Medicaid jobs near me - 1,488 jobs

Join BoldAge PACE and Make a Difference! Why work with us? A People First Environment: We make what is important to those we serve important to us. Make an Impact: Enhance the quality of life for seniors. BE PART OF OUR MISSION! Are you passionate about helping older adults live meaningful, independent lives at home with grace and dignity? BoldAge PACE is an all-inclusive program of care, personalized to meet the individual health and well-being needs of our participants. Our approach is simple: We listen to our participants and their caregivers to truly understand their needs and desires. Occupational Therapist POSITION SUMMARY: Plans, organizes, and implements Occupational Therapy services for PACE participants as a member of the PACE interdisciplinary team. Responsibilities include but are not limited to assessment; planning, providing treatment; and teaching of participant, caregivers or other appropriate representatives/family to maintain participant support in the community. ESSESNTIAL DUTIES AND RESPONSIBILITIES: Conduct initial and periodic in-person assessments to evaluate participants' functional abilities, home environment, and rehabilitation needs. Recommend and coordinate adaptive equipment, home modifications, and therapy services to promote safety and independence. Develop, implement, and revise individualized treatment plans based on participant progress and IDT collaboration. Deliver OT interventions across settings including the PACE center, clinic, participants' homes, and contracted facilities. Educate participants and caregivers on equipment use, home safety strategies, and ADL programs. Maintain timely, accurate documentation of assessments, treatment, and participant progress per regulatory and organizational standards. Actively participate in daily IDT meetings, contributing to comprehensive care planning and 24-hour care coordination. Supervise Certified Occupational Therapy Assistants (COTAs), including review of care plans, co-signing documentation, and providing ongoing mentorship. Train staff in safe OT practices and equipment use to enhance participant care. Support quality improvement, utilization review, and compliance initiatives. Perform other IDT duties as needed within scope of practice and competencies. Maintain current licensure, certifications, and participation in ongoing professional development. EXPERIENCE AND EDUCATION: Advanced degree in Occupational Therapy from an accredited school of Occupational Therapy Current license to practice Occupational Therapy in the state Two (2) years of experience working on an interdisciplinary team in a hospital, nursing home or community-based setting is preferable. 1 year of experience working with a frail or elderly population preferred. If this is not present, training on working with a frail or elderly population will be provided upon hiring (If applicable for the role). Competency position specific competencies for the Occupational Therapist will be met prior to assuming participant care. PRE-EMPLOYMENT REQUIREMENTS: All Employees - Must have reliable transportation, a valid driver's license, and the minimum state required liability auto insurance. Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact. Pass a comprehensive criminal background check that may include, but is not limited to, federal and state Medicare/Medicaid exclusion lists, criminal history, education verification, license verification, reference check, and drug screen. BoldAge PACE provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. * Match begins after one year of employment

Summary: As a PMO Manager, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve - a community's most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare's biggest challenges. The PMO Manager integrates project management and aspects of DevOps practices to ensure the successful delivery of software development projects. This client-facing, strategic role combines organizational, technical, and leadership skills to oversee project teams, and drive continuous improvement. Roles & Responsibilities: • Team Leadership & Collaboration o Manages client relationship. o Oversee project management team (10+ members), fostering collaboration, mentorship, and a culture of continuous improvement. o Provide periodic performance feedback and mentorship to team members, ensuring alignment with organizational goals. • Project & Process Management o Coordinate status reporting for internal and external stakeholders, ensuring clarity and compliance with requirements. o Proactively identify, mitigate, and manage project risks and issues, including response strategies and status tracking. o Integrate and coordinate efforts with internal and external leadership, internal and external project managers, and system managers. o Develop, maintain, and enforce processes related to system implementation. o Enforce change management and governance policies for both the organization and clients. o Collaborate with software development, QA, and IT teams to align priorities, requirements, and improve overall delivery performance. Required Skills & Experience: • Project Management: Minimum 3 years (preferably 6+) in similar roles; PMI certification; knowledge of PMBOK and best practices. • 9+ years' experience in project management both waterfall and agile methodologies • 7+ years' experience with healthcare delivery, health insurance management, managed care management or pharmacy benefit management. • Demonstrates advanced knowledge of project management methodologies and tools, client relations, IT industry, accounting, risk management, change management, and effort tracking. • Healthcare/IT Experience: Experience supporting healthcare claims, financial processing, or pharmacy benefits manager projects for state governments, hospitals, or insurance companies. • Technical Proficiency: Skilled in using laptops, Microsoft products, and project scheduling tools (e.g., Microsoft Project). • Leadership & Communication: Excellent verbal and written communication; ability to train, guide, and mentor personnel; effective with technical and non-technical stakeholders. • Attention to Detail: Strong compliance orientation and ability to analyze data and processes. • Advanced Planning: Project management skills to keep deliverables on track during review cycles. • Bachelor's degree in a relevant field (e.g., Computer Science, Information Technology, Business Administration). • Project Management Professional (PMP) certification required. Skills: Project Management, Medicaid, PMBOK, PMP, PMO, MS Products Education: Bachelors' Degree About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************ US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Recruiter Details: Name: Akib Email: *************************** Internal Id: 25-52840

CDP Tester (Adobe Experience Platform / Customer Data Platform) 100% Remote Long Term Contract through Dec 2026 **Unable to Provide Sponsorship or Do C2C** We are seeking a CDP Tester to support a large-scale Adobe Experience Platform (AEP) implementation for a major healthcare client. This role focuses on validating data ingestion, audience logic, and end-to-end functionality within the Customer Data Platform (CDP). Candidates with experience working in Adobe AEP, CDPs, or complex data validation environments will be highly successful in this role. This position is ideal for QA professionals or junior developers who enjoy testing, validating datasets, and ensuring accurate audience creation for real-time personalization and healthcare outreach campaigns. Key Responsibilities Test and validate customer data ingestion pipelines and transformations within Adobe CDP/AEP. Review and understand audience definitions, rules, and segmentation logic. Verify that audiences are built correctly based on business requirements and healthcare use cases (e.g., identifying care gaps for targeted outreach). Use qTest or similar QA tools to document, execute, and track test cases. Partner closely with Senior Developers and a Team Lead to ensure accurate deployment and performance of CDP updates. Validate data sets involving Medicare/Medicaid member information, ensuring accuracy and compliance. Collaborate with cross-functional teams, including data engineering (Snowflake), product owners, and architects. Support testing of new audience builds used in SMS/email outreach campaigns. Participate in meetings aligned with project deliverables and sprint requirements. Serve as a key owner of data accuracy within the CDP environment. Required Skills & Experience Experience testing within a Customer Data Platform (Adobe AEP preferred). Understanding of audience segmentation and data-driven customer journeys. Strong experience with QA methodologies and tools (qTest highly preferred). Ability to read and validate business logic, datasets, and transformations. Familiarity with healthcare data, ideally Medicare or Medicaid. Strong analytical skills with high attention to detail. Ability to work onshore in the U.S. and collaborate in CT/ET time zones. Nice-to-Have Skills Exposure to Adobe Experience Platform (AEP), XDM schemas, or CDP audience building. Experience with Snowflake or similar data environments. Background in healthcare analytics or care-gap data. Light scripting or SQL knowledge to support data validation. What Makes This Role Exciting Work directly on a major enterprise CDP initiative with long-term funding (through 2026). Support critical healthcare outreach programs that improve patient outcomes. Collaborate with a highly skilled team including senior CDP developers, architects, and data engineers. BENEFITS OF WORKING WITH BROOKSOURCE: Direct communication with the hiring manager, which allows us to move candidates through the interview process faster. Dedication to keep an open line of communication and provide full transparency. We are an equal opportunity employer and value diversity at our company. We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

