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PacificSource Health Plans jobs in Portland, OR

- 1918 jobs
  • Quality Assurance Audit Team Lead

    Pacificsource 3.9company rating

    Pacificsource job in Portland, OR

    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 Quality Assurance Audit Team Lead provides supervision, leadership, and guidance to Claims Analysts, Quality Assurance Audit Specialists, Reinsurance Business Analysts, and support staff, ensuring adherence to company policies, procedures, and workflows. This role is responsible for managing claims production and quality to meet or exceed company standards, resolving adjudication issues, and overseeing hiring, training, coaching, and performance evaluation. As a leader, the Team Lead fosters a collaborative and inclusive team culture, encourages innovation, and supports management change. They coach team members to improve individual performance, build strong team dynamics, and inspire commitment to shared goals and organizational vision. Essential Responsibilities: * Supervise, coach, train, and evaluate assigned staff to ensure claims processing meets department and company standards. * Analyze performance data to identify individual and team training needs and support ongoing development. * Collaborate with the Training Coordinator to deliver effective onboarding and continued education for team members. * Oversee and support accurate and timely processing of medical and dental claims, ensuring correct interpretation of benefit and policy provisions. * Assist with claim review and research to determine coverage based on contract terms, provider status, and processing guidelines. * Investigate and resolve claims adjudication issues, including disputes, and coordinate with appropriate departments to support grievance and appeal processes. * Respond to inquiries received by mail or email, and prepare clear, professional business correspondence and reports. * Communicate updates to claims-related processes and procedures to ensure team alignment and timely adoption. * Participate in interoffice committees and leadership peer groups to promote cross-functional collaboration and process efficiency. * Coordinate with other departments to support business activities and maintain effective partnerships. * Ensure compliance with HIPAA regulations and PacificSource privacy policies regarding the confidentiality and security of protected health information. * Support process improvement initiatives using lean methodologies and contribute to interdepartmental efforts to enhance workflows. * Use visual boards and daily huddles to monitor key performance indicators and identify opportunities for improvement. * Actively contribute to department meetings and strategic committees to share insights and represent company values. 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 4 years of claims experience, or related experience in insurance or healthcare industry required. Minimum of 1 year of supervisory experience required. Education, Certificates, Licenses: Requires high school diploma or equivalent. Knowledge: Ability to gain a thorough understanding of PacificSource products, plan designs, provider relationships, and health insurance terminology. Basic working knowledge of Oregon Insurance Division rules and regulations. Thorough understanding of claims processing systems and operations. Advanced PC skills including Microsoft Word and Excel. Ability to type using a standard keyboard, operate a 10-key pad accurately, and use a multi-line telephone system and fax machine. Strong research skills and ability to evaluate claims for accurate auditing. Advanced knowledge of medical terminology and CPT / ICD-10 coding. Effective and responsive leadership skills. Ability to stay current with changes in PacificSource business processes and procedures and communicate updates to team members. Ability to work under time pressure and manage difficult situations. Collaborative team player with a strong work ethic and ability to work effectively with individuals at varying skill levels. 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.
    $106k-131k yearly est. Auto-Apply 4d ago
  • Appeals Clinical Team Lead

    Pacificsource 3.9company rating

    Pacificsource job in Portland, OR

    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.
    $68k-95k yearly est. Auto-Apply 18d ago
  • Commercial Lines Customer Service Representative

    Brown & Brown 4.6company rating

    Meridian, ID job

    Brown & Brown is seeking a Commercial Client Service Representative to join our growing team in Meridian, Idaho! The Commercial Lines Customer Service Representative will be responsible for servicing client requests and questions, providing prompt, efficient, high-quality service, and assisting in the retention of existing accounts and quoting new business. How You Will Contribute : Provide service to existing clients via inbound calls, emails, and daily tasks Make outbound phone calls to provide customer service Quote and Bind insurance with various carriers for existing clients Respond to requests for certificates of insurance or auto ID cards Maintain a concern for timeliness and completeness on all service requests Utilize an electronic filing manager to maintain documentation and compliance Notate and file documents in our agency management system Skills & Experience to Be Successful: High school diploma or equivalent required Knowledge of Microsoft Office 365 (Outlook, Excel, OneNote, etc.) Strong oral and written communication skills Strong typing skills Exceptional customer service and interpersonal skills Demonstrated critical thinking and problem-solving skills 1-3 years of Commercial Insurance experience P&C license required or able to obtain within 90 days of hire AMS360 experience Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more. Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations. The Power To Be Yourself As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.
    $28k-33k yearly est. 1d ago
  • Senior Product Development Manager

