by twochickswithasidehustle | Nov 20, 2025 | Uncategorized
CreativeTime Solutions is seeking a dynamic and customer-focused Web E-Chat Representative to join our customer service team. The successful candidate will be the first point of contact for customers and will have direct responsibility for providing a professional, helpful, and timely service. For Web E-Chat Representative position, we expect you to be an outstanding communicator, listener, and problem solver.
Responsibilities:
- Handle and promptly respond to customer inquiries via web chat. Aim to resolve issues in the fastest time, without compromising on quality of service.
- Maintain comprehensive knowledge about products, services, policies, and procedures of CreativeTime Solutions. Use this knowledge to provide product information and recommendations to customers.
- Provide feedback on the efficiency of the customer service process. Proactively suggest improvements that enhance customer satisfaction and business performance.
- Work collaboratively with other team members to ensure the delivery of exceptional customer service. Participate in regular team meetings and share insights learned from interactions with customers.
- Document all communication with customers with accurate and detailed notes. Report any significant customer feedback to management for further analysis and response.
Qualifications:
- High school diploma or equivalent, with a bachelor’s degree preferred.
- Minimum of 1-2 years of customer service experience, preferably in a digital setting.
- Exceptional verbal and written communication skills. A positive, patient, and friendly customer service approach.
- Strong problem-solving skills. Ability to handle customers’ issues and complaints in a calm and professional manner.
- Excellent typing speed and accuracy. Proficiency in using Microsoft Office Suite and other software tools.
- Ability to work in a fast-paced environment and multitask. Comfort in adapting to new technologies quickly.
Benefits:
- Competitive compensation, including a full suite of benefits that include medical, dental, vision, and life insurance.
- Paid time off and vacation benefits that encourage work-life balance.
- Career advancement opportunities. We believe in promoting from within and provide numerous opportunities for professional growth.
- A commitment to a culture of diversity, inclusion, and respect. We value the unique perspectives and contributions of each employee.
- Continuous learning and development opportunities. We provide training and educational resources to help you build your skills and career.
At CreativeTime Solutions, we believe in excellence in everything we do, and we believe that our Web E-Chat Representatives play a significant role in upholding these values. If you enjoy helping people and have the qualifications we’re looking for, we would love to hear from you.
by twochickswithasidehustle | Nov 20, 2025 | Uncategorized
- Personalized Ads Evaluator
- Remote Internet Search Quality Rater – English (United States)
- Customer Support Expert- Remarkable AI
- iOS Evaluator
by Terrance Ellis | Nov 20, 2025 | Uncategorized
Use your analytical talent to shape smarter healthcare decisions. In this role, you’ll build tools, dashboards, and insights that directly influence clinical strategy and organizational performance—impacting care for hundreds of thousands of members.
About WellSense Health Plan
WellSense is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Medicaid, and Individual/Family plans. With more than 25 years of service, the organization is committed to delivering high-quality, equitable healthcare that works for every member.
Schedule
- Full-time, fully remote
- Standard business hours
- Collaboration across clinical, operational, and analytics teams
- Must maintain reliable attendance and meet timelines for analytic deliverables
What You’ll Do
⦁ Develop, maintain, and leverage a best-in-class clinical analytics infrastructure to support Medical Management strategy
⦁ Partner with cross-functional teams to understand data needs and ensure analysis accuracy
⦁ Lead analytic processes that benchmark performance and identify improvement opportunities
⦁ Present findings and insights to clinical leadership and support performance improvement initiatives
⦁ Work with Medical Management leadership to align operations and case management needs with data reporting
⦁ Build and maintain operational and clinical dashboards that drive decision-making
⦁ Create drill-down analyses to address over-utilization and identify trends
⦁ Develop performance measurement tools, operational dashboards, and reporting to track initiative impact
⦁ Gather business data requirements and collaborate with data architects to build required datasets
⦁ Translate clinical and operational needs into business reporting specifications
⦁ Support UM technical initiatives, including development of operational reports and specifications
⦁ Promote continuous improvement and best practices in data management
⦁ Ensure compliance with data governance and privacy policies
What You Need
⦁ Bachelor’s degree required
⦁ Experience in healthcare data analysis and reporting
⦁ Minimum 3 years of advanced analytics experience using SAS and/or SQL
⦁ Strong proficiency with Tableau (Desktop and Server)
⦁ Excellent analytical, critical-thinking, and problem-solving skills
⦁ Ability to communicate complex information and data methodologies clearly
⦁ Experience with enterprise data warehouses
⦁ Ability to manage multiple projects in a fast-paced environment
⦁ Strong initiative and ability to work both independently and collaboratively
Preferred
⦁ Some experience with Python scripting
⦁ Experience coordinating multiple analytic or technical initiatives
Benefits
⦁ Competitive salary
⦁ Comprehensive medical, dental, vision, and pharmacy coverage
⦁ 403(b) retirement plan with employer match
⦁ Paid time off and wellness resources
⦁ Career advancement and skill development opportunities
Ready to take on high-impact analytical challenges and make meaningful contributions to healthcare quality? Apply while the role is open.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 20, 2025 | Uncategorized
Play a key role in strengthening healthcare quality across Massachusetts and New Hampshire. This remote role helps drive accurate HEDIS reporting, regulatory compliance, and measurable quality outcomes for members.
