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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary<ul> <li>Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. </li> <li>Acts as a subject matter expert by providing training, coaching, or responding to complex issues. </li> <li>May handle customer service inquiries and problems.</li> </ul>Additional Responsibilities <ul> <li>Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. </li> <li>Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process.</li> <li>Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals.</li> <li>Insures all compliance requirements are satisfied and all payments are made against company practices and procedures.</li> <li>Identifies and reports possible claim overpayments, underpayments and any other irregularities.</li> <li>Performs claim rework calculations.</li> <li>Distributes work assignment daily to junior staff.</li> <li>Trains and mentors claim benefit specialists.</li> <li>Makes outbound calls to obtain required information for claim or reconsideration.</li> </ul>Required Qualifications<ul> <li>2+ years medical claim processing experience.</li> <li>Experience in a production environment.</li> <li>Demonstrated ability to handle multiple assignments competently, accurately and efficiently.</li> </ul> Preferred Qualifications<ul> <li>Self funded medical claim processing experience.</li> <li>DG system knowledge.</li> </ul>Education<ul> <li>High School Diploma or GED required.</li> <li>Preferred Associates degree or equivalent work experience.</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$18.50 - $42.35This 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 05/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Senior Claim Benefit Specialist

Overview Territory: Rego Park, Kew Gardens Full Time Salary Range: $113,000.00 to $120,000.00, with $20,000 Sign-On Bonus! Are you looking for a rewarding career in homecare? If so, we invite you to join our team at Amedisys, one of the largest and most trusted home health and hospice companies in the U.S. What's in it for you <ul> <li>A full benefits package with choice of affordable PPO or HSA medical plans.</li> <li>Paid time off.</li> <li>Up to $1,000 in free healthcare services paid by Amedisys yearly, when enrolled in an Amedisys HSA medical plan.</li> <li>Up to $500 in wellness rewards for completing activities during the year. Use these rewards to support your wellbeing with spa services, gym memberships, sports, hobbies, pets and more.*</li> <li>Mental health support, including up to five free counseling sessions per year through the Amedisys Employee Assistance program.</li> <li>401(k) with a company match.</li> <li>Family support with infertility treatment coverage*, adoption reimbursement, paid parental and family caregiver leave.</li> <li>Mileage reimbursement.</li> <li>And more.</li> </ul> Please note: Benefit eligibility can vary by position depending on shift status. *To participate, you must be enrolled in an Amedisys medical plan. Why Amedisys? <ul> <li>Community-based care centers with a supportive and inclusive work environment.</li> <li>Better work/life balance and increased flexibility compared to other settings.</li> <li>Job stability and the opportunity to advance with a growing company.</li> <li>The opportunity to make a meaningful impact on the lives of patients and their families providing much needed care where they want to be - in their homes.</li> </ul> Responsibilities <ul> <li>Performs patient assessments and collaborates with the care team to develop and implement a plan of care.</li> <li>Makes referrals to other disciplines as indicated by the patient's identified needs or documents rationale for not doing so.</li> <li>Promotes patient health and independence through teaching and appropriate rehabilitative measures, assisting patients in learning appropriate self-care techniques.</li> <li>Supervises LPNs and HHAs.</li> <li>Completes documentation timely and accurately.</li> <li>Regularly communicate patient progress to the clinical manager and care team.</li> <li>Plans and provides staff education.</li> <li>Performs on-call responsibilities and on-call services to patients/families as assigned.</li> <li>Participates in clinical development and continuing education programs.</li> <li>Other duties as assigned.</li> </ul> Qualifications <ul> <li>One (1+) year of clinical experience as a Registered Nurse (RN). If less than 1 year clinical experience as a RN, candidate must be approved by VP Clinical.*</li> <li>Current RN license, specific to the state(s) you are assigned to work.</li> <li>Current CPR certification.</li> <li>Valid driver's license, reliable transportation and liability insurance.</li> </ul> *Note - If less than 6 months clinical experience as a RN, candidate must participate in RN Intern program. Our compensation reflects the cost of labor across several U.S. geographic markets and may vary depending on location, job-related knowledge, skills, and experience. Amedisys is an equal opportunity employer. All qualified employees and applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition or carrier status or any other legally protected characteristic.

