Service Center Representative jobs at Tenet Healthcare - 54 jobs

_The Remote Medical Customer Service Specialist serves as the initial point of contact for customers, addressing inquiries, resolving issues, and delivering high-quality service to ensure a positive customer experience. This entry-level role requires excellent communication skills, attention to detail, and the ability to manage a variety of customer requests through multiple channels, including phone, email, and chat. The Representative works in a performance-driven environment, adhering to established service metrics and standards, while collaborating with other departments to ensure timely and effective resolution of customer concerns._ _As a Customer Service Specialist at Community Health Systems (CHS) - Shared Services, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental, and vision insurance, paid time off (PTO), 401(k) with company match, tuition reimbursement, and more._ **_Essential Functions_** + _Responds to customer inquiries through phone, email, chat, or other communication channels, providing accurate and timely information._ + _Clarifies and resolves customer issues by identifying their needs, determining root causes, and implementing effective solutions._ + _Escalates complex or unresolved issues to appropriate team members or departments, ensuring prompt follow-up and resolution._ + _Provides triage support for common issues related to platforms, applications, and back-office processes._ + _Documents all interactions accurately and thoroughly in the customer relationship management (CRM) system, ensuring detailed records of inquiries and resolutions._ + _Adheres to quality standards and key performance indicators (KPIs), including productivity, response times, and customer satisfaction ratings._ + _Delivers exceptional customer service by maintaining professionalism, patience, and a customer-focused attitude in all interactions._ + _Contributes to a team-oriented work environment by sharing insights, offering assistance, and collaborating effectively with peers and supervisors._ + _Performs other duties as assigned._ + _Complies with all policies and standards._ + _This is a fully remote opportunity._ **_Qualifications_** + _H.S. Diploma or GED required_ + _Associate Degree or some college coursework in a related field preferred_ + _1-2 years of customer service experience required, preferably in a call center or help desk environment required_ + _Familiarity with CRM software and customer service tools preferred_ **_Knowledge, Skills and Abilities_** + _Strong verbal and written communication skills, with the ability to clearly convey information and resolve customer concerns._ + _Proficient in using computer systems, including Microsoft Office Suite and CRM platforms._ + _Excellent problem-solving and critical-thinking abilities._ + _Ability to manage multiple tasks and prioritize effectively in a fast-paced environment._ + _Detail-oriented with a strong focus on accuracy and quality._ + _Demonstrated ability to work independently and as part of a team._ + _Strong interpersonal skills and the ability to build rapport with customers and colleagues._ We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. _This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer._ Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to ************************************************* to obtain the main telephone number of the facility and ask for Human Resources.

The Customer Service Representative I serves as the initial point of contact for customers, addressing inquiries, resolving issues, and delivering high-quality service to ensure a positive customer experience. This entry-level role requires excellent communication skills, attention to detail, and the ability to manage a variety of customer requests through multiple channels, including phone, email, and chat. The Representative works in a performance-driven environment, adhering to established service metrics and standards, while collaborating with other departments to ensure timely and effective resolution of customer concerns. Essential Functions Responds to customer inquiries through phone, email, chat, or other communication channels, providing accurate and timely information. Clarifies and resolves customer issues by identifying their needs, determining root causes, and implementing effective solutions. Escalates complex or unresolved issues to appropriate team members or departments, ensuring prompt follow-up and resolution. Provides triage support for common issues related to platforms, applications, and back-office processes. Documents all interactions accurately and thoroughly in the customer relationship management (CRM) system, ensuring detailed records of inquiries and resolutions. Adheres to quality standards and key performance indicators (KPIs), including productivity, response times, and customer satisfaction ratings. Delivers exceptional customer service by maintaining professionalism, patience, and a customer-focused attitude in all interactions. Contributes to a team-oriented work environment by sharing insights, offering assistance, and collaborating effectively with peers and supervisors. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications H.S. Diploma or GED required Associate Degree or some college coursework in a related field preferred 1-2 years of customer service experience required, preferably in a call center or help desk environment required Familiarity with CRM software and customer service tools preferred Knowledge, Skills and Abilities Strong verbal and written communication skills, with the ability to clearly convey information and resolve customer concerns. Proficient in using computer systems, including Microsoft Office Suite and CRM platforms. Excellent problem-solving and critical-thinking abilities. Ability to manage multiple tasks and prioritize effectively in a fast-paced environment. Detail-oriented with a strong focus on accuracy and quality. Demonstrated ability to work independently and as part of a team. Strong interpersonal skills and the ability to build rapport with customers and colleagues.