University Physicians' Association, Inc. Remote jobs - 370 jobs

Become a part of our caring community and help us put health first The Director, Revenue Cycle Management for Humana Pharmacy will own the billing, collections and reporting for CenterWell Pharmacy & Specialty pharmacy and Humana Pharmacy Solutions, Humana's captive PBM. This role will lead a large workforce across multiple geographies to maximize our billing while also ensuring to meet our patient, pharmaceutical clients and PBM partner needs. Within CenterWell Pharmacy, we continue to lead the industry with new product launches, including our Direct to Consumer and Direct to Employer offerings. This leader will be nimble and change oriented to meet the evolving market needs. This position may involve some financial budgeting as well as making decisions related to implementation of new/updated programs or large-scale projects to help support the strategic goals of the pharmacies. Additionally, the candidate will have the following key responsibilities: Own the reconciliation of billing with the GL with partnership with controllership team Provide comprehensive decision-making across the enterprise as it comes to revenue accounting Develop and maintain team performance across our BPO partner and internal associates Monitor performance by comparing and analyzing actual results with plans and forecasts Improve financial status by analyzing results and variances, identifying trends, and recommending actions Use your skills to make an impact Required Qualifications Bachelor's degree in finance, accounting or related field 8 or more years of revenue cycle management 5 or more years of management experience Experience advising senior leadership on billing/collections strategies Knowledge of pharmacy revenue cycle management Prior experience developing methods and criteria for revenue cycle management Exceptional communication and presentation skills, with the ability to influence and engage diverse audiences Ability to lead and manage special projects that may necessitate cross-functional partnerships Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Prior health insurance industry experience working in revenue cycle management Pharmacy pricing knowledge or experience Additional Information Interview Format As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $126,300 - $173,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **_Responsibilities_** + Investigate and resolve patient/physician inquiries and concerns in a timely manner + Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate + Proactive follow-up with various contacts to ensure patient access to therapy + Demonstrate superior customer support talents + Prioritize multiple, concurrent assignments and work with a sense of urgency + Must communicate clearly and effectively in both a written and verbal format + Must demonstrate a superior willingness to help external and internal customers + Working alongside teammates to best support the needs of the patient population or will transfer caller to appropriate team member (when applicable) + Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry + Must self-audit intake activities to ensure accuracy and efficiency for the program + Make outbound calls to patient and/or provider to discuss any missing information as applicable + Assess patient's financial ability to afford therapy and provide hand on guidance to appropriate financial assistance + Documentation must be clear and accurate and stored in the appropriate sections of the database + Must track any payer/plan issues and report any changes, updates, or trends to management + Handle escalations and ensure proper communication of the resolution within required timeframe agreed upon by the client + Ability to effectively mediate situations in which parties are in disagreement to facilitate a positive outcome + Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties + Support team with call overflow and intake when needed + Proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner. **_Qualifications_** + 3-6 years of experience, preferred + High School Diploma, GED or technical certification in related field or equivalent experience preferred **_What is expected of you and others at this level_** + Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments + In-depth knowledge in technical or specialty area + Applies advanced skills to resolve complex problems independently + May modify process to resolve situations + Works independently within established procedures; may receive general guidance on new assignments + May provide general guidance or technical assistance to less experienced team members **TRAINING AND WORK SCHEDULES:** Your new hire training will take place 8:00am-5:00pm CT, mandatory attendance is required. This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CT. **REMOTE DETAILS:** You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following: Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. **Dial-up, satellite, WIFI, Cellular connections are NOT acceptable** . Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issued equipment **Anticipated hourly range:** $21.50 per hour - $30.70 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 2/8/2026 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************

Provide initial employee support for technical inquiries received via phone, email, and messaging applications. Assess the nature of problems and resolve basic support issues. Troubleshoot software and hardware issues on laptops, desktops, tablets, and/or smartphones. Log or record support tickets and/or cases. For more complex issues, transfer internal customers to second-level Help Desk Technicians. Incumbent is subject to overtime, callback, and on-call as required. Remote work available once the onsite training program has been completed. Perform other duties as assigned. Job Responsibilities * Provides technical assistance to computer system users. * Solves problems dealing with a limited variety of concrete variables by interpreting written and verbal information and screen shots or other data supplied. * Maintains current knowledge of hospital information systems, software, networks and telecommunications technologies. * Uses advanced tools, knowledge and experience to analyze, diagnose and resolve problems. * Contributes to evaluation and maintenance of existing support documentation. * Completes assigned goals. Specifications Strong Communication Skills Strong Customer Service Skills Experience with Microsoft Office products to in MS Teams Experience Trouble Shooting Pc, printers, Thin Clients Experience with Active Directory Experience logging Incident into a ITIL based tracking system Experience Description Minimum Required Preferred/Desired Minimum of one to three year of related experience or educational equivalent of Associates Degree. Greater than 2 years experience or educational equivalent of Bachelor's degree. Licensure DRIVER'S LICENSE (CURRENT)

Description & Requirements Maximus is looking for a dynamic Senior Knowledge Analyst to serve as the dedicated Contact Center Content Specialist (CCCS). In this pivotal role, you'll collaborate closely with government and internal teams to identify content gaps, drive improvements, and ensure that agents are equipped with clear, effective, and bilingual resources. *Position is contingent upon contract award* This is a fully remote role. Must have the ability to pass a federal background check. Remote Position Requirements: - Hardwired internet (ethernet) connection - Internet download speed of 25mbps and 5mbps (10 preferred) upload or higher required (you can test this by going to ****************** - Private work area and adequate power source Essential Duties and Responsibilities: - Build and maintain knowledge base in SharePoint. - Build document management processes and procedures. - Assess knowledge base needs, inaccuracies, gaps; work quickly to resolve and make content current. - Work cross-functionally with internal teams for maximum efficiency and accuracy in documentation content. - Create hierarchy and ownership structure to sustain knowledge management. - Empower contributions from key stakeholders to improve the knowledge base. - Design and implement work flows to manage documentation process. - Establish standard templates for all documentation for the teams to utilize in document creation. - Collaborate with and support the Implementation Team to tune and evolve our Knowledge Base. - Create, promote and apply best practices for writing, style and content in Microsoft style. - Create training material in support of the Knowledge management process. - Improve search results by honing and maintaining the knowledge base taxonomy, labels list and ensuring symptoms and subject terms are present in each article. - Utilize SharePoint knowledge for site management, list creation, workflow creation/modification and document management within SharePoint. • Coordinate with client content teams, and the Senior Training Manager to identify and address content gaps specific to contact center operations. • Serve as a bilingual subject matter expert (English and Spanish) for contact center content development. • Support the creation and refinement of training materials for contact center agents. • Draft monthly action and improvement reports with recommendations on knowledge content, quality, customer satisfaction, and training materials. • Represent the contact center perspective in content-related discussions and decisions. • Work extensively with business partners and SMEs to perform knowledge needs analysis, develop and update training and knowledge resources that meet staff and stakeholder needs and organizational quality standards. • Manage and develop knowledge articles, chat quick text scripts and email templates. • Conduct audits of knowledge articles and procedures to ensure accuracy and relevance. • Identify emerging contact center trends and coordinate content updates to address urgent needs. • Collaborate with client content teams to create, update, and review contact center-specific content. • Serve as a subject matter expert for assigned customer agencies. • Salesforce and SharePoint experience preferred. • Call center knowledge and experience preferred. Minimum Requirements - Bachelor's degree with 5+ years of experience. - Advanced degree or professional designation preferred. - Develops solutions to a variety of complex problems. - Work requires considerable judgment and initiative. - Exerts some influence on the overall objectives and long-range goals of the organization. • Developing website content experience • Self-motivated and able to work independently EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************. Minimum Salary $ 65,000.00 Maximum Salary $ 85,200.00

