by Irma Moore | Aug 30, 2024 | Uncategorized
Description
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
Coram/CVS Health is looking for a high-energy healthcare professional to join our national team as a Benefit Verification Specialist! This rewarding opportunity allows you to work closely with our Patient Intake Coordinators and insurance providers to verify coverage for in-home IV therapy for Coram’s patients. We believe that Benefit Verification Specialists are a key part of creating a positive experience for our patients.
In this dynamic and fast-paced role, you will be responsible to verify insurance coverage, perform benefit investigation, and obtain prior authorization for both new and existing patients in order to process patient prescription orders in a timely manner while demonstrating excellent customer service directly to patients, healthcare professionals and insurance carriers.
This role will require an understanding of insurance carriers and concepts including drug cards, major medical benefits, and per diem coverage as well as knowledge of government and patient assistance programs.
The schedule for this position is Monday – Friday with hours between 7:30am-6pm CST. Colleague will be required to work mandatory overtime/extended work week when needed, as well as regular and predictable attendance. This role may require on-call scheduling based on departmental need. Preference will be given for later shift availability. This is a Work At Home role, which requires access to an appropriate work space that will ensure HIPPA compliance, privacy and consistent internet strength and availability.
Required Qualifications
– Analytical and problem-solving skills
– Attention to detail
– Ability to work independently
– Experience working in Microsoft Office, specifically Excel, Outlook and Word
– Strong computer skills
Preferred Qualifications
– Minimum one year experience working in a healthcare environment
– Experience working with health care insurance and medical terminology.
– Knowledge of Medicare, Medicaid, and third-party vendors
– Prior direct customer service experience (medical field preferred)
– Epic experience
Pay Range
The typical pay range for this role is:
$17.00 – $28.46
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health
We anticipate the application window for this opening will close on: 11/28/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
by Irma Moore | Aug 30, 2024 | Uncategorized
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
If you reside near Strongville, OH, you will enjoy the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
- Conduct root cause analysis on all issues and recommend a corrective action plan.
- Ensure timely update to stakeholders -Identify and mitigate risks/issues related to environments
- Provides accurate & timely reports to stake holders
- Experienced Cloud Services Engineer with experience using AWS/Azure/Google Cloud, IAAS, Configuration and Deployment, Container Based Deployments using Dockers, CICD Tools like Jenkins, System and Application Monitoring, Splunk and/or Dynatrace
- Maintain and Manage Cloud Services and Container Based systems using various tools
- Design, develop and deploy software applications and solutions across cloud platform
- Design software release process and policy, automate cloud infrastructure, perform code reviews
- Test, performance tune, code, debug, track defects, troubleshoot problems, resolve technical errors, generate reports, provide production support, etc.
- Provide post deployment support and to quickly respond to and resolve unexpected service problems in production
- Constantly improve functionality, reliability, testability, availability, latency, scalability, and efficiency of applications
- Adhere to version control, release management, and deployment protocols to distribute new functionality to the user base
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Bachelor’s Degree in Computer Science or a related field
- 5+ years of experience working on AWS/Azure/Google Cloud, IAAS, Configuration and Deployment, Container Based Deployments using Dockers, CICD Tools like Jenkins, System and Application Monitoring, Splunk and/or Dynatrace
- 5+ years of experience on JAVA, JavaScript, SQLServer and other relevant technology Exposure on Cloud Application development (full development cycle)
- 3+ years of experience on Continuous Integration and Delivery, DevOps implementation
- 3+ years of experience in Web services – Restful and Soap details
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
by Irma Moore | Aug 30, 2024 | Uncategorized
You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You’ll work with dynamic colleagues – experts in their fields – who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you’ll have new and exciting opportunities to make life brighter for our Clients – who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.
Job Description:
Location: We support US flexible working arrangements in the contiguous 48 states.
At Sun Life, we look for optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you’ll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America.
The opportunity:
The Policy Administrator is responsible for timely transactions and data integrity of underwriting information in the Administrative System. Provides ongoing maintenance of all policy plan design information for each policyholder in the Administrative System, including adding new cases and correcting existing ones.
