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Outlier

AI Training for Business to Business Digital Domain

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position SummaryThis is a full-time telehealth role within the US. Must reside in a compact state and hold a compact license. Hours Monday-Friday EST working 3 day shifts and 2 evening shifts a per weekEvening hours end at 9:00 PM EST Rotating 5 hour shifts on Saturdays will be required per business needs approximately quarterlyRotating Friday evening until 9:00 PM EST approximately quarterlyJob Descriptions The Health Coach Consultant utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote and influence member's decisions related to achieving and maintaining optimal health status. - Assessment of Members through the use of clinical tools and information/data review, conducts comprehensive evaluation of member's needs and benefit plan eligibility for available integrated internal and external programs/services. - Utilizes assessment techniques to determine member's level of health literacy, technology capabilities, and/or readiness to change.Enhancement of Medical Appropriateness &amp; Quality of Care: - Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits and/or member's needs to enable appropriate utilization of services and/or administration and integration with available internal/external programs. - Using holistic approach consults with supervisors, Medical Directors and/or others to overcome barriers to meeting goals and objectives. - Identifies and escalates quality of care issues through established channels. - Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. - Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. - Interprets and utilizes clinical guidelines/criteria to positively impact members health Provides up-to-date healthcare information to help facilitate the member¡¦s understanding of his/her health status. - Helps member actively and knowledgably participate with their provider in healthcare decision-making.Monitoring, Evaluation and Documentation of Care - Develops and monitors established plans of care, in collaboration with the member and/or attending physician, to meet the member's goals. - Utilizes internal policy and procedure in compliance with regulatory and accreditation guidelines. Required Qualifications - Must have an unrestricted compact license in the state of residence with ability to apply for and obtain additional licenses required per account needs - 3+ years of Adult Medical Surgical experience in a hospital or clinic setting - Must possess/be willing and able to obtain high speed internet access and be hardwired to internet - 1+ years of experience documenting in Electronic Medical Records Preferred Qualifications- Previous telephonic or face to face health coaching experience - Previous Managed Care experience - Experience with Microsoft Word, Outlook, Excel products- Experience using multiple digital applications simultaneously, while conducting assessment interviews and documenting member responses- Experience using Epic EducationAssociate or Bachelor’s degree requiredAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,095.00 - $116,760.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">Benefits | CVS Health</a>We anticipate the application window for this opening will close on: 03/13/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

RN - Registered Nurse - Health Coach Consultant - Chronic Conditions

Macy's

Core Trainer, Tulsa - Full Time (2052)

<h1>Provider Services - Provider Services Representative (OKC or Tulsa) 115-1023</h1> Oklahoma City, OK, USA ● Tulsa, OK, USA Req #788 Sunday, June 1, 2025 JOB SUMMARY: Primarily responsible for contracting, orientation and ongoing education of physicians, physician office staffs, hospitals and other providers regarding the policies and procedures of CommunityCare Managed HealthCare Plans. Serves as the liaison between the provider community and the health plan. KEY RESPONSIBILITIES: <ul> <li>Conducts educational and credentialing PCP and appropriate SCP office site visits according to established standards. Provides ongoing education, develops agendas, organizes informational material, facilitates workshops and participates in meetings for assigned networks. Prepares regular correspondence and special mailings to assigned providers. </li> <li>Researches and responds to issues and inquiries concerning benefits, claims, reimbursement and member issues and recommends appropriate actions to the requesting party. Assist internal departments by contacting provider offices regarding customer service/operational issues/complaints &amp; grievance resolutions and documents appropriately. </li> <li>Coordinate internal process and procedure among departments to ensure network contract / operational procedures are appropriately reflected in our systems/processes. Participate in departmental processes established to ensure accurate and timely contracting, credentialing, loading and education of providers.</li> <li>Assist contracting in all phases of the Contracting process established by CommunityCare Managed Healthcare Plans of Oklahoma. Process may include communication with provider during negotiation through completion of executed document implementation of contract, and on-going contract deliverables. Participate in the development of networks and key geographical areas as needed.</li> <li>Participates in special projects and assignments as directed, including the development of new/improved operating procedures.</li> <li>Job may contain dimensions that could affect performance of responsibility, which may involve dealing with members who are sensitive and/or emotional.</li> <li>Perform other duties as assigned.</li> </ul> QUALIFICATIONS: <ul> <li>Possess strong oral and written communication skills.</li> <li>Ability to monitor and assess rapidly changing information.</li> <li>Ability to think quickly and respond tactfully to sometimes difficult issues in dealing with providers.</li> <li>Successful completion of Health Care Sanctions background check.</li> <li>Proficient in Microsoft applications</li> <li>Must have a current driver’s license and insurance verification and reliable transportation.</li> </ul> EDUCATION/EXPERIENCE: <ul> <li>Bachelor's degree required OR each year of work experience in a healthcare industry can be substituted for each year of college not completed.</li> <li>Two to three years of industry related experience in managed care, insurance, physician environment or related area.</li> <li>Customer Service and sales related experience preferred.</li> </ul> CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin <h2 id="otherDetailsHeader">Other details</h2> <ul> <li> Job Family Commercial </li> <li> Pay Type Hourly </li> </ul> <a href="#"> Apply Now </a>

CommunityCare

Provider Services - Provider Services Representative (OKC or Tulsa) 115-1023

Core Trainer, Tulsa - Full Time (2102)

Department Hourly Supervisor (2010)

Department Hourly Supervisor (2500)

Department Hourly Supervisor (2041)

Department Hourly Supervisor (2230)

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our Senior Corporate Finance Analyst you will help support new customer growth, measure results and understand the revenue and cost implications of the strategic actions. ­­ Every day you will deliver systemic KPIs that ensure transparency to performance metrics, work with Operations to increase revenue and drive monthly and quarterly closing, reporting, and forecasting activities towards goals. To thrive in this role, you will thrive under pressure and see ambiguity and uncertainty as an opportunity to solve problems, innovate and deliver.Here’s what you will experience working as a Senior Finance Corporate Analyst:<ul> <li>Partnering with Operations to develop an outlook for multiple revenue streams, dynamic cost model, and performance measurement plan.</li> <li>Driving monthly and quarterly closing, reporting, and forecasting activities, clearly articulating progress toward goals.</li> <li>Preparing and reviewing calculations for multiple streams of revenue and working with clients to understand short- and long-range revenue forecasts.</li> <li>Aligning with Operations on cost accruals, developing detailed knowledge of billing details, vendor status, service levels, etc. in order to understand and track progress toward cost efficiency goals.</li> </ul>Required Skills:<ul> <li>A Bachelor’s degree and demonstrated academic achievement.</li> <li>Direct revenue cycle experience in denials reduction initiatives, including familiarity with insurance payors and portals. Advanced problem-solving skills, prior experience with Lean Six Sigma method preferred. </li> <li>Prior experience of at least 2 years, with an emphasis on healthcare operations, denial management, reimbursement, finance and/or data analytics. </li> </ul>For this US-based position, the base pay range is $59,282.00 - $110,424.03 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.This job is eligible to participate in our annual bonus plan at a target of 10.00%The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a <a href="http://go.r1rcm.com/benefits" target="_blank">competitive benefits package.</a>R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights <a href="https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf" target="_blank">California Consent </a>To learn more, visit: <a href="https://R1RCM.com" target="_blank">R1RCM.com</a>Visit us on <a href="https://www.facebook.com/R1RCM" target="_blank">Facebook</a>

R1 RCM

Senior Corporate Finance Analyst

4,915 Jobs