We are hiring a customer service representative to manage customer queries and complaints. To do well in this role you need to be able to remain calm when customers are frustrated and have experience working with computers. Pay $18/HR (Monday-Friday Day Shift) Work Environment: In-office training for 10 weeks. After successful training this position will become work from home. Additional Info: Must have reliable transportation and home internet access Must have Long Term Care, Medicare, or Medicaid experience for this role Customer Service Representative Responsibilities: Maintaining a positive, empathetic, and professional attitude toward customers at all times. Responding promptly to customer inquiries. Communicating with customers through various channels. Acknowledging and resolving customer complaints. Knowing our products inside and out so that you can answer questions. Processing orders, forms, applications, and requests. Keeping records of customer interactions, transactions, comments, and complaints. Communicating and coordinating with colleagues as necessary. Providing feedback on the efficiency of the customer service process. Managing a team of junior customer service representatives. Ensure customer satisfaction and provide professional customer support. Customer Service Representative Requirements: High school diploma, general education degree, or equivalent. Ability to stay calm when customers are stressed or upset. Comfortable using computers. Excellent communication skills and Microsoft Office Suite

The Element Care Social Worker participates in the planning, implementation and evaluation of care plans that meet the objectives, standards and policies of the PACE model of care. The social worker demonstrates proficiency in providing traditional social work services in a professional and respectful manner with the goal of helping older adults live safely and comfortably in their homes and communities for as long as they can. This position is full time M-F 8am to 4pm. Mandarin speaking required. Participates on the IDT's initial assessments, care planning and on-going re-assessments of participant care. actively participates in team meetings by sharing pertinent information, providing follow up to assigned tasks and helps to develop participant's plan of care. Facilitates hospital, rehabilitation and nursing home (NH) admissions and discharges as determined by the Interdisciplinary Team. Assists in the conversion process of the participant from community to long-term care. Works collaboratively with Medicaid Specialist, skilled nursing facility, and participant's caregiver to complete conversion. Refers participants and families to appropriate community services and acts as liaison and/or advocate with community organizations for participants. Maintains professional, accurate and timely social service documentation in the participants' medical records. Works collaboratively with Director of Social Work and Behavioral Health provider to ensure guardianship is up to date. Educates participant regarding health care proxy (HCP). Works collaboratively with fiscal department to maintain participant insurance benefits and completes required documentation of fiscal information in the medical record. Reviews plan of care with participants, guardian, and/or activated health care proxy as assigned. Complete authorizations for home care and other approved services timely and accurately. Completes home and/or skilled nursing facility visits to assess participant as indicated. Works collaboratively with Palliative care team; disenrollment, conversion to long term care, transfer of sites, participant and/or caregiver demographic changes). Frequent local travel. Current Social Work licensure in the Commonwealth of Massachusetts at the Masters level (L.Minimum of 1 experience in Social Work providing traditional Clinical or Case Management services with a geriatric population Vietnamese and/or Khmer speaking but all MSW eligible candidates to apply. Covid vaccinated preferred. Health insurance Dental insurance Retirement plan Element Care is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, sexual orientation, protected veteran status, or on the basis of disability. Element Care is committed to valuing diversity and contributing to an inclusive working environment. To learn more about Element Care, please click this link: Element Care 30th Anniversary Video

About Synapticure As a patient and caregiver-founded company, Synapticure provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. Partnering with providers, payers, ACOs, health systems, and life sciences organizations-including through CMS' new GUIDE dementia care model-Synapticure is dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases such as Alzheimer's, Parkinson's, and ALS. The Role Synapticure is seeking an experienced and highly capable Legal Counsel to serve as the company's in‑house attorney. In this critical role, you will function as a strategic business partner and trusted advisor to executive and clinical leadership-building and leading a right‑sized compliance program, managing legal risk, and ensuring regulatory alignment across our fast‑growing organization. The ideal candidate brings deep healthcare regulatory expertise, sound business judgment, and the ability to translate complex legal advice into actionable, practical guidance. You will oversee healthcare compliance, contracting, and general legal operations across the enterprise, supporting both the clinical delivery organization and the corporate entity. This is an exciting opportunity to shape the legal and compliance function at a mission‑driven, high‑growth healthcare company that is redefining access to specialized neurological care. Job Duties - What you'll be doing Healthcare Regulatory & Compliance Design, implement, and oversee a scalable healthcare compliance program, including policies, training, and internal monitoring frameworks Provide guidance on federal and state healthcare laws and regulations, including HIPAA, fraud and abuse (Stark and Anti‑Kickback Statute), corporate practice of medicine, and multi‑state telehealth requirements Advise on MSO/PC structures, payer contracting compliance, and corporate practice of medicine guardrails Provide counsel on complex billing, coding, and reimbursement issues, including Medicare and Medicaid participation Anticipate and communicate regulatory trends, advising leadership on both risk and strategic opportunity Oversee internal investigations, audits, and privacy/security initiatives in partnership with technology and clinical operations teams Contracting & Transactions Draft, review, and negotiate a wide range of contracts, including payer, health system, vendor, and technology agreements Support clinical and life sciences partnership agreements while maintaining appropriate corporate and compliance boundaries Develop and maintain contract templates, playbooks, and workflows to streamline review and approvals across the organization Corporate & Operational Legal Support Provide day‑to‑day legal counsel on corporate governance, employment, risk management, and marketing matters Collaborate with business and clinical leaders to translate legal and compliance advice into practical, operational solutions Serve as the primary point of contact for outside counsel, ensuring effective resource use and alignment with company strategy Educate and train internal teams on contracting best practices and healthcare regulatory requirements Support strategic initiatives, corporate development, and special projects as Synapticure continues to scale Requirements - What we look for in you Juris Doctor (J.D.) from an accredited law school and active licensure in at least one U.S. jurisdiction 5-10+ years of legal experience, ideally a blend of law firm and in‑house counsel roles within healthcare or health technology Demonstrated expertise in healthcare regulatory areas including HIPAA, fraud and abuse, corporate practice of medicine, telehealth, payer contracting, and MSO/PC structures Experience designing, managing, or scaling healthcare compliance programs tailored to growth‑stage or technology‑enabled healthcare companies Ability to assess and communicate risk clearly, balancing regulatory compliance with business objectives Strong interpersonal and communication skills, capable of translating complex legal issues into clear, actionable advice for diverse audiences Proven record of working cross‑functionally and collaborating with leadership, operations, and clinical teams Preferred Qualifications Experience in a telehealth or tech‑enabled healthcare environment Familiarity with value‑based care models and payer/provider partnerships Exposure to life sciences collaborations and related regulatory considerations Understanding of data privacy frameworks beyond HIPAA (e.g., CCPA, GDPR) Experience supporting corporate transactions, including fundraising or M&A activities Values Relentless focus on patients and caregivers. We are determined to provide an exceptional experience for every patient we serve, and we put our patients first in everything we do. Embody the spirit and humanity of those living with neurodegenerative disease. Inspired by our founders, families, and personal experiences, we recognize the seriousness of our patients' circumstances and meet that challenge with empathy, compassion, kindness, joy, and hope. Seek to understand, and stay curious. We listen first-to one another, our patients, and their caregivers-communicating authentically while recognizing there's always more to learn. Embrace the opportunity. We act with urgency and optimism, driven by the importance of our mission. Travel Expectations This is a fully remote position. Occasional travel to Synapticure's headquarters in Chicago, IL, or regional clinical team gatherings may be required. Salary & Benefits Competitive compensation based on experience Comprehensive medical, dental, and vision coverage 401(k) plan with employer matching Flexible scheduling and remote‑first work environment Life and disability insurance coverage Generous paid time off and sick leave Opportunities for professional development and advancement within a fast‑growing healthcare organization #J-18808-Ljbffr

