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You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This is a fully remote position seeking someone with one of the following license/certifications in LOUISIANA: Registered Nurse with case management experience, Clinical Psychologist, or Licensed Clinical Social Worker. Position Purpose: The Autism Service Navigator conducts care coordination to develop a comprehensive care plan based on the needs of the beneficiary and family by developing targeted goals and corresponding interventions for the beneficiary. The ASN is responsible to educate and communicate with all parties related to the beneficiaries care and coordinate the medical and local level services for beneficiaries diagnosed with Autism Spectrum Disorder.<ul> <li>Conduct initial care coordination and medical assessment to develop a comprehensive care plan based on the needs of the beneficiary and family. Develop targeted goals and corresponding interventions for the beneficiary at each six month interval and complete the execution of the care plan goals and objectives with the beneficiary and caregivers.</li> <li>Communicate effectively with a wide variety of contacts related to the beneficiary’s care including, but not limited to, the medical home, PCM, referring provider, family caregivers, MTF case managers and referral coordinators, EFMP coordinators and ABA providers.</li> <li>Administer and collect outcome measures at each applicable interval and ensure the integration of the scores over time are incorporated into the comprehensive care plan.</li> <li>Identify issues, anticipate complications, and create and execute action plan to avoid them. Provide health instruction to the patient/family. Refer the patient back to the physician, or other health care team members, as needed.</li> <li>Identify plateaus, improvements, regressions, and depressions. Counsels accordingly and recommends help as needed.</li> <li>Coordinate medical and behavioral health services, MTF services, TRICARE benefit, ECHO services, ABA services, parent mediated programs, and other state or local level services with other identified treatment goals and part of the comprehensive care plan to ensure that program goals are integrated.</li> <li>Coordinate and participate in medical team conference meetings and document a summary of the medical team conference calls.</li> <li>Facilitate continuity of care when a beneficiary in the ACD moves or has a change in benefit coverage. Coordinate all medical care, referrals, and authorizations as the beneficiary moves across regions.</li> <li>Provide educational resources about ASD to the beneficiary and/or family, including but not limited to, appropriate treatments and services, contractor provided parental education modules, available resources (both military and civilian), potential impact of the diagnosis of ASD on the family, and the potential long-term care required to support the beneficiary and help them reach their maximum potential.</li> <li>Clinical and non-clinical duties as assigned</li> </ul>Education/Experience: Associate’s degree, or equivalent experience, in Nursing, Social Work, or Psychology. 3+ years of clinical experience in pediatrics, behavioral health, and/or ASD required. Experience in a healthcare environment and experience in care experience, complex care coordination required. License/Certification: Current, valid, unrestricted license which may include: Registered Nurse with case management experience, Clinical Psychologist, or Licensed Clinical Social Worker.Pay Range: $68,700.00 - $123,700.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Oklahoma Complete Health

Autism Service Navigator

As Associate FDA Counsel, Advertising &amp; Promotion, you'll be responsible for reviewing advertising, promotional, and other consumer-facing materials, ensuring they are compliant with FTC and FDA regulations and guidelines. You’ll partner closely with our Growth and Marketing teams to counsel on marketing content across the full spectrum of platforms, including websites, social media, podcasts, billboards, and TV. You have a strong knowledge of FDA and FTC advertising regulations and cases, and particularly with respect to prescription drugs and health products. You're smart, collaborative, and comfortable working in a dynamic environment while handling several projects at the same time. <h3>What You'll Do:</h3> <ul> <li>Serve as an internal subject matter expert on FTC and FDA advertising and promotion issues as they pertain to health products, and provide guidance to cross-functional teams to maintain compliance with FTC and FDA laws and regulations.</li> <li>Review a wide variety of promotional content within Ro’s collaborative medical-legal-marketing review process. This content includes: Facebook and Google ads, website pages, national TV spots, podcast reads, billboards, contests and sweepstakes, and more.</li> <li>Maintain company-wide guidelines and conduct trainings on advertising and promotion.</li> <li>Learn Ro’s business through and through to enable a multi-dimensional review of content.</li> <li>Collaborate with cross-functional teams to support new strategic initiatives and advertising campaigns.</li> <li>Keep up with and understand the FTC regulatory environment, interpretation of regulations, and new case law.</li> <li>Stay abreast of changes in FDA and FTC regulations and industry trends in advertising, and monitor enforcement actions and relevant litigation.</li> <li>Collaborate closely with cross-functional teams, including Growth and Marketing.</li> <li>Demonstrate a willingness to grow and expand your expertise into adjacent areas of law to support the company’s evolving needs.</li> </ul><h3>What You'll Bring to the Team:</h3> <ul> <li>Juris Doctor (JD) from an accredited law school.</li> <li>Active member in good standing of a state bar association.</li> <li>2-4 years of experience practicing FDA law, with knowledge of the regulatory landscape for the advertising and promotion of FDA-regulated products.</li> <li>Exceptional analytical, research, and writing skills.</li> <li>Strong communication and interpersonal skills, with the ability to build relationships across all levels of the organization.</li> <li>Business-oriented mindset with the ability to translate legal advice into practical solutions.</li> <li>Adaptable and able to thrive in a fast-paced, dynamic environment.</li> <li>Self-starter with the ability to manage multiple projects simultaneously and meet deadlines.</li> <li>Team player with a collaborative work ethic.</li> <li>Passion for the telehealth industry and a desire to make a meaningful impact.</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 base salary for this position ranges from $116,500-$142,000, 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.