    Wikoff Color Corporation 4.4company rating

    Alpharetta, GA job

    The Senior Product Development Manager will lead the formulation and innovation activities for Wikoff Color's inks and coatings portfolio at the Alpharetta Technical Center. This individual will oversee a multidisciplinary team of formulation chemists/scientists specializing in Energy-Curable, waterborne, and solvent borne technologies, as well as color matching and customer support. The ideal candidate will bring strong technical depth in inks, coatings, or related polymer chemistry, proven people-leadership skills, and the ability to translate customer and market needs into commercially viable, sustainable solutions. This role is highly collaborative, interfacing with Sales, Manufacturing, Procurement, and Marketing to drive product innovation, technical excellence, and business growth. Minimum Education, Experience, and Technical Knowledge Required: · Bachelor's or Master's degree in Chemistry, Chemical Engineering, Polymer Science, or a related technical discipline. · 5+ years of progressive experience in the inks, coatings, or specialty chemicals industry. · Demonstrated expertise in formulating solventborne, waterborne, or energy-curable systems. · Prior experience supervising or leading technical teams in a laboratory environment. · Strong understanding of color science, pigment dispersion, and color matching techniques. · Proven track record of product development from concept to commercialization Key Responsibilities: · Provide technical and strategic leadership for product development projects across energy-curable, waterborne, and solventborne platforms. · Manage and mentor a team of formulation chemists and color specialists; set clear priorities, goals, and development plans for each team member. · Drive new product innovation aligned with Wikoff's strategic objectives and customer needs. · Evaluate new raw materials, technologies, and suppliers to enhance product performance, cost efficiency, or sustainability. · Partner with Sales and Marketing to identify market gaps and translate them into actionable R&D programs. · Guide formulation optimization and scale-up efforts in collaboration with Manufacturing and Quality. · Ensure timely project execution, accurate documentation, and communication of technical results. · Oversee color matching and color control standards for customer-specific formulations. · Maintain an active role in troubleshooting customer issues and providing technical expertise for complex applications. · Foster collaboration with other Wikoff R&D centers to share best practices, standardize procedures, and coordinate global development efforts. · Uphold and continuously improve laboratory safety, compliance, and organization standards Preferred Skills and Strengths: · Strategic thinker with strong problem-solving, decision-making, and project management skills. · Excellent leadership and mentoring capabilities. · Strong interpersonal skills for cross-functional collaboration with Sales, Operations, and Marketing. · Familiarity with regulatory and sustainability requirements affecting inks and coatings. · Ability to communicate technical information effectively to both technical and non-technical audiences. · Proficiency in laboratory data management and documentation systems. · Demonstrated commitment to quality, safety, and continuous improvement. Work Environment: · Full-time, onsite position at Wikoff Color's Alpharetta, GA Technical Center. · Primarily laboratory and office-based, with occasional travel to customer sites, suppliers, or other Wikoff facilities.
    $95k-130k yearly est. 3d ago
  • Insurance Services Assistant

    Lockton 4.5company rating

    Atlanta, GA job

    Entry Level Insurance Services Assistant - Atlanta based, Buckhead Office IN OFFICE - 50K to 55K plus a yearly bonus. Foot in the door - "Kick-start your career with stability and growth in the insurance broker industry.” Provide certificate and service request business, if you are detail oriented, have good administrative and internal customer service skills, enjoy a team environment and are resourceful please apply. Opportunity to Build a future at Lockton Southeast!
    $23k-30k yearly est. 4d ago
  • Financial Services Professional