Amedisys

Registered Nurse, Home Health- $20,000 Sign-On Bonus- Rockaways

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryCVS Health Aetna has an opportunity for a full-time Utilization Management (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. You would be responsible for ensuring the member is receiving the appropriate care at the appropriate time and at the appropriate location, while adhering to federal and state regulated turn-around times. This includes reviewing written clinical records. Key Responsibilities of the UM Nurse Consultant (Includes but is not limited to)<ul> <li>Reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the complex needs of the member.</li> <li>Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.</li> <li>Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work.</li> <li>Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.</li> <li>Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.</li> <li>Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure, and clinical judgment to render coverage determination/recommendation along the continuum of care.</li> <li>Communicates with providers and other parties to facilitate care/treatment.</li> <li>Identifies members for referral opportunities to integrate with other products, services and/or programs.</li> <li>Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization.</li> </ul>Required Qualifications<ul> <li>Registered Nurse (RN) with current unrestricted US licensure required.</li> <li>2+ years clinical practice experience as an RN required.</li> <li>2+ Years Utilization Management experience.</li> <li>Must be willing to travel to the local office as needed if living within approximately 45 minutes/miles.</li> </ul>Preferred Qualifications<ul> <li>Bilingual proficiency in Arabic, Korean, or Spanish preferred.</li> <li>1+ year(s) experience utilizing multiple computer systems and applications including Microsoft Word, Excel, Outlook, and web-based applications.</li> </ul>Education<ul> <li>Associate’s degree in Nursing.</li> <li>BSN preferred.</li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$29.10 - $62.32This 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 06/02/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Utilization Management Nurse Consultant

<h1>Financial Services - Data Risk Management, Manager</h1> <h1>Financial Services - Data Risk Management, Manager</h1> <a href="https://pwc.wd3.myworkdayjobs.com/US_Experienced_Careers/job/NY-New-York/Financial-Services---Data-Risk-Management--Manager_619741WD?source=US_EXP_Careers" target="_blank">Apply</a> Job Category Data and Analytics Level Manager Specialty/Competency Data, Analytics &amp; AI Time Type Full time Travel Requirements Up to 60% Job ID 619741WD Location(s) NC-Charlotte, IL-Chicago, DC-Washington, MA-Boston, NJ-Florham Park, NY-New York A career within Data and Analytics services will provide you with the opportunity to help organisations uncover enterprise insights and drive business results using smarter data analytics. We focus on a collection of organisational technology capabilities, including business intelligence, data management, and data assurance that help our clients drive innovation, growth, and change within their organisations in order to keep up with the changing nature of customers and technology. We make impactful decisions by mixing mind and machine to leverage data, understand and navigate risk, and help our clients gain a competitive edge. Our team helps clients navigate various analytics applications to get the most value out of their technology investment and foster confidence in their business intelligence. As part of our team, you'll help our clients implement enterprise content and data management applications that improve operational effectiveness and provide impactful data analytics and insights. To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future. As a Manager, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to: <ul> <li>Develop new skills outside of comfort zone.