What Jobs are available for Administration in Mesa?

**JOB DESCRIPTION**
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all enrollment and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts. This role is a multi facet internal stakeholder facing position.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Bridge communication and collaboration between IT, PMO, provider network teams and business end users to align objectives and drive coordination of project delivery activities
+ Serve as a business user partner in IT development, providing requirements, input on solution/UI design, and leading user acceptance testing.
+ Lead efforts in identifying and analyzing workflow inefficiencies, recommend process improvements, and collaborate with cross-functional teams to design and implement optimized solutions that enhance operational performance and productivity.
+ Deliver customer-focused support and training to ensure smooth project delivery, successful adoption and effective utilization of implemented solutions
+ Generates and prepares provider-related data and reports in support of Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry Research & Resolution, Provider Contracting/Provider Relationship Management).
+ Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations. Report examples may include: GeoAccess Availability Reports, Provider Online Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports.
+ Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation.
+ Develops and maintains documentation and guidelines for all assigned areas of responsibility.
**JOB QUALIFICATIONS**
**Required Education**
Bachelor's Degree or equivalent combination of education and experience
**Required Experience**
+ 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration.
+ 3+ years' experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 5+ years managed care experience
+ QNXT; SQL experience
+ Crystal Reports for data extraction
+ 3+ years' experience in Salesforce User Interface is required.
+ Experience in User Acceptance Testing is required (UAT).
Pay Range: $77,969 - $106,214 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Work from Home Office, Data Entry Remote Part-Time/Full-time Job

About the Job Position:

This remote entry-level role comes with training for qualified candidates. Depending on your expertise and desired area of interest, the remote duties may include work at home computer data entry, participating in market research activities such as survey design, focus group participation, product testing, social media and more. You may also be asked to assist with data analysis or providing feedback to support our clients in evaluating product potential. The position offers flexible work hours (part-time to full-time) with the opportunity to work from home and influence strategies across various industries, including automotive, healthcare, entertainment and more.

About Us:

Top Level Promotions specializes in market research, partnering with leading global brands to help businesses connect with customers and achieve sustainable growth. We are expanding our remote team and are looking for professionals to contribute valuable insights in a competitive environment.

Some of the Industries in Which We Work.

* Administration * Aerospace – Aviation & Atmosphere Science * Air Travelers & Airlines – International & Domestic Carriers * Amazon * Apparel/Accessories/Textiles – Online/Retail/Remote * Automotive – Design, Development, Manufacturing * Beverage Industry – Trends, Formulations & Technology * Candy/Confectionery – Chocolate, Sugar, Gum Products * Computers – Information and Online Communication Technology * Customer Service * Data Entry & Analytics * Education – Instruction and Training - Work from Home Programs * Film/Movie – Production, Film festivals, Distribution * Health Care – Public & Home Care * Manufacturing – Raw Materials & Machinery * Marketing & Study Design * Outdoor Gear – Outdoor Gear & Equipment * Pet Foods/Supplies/Pet Owners * Restaurants/Food Service * Travel/Tourism – Local/International * Toys – Industry Trends/Changes

Qualifications:

* Applicants are required to have access to home high-speed internet with a stable connection. * A functional home desktop or laptop computer with both camera and microphone capabilities. * It is imperative to have a designated quiet workspace available for work purposes.

Skills:

* Exceptional communication and interpersonal skills. * Strong organizational abilities while working independently. * Proficiency in fundamental computer applications and typing, encompassing email correspondence and data input. * Capacity to manage confidential information in a home office environment. * Attentive to detail and adept at delivering error-free work.

Job Perks:

* Enjoy the convenience of working from your home office, eliminating the need for a daily commute. * No prior experience necessary – all positions include comprehensive training. * Flexible options available for both in-person group meetings and online participation. * Customize your work schedule, whether you prefer part-time or full-time hours. * Contribute to market innovations and assist companies in enhancing their products and services. * Opportunities for career growth within companies based on active participation and seniority.