Associate FDA Counsel, Advertising & Promotion

<a href="https://career-hcm20.ns2cloud.com/careers?company=L3HHCM20&amp;clientId=jobs2web&amp;career_ns=job_application&amp;career_job_req_id=21749" target="_blank">Apply Now</a> L3Harris is dedicated to recruiting and developing high-performing talent who are passionate about what they do. Our employees are unified in a shared dedication to our customers’ mission and quest for professional growth. L3Harris provides an inclusive, engaging environment designed to empower employees and promote work-life success. Fundamental to our culture is an unwavering focus on values, dedication to our communities, and commitment to excellence in everything we do. L3Harris Technologies is the Trusted Disruptor in the defense industry. With customers’ mission-critical needs always in mind, our employees deliver end-to-end technology solutions connecting the space, air, land, sea and cyber domains in the interest of national security. Job Title: Lead, Release Train Engineer (RTE) Job Code: 21749 Job Location: Tulsa, OK (Onsite) Job Schedule: 9/80 Job Summary: L3Harris Aeromet is seeking a skilled and motivated engineer to join our Systems Engineering team. This role will serve as the Release Train Engineer, managing and optimizing the flow of value through an Agile Release Train, and instill process discipline and a culture of accountability focused on customer satisfaction and supreme quality. Job Description: <ul> <li>Ability to obtain and maintain a DoD Secret security clearance</li> <li>Managing the Agile Release Train (ART) flow of value, or steps used to create value for the project</li> <li>Coordinate and allign ART activities with program strategic goals.</li> <li>Serve as a liason between the software team and program management.</li> <li>Maintain calanders for product increments (Pis). </li> <li>Facilitate PI planning events and motor progress.</li> <li>Monitor the development and implementation of new product features.</li> <li>Collect productivity metrics to assist in improvement of PI workflow.</li> <li>Promote improvement of work flow through post PI retrospectives. </li> <li>Ability to work independently and as a member of a multi-disciplined integrated product team (IPT).</li> </ul> Qualifications: <ul> <li>Bachelor’s Degree and minimum 9 years of prior relevant experience. Graduate Degree and a minimum of 7 years of prior related experience. In lieu of a degree, minimum of 13 years of prior related experience.</li> <li>3 years experience with Scaled Agile Framework (SAFe).</li> </ul> Preferred Additional Skills: <ul> <li>Active DoD security clearance</li> <li>Degree in Electrical Engineering, Mechanical Engineering, Industrial Engineering, Computer Science, Physics, or similar degree path preferred.</li> <li>Knowledge and experience as a scrum master, product owner, release train engineer, or other stakeholder of an agile system.</li> <li>Proficiency in Jira and EasyBI or PowerBI for metric reporting. </li> <li>Experience with managing and coordinating multiple teams within a program or project.</li> <li>Excellent oral and written communication skills.</li> <li>Strong organizational and time management skills.</li> <li>The essential physical requirements of the position will be reviewed with the applicant during the interview.</li> </ul> #LI-AS1 L3Harris Technologies is proud to be an Equal Opportunity Employer. L3Harris is committed to treating all employees and applicants for employment with respect and dignity and maintaining a workplace that is free from unlawful discrimination. All applicants will be considered for employment without regard to race, color, religion, age, national origin, ancestry, ethnicity, gender (including pregnancy, childbirth, breastfeeding or other related medical conditions), gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, characteristic or membership in any other group protected by federal, state or local laws. L3Harris maintains a drug-free workplace and performs pre-employment substance abuse testing and background checks, where permitted by law. Please be aware many of our positions require the ability to obtain a security clearance. Security clearances may only be granted to U.S. citizens. In addition, applicants who accept a conditional offer of employment may be subject to government security investigation(s) and must meet eligibility requirements for access to classified information. By submitting your resume for this position, you understand and agree that L3Harris Technologies may share your resume, as well as any other related personal information or documentation you provide, with its subsidiaries and affiliated companies for the purpose of considering you for other available positions. L3Harris Technologies is an E-Verify Employer. Please click here for the E-Verify Poster in <a href="https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster.pdf" target="_blank">English</a> or <a href="https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf" target="_blank">Spanish</a>. For information regarding your Right To Work, please click here for <a href="https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRights_10_20.pdf" target="_blank">English</a> or <a href="https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRightsSp_10_20.pdf" target="_blank">Spanish</a>. <a href="https://career-hcm20.ns2cloud.com/careers?company=L3HHCM20&amp;clientId=jobs2web&amp;career_ns=job_application&amp;career_job_req_id=21749" target="_blank">Apply Now</a>

