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Showing 44 Specialty Shops jobs in West Palm Beach
Director, Specialty Accreditation - Remote
Posted 7 days ago
Job Viewed
Job Description
**Job category:** Medical & Clinical Operations
**Explore opportunities with CPS,** part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.**
As a **Director of Accreditation with CPS Solutions, LLC (CPS)** Specialty and Ambulatory team, you will work under the direction of and in collaboration with the Senior Director, Accreditation Specialty and Ambulatory Services. You will be responsible for overseeing the quality control of the organization's specialty pharmacy operations to include accreditation management/maintenance, staff education, auditing, reporting management, compliance, policy review/management, etc., and ultimately impacting the quality of service that we provide to our customers and their patients.
**This is a 60%+ travel position, home-based.**
You'll enjoy the flexibility to work remotely * from anywhere within the Pacific or Mountain time zones as you take on some tough challenges.
**Primary Responsibilities:**
+ Provide system-wide strategic leadership for pharmacy services across multiple hospitals and care settings, ensuring alignment with organizational goals.
+ Lead and develop pharmacy leadership teams, including hospital pharmacy directors and managers, ensuring consistency and accountability
+ Ensure enterprise-wide regulatory and accreditation compliance, overseeing readiness for audits and inspections across all sites
+ Oversee system-level financial performance, including contracting, purchasing strategies, and cost-reduction initiatives
+ Drive innovation, scalability and growth of pharmacy services, advancing technology, analytics and new models of care across the health system
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:**
+ 5+ years of pharmacy or healthcare experience in a Quality of Accreditation role
+ Deep understanding or the ability to learn specialty pharmacy accreditation standards, with emphasis on URAC and ACHC accreditation
+ Willingness and/or ability to travel for varying lengths of time away from home by plane or car
+ Active driver's license and access to reliable transportation
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 - $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_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._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
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Job Description
**Minimum Requirements:**
+ Must hold at least one of the following certifications: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H (COC) for a minimum of 2 years and have a minimum of 2 years relevant coding experience
+ Must be at least 18 years of age
**Benefits**
At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:
+ Competitive pay & weekly paychecks
+ Health, dental, vision, and life insurance
+ 401(k) savings plan
+ Awards and recognition programs
*Benefit eligibility is dependent on employment status.
**About Amergis**
Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions.
Amergis is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
**Job Category:** Revenue Cycle
**Job Function:** Revenue Cycle | Inpatient Medical Coder | Inpatient Medical Coder
**Job Type:** Contract - Full Time
**Setting:** Healthcare Facilities
**Position Type:** Healthcare
**Office Number:** 0774
**Contract Duration:** 52
**Pay Rate:** $1080 / Week
**Date Posted:** T18:19:05
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Specialty Coder II (REMOTE)
Posted 17 days ago
Job Viewed
Job Description
**Position Details:**
+ **Location:** Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina)
+ **Status:** Full time (non-exempt)
+ **Shift:** 8:00AM - 4:30PM
+ **Days:** Monday through Friday
This Specialty Coder II opportunity is a full-time remote position. This team member must reside in the state of Florida, George, North Carolina, or South Carolina.
_Sign on bonuses available!_
**Responsibilities:**
+ The Specialty Coder II is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD-10 CM and CPT-4 coding systems.
+ The Specialty Coder audits physician documentation to assign appropriate CPT codes, diagnosis codes, and modifiers related to anesthesia coding and billing as well as anesthesia minutes.
+ Mentors and training of other Specialty Coders.
+ Serves as a resource for the department.
+ Performs other duties as assigned.
**Preferred Coding Specialties**
+ Anesthesia
+ General Surgery
+ Cardiothoracic Surgery
+ Neurosurgery
+ Pediatric/ Preemie Surgery
**Why BayCare?**
Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that is built on a foundation of trust, dignity, respect, responsibility, and clinical excellence. Our team members focus on tomorrow by achieving personal and professional success today. That is why you will thrive in our forward-thinking culture, where we combine the best technology with compassionate service. We blend high-tech with high touch in ways that are advancing superior health care throughout the communities we serve.
