Medicare jobs near me - 1,673 jobs

*Employment Type:* Full time *Shift:* Day Shift *Description:* Looking for a career that combines purpose, flexibility, and innovation? At *Mount Carmel Home Care*, you'll deliver exceptional care to patients in the comfort of their own homes while being part of a supportive, mission-driven team. If you're an enthusiastic, detail-oriented Occupational Therapist, we want to hear from you! *Why You'll Love This Role:* *One-to-One Care:* Build meaningful relationships with your patients by providing personalized, patient-centered therapy in their homes. *Cutting-Edge Technology:* Utilize advanced tools and resources to deliver the best care possible. *Collaborative Environment:* Work alongside physicians, nurses, social workers, and home health aides in a multidisciplinary approach. *Flexibility & Independence:* Thrive in an autonomous work environment with the freedom to manage your schedule. *Growth Opportunities:* Access career paths, professional development, and tuition reimbursement of up to $5,250/year. *Your Key Responsibilities:* * Provide expert care to help patients achieve their rehabilitation goals in their homes. * Collaborate with a motivated, inspiring team of colleagues. * Use advanced, easy-to-use technology to improve patient outcomes. *What We're Looking For:* * Graduate of an accredited Occupational Therapy program. * Eligible for National Board Certification in Occupational Therapy (NBCOT). * Minimum 1-year experience (or ability to complete 6-8 weeks of preceptorship). * Home healthcare experience preferred. * Current driver's license and reliable transportation. * A passion for providing compassionate, mission-aligned care. *Benefits That Set Us Apart:* *Day One Benefits:* Medical, dental, and vision coverage. *403(b) Matching:* Plan for your future with our retirement program. *Generous PTO + Paid Holidays:* Recharge with ample time off. *Comprehensive Orientation:* Start strong with thorough onboarding. *Short- and Long-Term Disability Insurance:* Feel secure with added support. *About Us:* Mount Carmel Home Care is a member of [Trinity Health At Home]( a national home care, hospice and palliative care organization serving communities throughout eleven states. As a faith-based, not-for-profit agency, Mount Carmel Home Care serves patients and families in the comfort of home, offering skilled nursing, therapy (physical, occupational, speech) and medical social work. We are Medicare certified and accredited by The Joint Commission. Learn more about us at [MountCarmelHomeCare.org.]( *Our Commitment * Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, veteran status, or any other status protected by federal, state, or local law.

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.

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.

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!

*Employment Type:* Full time *Shift:* *Description:* As a Home Care Registered Nurse (RN) at Mount Carmel Home Care, you'll deliver one-on-one, high-quality care to patients in the comfort of their homes. Using advanced technology and your clinical expertise, you'll assess, plan and manage individualized care that promotes healing and independence. Why Join Us? Start Here… Grow Here... Stay Here! At our core, we believe in building careers, not just jobs. Many of our team members stay with us for the long haul-and for good reason. Our culture is built on support, growth, and opportunity. What You Can Expect: * *Consistent, Reliable Workloads* Enjoy steady assignments with guaranteed hours-no surprises. * *Competitive Pay & Low-Cost Benefits* Get exceptional coverage and real savings that make a difference. * *Supportive Leadership* Our management team is here to help you succeed every step of the way. * *Career Growth Opportunities* Every leader on our team started in a field role-your path to leadership starts here. * *Epic EMR System* Streamlined documentation and communication for better care and less stress. * *Fast Hiring Process* Quick interviews and job offers-because your time matters. * *Meaningful Work* Deliver one-on-one care that truly impacts lives. * *Zero On-Call Requirements* Focus on your work without the stress of being on call. *Minimum Qualifications* * Graduate of an accredited nursing program * Active RN license in the State of Ohio * Minimum of one (1) year of professional nursing experience *Benefits Highlights* * Medical, dental and vision insurance starting Day One * Short- and long-term disability coverage * 403(b) retirement plan with employer match * Generous paid time off + 7 paid holidays * Tuition reimbursement up to $5,250/year * Comprehensive onboarding and orientation *About Mount Carmel Home Care* Mount Carmel Home Care is a member of [Trinity Health At Home]( a national home care, hospice and palliative care organization serving communities throughout eleven states. As a faith-based, not-for-profit agency, Mount Carmel Home Care serves patients and families in the comfort of home, offering skilled nursing, therapy (physical, occupational, speech) and medical social work. We are Medicare certified and accredited by The Joint Commission. Learn more about us at [MountCarmelHomeCare.org.]( *Our Commitment * Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, veteran status, or any other status protected by federal, state, or local law.

