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UNIQUE CARE COMMUNITY SERVICES jobs - 41 jobs

  • Performance Quality Analyst II

    Carebridge 3.8company rating

    Columbus, OH job

    Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Performance Quality Analyst II is responsible for driving service quality excellence by evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. How you will make an impact: * Assists higher level auditor/lead on field work as assigned and acts as auditor in charge on small and less complex audits. * Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment & billing transactions and the corrective action plan process. * Demonstrates ability to audit multiple lines of business, multiple functions, and multiple systems. * Analyzes and interprets data and makes recommendations for change based on judgment and experience, applies audit policy, and assesses risks to minimize our exposure and mitigate those risks. * Works closely with the business to provide consultation and advice to management related to policy and procedure identified as out of date or incomplete and investigates, develops and recommends process improvements and solutions. * Functions as a subject matter expert for discrepancy review, questions from team and business partners, and interpretation of guidelines and audit process. * Acts as a mentor to peer auditors, providing training and managing work and projects as necessary. Minimum Requirements: Requires a BS/BA; a minimum of 3 years related experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector), including a minimum of 1 year related experience in a quality audit capacity; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: * WGS Claims processing experience strongly preferred. * Experience/knowledge with local claim processing. * Understanding of individual member benefits and cost shares preferred. * Understanding of small, large and national group benefits and cost shares preferred. * Prefer contract language. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $61k-83k yearly est. Auto-Apply 60d+ ago
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  • Field Advanced Practice Provider (US)

    Carebridge 3.8company rating

    Columbus, OH job

    Location: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. * This position will cover the territories of Bexley, Whitehall, Near East Side, Near South Side The Field Advanced Practice Provider is responsible for collaborating with company physicians, the patient's other physicians and providers, and their family members to develop complex plans of care in accordance with the patient's health status and overall goals and values. Provides clinical and non-clinical support to patients in palliative care within a designated territory. How you'll make a difference: * Provides services in home settings to provide care to patients. * Develops and implements clinical plans of care for adult patients facing chronic and complex conditions (e.g., co-morbid medical and mental health diagnoses, limited personal resources, chronic medical conditions.). * Gathers history and physical exam and diagnostics as needed, and then develops and implements treatment plans given the patient's goals of care and current conditions. * Meets the patient's and family's physical and psychosocial needs with support and input from the company's inter-disciplinary team. * Educates patients and families about medication usage, side effects, illness progression, diet and nutrition, medical adherence and crisis anticipation and prevention. * Maintains contact with other clinical team members, patients' other physicians and patients' other medical providers to coordinate optimal care and resources for the patient and his or her family in a timely basis and consistent with state regulations and company health standards and policy. * Maintains patient medical records and medical documentation consistent with state regulations and company standards and policy. * Participates in continuing education as required by state. * Prescribes medication as permitted by state prescribing authority. Minimum Requirements: * Requires an MS in Nursing. * Requires current unrestricted Nurse Practitioner (NP) license or Physician Assistant (PA) license in applicable state(s). * Possession of DEA registration or eligibility required. * CPR certification required. Preferred skills, qualifications and experiences: * 2 years of experience in home-based services, complex care cases, and hospice and/or palliative care preferred. * Bedside hospital, oncology, emergency room (ER) or intensive care unit (ICU) experience highly preferred. * Experience working with Electronic Medical Records (EMR) preferred. * Bilingual in English/Spanish preferred. For Carelon Health business unit, satisfactory completion of a Tuberculosis test is a requirement for this position. Travel m Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $39k-66k yearly est. Auto-Apply 60d+ ago
  • Director I Claims

    Carebridge 3.8company rating

    Columbus, OH job

    Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Director I Claims is responsible for directing the auditing of claim payments. Provides guidance on the most complex claims. How you will make an impact: * Develop strategies to improve claims efficiency. * Develop short/long-term objectives and monitor procedures to ensure these are met by staff. * Ensures area is staffed and trained. * Familiarity of state and federal regulations. * Hires, trains, coaches, counsels and evaluates performance of direct reports. * Light travel may be required. Minimum Requirements: Requires a BA/BS and 7 years leadership experience; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: * In depth knowledge of claim processes preferred. * Experience in claim auditing preferred. * Knowledge of claims systems (CIW and/or WGS) preferred. * Understanding of insurance policies preferred. * Strong leadership and team management skills to effectively lead and motivate a team preferred. * Excellent analytical and problem-solving skills to evaluate claims and develop improvement strategies preferred. * Strong organizational and multitasking abilities to manage multiple projects and deadlines preferred. * Strong written and oral communication skills, problem solving skills, attention to detail and well organized preferred. * Knowledge of stop loss product is preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $129,096 to $193,644. Locations: Minnesota. In addition to your salary, Elevance Health 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). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $129.1k-193.6k yearly Auto-Apply 60d+ ago
  • Social Media Specialist

