Make outbound or receive inbound calls from members to schedule doctor appointments, assist members that need to complete Health Needs Screenings or make payments to become eligible for enhanced benefits. Influence members to take advantage of additional benefits. Educate members on utilization of Emergency Departments in non emergent conditions. Identify and overcome bar

Account Payable I Specialist to process, input and maintain AP.Close month end, reconcile, and allocate expenses. This position requires you to be in the office Tues and Thurs 8 30am 5 00pm and work remotely Mon, Wed and Fri 8 30am 5 30pm. Work location 200 Oceangate Long Beach, CA 90802 Essential Functions Complete AP invoice tickets, identifying proper GL account number

Assist with the development of Community Engagement reports and informational materials . Provides guidance and oversight of the Volunteer Time Off (VTO) program and assist with the recruitment and training of event volunteers . Assists in planning and organizing project activities. Collaborates with internal and external parties to assist with organizing the various comp

Appeals Specialist I to be responsible for reviewing and resolving member and provider complaints and communicating resolution to members and provider (or authorized representatives) in accordance with the standards and requirements established by the Centers for Medicare and Medicaid . This position is fully onsite. Works schedule is M F 8am 5pm. Location 5055 E Washingt

The Community Well Care Coordination Manager must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordination Manager must, at a minimum, be a registered nurse or simil

Medical Assistant Health Coach to a ssists with health management activities/programs for members. Provides health coaching or intervention telephonically or in person for assigned health programs. Utilizes all data systems containing patient information and documents information appropriately. Assists with the identification of areas for which there is a need for health

The CRC Communications Coordinator position will provide coordination and support to the following state cultural commissions located with the Indiana Civil Rights Commission Position duties include the following 1. Social media content creation; graphics; social listening 2. Website content management 3. Meeting minutes and notices 4. Event coordination administrative; ph

The Community Well Care Coordination Manager must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordination Manager must, at a minimum, be a registered nurse or simil

Conduct assessments to understand clients' needs. Collaborate with other healthcare professionals, such as psychiatrists, psychologists, and social workers, to provide comprehensive care. Maintain accurate and confidential client records. Adhere to ethical guidelines and legal regulations. Participate in ongoing professional development to stay abreast of current research

We are seeking a dedicated and detail oriented individual to join our team as a Janitor. The primary responsibility of this role is to ensure that vacated apartments are thoroughly cleaned and prepared for new occupants. The ideal candidate will have a keen eye for cleanliness, excellent time management skills, and the ability to work independently. Responsibilities Clean

The Member Health Assessor engages with the member to establish an effective, professional relationship with primary responsibility to conduct their health risk assessment. Essential Functions Participate in the Integrated Care Coordination Team as needed. Coordinate logistics to support care plan goals and interventions as needed to address immediate member concerns. Ver

Researches the substance of complex appeal or retrospective review requests including pre pay and post payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in compliance with applicable regulations or standards. Perf

Performs routine facility maintenance tasks to ensure company employees have a safe and properly conditioned work environment. Assemble, relocate, and repair free standing or modular office furniture and equipment. Perform general maintenance tasks. Clean equipment, mechanical rooms, and work sites as directed. Perform preventative inspections. Respond to emergency calls

Seeking a Registered Nurse with current in state license, with Utilization review or quality management experience. This position is fully remote. Work schedule is Mon Fri, 8 00am 5 00pm. Must have at least 3 years' experience in a clinical setting. InterQual experience desired. Must have basic PC skills, beginner knowledge of Microsoft Word and Excel.

The Clinical Appeals Nurse is responsible for the completion of clinical appeals and state hearings from all states. Essential Functions Responsible for the completion of clinical appeals and state hearings from all states Review and complete all provider clinical appeals within required timeframes. Review and complete member clinical appeals within required timeframes. Re