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. KNOWLEDGE/SKILLS/ABILITIES * Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. * Requires an in-depth knowledge of provider services and contracting subject matter expertise. * Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. * Serves as a subject matter expert for other departments. * Trains other Provider Services Representatives, as appropriate. JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. Required Experience * 3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3-5 years' experience in managed healthcare administration and/or Provider Services. * 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. Preferred Education Bachelor's or master's degree. Preferred Experience * 5+ years' experience in managed healthcare administration and/or Provider Services. * 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. **KNOWLEDGE/SKILLS/ABILITIES** + Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. + Requires an in-depth knowledge of provider services and contracting subject matter expertise. + Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. + Serves as a subject matter expert for other departments. + Trains other Provider Services Representatives, as appropriate. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. + Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. **Preferred Education** Bachelor's or master's degree. **Preferred Experience** + 5+ years' experience in managed healthcare administration and/or Provider Services. + 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Department Name: Patient Balance Mgmt Work Shift: Varied Job Category: Revenue Cycle Estimated Pay Range: $17.67 - $26.50 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we're constantly improving to make Banner Health the best place to work and receive care. The PFS Customer Service Rep role coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. We work as a team to ensure reimbursement for services in a timely and accurate manner. This position is for our Call Center Team, answering high call-volume and high-level questions regarding patient billing questions. We are currently looking for experienced professionals with strong customer service skills to join our team. Location: Remote Schedule: Part time, 20hrs/wk. Mon-Fri 1:30pm-5:30pm AZ Time Ideal Candidates: Minimum of 1 year experience in Customer Service and/or Call Center, clearly reflected in resume; Minimum of 1 year Healthcare experience in Finance, Revenue Cycle, or Patient Financial Services This can be a remote position if you live in the following state(s) only: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR PA, SC, TN, TX, UT, VA, WA, WI, WV, WY Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner. CORE FUNCTIONS 1. Responds to incoming calls to provide assistance and excellent customer service to patients, patient families, providers, and other internal and external customers to resolve billing, payment and accounting issues 2. Responsible to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing and PCI compliance. 3. As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company's collection/self-pay policies to ensure maximum reimbursement. 4. Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients. 5. As assigned, works with walk-in patient's with accounts and processing payments. 6. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances. 7. Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately. 8. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members. Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day. NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager. SUPERVISORY RESPONSIBILITIES DIRECTLY REPORTING None MATRIX OR INDIRECT REPORTING None TYPE OF SUPERVISORY RESPONSIBILITIES None Banner Health Leadership will strive to uphold the mission, values, and purpose of the organization. They will serve as role models for staff and act in a people-centered, service excellence-focused, and results-oriented manner. PHYSICAL DEMANDS/ENVIRONMENT FACTORS OE - Typical Office Environment: (Accountant, Administrative Assistant, Consultant, Program Manager) Requires extensive sitting with periodic standing and walking. May be required to lift up to 20 pounds. Requires significant use of personal computer, phone and general office equipment. Needs adequate visual acuity, ability to grasp and handle objects. Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone. May require off-site travel. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge. Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences. Strong knowledge of insurance plans with deductibles and co-insurances. Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required. PREFERRED QUALIFICATIONS Work experience with the Company's systems and processes is preferred. Previous cash collections experience is preferred. Bi-lingual a plus. Additional related education and/or experience preferred. DATE APPROVED 03/30/2025 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. KNOWLEDGE/SKILLS/ABILITIES * Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. * Requires an in-depth knowledge of provider services and contracting subject matter expertise. * Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. * Serves as a subject matter expert for other departments. * Trains other Provider Services Representatives, as appropriate. JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. Required Experience * 3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3-5 years' experience in managed healthcare administration and/or Provider Services. * 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. Preferred Education Bachelor's or master's degree. Preferred Experience * 5+ years' experience in managed healthcare administration and/or Provider Services. * 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. **KNOWLEDGE/SKILLS/ABILITIES** + Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. + Requires an in-depth knowledge of provider services and contracting subject matter expertise. + Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. + Serves as a subject matter expert for other departments. + Trains other Provider Services Representatives, as appropriate. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. + Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. **Preferred Education** Bachelor's or master's degree. **Preferred Experience** + 5+ years' experience in managed healthcare administration and/or Provider Services. + 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. KNOWLEDGE/SKILLS/ABILITIES * Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. * Requires an in-depth knowledge of provider services and contracting subject matter expertise. * Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. * Serves as a subject matter expert for other departments. * Trains other Provider Services Representatives, as appropriate. JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. Required Experience * 3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3-5 years' experience in managed healthcare administration and/or Provider Services. * 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. Preferred Education Bachelor's or master's degree. Preferred Experience * 5+ years' experience in managed healthcare administration and/or Provider Services. * 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. KNOWLEDGE/SKILLS/ABILITIES * Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. * Requires an in-depth knowledge of provider services and contracting subject matter expertise. * Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. * Serves as a subject matter expert for other departments. * Trains other Provider Services Representatives, as appropriate. JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. Required Experience * 3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3-5 years' experience in managed healthcare administration and/or Provider Services. * 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. Preferred Education Bachelor's or master's degree. Preferred Experience * 5+ years' experience in managed healthcare administration and/or Provider Services. * 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. **KNOWLEDGE/SKILLS/ABILITIES** + Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. + Requires an in-depth knowledge of provider services and contracting subject matter expertise. + Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. + Serves as a subject matter expert for other departments. + Trains other Provider Services Representatives, as appropriate. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. + Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. **Preferred Education** Bachelor's or master's degree. **Preferred Experience** + 5+ years' experience in managed healthcare administration and/or Provider Services. + 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. **KNOWLEDGE/SKILLS/ABILITIES** + Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. + Requires an in-depth knowledge of provider services and contracting subject matter expertise. + Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. + Serves as a subject matter expert for other departments. + Trains other Provider Services Representatives, as appropriate. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. + Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. **Preferred Education** Bachelor's or master's degree. **Preferred Experience** + 5+ years' experience in managed healthcare administration and/or Provider Services. + 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. KNOWLEDGE/SKILLS/ABILITIES * Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. * Requires an in-depth knowledge of provider services and contracting subject matter expertise. * Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. * Serves as a subject matter expert for other departments. * Trains other Provider Services Representatives, as appropriate. JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. Required Experience * 3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3-5 years' experience in managed healthcare administration and/or Provider Services. * 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. Preferred Education Bachelor's or master's degree. Preferred Experience * 5+ years' experience in managed healthcare administration and/or Provider Services. * 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. KNOWLEDGE/SKILLS/ABILITIES * Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. * Requires an in-depth knowledge of provider services and contracting subject matter expertise. * Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. * Serves as a subject matter expert for other departments. * Trains other Provider Services Representatives, as appropriate. JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. Required Experience * 3 - 5 years customer service, provider service, or claims experience in a managed care setting. * 3-5 years' experience in managed healthcare administration and/or Provider Services. * 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. Preferred Education Bachelor's or master's degree. Preferred Experience * 5+ years' experience in managed healthcare administration and/or Provider Services. * 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. **KNOWLEDGE/SKILLS/ABILITIES** + Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners. + Requires an in-depth knowledge of provider services and contracting subject matter expertise. + Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. + Serves as a subject matter expert for other departments. + Trains other Provider Services Representatives, as appropriate. