Flexibility to work remotely!Are you interested in becoming prosperous, doubling your personal wealth, and growing your personal income from the comfort of your home? Then a career with KELLER WILLIAMS PACIFIC ESTATES is just what you need!Besides reaping the benefits of your large commission checks, we have a unique Profit Share System that can help you earn passive income upwards of $100,000/year simply by suggesting us to your friends and colleagues in the industry.Compensation:$100,000 Commission BasedResponsibilities:Please contact us:If you are interested in a new careerIf you are interested in returning to Real EstateIf you are interested in changing from your current officeIf you have ever considered an exciting and challenging career in a rejuvenating and dynamic industry OR if you are investigating a possible office change, KELLER WILLIAMS REALTY wants to meet and get to know you!We offer a wonderful tuition reimbursement program as well as an effective post-license...

Private practice with no doors and no overhead. Join the world's largest online counseling platform. We provide the marketing, the technology, and the additional income. You provide the professionalism, clinical experience, and care. More About BetterHelp: BetterHelp's secure online platform and broad network of licensed therapists help those facing life's challenges by providing easy, affordable, and private access to professional counseling. In 2015 we expanded our resources and expertise by joining Teladoc Health (NYSE:TDOC), the nation's first and world's largest telehealth organization, helping to make BetterHelp the world's largest and most reputable e-counseling platform. Benefits for Counselors: Counselors Focus on Clinical Work: Your focus is 100% on counseling. You do not need to worry about acquiring clients, billing, support, or operations. We handle it all! Flexibility: BetterHelp can be your major source of income ("full time") or a...

We're changing the way health care works for the better. That means consulting with our members, partnering with our physicians, and delivering drugs in the most efficient and effective way. Join us and start doing your life's best work.(sm) If you are located in the Pacific Time Zone, you'll enjoy the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: * Positions in this function analyze and monitor claims against fraud, waste and abuse related to network pharmacies * Investigates, reviews and analyzes claims data applying knowledge of pharmacy policy and practice and data mining techniques to determine details of fraudulent, erroneous, or abusive billing activity on Real Time Application System and various reports * Auditor will need to identify and document fraudulent or erroneous activities determined as a result of their work. Auditors typically are licensed pharmacy technicians with in - depth knowledge of pharmacy operations You'll...

If you are a Senior Software Engineer with full-stack experience, please read on! Based in Manhattan Beach, Los Angeles, we are a highly innovative software company with a PaaS that is being used to innovate and personalize application creation in the healthcare community! Due to growth and demand for our platform services we are in need of a talented Senior Software Engineer to join our diverse team! Location: REMOTE Due to Covid-19 restrictions our team is working remotely. Although we are open to the idea of this position remaining remote permanently, we do plan to return to our office once restrictions have lifted. Top Reasons to Work with Us HUGE opportunities for growth! Work 100% remotely! We are profitable Company equity! What You Need for this Position BSCS or equivalent technical degree HTML, CSS, JavaScript, or TypeScript experience Experience with AngularJS, Angular, React, or Vue Experience with Ruby on Rails or Sidekiq Experience with MySQL,...

OptumCare is succeeding at helping people live healthier lives by taking a different approach to health care. OptumCare uses a common sense approach, focused on avoiding jargon, finding more efficient ways to operate, and providing great, in-the-moment service. We provide that service by making sure serving our patients and providers is always the first priority. Each department works from the same central idea: "How does this affect the service we provide?" Because of the extreme commitment to service, OPTUMCARE focuses on recruiting passionate employees who will take advantage of being empowered to provide the highest level of service at each and every step. OptumCare is a network of health care providers in local markets whose mission is to help providers deliver the most effective and compassionate care to each patient they serve. OptumCare's primary focus is on doing the right things for patients, physicians, and the community. It uses an innovative service model focused...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) OptumCare is creating the leading medical group and high-value ambulatory care delivery network in the country that is physician-led, patient-centered and clinically focused. When you join our team, you'll be surrounded by focused, performance driven teammates who are dedicated to building the highest value healthcare delivery system. The Diagnostic Imaging Picture Archiving and Communications Systems (PACS) administrator oversees integration and configuration of Diagnostic Imaging modalities. This role is responsible for equipment...

Job Description Job SummaryMolina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities.Knowledge/Skills/AbilitiesThe Senior Specialist, QI Compliance - Quality Data contributes to one or more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance. • Acts as a lead specialist to provide project-, program-, and / or initiative-related direction and guidance for other specialists within the department and/or collaboratively with other departments.• Implements key quality strategies, which may include initiation and management of provider, member and/or...

We are looking for enthusiastic, career-minded, self-motivated individuals to fill a few open Benefits Representatives positions. This is an entry-level leadership role. The ideal candidate will work closely with new Representatives on daily functions such as client introductions; relationship management; product presentation and proper paperwork follow through. In the interest of community wellness, our company has adjusted our business operations. As such, all interviews will be conducted via Video Conferencing. Please make sure to download the program in advance to be able to attend. Benefits: • Paid weekly. • Ongoing leadership and in-field training opportunities. • Close-knit, family culture. • Lifetime residual income. • Variety of bonuses and incentives, such as paid sporting events, retreats, and more. • Paid, all-inclusive trips to exotic locations such as San Diego, Cancun, Puerto Rico, Disney, Bahamas, Vegas. • Annual awards and recognition...