Salary:

This work from home position pays between 18.50 and 36.00 per hour depending your field of interest.

Experience:

This is an introductory position and training is provided to successful candidates.

Application:

We look forward to reviewing your completed application. If you have any questions or need assistance, please feel free to reach out. Important Note: We are currently only accepting applications from candidates located in Canada, USA, United Kingdom and Australia. Please only apply if you reside in one of these countries.

Sincerely,

Top Level Promotions HR Department

**JOB DESCRIPTION**
**This role will have standard EST business hours.**
**Job Summary**
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Oversees receipt of and coordinates data from the provider network for entry into the plan's provider management system.
+ Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided.
+ Audits loaded provider records for quality and financial accuracy and provides documented feedback.
+ Assists in configuration issues with Corporate team members.
+ Assists in training current staff and new hires as necessary.
+ Conducts or participates in special projects as requested.
**JOB QUALIFICATIONS**
**Required Education**
Associate degree in Business or equivalent combination of education and experience
**Required Experience**
+ Min. 3 years managed care experience
+ Experience in one or more of the following: Claims, Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.
+ Claims processing background including coordination of benefits, subrogation, and/or eligibility criteria.
**Preferred Education**
Bachelor's Degree
**Preferred Experience**
+ 3+ years Provider Claims and/or Provider Network Administration experience
+ Experience in Medical Terminology, CPT, ICD-9 codes, etc.
+ Access and Excel - intermediate skill level (or higher)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**Job Description**
At Boeing, we innovate and collaborate to make the world a better place. We're committed to fostering an environment for every teammate that's welcoming, respectful and inclusive, with great opportunity for professional growth. Find your future with us.
The Boeing Company is seeking a **Senior Project Management Office Stakeholder Integration Focal** to join the team.
The Project Management Office (PMO) Stakeholder Integration Focal is a hands-on, relationship-driven program manager who partners with the PMO and process owners to synchronize plans, schedules, and delivery with our partner, TCS. You'll own a clear book of TCS-related workstreams, translate business needs into executable plans, surface risks early, and drive measurable outcomes. This is one of two focal roles supporting the broader PMO-TCS engagement, so collaboration and consistent communication are essential.
This position allows the candidate to be based out of one of the following: **Everett, WA; Seattle, WA; Auburn, WA; Renton, WA; Chicago, IL; Berkeley, MO; Hazelwood, MO; Mesa, AZ; Herndon, VA; North Charleston, SC; El Segundo, CA; Huntington Beach, CA; Long Beach, CA; Seal Beach, CA; Oklahoma City, OK; Colorado Springs, CO; Plano, TX; San Antonio, TX; Huntsville, AL,** or **Ridley Park, PA.**
**Position Responsibilities:**
+ Serve as the primary PMO contact for a defined set of TCS activities-translate PMO goals into clear tasks, timelines, and success measures
+ Build and sustain strong relationships with internal process owners, TCS teams, and cross-functional stakeholders to keep work aligned and issues resolved quickly
+ Maintain detailed project plans and schedules for your portfolio, tracking milestones and managing changes
+ Use systems such as Workday, ServiceNow, Worklife, and Teams Project Tracker to track progress, manage tasks, and report status, risks, and issues clearly
+ Identify delivery risks and opportunities early; drive mitigation plans and follow-through
+ Manage scope and change control-coordinate approvals, assess impacts, and communicate updates across teams
+ Translate business requirements into prioritized work items and workflow maps to support process owners
+ Coach teams on PMO best practices: schedule discipline, risk management, governance, and status cadence
+ Coordinate handoffs, dependencies, and escalations between internal teams and TCS; flag and remove roadblocks proactively
+ Monitor KPIs and service levels for TCS workstreams and recommend improvements
+ Lead meetings and workshops to align stakeholders, solve conflicts, and accelerate decision-making
+ Work closely with the other PMO focal to ensure consistent processes, shared visibility of risks, and seamless coverage
+ Partner with ISC to ensure contract adherence and facilitate statement of change orders as required
**Basic Qualifications (Required Skills/Experience):**
+ 5+ years of experience directing all phases of assigned cross-organizational or business unit projects demonstrating proficiency in all project management areas in accordance with accepted project management standards
+ 5+ years of experience with leading global teams across multiple time zones
+ 5+ years of experience developing presentations for and presenting to executive leadership
+ 5+ years of experience with any of the following: Project/Program Management, Procurement, Supplier Program Management, Engineering, Production Engineering, and/or Supplier Quality
+ 3+ years of experience using Microsoft Office suite including Word, Excel, PowerPoint and Project
**Preferred Qualifications (Desired Skills/Experience):**
+ Bachelors' degree or Project Management Professional (PMP) certification and 7 years of experience in project and program management in lieu of degree
+ Proven track record managing complex, cross-functional programs with multiple stakeholders and third-party suppliers
+ Strong analytical capability: schedule and variance analysis, risk assessment, and concise executive recommendations
+ Excellent interpersonal and influencing skills; comfortable working with process owners, vendor partners, and senior leaders
+ Hands-on knowledge of change control, baseline management, and program governance.
+ PMP, PgMP, or equivalent certification preferred (or equivalent experience)
Why join us:
+ Impact: Play a central role in optimizing a major delivery partnership and driving measurable outcomes
+ Collaboration: Work across teams and with senior leaders to influence strategy and delivery
+ Growth: Opportunity to refine PMO leadership skills and expand your experience with large-scale vendor engagements
**Drug Free Workplace:**
Boeing is a Drug Free Workplace where post offer applicants and employees are subject to testing for marijuana, cocaine, opioids, amphetamines, PCP, and alcohol when criteria is met as outlined in our policies.
**Pay and Benefits:**
At Boeing, we strive to deliver a Total Rewards package that will attract, engage and retain the top talent. Elements of the Total Rewards package include competitive base pay and variable compensation opportunities.
The Boeing Company also provides eligible employees with an opportunity to enroll in a variety of benefit programs, generally including health insurance, flexible spending accounts, health savings accounts, retirement savings plans, life and disability insurance programs, and a number of programs that provide for both paid and unpaid time away from work.
The specific programs and options available to any given employee may vary depending on eligibility factors such as geographic location, date of hire, and the applicability of collective bargaining agreements.
Pay is based upon candidate experience and qualifications, as well as market and business considerations.
Summary Pay Range: $100,300 - $156,400
Applications for this position will be accepted until **Nov. 01, 2025**
**Export Control Requirements:** This position must meet export control compliance requirements. To meet export control compliance requirements, a "U.S. Person" as defined by 22 C.F.R. §120.15 is required. "U.S. Person" includes U.S. Citizen, lawful permanent resident, refugee, or asylee.
**Export Control Details:** US based job, US Person required
**Relocation**
Relocation assistance is not a negotiable benefit for this position.
**Visa Sponsorship**
Employer will not sponsor applicants for employment visa status.
**Shift**
This position is for 1st shift
**Equal Opportunity Employer:**
Boeing is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national origin, gender, sexual orientation, gender identity, age, physical or mental disability, genetic factors, military/veteran status or other characteristics protected by law.
Boeing is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national origin, gender, sexual orientation, gender identity, age, physical or mental disability, genetic factors, military/veteran status or other characteristics protected by law.