About WellSense Health Plan
WellSense is a nonprofit health insurance company serving more than 740,000 members across MA and NH through Medicare, Medicaid, and Individual/Family plans. Founded in 1997, we’re committed to delivering high-quality, equitable healthcare and supporting members no matter their circumstances.
Schedule
- Full-time, fully remote
- Standard business hours with flexibility based on provider outreach and reporting timelines
- Must maintain reliable attendance and meet accuracy and productivity standards
What You’ll Do
⦁ Perform medical record abstraction and data entry for NCQA HEDIS and other audit-based measures
⦁ Maintain ≥90% inter-rater reliability accuracy and complete yearly testing
⦁ Conduct overreads to validate accuracy, consistency, and compliance with technical specifications
⦁ Navigate multiple EMR systems (Epic, Cerner, Allscripts) to retrieve and abstract medical records
⦁ Build and maintain strong relationships with provider partners to ensure timely record retrieval
⦁ Research member and claims data using internal systems to validate service information
⦁ Support chart procurement efforts and maintain a retrieval rate of ≥95%
⦁ Assist with training on HEDIS measures, abstraction methods, and data collection practices
⦁ Identify workflow improvement opportunities and contribute to quality initiatives
⦁ Participate in cross-functional project teams focused on performance and quality improvement
⦁ Promote a data-driven culture of continuous improvement
⦁ Perform other related duties as assigned
What You Need
⦁ Bachelor’s degree in Healthcare Administration, Nursing, Public Health, or related field (or equivalent experience)
⦁ Minimum 2 years of experience in healthcare quality, medical record abstraction, or managed care
⦁ Working knowledge of HEDIS measures and abstraction methodology
⦁ Strong attention to detail and problem-solving skills
⦁ Proficiency with Microsoft Office and ability to learn multiple software systems
⦁ Strong verbal and written communication skills
⦁ Ability to work collaboratively and independently
Preferred
⦁ Experience with quality reporting, audits, or supplemental data submissions
⦁ Coding/clinical background or health information certification
Benefits
⦁ Competitive salary: $61,500–$89,500 (adjusted for location)
⦁ Medical, dental, vision, and pharmacy benefits
⦁ 403(b) with employer match
⦁ Paid time off and wellness resources
⦁ Career growth opportunities
Ready to help improve healthcare quality across the region? Apply today — positions fill fast.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 20, 2025 | Uncategorized
Help drive clinical excellence and regulatory compliance across WellSense’s Medicaid and Medicare programs by leading quality improvement initiatives that directly impact member outcomes.
About WellSense Health Plan
WellSense is a nonprofit health plan serving more than 740,000 members across Massachusetts and New Hampshire. With more than 25 years of service, we provide accessible, high-quality health plans for Medicare, Medicaid, and Individual/Family members. Our mission is simple: deliver healthcare that works for every member, regardless of circumstance.