    Adl 3.9company rating

    Remote job

    Social Media Specialist REPORTS TO: Director, Social Media SUPERVISION EXERCISED: None Grade/Class: Grade E, Exempt, PSA-Eligible ABOUT THE ORGANIZATION: ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is “to stop the defamation of the Jewish people and to secure justice and fair treatment to all.” Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism and battling bigotry wherever and whenever it happens, ADL works to protect democracy and ensure a just and inclusive society for all. PRIMARY FUNCTION The Social Media Specialist will craft timely, platform-native content; manage daily publishing and community engagement; and help uphold and evolve ADL's brand voice-clear, credible, and courageous. This role sits within the Communications team and collaborates closely with Issue Area, Policy, and regional teams. Responsibilities Primary: Responsible for writing, producing, and publishing daily content (short-form video, reels, carousels, threads) across all social platforms while maintaining the team's content calendar. Ensure all published content and community responses consistently reflect the organization's established voice by following style, tone, and accessibility guidelines. Actively monitor social channels for mentions, comments, and messages, engaging with the community according to guidelines and escalating sensitive issues to senior team members. Track key metrics (e.g., reach, engagement, shares) by compiling data for weekly or monthly performance reports and documenting the results of content tests. Translate social insights into actionable recommendations for content, messaging, and audience targeting Collaborate with team members to execute the social media components of larger campaigns, events, and rapid-response situations under the guidance of team leadership. This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed. Qualifications Skills: Nimble, creative, and mission-driven; Able to move quickly without sacrificing accuracy; Easily adapts in a rapid-response environment, including weekends and after hours; Thinks critically about narratives, timing, and risk; recognizes and applies sound judgment to sensitive topics. Organized, able to manage multiple workstreams, deadlines, and approvals with crisp project management; Translate complex issues into accessible, platform-native content; Strong writing and editing skills; comfort adopting and consistently applying an established brand voice; Proficiency with social tools (e.g., Sprout), native analytics, and basic creative tools (e.g., Canva and/or Adobe for short-form video); Familiarity with accessibility best practices (alt text, captions, contrast) and community guidelines; Attributes: Committed to contributing to a culture where everyone thrives Collaborative team-player. Creative and innovative; takes initiative. Results-oriented - a problem solver (versus a problem identifier) Excels in dynamic environments that require adaptability Ability to manage multiple priorities simultaneously Energized by ADL's mission and work Work Experience: The ideal candidate has several years hands-on social media experience managing brand or cause-driven channels across X, Instagram, TikTok, Facebook, and LinkedIn. Education: Bachelor's degree in communications, or related field, or equivalent experience required. Work Environment: ADL is a hybrid environment; this role may require 3 days in the office. Weekend and after-hours work is expected to support rapid response and live event coverage needed for rapid response, and emerging issues. Compensation: This position has a salary range of $75,000 to $85,000. This salary range is reflective of a position based in New York, New York. Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit ********************************** ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply. ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws. ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at ************************* . ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws. The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.
    $75k-85k yearly Auto-Apply 32d ago
  • Utilization Management Representative II (Virtual in Ohio)

    Carebridge 3.8company rating

    Columbus, OH job

    Utilization Management Representative II Schedule: Monday-Friday 8am-5pm Eastern Time Must be located in the state of Ohio Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual/ work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law The MyCare Ohio health plan is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. How you will make an impact: * Responsible for managing incoming calls, including triage, opening of cases and authorizing sessions. * Primary duties may include, but are not limited to: Managing incoming calls or incoming post services claims work. * Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. * Obtains intake (demographic) information from caller. * Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given. * Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. * Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization. * Verifies benefits and/or eligibility information. * May act as liaison between Medical Management and internal departments. * Responds to telephone and written inquiries from clients, providers and in-house departments. * Conducts clinical screening process. Minimum Requirements: * Requires high school diploma or GED equivalent and a minimum of 2 years customer service experience in healthcare related setting and medical terminology training; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: * Experience with LTSS support or waivers strongly preferred. * Health plan knowledge (prior authorizations experience) strongly preferred. * Flexibility and strong attention to detail preferred. * For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $41k-62k yearly est. Auto-Apply 60d+ ago
  • Senior Director of Strategic Communications and Content Strategy