Team At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social - by partnering with organizations deeply connected to the communities we serve. We're building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support. Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients. We're one of the largest Enhanced Care Management providers in California and are on track to build the nation's largest clinically integrated network supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions. At Pair Team, were not just delivering care - we're building the future of more equitable, community-driven healthcare. Our Values Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection. Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness. Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo. Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent. Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others. In the News Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team Axios: Pair Team collects $9M for Medicaid-based care About the Opportunity The Regional Operations Director - Field oversees the full operational performance of your assigned region. You will manage a large, distributed field team delivering Enhanced Care Management and community-based care, ensuring your region meets its financial targets, visit expectations, quality standards, and plan-driven requirements. This role requires a strong operator who can balance strategic thinking with hands-on execution. You will identify performance gaps early, use data to guide decisions, and work cross-functionally with Product, Central Operations, Quality/Compliance, Finance, and Recruiting to remove barriers and support scale. You will serve as the operational point of accountability for your region and ensure consistent, reliable, high-quality field execution. This role reports into the SVP of Operations. Internally this role is referred to as Regional General Manager. What You'll Do Lead and develop a high-performing field team (LCMs, RNs, BHCMs), ensuring clear expectations, consistent accountability, and strong performance management Manage operational and financial performance for your region, including OpEx oversight, productivity, workforce planning, and cost-to-serve targets Monitor enrollment, caseload distribution, visit volumes, documentation quality, and program adherence to ensure reliable, high-quality execution Build and maintain regional operating rhythms, dashboards, SOPs, and performance routines that support scale and consistency across the field Partner closely with Product, Central Operations, Quality/Compliance, Finance, and Recruiting teams to remove operational barriers, improve workflows, and support regional growth Operationalize health plan requirements and ensure alignment with internal processes, documentation standards, and program expectations Prepare and share data-driven insights on performance, resourcing, and risks; escalate issues early and drive solutions collaboratively Support hiring, onboarding, and talent development across your region in partnership with Recruiting and People Ops Maintain full compliance with ECM, health plan, and internal quality requirement What You'll Need 5-7+ years years of experience leading operations or regional teams in a high-growth, service-delivery environment; healthcare or Medicaid program experience is a strong plus Experience leading large, distributed field or clinical teams Proven success managing regional or multi-site operational and financial performance Strong understanding of Medicaid populations, plan operations, or value-based care models preferred Data-driven operator with experience using dashboards, metrics, and forecasting to guide decision-making Excellent communication, problem-solving, and cross-functional collaboration skills Comfort working in a fast-paced, evolving environment with changing program requirement Because We Value You Competitive salary: $130,000 - $145,000 (depending on experience) Equity compensation package Flexible vacation policy - take the time you need to recharge Comprehensive health, vision & dental insurance $50 employer contribution to active HSA accounts 401k through Guideline Life insurance and AD&D Work entirely from the comfort of your own home Monthly $100 work from home expense stipend We provide the equipment needed for the role Opportunity for rapid career progression with plenty of room for personal growth! Pair Team is an Equal Opportunity Employer. At Pair Team, we value diversity and strive to provide an inclusive environment for all applicants and employees. All applicants will be considered without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, marital status, age, disability, political affiliation, military service, genetic information, or any other characteristic covered by federal, state, or local law. Pair Team participates in E-Verify to verify employment eligibility for new hires. Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use. We do not conduct any TA business outside of ***************** emails. If you're ever concerned about spam or fraudulent activity, please reach out to ***********************. Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!

JOIN TEAM TRILOGY: At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of long-term care, competitive pay, and exceptional benefits, Trilogy offers a work environment where you're supported, appreciated, and empowered to thrive in your career. If you're ready to join a team committed to your success, Trilogy is where you belong and thrive! WHAT WE'RE LOOKING FOR: The MDS Coordinator (LPN, RN) is responsible for overseeing the resident assessment and care planning process and ensuring compliance with federal and state regulations related to resident assessments, quality of care and Medicare/Medicaid reimbursement. Key Responsibilities Conduct and complete the Minimum Data Set (MDS) assessment to evaluate residents' physical, psychological and functional status, including the implementation of Care Area Assessments (CAA)s and triggers. Evaluate each resident's condition and pertinent medical data to determine any need for special assessment activities or a need to amend the admission assessment. Prepare and electronically transmit timely reports to the national Medicare and Medicaid databases. Develop a written plan of care (preliminary and comprehensive) for each resident that identifies the problems/needs of the resident and the goals to be accomplished for each problem/need identified. Provide information to residents/families on Medicare/Medicaid and other financial assistance programs available to the residents. Ensure that MDS notes are informative and descriptive of the services provided and of the residents' response to the service. Assist with completing the care plan portion of the residents' discharge plan. Evaluate and implement recommendations from established committees as they pertain to the assessment and/or care plan functions of the health campus. Qualifications Must have and maintain a current, valid state LPN or RN license Three (3) to five (5) years' experience working in the MDS or assessment role in a senior residential care, healthcare, senior living industry or long-term care environment, preferred Current, valid CPR certification required Compensation will be determined based on the relevant license or certification held, as well as the candidate's years of experience. WHERE YOU'LL WORK : Location: US-OH-Gahanna LET'S TALK ABOUT BENEFITS: Our comprehensive Thrive benefits program focuses on your well-being, offering support for personal wellness, financial stability, career growth, and meaningful connections. This list includes some of the key benefits, though additional options are available. Medical, Dental, Vision Coverage - Includes free Virtual Doctor Visits, with coverage starting in your first 30 days. Get Paid Weekly + Quarterly Increases - Enjoy weekly pay and regular quarterly wage increases. Spending & Retirement Accounts - HSA with company match, Dependent Care, LSA, and 401(k) with company match. PTO + Paid Parental Leave - Paid time off and fully paid parental leave for new parents. Inclusive Care - No-cost LGBTQIA+ support and gender-affirming care coordination. Tuition & Student Loan Assistance - Financial support for education, certifications, and student loan repayment. GET IN TOUCH: Misty APPLY NOW: Since our founding in 1997, Trilogy has been dedicated to making long-term care better for our residents and more rewarding for our team members. We're proud to be recognized as one of Fortune's Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor's Top 100 Best Companies to Work. At Trilogy, we embrace who you are, help you achieve your full potential, and make working hard feel fulfilling. As an equal opportunity employer, we are committed to diversity and inclusion, and we prohibit discrimination and harassment based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. NOTICE TO ALL APPLICANTS (WI, IN, OH, MI & KY): for this type of employment, state law requires a criminal record check as a condition of employment.

