinate, and provide employee orientation/education programs that encompass onboarding new employees as well as continuing education for all Utilization Management (UM) non-clinical staff. Develop and maintain policies and procedures, desktop references, and resource materials. “Train the trainer” by facilitating training and being a mentor for UM subject matter expert roles within Health Services (HS). Demonstrate effective leadership by developing teamwork, managing change, and encouraging innovation and staff involvement in utilization management. Support and develop initiatives that reflect the department vision and are committed to achieving the goals and objectives of Health Services. Essential Responsibilities: Develop, maintain, and present training programs in coordination with Health Services leadership and other training coordinators which ensure the UM team is trained to provide exceptional customer service, meet ongoing operational and regulatory needs, and achieve quality outcomes. Develop, organize, and maintain a centralized electronic system of standardized reference tools and training materials that reflect current practice and compliance standards both internally as well as within the broader health insurance industry. Ensure regulatory compliance with all state and federal guidelines as well as other accrediting entities. Assist with audit processes at least quarterly. Ensure UM materials are in a state of audit readiness. Participate in onsite audits as requested. Ensure that each new hire is provided with the tools to successfully begin their new position. Meet with the new employee regularly within their first 90 days of employment and at supervisor discretion thereafter to determine additional educational needs. Responsible for training and providing updates of new and revised team resource and training material to Health Services staff. Utilize LEAN methodologies and quality improvement principles to practice and promote continuous improvement; utilize visual boards and daily huddles to monitor and communicate key performance indicators (KPI) and identify opportunities for improvement and evaluation of actions taken. Participate in Health Service department and team meetings and other meetings as assigned. Assist employers, agents, and provider partners as indicated with questions regarding healthcare resources and procedures for employees, members and clients as indicated. Serve as a liaison to PacificSource departments to coordinate optimal provision of utilization management services and information. Assist with answering external and internal inquiries, providing exceptional service. Supporting Responsibilities: Act as backup for other Health Services department staff as needed and within scope of licensure. Serve on designated committees, teams, and task groups, as directed. Represent the Heath Services department, both internally and externally, as requested by Medical Director and Health Services leadership. Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. Work Experience: A minimum of four years of health insurance industry or medical background required. A minimum of two years working in the PacificSource Health Services Department preferred. Demonstrate an overall understanding of utilization management and claims costs. Education, Certificates, Licenses: High school degree or equivalent required. Knowledge: Microsoft Office software including Word and Excel. CPT/ICD-9 coding, call tracking software, mainframe and medical management software. Thorough knowledge of utilization management, including referral and preauthorization, to support continuity of care. Knowledge of health plan eligibility, benefits, medical interventions and management. Strong knowledge of medical terminology. Ability to work under time pressure. Ability to prioritize responsibilities and to diplomatically handle demanding situations. Ability to work independently with minimal supervision. Must be able to function as part of a collaborative, cohesive community. Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 25% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

We're looking for an experienced insurance professional to manage an established and active book of business. This book is positioned for continued growth across the full line of COUNTRY Financial products and services. COUNTRY Financial Insurance Agents have the opportunity and the autonomy to build a rewarding, financially stable career while enriching lives in the communities we serve. The Book of Business Details: Total P/C Premium**: $1,800,000 - $2,000,000 Total Financial AUC**: N/A Farm Certification***: No The Career Our insurance agents take a consultative approach to grow business with existing and prospective clients. As independent contractors, they are in business for themselves but not by themselves, and they: Diversify their income through our portfolio of property and casualty, life and health lines. Have the flexibility to manage their schedules to balance their careers and personal interests. Educate clients and prospects about our products and services. Collaborate with COUNTRY Trust Bank Financial Advisors to inform clients of our financial products and services. Establish an office and build a staff. We Offer COUNTRY Financial Insurance Agents have uncapped earning potential and: Opportunities to earn performance-based global trips and financial rewards. Access to continued learning and marketing resources. Affiliation with our 100-year-old brand heritage and family-focused culture that values authenticity and integrity. There is no buy-in required. Qualifications Successful COUNTRY Financial Insurance Agents are: Entrepreneurial, motivated, and