Schedule
• Full-time
• Fully remote
• Occasional travel for meetings or state-level quality sessions
• Cross-functional collaboration with clinical, operational, and analytics teams
What You’ll Do
• Serve as a subject matter expert for quality management across medical and behavioral health programs
• Lead the development and execution of corporate quality initiatives aligned with NCQA and state regulatory requirements
• Oversee quality improvement needs across all products in assigned regions (MA and/or NH)
• Chair workgroups and committees that track progress on corporate and regulatory quality initiatives
• Ensure compliance with contractual requirements from EOHHS, DHHS, EQRO, NCQA, and other regulatory bodies
• Develop detailed project plans, timelines, metrics, and outcome measures for performance improvement projects
• Facilitate large multidisciplinary teams to implement targeted quality interventions
• Prepare internal and external documentation, reports, and regulatory submissions
• Work closely with analytics teams to define data needs, analyze trends, and support quality decision-making
• Liaise with vendors to ensure accurate reporting and data integration
• Respond to regulatory inquiries and represent the plan at state quality meetings
• Identify improvement opportunities using internal and external data sources
• Manage day-to-day quality processes including document review, literature searches, and independent decision-making
• Ensure timely submission of all quality and regulatory deliverables
• Other duties as assigned
What You Need
• Bachelor’s degree in Nursing, Health Administration, or related field (or equivalent experience)
• Master’s degree in Social Work, Behavioral Health, Public Health, or related field preferred
• 5+ years of progressive experience in healthcare or managed care
• Strong knowledge of clinical quality management, quality improvement methodologies, and regulatory standards
• Experience working with Medicaid/Medicare populations preferred
• NCQA experience strongly preferred
• Project development or health policy experience a plus
• Lean Six Sigma or CPHQ training preferred
Benefits
• Competitive salary
• Full medical, dental, vision, and pharmacy coverage
• Flexible Spending Accounts
• Paid time off and wellness resources
• 403(b) retirement plan with employer match
• Career development and advancement opportunities
• Remote work with strong team support
If you’re ready to lead impactful quality initiatives and help shape better outcomes for vulnerable populations, this role is your next step.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 20, 2025 | Uncategorized
Help strengthen relationships with healthcare providers and ensure accurate claims processing across WellSense’s Medicare, Medicaid, and commercial networks.
About WellSense Health Plan
WellSense is a nonprofit health plan serving more than 740,000 members across Massachusetts and New Hampshire. For over 25 years, we’ve delivered accessible, high-quality Medicare, Medicaid, and Individual/Family coverage. Our mission is to make healthcare work for everyone, regardless of circumstance.
Schedule
• Full-time
• Remote role with travel requirements
• Up to 50% travel to local communities for provider meetings
• Fast-paced workload with cross-department collaboration
Responsibilities
• Investigate, document, track, and help resolve provider claim issues
• Partner with Claims, Benefits, Enrollment, Audit, and Clinical Services to ensure timely and accurate claim payments
• Identify system changes impacting claims and collaborate internally to drive solutions
• Analyze claims processing trends and assist with issue quantification
• Run claim reports to support provider visits and outreach
• Strengthen relationships with physicians, clinicians, community health centers, and hospitals
• Serve as the primary contact for provider reimbursement questions and issue resolution
• Provide education to providers on WellSense products, policies, procedures, and operational processes
• Communicate Plan updates and ensure smooth information flow across departments
• Conduct outreach aligned with Plan initiatives
• Facilitate interdepartmental coordination to resolve complex provider issues
• Research provider data discrepancies in Onyx and Facets and request system updates when needed
• Support credentialing, servicing, and recruitment through report preparation
• Ensure compliance with NCQA and state agency requirements
• Other duties as assigned
• Maintain regular, reliable attendance
Requirements
Education
• Bachelor’s degree in Business Administration or related field, or equivalent experience
Experience
• 2 or more years in managed care or healthcare preferred
• Understanding of Medicare and Medicaid reimbursement methodologies
• Familiarity with provider coding and billing practices
• Experience with ICD-10, CPT/HCPCS, and claim form standards
Skills & Competencies
• Strong communication skills, written and verbal
• Proven ability to manage multiple priorities with strong follow-up habits
• High proficiency with Microsoft Office
• Strong organizational and independent problem-solving skills
• Ability to work collaboratively with teams and external partners
Additional Requirements
• Valid driver’s license and access to a vehicle
• Pre-employment background check
Benefits
• Competitive salary
• Full medical, dental, vision, and pharmacy coverage
• 403(b) retirement plan with employer match
• Paid time off and wellness support
• Flexible Spending Accounts
• Career development opportunities
• Full-time remote flexibility with community-based travel
If you’re a detail-oriented relationship builder who can navigate claims, coding, reimbursement, and provider engagement with confidence, this role is built for you.
Happy Hunting,
~Two Chicks…
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