This is a 12-month, full time position with benefits; This position will coordinate medical charges according to ICD 10 and billing insurance guidelines; compiles, codes, and processes medical billing data; serves as a resource to provide information regarding coding, insurance coverage and participation to staff and patients; conducts patient check out and functions as patient advocate clarifying pre-authorizations, in-network and out-of-network benefits and resolving billing and payment issues. Minimum Requirements Knowledge normally acquired through high school education; three to five years of related and progressively more responsible or expansive work experience in medical billing including medical terminology, procedural coding, diagnostic coding, Blue Cross Blue Shield/Medicare/Medicaid/ HMO/PPO claims processing; experience with automated charge entry and accounts receivable software; experience with a variety of Employee Health Record (EHR) systems, specifically Athena; case policy adjustments; Aetna Student Insurance; Student Information System (SIS) processing; or an equivalent combination of education and experience Desired Qualifications Completion of college coursework in health care or business-related field; certification in medical coding; excellent interpersonal skills to assist students in understanding financial obligations. Equal Employment Opportunity Statement All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, age, disability or protected veteran status. Required Application Materials Resume Cover letter Work Hours STANDARD 8-5 Website uhw.msu.edu Summary of Health Risks TB and Human Tissue Remote Work Statement MSU strives to provide a flexible work environment and this position has been designated as remote-friendly. Remote-friendly means some or all of the duties can be performed remotely as mutually agreed upon. Bidding eligibility ends December 16, 2025, 11:55 PM

JOIN TEAM TRILOGY At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of long-term care, competitive pay, and exceptional benefits, Trilogy offers a work environment where you're supported, appreciated, and empowered to thrive in your career. If you're ready to join a team committed to your success, Trilogy is where you belong and thrive! POSITION OVERVIEW A Business Office Manager is responsible for overseeing the billing, collections and financial operations of the health campus. They handle financial tasks such receiving and depositing payments, making collections calls and issuing letters, discussing payment arrangements with account holders, and working with Medicare, Medicaid and insurance companies on claims and reimbursements. Key Responsibilities * Leads billing and collections for all of the campus payer types. * Establishes and maintains filing systems for accounts receivable and resident information. * Creates and manages the setup of new residents and resident trust accounts in the accounts receivable system. * Maintains census records in the Accounts Receivable system for accurate billing. * Manages monthly billing processes for all payer classes in an accurate and timely manner according to the monthly AR calendar. * Posts payments received appropriately to the correct resident account. * Monitors and collects accounts receivable. Qualifications * High school diploma or GED/HSE preferred * 1-3 years of relevant experience preferred LOCATION US-OH-New Albany Smiths Mill Health Campus 7320 Smith's Mill Road New Albany OH BENEFITS Our comprehensive Thrive benefits program focuses on your well-being, offering support for personal wellness, financial stability, career growth, and meaningful connections. This list includes some of the key benefits, though additional options are available. * Medical, Dental, Vision Coverage - Includes free Virtual Doctor Visits, with coverage starting in your first 30 days. * Get Paid Weekly + Quarterly Increases - Enjoy weekly pay and regular quarterly wage increases. * Spending & Retirement Accounts - HSA with company match, Dependent Care, LSA, and 401(k) with company match. * PTO + Paid Parental Leave - Paid time off and fully paid parental leave for new parents. * Inclusive Care - No-cost LGBTQIA+ support and gender-affirming care coordination. * Tuition & Student Loan Assistance - Financial support for education, certifications, and student loan repayment. TEXT A RECRUITER Misty ************** ABOUT TRILOGY HEALTH SERVICES Since our founding in 1997, Trilogy has been dedicated to making long-term care better for our residents and more rewarding for our team members. We're proud to be recognized as one of Fortune's Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor's Top 100 Best Companies to Work. At Trilogy, we embrace who you are, help you achieve your full potential, and make working hard feel fulfilling. As an equal opportunity employer, we are committed to diversity and inclusion, and we prohibit discrimination and harassment based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. NOTICE TO ALL APPLICANTS (WI, IN, OH, MI & KY): for this type of employment, state law requires a criminal record check as a condition of employment. A Business Office Manager is responsible for overseeing the billing, collections and financial operations of the health campus. They handle financial tasks such receiving and depositing payments, making collections calls and issuing letters, discussing payment arrangements with account holders, and working with Medicare, Medicaid and insurance companies on claims and reimbursements. Key Responsibilities * Leads billing and collections for all of the campus payer types. * Establishes and maintains filing systems for accounts receivable and resident information. * Creates and manages the setup of new residents and resident trust accounts in the accounts receivable system. * Maintains census records in the Accounts Receivable system for accurate billing. * Manages monthly billing processes for all payer classes in an accurate and timely manner according to the monthly AR calendar. * Posts payments received appropriately to the correct resident account. * Monitors and collects accounts receivable. Qualifications * High school diploma or GED/HSE preferred * 1-3 years of relevant experience preferred At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of long-term care, competitive pay, and exceptional benefits, Trilogy offers a work environment where you're supported, appreciated, and empowered to thrive in your career. If you're ready to join a team committed to your success, Trilogy is where you belong and thrive!

About Client: They help in transforming the leading organizations and communities around the world. Organizations infrastructure and culture is amazing. Best place!! Job Title: Health Payer Technology Medicare Consultant Job Level: Senior Level Job Description: THIS IS WHAT YOU WILL DO... You will be adapting existing methods and procedure to create possible alternative solutions to moderate complex problems. You will design and implement solutions that are Medicare complaint. You will be understanding the strategic direction set by senior management as it relates to team goals. WE ARE LOOKING FOR SOMEONE.!! Who holds 4 years of experience as a consultant! Who holds consulting experience in US Healthcare Payer market! Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is experienced in systems and processes required to support health plan! Who is currently in Medicare/ Medicaid! Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM experience! Who holds 2 years experience with Medicare systems and technologies with formal consulting! Qualifications Who holds 4 years of experience as a consultant! Who holds consulting experience in US Healthcare Payer market! Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Additional Information All your information will be kept confidential according to EEO guidelines.

