Practitioner Campaign Associate (Seasonal – Remote, $15/hour)

by twochickswithasidehustle | Oct 9, 2024 | Uncategorized

Description

American Specialty Health Incorporated is seeking a dynamic and engaging Practitioner Campaign Associate to join our team! This is an exciting opportunity support the practitioner recruitment team with prelaunch and execute campaigns, which includes working directly with telerecruiters, fielding incoming faxes, client and member nominations, and dissemination of credentialing documents to recruiters for follow up. This position plays an integral role in our company by expanding our network and supporting our mission to empower individuals to live healthier and longer.

Responsibilities

• Interfaces with prospective practitioner to encourage participation in our Clinical and Fitness programs.
• Makes outbound telephone calls to prospective practitioner to raise awareness of the programs, to set field appointments and provide follow up to assigned recruiter’s initial outreach in key campaigns.
• Initiates first time calls to practitioners in low profile campaigns.
• Invites practitioners to webinars, notifies them of upcoming seminars, and advises them of field appointments if requested by practitioner.
• Sends recruitment material to practitioners.
• Records contacts into the contact management database.
• Manages time to ensure the minimum required outbound calls per day and per week are met, as specified by management.
• Works off of daily and weekly call lists generated from database for key and on-going campaigns.
• Researches unique questions using all available sources. Refers difficult issues to Manager for appropriate answers.
• Handles incoming queue calls for absent reps as well as during high call volume in the department.
• Supports the recruitment team by conducting on-going internet searches when recruiters encounter disconnected and wrong numbers for clinical and fitness practitioners. 
• Conducts data research for records in the Primus database that are determined to be inaccurate.

Qualifications

• Associates degree required or equivalent. High school diploma required.
• Minimum six months experience in outbound or inbound call environments and/or customer service.
• Strong verbal/telephone communication skills. 
• Proficient in MS Office.
• Organized, results oriented team player, ability to work under time sensitive projects as directed by management.
• Demonstrates the ability to conduct outbound calls to clinical and fitness practitioners as follow up to recruiter’s initial outreach, to include coordination of field appointments.
• Ability to handle inbound calls as needed during high call volume times.
• The ability to field and handle typical objections and the ability to present information in a clear and concise manner utilizing campaign scripts.

Core Competencies 

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time.

Physical Requirements

Ability to speak, see and hear other personnel and/or objects.  Ability to communicate both in oral and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard.  Ability to lift up to 10 lbs.

Environmental Conditions

Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law. 

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.

Eligibility Research Rep I (Seasonal – Remote, $15/hour)

by twochickswithasidehustle | Oct 9, 2024 | Uncategorized

Description

American Specialty Health Incorporated is seeking a detail-oriented research representative for our Eligibility team. This position will research and resolve eligibility verification requests while providing the highest quality of customer service by maintaining a professional and courteous manner. The ideal candidate will have strong typing and 10-key skills while maintaining 98% accuracy. The research representative follows confidentiality guidelines to ensure security measures are enforced and proprietary information remains protected.

Remote Worker Considerations

Candidates who are selected for this position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).  

Responsibilities

• Verifies member eligibility from the eligibility file, communications logs, and health plan websites or by calling the health plan directly when all other resources are exhausted.
• Inputs and saves verified member’s information into the communications log and/or member maintenance.
• Promptly processes and completes research to ensure turnaround times are met.
• Makes follow up calls to practitioners and members to provide research results.
• Builds or updates member and group records in ASH’s proprietary claims processing system including documentation in notes.
• Follows confidentiality guidelines to ensure security measures are enforced and proprietary information is protected
• Must maintain a minimum production level of 85 claims, 60 CSS/MNA, or 60 ASHLink requests per day pro-rata with no less than 98% accuracy.
• Ability to assist in multiple functions as needed.
• Ability to participate in peer mentorship as needed.

Qualifications

• High School Diploma required.
• Minimum one year experience with 10 key, typing, and computer skills. 7,000-10,000 key strokes per hour required.
• Excellent customer service skills, experienced in making outbound calls and meeting expectations for productivity and accuracy required.
• Experience with claims processing or eligibility verification preferred.

Core Competencies

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time. 

Physical Requirements

Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.

Environmental Conditions

Work-from-home (WFH) environment.

Delegation Support Manager I (Remote)

by twochickswithasidehustle | Oct 9, 2024 | Uncategorized

Description

American Specialty Health Incorporated is seeking an experienced Client Audit Manager to join our Client Services – Clinical department. This position will provide support for client delegation (including pre-delegation) and regulatory compliance audits.  The position also supports other delegation oversight compliance efforts, as well compliance-related inquiries/reviews, in consultation with the Sr. Manager, Delegation Support and Director, Clinical Client Services.  The position also supports other compliance activities of the department related to internal compliance efforts.

Salary Range

American Specialty Health complies with state and federal wage and hour laws and compensation depends upon candidate’s qualifications, education, skill set, years of experience, and internal equity. $48,000  to $55,000 Full-Time Annual Salary Range.