**BayCare offers a competitive total reward package including:**
+ Benefits (Medical, Dental, Vision)
+ Paid Time Off
+ Tuition Assistance
+ 401K Match and additional yearly contribution
+ Annual performance appraisals and team award bonus
+ Family resources and wellness opportunities
+ Community perks and discounts
**Certifications and Licensures**
+ Required Certified Professional Coder (CPC) OR Certified Coding Specialist (CCS) OR Certified Coding Specialist - Physician Based (CCS-P)
**Education**
+ Required High School or equivalent
+ Preferred Associate Degree
**Experience**
+ Required 2 years Coding
+ And 1 year of Medical Office related experience
Equal Opportunity Employer Veterans/Disabled
**Position** Specialty Coder II (REMOTE)
**Location** Tampa | Business and Administrative | Full Time
**Req ID**
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Remote Insurance Verification Specialist, Specialty (Michigan)
Posted 9 days ago
Job Viewed
Job Description
**Job Summary:**
Responsible for verifying patient eligibility, coordinating benefits, running test claims, and determining patient coverage/responsibility for services. Handles inbound and outbound calls with customers, physician offices, patients or third-party providers about the company's products or services following standard SOPs and procedures, working under direct supervision. Ensures all contacts receive efficient and courteous service.
**Job Responsibilities:**
+ Respond to all levels of inbound Pharmacy Benefit Manager (PBM) and major medical insurance related phone calls.
+ Resolves questions and problems submitted by customers and Pharmacy Benefit Manager (PBM) following established guidelines and standard SOPs and procedures. Utilizes all available information to choose the best solution and resolve customer and PBM concerns.
+ Requests and loads PBM and/or Major Medical insurance plans.
+ Processes all non-clinical PBM rejections which may include but not limited to rejections for plan limits, coverage termed or prior authorization.
+ Assists physicians in the prior authorization process including initiation of prior authorizations.
+ May be cross-trained and/or work on Major Medical (MM) and Specialized PBM Plans.
+ Verifies benefits for Major Medical via online resources or over the phone. Confirms network status, reviews FDA guidelines, and prior authorization requirements to ensure payment of claims.
+ Resolves questions and problems submitted by customers and Major Medical plans following established guidelines and standard SOPs and procedures. Utilizes all available information to choose best solutions and resolves customer and plan covers.
+ Facilitates the reimbursement windshields for PBM major medical claims.
+ Identifies and assesses individual customer or patient needs and provide education on or assist with grant applications, complex funding needs, commercial copay assistance enrollment along with appropriate action to satisfy those needs.
+ Provides primary support and expertise for specialized programs such as the patient assistance program or special handling.
+ Manages Pharma requirements including but not limited to warm transfers, bridge/quick start, enhanced prior authorization and appeal support.
+ May administer order queue such as Submission Problems or Waiting for Payment.
+ Documents contact interactions, records details, complaints, comments, and actions taken.
**About Walgreens**
Founded in 1901, Walgreens ( proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.
**Job ID:** BR
**Title:** Remote Insurance Verification Specialist, Specialty (Michigan)
**Company Indicator:** Walgreens
**Employment Type:**
**Job Function:** Customer Contact Center
**Full Store Address:** 108 WILMOT ROAD,DEERFIELD,IL 60015
**Full District Office Address:** 41460 HAGGERTY CIR S,CANTON,MI, -S
**External Basic Qualifications:**
+ High school diploma/GED
+ Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction in healthcare, specialty pharmacy, PBM, call center setting or other related industry
+ Ability to communicate clearly and effectively (written and verbal). Good interpersonal skills with the ability to communicate in a diplomatic and confidential manner
+ Basic level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).
**Preferred Qualifications:**
+ Experience with providing customer service related to adherence, complex disease states quality, After Call Work (ACW), etc.
+ Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
+ Intermediate level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).
We will consider employment of qualified applicants with arrest and conviction records.