Education (one of the following required): MSW, PsyD, or PhD in a behavioral health field, OR M.A./M.S. in a behavioral health field with a clinical practice emphasis from a COAMFTE, CACREP, or CORE-accredited program Licensure (must reside in TN and hold one of the following): LMSW LPC LPC/MHSP LCSW LAPSW Experience: Minimum of 1 year direct experience in behavioral health, counseling, or social services Location: Remote, Tennessee residency required Benefits Comprehensive medical, dental, and life insurance 401(k) program with company match Company-matched student loan repayment program Short- and long-term disability (STD/LTD) Employee Assistance Program (EAP) Accrued PTO (earn up to 4 weeks in your first year) Opportunities for professional growth and advancement Compensation & Incentives In addition to base hourly pay, our crisis counselors are eligible for the following incentives: + $1.00/hour - Employees who voluntarily commit to both Saturday and Sunday on their recurring schedule receive a $1.00 increase to their base pay post-training. + $1.00/hour - for working a full 40-hour schedule in the workweek post-training Shift Differentials: Hourly shift differentials ranging between two and six dollars may be applied on an hourly basis, depending on your shift and tenure with the organization. These details will be provided at the time of offer to help you prepare for schedule confirmation with the Scheduling Team. Who We Are Protocall Services is a nationally recognized leader in behavioral healthcare and crisis intervention, supporting organizations across the U.S. and Canada. For five consecutive years, we have been awarded "Top Workplace" honors for our strong culture, mission-driven work, and commitment to employee well-being. We serve a wide range of nearly 700 different organizations nationwide, including Community Mental Health Centers, Certified Community Behavioral Health Clinics, Managed Behavioral Healthcare Organizations, University counseling centers, and Employee Assistance Programs following our brief immediate support model. As a remote-first organization headquartered in Portland, Oregon, our staff operate with excellence, compassion, and integrity while providing 24/7 telephonic support to individuals with various degrees of need. About the Role As a Crisis Counselor, you will be a telephonic first responder, delivering compassionate emotional support, risk assessment, crisis intervention, and stabilization services. You will engage with callers experiencing a broad range of emotional, behavioral, and situational challenges. This role requires emotional resilience, exceptional communication skills, and a strong ability to multitask while maintaining clarity and professionalism. While many calls involve acute needs, not all calls are crisis calls; some are administrative or supportive in nature. Regardless of the call type, you will ensure each caller receives professional, solution-focused care and a high-quality service experience. Primary Responsibilities * Provide empathetic, ethical, and professional telephonic support to individuals experiencing distress or seeking guidance. * Build rapport, actively listen, and foster client engagement. * Assess emotional and behavioral health concerns, including levels of risk and urgent safety issues. * Provide resources, coping strategies, referrals, and safety planning. * Intervene appropriately in emergent situations. * Maintain accurate, timely, and clinically sound documentation. * Multitask effectively while navigating multiple software systems. * Ensure a secure, HIPAA-compliant home workspace with a locking door and a wired, stable internet connection. What You Can Expect * Six-Week Paid Virtual Training Cohort: Monday-Friday, 8:00 AM to 4:30 PM PST A structured onboarding program including skills development, role-playing, mentored live call work, and crisis-care foundations. Successful completion is required for continued employment. * Remote Scheduling: Upon graduation from training, you will transition to your regular schedule, developed in collaboration with our Scheduling Department. Regular availability on weekends and holidays is required. Protocall Services Inc. is an Equal Opportunity Employer. We believe deeply in diversity of race, gender, sexual orientation, religion, ethnicity, national origin, and all of the other fascinating characteristics that make us different

Tennessee Cancer Specialists, formed in 2004 through a merger between two well-regarded, Knoxville-based oncology groups-Cancer Care of East Tennessee and East Tennessee Oncology Hematology. We have become the premier group in East Tennessee and proudly rank as the third largest group in the state. Our practice has grown to 14 physicians, and we offer services at 12 locations in the area. Although growing and serving nearly every hospital in the region, our specialists continue to maintain focus on quality care for our patients and their families. We are seeking a qualified and dedicated medical biller to join our administrative office. In this position, you will be responsible for a variety of tasks requiring data analysis, in-depth evaluation, and sound judgment. As our medical biller, your daily duties will include maintaining billing software, appealing denied claims, and recording late payments. To succeed in this role, you must possess in-depth knowledge of billing software and medical insurance policies. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as communicating with clients and various insurance agents will form a large part of the job. Pay: $14.00 - $20.00 per hour. Medical Biller Responsibilities: Prepare and submit billing data and medical claims to insurance companies. Ensure the patient's medical information is accurate and up to date. Prepare bills and invoices, and document amounts due to medical procedures and services. Collect and review referrals and pre-authorizations. Monitor and record late payments. Follow-up on missed payments and resolve financial discrepancies. Examine patient bills for accuracy and request any missing information. Investigate and appeal denied claims. Help patients develop patient payment plans. Maintain billing software by updating rate change, cash spreadsheets, and current collection reports. Medical Biller Requirements: Bachelor's degree in business, health care administration, accounting or relevant field. A minimum of 2 years' experience as a medical biller or similar role. Solid understanding of billing software and electronic medical records. Must have the ability to multitask and manage time effectively. Excellent written and verbal communication skills. Outstanding problem-solving and organizational abilities. Remote opportunity: This position can be done entirely remotely as long as the team member has direct access to a strong, reliable internet connection & a dependable cell phone connection. A quiet/uninterrupted workspace will be needed as well to ensure a seamless workflow. Tennessee Cancer Specialists provides an excellent compensation and benefits package, which includes a competitive salary, retirement savings plan, tuition reimbursement, comprehensive medical, dental, vision care, life insurance coverage, paid vacation and holidays. Tennessee Cancer Specialists is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, reproductive health decisions, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, genetic information, political views or activity, or other applicable legally protected characteristics.