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. + Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc. **Preferred Education** Bachelor's or master's degree. **Preferred Experience** + 5+ years' experience in managed healthcare administration and/or Provider Services. + 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Brookdale is hiring a Director of Clinical Services Specialists! This individual is well versed in clinical operations and understands state regulations. Compact license covering the state of Indiana required! This is a traveling role and at times will require a 10 day on 4 day off schedule Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Part and Full Time Benefits Eligibility * Medical, Dental, Vision insurance * 401(k) * Associate assistance program * Employee discounts * Referral program * Early access to earned wages for hourly associates (outside of CA) * Optional voluntary benefits including ID theft protection and pet insurance Full Time Only Benefits Eligibility * Paid Time Off * Paid holidays * Company provided life insurance * Adoption benefit * Disability (short and long term) * Flexible Spending Accounts * Health Savings Account * Optional life and dependent life insurance * Optional voluntary benefits including accident, critical illness and hospital indemnity Insurance, and legal plan * Tuition reimbursement Base pay in range will be determined by applicant's skills and experience. Full-time associates in role are also eligible for an annual bonus incentive. Temporary associates are not benefits eligible but may participate in the company's 401(k) program. Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply. To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year. The application window is anticipated to close within 30 days of the date of the posting. Manages the day-to-day healthcare operations of the community to ensure resident's healthcare needs are met. Ensures residents are treated with respect and dignity and ensures quality care as resident's healthcare needs change. Supervises licensed nurses and other direct care staff within the community. Strengthens clinical processes within community until a replacement is identified, then supports newly assigned Health and Wellness Director. Travels within the division as assigned to support management vacancy, start up, vacations, etc. * Responsible for the direct supervision of community-based licensed nursing staff (LPN/LVN, RN), the Med Techs/CMAs (if required by State Regulations) and/or Lead Resident Care Associates. May also supervise Resident Care Coordinators and Supervisor, Resident Care. * Assigns and directs work of subordinates; appraising performance; rewarding and disciplining associates; addressing complaints and resolving problems. * Provides training, supervision, and monitoring of associates in the administration of medications as described/allowed in Nurse Practice Act, to include auditing of medication administration records. * Provides training and education to resident care associates on an ongoing basis with classroom in-services, and situation-specific training. * Supervises the maintenance of resident charts and reviews documentation performed by care giving staff. * As described and allowed in the Nurse Practice Act, assesses health, functional and psycho-social status of residents, initiates individualized service plans, proactively manages care and services for each resident, evaluates effectiveness and maximizes the resident's opportunity to remain in their environment. * Manages the health care of residents, including the dissemination of information to families and associates. Ensures that family members are aware of resident's need for scheduled appointments. * Participates in pre-admission screening of prospective new residents. Assures that required documentation is completed prior to or upon resident admission, including nursing assessments, service plans, and other assigned forms. Updates assessments as required by policy and as described/allowed in Nurse Practice Act. * Performs on-site evaluations of residents admitted to alternate care environments for treatment, and maintains contact with resident families with the intent of returning resident to Brookdale. * Performs ongoing assessment/observation of residents' physical and psycho-social needs and coordinates with other departments to assure quality, proactive care. * Evaluates residents; documents changes in condition, and notifies executive director, physician, and resident's legally responsible party/family of resident's condition and reactions. Prepares Physician Visit Form and reviews and updates resident chart. * Facilitates continuity of care for those residents receiving home health care, hospice services, and other third party healthcare- related services. * Participates in or leads meetings relevant to resident care issues, such as Service Plan meetings, involving appropriate parties as needed. * Ensures in-house ancillary medical services such as podiatrist, doctor visits, dental visits, psych visits, lab, X-ray, ambulance, etc. are scheduled and followed through. * Participates in department quality improvement activities. * Assists in keeping the environment safe for associates to reduce the occurrence of Workers' Compensation claims by appropriately evaluating resident transfer and mobility needs and involving therapy services as indicated. * Shares on-call and manager on duty responsibilities/shifts as required. * Strengthens clinical process within the community until permanent replacement is identified. * Supports other requirements within the division as assigned. This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor. Education and Experience Education as required to obtain state nursing license (LPN/LVN or RN). Nurse management, senior living, or post-acute care experience preferred. Basic typing skills along with a working knowledge of personal computing and word processing software are required, preferably in a Microsoft Windows environment. Certifications, Licenses, and Other Special