Harris Corp - composite aero-structures division

Lead, Release Train Engineer

What you can expectThe Head of U.S. Government Relations will develop and execute public policy and government relations strategies to promote Zoom’s interests in the United States. S/he will develop relationships and work with government officials at the federal, state, and local levels, as well as with trade associations, think tanks, civil society groups, and other organizations to advance Zoom’s public policy objectives. S/he will ensure that Zoom’s leadership is apprised of and well-positioned to manage important public policy developments, both in Washington, DC and in key state capitals. The Head of U.S. Government Relations will report to the Head of Global Public Policy and Government Relations. About the TeamThe Global Public Policy and Government Relations team is Zoom’s API to governments around the world. We prepare Zoom for political and regulatory developments by providing analysis and developing policy strategies. We protect Zoom’s ability to compete by influencing public policies and representing the company before policymakers. We promote Zoom’s business by enhancing its freedom to operate and providing political “air cover”.Responsibilities<ul> <li>Ensuring that Zoom’s executive team and other key staff are aware of and understand the business significance of policy developments of relevance to the company.</li> <li>Collaborating with Zoom colleagues across the company to understand Zoom’s business objectives and product roadmap, in order both to channel Zoom’s individual interests into the policy influencing process, as well as to ensure an accurate understanding of the significance of policy developments to the company.</li> <li>Developing a broad and deep network of relationships with policymakers, thought leaders, and other policy professionals that enhance Zoom’s reputation as a constructive and thoughtful player in the development of public policy.</li> <li>Engaging with Members of Congress and Congressional staff, as well as top Executive Branch agencies (e.g., the White House, Department of Commerce, and Department of Homeland Security) to advocate Zoom’s interests.</li> <li>Managing Zoom’s memberships in U.S.-based trade associations to maximize collaboration with industry colleagues where joint action is beneficial.</li> <li>Driving Zoom’s thought leadership initiatives and partnerships in Washington, DC, including with think tanks, policy organizations, and NGOs focused on issues of relevance to Zoom.</li> <li>Working closely with Zoom’s press team to ensure a tailored communications strategy for Washington, DC, including by interacting with key media organizations and conducting press appearances.</li> <li>Coordinating Zoom’s advocacy and engagement at the state and local level, for example by managing consultants and trade associations focused on specific issues in state capitals.</li> </ul>Requirements<ul> <li>Extensive experience working with senior government officials, private sector leaders, and other public policy professionals in Washington, DC.</li> <li>Deep understanding of the U.S. public policy environment, including the entities within the Executive Branch, U.S. Congress, and otherwise that most directly impact Zoom.</li> <li>Prior experience developing and executing public policy strategies in the technology sector, including with respect to privacy, cybersecurity, and online safety issues.</li> <li>Skill at building diverse, cross-functional, and multi-level relationships and experience advising and interacting with senior business executives.</li> <li>Outstanding written, oral, and interpersonal communications skills, including relevant public speaking and media experience. </li> <li>Proven track record of consistently productive collaboration with diverse colleagues in a high-speed, technically advanced work environment.