    Bankers Life 4.5company rating

    Augusta, GA job

    Bankers Life , one of the most respected brands in the Financial Services industry, is seeking ambitious individuals to grow our team of Insurance Agents and Financial Representatives. If you have a passion for helping others achieve their financial goals, are a natural networker, enjoy critical thinking, and strive to better your career, then consider joining our winning team of Financial Professionals. Our award-winning training equips you with the knowledge, skills, and financial strategies you need to be successful and confident in this career. Many of our talented Insurance Agents use this advantage to become a Bankers Life Securities, Inc. Financial Representative, specializing in aiding clients in Wealth Management. Uncover your earning potential, build a workday around your lifestyle, and make an impact in your community every day. With access to local and national mentors, we will surround you with resources to aid in the development of your financial expertise, including but not limited to: Personal Planning Analysis - Asset & Income Protection - Investment & Advisory Services - Trust Services Wealth Management - Retirement Solutions As a Bankers Life Financial Services Professional Expect To: Build - Develop a client base by growing relationships with your network, establish and maintain strong customer relationships, offering guidance, and providing solutions to help families obtain financial freedom. Gain Expertise - Obtain knowledge beyond licensed agent training through sponsored course work, and proprietary agent development training. Guide - Presenting clients with the ability to preserve their retirement and grow their wealth. Use the latest software, and product illustrations to guide clients through important financial decisions. Own - Take ownership of your career as you master your craft and excel in Financial Services. Decide your path; delivering retirement protection, managing all client assets, or construct and lead your own team of agents and representatives. How Bankers Life will provide support: Hybrid Experience - Flexible in-office schedules once you complete your agent training and take off as a producing agent. Pre-Licensing Training - Bankers Life agents are provided pre-licensing training free of charge; individuals will need to pay for the state exam required to sell life and health products. Award-winning Training - Our training, conducted in office, by successful field leaders will fulfill your desire for continuous learning. Bankers Life has been named as a Training Apex Award Winner for eleven years and counting and a CLO LearningElite winner for five years and counting. Advancement Opportunities - Benefit-eligible management positions within local branch structure. What makes a great Financial Services Professional? Informative - Ability to present complicated concepts effectively and maintain uncompromising principals, such as honesty and integrity. Driven - Self-motivated to network and prospect for new clients, while demonstrating strong time-management skills. Sociable - Strong relationship building and communication skills will bond you with clients and colleagues. Dreamer - Competitive and entrepreneurial spirit to achieve success both for yourself and others. The Bankers Life Team comes from a variety of backgrounds including, but not limited to, sales, athletics, military, client services, or client-facing roles. Regardless of your professional experience level, we will provide you the skills and knowledge necessary for success. Our Financial Service Professionals help their clients live more and worry less. Apply now and join the team!! About us: With a rich history dating back to 1879, Bankers Life has grown from our founder's simple wish to make insurance affordable. Today we remain true to our heritage. Strength, stability, and service shape our culture as we help provide financial security solutions. Compensation & Benefits: Commission structure designed to grow with you Renewable income and Bonus programs Fully paid insurance licensing study course, SIE, Series 6, Series 63, CFP , and more Retirement Savings Program
    $50k-84k yearly est. 5d ago
  • Superintendent

    Hays 4.8company rating

    Atlanta, GA job

    Job Description: Senior Superintendent - K-12 & Municipal Projects Projects focused on ground-up K-12 education facilities and municipal buildings We are seeking a highly experienced Senior Superintendent to lead ground-up construction projects for K-12 schools and municipal facilities in the Atlanta area. The Superintendent will be responsible for managing all on-site operations, ensuring projects are delivered safely, on time, and within budget. This role requires strong leadership, organizational skills, and proven expertise in institutional and public-sector construction. Key Responsibilities Direct and oversee all field operations for K-12 and municipal ground-up projects. Supervise subcontractors, field staff, and vendors to ensure compliance with project plans and specifications. Maintain project schedules and proactively address delays or issues. Enforce safety standards and ensure OSHA compliance across all job sites. Conduct daily site inspections and progress meetings with project teams. Collaborate with project managers, architects, engineers, and school district/municipal representatives to resolve field issues. Track and report project progress, costs, and quality metrics. Ensure client satisfaction by delivering projects that meet educational and municipal facility standards. Qualifications 8+ years of experience as a Superintendent with a commercial general contractor. Proven track record managing ground-up K-12 education projects and/or municipal facilities. Strong knowledge of construction means, methods, and sequencing. Ability to read and interpret blueprints, specifications, and schedules. Excellent communication and leadership skills. OSHA 30 certification preferred. Proficiency with project management software (Procore, MS Project, or similar). Compensation & Benefits Competitive base salary Performance-based bonus opportunities Company truck or truck allowance Comprehensive healthcare package Profit sharing and retirement program Flexible work schedules and accelerated career growth opportunities Why Join Us Work with a respected Atlanta-based GC specializing in education and municipal projects. Be part of a people-first culture that values employees and clients equally. Gain exposure to repeat client work with school districts and municipalities, ensuring steady project flow. Opportunity to grow into senior leadership roles with regional influence.
    $68k-95k yearly est. 5d ago
  • Chief Financial Officer - The Portland Clinic