How you will contribute:
- Complete upfront review process for sold cases using documented procedures, consulting with Underwriting when appropriate
- Accurately load sold cases and plan changes on the system within specific timeframes
- Ensure accurate analysis and policy plan design coding of all cases on the system
- Re-rate or run accurate final rate calculation on cases from clients within specified limits
- Research any necessary items for Claims and Underwriting with knowledge of all downstream impacts
- Complete risk analysis, assessment and decision making when applicable during case reviews and/or initial set up.
- Perform quality review check of applications, contract plan designs and rating systems when setting up new cases
- Work product supports any necessary metrics in place within the department and meets departmental goals
- Accurately track workflow processes, including sold case, amendments, and terminations
- Complete tasks in a self-sufficient manner, maintaining satisfactory productivity and accuracy levels
- Act as a primary contact on a client assignment assigned to two or more Policy Specialists
- Assist in developing Policy Services manual, guidelines, and job aides, ensuring the accuracy of information provided
- Participate in special departmental projects as assigned
What you will bring with you:
- 1-year previous work experience required
- High School diploma or equivalent required
- 1-2 years insurance industry experience preferred; preferably with a background in compliance, underwriting support and/or policy issuance
- Knowledge of disability and life insurance contract language provisions preferred
- Good computer skills; proficient in a PC environment, with basic skills in Excel, Word and e-mail systems
- Ability to initiate and prioritize regular work duties and small projects
- Ability to multitask, be detail oriented, organized and exercise good time management skills
- Good communication skills, both written and verbal
- Good analytical skills, with the ability to effectively problem solve and implement solutions
- Customer service focused, following up on requests and implementing changes when needed
- Ability to work professionally and effectively with co-workers, clients, claimants, vendors and others with whom DRMS does business
Do you see yourself in this role even if you haven’t checked all the boxes above? We welcome all talented candidates and are committed to a culture that represents diversity in all forms. If you think you might thrive in this setting, we would love to hear from you.
Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!
Life is brighter when you work at Sun Life
- Excellent benefits and wellness programs to support the three pillars of your well-being – mental, physical, and financial – including generous vacation and sick time, market-leading paid family, parental and adoption leave, a partially-paid sabbatical program, medical plans, company paid life and AD&D insurance as well as disability programs and more
- Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account
- A flexible work environment with a friendly, caring, collaborative and inclusive culture
- Great Place to Work® Certified in Canada and the U.S.
- Named as a “Top 10” employer by the Boston Globe’s “Top Places to Work” two years running
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
If you are a California resident, the salary range for this position is:
- Southern California region: $41,700 – 56,300 annually
- Central California region: $43,900 – 59,300 annually
- Northern California region: $47,000 – 63,500 annually
If you are a Minnesota, Colorado or Nevada resident, the salary range for this position is $39,700 – 53,600 annually
If you are a Illinois, Connecticut or Maryland resident, the salary range for this position is $41,700 – 56,300 annually
If you are Washington, Washington D.C., and Rhode Island resident, the salary range for this position is $43,900 – 59,300 annually
If you are a New York resident, the salary range for this position is $47,000 – 63,500 annually
- The full range minimum and maximum listed in the job posting is tied to the GCF level and job family.
We consider various factors in determining actual pay including your skills, qualifications, and experience. In addition to salary, this position is eligible for incentive awards based on individual and business performance as well as a broad range of competitive benefits.
Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives. More than just a name, Sun Life symbolizes our brand promise of making life brighter -for our customers, partners, and communities. Join our talented, diverse workforce and launch a rewarding career. Visit us at www.sunlife.com/us to learn more.
At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.
by Irma Moore | Aug 30, 2024 | Uncategorized
Clari’s Revenue platform gives forecasting accuracy and visibility from the sales rep to the board room on revenue performance – helping them spot revenue leak to answer if they will meet, beat, or miss their sales goals. With insights like this, no wonder leading companies worldwide, including Okta, Adobe, Workday, and Zoom use Clari to drive revenue accuracy and precision. We never get tired of our customers singing our praises because it fuels us to help them continue to achieve remarkable. The next generation of revenue excellence is here…are you ready to achieve remarkable with us?
About the Team
The Revenue team’s mission at Clari is to lead the company and the market by selling the only platform purpose-built to run revenue. Our team’s purview spans all things revenue — operations, new logos, account management, and sales development — as well as enablement, programs, sales engineering, and value engineering. We’re responsible not just for creating and closing high-velocity pipelines, but also the programs and training that help turn pipelines into revenue.