goal driven. A strong communicator with excellent business acumen. Committed to linking your efforts with tangible rewards. Passionate about making positive impacts in their communities. Required Licenses* Property/Casualty State Insurance License* Life/Health State Insurance License* Preferred Experience Bachelor's Degree 2+ years of experience in the insurance and or financial services industry 5+ years of business ownership or managerial experience About Us COUNTRY Financial is the trade name for a collective of affiliated insurance and financial services companies. This means we have an extended family of support and a large backing. Since 1925, COUNTRY Financial has been dedicated to helping others plan for their future while also protecting what matters most to them. What started long ago as a simple commitment on Midwest farmlands has expanded to become a FORTUNE 1000 insurance and financial services organization proudly serving 19 states. Our insurance agents, financial advisors, and employees remain dedicated to serving nearly one million households with our diverse range of personal and business insurance products as and financial services products. And our consistent AM Best A+ rating means we have the financial strength to keep the promises we make to our clients. *These licenses are not required to apply; however, the candidate's ability to obtain these licenses is essential when a contract decision is made. **The Premiums and AUC indicated above are the estimated amounts. These amounts may change and are not guaranteed. Future value/size will depend on the strategies, tactics, and efforts of the agent, in addition to external factors including but not limited to pricing trends in the marketplace, competitive intensity, consumer preferences, client relationships, etc. ***Farm Certifications are done annually in January. If marked “Yes”, the agent must obtain certification the following January as a condition of the agent's contract. COUNTRY Financial is the marketing name for the COUNTRY Financial family of affiliated companies (collectively, COUNTRY), which include COUNTRY Life Insurance Company , COUNTRY Mutual Insurance Company , and their respective subsidiaries, located in Bloomington, Illinois. Investment management, retirement, trust, and planning services provided by COUNTRY Trust Bank . The investment objectives, risks, charges, and expenses of an investment company should be carefully considered before investing.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. The Manager of Case Management for Rising and Emerging Risk leads a specialized team focused on early identification, proactive engagement, and targeted interventions for members showing early signs of increasing health risk. This leader is responsible for ensuring members receive the right level of support at the right time to prevent avoidable escalation into moderate or high-risk categories. The role includes strategic oversight, operational leadership, and staff development to deliver high-quality, coordinated care management services that stabilize member health, reduce future utilization, and advance Pacific Source's population health goals. Essential Responsibilities: Responsible for oversight, management, development, implementation, and communication of department programs. Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports. Develop annual department budgets. Monitor spending versus the planned budget throughout the year and take corrective action where needed. Oversee the use of risk-stratification tools, predictive analytics, and member segmentation to identify rising-risk members early and prevent escalation into moderate or high-risk tiers. Partner with Analytics to refine forecasting models and ensure actionable data drives daily workflows and intervention strategies. Align closely with Transitions of Care teams to reduce re-admissions and maintain continuity of care. Ensure case management activities, documentation, and care plans meet regulatory and accreditation standards (e.g., CMS, OHA, NCQA). Monitor and improve member satisfaction, engagement, and activation in the care management program. Promote person-centered care by ensuring individualized care plans reflect member goals, preferences, and cultural considerations. Track outcomes for program improvement and support continuous optimization of member interventions. Develop short- and long-term strategic plans for the rising/emerging risk program, ensuring alignment with enterprise goals including Member Bridge and cost-of-care initiatives. Lead readiness efforts for major organizational initiatives (e.g., Epic, new analytic tools, vendor partnerships). Coordinate business activities by maintaining collaborative partnerships with key departments. Responsible for process improvement and working with other departments to improve interdepartmental processes. Utilize lean methodologies for continuous improvement. Utilize visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities. Actively participate as a key team member in Manager/Supervisor meetings. Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy. Lead and manage case management programs for rising and emerging risk populations, ensuring compliance with regulatory standards and organizational objectives. Collaborate with Health Services leadership and cross-functional teams to design, implement, and optimize care management processes, including physical and behavioral health integration. Develop and maintain workflows and data systems to track caseloads, program effectiveness, and patient outcomes, ensuring timely reporting and actionable insights. Provide leadership in hiring, training, coaching, and performance management of case management staff, fostering a culture of collaboration, accountability, and professional growth. Ensure timely communication of high-cost or complex cases to finance, underwriting, and leadership teams for risk mitigation and resource planning. Serve as a liaison with internal departments, provider networks, and community partners to coordinate care management programs that enhance member outcomes. Oversee and participate in clinical interdisciplinary rounds with our medical directors, utilization management, disease management, appeals and grievance and behavioral health to ensure members' needs are met. Monitor adherence to privacy standards and regulatory requirements, maintaining the integrity of personal health information. Establish and track goals for care management programs related to caseloads, timeliness, quality, and member outcomes, and report progress to senior leadership. Establish and track goals pertaining to enterprise metrics related to reduction in length of stay, reduction in readmission and reduction in hospital admissions. Stay current with best practices in case management and care coordination through continuing education and apply innovative models of care. Supporting Responsibilities: Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. SUCCESS PROFILE Work Experience: Minimum 5 years in case management or care coordination required. 3 years direct health plan experience in case management, disease management, care coordination, or equivalent preferred. Prior supervisory or management experience required. Education, Certificates, Licenses: Registered Nurse or Licensed Clinical Social Worker or other licensed healthcare or behavioral health care clinician, Oregon licensure required. Certified Case Manager Certification (CCM) as accredited by CCMC (The Commission for Case Management) strongly desired at time of hire. CCM certification required within two years of hire. Knowledge: Thorough knowledge and understanding of medical and behavioral health procedures, diagnoses, and treatment modalities, procedure codes, including ICD-9 & 10, DSM-IV & V, CPT codes, health insurance and State of Oregon mandated benefits. Knowledge of community services, providers, vendors and facilities available to assist members. Strong knowledge of health insurance; including managed care products as well as state mandated benefits. Ability to develop, review and evaluate utilization and care management reports. Experience in adult education preferred. Proficient in the use and implementation of the following tools and concepts across all teams within scope and accountability: Training, Coaching, Strategy Deployment, Daily Operations, Visual Management, Operational Improvement & Team Building/Development. Competencies Building Trust Building a Successful Team Aligning Performance for Success Building Partnerships Customer Focus Continuous Improvement Decision Making Facilitating Change Leveraging Diversity Driving for Results Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 20% of the time. Skills: Accountable leadership, Collaboration, Data-driven & Analytical, Delegation, Effective communication, Listening (active), Situational Leadership, Strategic Thinking Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Claims Call Center Analyst I at AllCare Health with the Claims department in Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options. Summary of the Position This position serves as a primary point of contact for provider offices, managing high volumes of incoming phone calls and email inquiries with professionalism and accuracy. The role focuses on building and maintaining positive provider relationships by delivering timely resolutions, aiming for a 95% same-day call resolution rate. In addition to frontline support, the position includes claims processing responsibilities during designated rotation periods by performing the following duties: Essential Duties Provider Communication & Support - Respond promptly to inbound calls and provider portal emails from provider offices or their authorized representatives, ensuring inquiries are addressed with professionalism and accuracy. Documentation & Resolution - Accurately document all calls in the incident module of the core claims system (or other approved software). Reprocess claims when appropriate and ensure provider concerns are resolved effectively. Inquiry Management - Understand and address provider inquiries by reviewing prior case history, gathering and researching relevant data, and delivering accurate responses. Confirm provider understanding of the information shared. Being bilingual in another language, including American Sign Language (ASL), is an invaluable skill that enhances our ability to deliver culturally responsive care. We strongly encourage you to apply if you are bilingual. All relevant experience can be listed in your resume to perform essential duties of the position including the following: lived, volunteer, professional, or a combination of experience and education . Education High school diploma or general education degree (GED). Experience Six months to one-year experience and/or training in claims, call center or Healthcare related position. Certificates, Licenses, and/or Registrations An AAPC Certified Professional Coder certificate is required or to be obtained within 12 months of hire date. Cost of certification is company paid and is subject to pay increase upon completion. Technical Skills Proficiency in Ez Cap, medical terminology, ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and familiarity with CMS-1500, UB-04, and other standard claim forms. Demonstrates advanced customer service