About Pair Team At Pair Team, were an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social -
JOB DESCRIPTION Job Summary Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets.
JOB DESCRIPTION Job Summary Responsible for the Management of internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as
Pharmacist In Um/Prior Authorization Department Molina Healthcare is hiring for a pharmacist in our UM/Prior Authorization department. This position is remote and can be worked from a variety of locations within the US. Shift times can
Job Title Must reside in Florida Job Summary Provides lead level clinical support to healthcare services team supporting one or more of the following functions: care management, utilization management, care transitions, long-term services and supports (LTSS), behavioral health,
P2S stands as a provider of professional engineering services to a broad range of markets, including higher education, healthcare, ports/harbors, industrial, entertainment, commercial, laboratories, municipal, and federal sectors. Our specialties include electrical, mechanical, plumbing, fire protection,
OVERVIEW: Our client, a US Fortune 1,000 company and a major process services provider to Government Health and Human services agencies in the US, seeks an accomplished “Bilingual Customer Service Rep (Local-REMOTE)” Position: Bilingual Customer Service
Overview: Our client, is a U.S. Fortune 1,000 company and a major process services provider to government health and human services agencies in the United States seeks a Bilingual Customer Service representative. * Candidate must be
Are you an experienced wage and hour attorney who is passionate about advocating for employees and handling impactful class action litigation? Are you looking to join a highly respected plaintiffs’ litigation team known for taking on
Job Description Shift: M-F 9:30am - 6pm Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. Essential Job Duties Provides support
Job Description Job Summary: Provides support for coordination of benefits review activities that directly impact medical expenses and premium reimbursement. Responsible for primarily coordinating benefits with other carriers responsible for payment. Facilitates administrative support, data entry,
Job Description 8am - 5pm Monday - Fri with alternative weekends Job Summary Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives
Job Title Provides entry level support for Molina enterprise credentialing activities. Ensures that the Molina provider network consists of providers that meet all regulatory and risk management criteria - effectively minimizing liability to the company and maximizing
Senior Level Audit Support Provides senior level audit support for delegation oversight activities. Responsible for ensuring delegates are compliant with the applicable state, federal, contractual requirements, National Committee for Quality Assurance (NCQA), and Molina requirements for
Job Title Provides senior level analyst support for risk-based process design initiatives leveraging a depth of internal audit, Sarbanes-Oxley (SOX), information technology and/or business experience to interpret significance of assessment findings, identify process improvement opportunities, develop
Job Title Provides analyst support for configuration oversight activities. Responsible for accurate and timely implementation and maintenance of critical information on claims/provider databases, validating data housed on databases and ensuring adherence to business and system requirements
Pharmacy Technician Provides support for pharmacy Medication Therapy Management (MTM) activities. Contributes to overarching pharmacy strategy to ensure member access to medically necessary prescription drugs, optimization of medication related health care outcomes, and quality cost-effective member care.
Care Manager RN Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure
Job Title Provides subject matter expertise and leads the deployment and integration of clinical programs, technologies, and workflows, ensuring alignment with regulatory requirements and organizational goals. Acts as a liaison between clinical, technical, and administrative teams, focused
Job Title Provides senior level analyst support for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance. Essential Job Duties Extracts and compiles