Requirements LPN/LVN or RN license. Physical Demands and Working Conditions * Standing * Requires interaction with co-workers, residents or vendors * Walking * Sitting * Occasional weekend, evening or night work if needed to ensure shift coverage * Use hands and fingers to handle or feel * On-Call on an as needed basis * Reach with hands and arms * Possible exposure to communicable diseases and infections * Climb or balance * Potential injury from transferring, repositioning, or lifting residents * Talk or hear * Taste or smell * Exposure to latex * Ability to lift: Up to 50 pounds * Possible exposure to blood-borne pathogens * Possible exposure to various drugs, chemical, infectious, or biological hazards * Subject to injury from falls, burns, odors, or cuts from equipment * Requires Travel: Occasionally * Vision Management/Decision Making Applies existing guidelines and procedures to make varied decisions within a department. Uses sound judgment and experience to solve moderately complex problems based on precedent, example, reasonableness or a combination of these. Knowledge and Skills Possesses extensive knowledge of a distinct skill or function and a thorough understanding of the organization and work environment. Has working knowledge of a functional discipline. Brookdale is an equal opportunity employer and a drug-free workplace.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** Optum has an immediate opening for a **Credential Representative - National Remote** . The Credential Representative - National Remote will be responsible for enrolling behavioral health providers with appropriate payers for associated entities. **Schedule:** Mon - Fri, 8:00AM - 5:00PM any time zone that you reside within You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system + Conduct audits and provide feedback to reduce errors and improve processes and performance + Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others + Solve complex problems on own; proactively identify new solutions to problems + Act as a facilitator to resolve conflicts on team + Perform as key team member on project teams spanning more than own function + Ability to submit 10 to 15 applications daily + Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements + Performs other duties as assigned **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required** **Qualifications:** + High School Diploma/GED (or higher) + 2+ years of experience in submitting at least 10-15 behavioral health provider payer enrollment applications + 2+ years of experience with submitting commercial payer enrollment applications + 2+ years of experience in submitting enrollment applications to that include at least 10 different payer enrollments within these states-Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, Nebraska + 2+ years of experience in submitting follow ups and issue resolutions from at least 10 different payer enrollments from these states Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, Nebraska + 2+ years of experience working with compliance workflows and processes, including NCQA policies and practices + 2+ years of experience in researching and applying government regulatory information + Intermediate level of proficiency with MS Excel and Word + Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) + Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service + Ability to work from 8:00 am to 5:00 pm CST **Preferred Qualifications:** + Knowledge of payers and provider enrollment applications for the following states: Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, and Nebraska **Soft Skills:** + Ability to work independently and as a team, and maintain good judgment and accountability + Ability to multi-task and prioritize tasks to meet all deadlines + Ability to work well under pressure in a fast-paced environment + Demonstrated ability to work well with health care providers and team members + Strong organizational and time management skills + Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO, #GREEN

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** The Optum Rx Paralegal is part of the Legal Operations Team responsible for all aspects of legal support for the pharmacies and PBM Clients at Optum. This position requires the ability to communicate and foster relationships with attorneys, team members, and business leadership. Candidates must be able to work independently, possess solid analytic skills, solid verbal and written communication skills, have keen attention to detail and demonstrate an ability to make sound judgment decisions. Previous contracting and/or legal operations experience preferred. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. **Primary Responsibilities:** + Draft, review and redline agreements (Non-Disclosure Agreements, Business Associate Agreements, PBM, Payer, Network and Vendor Agreements) using established tools and processes + Legal and contracting intake, triage and tracking + Facilitate effective communication among team members, stakeholders, and clients + Process improvement initiatives + Playbook creation + Bulk contracting project support + Administrative support for internal systems (ContractHub, ServiceNow) + Regulatory compliance support You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + 5+ years of legal field experience as a paralegal, legal specialist, legal project support or legal operations support + Experience working with multiple teams and levels within a matrixed organization + Solid technical proficiency in Microsoft Office Suite (Outlook, Word, Excel) + Proven solid customer service skills + Proven solid verbal & written communication skills + Proven sound organization and prioritization skills **Preferred Qualifications:** + Paralegal certificate or equivalent experience, legal studies degree, or other applicable college degree + Legal Project Management, legal operations, and contract lifecycle management experience + Experience navigating and providing legal support