    Health e Practices, LLC 4.1company rating

    Portland, OR job

    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.
    $105k-168k yearly est. 3d ago
  • Pharmacy Technician II

    Pacificsource 3.9company rating

    Pacificsource job in Portland, OR

    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. Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy team. Handle pharmacy-related inquiries and communicate benefit determinations. Provide pharmacy services helpdesk support to pharmacies, providers, and members. Perform pharmacy authorization and claim processing services. Essential Responsibilities: * Act as principal contact regarding drug authorizations and system overrides. Help to resolve pharmacy services and benefits inquiries through skillful knowledge of the pharmacy claims, medical claims, and utilization management platforms. * Initiate clinical review and decision-making of authorization requests under the guidance of clinical pharmacists. * Effectively communicate and collaborate in a clear and concise manner to internal and external partners, including translating clinical and technical industry jargon to appropriate audiences. * Function as liaison with pharmacy benefit manager, pharmacies, physicians, and others in order to apply benefits, and assist with pharmacy benefit determinations. * Consult with clinical pharmacists and other staff in determining coverage for pharmacy-related services and pharmaceuticals. * Prepare and process member-submitted pharmacy claims in the pharmacy benefit manager's claims processing system. * Ensure all coverage determinations are processed in a timely and accurate manner, consistent with Commercial, Medicare & Medicaid regulatory requirements and department policies. * Serve as primary resource to members and providers for pharmacy questions related to the health plan and in navigating through the health systems. Supporting Responsibilities: * Provide support and maintenance for department communication tools (ie. Sharepoint), as applicable. * Assist Pharmacy Services Leadership to ensure compliance with all rules and regulations as applicable. * 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: Minimum two years Pharmacy Technician experience. Demonstrated ability to work efficiently and effectively with a high attention to detail. Education, Certificates, Licenses: Minimum high school diploma or equivalent. Unrestricted pharmacy technician license by the Board of Pharmacy and previously passed National Pharmacy Technician certification exam required. Maintain continuing education requirements for license renewal. Knowledge: Good understanding of Medical Terminology required. Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful. Microsoft Office products including Word, Excel, and Outlook. Ability to work under time sensitive deadlines. Ability to prioritize responsibilities, diplomatically, handle demanding situations and manage workload with direct supervision. Demonstrate organizational and time management skills. Ability to understand and interpret Federal and State specific regulatory requirements helpful. Ability to communicate effectively across all levels of the business on a consistent basis. 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.
    $38k-46k yearly est. Auto-Apply 5d ago
  • Automotive Detailer

    Integro Professional Services 4.2company rating

    Statesboro, GA job

    Exciting Career Opportunities in the Automotive Industry! Are you passionate about cars and looking to turn your passion into a fulfilling career? INTEGRO is seeking enthusiastic individuals to join our team as Automotive Detailers. No experience? No problem! We provide comprehensive training for all new hires. Why Choose Us: High Earning Potential: Earn $500 to $850 per week with bonus opportunities. Weekly Pay: Get paid weekly via direct deposit. Full Benefits: Enjoy healthcare options, retirement plans, and paid time off. Training and Advancement: Receive paid onsite training and opportunities for career growth. Flexible Hours: Full-time and part-time positions available with flexible scheduling. Qualifications: Team Player: Collaborate effectively with team members. Attention to Detail: Demonstrate meticulous attention to detail in all tasks. Strong Work Ethic: Work efficiently in a fast-paced, customer-focused environment. Professionalism: Present yourself with professionalism and integrity. Communication Skills: Communicate effectively with customers and colleagues. Availability: Flexible schedule with weekend availability. Responsibilities: Washing and detailing vehicles to the highest standards. Applying protectants and marketing materials. Conducting tire maintenance and inspections. Delivering exceptional customer service. Other duties may be assigned based on location requirements. This position does require frequent movement and getting into and out of vehicles repeatedly during each work shift. Portions of this work may be completed inside or outside under varying climate conditions. Ready to embark on an exciting career journey? Join the INTEGRO team and start your automotive career today! Apply now. With over 40 years in the automotive industry, we have provided a wide range of products and services to all levels within the automotive sector. If you are looking for a career in the automotive industry, this is an excellent opportunity for you. INTEGRO is proud to be an equal opportunity employer and a drug-free, alcohol-free, and substance-free workplace. All employment is contingent upon completing a background investigation and drug testing. INTEGRO is proud to be an equal opportunity employer and a drug-free, alcohol-free, and substance-free workplace. All employment is contingent upon completing a background investigation and drug testing.
    $500-850 weekly Auto-Apply 60d+ ago
  • Customer Experience Consultant - 100% Commission (TSG-20251204-057)

