by Terrance Ellis | Nov 20, 2025 | Uncategorized
Start a stable, full-time remote role supporting claims accuracy for a mission-driven health plan.
About WellSense Health Plan
WellSense is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire. For 25 years, we’ve delivered high-quality Medicaid, Medicare, and Individual/Family plans that support members no matter their circumstances. We’re dedicated to improving health equity and expanding access to care.
Schedule
• Full-time, remote
• Monday–Friday with occasional overtime during peak periods
• Reliable internet required
Responsibilities
• Review and process Medicaid claims using Coordination of Benefits (COB) rules
• Update and maintain member coverage information across claims systems
• Communicate with providers to resolve claim-related inquiries
• Follow federal and state COB guidelines for Commercial, Medicare, and Medicaid
• Navigate multiple systems to research, update, and verify claim details
• Complete other tasks as assigned
Requirements
• High School Diploma or GED required
• 2+ years of claims processing experience
• 2+ years of health insurance experience with working knowledge of industry terminology
• Proficiency with Microsoft Office and the ability to work across multiple systems
• Strong attention to detail and the ability to follow written instructions
• Clear, professional communication skills
• Understanding of COB rules (Commercial, Medicaid, Medicare)
Preferred Qualifications
• Consecutive 2-year work history
• Experience with Cognizant systems (Facets, QNXT)
Benefits
• Competitive salary range: $16.35–$22.84/hr
• Comprehensive medical, dental, vision, and pharmacy benefits
• 403(b) with company match
• Flexible Spending Accounts
• Paid Time Off and holidays
• Career advancement opportunities
• Employee wellbeing resources
• Full-time remote work
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 20, 2025 | Uncategorized
Help shape the future of value-based senior care by driving the analytics behind Curana Health’s risk adjustment strategy.
About Curana Health
Curana Health is a national leader in value-based care for older adults, partnering with more than 1,500 senior living communities across 32 states. With 1,000+ clinicians and support professionals, we deliver on-site primary care, ACO programs, and Medicare Advantage Special Needs Plans that improve outcomes for over 200,000 seniors. Our mission is simple: improve the health, happiness, and dignity of older adults.
Schedule
• Full-time, remote
• Standard weekday schedule
• Requires reliable high-speed internet
Responsibilities
• Lead end-to-end analyses supporting risk adjustment operations and strategy
• Build, maintain, and reconcile complex datasets using internal data and regulatory response files (MMR, MOR, RAPS, EDPS, MAO-002/004, etc.)
• Identify trends and communicate insights to internal teams, leadership, providers, and partners
• Improve processes that ensure accurate risk score capture and minimize error rates
• Maintain existing reports and develop new dashboards to support companywide goals
• Serve as a subject matter expert on risk models, CMS guidance, and annual risk adjustment cycles
• Conduct vendor oversight and reconcile submissions for compliance and accuracy
• Support RADV and other audits through documentation and analysis
• Perform root cause analysis on data issues to prevent discrepancies or gaps
• Collaborate with internal stakeholders to resolve member, provider, claim, and pharmacy data issues
• Provide analytical support for financial projections, pricing efforts, and cost utilization modeling
• Interpret regulatory updates, attend training sessions, and maintain a high level of compliance knowledge
Requirements
• Bachelor’s degree required
• 5+ years of experience in Risk Adjustment (health plan, provider group, or RA vendor)
• Strong understanding of value-based care models and Medicare Advantage
• Experience with SQL and advanced Excel; PowerBI or PTT experience a plus
• Strong analytical, problem-solving, and communication skills
• Ability to simplify complex data for executive audiences
• Experience in fast-paced, data-driven environments
• Coding certification (AAPC or AHIMA) is a plus
Benefits
• Comprehensive medical, dental, and vision
• Paid Time Off and paid holidays
• 401(k) with company match
• Remote work flexibility
• Opportunities for advancement in one of the fastest-growing healthcare companies in the U.S.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 20, 2025 | Uncategorized
Lead and support a growing team helping seniors get the care they deserve. This role guides non-clinical support staff who keep Curana Health’s care management operations running efficiently across the country.