Remote Worker Considerations

Candidates who are selected for this position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).  

Responsibilities

• Provides support related to complex delegation support activities in consultation with and under the direction of Sr. Manager, Delegation Support.
• Leads audits on behalf of ASH with assigned clients.
• Facilitates and leads internal and external meetings acting as owner of information.  This includes creating and distributing meeting agendas, kicking off the discussion with a high-level overview and purpose of the meeting, introductions, and then closing the discussion with action items.  This also includes facilitating and leading any internal preparation meetings and/or sending out details to the internal stakeholders prior to the meeting so they have enough information to prepare for their role in the discussion.
• Proactively engages internal customers and subject matter experts to effectively manage internal and external customer expectations.
• Seeks support from and provides client updates at internal committee meetings as appropriate.
• Travels, as directed by the Sr. Manager, Delegation Support, to support audits in locations other than the position’s designated ASH office location.
• Provides support for internal compliance activities, as needed, based on direction from Sr. Manager, Delegation Support.
• Actively participates in collaborative team environment to educate, coordinate activities, and resolve unique problems with recommended courses of action to internal stakeholders.
• Accepts and/or returns phone calls from clients within the same business day of receipt, Monday through Friday.
• At a minimum, acknowledges receipt of emails from clients within 24 hours of receipt.
• Maintains timely and accurate documentation of client interactions, activities, processes and issue resolution; ensures meeting minutes and action items are prepared and documented within two days of a client meeting as applicable.
• Ensures high level of service to meet client expectations on a daily basis.
• Communicates with Sr. Manager Delegation Support and Director, CTC, on high level issues to ensure appropriate response and resolution.
• Establishes and maintains positive professional relationships with internal and external customers.
• Interfaces with ASH staff to resolve issues, answer questions and triage responses.
• Schedules internal and external meetings to support audit initiatives as applicable. 
• Acts as a back-up for other Delegation Support Managers.
• Maintains compliance with ASH policies and procedures.
• Seeks support and training from designated Delegation Support Manager II, Senior Delegation Support Manager, and/or Director, Client Services to aide in gaining the experience and skills required to advance to a Delegation Support Manager II.
• Maintains confidentiality of all reports, files, schedules, databases, and documents; as well as all member, provider, and proprietary information and ensures the Delegation Support team does the same.
• At the direction of the Sr. Manager, Delegation Support, communicates unique aspects of client delegation activities at various meetings with internal and external customers to support delegation functions.
• At the direction of the Sr. Manager, Delegation Support participates in activities related to internal and external process improvements.
• Manages compliance attestation requests from clients requiring Compliance Office signature, including keeping the Compliance Office informed of attestation requests and working with department staff and internal stakeholders to monitor and track requirements set forth in attestations, particularly new requests and requests not previously specified via contract with clients.

Qualifications

• Bachelor’s degree in in related field or equivalent experience.  If equivalent experience, high school diploma required.
• Proficiency in MS Office with intermediate experience in Word, Outlook and Excel required. 
• Experience in health care administration preferred but not required. 
• Experience in managed care operations preferred but not required.  Experience may include accreditation, account management, regulatory compliance, contract review,
• Proven experience and developed Customer Service skills required.
• Experience in project management, meeting facilitation and documentation required.
• Training or certification in health care beneficial but not required.

Core Competencies

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time. 

Physical Requirements

Ability to speak, see and hear other personnel and/or objects.  Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard.  Ability to lift up to 10 lbs.

Environmental Conditions

Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law. 

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information.

Clinical Network Recruiter I (Entry level, remote, $17/hour plus incentives)

by twochickswithasidehustle | Oct 9, 2024 | Uncategorized

Description

American Specialty Health Incorporated is seeking a Clinical Network Recruiter I to join our Practitioner Contracting/Communications team. This position will make outbound sales type calls to prospective practitioners to encourage participation in our Clinical programs through ASHP/ASHG groups.

Remote Worker Considerations

Candidates who are selected for this position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).  

Remote Worker Considerations:

Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment.

Responsibilities

• Interfaces with various practitioner types to promote American Specialty Health and to execute practitioner contracts.
• Makes outbound telephone calls to prospective practitioner types.
• Meets the minimum required outbound calls per day and per week, as specified by management.
• Utilizes contact management database.
• Adheres to standards and practices as outlined in the Practitioner Contracting/Communications Incentive Guidelines
• Submits weekly activity report to Supervisor as requested.
• Meets (minimum) monthly recruitment goals for applications received, as specified by management.
• Provides all applicable Agreements and Links to practitioners to review by utilizing ASHlink and other ASH resources. Supports department by assisting on special projects as directed.
• Participates in formal/informal training and team meetings.

Qualifications

• Associates degree required or equivalent experience. If equivalent experience, high school diploma required
• Minimum of one year experience in outbound sales and/or customer service.
• Strong verbal/telephone communication skills with a focus on reaching decision -makers.
• Proficient in MS Office.
• Organized, results oriented team player.
• Demonstrates the skill sets for knowledge and sales relationship building to include the ability to qualify clinical practitioners based on documented criteria, the ability to field and handle typical objections, and the ability to present information in a clear and concise format based on scripts provided.