skills, including service recovery and multi-line call center operations. Skilled in healthcare industry practices, HIPAA compliance, and trauma-informed care. Strong computer literacy, including Microsoft Office, with excellent writing, editing, and organizational abilities. Experienced in interpreting data, identifying process improvements, and synthesizing information from multiple sources. Knowledgeable in training best practices, adult learning principles, and the impact of identity, bias, and equity in organizational systems. Interpersonal Skills Demonstrates accountability, empathy, and professionalism while working effectively in a fast-paced, multicultural environment. Communicates clearly, resolves conflicts independently, and collaborates across diverse teams. Adapts to change, manages stress, and prioritizes tasks to meet competing deadlines. Applies sound judgment, cultural awareness, and inclusive practices to deliver respectful, high-quality service to all individuals. Physical Demands & Work Environment The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties. The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The noise level in the work environment is usually moderate. The employee must be able to work onsite as needed. The employee must be able to work from a home office as needed. Company Overview AllCare Health Website: ****************************** AllCare Health is incorporated as an Oregon Benefit Corporation and has earned the coveted Certified B Corp status since 2017. As such, AllCare Health considers its impact on community, society, and the environment in all business decisions. We have long recognized the value in social, economic, and environmental concerns of our employees, customers, and community members. (Learn more about B Corps at *************************************** AllCare Health headquarters are located in Grants Pass in Southern Oregon on the Rogue River, surrounded by mountains, forests, small farms, and breathtaking views. This thriving and energetic community is ideal for families and outdoor enthusiasts, with a temperate Pacific Northwest climate. We enjoy easy access to outdoor sports and recreation, river rafting, fishing, hiking, biking, wineries, outdoor concerts, the world-famous Ashland Shakespeare Festival, the stunning Oregon coast, magnificent redwood forests, pristine beaches, and much more. The AllCare Health family of businesses is guided by our corporate principles: Purpose | Working together with our communities to improve the health and well-being of everyone. Values | Trust, Innovation, Relationships, and Voice. Vision | Thriving, Inclusive, and Equitable communities. Brand Promise | Changing Healthcare to Work for You. AllCare Health is dedicated to building a diverse and authentic workplace centered in belonging and serving our growing community. If you are excited about this open position but your experience does not align perfectly with every qualification in this post, we encourage you to apply anyway or reach out to our human resources department. You may just be the right candidate for this role or others. If you need accommodations, help in the application process, or wish to receive this job announcement in an alternative format, please call ************ and ask for Human Resources. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disabled status, or genetic information. Monday - Friday; 8am - 5pm with a 1 hour unpaid lunch and two 15 minute paid breaks 40 hours per week

We're looking for ambitious and established candidates who want to own their business and help clients prepare for life's planned and unexpected moments with the right financial services and insurance products. Our financial advisors are contracted as COUNTRY Trust Bank Financial Advisors, Registered Representatives of COUNTRY Capital Management Company, and Insurance Agents of COUNTRY Life Insurance Company and COUNTRY Mutual Insurance Company and their subsidiaries. The Career COUNTRY Trust Bank Financial Advisors take a consultative approach to grow business with existing and prospective clients. As independent contractors, they are in business for themselves but not by themselves, and they: Diversify their income through multiple product lines beyond financial services. Leverage the portfolio of property and casualty, life and health, and annuities and investment products and services. Educate clients and prospects about our products and services. Collaborate with COUNTRY Financial Insurance Agents to secure business. Establish an office and build a staff. Conduct financial solution seminars. Have the flexibility to manage their schedules to balance their careers and personal interests. We Offer Our financial advisors have uncapped earning potential and: Opportunities to earn performance-based global trips and financial rewards. Access to continued learning and marketing resources. Corporate office support. Affiliation with our 100-year-old brand heritage and family-focused culture that values authenticity, integrity, and inclusivity. There is no buy-in required. Qualifications Successful COUNTRY Trust Bank Financial Advisors are: Entrepreneurial and self-motivated. Goal-driven with track records of business growth in the insurance and or financial services industry. Strong communicators with excellent business acumen. Committed to building and maintaining solid connections between their efforts and their rewards. Focused on achieving professional success through securing clients' trust. Passionate about making positive impacts in their communities. Required Qualifications Series 6/63 licenses Passed SIE Life/Health State Insurance License* Property/Casualty State Insurance License* Preferred