</li> <li>A high degree of integrity, professionalism, and ability to handle confidential matters.</li> <li>A Bachelor’s degree, and preferably an advanced degree, in law, public policy, business, economics, international affairs, or similar field.</li> <li>A minimum of eight years of experience developing and executing public policy strategies and interacting professionally in a public policy environment.</li> <li>Emotional intelligence, strong interpersonal skills, and a sense of humor.</li> </ul>Salary Range or On Target Earnings:Minimum:$150,800.00Maximum:$329,900.00In addition to the base salary and/or OTE listed Zoom has a Total Direct Compensation philosophy that takes into consideration; base salary, bonus and equity value.Note: Starting pay will be based on a number of factors and commensurate with qualifications &amp; experience.We also have a location based compensation structure; there may be a different range for candidates in this and other locationsAt Zoom, we offer a window of at least 5 days for you to apply because we believe in giving you every opportunity. Below is the potential closing date, just in case you want to mark it on your calendar. We look forward to receiving your application!Anticipated Position Close Date:04/30/25Ways of Working Our structured hybrid approach is centered around our offices and remote work environments. The work style of each role, Hybrid, Remote, or In-Person is indicated in the job description/posting.Benefits As part of our award-winning workplace culture and commitment to delivering happiness, our benefits program offers a variety of perks, benefits, and options to help employees maintain their physical, mental, emotional, and financial health; support work-life balance; and contribute to their community in meaningful ways. Click <a href="https://careers.zoom.us/benefits" target="_blank">Learn</a><a href="http://careers.zoom.us/benefits" target="_blank"> </a>for more information.About Us Zoomies help people stay connected so they can get more done together. We set out to build the best collaboration platform for the enterprise, and today help people communicate better with products like Zoom Contact Center, Zoom Phone, Zoom Events, Zoom Apps, Zoom Rooms, and Zoom Webinars. We’re problem-solvers, working at a fast pace to design solutions with our customers and users in mind. Here, you’ll work across teams to deliver impactful projects that are changing the way people communicate and enjoy opportunities to advance your career in a diverse, inclusive environment. Our Commitment​ We believe that the unique contributions of all Zoomies is the driver of our success. To make sure that our products and culture continue to incorporate everyone's perspectives and experience we never discriminate on the basis of race, religion, national origin, gender identity or expression, sexual orientation, age, or marital, veteran, or disability status. Zoom is proud to be an equal opportunity workplace and is an affirmative action employer. All your information will be kept confidential according to EEO guidelines.We welcome people of different backgrounds, experiences, abilities and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. If you need assistance navigating the interview process due to a medical disability, please submit an <a href="https://form.asana.com/?k=OIuqpO5Tv9XQTWp1bNYd8w&amp;d=1127274756253361" target="_blank">Accommodations Request Form</a> and someone from our team will reach out soon. This form is solely for applicants who require an accommodation due to a qualifying medical disability. Non-accommodation-related requests, such as application follow-ups or technical issues, will not be addressed.#LI-Remote