in a matrixed or cross-functional environment + Familiarity with matter management systems, contract management systems + Intermediate level of proficiency in PowerPoint, Teams, SharePoint, Visio *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Optum has an immediate opening for a Credential Representative - National Remote. The Credential Representative - National Remote will be responsible for enrolling behavioral health providers with appropriate payers for associated entities. Schedule: Mon - Fri, 8:00AM - 5:00PM any time zone that you reside within You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system * Conduct audits and provide feedback to reduce errors and improve processes and performance * Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others * Solve complex problems on own; proactively identify new solutions to problems * Act as a facilitator to resolve conflicts on team * Perform as key team member on project teams spanning more than own function * Ability to submit 10 to 15 applications daily * Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements * Performs other duties as assigned What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: * Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays * Medical Plan options along with participation in a Health Spending Account or a Health Saving account * Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts * Employee Assistance Program * Employee Referral Bonus Program * Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) * More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * High School Diploma/GED (or higher) * 2+ years of experience in submitting at least 10-15 behavioral health provider payer enrollment applications * 2+ years of experience with submitting commercial payer enrollment applications * 2+ years of experience in submitting enrollment applications to that include at least 10 different payer enrollments within these states-Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, Nebraska * 2+ years of experience in submitting follow ups and issue resolutions from at least 10 different payer enrollments from these states Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, Nebraska * 2+ years of experience working with compliance workflows and processes, including NCQA policies and practices * 2+ years of experience in researching and applying government regulatory information * Intermediate level of proficiency with MS Excel and Word * Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) * Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service * Ability to work from 8:00 am to 5:00 pm CST Preferred Qualifications: * Knowledge of payers and provider enrollment applications for the following states: Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, and Nebraska Soft Skills: * Ability to work independently and as a team, and maintain good judgment and accountability * Ability to multi-task and prioritize tasks to meet all deadlines * Ability to work well under pressure in a fast-paced environment * Demonstrated ability to work well with health care providers and team members * Strong organizational and time management skills * Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others * All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO, #GREEN

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** Optum has an immediate opening for a **Credential Representative - National Remote** . The Credential Representative - National Remote will be responsible for enrolling behavioral health providers with appropriate payers for associated entities. **Schedule:** Mon - Fri, 8:00AM - 5:00PM any time zone that you reside within You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system + Conduct audits and provide feedback to reduce errors and improve processes and performance + Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others + Solve complex problems on own; proactively identify new solutions to problems + Act as a facilitator to resolve conflicts on team + Perform as key team member on project teams spanning more than own function + Ability to submit 10 to 15 applications daily + Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements + Performs other duties as assigned **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required** **Qualifications:** + High School Diploma/GED (or higher) + 2+ years of experience in submitting at least 10-15 behavioral health provider payer enrollment applications + 2+ years of experience with submitting commercial payer enrollment applications + 2+ years of experience in submitting enrollment applications to that include at least 10 different payer enrollments within these states-Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, Nebraska + 2+ years of experience in submitting follow ups and issue resolutions from at least 10 different payer enrollments from these states Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, Nebraska + 2+ years of experience working with compliance workflows and processes, including NCQA policies and practices + 2+ years of experience in researching and applying government regulatory information + Intermediate level of proficiency with MS Excel and Word + Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) + Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service + Ability to work from 8:00 am to 5:00 pm CST **Preferred Qualifications:** + Knowledge of payers and provider enrollment applications for the following states: Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, and Nebraska **Soft Skills:** + Ability to work independently and as a team, and maintain good judgment and accountability + Ability to multi-task and prioritize tasks to meet all deadlines + Ability to work well under pressure in a fast-paced environment + Demonstrated ability to work well with health care providers and team members + Strong organizational and time management skills + Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO, #GREEN