Experience Accredited Asset Management Specialist (AAMS) Chartered Financial Analyst (CFA) Certified Public Accountant (CPA) Certified Financial Planner (CFP) Chartered Financial Consultant (ChFC) Bachelor's Degree 2+ years of experience in the insurance and or financial services industry 5+ years of business ownership or managerial experience About Us COUNTRY Financial is the trade name for a collective of affiliated insurance and financial services companies. This means we have an extended family of support and a large backing. Since 1925, COUNTRY Financial has been dedicated to helping others plan for their future while also protecting what matters most to them. What started long ago as a simple commitment on Midwest farmlands has expanded to become a FORTUNE 1000 insurance and financial services organization proudly serving 19 states. Our insurance agents, financial advisors, and employees remain dedicated to serving nearly one million households with our diverse range of personal and business insurance products as and financial services products. And our consistent AM Best A+ rating means we have the financial strength to keep the promises we make to our clients. *These licenses are not required to apply; however, the candidate's ability to obtain these licenses is essential when a contract decision is made. COUNTRY Financial is the marketing name for the COUNTRY Financial family of affiliated companies (collectively, COUNTRY), which include COUNTRY Life Insurance Company , COUNTRY Mutual Insurance Company , and their respective subsidiaries, located in Bloomington, Illinois. Investment management, retirement, trust, and planning services provided by COUNTRY Trust Bank . The investment objectives, risks, charges, and expenses of an investment company should be carefully considered before investing.

Senior Insurance Loss Control Consultant Job Description At Alexander & Schmidt, a Senior Loss Control Consultant performs inspections and prepares in-depth reports for insurance underwriting purposes. Insurance companies use the reports to properly insure a commercial building, or business operations, for a new policy or renewal of a current policy. Required Skills A Minimum 10 years' experience with a major carrier or working as an independent contractor providing loss control services. Extensive understanding of commercial property and casualty lines. Property assessments will potentially include the necessity to determine adequacy of sprinkler systems based on occupancy, commodities and racking systems. Inland Marine coverages will include builders risk, contractor's equipment, motor truck cargo, WLL and MOLL and other specialty coverage's. Commercial General Liability will include Premises, Operations, Products and Completed Operations. Workers Compensation assessments for regulatory compliance and workplace safety. Loss analysis involving identification of trends, root cause and appropriate corrective action. Specialty fields such as Environmental and Professional Liability Risk Improvement services including training, consulting, hazard analysis and regulatory assessments will also be conducted. Solid communication skills-including exceptional writing ability, organizational skills, and computer skills Excellent Time management skills Professional certifications CSP, OHST, ALCM and/or ARM are preferred, but not required. Uploading completed reports, photos and diagrams through a special website or complete reports on web based systems Travel within a reasonable territory, 50 mile radius This work will be challenging and covers everything from contractors to real estate to retail to warehouse and distribution to manufacturing. High-quality, accurate loss control surveys guide the underwriter in the selection of profitable business, and assist the insured in controlling losses through the demonstrated value of the loss control services provided.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. The Manager of Payment Integrity (PI) leads the strategic design, implementation, and execution of programs aimed at improving payment accuracy and enhancing member affordability. This role serves as a key liaison for reimbursement policy and PI initiatives, ensuring alignment between cost-of-care objectives and departmental priorities through structured governance, ideation, and business case development. The Manager oversees program-level performance tracking to ensure measurable impact and continuous improvement. In close collaboration with Health Care and Finance divisions, this role supports enterprise-wide cost-of-care strategies by identifying operational efficiencies, uncovering savings opportunities, and fostering innovative partnerships that expand the reach and effectiveness of PI initiatives. Essential Responsibilities: Leads the development and execution of enterprise-wide Payment Integrity strategies aligned with financial and operational goals. Oversees a comprehensive suite of pre- and post-payment programs-including claims editing, audits, subrogation, readmission reviews, and coordination of benefits-while continuously refining approaches to address evolving trends such as value-based care, regulatory shifts, and emerging fraud schemes. Manages external vendors supporting audits, analytics, and fraud detection. Ensures accountability through robust service-level agreements (SLAs), key performance indicators (KPIs), and contract negotiations. Monitors and reports on recovery rates, audit turnaround times, and dispute resolution outcomes. Directs Fraud Waste and Abuse (FWA) detection efforts in collaboration with Special Investigations Unit (SIU) and compliance teams. Leverages predictive analytics and rules