Job Description Job Summary This Mgr, FP&A will be involved in budgeting, forecasting, finance projects and financial analysis and decision-making using claims and payment integrity data. There will be involvement in looking at how Molina can improve productivity and operations optimization. This role will sit with Molina's Health Plan Services FP&A team and will be an individual contributor. Healthcare finance experience is required. Ideal candidates would have SQL experience. This is a REMOTE position but incumbent will work on Pacific Time. Responsible for developing the organization's short- and long-term financial plans and identifying financial opportunities to improve the organization's profitability Knowledge/Skills/Abilities • Manages timely submission of analytics and reports required for the FP&A function • Responsible for ensuring the integrity and completeness of financial data and information contained in reports • Reviews and develops when...

Job Description Job SummaryMolina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient outcomes, medications safety and medication use policies).Knowledge/Skills/Abilities• Performs initial receipt and review of non-formulary or prior authorization requests against plan approved...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) We are currently seeking an Inpatient Care Management Medical Director to join our Enterprise Clinical Services (ECS) team. This team is responsible for conducting inpatient bed day reviews for UnitedHealth Group's clients; to include local and national commercial employer, Medicare and state Medicaid plans. The ECS Medical Directors work with groups of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level. If you live in Hawaii, you'll enjoy the flexibility to telecommute* as...

Job Title: Contracts Administrator Duration: 6 Months Location: 100% Remote open to candidates across US Job Overview: URGENT BUSINESS NEED FOR PROCUREMENT DEPARTMENT Candidate can be located anywhere in the US to qualify for the position. There are no time zone requirements or restrictions MUST HAVE experience with the following requirements: contract negotiation contract language construction interpretation of regulations in depth contract understanding. Possibility for temp to hire Job Summary: Active collaborator providing support around the redlining; negotiating; formal execution of contracts between outside party and Company. Serves as key role player in the collection/distribution of any agreement traffic between key business partners and Compliance; Legal; and Finance, as needed. Required Experience 3-5 years' experience with contract lifecycle management/best practices Knowledge/Skills/Abilities:...

Job Description Job SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.Knowledge/Skills/Abilities• Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines.• Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts inpatient reviews to determine financial responsibility for Molina...

Job Description Job SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.Knowledge/Skills/Abilities• Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines.• Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts inpatient reviews to determine financial responsibility for Molina...

Job Description Job SummaryMolina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.Knowledge/Skills/Abilities• Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines.• Identifies appropriate benefits and eligibility for requested treatments and/or procedures. • Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and its members.•...

Job Description Job SummaryResponsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and similar financial projects or programs. Duties include gathering, interpreting, and evaluating financial information; generating forecasts and analyzes trends in sales, finance and other areas of business; Creating financial models for future business planning decisions in areas such as new product development, new marketing strategies, etc.Knowledge/Skills/Abilities• Forecasts and monitors economic benefits of Molina investments in infrastructure and operations (enhancements in operating efficiency and effectiveness).• Allocates limited resources among different investments in infrastructure and operations by ranking based upon economic benefit.• Analyzes capital equipment purchases. Performs lease vs. buy analyses.• Assists the IT Technology department with...

Remote work from home administrative assistant, data entry clerk, typing, customer service representative, get started now. Thank you for checking us out! Work From Home Data Entry Jobs - Part Time, Full Time We are seeking individuals who are looking for part time or full time work or side gigs to be connected with companies who are hiring employees directly to work from their homes. You will find both full-time and part-time remote opportunities in a variety of career fields. Legitimate Work From Home Data Entry Jobs are going to require that you have skills relevant to the position you are applying for. Training is provided based on the position. JOB REQUIREMENTS Computer with internet access Quiet workspace away from distractions Must be able and comfortable to working in an environment without immediate supervision Ability to read, understand, and follow oral and written instructions. Data entry or administrative assistant experience is not needed but can be...

Job DetailsLevelExperiencedJob LocationVirtual - Long Beach, CARemote TypeN/APosition TypeFull TimeEducation LevelHigh School Diploma or GEDSalary RangeUndisclosedTravel PercentageUndisclosedJob ShiftDayJob CategoryInsurancePOSITION: Claims Examiner III -Property, Auto, Professional and General LiabilityCOMPANY: TRISTAR Risk Enterprise ManagementDEPARTMENT: Irving, TX 230400REPORTS TO: Claims SupervisorSTATUS: ExemptDATE PREPARED: 01/04/2021POSITIONS SUPERVISED: Not applicablePOSITION SUMMARY: Under general supervision manages all aspects of Liability claims handling from inception to conclusion within established authority and guidelines. DUTIES AND RESPONSIBILITIES:Investigate and handle claims in compliance with Best Practices , set jurisdictional guidelines and Client Claim Handling InstructionsExperience handing public entity claims and Risk accounts.Maintain timely current Diary, working the files in a pro-active manner, addressing coverage, liability, exposure, subrogation,...