The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits
**Shift:**
**Store:**
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Remote Insurance Verification Specialist, Specialty (Pennsylvania
Posted 9 days ago
Job Viewed
Job Description
**Job Summary:**
Responsible for verifying patient eligibility, coordinating benefits, running test claims, and determining patient coverage/responsibility for services. Handles inbound and outbound calls with customers, physician offices, patients or third-party providers about the company's products or services following standard SOPs and procedures, working under direct supervision. Ensures all contacts receive efficient and courteous service.
**Job Responsibilities:**
+ Respond to all levels of inbound Pharmacy Benefit Manager (PBM) and major medical insurance related phone calls.
+ Resolves questions and problems submitted by customers and Pharmacy Benefit Manager (PBM) following established guidelines and standard SOPs and procedures. Utilizes all available information to choose the best solution and resolve customer and PBM concerns.
+ Requests and loads PBM and/or Major Medical insurance plans.
+ Processes all non-clinical PBM rejections which may include but not limited to rejections for plan limits, coverage termed or prior authorization.
+ Assists physicians in the prior authorization process including initiation of prior authorizations.
+ May be cross-trained and/or work on Major Medical (MM) and Specialized PBM Plans.
+ Verifies benefits for Major Medical via online resources or over the phone. Confirms network status, reviews FDA guidelines, and prior authorization requirements to ensure payment of claims.
+ Resolves questions and problems submitted by customers and Major Medical plans following established guidelines and standard SOPs and procedures. Utilizes all available information to choose best solutions and resolves customer and plan covers.
+ Facilitates the reimbursement windshields for PBM major medical claims.
+ Identifies and assesses individual customer or patient needs and provide education on or assist with grant applications, complex funding needs, commercial copay assistance enrollment along with appropriate action to satisfy those needs.
+ Provides primary support and expertise for specialized programs such as the patient assistance program or special handling.
+ Manages Pharma requirements including but not limited to warm transfers, bridge/quick start, enhanced prior authorization and appeal support.
+ May administer order queue such as Submission Problems or Waiting for Payment.
+ Documents contact interactions, records details, complaints, comments, and actions taken.
**About Walgreens**
Founded in 1901, Walgreens ( proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.
**Job ID:** BR
**Title:** Remote Insurance Verification Specialist, Specialty (Pennsylvania
**Company Indicator:** Walgreens
**Employment Type:**
**Job Function:** Customer Contact Center
**Full Store Address:** 108 WILMOT ROAD,DEERFIELD,IL 60015
**Full District Office Address:** 130 ENTERPRISE DR,PITTSBURGH,PA, -S
**External Basic Qualifications:**
+ High school diploma/GED
+ Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction in healthcare, specialty pharmacy, PBM, call center setting or other related industry
+ Ability to communicate clearly and effectively (written and verbal). Good interpersonal skills with the ability to communicate in a diplomatic and confidential manner
+ Basic level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).
**Preferred Qualifications:**
+ Experience with providing customer service related to adherence, complex disease states quality, After Call Work (ACW), etc.
+ Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
+ Intermediate level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).
We will consider employment of qualified applicants with arrest and conviction records.
The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits
**Shift:**
**Store:**
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Remote Insurance Verification Specialist, Specialty (Texas)
Posted 7 days ago
Job Viewed
Job Description
**Job Summary:**
Responsible for verifying patient eligibility, coordinating benefits, running test claims, and determining patient coverage/responsibility for services. Handles inbound and outbound calls with customers, physician offices, patients or third-party providers about the company's products or services following standard SOPs and procedures, working under direct supervision. Ensures all contacts receive efficient and courteous service.
**Job Responsibilities:**
+ Respond to all levels of inbound Pharmacy Benefit Manager (PBM) and major medical insurance related phone calls.
+ Resolves questions and problems submitted by customers and Pharmacy Benefit Manager (PBM) following established guidelines and standard SOPs and procedures. Utilizes all available information to choose the best solution and resolve customer and PBM concerns.
+ Requests and loads PBM and/or Major Medical insurance plans.