About Curana Health
Curana Health is a national leader in value-based senior care, partnering with 1,500+ senior living communities across 32 states. Our mission is to radically improve the health, happiness, and dignity of older adults through on-site primary care, ACO programs, and Medicare Advantage Special Needs Plans. With more than 1,000 clinicians and care professionals, we deliver proactive solutions proven to enhance outcomes for over 200,000 seniors.
Schedule
• Full-time, remote position
• Standard weekday hours
• Occasional travel to local or out-of-state Senior Living Communities
• Requires a reliable high-speed internet connection
What You’ll Do
• Lead, supervise, and support non-clinical staff, including Medical Assistants and virtual support teams
• Hire and onboard new staff members
• Evaluate workload, adjust resources, and improve operational efficiency
• Partner with the Manager of Care Management Operations on staffing, program needs, and problem-solving
• Facilitate weekly team meetings for training, alignment, and workflow updates
• Approve payroll, track attendance, and oversee employee leave and scheduling
• Educate staff on Curana workflows, policies, and procedures
• Implement and monitor new care management programs
• Conduct quality assurance audits to ensure accuracy and consistency
• Complete additional tasks as assigned
What You Need
• Strong knowledge of care coordination and non-clinical provider support processes
• Proficiency with Microsoft Office and comfort learning new systems
• Excellent organizational and time-management skills
• Ability to travel occasionally
• Strategic mindset and strong process-improvement instincts
• Associate degree in a healthcare-related field or healthcare certification
• Minimum 2 years in a supervisory or leadership role
• 2+ years of experience in a medical office, Senior Living Community, or related environment
Benefits
• Comprehensive health benefits
• Paid Time Off and holidays
• 401(k) with company match
• Remote work flexibility
• Opportunities to impact senior care at scale
Curana Health is one of the fastest-growing private companies in the nation, ranking No. 147 on the Inc. 5000 list—with major opportunities for career growth as we continue to expand.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 20, 2025 | Uncategorized
Help ensure seniors receive safe, high-quality care by supporting Curana Health’s Credentialing Committee with accurate provider data, compliance reviews, and efficient communication workflows.
About Curana Health
Curana Health is a fast-growing leader in value-based senior care, partnering with 1,500+ communities across 32 states. Our teams deliver on-site primary care, ACO programs, and Medicare Advantage Special Needs Plans designed to improve health outcomes, streamline operations, and enhance quality of life for more than 200,000 older adults. We are united by one mission—to radically improve the health, happiness, and dignity of seniors nationwide.
Schedule
• Full-time, remote role
• Standard weekday hours
• Collaborative virtual environment across Credentialing, Medical Directors, and Operations teams
What You’ll Do
• Support the enterprise-wide credentialing process for practitioners and healthcare organizations
• Maintain strict confidentiality of practitioner data and sensitive information
• Keep credentialing software up to date with accurate and complete information
• Collect, analyze, and present provider data for bi-monthly Credentials Committee meetings
• Track inbound and outbound communication for Medical Directors
• Communicate with providers to clarify missing information and resolve questions
• Draft and distribute approval letters, requests for information, and termination notices
• Compile provider responses to ensure clarity and accuracy in committee documentation
• Prepare the bi-monthly Credentials Committee agenda and record meeting minutes
• Review and process NPDB Continuous Query reports and escalate concerns appropriately
What You Need
• High school diploma required; associate degree preferred
• 2–5 years of credentialing experience within a hospital or insurance plan
• Working knowledge of Joint Commission, NCQA, URAC, and HFAP standards
• CPCS certification preferred
• Ability to manage confidential information with discretion
• Strong organizational, communication, and data accuracy skills
Benefits
• Medical, dental, and vision coverage
• 401(k) with company match
• Paid Time Off and paid holidays
• Remote work flexibility
• Opportunity to support meaningful improvements in senior healthcare
Curana Health is ranked No. 147 on the Inc. 5000 list—reflecting rapid expansion and major opportunities for career growth.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 20, 2025 | Uncategorized
Support a mission-driven healthcare organization by ensuring providers are fully enrolled, credentialed, and ready to care for seniors without delay.