engines to identify suspicious billing patterns, ensuring timely investigation, documentation, and resolution. Ensures compliance with ICD-10, CPT/HCPCS, DRG, and CMS guidelines to support accurate coding and reimbursement. Serves as a subject matter expert on complex coding issues and documentation standards, providing training and oversight to internal teams and vendors. Integrates Payment Integrity efforts with care quality initiatives, targeting avoidable readmissions and preventable complications. Maintains compliance with CMS, Medicaid, ACA, and state-specific regulations. Leads audit responses and represents the organization in national forums such as AHIP, AAPC, HPRI, NHCAA, New York State DFS, DOH, and HPA. Champions the adoption of Artificial Intelligence (AI), machine learning, and automation in audit workflows and fraud detection. Pilots emerging technologies and integrates them into core operations. Collaborates with IT and analytics teams to enhance data infrastructure and reporting capabilities. Partners across Claims Operations, Finance, Provider Relations, Compliance, IT, and Care Management to embed Payment Integrity throughout the organization. Translates complex technical concepts into actionable insights for diverse stakeholders. Responsible for oversight, management, development, implementation, and communication of department programs. Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports. Develop annual department budgets. Monitor spending versus the planned budgeted throughout the year and take corrective action where needed. Coordinate business activities by maintaining collaborative partnerships with key departments. Responsible for process improvement and working with other departments to improve interdepartmental processes. Utilize lean methodologies for continuous improvement. Utilize visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities. Actively participate as a key team member in Manager/Supervisor meetings. Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy. Supporting Responsibilities: Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. SUCCESS PROFILE Work Experience: A minimum of 5 years of progressive experience in healthcare operations. Expertise in claims processing, clinical coding, reimbursement strategies, and/or fraud prevention required. Demonstrated success in strategic planning, vendor oversight, and cross-functional collaboration to drive operational excellence and cost containment required. Education, Certificates, Licenses: Bachelor's degree required. Candidates with an associate's degree and 2 years of relevant experience, or a high school diploma and 4 years of relevant experience, in addition to the required minimum years of Work Experience will also be considered Preferred area of focus: Healthcare Operations, Statistics, or a related field. Knowledge: Proven track record of leading operational initiatives from concept through execution, with a focus on provider reimbursement and claims payment integrity. Deep expertise in managed care claims coding, including CPT, ICD, HCPCS, Revenue Codes, and comprehensive understanding of federal and state Medicaid payment regulations. Proficient in Excel and SQL, leveraging data analysis to drive informed business decisions without reliance on technical support. Competencies Building Trust Building a Successful Team Aligning Performance for Success Building Partnerships Customer Focus Continuous Improvement Decision Making Facilitating Change Leveraging Diversity Driving for Results Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 10% of the time. Skills: Accountable leadership, Collaboration, Data-driven & Analytical, Delegation, Effective communication, Listening (active), Situational Leadership, Strategic Thinking Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Collaborate closely with physicians, nurses, social workers and a wide range of medical and non-medical professionals to coordinate delivery of healthcare services. Assess the member's specific health plan benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services which promote quality, cost-effective outcomes by helping member populations achieve effective utilization of healthcare services. Facilitate outstanding member care using fiscally responsible strategies. Essential Responsibilities: Collect and assess member information pertinent to member's history, condition, and functional abilities in order to promote wellness, appropriate utilization, and cost-effective care and services. Coordinate necessary resources to achieve member outcome goals and objectives. Accurately document case notes and letters of explanation which may become part of legal records. Perform concurrent review of members admitted to inpatient facilities, residential treatment centers, and partial hospitalization programs. Maintain contact with the inpatient facility utilization review personnel to assure appropriateness of continued stay and level of care. Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions. Review referral and preauthorization requests for appropriateness of care within established evidence-based criteria sets. When applicable, identify and negotiate with appropriate vendors to provide services. When appropriate, negotiate discounts with non-contracted providers and/or refer such providers to Provider Network Department for contract development. Work with multidisciplinary teams utilizing an integrated team-based approach to best support members, which may include working together on network not available (NNA), out of network exceptions (OONE), and one-time agreements (OTA). Serve as primary resource to member and family members for questions and concerns related to the health plan and in navigating through the health systems issues. Interact with other PacificSource personnel to assure quality customer service is provided. Act as an internal resource by answering questions requiring medical or contract interpretation that are referred from other departments, as well as physicians and providers of medical services and supplies. Assist employers and agents with questions regarding healthcare resources and procedures for their employees and clients. Identify high cost utilization and refer to Large Case Reinsurance RN and Care Management team as appropriate. Assist Medical Director in developing guidelines and procedures for Health Services Department. Supporting Responsibilities: Act as backup and be a resource for other Health Services Department staff and functions as needed. Serve on designated committees, teams, and task groups, as directed. Represent the Heath Services Department, both internally and externally, as requested by Medical Director. Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. SUCCESS PROFILE Work Experience: Minimum of three (3) years of nursing or behavioral health experience with varied medical and/or behavioral health exposure and capability required. Experience in acute care, case management, including cases that require rehabilitation, home health, behavioral health and hospice treatment strongly preferred. Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Registered Nurse or a clinically licensed behavioral health practitioner with current unrestricted state license. Within six (6) months of hire licensure may need to include Oregon, Montana, Idaho and/or other states as needed. Case Manager Certification as accredited by CCMC preferred. Knowledge: Thorough knowledge and understanding of medical and behavioral health processes, diagnoses, care modalities, procedure codes including ICD and CPT Codes, health insurance and state-mandated benefits. Understanding of contractual benefits and options available outside contractual benefits. Working knowledge of community services, providers, vendors and facilities available to assist members. Understanding of appropriate case management plans. Ability to use computerized systems for data recording and retrieval. Assures patient confidentiality, privacy, and health records security. Establishes and maintains relationships with community services and providers. Maintains current clinical knowledge base and certification. Ability to work independently with minimal supervision. Must be able to function as part of a collaborative, cohesive community. Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Responsible for successful execution, coordination and support of PacificSource's clinical initiatives. Key areas of focus include oversight and management of provider performance on clinical quality, risk assessment, care management and coordination of collaborative efforts related to patient and member health outcomes. Collaboration with targeted provider groups to guide and develop practice specific strategies designed to optimize clinical outcomes and accurate documentation of behavioral health chronic conditions. This position will work directly with internal PacificSource departments to build/strengthen relationships with strategic provider partners; ensure effective education, reporting and proactively identify improvement opportunities that support PacificSource's strategic goals. Essential Responsibilities: Contribute to the development and execution of organization wide provider campaigns focused on improving clinical outcomes and alignment with PacificSource strategic goals. Identify and facilitate implementation of evidence-based practices and interventions to help providers improve care outcomes and decrease costs. Work with stakeholders to develop improvement action plans and strategies based on performance analysis to achieve specific outcomes. Develop and implement strategies that further the integration of primary care and behavioral health, and increase communication between primary care and specialty behavioral health providers. Assure specialty behavioral health services that are based on fidelity models are accessible to members and meet relevant regulatory requirements designed to achieve the highest possible outcomes. Identify and monitor metrics to ensure progress aligns with shared goals. Evaluate need for mitigation strategies as barriers arise. Create and/or distribute shared business plans and monitoring documents to support shared goals; including charts, graphs and analytics related to key performance metrics. Provide ongoing training, coaching and high touch support to network providers and clinic staff toward the development and implementation of improvement initiatives to drive gap closure, member experience, appropriate documentation, and care outcomes within their own practices. Establish credible, consultative relationships with network physicians and clinic staff to unite PacificSource internal resources with provider groups to ensure coordinate efforts and decrease member abrasion. Work closely with internal departments to share provider feedback and proactively facilitate issue resolution. Collaborate with Risk Assessment and Provider Network departments to develop and deploy aligned quality performance programs to drive better provider satisfaction and quality outcomes. Maintains a detailed understanding of all shared data elements, the systems necessary to support actionable interventions/review and drives internal initiatives designed to improve the collection and reporting of supplemental data. Evaluate provider-related programs, initiatives and interventions to