An Orthodontic Manufacturer and Distributor is looking for a talented and competitive Inside Sales Representative that thrives in a quick sales cycle environment and is exceptional in closing sales. The successful candidate will play a critical role in achieving our revenue growth objectives by driving and managing existing customer accounts. This position can be remote. Summary: This position is responsible for selling to existing customers on an outbound call basis. Primary focus is on growing highly profitable customer segments, developing high growth and high potential accounts via outbound calls. Sales achievement, accuracy, customer service and teamwork are the primary measurements for this role. Responsibilities include but not limited to: Manages assigned accounts and plans sales calls, utilizing reporting resources and company databases. Meets call volume requirements as determined by company Builds and utilizes customer relationships to proactively sell and generate revenue via calls, emails and mailers. Recommends products not currently being purchased on accounts Develops in-depth product knowledge by studying/researching product descriptions Provides technical support on product features and applications Reports customer complaints in accordance to complaint handling process Attends meetings as assigned to represent the company. Assists with order taking and fulfillment, as needed Completes other tasks as assigned. Requirements: A Bachelor's degree required, a BS in Business or Marketing is preferred Must be independent and disciplined enough to work remotely Proven inside sales experience Track record of over-achieving quota Strong phone presence and experience dialing dozens of calls per day Superior presentation and interpersonal skills Must be passionate about customer satisfaction Ability to “warm call” prospective customers from mailing list Excellent verbal and written communication skills Strong working knowledge of computers, specifically Microsoft office Ability and willingness to learn product lines and offerings to become the technical support Benefits: Some of the benefits provided to Regular Full Time employees are: Medical, Dental, Vision, and Life insurance. 401k with an employer contribution. Paid vacation and holidays. And much more. To Apply: If you're interested in joining our Sales Team please apply online!

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. For more information, visit AmHealthPlans.com. If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application! Benefits and Perks include: * Affordable Medical/Dental/Vision insurance options * Generous paid time-off program and paid holidays for full time staff * TeleMedicine 24/7/365 access to doctors * Optional short- and long-term disability plans * Employee Assistance Plan (EAP) * 401K retirement accounts * Employee Referral Bonus Program ESSENTIAL JOB DUTIES: To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation. * Conduct pre-pay and post-pay audits to ensure accurate claims payments and denials * Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of claims processing standards * Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment * Work assigned claim projects to completion * Provide a high level of customer service to internal and external customers; achieve quality and productivity goals * Escalate appropriate claims/audit issues to management as required; follow departmental/organizational policies and procedures * Maintain production and quality standards as established by management * Participate in and support ad-hoc audits as needed * Other duties as assigned JOB REQUIREMENTS: * Proficient in processing/auditing claims for Medicare and Medicaid plans * Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other complex claim processing rules and regulations * Current experience with both Institutional and Professional claim payments * Knowledge of automated claims processing systems * Hybrid role that may require 2-3 days per week onsite at the Franklin, TN office. REQUIRED QUALIFICATIONS: * Experience: * Two (2) years' experience with complex claims processing and/or auditing experience in the health insurance industry or medical health care delivery system * Two (2) years' experience in managed healthcare environment related to claims processing/audit * Two (2) years' experience with standard coding and reference materials used in a claim setting, such as CPT4, ICD10 and HCPCS * Two (2) years' experience with CMS requirements regarding claims processing; especially Skilled Nursing Facility and other complex claim processing rules and regulations * Two (2) years' experience processing/auditing claims for Medicare and Medicaid plans * License/Certification(s): * Coding certification preferred EQUAL OPPORTUNITY EMPLOYER Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. This employer participates in E-Verify.

Director of Enterprise FP&A Hybrid for candidates in Nashville and surrounding areas. Remote option available for candidates outside of surrounding areas. The Director of Enterprise FP&A will fill a key role within the Corporate Finance organization. This position will help oversee the enterprise-wide forecasting, budgeting, and long-range planning processes. This position is responsible for developing and maintaining a cohesive financial planning framework that aligns strategic objectives with operational execution across all business units. The ideal candidate will demonstrate deep expertise in financial modeling, forecasting accuracy, and budget management, as well as the ability to partner with senior executives to drive enterprise performance. QUALIFICATIONS: Bachelor's degree in Finance, Accounting, Healthcare Administration, or related field 6+ years of related finance experience, with at least 3 years in FP&A, enterprise budgeting/ forecasting roles Strong accounting, M&A and/or finance background preferred Advanced proficiency in Excel, financial modeling, and planning/consolidation systems. Onestream experience is a plus Proven experience leading a finance team or functional area with responsibility for forecasting and budgeting Demonstrated ability to design, implement, and enhance forecasting, budgeting, and financial reporting processes Hands-on leadership style with proven ability to drive results Demonstrated ability to consult and advise business leaders on a range of issues related to financial performance, business planning, and business case analysis Excellent communication and presentation skills, including the ability to present financial results and projections to executive leadership and board members Exceptional organizational skills and attention to detail, with the ability to manage multiple deliverables in a fast-paced environment Solid values and high standards of ethics, integrity, and trust Interest in rapid ability to prepare decision-support analysis on a range of issues related to financial performance, business planning, strategic opportunities, and business case analysis Exceptional communication and organization skills Experience in healthcare, hospital, ASC, or joint venture environments strongly preferred Executive presence and ability to influence across all levels of the organization Key competencies required for the position: Deep Financial Planning & Analysis Capabilities: Leading Candidates must possess significant FP&A experience, including the ability to develop and maintain a comprehensive financial projection model. Budgeting Excellence: Proven ability to lead annual budget processes, including coordination across business units, consolidation, variance analysis, and presentation of final plans to senior leadership. Results Oriented: Results oriented, including the capacity to both think strategically and execute tactically, embodying a blend of technical, creative, business and communications skills. Effective Communication and Decision Making: Ability to distill complex financial data into clear, actionable insights and recommendations for senior executives and stakeholders. Cross-Functional Collaboration: Skilled at building relationships with operational, development, and corporate teams to ensure financial plans align with business realities. Results Orientation: A focus on accuracy, timeliness, and continuous improvement in financial processes and reporting. Duties & Responsibilities Lead the enterprise-wide forecasting and budgeting processes, ensuring alignment between corporate strategy and financial objectives. Develop and maintain dynamic financial models that support scenario planning, long-range forecasts, and sensitivity analysis. Collaborate with business intelligence to create real time actionable analysis Coordinate with business leaders and finance partners to gather inputs, validate assumptions, and ensure consistency across all business units. Oversee development of monthly forecast updates, variance analysis, and performance reporting to drive accountability and informed decision-making. Performs other duties as assigned Benefits: Comprehensive health, dental, and vision insurance Health Savings Account with an employer contribution Life Insurance PTO 401(k) retirement plan with a company match And more! ENVIRONMENTAL/WORKING CONDITIONS: Normal busy office environment with much telephone work. Possible long hours as needed. The description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve. *If you are viewing this role on a job board such as Indeed.com or LinkedIn, please know that pay bands are auto assigned and may not reflect the true pay band within the organization. *No Recruiters Please