+ Processes all non-clinical PBM rejections which may include but not limited to rejections for plan limits, coverage termed or prior authorization.
+ Assists physicians in the prior authorization process including initiation of prior authorizations.
+ May be cross-trained and/or work on Major Medical (MM) and Specialized PBM Plans.
+ Verifies benefits for Major Medical via online resources or over the phone. Confirms network status, reviews FDA guidelines, and prior authorization requirements to ensure payment of claims.
+ Resolves questions and problems submitted by customers and Major Medical plans following established guidelines and standard SOPs and procedures. Utilizes all available information to choose best solutions and resolves customer and plan covers.
+ Facilitates the reimbursement windshields for PBM major medical claims.
+ Identifies and assesses individual customer or patient needs and provide education on or assist with grant applications, complex funding needs, commercial copay assistance enrollment along with appropriate action to satisfy those needs.
+ Provides primary support and expertise for specialized programs such as the patient assistance program or special handling.
+ Manages Pharma requirements including but not limited to warm transfers, bridge/quick start, enhanced prior authorization and appeal support.
+ May administer order queue such as Submission Problems or Waiting for Payment.
+ Documents contact interactions, records details, complaints, comments, and actions taken.
**About Walgreens**
Founded in 1901, Walgreens ( proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.
**Job ID:** BR
**Title:** Remote Insurance Verification Specialist, Specialty (Texas)
**Company Indicator:** Walgreens
**Employment Type:**
**Job Function:** Customer Contact Center
**Full Store Address:** 108 WILMOT ROAD,DEERFIELD,IL 60015
**Full District Office Address:** 10530 JOHN W ELLIOTT DR,STE 100,FRISCO,TX, -S
**External Basic Qualifications:**
+ High school diploma/GED
+ Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction in healthcare, specialty pharmacy, PBM, call center setting or other related industry
+ Ability to communicate clearly and effectively (written and verbal). Good interpersonal skills with the ability to communicate in a diplomatic and confidential manner
+ Basic level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).
**Preferred Qualifications:**
+ Experience with providing customer service related to adherence, complex disease states quality, After Call Work (ACW), etc.
+ Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
+ Intermediate level PC skills, MS Windows, MS Office Suite and/or other similar operating/software programs (for example: start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, save files, print documents and/or access information on-line).
We will consider employment of qualified applicants with arrest and conviction records.
The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits
**Shift:**
**Store:**
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Clinical Specialty Program Pharmacist - Remote
Posted 16 days ago
Job Viewed
Job Description
**Job category:** Pharmacy
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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
Lead and manage ongoing client relationships, pharmacy benefit analysis and consultation delivery to clients. Collaborate in development of strategy as outward-facing, dedicated resources for assigned accounts, typically with direct client contact for large/complex accounts. Builds client relationships and serves as primary point of contact for clinical specialty pharmacy needs. Represents client(s) internally and coordinates with other functions to implement client systems, complete projects, and address ongoing pharmacy service needs.