Zoom

Head of U.S. Government Relations

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 SummarySchedule: Tuesday - Saturday | 11am-7:30pm EST Holiday work is expected.Schedules may be adjusted based on business need.Responsible for provision of telephone-based consultation, counseling and informational services to members.Provides one-time or ongoing counseling and lifestyle management services, leveraging the outcomes tools in support of optimal careMember Support:<ul> <li>Consultation - Provides telephone triage, crisis intervention and related services.</li> <li>Assesses member’s immediate clinical needs and utilizes appropriate clinical tools to identify and provide services.</li> <li>Engages members and provides immediate support and assists with coping skills to address ongoing lifestyle management.</li> <li>Determines appropriate intervention, action steps in dealing with member’s situational concerns including members in crisis.</li> </ul>Counseling: <ul> <li>Provides telephone counseling to individuals with a variety of presenting issues including but not limited to mental, emotional, disorders, conditions, addictions, lifestyle management and worklife concerns.</li> <li>Can consist of individual, joint or family sessions</li> <li>Can be stand alone or on-going sessions</li> <li>Provides clinical services utilizing a variety of advanced clinical assessments, therapeutic interventions and/or models, which supports the level of care and engagement of members and are in alignment with the member’s theory of change.</li> <li>Uses appropriate and acceptable judgment, clinical theories, knowledge, methods, ethics, and professional use of self to restore or enhance social, psychosocial, or biopsychosocial functioning of members.</li> <li>Provides intensive case management and consultation for clinical risk cases and management referrals.</li> </ul>Informational Services:<ul> <li>Provides information to members and providers regarding mental health, substance abuse benefits, community treatment resources, and related mental health programs</li> <li>Assists members with linkage to resources to aid in the alleviation of stressors</li> </ul>Team member support:<ul> <li>Collaborates with team of professionals in a way that supports a positive clinical outcome and continuity of care for all members</li> <li>Interacts with internal and external providers as appropriate to discuss clinical questions and concerns regarding specific cases</li> <li>Provides consultation to supervisors and other account representatives in order to facilitate appropriate EAP response to employees with performance, attendance, safety, and fitness for duty, critical incidents and other work related problems</li> </ul>Compliance with Policies and Regulatory Standards:<ul> <li>Protects the confidentiality of member information and adheres to enterprise, EAP policies regarding confidentiality.</li> <li>Maintains accurate and complete documentation of required information that meets risk management and regulatory requirements.</li> <li>Maintain current independent clinical licensure in good standing, meet all licensure requirements within state guidelines and seek professional development</li> </ul>Required Qualifications<ul> <li>1+ year of crisis intervention skills required</li> <li>Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/ one or more or equivalent is required: LPC, LMFT, LCSW, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist.</li> </ul> Preferred Qualifications<ul> <li>1+ years of EAP, Behavioral Health or Social Services experience</li> <li>Experience working with diverse populations - Familiarity with brief therapy models and Motivational Interviewing</li> <li>Call Center work experience preferred</li> <li>Ability to establish and maintain rapport quickly to develop a high level of customer trust</li> <li>Experience in facilitating patient/client positive behavior change</li> <li>Strong computer and literacy skills</li> <li>24x7x365 call center coverage needed, holiday coverage may be required</li> <li>Experience in handling mental health, psychiatric care, family situations and relationship concerns preferred</li> </ul> EducationMaster’s Degree in behavioral health counseling profession.Anticipated 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. 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: 03/26/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

EAP Clinical Counselor

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.Implements Value Based Care (VBC) National Primary Care network strategies, monitors provider performance metrics, leads dispute resolution processes, and collaborates with key stakeholders to drive network growth and ensure high-quality provider relationships. What you will do<ul> <li>Develops and implements internal and external strategies to effectively assess and advance the performance of healthcare providers within the company's network.</li> <li>Develops and maintains provider scorecards and performance reports to track and communicate performance metrics to internal stakeholders, executives, and network providers.</li> <li>Monitors and evaluates provider performance metrics, such as quality indicators, patient satisfaction scores, cost efficiency measures, and adherence to clinical guidelines.</li> <li>Communicates with providers to develop and implement initiatives aimed at enhancing quality of care, patient outcomes, and operational efficiency.</li> <li>Contributes to business objectives by collaborating with the network development team to identify providers that align with the company's strategic goals and objectives.</li> <li>Manages operational aspects of the team, and implements workforce and succession plans to successfully achieve business goals.</li> <li>Guides management for individual performance evaluations aimed to provide critical feedback for skills development and depth of work area experience.</li> <li>Develop JOC decks and lead presentations with external facing provider groups</li> </ul> Required Qualifications:<ul> <li>A minimum of 5 years related experience with provider engagement, relations, or account management.</li> <li>Working knowledge of Medicare contracts.</li> <li>An understanding of value based contracts, how they work, what is the value.</li> <li>Strong presentation skills, the ability to communicate effectively.</li> <li>Mastery of problem solving and decision making skills </li> <li>Strong MS Office skills.</li> </ul>Preferred Qualifications:<ul> <li>The ability to use data to tell a story.</li> <li>Mastery of growth mindset (agility and developing yourself and others) skills.</li> </ul> Education:<ul><li>Bachelor's degree preferred or a combination of professional work experience and education. </li></ul>Pay RangeThe typical pay range for this role is:$67,900.00 - $199,144.00 This 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. This position also includes an award target in the company’s equity award program. 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: 03/22/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Provider Performance Sr. Manager, Primary Care