**_What Information Security and Risk contributes to Cardinal Health_** Information Security and Risk develops, implements, and enforces security controls to protect the organization's technology assets from intentional or inadvertent modification, disclosure or destruction. This job family develops system back-up and disaster recovery plans. Information Technology also conducts incident response, threat management, vulnerability scanning, virus management and intrusion detection and completes risk assessments. The _Director, Information Security and Risk (Identity & Access Management)_ is responsible for leading the organization's Identity & Access Management (IAM) strategy, governance, and operations to ensure secure, efficient, and compliant access to technology resources. This role requires a leader with proven ability to execute large-scale enterprise IAM programs that directly impact how employees, contractors, and customers interact with Cardinal Health technology. Success in this role demands a balance between delivering a frictionless, user-friendly experience and maintaining the highest standards of security. The Director must also excel at building partnerships across the organization and collaborating on program delivery, while driving operational excellence and anticipating business risks associated with IAM changes. **Location** - Ideally targeting individuals local to Central Ohio, but open to candidates located nationwide (fully remote). If living within commutable distance of our corporate HQ in Dublin, OH - the expectation would be to come in-office two or three days a month for team meetings. **Responsibilities** + Act as a visionary in designing and executing multi-year IAM strategy that aligns with business goals and customer needs + Develop and oversee enterprise IAM policies, standards, and procedures, ensuring consistent enforcement across the organization. + Lead IAM initiatives including identity lifecycle management (provisioning, de-provisioning, role-based access, entitlement reviews). + Direct privileged access management (PAM) programs to safeguard critical systems and sensitive data. + Ensure compliance with internal policies and external regulatory requirements (e.g., SOX, HIPAA, GDPR, PCI-DSS) through strong access controls. + Execute enterprise IAM programs with significant business impact, ensuring seamless access for employees, contractors, and customers. + Balance user experience with security by designing IAM solutions that are simple, intuitive, and resilient. + Drive operational excellence by establishing repeatable processes, KPIs, and service delivery models for IAM functions. + Build strong partnerships across IT, Security, HR, and business units to align IAM delivery with organizational priorities. + Establish metrics and reporting mechanisms to monitor IAM effectiveness, operational performance, and program maturity for executive leadership. + Lead training and awareness programs related to IAM policies, secure access practices, and identity governance. **Qualifications** + Bachelor's degree in Information Technology, Computer Science, Cybersecurity, or a related field preferred. + Ideally targeting individuals with 12+ years of IT/security experience with at least 5 years in IAM leadership roles preferred. + Proven track record of executing enterprise IAM programs with measurable business impact. + Prior people leadership experience and demonstrated ability to manage operational IAM teams, highly preferred. + Expertise with IAM tools and platforms (e.g., Okta, SailPoint, CyberArk, Azure AD). + Strong understanding of relevant Regulatory and Compliance requirements (HIPAA, SOX, HITRUST CSF, etc.). + Strong understanding of authentication protocols (SAML, OAuth, OpenID Connect, Kerberos) and cloud IAM (AWS IAM, Azure RBAC, GCP IAM). + Certifications such as CISSP, CIAM, or CISM preferred. + Strong analytical, relationship management, and communication skills (both written and verbal). + Ability to collaborate across functions and influence stakeholders to achieve IAM program success. **What is expected of you and others at this level** + Provides leadership to managers and experienced professional staff; may also manage front line supervisors + Manages an organizational budget + Develops and implements policies and procedures to achieve organizational goals + Assists in the development of functional strategy + Decisions have an extended impact on work processes, outcomes, and customers + Interacts with internal and/or external leaders, including senior management + Persuades others into agreement in sensitive situations while maintaining positive relationships _\#LI-LP_ _\#LI-Remote_ **Anticipated salary range:** $135,400 - $228,910 **Bonus eligible:** Yes **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 12/25/2025 *if interested in opportunity, please submit application as soon as possible. The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Iowa, Idaho, Louisiana, and Indiana with planned expansion into other states in 2025. For more information, visit AmHealthPlans.com. If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application! Benefits and Perks include: * Affordable Medical/Dental/Vision insurance options * Generous paid time-off program and paid holidays for full time staff * TeleDoc 24/7/365 access to doctors * Optional short- and long-term disability plans * Employee Assistance Plan (EAP) * 401K retirement accounts with company match * Employee Referral Bonus Program JOB SUMMARY: The Utilization Review Nurse is to assess the medical necessity and quality of healthcare services by conducting pre-service, concurrent, and retrospective utilization management reviews. The primary role of the Utilization Management (UM) Nurse is to provide clinical support to the Clinical Services Department and Medical Director to assure that members receive all appropriate medical services in compliance with medical and regulatory guidelines. ESSENTIAL JOB DUTIES: To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation. * Assess the medical necessity, quality of care, level of care and appropriateness of health care services for plan members * Identify placement settings that offer the lowest level of restriction and greatest level of autonomy for the members based upon medical necessity * Conduct outreach to requesting providers which can include specialty physicians, ancillary providers and institutions to gather the appropriate/necessary clinical data * Apply clinical review criteria, guidelines, and screens in determining the medical necessity of health care services against the clinical data provided * Certify cases that meet clinical review criteria, guidelines and/or screens * Consult with physician when reviews do not meet clinical review criteria, guidelines, and screens * Refer cases to other professionals internally, including case management and medical consultation when indicated * Adhere to accreditation, contractual and regulatory timeframes in performing all utilization management review processes * Ensure that the Director of Medical Management or designee is made aware of any potential risk management issues in a timely manner * Other duties as assigned JOB REQUIREMENTS: * Maintain privacy and confidentiality of records, conditions, and other information relating to residents, employees and facility * Encourage an atmosphere of optimism, warmth and interest in patients' personal and health care needs * Develop and maintain collaborative relationships with providers and educate on levels of care * Ensure the integrity and high quality of utilization management services * Self-motivated * Ability to work independently and as part of a team * Able to work congenially with a wide variety of individuals * Maintain the highest level of confidentiality and professionalism at all times * Strong oral and written communications skills, including active listening * Proficient in navigating through multiple computer applications * Positive, engaging customer service skills * Critical thinking and decision-making skills * Successful completion of required training * Handle multiple priorities effectively * Independent discretion/decision making * Make decisions under pressure REQUIRED QUALIFICATIONS: * Experience: o At least 1 year experience in utilization management with a health plan or hospital-based UM department with use of Interqual or MCG o Prefer clinical experience o Broad knowledge of Medicare regulations and guidance o Trained in clinical certification, utilization management, URAC and NCQA principles, policies, and procedures o Excellent customer service experience o Strong knowledge of medical terminology and CPT, ICD-10, and HCPCS codes o Proven ability to problem-solve and make solid decisions * License/Certification: o Current Certified Case Manager (CCM) credential is a plus o Current, active and unrestricted Registered Nurse (RN) license EQUAL OPPORTUNITY EMPLOYER This Organization is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. This Organization will make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Organization including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **_Responsibilities_** + Investigate and resolve patient/physician inquiries and concerns in a timely manner + Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate + Proactive follow-up with various contacts to ensure patient access to therapy + Demonstrate superior customer support talents + Prioritize multiple, concurrent assignments and work with a sense of urgency + Must communicate clearly and effectively in both a written and verbal format + Must demonstrate a superior willingness to help external and internal customers + Working alongside teammates to best support the needs of the patient population or will transfer caller to appropriate team member (when applicable) + Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry + Must self-audit intake activities to ensure accuracy and efficiency for the program + Make outbound calls to patient and/or provider to discuss any missing information as applicable + Assess patient's financial ability to afford therapy and provide hand on guidance to appropriate financial assistance + Documentation must be clear and accurate and stored in the appropriate sections of the database + Must track any payer/plan issues and report any changes, updates, or trends to management + Handle escalations and ensure proper communication of the resolution within required timeframe agreed upon by the client + Ability to effectively mediate situations in which parties are in disagreement to facilitate a positive outcome + Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties + Support team with call overflow and intake when needed + Proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner. **_Qualifications_** + 3-6 years of experience, preferred + High School Diploma, GED or technical certification in related field or equivalent experience preferred **_What is expected of you and others at this level_** + Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments + In-depth knowledge in technical or specialty area + Applies advanced skills to resolve complex problems independently + May modify process to resolve situations + Works independently within established procedures; may receive general guidance on new assignments + May provide general guidance or technical assistance to less experienced team members **TRAINING AND WORK SCHEDULES:** Your new hire training will take place 8:00am-5:00pm CT, mandatory attendance is required. This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CT. **REMOTE DETAILS:** You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following: Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. **Dial-up, satellite, WIFI, Cellular connections are NOT acceptable** . Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issued equipment **Anticipated hourly range:** $21.50 per hour - $30.70 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 2/11/2026 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************