ABOUT VISANTE We are a specialized consulting firm focused on helping hospitals and health systems accelerate strong clinical, operational, and financial performance through pharmacy. Our team of professionals brings deep, contemporary expertise and innovation to optimizing all aspects of a fully integrated health system pharmacy program, driving significant value quickly. Our mission is to transform healthcare through pharmacy, and our vision is to reimagine pharmacy to improve lives. Visante is looking to add a Medication Specialist to our Specialty Pharmacy Services line. This individual will be responsible for providing medication access and affordability services to Visante clients and their patients. ABOUT THE ROLE (Remote, work from home) The Medication Specialist's responsibilities include the following: Reviewing medication authorizations submitted by clients Performing appropriate actions based on client and patient needs, including: Identifying the process to submit authorizations Reviewing documentation in the client's medical record that is required for authorization submissions Performing benefits investigation reviews to determine patient coverage and out-of-pocket costs Identifying patient assistance programs, copay cards, grants, or funds that could be utilized to reduce patient financial burdens Communicating with the clinic to obtain additional information or guidance related to prior authorization submission Assisting clinics with submitting appeals related to coverage denials Communicates determinations and relevant follow-up with patients on behalf of clients, including: Sharing information related to medication coverage and financial assistance options Providing pharmacy options for where prescriptions can be filled Ensuring timely and accurate documentation related to services provided to clients and their patients by appropriately documenting information in clients' EMR systems based on the agreed-upon Visante-client workflow and documenting information in Visante systems for tracking prior authorization volumes and associated fees Supporting clients with onboarding and training of client-employed medication access specialists, when directed and supporting Visante with continual process improvement and client-specific workflow and process development Collaborating with Visante team members and leaders to provide insight and constructive feedback into day-to-day operations Supporting clients with improving clinical staff and client pharmacy workflows and communications Completing other duties as assigned by the supervisor Requirements Education Required: High school diploma or equivalent Experience Required: 3 years of experience working within healthcare or with pharmacy providers on medication access Preferred: Previous consulting and/or client-facing experience; Experience with electronic medical record documentation and prior authorization workflows; Experience with performing retail pharmacy PBM adjudication; Experience in utilizing CoverMyMeds to submit prior authorizations; Two (2) years of experience in healthcare revenue cycle that includes medication authorizations; Knowledge of CPT and ICD coding is highly desired; Knowledge of Medicare and third-party payer regulations and guidelines is highly desired; Two (2) years of experience in preadmission/precertification Skills and Abilities Demonstration of good judgment, multi-tasking and meeting deadlines with a sense of urgency, and being able to prioritize competing demands; Strong client relationship, interpersonal, and team skills; Proven ability to diagnose and resolve issues, demonstrating strong analytical and creative skills; Ability to make sound and timely decisions based on analysis, experience, and judgment; Clear and concise verbal and written communication skills and the ability to advise clients professionally and positively; Maintains confidentiality of all patient-related information; Excellent knowledge of medication reimbursement and healthcare prior authorization/coding; Excellent knowledge and proficiency in MS Word, Outlook, PowerPoint, and Excel Compensation and Benefits: We offer competitive salary and benefits for this full-time salaried role. Equal Opportunity Statement: Visante is an equal opportunity employer. Visante's people are its greatest asset and provide the resources that have made the company what it is today. Visante is, therefore, committed to maintaining an environment free of discrimination, harassment, and violence. This means there can be no deference because of age, religion or creed, gender, gender identity or expression, race, color, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by applicable laws and regulations

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!