**Become a part of our caring community and help us put health first**
The Manager, Clinic/Center Administration plans and directs the work of professional and support personnel who provide outpatient care to patients in a clinical setting. The Manager, Clinic/Center Administration works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.
The Manager, Clinic/Center Administration helps develop and leads implementation for staffing plans, policies and procedures for the facility and works closely with clinicians to ensure optimal patient outcomes. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
**Use your skills to make an impact**
Required Qualifications: - Must be able to work on-site at assigned Center(s). - 5+ years of operational leadership experience within a multi-physician office or clinical group, including front of house management and clinical operations, along with direct leadership experience and a demonstrated ability to lead, coach, and mentor teams. - Primary Care experience, full-risk VBC experience, understanding of state and federal healthcare regulations. - Experience with Electronic Medical Record (EMRs) or Health Information Management (HIMs) systems and knowledge of various software tools. - Proven interpersonal skills with the ability to interface effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives, medical groups, IPA's, community organizations and other health plan staff. - Job is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. Candidates selected for this job will be required to be screened for TB. - Candidates selected for this job will be required to adhere to Humana's flu vaccine policy. - Current CPR certification Associates working in the State of Florida will need ACHA Level II Background clearance. Preferred Qualifications: - Bachelor's degree, preferably in Business Administration, Healthcare Administration, or a related field; or, in lieu of a bachelor's degree, 5+ years of Healthcare Administration/Leadership experience - Basic knowledge of Population Health Strategy - Familiarity with Medicare - Experience managing a budget of $500,000 **Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$1,100 - 97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About Us**
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options