</li> <li>Act to resolve issues which prevent the team working effectively.</li> <li>Coach others, recognise their strengths, and encourage them to take ownership of their personal development.</li> <li>Analyse complex ideas or proposals and build a range of meaningful recommendations.</li> <li>Use multiple sources of information including broader stakeholder views to develop solutions and recommendations.</li> <li>Address sub-standard work or work that does not meet firm's/client's expectations.</li> <li>Use data and insights to inform conclusions and support decision-making.</li> <li>Develop a point of view on key global trends, and how they impact clients.</li> <li>Manage a variety of viewpoints to build consensus and create positive outcomes for all parties.</li> <li>Simplify complex messages, highlighting and summarising key points.</li> <li>Uphold the firm's code of ethics and business conduct.</li> </ul> The Opportunity As part of the Data and Analytics - Business Intelligence team you are responsible for leading efforts in developing and implementing data-driven strategies to drive business growth and enhance decision-making. As a Manager, you guide and mentor your team, facilitating the successful planning, execution, and completion of projects while maintaining exemplary standards and leveraging team strengths to meet client expectations. You play a crucial role in aligning data initiatives with organizational goals, managing data strategy programs, and embracing technology and innovation to improve delivery. Responsibilities - Oversee the planning and completion of data initiatives, maintaining quality standards - Align data strategies with organizational objectives to drive growth - Leverage team strengths to meet and exceed client expectations - Manage data strategy programs to improve decision-making - Foster a culture of continuous improvement and learning within the team What You Must Have - Bachelor's Degree in Computer and Information Science, Computer and Information Science &amp; Accounting, Economics, Economics and Finance &amp; Technology, Operations Management/Research, or Statistics - 5 years of experience What Sets You Apart - Master's Degree in Computer Science, Computer Engineering, or Engineering preferred - Proficiency in data risk management and technology risk management - Developing data-driven strategies for business growth - Aligning data initiatives with organizational goals - Managing data strategy program success - Programming using Python and SQL - Designing advanced analytics solutions and AI/ML models - Understanding of Master Data Management and Data Governance - Supporting reliable and scalable solutions architectures Learn more about how we work: <a href="https://pwc.to/how-we-work" target="_blank">https://pwc.to/how-we-work</a> PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: <a href="https://pwc.to/H-1B-Lottery-Policy" target="_blank">https://pwc.to/H-1B-Lottery-Policy</a>. All qualified applicants will receive consideration for employment at PwC without regard to race; creed; color; religion; national origin; sex; age; disability; sexual orientation; gender identity or expression; genetic predisposition or carrier status; veteran, marital, or citizenship status; or any other status protected by law. PwC is proud to be an affirmative action and equal opportunity employer. The salary range for this position is: $100,000 - $232,000, plus individuals may be eligible for an annual discretionary bonus. For roles that are based in Maryland, this is the listed salary range for this position. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation and more. To view our benefits at a glance, please visit the following link: <a href="https://pwc.to/benefits-at-a-glance" target="_blank">https://pwc.to/benefits-at-a-glance</a> <h1>Financial Services - Data Risk Management, Manager</h1> <a href="https://pwc.wd3.myworkdayjobs.com/US_Experienced_Careers/job/NY-New-York/Financial-Services---Data-Risk-Management--Manager_619741WD?source=US_EXP_Careers" target="_blank">Apply</a>