    Strickland Group LLC 3.7company rating

    Augusta, GA job

    Job DescriptionThe Strickland Group is a family-driven, vision-first insurance and financial services agency backed by a major national carrier. From day one, we provide warm leads, mentorship, and proven systems so you can build a business - not just have a job. In this 100% commission role, you will meet with families virtually or in person, uncover financial protection needs, and offer life insurance, mortgage protection, and retirement solutions. We seek coachable, growth-minded individuals who want schedule freedom, personal development, and a clear path to agency ownership.
    $70k-111k yearly est. 23d ago
  • Senior Web Designer (Webflow)

    Iron Horse 4.7company rating

    Portland, OR job

    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.
    $76k-109k yearly est. 52d ago
  • Project Manager (Heavy Civil)

    Hays 4.8company rating

    Atlanta, GA job

    Your new company I am currently working with a great heavy civil construction company that specializes on Earthwork / Utilities projects throughout the Atlanta area. They are actively looking to add an experienced Project Manager to the team. What you'll need to succeed 2-5+ year of Civil Project Management experience Must have experience on Earthwork / Underground Utilities projects Can manage and work well in a team environment BS degree preferred Estimating / Takeoff experience a bonus What you'll get in return You'll get the opportunity to work for a company that self performs a large number of their projects. Those who perform well are rewarded with long tenure and growth opportunities. Currently offering above market salary, relocation assistance, 401k match, PTO, vehicle or vehicle allowance and benefit package. What you need to do now Like to know more? Apply with your resume via this advert. If you think this position may not be for you, we have various other roles in the area for Project Engineers, Estimators, and Superintendents.
    $67k-101k yearly est. 3d ago
  • Care Management Clinician (Sunday - Thursday)

    Pacificsource 3.9company rating

    Pacificsource job in Salem, OR

    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. Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. Clinicians incorporate the essential functions of professional case management concepts to enhance patients' quality of life and maximize health plan benefits. These functions include but are not limited to: coordination and delivery of healthcare services, consideration of physical, psychological, and cultural factors, assessment of the patient's specific health plan benefits, and additional medical, community, or financial resources available. Essential Responsibilities: Clinician Care Managers facilitate the achievement of client wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation. Collect and assess patient information pertinent to patient's history, condition, and functional abilities in order to develop a comprehensive, individualized care management plan that promotes appropriate utilization, and cost-effective care and services. Based on the needs and values of the client, and in collaboration with all service providers, the clinician links clients with appropriate providers and resources throughout the continuum of health and human services and care settings, while ensuring that the care provided is safe, effective, client-centered, timely, efficient, and equitable. Clinicians have direct communication among, the client, the payer, the primary care provider, and other service delivery professionals. The case manager is able to enhance these services by maintaining the client's privacy, confidentiality, health, and safety through advocacy and adherence to ethical, legal, accreditation, certification, and regulatory standards or guidelines. 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. Practice and model effective communication skills: both written and verbal. Utilize and promote use of evidence-based tools. Utilize lean methodologies for continuous improvement. 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 three (3) years of clinical experience, including case management. Insurance industry experience preferred. Education, Certificates, Licenses: Clinical Social Worker, Licensed Professional Counselor, or Licensed Independent Clinical Social Worker with unrestricted license required in current state of residence. OR Registered Nurse with current appropriate unrestricted state license based on line of business: Commercial and Medicare: Oregon, Idaho or Montana, and Washington; Medicaid and DSNP: Oregon. 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: Knowledge of health insurance and state mandated benefits. Experience and expertise in case management practice including advocacy, assessment, planning, communication, education, resource management and service facilitation. Ability to deal effectively with people who have various health issues and concerns. Knowledge and understanding of contractual benefits and options available outside contractual benefits. Knowledge of community services, providers, vendors and facilities available to assist members. 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. 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.
    $77k-103k yearly est. Auto-Apply 7d ago
  • Bookkeeper