    Adl 3.9company rating

    Remote job

    JOB TITLE: Senior Director of Strategic Communications and Content Strategy REPORTS TO: Vice President of Communications and Digital SUPERVISION EXERCISED: Editorial Team Grade/Class: Grade I, Exempt, Non-Union About the Organizations: ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is "to stop the defamation of the Jewish people and to secure justice and fair treatment to all." Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism, and battling bigotry wherever and whenever it happens, ADL works to ensure a just and inclusive society for all. Primary Function: The Senior Director of Strategic Communications and Content Strategy serves as a key partner to the Vice President of Communications and Digital, helping to translate and implement strategies across ADL's communications ecosystem. This role ensures consistent, compelling, and mission-aligned messaging across all communications touchpoints, overseeing editorial strategy and content development for earned media outreach, social media platforms, partner with marketing and development teams and organizational publications. The Senior Director translates complex policy and research into accessible, impactful content that advances ADL's mission and engages diverse audiences. Responsibilities Core Responsibilities: Communications Editorial Strategy & Leadership Develop and implement the editorial strategy aligned with priorities, leading cross-functional meetings and driving communications content calendars to execute campaigns. Establish and maintain all editorial standards and messaging frameworks across all communications channels. Provide creative and visual direction for all communications content (social video, reports, multimedia), developing innovative approaches to break through the noise and engage audiences. Team Management & Development Manage and mentor a diverse team of content creators and professionals, overseeing performance reviews and professional development while fostering a collaborative, mission-driven editorial culture. Coordinate cross-departmental editorial workflows and approval processes to ensure alignment with established strategies. Crisis Communications & Rapid Response Lead rapid-response editorial execution during breaking news and crises, implementing approved strategies to ensure accurate, timely, and impactful multi-platform messaging. Manage team performance and maintain organizational discipline in high-pressure situations, ensuring brand consistency, quality, and composure. Integrated Media Strategy Translate defined integrated strategies into actionable editorial plans and frameworks for communications campaigns across all paid, earned, and owned channels. Ensure all content is channel-optimized and message-consistent, collaborating with media relations, marketing, and other departments to maximize amplification. Content Development & Management Lead integrated content strategy and creation: Oversee the editorial process for all earned media (press releases, op-eds), social media, and digital reports, innovating to make complex topics accessible and align with strategy. Enforce universal communications consistency: Direct editorial standards across all platforms and formats (social, video, publications) to ensure communications integrity and optimize engagement. Manage cross-functional content approvals: Serve as the central communications marketing, fundraising, and donor-facing content. Analytics, Insights & Performance Leadership Lead communications analytics strategy: Operationalize priorities by developing insights, monitoring real-time risks/trends, and delivering executive readouts with clear recommendations to guide decisions. Own the communications performance measurement ecosystem: Establish and manage the organization-wide KPI framework, the master analytics dashboard as the single source of truth, and all vendor/tool relationships. Drive data-driven campaigns and insights: Build integrated campaign measurement plans (e.g., test-and-learn) and translate complex data into actionable recommendations for communications and other departments. Foster a data-literate culture: Mentor team members on analytics to elevate a culture of data-informed creativity and continuous improvement. This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed. Qualifications Skills: Demonstrable ability to remain calm and effective under intense pressure and during crises; Creative vision with a track record of innovative content concepts and campaigns; Deep understanding of paid, earned, and owned media integration and optimization; Proven experience managing and developing high-performing creative teams; Strong visual/design sensibility for multimedia content across formats; Deep understanding of social analytics and data-driven optimization; Experience with influencer marketing and partnership strategies; Exceptional written and verbal communication skills; adaptable tone/style for diverse audiences; Crisis communications and rapid-response experience; Proficiency with CMS, social platforms, and digital publishing tools. Attributes: Committed to building a culture where everyone thrives; Collaborative team player who excels in matrixed organizations; Creative and innovative; takes initiative and ownership; Results-oriented problem solver with resilience under pressure; Comfort managing multiple priorities; Demonstrated passion for fighting antisemitism and extremism; Energized by ADL's mission and work. Work Experience: The ideal candidate has significant years' experience of progressive communications and editorial experience, with a strong communications background in agency or in-house environments, and several years in a senior leadership and team management role. Education: BA/BS degree or equivalent experience required; Advanced degree preferred. Work Environment: Flexibility for after-hours/weekend work for breaking news and crises. ADL maintains a hybrid work environment; this role may require up to three days in person per week. Compensation: This position has a salary range of $160,000 to $175,000. This salary range is reflective of a position based in (New York, NY). Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit ********************************** ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply. ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws. ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at ************************* . ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws. The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.
    $160k-175k yearly Auto-Apply 56d ago
  • Housing Modification Specialist

    Carebridge 3.8company rating

    Columbus, OH job

    Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Work Schedule : Monday - Friday 8am - 5pm EST The Housing Modification Specialist is responsible for developing and implementing the health plans home modification strategy and program. This includes the approach to assisting individuals in the HCBS Waiver in receiving modifications to their home to allow them to have greater access to their home environment (i.e. wheelchair accessible ramp, accessible shower, widening of doorways, etc.). How you will make an impact : * Collaborate with home modification providers and internal health plan stakeholders to ensure an efficient process for members accessing home modifications. * Partner with MyCare lead trainers to develop and implement training specific to home modifications in Ohio. * Support Care Coordinators and Support Coordinators in identifying home modification needs and ensuring an efficient process. Minimum Requirements: * Requires a minimum of 3 years experience in developing housing and/or housing policy at a local, state or federal level for special populations such as the elderly, people with disability and/or people with mental health challenges to secure accessible, affordable housing through Federal and local programs; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities & Experiences: * Certified Aging in Place Specialist (CAPS) preferred or commitment to obtain certification within one year of employment. * Strong preference for case management experience with older adults or individuals with disabilities. * BA/BS in Health/Nursing preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $34k-47k yearly est. Auto-Apply 60d+ ago
  • Medical Management Specialist I

    Carebridge 3.8company rating

    Columbus, OH job

    The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. Medical Management Specialist I Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. This position will be based at any Pulse Point available in Ohio, US. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: This position will work an 8-hour from shift 8:00 am - 5:00 pm (EDT) Monday to Friday. Additional hours may be necessary based on company needs. The Medical Management Specialist I responsible for providing non-clinical support to the Care Coordination Team. How you will make an impact. Primary duties may include, but are not limited to: * Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review). * Provides information regarding network providers or general program information when requested. * May assist with complex cases. * Prepares reports and documents all actions. * Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information. * Receive incoming member and provider calls and provide support with basic information and triage other issues to the appropriate location. * Conduct member and provider outreach to follow up on activities of care coordination. * Confirm service initiation and coordinate service delivery. * Support Care Coordinators with scheduling visits and collecting information from providers. * Help members with scheduling transportation and accessing community resources. * Facilitate exchanges of documentation between interdisciplinary teams. Minimum Requirements: * Requires a H.S. diploma or equivalent and a minimum of 1 year experience or any combination of education and experience which would provide an equivalent background. Preferred Qualifications: * Understanding of managed care or Medicaid/Medicare strongly preferred. * Call center or other phone-based customer service experience strongly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $33k-44k yearly est. Auto-Apply 60d+ ago
  • Analyst, Center on Extremism