Financial Services - Data Risk Management, Manager

<h1>Financial Services - Data Risk Management, Senior Associate</h1> <h1>Financial Services - Data Risk Management, Senior Associate</h1> <a href="https://pwc.wd3.myworkdayjobs.com/US_Experienced_Careers/job/NY-New-York/Financial-Services---Data-Risk-Management--Senior-Associate_619742WD?source=US_EXP_Careers" target="_blank">Apply</a> Job Category Data and Analytics Level Senior Associate Specialty/Competency Data, Analytics &amp; AI Time Type Full time Travel Requirements Up to 60% Job ID 619742WD Location(s) NC-Charlotte, IL-Chicago, DC-Washington, MA-Boston, NJ-Florham Park, NY-New York A career within Data and Analytics services will provide you with the opportunity to help organisations uncover enterprise insights and drive business results using smarter data analytics. We focus on a collection of organisational technology capabilities, including business intelligence, data management, and data assurance that help our clients drive innovation, growth, and change within their organisations in order to keep up with the changing nature of customers and technology. We make impactful decisions by mixing mind and machine to leverage data, understand and navigate risk, and help our clients gain a competitive edge. Our team helps clients navigate various analytics applications to get the most value out of their technology investment and foster confidence in their business intelligence. As part of our team, you'll help our clients implement enterprise content and data management applications that improve operational effectiveness and provide impactful data analytics and insights. To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future. As a Senior Associate, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to: <ul> <li>Use feedback and reflection to develop self awareness, personal strengths and address development areas.</li> <li>Delegate to others to provide stretch opportunities, coaching them to deliver results.</li> <li>Demonstrate critical thinking and the ability to bring order to unstructured problems.</li> <li>Use a broad range of tools and techniques to extract insights from current industry or sector trends.</li> <li>Review your work and that of others for quality, accuracy and relevance.</li> <li>Know how and when to use tools available for a given situation and can explain the reasons for this choice.</li> <li>Seek and embrace opportunities which give exposure to different situations, environments and perspectives.</li> <li>Use straightforward communication, in a structured way, when influencing and connecting with others.</li> <li>Able to read situations and modify behavior to build quality relationships.</li> <li>Uphold the firm's code of ethics and business conduct.</li> </ul> The Opportunity As part of the Data and Analytics - Business Intelligence team you are responsible for leading efforts in developing and implementing data-driven strategies to drive business growth and enhance decision-making. As a Senior Associate, you play a crucial role in aligning data initiatives with organizational goals, managing data strategy programs, and embracing technology and innovation to improve delivery. Responsibilities - Oversee the planning and completion of data initiatives, maintaining quality standards - Align data strategies with organizational objectives to drive growth - Leverage team strengths to meet and exceed client expectations - Manage data strategy programs to improve decision-making - Foster a culture of continuous improvement and learning within the team What You Must Have - Bachelor's Degree in Computer and Information Science, Computer and Information Science &amp; Accounting, Economics, Economics and Finance &amp; Technology, Operations Management/Research, or Statistics - 3 years of experience What Sets You Apart - Master's Degree in Computer Science, Computer Engineering, or Engineering preferred - Proficiency in data risk management and technology risk management - Developing data-driven strategies for business growth - Aligning data initiatives with organizational goals - Managing data strategy program success - Programming using Python and SQL - Designing advanced analytics solutions and AI/ML models - Understanding of Master Data Management and Data Governance - Supporting reliable and scalable solutions architectures Learn more about how we work: <a href="https://pwc.to/how-we-work" target="_blank">https://pwc.to/how-we-work</a> PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: <a href="https://pwc.to/H-1B-Lottery-Policy" target="_blank">https://pwc.to/H-1B-Lottery-Policy</a>. All qualified applicants will receive consideration for employment at PwC without regard to race; creed; color; religion; national origin; sex; age; disability; sexual orientation; gender identity or expression; genetic predisposition or carrier status; veteran, marital, or citizenship status; or any other status protected by law. PwC is proud to be an affirmative action and equal opportunity employer. The salary range for this position is: $84,000 - $202,000, plus individuals may be eligible for an annual discretionary bonus. For roles that are based in Maryland, this is the listed salary range for this position. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation and more. To view our benefits at a glance, please visit the following link: <a href="https://pwc.to/benefits-at-a-glance" target="_blank">https://pwc.to/benefits-at-a-glance</a> <h1>Financial Services - Data Risk Management, Senior Associate</h1> <a href="https://pwc.wd3.myworkdayjobs.com/US_Experienced_Careers/job/NY-New-York/Financial-Services---Data-Risk-Management--Senior-Associate_619742WD?source=US_EXP_Careers" target="_blank">Apply</a>

