Own and manage assigned health plan accounts as the primary point of contact.
Build strong, trusted relationships with clients, handling escalations professionally.
Coordinate with internal teams to track and resolve complex client issues promptly.
They are focused on connecting candidates with jobs through an AI-powered matching process. They value engagement, offer continued learning opportunities, and encourage community involvement.
Collaborate cross-functionally to resolve issues and ensure full renewals and expansion.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly. They connect candidates with employers, and internal teams manage the final hiring decisions.
Makes outbound calls to educate prospective patients and schedule provider visits.
Understands patient requirements and asks questions to gain trust and understanding.
Acts on opportunities to provide value to the patient through information about Strive Health programming.
Strive Health is dedicated to transforming the kidney care system through early identification, engagement, and coordinated care. They aim to improve outcomes for people with kidney disease, integrating with local providers and utilizing predictive data to support patients' care journey.
Provide compassionate support and expert guidance to Medicaid recipients.
Address inquiries and resolve issues to impact the health and satisfaction of clients.
Join a dynamic team dedicated to making a difference in the lives of underserved communities.
Avesis has been providing essential ancillary benefit solutions since 1978. Today, their programs cover more than 8.5 million members throughout the country. They strive for excellence in all that they do and their benchmark performance in terms of member satisfaction and client retention underscores this singular focus.
Supervise a team of appeals and grievances coordinators; develop/implement strategies to improve team performance and efficiency.
Receive, document, and manage member and provider appeals and grievances in accordance with Dignity Health MSOs policies and standards. Prepare and present reports on appeals and grievances activity.
Maintain detailed and accurate records of all appeals and grievances, including documentation of investigations, outcomes, and communications.
Dignity Health MSO offers management and business services that leverage economies of scale across provider types and geographies, leading the effort in developing Dignity Health’s Medicaid population health care management pathways. They focus on coordinating patient care while containing costs and improving quality of service. The company offers a Total Rewards package that integrates competitive pay with flexible Health & Welfare benefits and a generous employer-matched 401k retirement plan.
Responsible for being the main point of contact for TPA (an external client) for new group implementations.
Ensure all requirements are documented in the standard project templates and tools.
Manage day to day coordination and task managements for a pod of Implementation Managers and/or Implementation Specialists to maintain workplace productivity.
SmithRx is a rapidly growing, venture-backed Health-Tech company aiming to disrupt the Pharmacy Benefit Management (PBM) sector. They accomplish this through technology and customer service, with a mission-driven and collaborative culture that inspires employees.
Provide a seamless, high-quality support experience to members
Assist members with insurance education, eligibility, and enrollment support
Submit applications to carriers and own cases through approval
Vitable is a health benefits platform making healthcare better for employers of everyday workers. They bring accessible, high-quality care to over 85 million uninsured and underinsured Americans. Vitable is growing rapidly and looking for eager team members who are hungry for change and passionate about delivering better care to the everyday worker.