BerryDunn is seeking a Third-Party Liability (TPL) Subject Matter Expert (SME) to join our Medicaid Practice Group. This position will support client work for a State Health and Human Services (HHS) agency that has requested subject matter expertise and technical support services to strengthen and enhance its TPL program. The TPL SME will focus on ensuring Medicaid operates as the payer of last resort by supporting identification, coordination, and recovery of payments from liable third parties such as commercial insurers, Medicare, and casualty/liability carriers. In this role, the TPL SME will review existing TPL processes, support business process redesign (BPR) efforts, and provide guidance to agency staff on compliance with federal and state requirements. The position will also provide support for audits, federal reporting, and quality assurance activities related to TPL recovery. In addition, the TPL SME will be responsible for assisting the agency in policy interpretation, training development, and data analysis to maximize recoveries and strengthen operational efficiency. Your initial focus will be on supporting our Hawai'i client. You will report to and partner with senior management in our Medicaid team, both for client work and career development. With a growth mindset, you will drive your development with the support of a learning and development culture. This position offers flexibility in work location, with the option to work fully onsite or in a hybrid capacity. Given that you may be collaborating with teams across multiple time zones, you will need to manage your schedule effectively to ensure availability for meetings and meet deadlines, while having the freedom to work independently when necessary. Travel Expectations: Travel to client sites can range up to 50%. You Will Provide frequent, clear, and consistent communication to the client, team members, vendors, and stakeholders regarding TPL activities and outcomes. Participate in TPL unit and/or cross-functional Medicaid team meetings to provide SME input and updates. Perform quality reviews of claims, eligibility records, and third-party data to ensure Medicaid is acting as the payer of last resort. Review existing TPL processes and support business process redesign (BPR) efforts to increase efficiency, compliance, and recovery outcomes. Serve as an SME on TPL policies, regulations, and recovery processes, guiding staff and State leadership. Aid in the development of policies, procedures, and training materials to strengthen TPL operations. Support audits, federal reporting, and compliance reviews related to TPL performance and recovery. Perform assigned administrative and technical tasks efficiently and effectively, asking questions when instructions are unclear. You Have Ability to conduct research and analysis related to Medicaid claims, eligibility systems, and third-party payer data to identify recovery opportunities. Strong knowledge of federal and state TPL requirements and coordination of benefits processes. Prior experience supporting a state Medicaid agency TPL program (preferred experience in cost avoidance, recovery, or related audit/compliance activities). Experience reviewing processes and supporting business process redesign (BPR) efforts. Strong experience with Microsoft Excel, Word, and PowerPoint, and ability to work with Medicaid eligibility and claims processing systems. Demonstrated ability to interpret and apply complex regulations, policies, and contracts related to Medicaid and TPL. Excellent written and verbal communication skills, with the ability to convey technical TPL concepts clearly to staff, leadership, and external partners. Compensation Details The base salary range targeted for this role is $85,000 - $115,000. This position may also be eligible for a discretionary annual bonus based on factors such as company and personal performance. This salary range represents BerryDunn's good faith and reasonable estimate of the range of possible compensation at the time of posting. If an applicant possesses experience, education, or other qualifications more than the minimum requirements for this posting, that applicant is encouraged to apply, and a final salary range may then be based on those additional qualifications; compensation decisions are dependent on the facts and circumstances of each case. The salary of the finalist selected for this role will be based on a variety of factors, including but not limited to years of experience, depth of experience, seniority, merit, education, training, amount of travel, and other relevant business considerations. BerryDunn Benefits & Culture Our people are what make BerryDunn special, and in return we strive to support our employees and help them thrive. Eligible employees have access to benefits that go beyond what's expected to support their physical, mental, career, social, and financial well-being. Visit our website for a complete list of benefits and a look into our culture: Experience BerryDunn. We will ensure that individuals are provided reasonable accommodation to participate in the job application or interview process or perform essential job functions. Please contact ********************* to request an accommodation. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. About BerryDunn BerryDunn is the brand name under which Berry, Dunn, McNeil & Parker, LLC and BDMP Assurance, LLP, independently owned entities, provide services. Since 1974, BerryDunn has helped businesses, nonprofits, and government agencies throughout the US and its territories solve their greatest challenges. The firm's tax, advisory, and consulting services are provided by Berry, Dunn, McNeil & Parker, LLC, and its attest services are provided by BDMP Assurance, LLP, a licensed CPA firm. BerryDunn is a client-centered, people-first professional services firm with a mission to empower the meaningful growth of our people, clients, and communities. Led by CEO Sarah Belliveau, the firm has been recognized for its efforts in creating a diverse and inclusive workplace culture, and for its focus on learning, development, and well-being. Learn more at berrydunn.com. #BD_CT Don't See A Match For You At This Time? We invite you to join our Talent Connection and let's stay in touch