    Adl 3.9company rating

    Remote job

    Analyst, Center on Extremism REPORTS TO: Senior Associate Director, Center on Extremism SUPERVISION EXERCISED: None Grade/Class: Grade F, Exempt, PSA-Eligible ABOUT THE ORGANIZATION: ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is “to stop the defamation of the Jewish people and to secure justice and fair treatment to all.” Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism and battling bigotry wherever and whenever it happens, ADL works to protect democracy and ensure a just and inclusive society for all. PRIMARY FUNCTION: The Analyst (Antisemitism) will be responsible for advancing the mission of Center on Extremism by researching and analyzing antisemitism in diverse ideological movements and demographics. The Analyst will write reports and articles for public distribution, and analyses for internal use, and will participate in planning and carrying out agency responses to research findings. The Analyst will conduct presentations and trainings for law enforcement and other constituents. Responsibilities Primary: Research and analyze antisemitic movements and ideologies, groups, and individuals. Gather information from a wide variety of primary and secondary sources, including traditional media, social media, third party research sources, and others. Help develop qualitative and quantitative analysis of subject area, potentially with the use of a range of technical tools Draft and edit internal memoranda based on research findings for agency use. Create written reports and articles, and deliver verbal presentations and trainings, for external partners, law enforcement, outside constituents, and the public. Assist in planning and executing agency responses to research findings. Support regional offices and CSC departments on relevant subject matter by providing information, guidance, and other assistance. Ensure that research materials and findings are properly archived for use by current and future ADL employees. This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed. Qualifications Skills: A strong understanding of contemporary and historical antisemitism required. Excellent research skills in primary and secondary sources. Demonstrated experience with social media monitoring tools and OSINT techniques required. Ability and willingness to quickly learn new technologies and adapt to a changing research environment. Ability to switch between quantitative and qualitative analytic lenses. Ability to thrive in a demanding, fast-paced multi-tasking environment. Strong interpersonal skills and ability to work in teams Excellent analytical and writing skills. Ability to demonstrate good judgment under pressure. Attributes: Committed to contributing to a culture where everyone thrives Collaborative team-player. Creative and innovative; takes initiative. Results-oriented - a problem solver (versus a problem identifier). Excels in dynamic environments that require adaptability. Ability to manage multiple priorities simultaneously. Energized by ADL's mission and work. Work Experience: The ideal candidate has demonstrable experience and expertise in research, academia, or public policy. Education: Bachelor's degree or equivalent experience required. Graduate degree preferred. Work Environment: Office environment. Additional hours may be needed on occasion to keep up with heavy workload and attend special events. ADL is a hybrid environment; this role may require 3 days in the office. Compensation: This position has a salary range of $60,000 to $72,000. Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit ********************************** ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply. ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws. ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at ************************* . ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws. The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.
    $60k-72k yearly Auto-Apply 60d+ ago
  • Audit & Reimbursement Senior

    Carebridge 3.8company rating

    Columbus, OH job

    Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. * Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement Senior will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and Medicare Part A reimbursement. This position provides a valuable opportunity to gain advanced experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities. How you will make an impact: * Evaluate the work performed by other associates to ensure accurate reimbursement to providers. * Assist Audit and Reimbursement Leads and Managers in training, and development of other associates. * Participates in special projects as assigned. * Able to work independently on assignments and under minimal guidance from the manager. * Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements. * Analyze and interpret data with recommendations based on judgment and experience. * Must be able to perform all duties of lower-level positions as directed by management. * Participate in development and maintenance of Audit & Reimbursement standard operating procedures. * Participate in workgroup initiatives to enhance quality, efficiency, and training. * Participate in all team meetings, staff meetings, and training sessions. * Assist in mentoring less experienced associates as assigned. * Prepare and perform supervisory review of cost report desk reviews and audits. * Review of complex exception requests and CMS change requests. * Perform supervisory review of workload involving complex areas of Medicare part A reimbursement such as Medicare DSH, Bad Debts, Medical Education, Nursing and Allied Health, Organ Acquisition, Wage Index and all cost based principles. Minimum Qualifications: * Requires a BA/BS and a minimum of 8 years of audit/reimbursement or related Medicare experience; or any combination of education and experience which would provide an equivalent background. * This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Qualifications: * Accounting degree preferred. * Knowledge of CMS program regulations and cost report format preferred. * Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred. * Must obtain Continuing Education Training requirements. * MBA, CPA, CIA or CFE preferred. * Demonstrated leadership experience preferred. * A valid driver's license and the ability to travel may be required. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $ 73,720 to $122,220 Locations: Maryland, Minnesota, Nevada and New York In addition to your salary, Elevance Health 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). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $73.7k-122.2k yearly Auto-Apply 60d+ ago
  • Director II Medical Cost Intelligence AI & Engineering