The Clinical Specialty Program Pharmacist are responsible for Specialty execution on all clinical strategies, patient care support, Specialty Drug List consultation and quality initiatives. The Clinical Specialty Program Pharmacists shall participate in quarterly business reviews detailing pipeline tracking, including forecasting, key performance indicator (KPI) review, strategic guidance, and comprehensive medical management initiatives.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
**Primary Responsibilities:**
+ Support routine reporting to client management leadership regarding milestone attainment and any significant issues within their segment that may be impacting overall team performance
+ Maintains understanding of individual client contracts and ensures proper execution of all relevant deliverables specific to those agreements
+ Work with the Client Management Leadership Team to drive and execute toward strategic goals and objectives
+ Collaborates with clients to establish achievable but aggressive specialty program goals, including support on patient care support, Specialty Drug list consultation and quality initiatives
+ Formulates and delivers clinically-sound and fiscally responsible recommendations to clients based on trend
+ Create action plans to address any client satisfaction concerns
+ Stays aware of and provides market intelligence to clients on specialty pharmacy products
+ Provides education for clients, pharmacists, members and physicians per contractual requirements
+ Supports strategies around other revenue-enhancement efforts (e.g., specialty, formulary, UM, mail, etc.) in coordination with client mgmt./sales teams where appropriate
+ Routinely collaborates with client management leadership peers to provide well-coordinated, impactful quarterly performance review sessions with clients
+ Serves a key resource for new clinical product/service ideation and liaison to clinical product development / management areas to create new or enhance existing programs
+ Identifies and collaborates with clinical management leadership on specialty management strategies
+ Drives enhanced client relationships through senior-level strategic discussions and planning which addresses issues of highest priority for the client
+ Consistently looks at existing processes, methods, and materials to find opportunities for improvement
+ Maintains strategic relationships with client leaders, key stakeholders, and brokers/consultants
+ Serves as Subject Matter Expert (SME) for other departments on Specialty Pharmacy-specific issues/inquiries
+ Lead departmental and interdepartmental workgroup and project work
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 of Science in Pharmacy or PharmD
+ Active, unrestricted US state-specific pharmacist license
+ 2+ years of experience in PBM
+ Experience with specialty pharmacy
+ Experience with total cost of care
+ Advanced proficiency in delivering presentations to various audiences
+ Proficient skills in Microsoft Office and Outlook
+ Willing to work with clients and colleagues across various time zones
+ Ability to travel up to 10%
**Preferred Qualifications:**
+ 2+ years of PBM operations experience
+ 2+ years of experience supporting PBM Healthplan clients
+ Experience giving formal presentations
+ Experience in data analytics and drawing insights
+ Experience in Rx Claim
+ Experience in MediSpan
+ Advanced understanding of PBM industry
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
**Application Deadline** : This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_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._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
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Specialty Benefits Analyst - Stop Loss (Remote)
Posted 7 days ago
Job Viewed
Job Description
**PURPOSE:**
The Analyst, Specialty Market supports CareFirsts sales activities by creating Stop Loss insurance proposals for both new sales and renewal group business. Utilizes knowledge of stop-loss, self-funding arrangements and benefit plans, to analyze Stop Loss market information and trends to ensure Stop Loss proposals are comprehensive and competitive to meet client needs.
**ESSENTIAL FUNCTIONS:**
+ Works with external stop-loss vendors to secure quotes for new TPA and CareFirst business. Analyzes census data, shock reports and claims history for current TPA and CareFirst groups to evaluate current Stop Loss coverage and develop proposal for the group renewal. Analyzes quotes from insurance carriers, and ensures that quoted groups receive appropriate and competitive coverage based on group needs and industry trends.
+ Consults with insurance carriers to understand differences between requested and provided quotes, clarifies group needs and ensures carriers provide competitive quotes with appropriate coverage levels. Analyzes quote term differences, makes recommendations and creates Stop Loss proposals in collaboration with the appropriate TPA and CareFirst sales teams. Accurately enters all stop loss quote and proposal information into Salesforce and ensures correct stop loss illustration is sent to brokers and/or groups.
+ Creates and maintains the accuracy of Stop Loss content for documents and collateral provided to internal and external customers. Ensures the accuracy of current information, and updates with new marketing information as insurance trends change. Develops and maintains internal documents and reports as needed including Salesforce reporting and Standard Operating Procedures (SOP's). Ensures the accuracy of schedules of insurance, policies, and contracts with attention to detail and thorough understanding of contingencies.
+ Builds and maintains favorable relationships with CareFirst sales and TPA Account Management staff and proactively reaches out to account management team for upcoming group renewal information. Tracks and manages receipt of signed rates prior to effective date of coverage and ensures the information is provided to the Finance teams. Reviews stop loss cases with management/Sr. Analyst as appropriate and ensures that proposed proposal recommendations meet client needs.
**QUALIFICATIONS:**
**Education Level:** Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
**Experience:** 3 years experience in the health insurance/healthcare industry, with knowledge of benefit products and self-funded rating arrangements.
**Preferred Qualifications**
+ Previous experience in a business analyst capacity for a health care organization.