Description & Requirements Maximus is seeking a dynamic and experienced Vice President-Federal Communications and Marketing to join our innovative team. The ideal candidate will bridge the gap between technology, business process services and marketing in the Federal Government sector. In this role, you will be responsible for Team Leadership and Change Management in a large organization. The VP-Federal Communications and Marketing will collaborate with cross-functional teams to drive Federal solutions and offerings. If you are a strategic thinker with a passion for technology services and marketing, and if you thrive in a dynamic and collaborative environment, we invite you to apply to the position at Maximus. This is a hybrid position with the need to go into the office a minimum of 3 days per week and occasionally attend meetings and/or events in the Tyson Corners, VA/ Washington, DC area. This position requires some travel. The selected candidate must live in this geographical area. Key Areas of Responsibility - Identify, plan, develop, and oversee differentiated and impactful marketing strategies/materials. - Developing new programs for customer engagement including integrated marketing programs from concept to execution - Drive Maximus Federal solutions and offerings. - Manage digital and social media strategies across the federal market - Build, manage, and coach a high-performing marketing team. - Direct and support market research collection, analysis, interpretation of market data for short- and long- term market forecasts and reports. - Work closely with the growth leaders to align sales and marketing strategies - Maintain brand standards and ensure compliance across all marketing and communications channels. - Build long-term relationships with employees, clients, government officials, and stakeholders. - Serve as a collaborative and senior leader on the Maximus Communication & Marketing Team, helping to align strategy and outcomes across the company. - Drive the implementation of marketing campaigns that meet business objectives and drive customer engagement. - Develop relationships with associations, academia and industry partners to drive thought leadership and brand elevation. This role will develop and oversee the Maximus Federal segment marketing strategy. Responsibilities include building brand visibility in the Federal marketplace, driving customer and partner engagement to support growth goals. This position will be responsible for developing annual marketing plans building strategy, managing the cross functional team and budget and, leveraging partner relationships, driving go-to-market solutions. Qualifications: -15+ years of experience in a Federal Marketing and Industry Analysis position including 7+ years managing a team. -Previous experience at a corporation focused on the Federal sector. -Bachelor's degree in Marketing, Business, or a related field; technical background and digital marketing are a plus. Additional experience in lieu of degree will be considered. -MA degree in Marketing, Communication, or similar relevant field, preferred. -Outstanding communication, presentation, and leadership skills. -In-depth knowledge of the Federal sector. -Critical thinker with problem-solving skills. -Strong interpersonal and communication skills. Key Competencies include the following: Marketing and Communication Strategies, Team Leadership, Technical Expertise, Cross-Functional Collaboration, Content Development, Sales Enablement, Product and Solutions Positioning and Change Management EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************. Minimum Salary $ 216,155.00 Maximum Salary $ 292,455.00