<h3>Details </h3><ul> <li> Department: Med/Surg</li> <li> Schedule: Part Time, Night Shift, 24 hours per week </li> <li> Hospital: Ascension St. John Sapulpa</li> <li> Location: Sapulpa, Ok. </li> </ul><h3>Benefits </h3>Paid time off (PTO) Various health insurance options &amp; wellness plans Retirement benefits including employer match plans Long-term &amp; short-term disability Employee assistance programs (EAP) Parental leave &amp; adoption assistance Tuition reimbursement Ways to give back to your communityBenefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer.<h3>Responsibilities </h3>Provide care to patients under the direction of a registered nurse or physician, functioning within scope of license.<ul> <li>Contribute to the assessment of patients and assure the well-being of patients.</li> <li>Administer medications and observe patients for adverse reactions to medications or treatments.</li> <li>Perform laboratory tests and therapeutic services.</li> <li>Educate patients/families about disease treatment plan including self care post discharge, holistic health needs, available resources and follow up care.</li> </ul><h3>Requirements </h3>Licensure / Certification / Registration:<ul> <li>BLS Provider obtained within 1 Month (30 days) of hire date or job transfer date required. American Heart Association or American Red Cross accepted.</li> <li>Licensed Practical/Vocational Nurse credentialed from the Oklahoma Board of Nursing required.</li> </ul>Education:<ul><li>High School diploma equivalency or 1 year of applicable cumulative job specific experience required.<ul><li>Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.</li></ul> </li></ul><h3>Additional Preferences </h3>Experienced Nurse with good customer service.<h3>Why Join Our Team </h3>Ascension St. John has been serving Northeast Oklahoma with compassionate, personalized care since 1926. Join more than 7,000 associates and find a rewarding healthcare career at one of our 6 hospitals and numerous other sites of care. When you join our care teams, you join a team dedicated to providing spiritually centered, holistic care which sustains and improves the health of the communities we serve.Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.<h3>Equal Employment Opportunity Employer </h3>Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.For further information, view the <a href="https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRights_10_20.pdf" target="_blank">EEO Know Your Rights (English)</a> poster or <a href="https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRightsSp_10_20.pdf" target="_blank">EEO Know Your Rights (Spanish)</a> poster.As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.<a href="https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf" target="_blank">Pay Non-Discrimination Notice</a>Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.<h3>E-Verify Statement </h3>This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. <a href="https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf" target="_blank">E-Verify</a>

Ascension

LPN/LVN - Licensed Practical Nurse - Med/Surg Unit

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 SummaryResponsible for intake, investigation and resolution of appeals, complaints and grievances scenarios for all products, which may contain multiple issues and, may require coordination of responses from multiple business units. Ensure timely, customer focused response to appeals, complaints and grievance. Identify trends and emerging issues and report and recommend solutions.-Research incoming electronic appeals, complaints and grievance to identify if appropriate for unit based upon published business responsibilities. Identify correct resource and reroute inappropriate work items that do not meet appeals, complaints and grievance criteria. -Research Standard Plan Design or Certification of Coverage relevant to the member to determine accuracy/appropriateness of benefit/administrative denial. -Research claim processing logic to verify accuracy of claim payment, member eligibility data, billing/payment status, prior to initiation of appeal process. -Identify and research all components within member or provider/practitioner appeals, complaints and grievance for all products and services. -Triage incomplete components of appeals, complaints and grievance to appropriate subject matter expert within another business unit(s) for resolution response content to be included in final resolution response. -Responsible for coordination of all components of appeals, complaints and grievance including final communication to member/provider for final resolution and closure. -Serve as a technical resource to colleagues regarding appeals, complaints and grievance issues, and similar situations requiring a higher level of expertise. -Identifies trends and emerging issues and reports on and gives input on potential solutions.-Ability to meet demands of a high paced environment with tight turnaround times. -Ability to make appropriate decisions based upon Aetna's current policies/guidelines. -Collaborative working relationships. -Thorough knowledge of member and/or provider appeals, complaints and grievance policies. -Strong analytical skills focusing on accuracy and attention to detail. -Knowledge of clinical terminology, regulatory and accreditation requirements. -Excellent verbal and written communication skills. -Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word. Required Qualifications-Experience in reading or researching benefit language. -1-2 years experience that includes but is not limited too claim platforms, products, and benefits; patient management; product or contract drafting; compliance and regulatory analysis; special investigations; provider relations; customer service or audit experience. Preferred Qualifications -Experience in research and analysis of claim processing a plus. Education-Some college preferred. -High School or GED equivalent.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: 03/31/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Appeal and Grievance Coordinator - MUST live in OK