determine the effectiveness of activities and make recommendations to improve outcomes. Coordinate and lead cross functional teams to support critical engagement activities and to achieve performance targets. Supporting Responsibilities: Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. Work Experience: At least five years of experience in behavioral health care with a strong clinical focus. Experience in quality improvement, practice and systems facilitation, and program development. Education, Certificates, Licenses: Master's degree required in counseling, psychology, social work, or related field. License in behavioral health related field preferred. Knowledge: Knowledge of State of Oregon Medicaid regulations, mandated benefits and systems of care for behavioral health. Thorough knowledge and understanding of the needs of the SPMI population, Substance Use Disorders, youth and adult developmental stages, effective treatment modalities and relevant procedure codes. Ability to develop, review, and evaluate utilization reports. Knowledge of quality improvement methodology. Experience giving presentations. Organizational skills with solid experience in using computers and various software applications including Word, Excel, PowerPoint, Outlook, SharePoint, and audio-visual equipment. Ability to work independently with minimal supervision. Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 10% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. Supervise and provide guidance to the Government Enrollment and Billing team regarding company and department policies, procedures and workflow. Set goals and implement strategies to ensure internal processes are current and metrics are met. Coach team members to improve individual performance and develop teamwork. Essential Responsibilities: Maintain broad knowledge of all job positions assigned to team lead and provide supervision, training, evaluation and leadership to assigned staff. Evaluate performance of team members. Analyze results of performance reports to determine staffing and training needs related to department goals. Provide feedback, including regular one-on-one meetings with direct reports. Conduct and submit performance evaluations on a timely basis. Have a thorough understanding and use of the eligibility and member billing operation systems (EAM and EMS). Maintain workload in these specialty areas. Provide and/ or oversee training and orientation of new hires. Develop programs to assure ongoing training and coaching to new and current membership staff. Understand all applicable CMS and HPMS regulations and have the ability to educate internal and external customers. Investigate and settle issues within contract guidelines as needed. Relay information for dispute resolution to appropriate departments and personnel. Understand all applicable OHA and OAR regulations and have the ability to educate internal and external customers. Ensure all direct reports understand processes from end-to-end and assist with gaps as needed. Assist with answering inquiries from members as well as conduct auditing of member accounts, verifying the validity of any past-due accounts and the delinquent letter process to Medicare members. Ensure that all member-billing issues are submitted to business partners/vendors. Coordinate business activities by maintaining collaborative partnerships with key departments. Serve on various interoffice committees. Document and report any pertinent communication back to the manger, team or other. Assist with hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports. Assist with process improvement and work with other departments to improve interdepartmental processes. Utilize lean methodologies for continuous improvement opportunities. Use visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities. Assist the manager with daily operations including the development, analysis and implementation of policies and procedures, training, reporting and recognition programs. Actively participate as a key team member while creating and supporting a high-quality work environment to encourage a high performance. Provide backup for any of the department tasks that may become backlogged, have compliance risks or have other reasons for being unworkable by staff. Supporting Responsibilities: Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Support and participate in continuous improvement initiatives. Maintain professional, service oriented relationships. Ability to judge severity of problems and the need to escalate to management or employ external services. Perform other duties as assigned. Work Experience: Minimum of four years administrative experience in the health care industry, including two years in enrollment and billing in insurance. Supervisory experience preferred. Education, Certificates, Licenses: Associates degree or equivalent combination of experience and education. Knowledge: Effective written and oral communication. Ability to read and communicate policy and contract language. Demonstrated time management, critical thinking and problem solving skills. Ability to understand and interpret Federal and State regulations. Advanced proficiency in Microsoft Office Applications. Excel skills should include formulas, sorts, filters, VLOOKUP, IF statements, etc. Requires the ability to clearly articulate problem statements, collect data and establish facts. Competencies: Building Trust Building a Successful Team Aligning Performance for Success Building Customer Loyalty Building Strategic Work Relationships Continuous Improvement Decision Making Facilitating Change Leveraging Diversity Driving for Results Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.