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. **Together, we can get life-changing therapies to patients who need them-faster** Are you ready to lead change at the forefront of healthcare innovation in patient access and support? Sonexus is undergoing a major transformation-scaling rapidly, reimagining how we deliver patient services, integrating emerging technologies & AI, and collaborating across the specialty pharma ecosystem. We're looking for a Senior Change & Transformation Consultant who's not just experienced but energized by the opportunity to shape the future of patient care and a rapidly growing business division of Cardinal Health. This is a high-impact role reporting to the Director of Business Transformation and Change Management. This consultant will be responsible for driving adoption, inspiring stakeholders, and embedding lasting change across complex, regulated environments. Too often, patients forego or can't complete prescribed therapy because of complicated qualification processes, unmanageable costs, or uncertainty about their medications. Cardinal Health Sonexus Access and Patient Support combines best-in-class program and pharmacy operations with smart digital tools to streamline patient onboarding and increase adherence to prescribed care. If you thrive in fast-paced settings and want to make a real difference in the lives of patients, this is your moment. **Responsibilities** · Design and execute enterprise-level change strategies that support transformation across patient services, pharmacy operations, and digital/AI innovation. · Conduct impact assessments, stakeholder analyses, and readiness evaluations to guide successful implementation. · Build strong partnerships across Patient Access, Case Management, Specialty Hubs, Pharmacy Operations, IT, and executive leadership. · Develop and facilitate dynamic workshops to elevate organizational change capability and leadership transformation IQ to scale a rapidly growing business. · Design communication strategies, plans, and craft visually appealing and compelling communications (infographics, Veeva Engage posts, slides, manager huddle scripts) tailored to diverse audiences-from frontline teams to senior leaders. · Champion AI initiatives includes building use cases, managing barriers to change and adoption, and managing the complex people-side of change for adopting AI (must have prior experience). · Monitor adoption metrics, create surveys, feedback loops, and performance indicators to ensure long-term success. · Identify risks and lead proactive mitigation strategies to keep business and AI transformation momentum strong. Leverage data and insights to refine approaches. · Contribute to the evolution of our new Transformation and Change office. **Qualifications** · Bachelor's degree in Business, Organizational Development, Healthcare Administration, or related field, preferred · Strong consulting, communication, analysis, data gathering and organizational skills. · Microsoft Office 365 (Teams, Copilot) Proficiency preferred · Ability to work in a fast-paced, collaborative environment and deliver quality results within aggressive timeframes. · Willingness to travel up to 25%. · Must be willing to work Central Time Zone business hours. Prefer candidates located in Columbus, OH or Dallas, TX area. · 6+ years of experience in change management with AI, digital business transformation experience, preferred · Prosci certification required; CCMP certification preferred with advanced certifications in digital/AI transformation, coaching, training facilitation, lean six sigma, organizational development (ODCP), etc. · Deep understanding and application of Change Management methodology end-to-end from strategy and planning to change impact analysis, communications plans and messaging, stakeholder analysis and engagement, readiness assessments, training and facilitation, change reporting and metrics, and reinforcement and sustainability. · Must be comfortable and proficient delivering change and transformation workshops and courses. · Proven success managing change for AI-driven solutions, preferred within patient services or pharmacy operations. · Solid understanding of the specialty pharma ecosystem, with highly preferred experience in Payors, PBMs, Specialty Hubs, Patient Services, Patient Assistance Programs, Medicaid, and Pharmacy Operations. · Exceptional communication, executive presence, facilitation, and stakeholder management skills. · Experience with CRM platforms like Salesforce, patient support technologies, or specialty pharmacy systems is a plus. · Can identify the differences between change and transformation, and provide work/project examples, including knowledge of transformation methodologies, models, AI strategy/transformation models, frameworks, building roadmaps. Framework examples include SAP BTM2, USAII, and CXO Transform. · Knowledge of product, agile methodologies a plus. **Why Join Us?** · Be a catalyst for change in a mission-driven organization transforming patient care. · Work alongside passionate professionals in a collaborative, forward-thinking environment. · Lead initiatives that integrate cutting-edge technologies like AI to improve outcomes and efficiency. · Make a lasting impact on how specialty pharma supports patients across the care continuum. **TRAINING AND WORK SCHEDULES:** + Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required. + This position is full-time (40 hours/week). + Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. **REMOTE DETAILS:** + You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to highspeed internet. + We will provide you with the computer, technology and equipment needed to successfully perform your job. + You will be responsible for providing high-speed internet. + Internet requirements include the following: + Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. + Download speed of 15Mbps (megabyte per second) + Upload speed of 5Mbps (megabyte per second) + Ping Rate Maximum of 30ms (milliseconds) + Hardwired to the router + Surge protector with Network Line Protection for CAH issue **Anticipated salary range:** $105,100-$150,100 **Bonus eligible:** Yes **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with my FlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 1/13/2026 *if interested in opportunity, please submit application as soon as possible. The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (***************************************************************************************************************************

TITLE: Specialty Pharmacy Technician REPORTS TO: Specialty Pharmacist FLSA: Non-Exempt DEPARTMENT: Pharmacy LOCATION: East Jackson (ON SITE) JOB SUMMARY: The Specialty Pharmacy Technician supports the operations of a specialty pharmacy by assisting the pharmacist with the preparation, processing, and dispensing of specialty medications (e.g. hepatitis C, HIV). This role focuses on ensuring timely and accurate prescription fulfillment while maintaining compliance with regulatory requirements. The Specialty Pharmacy Technician plays a key role in coordinating patient care via patient-facing interactions and via the specialty pharmacy call center. Additional responsibilities include benefits investigation, obtaining prior authorizations, initiating patient assistance, managing inventory, coordinating medication delivery, and facilitating communication between providers, patients, and insurance companies. MAJOR DUTIES AND RESPONSIBILITIES: Specialty Pharmacy Workflow: · Process and fill specialty medication prescriptions under the supervision of a specialty pharmacist · Conduct benefits investigations and obtain prior authorizations, working closely with insurance companies and providers · Manage specialty medication inventory ensuring proper storage, handling, and tracking · Document and maintain thorough records of patient interactions for regulatory compliance · Assist with quality assurance programs and ensure adherence to all federal, state, and local regulations · Stay up to date on new specialty pharmacy regulations and company policies Specialty Pharmacy Call Center Workflow: · Serve as the primary point of contact by answering inbound calls from patients, providers, and pharmacy staff members regarding prescriptions and pharmacy services · Process specialty prescription refill requests and verify patient information · Coordinate patient follow-ups to monitor adherence and address concerns · Provide patients with updates on prescription status and delivery timelines · Escalate clinical issues, beyond the scope of a pharmacy technician, to the specialty pharmacist when necessary · Work closely with internal pharmacy staff to resolve medication-related concerns · Assist with outbound calls for prescription reminders and follow-ups as needed In-House Pharmacy Workflow: · Assist in-house pharmacy staff with general, retail-style pharmacy workflow and tasks in the event pharmacy technician coverage is needed · Accurately enter prescription drug data into pharmacy operating system · Processing patient transactions, including ringing up purchases and handling payments Communication: · Treats patients, co-workers, and clinic staff in a respectful and confidential manner. · Able to respond to the requests of patients, co-workers, clinic staff requests in a courteous and timely manner · Understands and adheres to patient confidentiality practices and procedures, and will hold themselves accountable to ensuring patient privacy Regulatory / Record Compliance: · Engages in quality assurance activities to support specialty pharmacy operations and patient care · Accurately document required information in an efficient and timely manner to support seamless patient care and with adherence specialty pharmacy regulation and compliance Other Duties as Assigned: · Performs other clinical and pharmacy duties as assigned to accommodate reasonable needs of the patients and the department provided duties to meet practice norms and legal regulations/standards EDUCATION AND EXPERIENCE: Requirements: High School Diploma or GED Tennessee state Pharmacy Technician licensure in good standing Pharmacy Technician Certification (PTCB or equivalent) in good standing Strong knowledge of pharmacy calculations and sig codes, and commonly prescribed medications Minimum of 1 year of experience in a specialty pharmacy setting Minimum of 2 years of experience in any of the follow settings: retail pharmacy, hospital pharmacy, or pharmacy call center Basic knowledge and navigational skills of Microsoft Office programs (Microsoft Teams, Word, Excel, Outlook, etc.) Strong problem-solving and investigative skills Strong customer service and verbal and written communication skills Desired Experience: Proficiency in navigating TherigySTM specialty pharmacy management software highly preferred Proficiency in eClinicalWorks highly preferred Proficiency in PioneerRx pharmacy software highly preferred Proficiency in navigating prior authorization hub CoverMyMeds and experience in prior authorization processing Previous call center experience preferably in a healthcare and/or pharmacy setting Preferred Bachelors and/or post graduate degree 5+ years' work experience in a specialty pharmacy setting 5+ years' work experience in a retail pharmacy, hospital pharmacy, or pharmacy call center setting Benefits: Competitive salary Health, dental, and vision insurance 401(k) plan with company match Paid time off and holidays Opportunities for professional development WORKING CONDITIONS/PHYSICAL DEMANDS: Work is performed in a structured pharmacy setting. Physical demands include being required to walk throughout the clinic, pharmacy, lifting items up to 20 pounds, experiencing long periods of sitting and standing, and frequent use of computer, keyboard, headset, and phone. INCLEMENT WEATHER POLICY In the event of inclement weather, the Specialty Pharmacy Technician may be expected to provide call center and pharmacy support virtually. Appropriate equipment will be provided in order for tasks such as receiving inbound calls, prescription inputting, etc. to be performed remotely. The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