Salary: Interested in making an impact in the lives of high school and elementary aged youth?Join DREAMs Guided Mentoring program and become an influential figure in the lives of youth. As a Mentor Guide in this two-tiered, cross-age Mentor-in-Training program you help provide high school students with the tools, resources, and confidence to provide mentorship to elementary school-aged youth. The Experience of Service as a Mentor Guide: In collaboration with the Guided Mentoring team, you will focus on engaging and supporting around 5-10 high school mentors in the curriculum and practices of the Guided Mentoring program. You will help plan and facilitate lessons and activities which are fun, play-based, and help youth dream big. These activities will be delivered through weekly school day classroom programming and/or afterschool programming, as well as occasional out of school time adventure experiences. Our objectives include helping to prepare high school youth to have effective, impactful mentorship relationships with elementary age youth, and provide opportunities for them to strengthen and expand their sense of place, identity, and meaning and purpose.Various options for hours of service are available, you can find specific details under the Compensation and AmeriCorps Benefits section of this job description. Flexibility exists in the breadth and depth of the Mentor Guides role and responsibilities which will be determined in partnership with the regional manager and school personnel partners. When applicable, you will also assist with planning and activities for Summer, weekends, and other times that are carried out during our out of school hours that are created to maintain relationships and expand horizons. Primary Objectives of Service as a Mentor Guide: You will create powerful, developmentally appropriate mentoring relationships with high school mentor groups and individual high school mentors. You will attend weekly programming sessions with mentors and mentees. Secondary Objectives: You will foster a bonded, positive, and supportive community of high school aged mentors and elementary aged mentees. You will ensure thoughtful and thorough curriculum lessons and activities, based on DREAMs Guided Mentoring curriculum,incorporation of the Search Institutes Developmental Relationships Framework,and Mentors Elements of Effective Practiceand formal reflection assessments. These will help each high school mentor to be prepared, trained and ready to provide a safe and culturally appropriate experience to elementary school aged mentees. You will ensure, primarily through curriculum lessons, activities, and reflections, that high school mentors have a strong understanding of the four curricular themes: mentoring, identity, sense of place, and meaning & purpose. You will facilitate development of high school mentors organizational and time management skills. You will communicate with mentors weekly. You will help ensure that thorough communications and dialogue with DREAM youth and their families support them in having agency and influence over their DREAM experience. Additional Objectives: Contribute to building connections and relationships with parents and community partners. Required Qualifications: Commitment to the entire service term. Commitment to the mission of AmeriCorps and DREAM. Desire to enhance existing skills and develop new skills necessary for service. Commitment to serve as a role model for youth. A passion for supporting the ongoing work of creating an inclusive and welcoming environment for all youth. A dedicated personal, off site, non DREAM supported space for work, with: An internet connection capable of easily handling Google Workspace apps and specifically, a Google Meet. Access to resources necessary to support your remote work/service experience (electrical power outlet to keep devices charged, reliable wifi connection that can connect with our cloud-based softwares). Ability to regularly meet in person with your team or your service assignment in their assigned location (including responsibility for transportation to and from). Access to a reliable phone. To be an AmeriCorps member you MUST be 17 years or older and be a US Citizen, US National, or Lawful Permanent Resident. Preferred Qualifications: Valid driver's license and insurance High School Diploma, Post Secondary Education Certification or Training and/or College Coursework 18+ years old with a clean driving record Youth one-on-one and group facilitation experience Interest and investment in youth development Ability to work independently and as a member of a team Commitment to holding unconditional positive regard for DREAM you Willingness to obtain certification and transport students in DREAMs 15 passenger van. This requires being 19 years old and having had your license for at least 2 years. If possible, we would like individuals to be able to serve two years in the program (not required). Compensation and AmeriCorps Benefits: A living stipend is provided to you in biweekly payments. The stipend amount is dependent upon your weekly hours commitment. Hours options: PT: 7-14, 15-20, 21-30 hours weekly 7-14: $250 biweekly stipend 15-20: $425 biweekly stipend 21-30: $637.50 biweekly stipend Full time: 31-40 hours weekly, $850 biweekly stipend This position operates through the 2025-2026 academic year; approximately mid-August through mid-June This position serves one or more of DREAMs Guided Mentoring for High School Youth program sites. AmeriCorps members are also eligible for (based on total annual income): Supplemental Nutrition Assistance Program (SNAP) (food stamps) Child care assistance Medicaid Student loan deferment (forbearance) Other publicly-funded benefits, such as heating and utility assistance. Upon the completion of the service term, AmeriCorps members are eligible to receive the Segal Education Award, which can be used to pay education expenses or repay qualified student loans. As an AmeriCorps member at DREAM, you will have the additional support of a DREAM AmeriCorps Director to help you navigate your service term and apply for publicly funded programs. If you engage in work-related travel outside of a commute, DREAM will provide reimbursement for mileage. Work environment: This position operates in multiple spaces. The spaces included are primarily an indoor/outdoor environment with active children, within the school communities we serve, in public/field trip spaces in the local area, and occasionally in a workplace environment for planning and meetings. You may also be visiting our rustic Camp DREAM. The role also may at times utilize equipment characteristic of an outdoor and indoor youth day camp (pop-up shade canopies/tents, hand tools, activity supplies, food preparation equipment, storage spaces and sports equipment/toys). This role routinely uses computers, as well as phones and printers for communications and activity planning. During the summer, conditions will be warm and activities will often be held outdoors. Physical demands:The physical demands described here are representative of those that must be met by an employee/member to successfully perform the essential functions of this job: This position requires comfort working in outdoor environments, regardless of the weather. This position is very active and frequently requires standing, walking, bending, kneeling, stooping, crouching, crawling, and climbing. While performing the duties of this job, the employee/member is regularly required to communicate with individuals who talk and hear. The employee/member may occasionally lift and/or move items over 50 pounds. While performing the duties of this job, the employee/member is regularly required to observe and comprehend using vision abilities that include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. Travel: Travel includes local travel during the work hours described. Out-of-the-area and overnight travel may be occasionally expected. AAP/EEO Statement: The DREAM Program is an equal opportunity employer and an incorporated 501(c)3 charitable organization. The DREAM Program prohibits discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. At will employment: The DREAM Program is an at will employer. AmeriCorps membership with The DREAM Program is voluntary and is subject to termination by you or The DREAM Program at will, with or without cause, and with or without notice, at any time. The policy of employment-at-will may not be modified by any officer or employee.

About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit **************** Applications Due January 5th, 2026 Position Summary: The PGY1 Managed Care Resident helps to ensure safe and cost-effective medication therapy for our members, supports initiatives to maintain the drug benefit for commercial, Medicare, Medicaid, and health insurance marketplace clients, and plays an active role in the development and maintenance of formularies and clinical programs as part of their learning experience. Position Responsibilities: Support initiatives to maintain the drug benefit for commercial, Medicare, Medicaid, and health insurance marketplace clients Play an active role in the development and maintenance of formularies for multiple lines of business Analyze pharmacy cost of care, trends, and coordinate the development of appropriate utilization management edits including step therapy, prior authorization, and quantity limits Design pharmacy benefits for populations of patients based on client-specific elections Create pharmaceutical pipeline newsletters / publications / presentations Provide clinical resource including support of the prior authorization unit and clinical call center Analyze utilization data and creates reports for group plan sponsors (i.e., employers, labor unions, etc.) Participate in the development and maintenance of clinical programs such as drug utilization review, medication therapy management, adherence, and disease management programs Evaluate industry data to improve existing clinical programs and make recommendations with a focus on clinical offerings and value proposition Support the clinical client management team, as needed Observe and participate in committee activities related to the pharmacy program Design, manage, and complete a clinical residency project for presentation at a conference with the intent to publish research findings Supervise pharmacy students and further develop the student program, including coordination with preceptors as needed Support quality improvement projects, as needed Support request for information and request for proposal submissions, as needed Support general business needs and operations, as required All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. Minimum Qualifications: Doctor of Pharmacy (PharmD) Degree from an accredited School of Pharmacy completed prior to start of residency program Strong academic performance with a minimum of 2.8 GPA and successful completion of all APPE rotations Licensed Pharmacist or eligible for licensure (must be licensed by September 30th of the residency year) Proficient in Microsoft office Suite with emphasis on Microsoft Excel Ability to balance multiple complex projects simultaneously Excellent communication and interpersonal skills, and ability to work with team members, executive management, and business partners in a polished and professional manner Ability to work independently, virtually, and in a team environment to produce solutions from concept to final deliverables required Familiarity working with large data sets Exceptional written and verbal communication skills Extremely flexible, highly organized, and able to shift priorities easily Attention to detail and commitment to delivering high quality work product This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Salary Range$50,000-$50,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************