    Carebridge 3.8company rating

    Columbus, OH job

    Director II Medical Cost Intelligence AI & Engineering (Dir II Engineering) Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidate resides within a commutable distance from an office. The Director II Medical Cost Intelligence AI & Engineering is responsible for strategic oversight and delivery of enterprise technology solutions, inclusive of AI, analytics and agentic solutions, business units and enterprise functions focused on managing medical cost. Delivery responsibilities will include leading engineering teams and collaborating with internal technology teams to deliver scalable enterprise level solutions that will proactively manage medical costs through the use of AI & analytics focused capabilities to drive affordable healthcare across the industry. The role will also be responsible for drive innovation technology solutions that change the strategic landscape of how Elevance Health manages medical costs and proactively identifies and takes actions to ensure affordable healthcare. How you will make an impact: * Planning, directing, and controlling multiple teams of resources and initiatives to accomplish the objectives and requirements defined by senior technology and product management across multiple teams. This is inclusive of design, development, and testing teams delivering AI & analytics solutions. * Provides technology thought leadership to business partners ensuring teams are delivering scalable solutions that enable enterprise level priorities and financial goals. * Responsible for the planning and execution of technology solutions and the ability to manage to budgetary constraints. * Interfaces with key technology solution vendors; develops strategies and facilitates performance measurement plans to optimize vendor and associate performance and outcomes. * Develops application technology plans, forecasting for an enterprise application, enterprise-wide tool, infrastructure, or a center or domain that is equivalent in scope and complexity. * Manages a domain or suite of applications (or the equivalent capital and/or level of responsibility). * Oversees strategic planning, budget development, and management for a single large or multiple cost centers, contract compliance, and any necessary integration of government regulatory requirements. * Ensures disaster recovery and business continuity plan are implemented, monitored, and updated on a recurring basis. * Ensures delivery and supports system solutions that support the continuous operations. * Identifies and resolves hurdles for assigned areas/groups according to established deadlines. * Establishes and maintains collaborative relationships with key business partners. * Partners with customers in order to understand new product enhancements or features being requested. * Plans and executes annual projects while maintaining profit and loss (P&L) responsibility. * Establishes and maintains collaborative relationships with key business partners. * Hires, trains, coaches, counsels, and evaluates performance of direct reports. Minimum Requirements: Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 8 years of IT management experience in the area of function being managed; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences: * Health insurance industry experience, specifically at a provider or payer strongly preferred. * AI delivery of business solutions strongly preferred. * Experience delivering AI and technology solutions for a targeted business function strongly preferred. * Prior people leadership experience preferred. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. Please Note: If this is not a straight backfill, please consult with your HR Business Partner prior to posting/using this job. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $199,936 to $327,168. Locations: California, District of Columbia (Washington DC), Illinois, New York In addition to your salary, Elevance Health 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). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $108k-153k yearly est. Auto-Apply 60d+ ago
  • Medical Management Clinician

    Carebridge 3.8company rating

    Columbus, OH job

    The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. Medical Management Clinician Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. This position will be based at any Pulse Point available in Ohio, US Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: This position will work an 8-hour from shift 8:00 am - 5:00 pm (EDT) Monday to Friday. Additional hours may be necessary based on company needs. The Medical Management Clinician responsible for ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or medical policies. May collaborate with healthcare providers. Focuses on moderately complex case types that do not require the training or skill of a registered nurse. How you will make an impact. Primary duties may include, but are not limited to: * Responsible for moderately complex cases that may require evaluation of multiple variables against guidelines when procedures are not clear. * Work may be facilitated, in part, by algorithmic or automated processes. * Handles moderately complex benefit plans and/or contracts. * Works on reviews that may require guidance by more senior colleagues and/or management. * May serve as a resource to less experienced staff. * Conducts and may approve precertification, concurrent, retrospective, out-of-network, and/or appropriateness of treatment setting reviews by assessing clinical information against appropriate medical policies, clinical guidelines, and the relevant benefit plan/contract. * May process a medical necessity denial determination made by a Medical Director. * May work directly with healthcare providers to obtain and understand clinical information. * Refers complex or unclear reviews to higher level nurses and/or Medical Directors. * May educate members about plan benefits and physicians. Does not issue medical necessity non-certifications. Minimum Requirements: * Requires H.S. diploma or equivalent. Requires a minimum of 4 years of clinical experience and/or utilization review experience. * Current active, valid and unrestricted LPN/LVN license or RN license and/or certification to practice as a health professional within the scope of licensure in applicable state(s) or territory of the United States required. * Multi-state licensure is required if this individual is providing services in multiple states. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $33k-66k yearly est. Auto-Apply 60d+ ago
  • Assistant Director, Volunteer Advocacy and Community Mobilizations

    Adl 3.9company rating

    Remote job

    Assistant Director, Volunteer Advocacy and Community Mobilizations REPORTS TO: Director, Volunteer Advocacy and Community Mobilization SUPERVISION EXCERCISED: None ABOUT THE ORGANIZATION: ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is “to stop the defamation of the Jewish people and to secure justice and fair treatment to all.” Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism and battling bigotry wherever and whenever it happens, ADL works to protect democracy and ensure a just and inclusive society for all. PRIMARY FUNCTION: This position is an integral member of the Volunteer Advocacy and Community Mobilizations team within the National Affairs department. The Assistant Director of Volunteer Advocacy and Community Mobilizations will share responsibility for facilitating and coordinating a robust community engagement strategy for ADL, with a particular focus on building relationships with volunteer leaders and community partners. This person will be responsible for designing, implementing, and tracking strategies that mobilize people to advocate and volunteer to further ADL's mission and policy priorities. Responsibilities Primary: Support and help lead the implementation of grassroots and grasstops advocacy campaigns; Grow ADL's base of volunteer support and collaborate on the creation of a network of ambassadors and messengers to represent ADL; Oversee the training and coordination of our volunteers, equipping them with the skills and knowledge needed to effectively advocate for ADL's policy priorities; Create and support the development of materials, toolkits, and resources for volunteer advocates; Own, develop and maintain a system to track and analyze the impact of volunteer- led advocacy campaigns, leveraging data to support strategy refinement; Support digital efforts to mobilize the ADL community and its allies in support of policy efforts, including digital activations like Calls to Action, social media campaigns, etc. Secondary: Provide logistical support for the Volunteer Advocacy and Community Mobilizations team; Become the ambassador for empowering volunteers to other departments and colleagues at ADL; Drive and support the execution/mobilization efforts of the ADL federal and state lobby days; Provide ongoing reports on programming impact; Manage interns as needed on community engagement projects. This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed. Qualifications Skills: Excellent communication skills and ability to engage with community leaders; Commitment to advancing transparency and accountability in addressing antisemitism; Able to support and execute multiple projects; Creative problem solver with entrepreneurial spirit and self-starting nature; Results-oriented with a sense of urgency; Team player with willingness to play multiple positions as needed; Technology skills including expertise with EveryAction/NGP/VAN and visual storytelling and experience with AI tools; Strong organizational and project coordination skills. High tolerance for ambiguity Attributes: Committed to contributing to a culture where everyone thrives Collaborative team-player. Creative and innovative; takes initiative. Results-oriented - a problem solver (versus a problem identifier) Excels in dynamic environments that require adaptability Ability to manage multiple priorities simultaneously Work Experience: The ideal candidate has several years' experience in electoral work, volunteer management, social impact design, project management, community organizing or other related areas required. Demonstrable experience supporting advocacy campaigns and volunteer mobilization efforts preferred Work Environment: ADL is a hybrid environment; this role may require 3 days in the office. Flexibility is required to work extended hours or on weekends as needed. Occasional travel is required to attend meetings, events and conferences. Compensation: This position has a salary range of $70,000 to $80,000. This salary range is reflective of a position based in New York, NY. Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit ********************************** ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply. ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws. ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at ************************* . ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws. The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.
    $70k-80k yearly Auto-Apply 3d ago
  • Program Consultant - Ohio MyCare