    Associated Administrators 4.1company rating

    Tualatin, OR job

    The Bookkeeper provides financial accounting for assigned Client(s) and Trust Fund(s) in accordance with company policies, regulatory requirements, and plan guidelines. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by /Role." Key Duties and Responsibilities Balances FICA, federal withholding, and payroll taxes; makes appropriate deposits. Reconciles checking, savings, and investments accounts. Posts journal entries to general ledger. Prepares and distributes Trust financial statements and statistics. Assists in the preparation of 941 and 945 forms. Ensures accounting files are current and in good order. Reviews vendor invoices for accuracy and reasonableness. Makes daily/weekly money transfers as needed. Prepares and sends disbursement letters. May also perform accounts payable function. Performs other duties as assigned. Minimum Qualifications High School diploma or GED. Two years of experience in an accounting role. Knowledge of common accounting principles and practices. Excellent verbal and written communication skills, including interpersonal skills. Ability to read and understand financial statements. Computer proficiency including Microsoft Office tools and applications. Preferred Qualifications Experience in a third-party administrator. Familiarity with accounting software. *Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice. Working Conditions/Physical Effort Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. Disability Accommodation Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at ******************************, and we would be happy to assist you. Zenith American Solutions Real People. Real Solutions. National Reach. Local Expertise. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before. We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American! We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!
    $42k-53k yearly est. Auto-Apply 55d ago
  • Residential Property Inspector - Indian Valley, ID.

    CIS Group of Companies 4.6company rating

    Idaho job

    Looking to Supplement Your Income or Just Be Productive? Become an Independent Residential Insurance Inspector with CIS Group! Are you looking for a flexible, rewarding opportunity that allows you to be your own boss and take control of your schedule? CIS Group is seeking motivated, detail-oriented individuals to join our team as 1099 Property Insurance Inspectors. If you own an LLC and are looking to diversify your work, this might be the perfect opportunity for you! Why Work With Us? Since 1996, CIS Group has been one of the largest and most trusted names in the insurance inspection industry. We offer a platform that allows Independent Contractors to create and grow their own businesses, work flexible hours, and take on a variety of inspections. Whether you're supplementing your current work or looking for a new venture, this position offers flexibility and autonomy. What You'll Do: Travel to residential homes to complete exterior (interior photos here and there) property inspections. Take photos, collect property data, and upload your findings using your smartphone or tablet. Provide high-quality, professional service that delivers accuracy and on-time service, with exceptional communication. Maximize this opportunity by utilizing your unique skillset What We're Looking For: 1099 Independent Contractors - Be your own boss, set your own schedule! Flexible Hours - Work during daylight hours, Monday through Saturday. Comfortable Working Outdoors - This role requires you to work in various weather conditions. Tech-Savvy - A recent smartphone or tablet capable of taking and storing hundreds of photos. Computer Access - Wi-Fi-enabled for uploading data. Reliable Vehicle & Driver's License - Travel to residential properties within your area. Strong Communication Skills - You're a professional and a persistent communicator. You're not someone who just disappears when things get tough. Microsoft Excel Familiarity - Basic computer skills are necessary for managing your inspections. Compensation: Independent Contractors - You get paid per inspection. Fees - Vary based on location and inspection type, allowing for higher earning potential as you demonstrate competency. Why This Is Perfect for You: You've taught yourself how to solve problems and take on new challenges, and you're driven to succeed no matter the obstacles. This opportunity will allow you to create and or build your own business, and the flexibility to grow your income in an industry that remains resilient even through economic downturns. Ready to take control of your future and join a company that values your persistence and resourcefulness? Submit your resume now and become part of the CIS Group team! Job Types: Part-time, Contract Pay: $1,200.00 - 1,500.00 per month Benefits: Flexible schedule Compensation Package: 1099 contract Work Location: On the road
    $1.2k-1.5k monthly 22d ago
  • Inventory Control Analyst & Powered Industrial Truck Operator