SpecialtyCare continues to grow and we'd like you to grow with us! We are seeking a Senior Business Applications Analyst to join our Information Services team. This position does offer the opportunity to work fully remote! SpecialtyCare is the industry leader in intraoperative neuromonitoring (IONM) services in the US-monitoring over 100,000 cases annually, providing IONM services to over 450 hospitals nationwide, and supporting over 2,300 surgeons. With SpecialtyCare, you will be able to share your acquired expertise with your colleagues and customers, all while providing safer surgery and better outcomes for your patients. Our surgical neurophysiologists are the most experienced in the industry. ESSENTIAL JOB FUNCTIONS * Provide second and third-tier level support (after Help Desk) by analyzing, diagnosing and resolving issues for the following applications: * PeopleSoft General Financial - General Ledger, Asset Management, Account Payables, Travel & Expenses * PeopleSoft Order to Cash - Order Management, Billing, Account Receivables * PeopleSoft Supply Chain Management - eProcurement, Purchasing, Inventory * Create/Review process documents and user guides. * Provide communication/training to end users. * Ensure application security. * Create and utilize advanced queries as needed. * Act as a liaison between the IT development group and business units. * Evaluate new applications/functions and identify system requirements. * Recommend appropriate systems alternatives and/or enhancements to current systems. * Develop test plans, and coordinate and perform software testing. * Document system requirements, define scope and objectives, and assist in the creation of system specifications. * Basic SQL knowledge * Participate as a project team member or act as a lead on multi-disciplinary projects related to the assigned application as needed. * Manage small to medium projects independently. * NextGen PM Support * Live the SpecialtyCare Values - Integrity, Teamwork, Care & Improvement. * Perform other duties as assigned. Salary Estimate: $115,000 / year (Several factors, such as specific skill set, education level, certifications and years of experience, are considered to determine actual compensation.) BASIC QUALIFICATIONS * Education: * Bachelor's degree in Computer Science or Business Administration, or equivalent relevant work experience * Experience: * At least Five (5) years of related Financial Applications experience. * Proficient in the following application groups: PeopleSoft Financials, Order to Cash, and/or Supply Chain. * Experience with PeopleSoft HCM, NextGen PM, and/or Salesforce a plus. * Equivalent combination of education and experience. Knowledge and Skills: * Ability to develop documentation and provide communication/training to end users. * Ability to work as part of a collaborative team in order to be successful. * Pro-active, have initiative and ability to reach out to ensure tasks and deliverables are met, risks and mitigation strategies uncovered. * Must communicate with confidence, build relationships through inspiring trust and sharing information and be able to challenge assumptions. * Likes to work in a fast paced, highly collaborative environment with the ability to meet deadlines. * Strong attention to detail. SpecialtyCare is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

MySeniorHealthPlan.com is a direct-to-consumer insurance brokerage specializing exclusively in Medicare and Senior Health Insurance. We provide honest, unbiased plan comparisons by representing top insurance carriers. Our focused expertise keeps us up to date on the latest Medicare products, regulations, and technology. Position Overview: We're seeking an experienced Medicare Insurance Compliance Manager to oversee CMS and state regulatory compliance and support company-wide compliance initiatives. This fully remote role reports to the Sales Manager. Key Responsibilities: Develop and maintain compliance with CMS, Medicare Advantage, Part D, and DSNP regulations Lead compliance strategy and internal audit programs Stay current on federal and state healthcare laws and regulations Create, update, and enforce company compliance policies Conduct risk assessments and oversee audit preparedness Provide compliance guidance and training to staff Coordinate responses to audits, regulatory requests, and investigations Qualifications: 3-5 years of insurance compliance experience (Medicare/Medicaid focus) Strong understanding of CMS, HIPAA, and healthcare regulatory requirements Experience with Medicare managed care, Part D systems, and DSNP Proficiency with Salesforce or similar CRM systems Excellent communication, analytical, and organizational skills Bachelor's degree required; Master's preferred Bilingual (English/Spanish) a plus Details: Job Type: Part-Time, Contract Schedule: Monday-Friday, Day Shift Compensation: Competitive, based on experience Work Location: Remote My Senior Health Plan is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, religious creed, gender, sexual orientation, gender identity, gender expression, transgender, pregnancy, marital status, national origin, ancestry, citizenship status, age, disability, protected Veteran Status, genetics or any other characteristic protected by applicable federal, state, or local law. *All offers of employment are contingent upon successfully passing a pre-employment drug test and background check. My Senior Health Plan participates in E-Verify. AI Use Disclosure To make our hiring process smooth and efficient, we use tools like BambooHR (application tracking), Hireflix (on-demand interviews), Calendly (scheduling), and TestGorilla (skills assessments). These tools help us stay organized, but all applications and results are carefully reviewed by real people. AI supports our process, it doesn't replace human judgment. We also take steps to reduce potential bias in the tools we use, so every candidate is considered fairly.