    Carebridge 3.8company rating

    Columbus, OH job

    The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. Program Consultant - Ohio MyCare Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. This role is based in Ohio with positions located in either the Columbus, Cincinnati, Mason, or Seven Hills area. Must be available to travel to different office locations as needed. Ohio residency is a requirement for this position. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: This position will work an 8-hour from shift 8:00 am - 5:00 pm (EDT) Monday to Friday. Additional hours, including weekends or holidays, may be required based on operational needs. The Program Consultant is responsible for the development and ongoing management of one or more external client facing programs within a business unit. Program consultants typically support business strategies through an integrated portfolio of external client facing projects or initiatives. How You Will Make an Impact Primary duties may include, but are not limited to: * Manages the development, approval, implementation and compliance of on-going external client facing programs. * Ensures program meets its stated objectives and provides subject matter expertise in response to day-to-day business issues. * Researches applicable subject matter practices and remains aware of industry trends. * Maintains external business partner profiles by managing relationships with corporate and regional partners. * Coordinates training related to the external client facing program, develops program success measures and performs periodic assessments of external client facing program. * Supports partners in performing readiness assessments when new services are rolled out or when existing services are expanded or enhanced. * Works with the delegated agencies to drive transformation , policies, audit and provide day to day supports to ensure compliance. Minimum Requirements: * Requires a BA/BS in a related field and minimum of 3 years experience in external client facing program management; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences: * Lived experiences with behavioral health and HCBS waiver service programs is strongly preferred. * Experience with relationship building, training and compliance preferred. * Field or project management experience preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $54k-83k yearly est. Auto-Apply 60d+ ago
  • Credit & Collections Specialist (US)

    Carebridge 3.8company rating

    Remote or San Juan, PR job

    A proud member of the Elevance Health family of companies, Carelon Global Solutions, formerly Legato Health Technologies is a managed service delivery organization, providing information technology and business operations services for health plans. Credit & Collections Specialist Location: This role requires associates to be in-office [1] days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of remote work, promoting a dynamic and adaptable workplace. When report to the office this position will be based at PR-San Juan, 654 Ave Munoz Rivera. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: This position will work an 8-hour from shift 8:00 am - 5:00 pm (EDT) Monday to Friday. Additional hours may be necessary based on company needs. The Credit & Collections Specialist is responsible for collection activities related to past due health insurance premiums and/or past due health insurance claims. How you will make an impact. Primary duties may include, but are not limited to: * Follows established guidelines, contacts group for the purpose of collecting past due insurance premiums and/or past due health insurance claims. * Researches validity of past due and/or disputed debt. * Generates demand letters. * Prepares reports reflecting status of credit and collection activities for management review. Minimum Requirements: * Requires a H.S. diploma or equivalent and a minimum of 1 year of prior commercial debt collection experience; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences: * Fully Bilingual (English & Spanish), Must be able to write, read and speak both languages in a proficiency level preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $39k-48k yearly est. Auto-Apply 60d+ ago
  • Manager Behavioral Health Services

    Carebridge 3.8company rating

    Columbus, OH job

    JR167272 Manager Behavioral Health Services Responsible for overseeing Behavioral Health Utilization Management (BH UM), this position supports the Medicaid line of business. Location: Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. How will you make an impact: * Serves as a resource for medical management programs. Identifies and recommends revisions to policies/procedures. * Ensures staff adheres to accreditation guidelines. * Supports quality improvement activities. * May assist with implementation of cost of care initiatives. * May attend meetings to review UM and/or CM process and discusses facility issues. * Hires, trains, coaches, counsels, and evaluates performance of direct reports. * Responsibilities for BH UM may include: Manages a team of licensed clinicians and non-clinical support staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of BH services through level of care determination, accurate interpretation/application of benefits, corporate medical policy and cost efficient, high quality care; manages consultation with facilities and providers to discuss plan benefits and alternative services; manages case consultation and education to customers and internal staff for efficient utilization of BH services; leads development and maintenance of positive relationship with providers and works to ensure quality outcomes and cost effective care; assists in developing clinical guidelines and medical policies used in performing medical necessity reviews; provides leadership in the development of new pilots and initiatives to improve care or lower cost of care. Minimum requirements: LICENSURE REQUIREMENTS FOR ALL FUNCTIONS: * Requires current, active, unrestricted license such as LCSW (as applicable by state law and scope of practice), LMHC, LPC, LMSW (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States. * For Government business only: LAPC, and LAMFT are also acceptable if allowed by applicable state laws and any other state or federal requirements that may apply; provided that the manager's director has one of the types of licensures specified in the preceding sentence. * Licensure is a requirement for this position. EDUCATION/EXPERIENCE REQUIREMENTS: * Prior experience in Managed Care setting required. * Additional requirements for BH UM: MS in social work, counseling, psychology or related behavioral health field or a degree in nursing and minimum of 5 years of clinical experience with facility-based and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of education and experience, which would provide an equivalent background. * Experience applying clinical and policy knowledge on the continuum of Behavioral Health treatment strongly preferred. Preferred Skills, Capabilities, and Experiences: * Leadership and prior management experience. * Experience in managed care. * Candidates from all states are welcome, but they must reside within commuting distance of a Pulse Point office location where we have an office to be considered. * Proficiency in MS Office and data reporting. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $65k-84k yearly est. Auto-Apply 60d+ ago
  • Policy Counsel