    Malone Workforce Solutions 4.6company rating

    LaGrange, GA job

    Step into a role where accuracy moves everything forward At 8:00 AM, you're on the floor with a plan: verify counts, reconcile discrepancies, and keep product flowing. By 4:30 PM, you've tightened inventory accuracy, supported on-time operations, and safely operated equipment to position materials exactly where they need to be. Role Snapshot Location: Shift: 8:00 AM - 4:30 PM, Monday-Friday Starting Pay: $18.00/hr Why you'll love it Competitive hourly pay at $18.00 Consistent first-shift schedule: Monday-Friday Paid company holidays What you'll do Own cycle counts and close the loop on any discrepancies you uncover Stage, move, and organize materials, supplies, and equipment to designated areas Operate forklifts, hand trucks, and pallet jacks safely and efficiently What you bring At least 1 year of recent forklift operating experience (license/certification preferred) Hands-on warehouse background with strong inventory control/cycle count skills Proficiency with Warehouse Management Systems (WMS) Stamina to stand and walk 8+ hours per day Sharp attention to detail and basic computer competence Comfort with standard pre-employment screening processes (drug and background checks) Proficiencies and tools Proficient in warehouse operations Forklift licensed Machines & technologies you'll use: Forklifts Legal Malone Workforce Solutions is an Equal Opportunity Employer. Must be willing to submit to a drug screening and criminal background check
    $18 hourly 2d ago
  • Receptionist

    Pacificsource 3.9company rating

    Pacificsource job in Salem, OR

    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. Provide coverage of telephone and front desk duties. Answer incoming calls in a prompt, courteous manner according to PacificSource customer service quality standards. Greet and assist visitors in a professional and efficient manner. Essential Responsibilities: * Answer incoming calls in a prompt, courteous manner. * Assist callers by quickly determining the caller's needs and accurately directing calls to the appropriate personnel and/or department. * Communicate efficiently and effectively in obtaining, giving and exchanging information. * Greet and direct visitors. * Assure guests are identified and registered before allowing access to secured sections of the building * Partner with building maintenance to ensure general office maintenance and cleanliness * Coordinate office vendors to keep office operating efficiently * Receive premium payments, prepare receipts, and secure premiums. * Maintain the lobby as a professional first impression of PacificSource. * Assist in developing and maintaining related policies and procedures. * Complete all clerical duties such as address changes, documenting company survey results, preparing packets, and other general clerical duties as assigned. * Maintain office supply inventory and order supplies as needed and/or requested. * Attend to the safety of employees and guests to the extent that does not endanger self or others. * Provide front line communication and relay information in urgent or emergency situations. Supporting Responsibilities: * Assist with clerical tasks of other departments as needed. * 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: One year of multiline phone experience and/or reception duties preferred. Education, Certificates, Licenses: High School Diploma or equivalent required. Knowledge: Typing, 10-key required. Computer skills preferred. Competencies: Building Customer Loyalty Building Strategic Work Relationships Contributing to Team Success Planning and Organizing Continuous Improvement Adaptability Building Trust Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is not required. 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.
    $30k-37k yearly est. Auto-Apply 13d ago
  • Summer 2026 Risk Management Intern

    Sterling Seacrest Pritchard 3.8company rating

    Atlanta, GA job

    Sterling Seacrest Pritchard offers a 10-week internship which allows for professional growth throughout our agency. Interns will receive the same new hire training as our incoming hires and will have the opportunity to intern in a specific insurance niche area. Interns will be providing assistant level support to our teams and will work on a variety of different projects throughout the summer. Interns will also have the opportunity to network across multiple groups and listen to speakers in a variety of niche areas within the firm. The objective of our internship is to provide students with a full understanding of what a brokerage firm does. In addition to direct support for our teams, interns will also have an opportunity to work on a variety of customer service skills. Our interns are given projects throughout the summer that allow them to showcase their creativity and knowledge to our shareholders. About Sterling Seacrest Pritchard Sterling Seacrest Pritchard is a customer driven agency, pursuing growth by providing professional insurance services to our clients. We take pride in our integrity, responsiveness, results and stellar customer service. As one of the fastest growing risk management and insurance firms in the state of Georgia and the Southeast, Sterling Seacrest Pritchard works in partnership with our clients to provide services and solutions customized to today's dynamic marketplace. Expertise, Integrity and Client Service form the cornerstones of our success.
    $42k-72k yearly est. 60d+ ago
  • Senior Director, Product & Regulatory Management

    Pacificsource 3.9company rating

    Pacificsource job in Salem, OR

    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.
    $149k-191k yearly est. Auto-Apply 3d ago

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