Serves in an operational leadership role for a defined RSI team, process, and/or function, either on an enterprise (multi-site) basis or a high-impact function for a single site. Coordinates own and team member roles and work assignments to deliver success over the area managed and its outputs. Formally supervises one or more staff, or in lieu of having direct formal HR supervisory duties, is personally accountable for a defined core revenue function or process with large financial impact to organization and requiring manager-level capabilities. Participates in the identification of opportunities to improve revenue performance and efficiency/effectiveness of the assigned area and acts as a catalyst for realizing these improvements. Brings awareness of current external environment issues relevant to the area managed. This position will lead and oversee government reimbursement (Medicare/Medicaid) operations across Mayo Clinic and Mayo Clinic Health System, ensuring strategic alignment, compliance, and optimization of financial performance. Primary Responsibilities Provide strategic direction and oversight for data management and analysis related to Medicare/Medicaid reimbursement, ensuring actionable insights drive organizational performance. Develop and implement strategies to optimize government reimbursement processes, identifying new opportunities and guiding operational improvements. Interpret and advise on regulatory changes for Medicare Part A and B and other government programs, ensuring compliance and influencing practice strategies across the enterprise. Oversee preparation and submission of Medicare cost reports and other government reporting requirements, ensuring accuracy, timeliness, and adherence to compliance standards. Lead cross-functional collaboration with administration, physician leadership, finance, revenue cycle, compliance, and operational teams to align reimbursement strategies with organizational goals. Mentor and guide team members, fostering professional development and building expertise in government reimbursement practices. Bachelors' degree, preferably in a business-related field is required. Minimum three (3) years in a professional role in a health care organization with direct experience in the specific assigned functional area, and involved in the strategic, financial, and technical elements of the function. Specific assigned functional areas can include Pricing/Chargemaster, Medicare Reimbursement, Actuarial Science, Payment Reform, and Reimbursement/Revenue Analytics. Must have outstanding skills in team leadership, stakeholder relationship management, planning, decision making and detail-oriented quantitative analysis. Needs strong skills in verbal and written communications and managing multiple tasks concurrently. Positive attitude and persuasive skills are essential for success. Preferred Qualifications Master's degree in healthcare, accounting/finance, or data science with four years of experience in a healthcare reimbursement, accounting/finance, or data analysis role or bachelor's degree with seven years of healthcare reimbursement, data analysis, accounting, and/or finance related experience. This vacancy is not eligible for sponsorship/ we will not sponsor or transfer visas for this position. Also, Mayo Clinic DOES NOT participate in the F-1 STEM OPT extension program.

Job description Equivity is seeking an experienced virtual paralegal to support attorneys in estate planning, probate, and elder law matters. Experience with conservatorships, guardianships, long-term care planning, asset protection, or Medicaid planning is a strong plus. This is a remote opportunity to work on meaningful cases that help individuals and families navigate complex legal issues with confidence and care. Key Responsibilities: Draft estate planning documents, including wills, trusts, powers of attorney, and advance directives. Prepare and file probate documents, such as petitions, asset inventories, creditor notices, and accountings. Provide support in elder law matters, including long-term care planning and communication with beneficiaries and financial institutions. Maintain and manage case files, calendars, deadlines, and correspondence using cloud-based legal software. Assist with client intake, court filings, and coordination with court personnel and financial professionals. Maintain proactive and professional communication with clients during standard business hours (9 AM - 6 PM) About You: Minimum of 3 years of recent paralegal experience in estate planning and/or probate law. Elder law experience is preferred and valued. Experience with conservatorships, guardianships, or Medicaid planning is a plus. Familiarity with case management software such as Clio, MyCase, or similar. Familiarity with legal drafting software like WealthCounsel and HotDocs is strongly preferred. Skilled in managing probate administration and preparing comprehensive estate planning packages. Highly organized, self-motivated, and comfortable working independently in a virtual environment. Equipped with a Windows-based laptop, smartphone, and broadband internet connection. Why Work with Equivity? Comprehensive Benefits: Medical, dental, vision, paid sick leave, employee discounts, EAP, and expense reimbursements. Flexible Remote Work: Enjoy the autonomy of working from home while contributing to meaningful legal work. Performance Bonuses: Quarterly incentives are awarded for exceptional performance. Professional Growth: Work with a team of experienced professionals and develop long-term relationships with a variety of clients. About Equivity: Equivity provides virtual paralegal, administrative, and marketing support to attorneys and businesses across the United States. Our remote team members enjoy flexible work schedules while building strong, long-term relationships with clients. Requirements: Bachelor's degree. Minimum 3 years of recent paralegal experience, one at least two (2) of the areas listed above. Availability to respond to client requests within one hour, Monday through Friday, 9 AM - 6 PM Ability to work 20-40 hours per week on an ongoing basis. Minimal Specifications: Windows 10 2GHz processing speed (typically Intel or AMD) i5 processor & above 8GB+RAM 100GB+of hard drive space Bitdefender, McAfee Antivirus Plus OR Symantec Norton AntiVirus Basic To learn more about Equivity, visit ****************** Equivity is an Equal Opportunity Employer. We are committed to fostering a diverse, inclusive, and respectful work environment free from discrimination and harassment. All done! Your application has been successfully submitted! Other jobs

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary: WellSense Health Plan is seeking a dedicated and experienced Senior Health Data Analyst to join our team on a full-time, regular basis. The Senior Health Data Analyst is a key member of the team and serves as a strategic partner to various functional areas throughout the organization to meet corporate objectives. Under the leadership and guidance of Senior Director of Clinical, Operational, and Payment Analytics, the analyst will focus on planning, developing and building of analytical tools to further assess and manage healthcare KPIs during key analytic exercises. The ideal candidate will have a strong background in health data analysis, excellent problem-solving skills, and the ability to communicate complex information clearly to stakeholders. Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits Key Functions/Responsibilities: · Work closely with the Senior Director of Clinical, Operational, and Payment Analytics to develop, maintain, and leverage a best in class clinical analytics infrastructure to support the Plan's Medical Management strategy. · Collaborate with cross-functional teams to understand data requirements and ensure the accuracy and integrity of data analysis · Lead the development of critical analytic processes comparing Plan's performance against benchmarks to determine areas of focus and opportunity and help maintain industry competitiveness and intelligence. · Work closely with supervisor to present data and findings with insights to the clinical leadership teams to help launch performance improvement initiatives. · Work closely with all levels of Medical Management (including Case Management) leadership in determining how operational and clinical data might assist in addressing their needs. · Build and maintain dashboards that are critical to fine tuning operations. · Work closely with stakeholders to develop critical drill downs as needed to support the development of initiatives to target the areas of over-utilization. · Develop and maintain operational dashboards and performance measurement tools, and reports to measure impact of initiatives · Work with internal and external customers to elicit business data requirements; collaborates with data architects and develops code to meet the data needs of all constituents. · Understand processes and workflows within Medical Management Operations, and translate clinical and operational metric needs into business reporting requirements · Coordinate and participate in Medical Management Operations' technical initiatives, including the development of operational reports and technical specifications in support of all aspects of our UM initiatives. · Work to ensure continuous improvement and adoption of data management best practices · Ensuring compliance with data governance and privacy policies Qualifications: Education: · Bachelor's Degree required Experience: · Experience in healthcare data analysis and reporting is required. · Three or more years conducting advanced analytics using SAS and/or SQL. · Must have deep understanding and hands-on experience with Tableau or other data visualization tools · Excellent problem solving and analytical skills · Self-motivated, takes initiative to identify opportunities for improvement and makes recommendations for improvement · Ability to work independently and collaboratively · Ability to communicate customers about data needs and explaining report methodologies · Working knowledge of utilizing Enterprise Data Warehouse · Ability to think out-of-the-box to handle any challenging and complex request · Experience managing multiple initiatives or projects at a given time · Ability to foster teamwork and positive attitude. Certification or Conditions of Employment: · Pre-employment background check Competencies, Skills, and Attributes : · Advanced SAS and/or SQL programming skills. · Proficient in Microsoft Excel. · Proficient in Tableau (Desktop and Server) · Some knowledge of Python scripting · Strong analytical and problem solving abilities. Ability to use all relevant data to support decision making. · Enjoy analytical challenges in a fast paced environment with strong ability for managing multiple projects simultaneously and meeting deadlines. About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