About the Role
Clari is hiring a Senior Sales Engineer to help expand our customer base and grow new revenue. Your day-to-day will focus on helping large, complex organizations drive greater revenue predictability across their global customer-facing, revenue teams. If you thrive in high-growth environments and want to prove you can sell to the best CROs and VPs of Sales in the world, Clari is the place for you.
This is a fully remote opportunity and can be worked from any location in the United States.
Responsibilities
- Deliver world-class, value narrative demos to executive audiences
- Understand customers’ revenue objectives and consult how to improve revenue processes to achieve them
- Design and manage the technical and product strategy in deals
- Own all technical aspects of the sales cycle including discovery, security, custom demonstrations, and RFP’s
- Partner with cross-functional departments on strategic company projects focused on accelerating growth, expanding our market, and building for our future
- Advise product teams on capabilities needed to best support prospects and customers
Qualifications
- 5+ years of experience in a pre-sales, customer-facing role: Solutions Engineer, Solutions Consultant, Sales Engineer, Solutions Architect, etc.
- Salesforce administration or development experience is required
- Proven track record of winning software deals, with C-suite and Sales, at enterprise accounts
- Experience running and managing enterprise-level proof of concepts (POC) required
- Reliable professional with a growth mindset who will hit the ground running
- Remarkable communications skills (presentation, written, and verbal) and executive presence
- Experience with installing and administering SaaS applications
- Working knowledge of APIs and enterprise systems architecture
- Experience with the Revenue Operations landscape is a plus
- Working knowledge of Data Warehousing and common schema structures preferred but not required
- Salesforce certifications preferred but not required
- Basic JSON knowledge preferred but not required
Perks and Benefits @ Clari
- Remote-first with opportunities to work and celebrate in person
- Medical, dental, vision, short & long-term disability, Life insurance, and EAP
- Mental health support provided by Modern Health
- Pre-IPO stock optionsWell-being and professional development stipends
- Retirement 401(k) plan
- 100% paid parental leave, plus fertility and family planning support provided by Maven
- Discretionary paid time off, monthly ‘take a break’ days, and Focus Fridays
- Focus on culture: Charitable giving match, plus in-person and virtual events
#BI-Remote
#LI-Remote
You’ll often hear our CEO talk about being remarkable. To Clari, remarkable means many things. We believe in providing interesting and meaningful work in a supportive and inclusive environment – free from discrimination for everyone without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, gender identity, or veteran status.
Clari focuses on culture add, not culture fit, and believe we are made stronger by what makes you unique. If you are passionate about learning and excited about what we are doing, then we want to hear from you!
by Irma Moore | Aug 30, 2024 | Uncategorized
ClassDojo’s goal is to give every child on Earth an education they love.
We started by building a powerful network for communication. ClassDojo’s flagship app is the #1 communication app connecting K-8 teachers, children, and families globally. Teachers use it to share what’s happening throughout the day through photos, videos, and messages that make parents feel like they’re there. It’s actively used in over 95% of US schools, reaching over 50 million children in 180 countries, with a team of just around 200 people [1]. We are now beginning to use this network to give kids the best learning experiences in the world, far beyond those a standard school can provide.
We hire for talent density. Our team comprises the most talented, entrepreneurial, and innovative teammates from around the world, with experience in education and large scale consumer internet companies, including Instagram, Netflix, Dropbox, Stripe, Uber, Y Combinator, and more. We’re building a company where the most talented people want to work. We believe you’ll do the best work of your life here—and you’ll pioneer the future of education, too.
What you’ll do:
ClassDojo is looking for people to join our virtual worlds platform team. Dojo Islands, our virtual playground, is being used by millions of kids in classrooms and at home. The world is procedurally generated and user customizable. Students use this in the classrooms to learn to work collaboratively to build on the island and teachers can use this to set up STEM activities for the kids to collaborate on. The virtual world is built using web technologies with the goal that it is performant and scalable on the low end devices used in schools or at home. This includes a wide range of chromebooks, tablets (iOS and Android) and web browsers.