Ranked one of Tennessee's top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals. Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness. Since then, we have expanded our services to children and adolescents with severe emotional disorders across Middle and East Tennessee. Our sole purpose is to support and treat those challenged with serious mental illness and poverty. Although based out of Nashville, we serve several communities across middle and East Tennessee with satellite offices in Antioch, Gallatin, Dickson, Columbia, Cleveland, Murfreesboro, Clarksville, Cookeville, Chattanooga, and Memphis. If you are interested in joining a team that is caring, collaborative, innovative and energizing this might be a great place for you! The Hospital Engagement Specialist fosters the relationship between area hospitals and MHC. This position acts as a bridge to bring Consumers into MHC services directly from the hospital. The Hospital Engagement Specialist works to ensure Consumers are connected to the right serve at the right time. Job Title: Hospital Engagement Specialist (Remote) Schedule: Monday -Friday, 8:00am-4:30pm JOB SUMMARY: The Hospital Engagement Specialist fosters the relationship between area hospitals and MHC. This position acts as a bridge to bring Consumers into MHC services directly from the hospital. The Hospital Engagement Specialist works to ensure Consumers are connected to the right serve at the right time. RESPONSIBILITIES: Work with area hospitals to identify Consumers who need MHC services. Identify appropriate services based on hospital discharge paperwork, face to face, and telephonic meetings. Provide education and marketing to area hospitals about MHC services. Travel to satellites to provide education to staff as needed. Create and foster relationships with area hospital staff, discharge planners, and administration. Track quality improvement data as outlined by Director. Track engagement data as outlined by Director. Summarize quality improvement and engagement data as needed and present to MHC leadership. Review ER utilization and inpatient hospitalization reports to identify Consumers needing MHC services. Develop relationships with local Emergency Rooms in order to collaborate on admission of high utilizers of emergency services. Attend and participate in agency multidisciplinary team meetings as needed. Represent the Agency with visitors learning about the agency model. Responsible for attending all mandatory in-services, continuing education and annual health requirements. Comply with all Corporate Compliance policies, practices and procedures. Report all unethical activities to supervisor, Corporate Compliance Office, Values Hotline number or Human Resource Director Comply with all OSHA and safety policies, practices, and procedures. Report all unsafe practices or accidents to supervisor, Safety Supervisor and/or OSHA Coordinator. Will be compliant with the relevant regulations concerning the privacy and security of consumer's protected health information (PHI) as established by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Participate in proactive team efforts to achieve departmental and company goals. Perform other duties as assigned. Provide leadership to others through example and sharing of knowledge/skill. Follow all policies and procedures set by the Agency. REQUIREMENTS: Master's Degree in a health-related field of counseling, psychology, or social work. Must be licensed or license eligible (LPC, LMSW, LCSW, LMFT or equivalent) Valid Tennessee Driver's License Acceptable Motor Vehicle Report (MVR) Acceptable Criminal Background Investigation Personal Automobile Insurance Cell Phone BENEFITS: Mental Health Cooperative offers a full comprehensive benefit plan for you to participate in. The following products are available: Medical Insurance/Prescription Drug Coverage Health Savings Account Dental Insurance Vision Insurance Basic Life and AD&D Insurance Short- & Long-Term Disability Supplemental Life Insurance Cancer Insurance Accident Insurance Critical Illness Insurance 403b - Retirement Plan Calm App for medication and mental health Gym membership discounts Mental Health Cooperative embraces inclusion, diversity and equal opportunity. We're committed to building a team that represents a variety of backgrounds, perspectives, and skills. Mental Health Cooperative is an equal opportunity employer and does not discriminate on the basis of race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.

University Health Network is looking for a full-time Certified Medical Coder to focus on risk adjustment for the clinically integrated network associated with The University of Tennessee Medical Center and University Physicians' Association. This position requires normal business hours Monday-Friday. This is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. This role involves performing detailed clinical documentation and risk adjustment reviews and accurately coding procedures and diagnoses using ICD-10-CM, CPT, HCPCS, and modifiers for professional services associated with The University of Tennessee Medical Center and University Physicians' Association. Essential Duties and Responsibilities (this list does not include all duties assigned) Performs coding services while meeting daily production and quality goals * Conduct thorough reviews of clinical documentation to ensure accuracy and compliance with coding standards. * Assign appropriate ICD-10-CM, CPT, HCPCS, and modifiers for professional services. * Collaborate with healthcare providers to clarify diagnoses and procedures to ensure accurate coding. * Uses CMS and HHS risk adjustment mapping tools to identify HCC coding and documentation opportunities * Participate in ongoing education and training to stay current with coding updates and guidelines * Actively participates in designated team meetings * Consistently meets coding productivity and accuracy standards while managing different responsibilities and workflows. If unable to maintain productivity and accuracy standards, team members will work onsite at the UHN office until standards are met and maintained. Partners with providers, practice staff, and UHN Coding team to improve quality and efficiencies in coding and documentation * Educates and coaches on compliant coding and documentation practices and accurate risk adjustment guidelines * Facilitates and supports a culture of compliance, ethics, and integrity * Recognized as an expert in risk adjustment coding compliance * Interacts effectively and builds respectful working relationships across the organization. Maintains HIPPA Guidelines for privacy * Respects the privacy of all patients 100% of the time * Understands and abides by HIPAA laws and regulations and UPA HIPAA policy at all times * Obtains consent to release protected health information * Reports all HIPAA issues to the Supervisor Remains current on coding rules and guidelines * Remains up to date with official AMA ICD-10 coding guidelines and regulations, Medicare, other MA and commercial plans, and internal guidelines * Remains up to date with CMS and HHS HCC risk adjustment models * Meets CEU requirements and remains in good standing with AAPC/AHIMA certifications Full benefit package available, including PTO, Medical, Dental, Vision, STD/LTD, Life Insurance, 401k + Company Match, and more! Requirements * Current CPC or RHIT certification required. * CRC required within 6-months of hire * Preferred at least two years of professional medical coding experience in an ambulatory care setting. E/M coding experience a plus. * Preferred experience and knowledge of HCC coding, knowledge related to chronic illness diagnosis, treatment, and management * Must be a team player with effective written and verbal communication, relationship-building, and interpersonal skills * Must be initiative-taking, highly organized, and have excellent time management * Must possess good problem solving and critical thinking skills * Exceptional attention to detail and proficiency in Microsoft Outlook (Outlook, Word, Excel, and PowerPoint) * Demonstrates integrity by adhering to high standards of personal and professional conduct