Our Company Amerita Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. As one of the most respected Specialty Infusion providers in America, we service thousands of patients nationwide through our growing network of branches and healthcare professionals. The Refund/Dispute Specialist is responsible for processing incoming payer refund requests by researching to determine whether the refund is appropriate or a payer dispute is warranted in accordance with applicable state/federal regulations and company policies. The Refund/Dispute Specialist works closely with other staff to identify, resolve, and share information regarding payer trends and provider updates. The employee must have the ability to prioritize, problem solve, and multitask. This is a Remote opportunity. Applicants can reside anywhere within the Continental USA. Schedule: Monday-Friday, 7:00AM to 3:30PM Mountain Time We Offer: • Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts • Supplemental Coverage - Accident, Critical Illness and Hospital Indemnity Insurance • 401(k) Retirement Plan with Employer Match • Company paid Life and AD&D Insurance, Short-Term and Long-Term Disability • Employee Discounts • Tuition Reimbursement • Paid Time Off & Holidays Responsibilities Reverses or completes necessary adjustments within approved range. Ensures daily accomplishments by working towards individual and company goals for cash collections, credit balances, medical records, correspondence, appeals/disputes, accounts receivable over 90 days, and other departmental goals Understands and adheres to all applicable state/federal regulations and company policies Understands insurance contracts in terms of medical policies, payments, patient financial responsibility, credit balances, and refunds Verifies dispensed medication, supplies, and professional services are billed in accordance to the payer contract. Validates accuracy of reimbursement and the appropriate deductible and cost share amounts billed to the patient per the payer remittance advice. Reviews remittance advices, payments, adjustments, insurance contracts/fee schedules, insurance eligibility and verification, assignment of benefits, payer medical policies and FDA dosing guidelines to determine if a refund or dispute is needed. Completes payer/patient refunds as needed and validates receipt of previously submitted refunds/disputes. Creates payer dispute letters utilizing Amerita's standard dispute templates and gathers all supporting documentation to substantiate the dispute. Submits disputes to payers utilizing the most efficient resources, giving priority to electronic solutions such as payer portals. Scans and attaches disputes to patient's electronic medical record in CPR+. Works closely with intake, patients, and payers to settle coordination of benefit issues. Communicates new insurance information to intake for insurance verification and authorization needs. Submits credit rebill requests as needed to the billing department or coordinates patient-initiated billing efforts to insurance companies. Initiates and coordinates move and cash research requests with the cash applications department. Utilizes approved credit categorization criteria and note templates to ensure accurate documentation in CPR+ Works within established departmental goals and performance/productivity metrics Identifies and communicates issues and trends to management Qualifications High School diploma/GED or equivalent required; some college a plus A minimum of one to two (1-2) years of experience in revenue cycle management with a working knowledge of Managed Care, Commercial, Government, Medicare, and Medicaid reimbursement Working knowledge of automated billing systems; experience with CPR+ and Waystar a plus Working knowledge and application of metric measurements, basic accounting practices, ICD 9/10, CPT, HCPCS coding, and medical terminology Solid Microsoft Office skills with the ability to type 40+ WPM Strong verbal and written communication skills with the ability to independently obtain and interpret information Strong attention to detail and ability to be flexible and adapt to workflow volumes Knowledge of federal and state regulations as it pertains to revenue cycle management a plus Flexible schedule with the ability to work evenings, weekends, and holidays as needed About our Line of Business Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit ****************** Follow us on Facebook, LinkedIn, and X. Salary Range USD $18.00 - $20.00 / Hour

Company Navitus About Us Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at ************************************ to be considered for internal opportunities. Pay Range USD $17.78 - USD $20.91 /Hr. STAR Bonus % (At Risk Maximum) 0.00 - Ineligible Work Schedule Description (e.g. M-F 8am to 5pm) M-Th between 8:30am to 7pm and F 8:30am-5pm Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview Navitus Health Solutions is seeking a Clinical Intern to join our team! The Clinical Intern will be a key contributor to the success of our Clinical Engagement Center focused on improving member's health and wellness via tele-pharmacy and wellness coaching. Under the supervision of a clinician, this individual is responsible for the delivery of the Medication Therapy Management (MTM) services for commercial and Medicare members. In addition, the Clinical Intern will assist in the development and execution of additional clinical outreach programs to exceed client expectations. The MTM program will include telephonic and/or video chat outreach with members to complete an analysis of a member's medication regimen for prescription, OTC, herbal and supplement medications. The assessment will include the development of a personalized Medication Action Plan in partnership with the member as required by CMS. Is this you? Find out more below! Responsibilities How do I make an impact on my team? Conduct medication therapy management (MTM) and expanded clinical programs in accordance with the Centers for Medicare & Medicaid Services (CMS). Develop appropriate clinical algorithms, pathways and call scripts to support pharmacy staff in delivering MTM services. Review and update all algorithms and call scripts with updated clinical guidelines. Develop documentation standards for clinical outreach. Collaborate with other CEC staff to develop and maintain a high quality and consistent MTM product. Assist CEC leadership to develop programs to support STAR ratings outreach. Provide clinical outreach to members, prescribers, and pharmacy providers in order to enhance care coordination. Develop a full understanding of Navitus' Clients' member experience and how the engagement center contributes to improved health and wellness. Adhere to compliance and HIPAA regulations. Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives. Other duties as assigned Qualifications What our team expects from you? Education: In DPH-2 or DPH-3 year. CPhT Preferred. Experience: Must be 18 years or older. Experience working in Microsoft Office suite, particularly Word, Excel, and PowerPoint preferred. The intern role is considered a learning opportunity and as such, no specific experience is required. Preference may be given to candidates with work experience or education paths determined desirable by the department each intern supports. Participate in, adhere to, and support compliance program objectives. The ability to consistently interact cooperatively and respectfully with other employees. Participate in, adhere to, and support compliance program objectives The ability to consistently interact cooperatively and respectfully with other employees What can you expect from Navitus? Top of the industry benefits for Health, Dental, and Vision insurance 20 days paid time off 4 weeks paid parental leave 9 paid holidays 401K company match of up to 5% - No vesting requirement Adoption Assistance Program Flexible Spending Account Educational Assistance Plan and Professional Membership assistance Referral Bonus Program - up to $750! #LI-Remote Location : Address Remote Location : Country US