    Adl 3.9company rating

    Remote job

    Policy Counsel REPORTS TO: VP, Policy Counsel SUPERVISION EXERCISED: None GRADE/CLASS: Grade H, Exempt, PSA-eligible ABOUT THE ORGANIZATION ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is “to stop the defamation of the Jewish people and to secure justice and fair treatment to all.” Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism, and battling bigotry wherever and whenever it happens, ADL works to ensure a just and inclusive society for all. PRIMARY FUNCTION The Policy Counsel will play a central role in shaping and implementing ADL's local, state and national legislative and policy agenda using evidence-based legal approaches and tactics. As a legal, legislative, and policy subject matter expert on ADL's national advocacy priorities, the Policy Counsel will work in close coordination with external experts and ADL's national and regional teams to ensure that the policy and advocacy approaches ADL supports are legally sound, effective, and impactful. Responsibilities Primary: Lead the development and implementation of legal and policy strategies in pursuit of ADL policy priorities, consistent with ADL research. Monitor and analyze federal and state legislative, regulatory, and judicial developments that affect the safety of the Jewish community. Partner with ADL's national and regional teams, including COE, CAR, the federal affairs team, the state and local advocacy team, regional offices, the litigation team, and other experts to provide real-time policy responses to incidents and trends. Draft legislation, regulations, memoranda, position papers, public comments, and advocacy materials. Collaborate with national security, law enforcement, and civil society partners to shape effective, constitutionally informed responses to threats. Serve as a spokesperson or expert representative in public fora, during legislative briefings, and through media engagements as appropriate. This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed. Qualifications Skills: Exceptional legal research, analysis, and writing skills. Strong public speaking and coalition-building capabilities. Attributes: Passionate about ADL's mission and driven to combat antisemitism in all forms. Open-minded and solutions-oriented with the ability to understand diverse perspectives. Strategic thinker and effective advocate who can build consensus and advance complex policy goals. Entrepreneurial mindset with the ability to lead initiatives and respond to emerging challenges. Collaborative, strategic, and responsive under pressure. Work Experience: Demonstrated experience in policy, litigation, or advocacy roles. Government, nonprofit, or legislative experience preferred but not required. Experience with online harm, content moderation, and/or technology regulation is highly desirable. Education: J.D. degree required. Work Environment: Flexibility to work extended hours and travel occasionally as required. Must be able to engage in prolonged computer and desk work. Willingness to travel to regional offices, national convenings, or public events, including some weekends. ADL is a hybrid environment; this role may require 3 days in the office. Compensation: This position has a salary range of $90,000 to $125,000. This salary range is reflective of a position based in Dallas, Texas. Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit ********************************** ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply. ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws. ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at ************************* . ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws. The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.
    $30k-42k yearly est. Auto-Apply 39d ago
  • Provider Contract/Cost of Care Consultant (US)

    Carebridge 3.8company rating

    Columbus, OH job

    Provider Contract/Cost of Care Consultant Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. PLEASE NOTE: This position is not eligible for current or future VISA sponsorship. The Provider Contract/Cost of Care Consultant provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction. Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues. Works on large scale initiatives with high dollar cost savings opportunities. Partners with provider contractors to develop contracting strategy and supports all aspects of the contract negotiation process. Can work with multiple provider types, e.g. physician, ancillary, medical groups, or hospitals. Supports a full range of contract arrangements and pricing mechanisms. Works on complex enterprise-wide initiatives and acts as project lead. How you will make an Impact: * Uses analytic tools to track both health risks and compliance, as well as supporting the contract negotiation process. * Types of analyses include performing sophisticated retrospective data analytics; building new and modifying existing complex models to create predictive impact decision making tools; performing healthcare cost analysis to identify strategies to control costs; projecting cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis; preparing pre-negotiation analysis to support development of defensible pricing strategies; performing modeling to compare various contract scenarios based on member utilization patterns and 'what if' logic; measuring and evaluating the cost impact of various negotiation; researching the financial profitability/stability and competitive environment of providers to determine impact of proposed rates; and projects different cost of savings targets based upon various analytics. * Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures. * Recommends policy changes and claim's system changes to pursue cost savings. * Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable. * Recommends standardized practices to optimize cost of care. * Educates provider contractors on contracting analytics from a financial impact perspective. * May recommend alternative contract language and may go on-site to provider premises during contract negotiations. * Participates on project team involved with enterprise wide initiatives. * Acts as a source of direction, training and guidance for less experienced staff. Minimum Requirements: Requires BS/BA degree in Mathematics, Statistics, or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical analysis and healthcare modeling; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: * Healthcare Industry highly preferred. * High proficiency in SQL * Data analytics within healthcare industry * Exposure to Python or R * Master's degree preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $51k-80k yearly est. Auto-Apply 60d+ ago
  • Medical Director- Long Term Support and Service (LTSS)