Core Competencies

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

Ability to travel. Ability to sit and work within an office environment.

Physical Requirements

Ability to speak, see, and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within and outside the facility. Ability to drive and travel by air. Ability to move up to 50 lbs. Capable of using a telephone and computer keyboard.

Environmental Conditions

Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.

Shared Services Coordinator

by twochickswithasidehustle | Oct 9, 2024 | Uncategorized

locationsRemote – United Statestime typeFull timeposted onPosted 16 Days Agojob requisition idR00000063823

This position is responsible for supporting the employer, commercial or health plan businesses with coordination of services. Responsible for locating available providers, facilities and scheduling appointments for clients related to EAP or Health Plan Services, outpatient managed care appointments and higher level of care bed searches. Completes requests for organizational and employee services to include, but not limited to scheduling: worksite and virtual trainings, customer training, critical incident response, single care agreements, crisis calls, webinars, health fairs, mindfulness, and other related presentations, or support services.

• Links clients to appropriate services, information and materials within the community by conducting Community Resources searches.
• Uses independent judgement to understand the logistics of available timeslots and if the location, distance and/or time of available appointments is a reasonable distance/timeframe to book an appointment.
• Troubleshoots for client and/or business unit when an appropriate provider, type of service, or appropriate level of care cannot be readily found.
• Completes service documentation accurately and timely in appropriate systems in accordance with policy/regulatory standards.
• Assists in efforts to continuously improve by identifying inefficiencies and sharing ideas with management on how to better implement more efficient, more effective processes and/or procedures to provide better service to our clients.
• Participates in activities as requested that help improve Shared Services overall performance and contribute to a high- performance team.
• Demonstrates flexibility in areas such as job duties and scheduling to better serve members and help the company achieve its business and operational goals.
• Meets and adheres to attendance and schedule, production and performance metrics, and quality goals.
• Demonstrates respect, sensitivity, confidentiality, and understanding for the client’s circumstance while maintaining professionalism.
• Remains responsible for updating self on ever changing laws, policies and service delivery information to ensure accuracy when dealing with members and providers and procedures.
• Assumes responsibility for self-development and career progression. Proactively seeks and participates in ongoing training (formal and informal) in all aspects of the role.
• Adheres to professional standards as outlined by protocols, rules and regulations and our code of conduct.
• All other duties as assigned.

Appointment Search:

• Locates and coordinates all aspects of member provider appointments (urgent, routine, etc.) in compliance with individual company contractual requirements.
• Reviews client eligibility, benefits and/or authorizations prior to scheduling services.
• Locate member community resources
• Locate ‘higher level of care’ placements (i.e., detox bed)
• Compile medical vendor lists
• Engage in live website ‘chats’ with members and providers

Customer Training:

• Coordinates training requests with training team, account management, and customers.
• Consults to ensure request and details meet customer expectations.
• Hires trainers to meet parameters of customer training requests (time, location, topic, etc.).
• Coaches trainers as needed.
• Ensures trainers, account management and customers have resources and materials necessary to deliver training.
• Maintains trainer network, screens new trainers, monitors trainer performance, and updates records.
• Maintains training materials by updating listings in systems, codes for organization, applying custom branding, and providing utilization data.
• Provides and supports reporting on customer satisfaction surveys and monthly/quarterly reporting.

Critical Incident Response (CIR) and Health Fairs:

• Coordinates CIR/Health Fair requests with CIR team, account management, and customers.
• Consults to ensure request and details meet customer expectations.
• Hires providers to meet parameters of customer requests primarily with short TAT  (time, location, intervention, etc.).
• Coaches providers as needed.
• Ensures providers, account management and customers have resources and materials necessary to deliver services.
• Ensure appropriate pass off to ‘after hours’ teams for timely and accurate service fulfilment. 

Other Job Requirements

Responsibilities2+ years of Call Center, customer service or shared services.
2+ years of experience in a managed care environment, integrated medical & behavioral health care.
Understanding of plan benefit structures, psychiatric terminology, medical terminology, and local communication resources.
Knowledge of EAP/managed care business and service delivery.
Possess service excellence attitude.
Strong data entry and telephone skills.
Working knowledge of Microsoft Office and ability to learn and utilize software applications.
Excellent listening, comprehension, communication (verbal and written) problem solving and customer service skills.
Experience handling high volume calls while maintaining a calm and friendly demeanor.
Ability to maintain a flexible schedule.

General Job Information

TitleShared Services Coordinator

Grade19

Work Experience – RequiredClinical, Customer Service, Healthcare

Work Experience – Preferred

Education – RequiredGED, High School

Education – PreferredAssociate

License and Certifications – Required

License and Certifications – PreferredCEAP – Certified Employee Assistance Professional – Care Mgmt

Salary Range

Salary Minimum:$37,725

Salary Maximum:$56,595

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.