Financial Services - Data Risk Management, Senior Associate

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryBring 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 SummaryHealth Concierge is the face of Aetna to provide targeted, personalized service based on a holistic view of the member, benefits, health information, and through engagement. Handles customer service inquiries and problems via telephone, internet, web-chat or written correspondence. Engages, consults and educates members based upon the member’s unique needs, preferences and understanding of Aetna plans, tools and resources to help guide the members along a clear path to care. Utilizes resources to assist customers in understanding components of the Aetna products including claims, accumulators, usage and balances, and cost sharing.<ul> <li>Answers questions and resolves issues as a “single-point-of-contact” based on phone calls, plan sponsors, PSS/ISO, members and providers.</li> <li>Provides customized interaction based on customer preference and individualized needs, creating an emotional connection with our members by understanding and engaging the member to the fullest.</li> <li>Fully understands the member’s needs by building a trusting and caring relationship with the member. Anticipates customer needs.</li> <li>Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.</li> <li>Uses customer service threshold framework to make financial decisions to resolve member issues.</li> <li>Educates and assists customers on various elements of benefit plan information and available services created to enhance the overall customer service experience with the company (i.e., assistance with member self-service tools, Consultation Opportunities – Simple Steps, Cost of Care Tools, Natural Alternatives Program, etc.).</li> <li>Utilizes all relevant information to effectively influence member engagement.</li> <li>Takes immediate action when confronted with a problem or made aware of a situation.</li> <li>Takes ownership of each customer contact to resolve their issues and connect them with additional services as appropriate.</li> <li>Identifies member needs beyond the initial inquiry by answering the unasked questions.</li> <li>Resolves issues without or with limited management intervention.</li> <li>Provides education to members to support them in managing their health.</li> <li>Responds quickly to meet customer needs and resolve problems while avoiding over-committing.</li> <li>Other activities may include: providing claim status information, benefit coverage interpretations, and explaining plan eligibility.</li> <li>Processes claim referrals, new claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals.</li> <li>Initiates out-reach/welcome calls to ensure constituents expectations are met or exceeded.</li> <li>Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase post-enrollment member satisfaction.</li> <li>Partners with other departments to deliver client specific presentations.</li> <li>Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service.</li> <li>Works collaboratively with colleagues to deliver the best customer experience Seeks to understand the customer, including circumstances, problems, expectations and needs.</li> <li>Asks probing questions to identify the underlying customer needs.</li> <li>Appropriately transitions conversations to explore possibilities for extending customer interactions.</li> <li>Guides members to the appropriate health resource Offers alternatives where appropriate.</li> <li>Acts with the best interest of customer in mind and central to all interactions.</li> <li>Collaborates with colleagues and co-workers to deliver a world class customer experience.</li> <li>Serves as SME providing technical assistance when needed on call related issues, products, and/or system applications delivery matters.</li> <li>May participate in preparation and presentation of client specific presentations.</li> <li>May track and trend data.</li> <li>Coaches, trains and assists in the development of call center staff, as required.</li> <li>Participates in and/or leads special projects/initiatives addressing service issues, as necessary.</li> <li>Provides technical or subject matter expertise concerning policies, procedures, and function-related applications/systems tools as needed.</li> <li>Delivers internal quality reviews.</li> <li>Provides appropriate support in third party audits when required.</li> <li>Documents and tracks all contacts, events, and outcomes with clients using appropriate systems and processes.</li> </ul> Required Qualifications<ul> <li>Customer Service experiences in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate.</li> <li>Effective organizational skills and ability to manage multiple tasks.</li> <li>Effective communication skills, both verbal and written</li> <li>Experience working with computers Education High School Diploma </li> </ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$17.00 - $25.65This 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 05/06/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Health Concierge