+ Previous experience working with stop loss.
+ Previous experience in the self-funded market.
**Knowledge, Skills and Abilities (KSAs)**
+ Must have the ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
+ Ability to run reports, business correspondence, and procedure manuals.
+ Ability to successfully manage multiple projects, tasks and priorities.
+ Ability to be thorough while maintaining efficiency and accuracy.
+ Demonstrated knowledge and understanding of stop loss.
+ Ability to analyze essential facts, make timely and sound decisions, make recommendations and resolve performance and job-related issues.
+ Demonstrated desire to share knowledge and work as a team.
Salary Range: $53,352 - $105,963
**Salary Range Disclaimer**
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
**Equal Employment Opportunity**
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
**Federal Disc/Physical Demand**
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
**Physical Demands:**
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
**Sponsorship in US**
Must be eligible to work in the U.S. without Sponsorship.
\#LI-LJ1
REQNUMBER: 22238
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Director, Software Engineering - Shopping (Remote-Eligible)
Posted 8 days ago
Job Viewed
Job Description
**Interested in joining a dynamic remote first engineering team in a fast-paced environment full of greenfield problem-solving? Then Capital One Shopping might be the place for you. Join us in supporting a growth-stage line of business with a startup mindset as we build technology to save our customers money.**
**As a Capital One Director of Software Engineering, you'll work on customer-facing web and services to help launch high visibility features and products. You will lead teams using cutting-edge frameworks, technologies and Machine learning models using the hottest techniques in Big Data. You'll bring solid experience in emerging and traditional technologies such as: node.js, Java, GO, React, Python, REST, JSON, NoSQL databases, relational databases and AWS/Cloud Infrastructure to name a few.**
**You will:**
+ **Lead, manage and grow multiple teams of product focused software engineers**
+ **Mentor and guide the professional and technical development of engineers on your team.**
+ **Work with product managers to understand desired application capabilities and testing scenarios**
+ **Continuously improve software engineering practices**
+ **Work within and across Agile teams to design, develop, test, implement, and support technical solutions across a full-stack development tools and technologies**
+ **Lead the craftsmanship, availability, resilience, and scalability of your solutions**
+ **Bring a passion to stay on top of tech trends, experiment with and learn new technologies, participate in internal & external technology communities, and mentor other members of the engineering community**
+ **Encourage innovation, implementation of cutting-edge technologies, inclusion, outside-of-the-box thinking, teamwork, self-organization, and diversity**
+ **Work across to improve the velocity of your and other teams**
+ **Lead efforts to deploy new and existing applications into AWS environments**
+ **Break existing monolithic applications into micro service architectures and build new microservices**
**Basic Qualifications** **:**
+ **Bachelor's Degree**
+ **At least 7 years' experience in software development**
+ **At least 5 years' experience in people management**
**Preferred Qualifications:**
+ **Master's Degree in Computer Science or a Master's Degree in Software Engineering**
+ **10+ years' of experience in software development**
+ **5+ years' of experience in Agile practices**
+ **3+ years' of experience in launching product from the ground up**
**_Capital One will consider sponsoring a new qualified applicant for employment authorization for this position._**
The minimum and maximum full-time annual salaries for this role are listed below, by location. Please note that this salary information is solely for candidates hired to perform work within one of these locations, and refers to the amount Capital One is willing to pay at the time of this posting. Salaries for part-time roles will be prorated based upon the agreed upon number of hours to be regularly worked.
Remote (Regardless of Location): $244,700 - $279,200 for Director, Software Engineering
McLean, VA: $269,100 - $307,200 for Director, Software Engineering
Candidates hired to work in other locations will be subject to the pay range associated with that location, and the actual annualized salary amount offered to any candidate at the time of hire will be reflected solely in the candidate's offer letter.
This role is also eligible to earn performance based incentive compensation, which may include cash bonus(es) and/or long term incentives (LTI). Incentives could be discretionary or non discretionary depending on the plan.