The Engine & Tools team is responsible for delivering the proprietary engine and homegrown editor that powers the creation of the open virtual world. As an engineer on the team, you will be working on the cutting edge of web technologies including WebGL and WebGPU. You will be bringing your expertise in one or more of the game subsystems like rendering, networking, avatars and performance engineering to help us deliver the highest quality game to our players. You will do that while collaborating with other engineers and cross-functional team members in a continuous delivery environment. As with any other team in ClassDojo, this team also follows agile kanban methodology and strikes a tight balance between iteration and building with a long view.
You will be a match if you have:
- 7+ years of experience working on game engine technologies including one or more areas across rendering, networking, physics and runtime data model with deep expertise in at least one of the areas.
- Track record of delivery complex features in a CI/CD environment.
- Experienced in near real-time responsiveness in LiveOps platforms
- Track record of delivering online multiplayer experiences at platform scale
- Demonstrated technical leadership driving engineering practices and processes with clear outcomes.
You might be a good match if you have:
- Experience with WebGL
- Playcanvas experience is a bonus!
- Experience with web development workflows including but not limited to
- Node.js, Javascript, Typescript
- React
- Experience and familiarity of working with DevOps and Platform Infrastructure such as:
- AWS Cloud Infrastructure (EC2, Lambda, DynamoDB)
- Cloud infrastructure for deployment, scaling and optimization (e.g. Terraform, Docker, Consul, Nomad)
- MySQL, MongoDB, Redis
- Azure PlayFab game services
Bonus if you are:
- An avid learner curious about new technologies especially in the confluence of AI and content creation
- An open source code contributor
[1] Some more context:
(If you are on LinkedIn, you will not be able to access the hyperlinks below. Once you click apply, you will be directed to our career website (if you are not on there already) and will be able to access the hyperlinks)
– ClassDojo’s $125m Series D (Forbes) and Sam’s note about it.
– ClassDojo is one of Y Combinator’s Top 100 companies
– ClassDojo’s Second Act Comes with First Profits (TechCrunch) and Sam’s note about it.
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. In accordance with the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are happy to accommodate any disabilities or special needs. We are a distributed company, so we hire regardless of location, as long as you are willing to have significant hours overlap with one of the Americas time zones.
ClassDojo takes a number of factors into consideration when determining compensation, including geographic location, experience, and skillset. Salary ranges (United States):
CA, WA, NY, NJ, CT states: $171,500 – $244,000 (USD)
All other states in the US: $146,000 – $207,500 (USD)
by Irma Moore | Aug 29, 2024 | Uncategorized
About the Role:
Under the Quality department, the Clinical Operations team leads the efforts that improves health outcomes by coordinating and delivering key clinical care. Through outreach and education, we inspire patients to take a preventive approach to maintaining their health and to be active in their chronic disease management. Together, we strive to achieve healthy living for all through all stages of life.
As a Medical Coder, you are part of a patient-centered team that provides support for our clinical teams. You will follow up on post-visit documents from clinical providers, communicate and review documentation issues and queries with providers, and enter accurate codes for claims across our various programs. This role will report to the Coding & Billing Supervisor.
What You’ll Do:
- Review provider documentation of diagnostic data from medical record to verify that all Medicare Advantage and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
- Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)
- Perform thorough review on the surveys and medical records provided by our nurse practitioners to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines
- Interacts with our team of providers regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
- Verify patient eligibility with insurance as needed, maintaining an open line of communication with all insurance carriers including follow-up, denials, and appeals
- Bill, post, review, and analyze superbills from providers to ensure accuracy in codes as per billing guidelines
- Other duties in support of department programs and goals
Qualifications:
- High School diploma/GED or higher education
- Must possess and maintain AAPC or AHIMA certification, & Certified Coding Specialist (CCS-P), CCS, CPC
- Minimum of two years of experience in medical coding
- PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
You’re great for this role if you have:
- Certified Risk Adjustment Coder (CRC)
- Knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
- General knowledge of medical billing
- Knowledge in insurance verification & eligibility
- Experience with Medicare STAR metrics and HEDIS measures
- Experience using EHR systems
- Honesty, integrity, and team-oriented mentality
- Value quality over quantity
Who We Are:
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
Our platform currently empowers over 10,000 physicians to provide care for ~1 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
Environmental Job Requirements and Working Conditions:
- This is a remote position. The home office is located at 568 W. Garvey Ave., Monterey Park, CA 91754.
- The total compensation target pay range for this role is: $19.00-24.00 per hour. The range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.
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