RAYUS now offers DailyPay! Work today, get paid today! RAYUS Radiology is looking for a Scheduling Specialist to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As a Scheduling Specialist, you will be responsible for providing services to patients and referring professionals by answering phones, managing faxes and scheduling appointments. This is a full-time position working 9:00AM - 5:30PM CST Mon-Fri, Rotating Saturday 7am-1pm CST. ESSENTIAL DUTIES AND RESPONSIBILITIES: (85%) Scheduling Activities Answers phones and handles calls in a professional and timely manner Maintains positive interactions at all times with patients, referring offices and team members Schedules patient examinations according to existing company policy Ensures all appropriate personal, financial and insurance information is obtained and recorded accurately Ensures all patient data is entered into information systems completely and accurately Ensures patients are advised of financial responsibilities, appropriate clothing, preparation kits, transportation and/or eating prior to appointment Communicates to technologists any scheduling changes in order to ensure highest level of patient satisfaction Maintains an up-to-date and accurate database on all current and potential referring physicians Handles overflow calls for other centers within market to ensure uninterrupted exam scheduling for referring offices Provides back up coverage for front office team members as requested by supervisor (i.e., rest breaks, meal breaks, vacations and sick leave) Fields 1-800 number calls and routes to appropriate department or associate (St. Louis Park only (10%) Insurance Activities Pre-certifies all exams with patient's insurance company as required Verifies insurance for same day add-ons Uses knowledge of insurance carriers (example Medicare) and procedures that require waivers to obtain authorization if needed prior to appointment (5%) Other Tasks and Projects as Assigned

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

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.