Your work days are brighter here.At Workday, it all began with a conversation over breakfast. When our founders met at a sunny California diner, they came up with an idea to revolutionize the enterprise software market. And when we began to rise, one thing that really set us apart was our culture. A culture which was driven by our value of putting our people first. And ever since, the happiness, development, and contribution of every Workmate is central to who we are. Our Workmates believe a healthy employee-centric, collaborative culture is the essential mix of ingredients for success in business. That’s why we look after our people, communities and the planet while still being profitable. Feel encouraged to shine, however that manifests: you don’t need to hide who you are. You can feel the energy and the passion, it's what makes us unique. Inspired to make a brighter work day for all and transform with us to the next stage of our growth journey? Bring your brightest version of you and have a brighter work day here.At Workday, we value our candidates’ privacy and data security. Workday will never ask candidates to apply to jobs through websites that are not Workday Careers. Please be aware of sites that may ask for you to input your data in connection with a job posting that appears to be from Workday but is not.In addition, Workday will never ask candidates to pay a recruiting fee, or pay for consulting or coaching services, in order to apply for a job at Workday.About the TeamWorkday’s Financial Services and Insurance (FSI) Industry team’s main purpose is to deliver Workday’s consulting services and build an outstanding customer experience by delivering engaging and innovative consulting services. In addition to bring leading practices to our customers, partners, and employees make the most of the Workday system.About the RoleJob DescriptionThe Financial Services &amp; Insurance Industry (FSI) Principal Financials Consultant will be responsible for ensuring the successful implementation of Workday’s Financials solution for our FSI customers and help establish and champion best practices for all FSI deployments. The ideal candidate for this position should have experience within the FSI Industry in General Ledger, Consolidations, Allocations, Currency Revaluations and Translations. Additionally, candidate should have an understanding of financial touch points to Projects, Accounts Payable, Cash Managementand Assets. Key Areas of Responsibility:<ul> <li>Become an expert in the Workday Financials product suite</li> <li>Provide FSI Industry perspective for customer business requirements</li> <li>Ensure FSI Industry best practices are maintained to reflect new industry requirements and trends</li> <li>Perform the following on an engagement: understand client business requirement</li> <li>Serve as a mentor for new Financial Consultants</li> <li>Ensure the client takes advantage of Workday FSI Industry best practices</li> <li>Ensure the client is referenceable once the client is in production</li> <li>Participate in update training and other events that help share one’s product skills with other consultants</li> </ul>About You Basic Qualifications P - 5 <ul> <li>7 years FSI industry - ERP Implementations</li> <li>General Ledger, Consolidations, Allocations, Currency Revaluations and Translations Implementations experience</li> <li> Financial touchpoints to Projects, Accounts Payable, Cash Management and Assets Experience </li> <li>Workday Deployment Experience</li> <li>Ability to travel up to 50% of the time</li> </ul> P- 4 <ul> <li>5 years FSI industry - ERP Implementations</li> <li>General Ledger, Consolidations, Allocations, Currency Revaluations and Translations Implementations experience</li> <li> Financial touchpoints to Projects, Accounts Payable, Cash Management and Assets Experience </li> <li>Workday Deployment Experience</li> <li>Ability to travel up to 50% of the time</li> </ul> Other Qualifications <ul> <li>Ability to learn technology quickly through instruction and self-training</li> <li>Experience mentoring others</li> <li>Proven project management skills</li> <li>Previous consulting experience either as an internal consultant or with a consulting/software company</li> <li>Experience with Workday Accounting Center</li> <li>Experience implementing Workday, SAP, Oracle, PeopleSoft.</li> <li>Bachelor’s degree or relevant experience</li> <li>Passion for customer service.</li> <li>Excellent verbal and written communication skills and the ability to manage multiple projects at a time.</li> <li>Business analysis and requirements gathering abilities</li> </ul> Workday Pay Transparency StatementThe annualized base salary ranges for the primary location and any additional locations are listed below. Workday pay ranges vary based on work location. As a part of the total compensation package, this role may be eligible for the Workday Bonus Plan or a role-specific commission/bonus, as well as annual refresh stock grants. Recruiters can share more detail during the hiring process. Each candidate’s compensation offer will be based on multiple factors including, but not limited to, geography, experience, skills, job duties, and business need, among other things. For more information regarding Workday’s comprehensive benefits, please <a href="http://workdaybenefits.com/us/welcome-to-workday-benefits/prospective-workmates" target="_blank">click here</a>.Primary Location: USA.IL.Chicago Primary Location Base Pay Range: $147,400 USD - $221,100 USD Additional US Location(s) Base Pay Range: $133,300 USD - $236,800 USD Our Approach to Flexible Work With Flex Work, we’re combining the best of both worlds: in-person time and remote. Our approach enables our teams to deepen connections, maintain a strong community, and do their best work. We know that flexibility can take shape in many ways, so rather than a number of required days in-office each week, we simply spend at least half (50%) of our time each quarter in the office or in the field with our customers, prospects, and partners (depending on role). This means you'll have the freedom to create a flexible schedule that caters to your business, team, and personal needs, while being intentional to make the most of time spent together. Those in our remote "home office" roles also have the opportunity to come together in our offices for important moments that matter.Pursuant to applicable Fair Chance law, Workday will consider for employment qualified applicants with arrest and conviction records.Workday is an Equal Opportunity Employer including individuals with disabilities and protected veterans.Are you being referred to one of our roles? If so, ask your connection at Workday about our Employee Referral process!