    Carebridge 3.8company rating

    Columbus, OH job

    Medical Director -Long Term Support and Services Preferred Location: Ohio. Please note that per our policy this role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. The Medical Director -Long Term Support and Services is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations. May identify cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. How will you make an impact: * Oversee all primary and physical health services provided to individuals of the health plan, including those receiving LTSS, ensuring the appropriate level of medical care is received. Identifies potential issues, project change, and scope data. * Ensure services align with LTSS clinical and service coordination requirements as defined by state and federal contracts/rules. * Conduct targeted LTSS Case Management training sessions, emphasizing the most prevalent medical diagnoses affecting the key LTSS populations. * Assist with resource development and drive Health Plan collaborations to support LTSS/HCBS populations. * Supports clinicians to ensure timely and consistent responses to members and providers. * Provides guidance for clinical operational aspects of a program. * Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians. * May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations. Minimum Requirements: * Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). * Must possess an active unrestricted medical license to practice medicine or a health profession. Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US. * A minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * For Health Solutions and Carelon organizations (including behavioral health) only, a minimum of 5 years of experience providing health care is required. * * Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency.* Preferred Skills, Capabilities and Experiences: * Minimum of ten years of clinical experience, including at least five years of experience directing healthcare services for target populations strongly preferred. * 1-2 years Utilization Management experience strongly preferred. * Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
    $37k-72k yearly est. Auto-Apply 60d+ ago
  • Influencer and Paid Media Strategist

    Adl 3.9company rating

    Remote job

    Influencer and Paid Media Strategist REPORTS TO: Senior Director Communications SUPERVISION EXERCISED: None Grade/Class: Grade F, Exempt, PSA-Eligible ABOUT THE ORGANIZATION: ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is “to stop the defamation of the Jewish people and to secure justice and fair treatment to all.” Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism and battling bigotry wherever and whenever it happens, ADL works to protect democracy and ensure a just and inclusive society for all. PRIMARY FUNCTION: The Influencer and Paid Media Strategist expands our reach, strengthens creator partnerships, and drives data-informed decisions. This role leads influencer programs, manages ADL's Digital Leadership Council (DLC), plans and optimizes paid campaigns across Meta (Facebook and Instagram), LinkedIn, and TikTok, using social analytics and internal dashboards. The Manager collaborates closely with internal teams and external agencies/vendors to deliver measurable outcomes while upholding ADL's brand voice; clear, credible, and courageous. Responsibilities Primary: Collaborate on the strategy and growth of the Digital Leadership Council (DLC) by overseeing the entire lifecycle of creator partnerships, from recruitment and onboarding to briefing, relationship management, content toolkit development and post-campaign reporting. Participate in the development of search-driven influencer strategies and always-on content planning to fuel discovery and conversion. Help create holistic campaign strategies that integrate influencer, earned media, social conversation, and experiential activations. Direct the end-to-end execution of paid media campaigns across all social channels, owning campaign setup, budget management, A/B testing, and performance analysis to deliver actionable insights and maximize ROI. Orchestrate the planning and on-site execution of key events, including DLC meetups and major conferences, managing all logistics, vendor relationships, and the rapid capture and deployment of live content. Serve as the steward for brand integrity across all activations, upholding the organizational voice while enforcing brand safety, platform policies, and accessibility best practices. Function as a key integrator, partnering with internal teams (Communications, Marketing Legal, Development) and external agencies to ensure that influencer, paid, and event strategies are aligned with broader organizational goals and messaging. This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed. Qualifications Skills: Hands-on expertise with Meta Ads (Facebook and Instagram), LinkedIn Campaign Manager, TikTok Ads Manager, Social analytics and listening tools Strong analytical and storytelling skills: ability to translate data into clear insights and creative action. Excellent writing, briefing, and communication skills; meticulous organization and documentation. Experience collaborating with agencies and vendors; confident reviewing media plans and optimizing toward performance goals. Proven experience managing creator programs or councils (DLC-equivalent), including contracts, briefs, deliverables, and measurement. Demonstrated event production skills: planning, vendor coordination, run-of-show creation, on-site execution, and live social content capture. Experience with social listening, brand safety tools, influencer discovery platforms, and data pipelines/connectors, preferred. Light creative/editing skills (e.g., Canva, Adobe Express, CapCut) to adapt assets for paid and creator use a plus. Knowledge of ADL's issues space and social media landscape Attributes: Committed to contributing to a culture where everyone thrives Collaborative team-player. Creative and innovative; takes initiative. Results-oriented - a problem solver (versus a problem identifier) Excels in dynamic environments that require adaptability Ability to manage multiple priorities simultaneously Energized by ADL's mission and work Work Experience: Significant years' experience across influencer marketing, paid social buying, and social analytics with demonstrable creativity in concepting campaigns, briefs, and content frameworks that resonate across platforms and audiences. Willingness to travel for key events and DLC activations, as needed. Education: Bachelor's degree in communications, or related field, or equivalent experience required. Work Environment: ADL is a hybrid environment; this role may require 3 days in the office. Occasional after-hours or weekend support for launches, live events, and rapid response. Compensation: This position has a salary range of $90,000 to $105,000. This salary range is reflective of a position based in (New York, NY). Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit ********************************** ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply. ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws. ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at ************************* . ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws. The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.
    $31k-50k yearly est. Auto-Apply 41d ago

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