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

The Health Data Analyst provides information, analyses, and consultation to internal and external stakeholders. This position assesses the performance of pharmacy benefits and/or networks and develops recommendations for improvements or enhancement to support departmental and organizational objectives. This position will participate in the development of new reports, analytical models, and products/benefit programs that align with strategic imperatives. Responsibilities Assumes responsibility for moderately complex analytic and consultative work such as analyzing and interpreting client pharmacy benefit data, trends and reports and partnering with analytics team to deliver recommendations or project status updates to internal and external stakeholders; investigates follow up items or questions regarding project and/or request scope Investigates key drivers of benefit performance Create new queries using Alteryx including multiple table joins, understanding of table structures, creation of detailed formulas Participates in development of analytic methodologies, models, reports and new products May be responsible for Centers for Medicaid/Medicare Services reporting and analysis, including the management of directories and bid support Other duties as assigned Minimum Qualifications Bachelors degree in Mathematics, Finance, or related field, or the equivalent combination of education and/or relevant work experience; HS diploma or GED is required 2 years of experience in pharmacy benefits management, reporting & analytics, benefits consulting, healthcare, financial services or related field Must be eligible to work in the United States without need for work visa or residency sponsorship Additional Qualifications Advanced Microsoft Excel skills ability to create complete formulas and efficient data manipulation. Intermediate troubleshooting skills, including in-depth client data research, which may involve research and drivers of utilization; understands resources needed and steps/processes on how to complete the problem; able to understand when an issue arises how-to navigate to a resolution Strong PBM industry knowledge; able to articulate the industry trends to clients and the impact of trends and changes to client financials Ability to establish rapport and effectively influence at all levels within an organization Ability to communicate effectively and present complex data to a wide variety of audiences Preferred Qualifications Knowledge of the PBM (Pharmacy Benefit Management) industry and PBM data; understands key PBM metrics (such as PMPM, generic utilization) Experience working with large sets of pharmacy, claims, medical, and/or financial data Previous experience in a client facing or consultative role Extensive experience using analytic tools; familiarity with Alteryx Minimum Physical Job Requirements Constantly required to sit, use hands to handle or feel, talk and hear Frequently required to reach with hands and arms Occasionally required to stand, walk and stoop, kneel, and crouch Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Pioneering trusted medical solutions to improve the lives we touch: Convatec is a global medical products and technologies company, focused on solutions for the management of chronic conditions, with leading positions in Advanced Wound Care, Ostomy Care, Continence Care, and Infusion Care. With more than 10,000 colleagues, we provide our products and services in around 90 countries, united by a promise to be forever caring. Our solutions provide a range of benefits, from infection prevention and protection of at-risk skin, to improved patient outcomes and reduced care costs. Convatec's revenues in 2024 were over $2 billion. The company is a constituent of the FTSE 100 Index (LSE:CTEC). To learn more please visit **************************** Position Overview: To provide client service support to the Account Management teams. Collect medical documentation and information to setup new clients of 180 Medical. Key Responsibilities: Contact clients to set up medical supply orders Handle incoming phone calls from clients regarding orders & customer service issues Request Medicare documentation on Medicare clients Contacts HH agencies to coordinate sending supplies Make entries as appropriate in Medtrack an internal Microsoft Access database Place orders in Medtrack Change orders in Medtrack Support Team Supervisor on miscellaneous projects Obtain verbal authorization for supplies from facilities Suspense auditor to obtain Plan of Cares and chart notes when needed Verifying insurance for existing customer insurance changes Performs follow up phone calls to clients after initial shipment Verifies that client files are complete and all necessary documentation is in place All other duties as assigned. Qualifications/Education: Must have a high school diploma, college degree preferred, not required. Six months to one year related experience and/or training; or equivalent combination of education and experience. Typing: 35-40 wpm with 40 (adjusted) highly recommended Possess medical administrative skills Good communication skills with professionals in clinics and hospitals Sales experience preferred Ability to reason, problem solve, and think outside the box Multi-task a variety of issues Good organization skills and can prioritize tasks Proficient in Microsoft Office programs Good attention to detail Reliable/dependable Flexible and adaptable to changes in environment and industry Team Player; work well with others Dimensions: Physical Demands Regularly required to sit, stand, walk, and occasionally bend and move about the facility. Infrequent light physical effort required. Occasional lifting up to 10 lbs. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Working Conditions Work performed in an office environment, Special Factors This role can be performed remotely. Beware of scams online or from individuals claiming to represent Convatec A formal recruitment process is required for all our opportunities prior to any offer of employment. This will include an interview confirmed by an official Convatec email address. If you receive a suspicious approach over social media, text message, email or phone call about recruitment at Convatec, do not disclose any personal information or pay any fees whatsoever. If you're unsure, please contact us at ********************. Equal opportunities Convatec provides equal employment opportunities for all current employees and applicants for employment. This policy means that no one will be discriminated against because of race, religion, creed, color, national origin, nationality, citizenship, ancestry, sex, age, marital status, physical or mental disability, affectional or sexual orientation, gender identity, military or veteran status, genetic predisposing characteristics or any other basis prohibited by law. Notice to Agency and Search Firm Representatives Convatec is not accepting unsolicited resumes from agencies and/or search firms for this job posting. Resumes submitted to any Convatec employee by a third party agency and/or search firm without a valid written and signed search agreement, will become the sole property of Convatec. No fee will be paid if a candidate is hired for this position as a result of an unsolicited agency or search firm referral. Thank you. Already a Convatec employee? If you are an active employee at Convatec, please do not apply here. Go to the Career Worklet on your Workday home page and View "Convatec Internal Career Site - Find Jobs". Thank you!