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.<ul><li>Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.</li></ul><ul><li>Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making.</li></ul><ul><li>Supports effective implementation of performance improvement initiatives for capitated providers.</li></ul><ul><li>Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.</li></ul><ul><li>Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.</li></ul><ul><li>Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.</li></ul><ul><li>Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes.</li></ul><ul><li>Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.</li></ul><ul><li>Participates in provider network development and new market expansion as appropriate.</li></ul><ul><li>Assists in the development and implementation of physician education with respect to clinical issues and policies.</li></ul><ul><li>Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.</li></ul><ul><li>Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care.</li></ul><ul><li>Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality.</li></ul><ul><li>Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.</li></ul><ul><li>Develops alliances with the provider community through the development and implementation of the medical management programs.</li></ul><ul><li>As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.</li></ul><ul><li>Represents the business unit at appropriate state committees and other ad hoc committees.</li></ul><ul><li>May be required to work weekends and holidays in support of business operations, as needed.</li></ul>Education/Experience: Medical Doctor or Doctor of Osteopathy. Utilization Management experience and knowledge of quality accreditation standards preferred. Actively practices medicine. Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous. Experience treating or managing care for a culturally diverse population preferred. License/Certifications: Board certification by the American Board of Psychiatry and Neurology. Current state medical license without restrictions. Medical Licenses in CA, NV, OR, and / or WA, preferred Pay Range: $231,900.00 - $440,500.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Remote Behavioral Medical Director - West Region

<h3>Details </h3><ul> <li> Department: Plastic Surgery Clinic</li> <li> Schedule: Full Time, Monday-Friday: 8:00am-5:00pm</li> <li> Location: Ascension Medical Group - Tulsa, Ok. </li> </ul><h3>Benefits </h3>Paid time off (PTO) Various health insurance options &amp; wellness plans Retirement benefits including employer match plans Long-term &amp; short-term disability Employee assistance programs (EAP) Parental leave &amp; adoption assistance Tuition reimbursement Ways to give back to your communityBenefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer.<h3>Responsibilities </h3>Provide care to patients under the direction of a registered nurse or physician, functioning within scope of license.<ul> <li>Contribute to the assessment of patients and assure the well-being of patients.</li> <li>Administer medications and observe patients for adverse reactions to medications or treatments.</li> <li>Perform laboratory tests and therapeutic services.</li> <li>Educate patients/families about disease treatment plan including self care post discharge, holistic health needs, available resources and follow up care.</li> </ul><h3>Requirements </h3>Licensure / Certification / Registration:<ul> <li>BLS Provider obtained within 1 Month (30 days) of hire date or job transfer date required. American Heart Association or American Red Cross accepted.</li> <li>Licensed Practical/Vocational Nurse credentialed from the Oklahoma Board of Nursing required. Valid OK LPN license or license issued by State of Kansas for positions residing in Kansas required. Knowledge and skill in writing prescriptions for the Physician as needed.</li> </ul>Education:<ul><li>High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.<ul><li>Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.</li></ul> </li></ul><h3>Additional Preferences </h3>No additional preferences.<h3>Why Join Our Team </h3>Ascension St. John has been serving Northeast Oklahoma with compassionate, personalized care since 1926. Join more than 7,000 associates and find a rewarding healthcare career at one of our 6 hospitals and numerous other sites of care. When you join our care teams, you join a team dedicated to providing spiritually centered, holistic care which sustains and improves the health of the communities we serve.Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.<h3>Equal Employment Opportunity Employer </h3>Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.For further information, view the <a href="https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRights_10_20.pdf" target="_blank">EEO Know Your Rights (English)</a> poster or <a href="https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRightsSp_10_20.pdf" target="_blank">EEO Know Your Rights (Spanish)</a> poster.As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.<a href="https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf" target="_blank">Pay Non-Discrimination Notice</a>Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.<h3>E-Verify Statement </h3>This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. <a href="https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf" target="_blank">E-Verify</a>

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