Workday

Principal Consultant - Financials, FSI Industry

Ro is a direct-to-patient healthcare company with a mission of helping patients achieve their health goals by delivering the easiest, most effective care possible. Ro is the only company to offer nationwide telehealth, labs, and pharmacy services. This is enabled by Ro's vertically integrated platform that helps patients achieve their goals through a convenient, end-to-end healthcare experience spanning from diagnosis, to delivery of medication, to ongoing care. Since 2017, Ro has helped millions of patients in nearly every single county in the United States, including 98% of primary care deserts. The healthcare system today is not designed to help patients achieve their goals. It’s designed around institutions such as hospitals and insurance companies. A patient centric healthcare system is one that is designed around the goals a patient wants to achieve. We’re building healthcare that puts patients in control, provides reactive and proactive care, has transparent pricing and process, is extremely effective and ridiculously convenient, and evolves over time based on patients’ goals. Ro has been recognized as a Fortune Best Workplace in New York and Health Care for four consecutive years (2021-2024). In 2023, Ro was also named Best Workplace for Parents for the third year in a row. In 2022, Ro was listed as a CNBC Disruptor 50. The Role: We’re looking for a hands-on Engineering Manager to join our Infrastructure team. This role is ideal for someone who loves to lead by example — someone who can both support and grow a high-performing team and roll up their sleeves to solve complex technical problems alongside them. You’ll be working across areas like observability, performance, developer tooling, and databases— helping shape strategy, drive execution, and foster a culture of excellence and ownership. If you're excited about being a player-coach, blending technical leadership with mentorship and team-building, we’d love to talk to you!<h3>What You'll Do</h3> <ul> <li>Lead and mentor a team of infrastructure engineers, fostering a culture of collaboration, ownership, and technical excellence.</li> <li>Act as a player-coach: contribute directly to the codebase, architecture decisions, and technical problem-solving while growing team capabilities.</li> <li>Drive and support strategic initiatives across observability, performance, developer experience, and database infrastructure.</li> <li>Partner with cross-functional teams to align infrastructure priorities with business goals and product needs.</li> <li>Own the planning and execution of high-impact projects — balancing scope, velocity, and long-term sustainability.</li> <li>Help shape and evolve technical direction, making pragmatic choices between scaling, automation, and reliability.</li> <li>Recruit, develop, and retain top engineering talent through strong coaching, feedback, and support.</li> <li>Champion engineering best practices, operational excellence, and a continuous improvement mindset across the team.</li> </ul><h3>What You'll Bring</h3> <ul> <li>A strong technical foundation in infrastructure, systems engineering, or platform development — with the ability to dive deep when needed.</li> <li>Proven experience leading and mentoring engineers, with a focus on helping individuals grow while delivering impactful results.</li> <li>A pragmatic, delivery-focused mindset — knowing when to aim for excellence and when to ship “good enough” solutions.</li> <li>A track record of working across teams and functions to align infrastructure priorities with organizational needs.</li> <li>Comfort operating in ambiguous environments and driving clarity through thoughtful planning and communication.</li> <li>A collaborative, team-first attitude with the ability to both support and challenge — especially in a high-trust, high-autonomy environment.</li> </ul><h3>We’ve Got You Covered</h3> <ul> <li>Full medical, dental, and vision insurance + OneMedical membership</li> <li>Healthcare and Dependent Care FSA</li> <li>401(k) with company match</li> <li>Flexible PTO</li> <li>Wellbeing + Learning &amp; Growth reimbursements</li> <li>Paid parental leave + Fertility benefits</li> <li>Pet insurance</li> <li>Student loan refinancing</li> <li>Virtual resources for mindfulness, counseling, and fitness</li> </ul>The target for this position ranges from $208,000 to $250,000, in addition to a competitive equity and benefits package (as applicable). When determining compensation, we analyze and carefully consider several factors, including location, job-related knowledge, skills and experience. These considerations may cause your compensation to vary. Ro recognizes the power of in-person collaboration, while supporting the flexibility to work anywhere in the United States. For our Ro’ers in the tri-state (NY) area, you will join us at HQ on Tuesdays and Thursdays. For those outside of the tri-state area, you will be able to join in-person collaborations throughout the year (i.e., during team on-sites). At Ro, we believe that our diverse perspectives are our biggest strengths — and that embracing them will create real change in healthcare. As an equal opportunity employer, we provide equal opportunity in all aspects of employment, including recruiting, hiring, compensation, training and promotion, termination, and any other terms and conditions of employment without regard to race, ethnicity, color, religion, sex, sexual orientation, gender identity, gender expression, familial status, age, disability and/or any other legally protected classification protected by federal, state, or local law. See our California Privacy Policy <a href="https://ro.co/job-applicant-privacy-policy/" target="_blank">here</a>.