**Summary**
Dickinson Financial Corporation and its affiliated banks-Academy Bank, N.A. and Armed Forces Bank, N.A.-are in growth mode and rely on experienced commercial banking professionals to reach our growth objective. The Commercial Banking Administrator is responsible for efficient and orderly administrative functions of the assigned commercial banking team. The Commercial Banking Administrator's primary role is understanding all team members' responsibilities and client needs so as to anticipate and provide timely administrative support at an executive level. A successful Commercial Banking Administrator is detail-oriented, organized, willing to take on both basic and complex administrative assignments, understands commercial loan closing and processing, and a stellar communicator in all media.
**Responsibilities**
+ Responsible for all administrative duties of assigned commercial banking team, including for example SalesForce and nCino support for Commercial Banking Officers, processing loan documentation; clearing exceptions; assisting in monitoring tickler files, loan annual reviews, covenant testing, taxes, insurance, and financial documentations; preparing and revising presentation materials; communicating with internal stake holders, inhouse and outside legal counsel, clients and third parties to facilitate loan closings and portfolio maintenance; tracking loan covenants; on-line research; facilitating additional banking services for clients; overseeing routing of documents between stakeholders while accurately maintaining electronic files.
+ Frequently monitors loans in the closing pipeline (SalesForce and nCino); professionally and proactively works with loan officers, clients, inhouse and outside legal counsel, the closing department, loan operations, title companies and all other stake holders to ensure that all loan documentation is accurate and timely and that all closing conditions are met prior to funding; coordinates commercial loan closings with all stakeholders.
+ Assists with more specific loan administration duties of the region or vertical, the specifics of which will depend upon area assigned.
+ Supports Commercial Bankers at all levels with individual professional needs, including submitting expense reports; ordering supplies; scanning, copying, and filing documents; submitting requests for charitable donations; submitting invoices for payment; opening mail; maintaining calendars and the like.
+ Actively improves processes and suggests innovations within team to enhance internal and external client service.
+ Stays knowledgeable about applicable company policies and regulations.
+ Timely completes company-provided training.
+ Understand, communicate, and instill the Company's mission, vision, and values (Pillars of Success).
+ Complete monthly training in a timely manner to ensure knowledge of bank regulatory requirements, policies, and procedures.
+ Working at the worksite during regular business hours and/or assigned hours.
+ Other specified duties as assigned.
**Skills**
+ Strong track record of independently setting and reaching goals, planning, organizing, collaborating, and team building.
+ Excellent interpersonal, verbal, and written communication skills, including a demonstrated ability to communicate effectively and professionally under pressure of strict deadlines.
+ Highly proficient in standard office equipment, including but not limited to computer, copier, scanner.
+ Highly proficient in Microsoft Office suite of products and other standard business applications, such as email system and Intranet applications.
**Education & Experience**
+ High school diploma or equivalent, required.
+ Minimum 3 years' experience assisting Commercial Bankers, or similar experience.
+ General real estate knowledge in an administrative support or similar role, preferred.
+ Prior experience utilizing real estate management information tracking software, preferred.
**Physical Requirements**
The work environment is typical of a standard office or retail banking setting. The position is sedentary, involving sitting most of the workday; however, the position will involve moving about the workspace to reach entrances/exits, restrooms, conference rooms, or other areas within the work environment. Reaching may be required involving the ability to move arms in any direction. Office equipment, such as a computer and telephone, will be used requiring the ability to manipulate a keyboard, mouse, and/or keypad. The ability to decipher a computer screen or written documents is necessary. The ability to express or exchange ideas; impart information to clients, coworkers, or the public; or to convey detailed or important instructions; is required. The ability to receive and understand detailed information shared through oral or written communication is required. Position requires lifting and/or the exerting of up to 10 pounds of force.
**Compensation & Benefits**
The Commercial Banking Admin position pay range is $34.13 - $38.46
Full‐time associates are eligible for our benefits package:
+ Medical
+ Dental
+ Vision
+ 401(k) plan
+ Company paid life insurance
+ Short and Long-term disability insurance
+ Company paid vacation, paid leave and holidays
This position will remain open until a qualified applicant is hired.
Equal Opportunity Employer/Disabled/Veterans
Academy Bank and Armed Forces Bank provides equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, protected veteran status, disability. Academy Bank and Armed Forces Bank provides affirmative action data on protected veteran status or disability. If you need an accommodation for any part of the employment process, please email