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

Company Overview: Health Network One (HN1) partners with health plans and providers to modernize how specialty care is delivered and managed, reducing complexity, driving better performance, and improving lives. With over 30 years of experience, Health Network One advances care in several unique specialties: Total Eye, Sleep Well, Pure Derm and Thrive Therapy. By curating specialty networks and credentialing providers who meet rigorous access and quality standards, we bring together value-based models and clinical expertise to ensure providers thrive, payers succeed, and members receive the high-quality care they deserve. Position Summary: We are seeking a highly skilled Configuration Manager with deep expertise in the Plexis system and a strong background in specialty managed care. This role is essential to ensuring accurate and efficient configuration of benefits within our systems, supporting operational excellence. Key Responsibilities Lead the configuration and ongoing maintenance of benefit plans within the Plexis platform, ensuring accuracy, compliance, and alignment with plan designs. Collaborate cross-functionally with Claims, Provider Administration, IT, and Clinical Operations to support benefit implementation, updates, and issue resolution. Serve as the subject matter expert on Plexis configuration capabilities, limitations, and optimization opportunities. Translate complex benefit documentation into system configuration requirements. Manage configuration projects related to new product launches, expansions, and regulatory changes. Conduct audits and quality checks to ensure benefit setups are functioning as intended. Oversee the maintenance and regular updates of key reference tables (including RBRVS, NCCI, Optum, Interest, and other regulatory or industry-standard tables) within the Plexis platform to ensure accurate claims adjudication and compliance. Manage the configuration, implementation, and ongoing updates of fee schedules, ensuring alignment with contractual, regulatory, and operational requirements. Monitor industry changes and regulatory updates impacting table structures and fee schedules, coordinating timely system updates and stakeholder communication. Collaborate with Claims, Provider Relations, and IT teams to resolve table-related issues and optimize table configuration for operational efficiency. Provide training and support to internal teams on Plexis functionality and configuration processes. Identify and implement process improvements to enhance efficiency and reduce errors. Qualifications: Bachelor's degree in healthcare administration, business, or related field (or equivalent experience). Minimum of 5 years of experience in benefit configuration within a managed care organization. Extensive hands-on experience with the Plexis system is required. Background in specialty benefit administration strongly preferred. Strong analytical and problem-solving skills with high attention to detail. Excellent communication, collaboration, and project management skills. Ability to work independently and manage multiple priorities in a dynamic environment. Preferred Skills: Familiarity with Medicaid and Medicare managed care regulations. Experience with system implementations or migrations involving Plexis. Process improvement certifications (e.g., Lean, Six Sigma) are a plus. Location: Remote Position.

at Healthmap Solutions, Puerto Rico LLC Company Background Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations. Healthmap Solutions uses clinical big data resources and high-powered analytics to power complex specialty health management programs. Healthmap Solutions is a diverse, growing company committed to our clients and our employees. We are champions for better health, for those who need us most. Position Summary: Healthmap's Clinical Services Wellness Coach interacts with members to address care needs, promote wellness, mitigate social determinants of health and improve overall health outcomes. The Wellness Coach will focus on Education, Special Programs and Assessments as part of a Care Team that includes nurses, social workers, and dietitians. This role will manage their caseload through a variety of communications platforms and is responsible for providing exceptional customer service that encourages progress toward healthier habits. Responsibilities: Connect with members to develop and support health care. Identifying and addressing barriers and solutions like medication reminders, scheduling appointments, and direction towards community-based support programs, etc. Establish trusting, supportive, and collaborative relationships with members and their caregivers to guides access to resources that allow strengths to be leveraged for positive change Meet with team to review set goals and address targets established by the department and Service Level Agreements Collect and document relevant member demographics and healthcare information and ensure accuracy in the Employee Health Record (EHR) system Answer inbound and outbound calls from members, providers, and other resources to support company objectives Conduct a minimum of outreach calls a day to a targeted list of eligible patients to describe the benefits of Healthmap Kidney Health Management program and enroll Receive inbound self-referral member calls to enroll in Healthmap's KHM program Engage with members so they understand and are comfortable with the terms of care, following internal scripting and/or talking points to respond to resistance with professional courtesy Report complaints and identify potential corrective and preventative actions to solve issues where possible, some issues may require escalation based on established procedures Perform other duties as assigned Requirements: Associate's degree in relevant field. Equivalent experience with specific certification may be considered in lieu of education 2 years' experience working in healthcare with individuals preferably with chronic diseases and/or behavioral health needs Experience in managed care, physician office, or account management preferred Experience working with Medicare, Medicaid, preferred Previous experience working in a metrics-driven environment, preferred Bilingual English/Spanish fluency is required Residency in Puerto Rico required Skills: Ability to problem-solve and execute initiatives Excellent verbal and written communication skills Ability to manage multiple priorities Must be proficient in Microsoft Office: Outlook, Word, Excel, PowerPoint Travel: Limited Travel, Scheduled per needs of the business #LI-Remote Americans with Disability Specifications The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. As an Equal Opportunity Employer, we will not discriminate against any job candidate or employee due to age, race, religion, ethnicity, national origin, gender, gender identity/expression, sexual orientation, disability, familial status, veteran status, marital status, parental status, or pregnancy. In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.