Engineering Manager, Infrastructure

The Aspen Group (TAG) is one of the largest and most trusted retail healthcare business support organizations in the U.S. and has supported over 20,000 healthcare professionals and team members with close to 1,500 health and wellness offices across 50 states in four distinct categories: dental care, urgent care, medical aesthetics, and animal health. Working in partnership with independent practice owners and clinicians, the team is united by a single purpose: to prove that healthcare can be better and smarter for everyone. TAG provides a comprehensive suite of centralized business support services that power the impact of five consumer-facing businesses: Aspen Dental, ClearChoice Dental Implant Centers, WellNow Urgent Care, Chapter Aesthetic Studio, and AZPetVet. Each brand has access to a deep community of experts, tools and resources to grow their practices, and an unwavering commitment to delivering high-quality consumer healthcare experiences at scale.​​As a reflection of our current needs and planned growth we are very pleased to offer a new opportunity to join our dedicated team as a Practice Accountant.Job SummaryThis position is an integral part of the monthly financial statement close process for a growing dental management company in Syracuse, NY with plenty of growth opportunities. The position supports various aspects of finance and accounting for a territory within the organization. The position requires individuals who can contribute to a fast-paced close process and have great attention to detail.Essential Responsibilities <ul> <li>Provide finance support to regional managers, territory directors and DVP’s within the field organization as well as dental office owners;</li> <li>Ensure compliance with company policy and general accepted accounting principles;</li> <li>Analyze and post standard and non-standard journal entries;</li> <li>Calculate and process incentives for office and Field level incentives across the responsible territory;</li> <li>Receive requests regularly to change items in the P&amp;L or incentive calculations. Determine whether the change is warranted due to an error or a special request from the owner. Any changes related to wages greater than $10,000 at an individual level requires manager approval. Any accounting adjustments greater than $25,000 at an individual office level require manager approval. It is expected than at least 75% of the adjustments can be made using practice accountant judgement. </li> <li>Submit incentive payments to payroll for processing on a monthly basis. Answer questions from employees or Field on the incentive calculations.</li> <li>Participate on monthly calls with owners, DVPs, and Directors to answer finance related questions. Provide guidance to owners on P&amp;L items and receive requests from owners on the P&amp;Ls.</li> <li>It is expected that approximately 50% of the job responsibilities will be handling requests from the Field and most of those requests will require the use of discretion or judgement. Any unusual requests should be elevated to manager for review and approval. </li> <li>Reconcile Balance Sheet and P&amp;L accounts on a monthly basis;</li> <li>Analyze accounts to identify incorrect postings and necessary reclassifications;</li> <li>Review and analyze assigned P&amp;L’s categories and independently identifying monthly adjusting entries as needed; </li> <li>Preparing and distributing various recurring reporting and other ad-hoc reports or analysis;</li> <li>Acting as a key support person for external annual audit requests;</li> <li>Assist in preparation of quarterly financial statements and report packages;</li> <li>Work with POP independent CPA’s to provide financial information to support tax return preparation;</li> <li>Manage cross functional execution of financial close execution and required documentation;</li> <li>Special projects and ad-hoc requests as assigned.</li> </ul>Requirements/Qualifications <ul> <li>Bachelor’s Degree in Accounting;</li> <li>Public or private accounting experience for a large organization is a plus;</li> <li>Strong analytical, written, and verbal communication skills;</li> <li>Knowledge of Generally Accepted Accounting Principles;</li> <li>Above average Microsoft Office skills, most notably Excel, with ability to learn new skills quickly;</li> <li>Highly motivated self-starter with the ability to multi-task and complete assignments within tight time constraints and deadlines.</li> </ul>Salary: $61,000 $65,000

Aspen Dental Management Inc.

Practice Accountant

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary Responsible for the review and resolution of clinical appeals. Reviews documentation and interprets data obtained from clinical records to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and provider issues. Independently coordinates the clinical resolution with internal/external clinician support as required. This position may support UM, MPO, Coding, or Behavioral Health appeals. Required Qualifications • Must have active and unrestricted RN licensure in state of residence • 3+ years clinical experience Preferred Qualifications• Appeals Experience • Managed Care Experience • Utilization review experience • Proficiency with computer skills including navigating multiple systems • Exceptional communication skills. • Time efficient, highly organized, and ability to multitask Education • Associate's Degree minimumAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$66,575.00 - $142,576.00This 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

195 Jobs in New York, NY, USA