Capital One offers a comprehensive, competitive, and inclusive set of health, financial and other benefits that support your total well-being. Learn more at the Capital One Careers website ( . Eligibility varies based on full or part-time status, exempt or non-exempt status, and management level.
This role is expected to accept applications for a minimum of 5 business days.
No agencies please. Capital One is an equal opportunity employer (EOE, including disability/vet) committed to non-discrimination in compliance with applicable federal, state, and local laws. Capital One promotes a drug-free workplace. Capital One will consider for employment qualified applicants with a criminal history in a manner consistent with the requirements of applicable laws regarding criminal background inquiries, including, to the extent applicable, Article 23-A of the New York Correction Law; San Francisco, California Police Code Article 49, Sections ; New York City's Fair Chance Act; Philadelphia's Fair Criminal Records Screening Act; and other applicable federal, state, and local laws and regulations regarding criminal background inquiries.
If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation, please contact Capital One Recruiting at or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodations.
For technical support or questions about Capital One's recruiting process, please send an email to
Capital One does not provide, endorse nor guarantee and is not liable for third-party products, services, educational tools or other information available through this site.
Capital One Financial is made up of several different entities. Please note that any position posted in Canada is for Capital One Canada, any position posted in the United Kingdom is for Capital One Europe and any position posted in the Philippines is for Capital One Philippines Service Corp. (COPSSC).
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Anesthesia Specialty Coder II (REMOTE)
Posted 17 days ago
Job Viewed
Job Description
**Position Details:**
The **Anesthesia Specialty Coder II** is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD-9 CM and CPT-4 coding systems, and audits physician documentation. The Anesthesia Specialty Coder II audits physician documentation to assign appropriate anesthesia CPT codes, diagnosis codes, and modifiers related to anesthesia coding and billing as well as anesthesia minutes. Mentors and training other Specialty Coders. Serves as a resource for the department. Performs other duties as assigned. Required experience includes 2 years of coding experience and 1 year of medical office related experience.
+ **Location:** Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina)
+ **Status:** Full time (non-exempt)
+ **Shift:** 8:00AM - 4:30PM
+ **Days:** Monday through Friday
The **Anesthesia Specialty Coder II** opportunity is a full-time remote position. This team member must reside in the state of Florida, George, North Carolina, or South Carolina.
**Responsibilities:**
+ The Specialty Coder II is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD-10 CM and CPT-4 coding systems.
+ The Specialty Coder audits physician documentation to assign appropriate CPT codes, diagnosis codes, and modifiers related to anesthesia coding and billing as well as anesthesia minutes.
+ Mentors and training of other Specialty Coders.
+ Serves as a resource for the department.
+ Performs other duties as assigned.
**Preferred Coding Specialties**
+ Anesthesia
+ General Surgery
+ Cardiothoracic Surgery
+ Neurosurgery
+ Pediatric/ Preemie Surgery
**Why BayCare?**
Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that is built on a foundation of trust, dignity, respect, responsibility, and clinical excellence. Our team members focus on tomorrow by achieving personal and professional success today. That is why you will thrive in our forward-thinking culture, where we combine the best technology with compassionate service. We blend high-tech with high touch in ways that are advancing superior health care throughout the communities we serve.
**BayCare offers a competitive total reward package including:**
+ Benefits (Medical, Dental, Vision)
+ Paid Time Off
+ Tuition Assistance
+ 401K Match and additional yearly contribution
+ Annual performance appraisals and team award bonus
+ Family resources and wellness opportunities
+ Community perks and discounts
**Certifications and Licensures**
+ Required Certified Professional Coder (CPC) **OR** Certified Coding Specialist (CCS) **OR** Certified Coding Specialist - Physician Based (CCS-P)
**Education**
+ Required High School or equivalent
+ Preferred Associate Degree
**Experience**
+ Required 2 years Coding
+ And 1 year of Medical Office related experience
Equal Opportunity Employer Veterans/Disabled
**Position** Anesthesia Specialty Coder II (REMOTE)
**Location** Tampa:Concourse Center | Business and Administrative | Full Time
**Req ID**
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