**Become a part of our caring community and help us put health first**
The UM (Utilization Management) Administration Coordinator 2 contributes to administration of utilization management. We focus on living out our values daily by creating an environment where you feel valued, respected and treated with kindness. We work and learn together, creating the best solutions for the people we serve. We are committed to fulfilling our purpose by delivering on our commitments to serving our customers with excellence.
As a Utilization Management Coordinator 2, you will be an integral part of a fast-paced, metric-driven team responsible for managing prior authorization requests from providers and members. The role involves sitting at a desk throughout the day and handling approximately 30-50 in-bound calls from providers, with future opportunities to assist with member calls.
**Key Responsibilities:**
+ Responsible for taking inbound calls and assisting providers in determining whether a specific service for a member requires prior authorization or referral, ensuring compliance with established guidelines and processes.
+ Initiate the authorization process by collecting clinical information and verifying medical necessity, ensuring members are not subjected to unnecessary services or expenses.
+ Responds to provider inquiries regarding existing authorizations or referrals, and provides timely updates as needed through fax or inbound phone line, ensuring compliance with organizational policies and applicable federal regulations.
+ Document all call information according to standard operating procedures and attach clinical information when necessary
+ Support members with authorization requests, including outbound calls to provider offices when required.
+ Review resources and data to facilitate positive outcomes for consumers, adapting to ongoing changes in processes and procedures due to CMS regulations.
+ Maintain high-quality standards and meet monthly quality requirements
+ Ability in maneuvering multiple systems simultaneously
+ **Work Shift can be between the hours of 6am-7pm CST, including occasional weekends**
**Core Competencies:**
+ Communicate ideas and updates clearly to team members, actively listen to feedback and concerns, and facilitate open, honest dialogue.
+ Collaborate and contribute effectively to team projects and goals, supporting colleagues and resolving issues that impact the team.
+ Share knowledge, work effectively with cross-functional teams, and coordinate tasks and responsibilities among team members.
+ Identify and address potential conflicts within the team, facilitating constructive discussions to resolve disagreements.
***Be sure to** **include a resume** **with your application***
**Use your skills to make an impact**
**Required Qualifications**
+ Minimum 1 year of customer service experience, including the ability to effectively de-escalate challenging situations
+ **After training, you** **must be available to work any shift between the hours of 6am - 7pm CST and occasional weekends** **based on business needs**
+ Excellent verbal and written communication skills
+ Demonstrated attention to detail
+ Ability to navigate process flows and follow procedure documents
+ Proficient keyboarding skills for data entry and documentation
+ Capacity to multitask across various computer systems while engaging with providers or members
+ Quick aptitude for learning and navigating new technology systems and applications
+ Proficiency in Microsoft Office applications, including Word and Excel
+ A designated workspace, with a closed door, that minimizes distractions and meets leadership approval
+ Must effectively manage personal responsibilities to ensure a professional work environment conducive to achieving performance goals
**Preferred Qualifications**
+ Proficient utilizing electronic medical record and documentation programs
+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
+ Knowledge of Medical Terminology and/or ICD-10 codes
+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
+ Bilingual (English & Spanish) fluent in written and verbal communication
**Additional Information**
**Work-At-Home Requirements**
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided with a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**Interview Format**
As part of our hiring process for this opportunity, we will be using exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first-round interview, you will receive an email correspondence inviting you to participate in a HireVue interview. In this interview, you will receive a set of interview questions over your phone, and you will provide recorded or text message responses to each question. **_For best interview experience use a computer over a phone._** You should anticipate this interview to take about 15-20 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
**Humana Benefits**
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:
Health benefits effective day 1
Paid time off, holidays, volunteer time and jury duty pay
Recognition pay
401(k) retirement savings plan with employer match
Tuition assistance
Scholarships for eligible dependents
Parental and caregiver leave
Employee charity matching program
Network Resource Groups (NRGs)
Career development opportunities
**Social Security Task**
Humana value's personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana's secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$40,000 - $52,300 per year
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our