About Curana Health
Curana Health is a national leader in value-based senior care, partnering with senior living and skilled nursing communities across 32 states. We deliver on-site primary care, ACO programs, and Medicare Advantage Special Needs Plans designed to improve outcomes and enhance quality of life for more than 200,000 older adults. Our fast-growing team of clinicians and support professionals is united by one mission—to radically improve the health, happiness, and dignity of seniors.
Schedule
• Full-time, remote role
• Standard weekday hours with independent workflow
• Collaborates virtually across Credentialing, HR, and Operations teams
What You’ll Do
• Coordinate the full provider enrollment process for physicians, NPs, and PAs joining the medical group
• Prepare and submit Medicare, Medicaid, and commercial payer enrollment applications
• Manage facility privileging and attestation requirements across senior living and skilled nursing sites
• Maintain accurate provider data in systems including NPPES, PECOS, CAQH, and internal HRIS platforms
• Partner with Credentialing, HR, and Operations to align enrollment timelines with onboarding
• Follow up with payers, facilities, and clinicians to collect missing information and resolve discrepancies
• Track enrollment status and communicate updates to Market Operations and Finance
• Process revalidations, terminations, and address changes to maintain active enrollment
• Support reporting, audits, and compliance reviews related to provider enrollment
What You Need
• High school diploma required; associate’s degree preferred
• Minimum 2 years of experience in provider enrollment, credentialing, or healthcare administration
• Familiarity with Medicare/Medicaid enrollment workflows preferred
• Experience with CAQH, NPPES, PECOS, or similar systems strongly preferred
• Strong communication, organization, and problem-solving skills
• Ability to manage deadlines and maintain accuracy across complex data
Benefits
• Medical, dental, and vision coverage
• 401(k) with company match
• Paid Time Off and paid holidays
• Remote work flexibility
• Opportunity to support meaningful healthcare impact
Curana Health is ranked No. 147 on the Inc. 5000 list and continues to grow rapidly—creating career paths for professionals who want to make a difference.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Nov 20, 2025 | Uncategorized
Play a key role in improving healthcare outcomes for seniors through accurate, compliant medical coding.
About Curana Health
Curana Health is a national leader in value-based senior care, partnering with senior living communities and skilled nursing facilities to elevate outcomes, streamline operations, and enhance quality of life for older adults. Our rapidly growing organization supports more than 200,000 seniors across 1,500 communities in 32 states. With over 1,000 clinicians and a multidisciplinary team, we’re transforming how senior care is delivered—with compassion, integrity, and innovation at the center.
Schedule
• Full-time, remote
• Standard weekday schedule
• Work-from-home environment with independent workflow management
What You’ll Do
• Perform diagnostic and procedural coding for outpatient and/or inpatient medical records in a multi-specialty environment
• Assign accurate codes and modifiers following industry-standard coding practices
• Meet productivity, quality, and timeliness benchmarks for coding and abstracting
• Apply regulatory requirements and coding guidelines consistently across all cases
• Serve as a subject matter expert and resource for peers
• Complete additional duties assigned by leadership as needed
What You Need
• Coding certification required; RHIA preferred
• Minimum of 3 years of outpatient coding experience preferred
• Bachelor’s degree preferred
• Strong organizational skills and high attention to detail
• Ability to multitask and work independently in a remote environment
• Knowledge of Microsoft Word, Excel, and Outlook
• Experience using 3M Coding Software
Benefits
• Medical, dental, and vision benefits
• 401(k) with company match
• Paid Time Off and paid holidays
• Remote work flexibility
• Mission-driven culture with opportunities for growth
Curana Health is recognized as one of the fastest-growing private companies in the nation, ranking No. 147 on the Inc. 5000 list and No. 16 in Healthcare & Medical—proof of our rapid momentum and impact.
Join a team committed to delivering dignified, high-quality care for seniors while supporting your professional growth.
Happy Hunting,
~Two Chicks…
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