**JOB DESCRIPTION**
**Job Summary**
Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and services. Also responsible for operational compliance and adherence to federal regulations. Works collaboratively with business and operational units to ensure the Medicare and Dual Eligible operations are supported by effective, accurate and efficient business processes; benefits are accurately defined, communicated, and configured; all member communications are compliant and data exchanges and reports are accurate, timely and meet federal requirements.
**KNOWLEDGE/SKILLS/ABILITIES**
+ The lead demonstrates superior SME on health plan operations and Medicare and MMP program requirements, and is looked to within the department as a leader
+ Assist functional business owners identify and implement operational process improvements
+ Support Medicare-Medicaid plans on Medicare and MMP member retention, performance optimization, MMP reporting, and new member acquisition objectives
+ Support department leaders on wide-ranging assignments involving sales, compliance, analytics, strategy, and policy
+ Develop Medicare Advantage analytic reports.
**JOB QUALIFICATIONS**
**Required Education**
BA/BS degree or minimum equivalent employment experience of 7+ years in Health Care or related field required
**Required Experience**
7+ years of experience in the managed healthcare industry in a health plan or related field with MMP - Medicare-Medicaid plans. Must have strong, quantitative, analytical skills and ability.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $141,371 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**JOB DESCRIPTION**
**Job Summary**
Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and services. Also responsible for operational compliance and adherence to federal regulations. Works collaboratively with business and operational units to ensure the Medicare and Dual Eligible operations are supported by effective, accurate and efficient business processes; benefits are accurately defined, communicated, and configured; all member communications are compliant and data exchanges and reports are accurate, timely and meet federal requirements.
**KNOWLEDGE/SKILLS/ABILITIES**
+ The lead demonstrates superior SME on health plan operations and Medicare and MMP program requirements, and is looked to within the department as a leader
+ Assist functional business owners identify and implement operational process improvements
+ Support Medicare-Medicaid plans on Medicare and MMP member retention, performance optimization, MMP reporting, and new member acquisition objectives
+ Support department leaders on wide-ranging assignments involving sales, compliance, analytics, strategy, and policy
+ Develop Medicare Advantage analytic reports.
**JOB QUALIFICATIONS**
**Required Education**
BA/BS degree or minimum equivalent employment experience of 7+ years in Health Care or related field required
**Required Experience**
7+ years of experience in the managed healthcare industry in a health plan or related field with MMP - Medicare-Medicaid plans. Must have strong, quantitative, analytical skills and ability.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $141,371 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.