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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 Research and process grievances and appeals for Dual eligible members and providers. Perform outreach to obtain additional information. Interact with Medical Directors and Nurses as well as Leadership. Required Qualifications<ul><li>1 year of experience processing health insurance grievance and appeal cases.</li></ul> Preferred Qualifications<ul><li>6+ years of experience Medicare and Medicaid appeal and grievance preferred</li></ul> Education<ul><li>High School Diploma or GED required</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$21.10 - $44.99This 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: 06/04/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Complaint and Appeals Analyst - Fully Remote

Overview Are you looking for a rewarding career? 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. Attractive pay $135,000.00 - $145,000.00 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. What's in it for you A full benefits package with choice of affordable PPO or HSA medical plans. Paid time off. Up to $1,000 in free healthcare services paid by Amedisys yearly, when enrolled in an Amedisys HSA medical plan. 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.* Mental health support, including up to five free counseling sessions per year through the Amedisys Employee Assistance program. 401(k) with a company match. Family support with infertility treatment coverage*, adoption reimbursement, paid parental and family caregiver leave. And more. Please note: Benefit eligibility can vary by position depending on shift status. *To participate, you must be enrolled in an Amedisys medical plan. **For full-time caregivers meeting certain requirements. Why Amedisys Amedisys is a leading provider of home health, hospice, and high-acuity care, dedicated to helping patients and families navigate the complex healthcare system. With a focus on compassionate, patient-centered care, you would be joining a team of professionals committed to improving the lives of those they serve. Don’t just take it from us “I have worked here just shy of a year and it’s the best job I’ve ever had! We have an awesome team and administration is very supportive. I never felt so appreciated.” – Amedisys caregiver Responsibilities You will be responsible for designing, implementing, evaluating, and overseeing learning programs that enhance the skills, knowledge, and competencies of employees and volunteers in conjunction with clinical and operational business leaders. This position plays a pivotal role in shaping the growth and professional development of clinical staff and care center leadership. Strategic Planning: <ul> <li>Partners with the clinical operations leadership team, actively supporting and advancing the company's overall business goals and strategic direction.</li> <li>Works closely with the Business Leadership Team to develop a comprehensive learning and</li> <li>development strategy that aligns with the business unit, overall learning strategy, and company mission and values.</li> <li>Identifies key learning priorities and creates a roadmap for continuous improvement.</li> <li>Provides crucial support to decision-markers in clinical operations by aligning educational initiatives with organizational goals and regulatory requirements.</li> </ul> Program Design and Implementation: <ul> <li>Designs content aligned with strategy.</li> <li>Directs and implements learning content, workshops, and training sessions.</li> <li>Utilizes the e-learning platform effectively to deliver accessible, engaging training content.</li> <li>Ensures that learning programs address both organizational needs and individual employee development plans while adhering to adult learning principles and includes consideration of appropriate content, format, length, and timing.</li> </ul> Staff Development: <ul> <li>Collaborates with departmental managers and stakeholders to assess learning needs across various roles (clinical, administrative, and support staff).</li> <li>Develops targeted training programs to enhance skills, competencies, and overall performance.</li> <li>Fosters a culture of continuous learning and professional growth through innovative blended learning offerings (in-person, virtual, and self-paced training).</li> <li>Assists enterprise leadership in planning, directing, organizing, and facilitating individual and group education across the organization. Aligns training program development and delivery with business needs and goals.</li> <li>Mentors and coaches employees to achieve their defined goals and objectives, utilizing performance assessments and feedback to drive accountability.</li> </ul> Quality and Continuous Improvement: <ul> <li>Monitors the effectiveness of learning programs through continuous feedback, assessments, and performance metrics, making data-driven adjustments to improve program outcomes.</li> <li>Stays informed about industry trends and best practices in learning and development to ensure programs remain relevant and impactful.</li> <li>Communicates program success metrics, feedback, and recommendations to stakeholders.</li> </ul> Compliance and Regulatory Training: <ul> <li>Ensures all staff members receive mandatory training related to business unit regulations, safety, compliance and organizational required learning content and training.</li> <li>Collaborates with relevant departments to maintain compliance with state and federal requirements, as well as the Amedisys Compliance Program and other internal policies and procedures.</li> </ul> Collaboration: <ul> <li>Partners with the People Team to integrate learning initiatives into overall talent management processes.</li> <li>Builds and maintains meaningful relationships with stakeholders to understand its training and educational needs and gain buy-in for strategic plans.</li> <li>Leads and develops a high-performing team, fostering collaboration, accountability, and professional growth to achieve organizational goals.</li> <li>Collaborates with external training providers, educational institutions, and industry associations to supplement internal capabilities.</li> <li>Performs other duties as assigned.</li> </ul> Qualifications Required: <ul> <li>Current, unencumbered license to practice as a Registered Nurse.</li> <li>Bachelor's degree in education, business, or a related field.</li> <li>Ten (10+) years of experience in learning and development, preferably in healthcare or home health/hospice settings.</li> <li>Five (5+) years' supervisory experience.</li> <li>Strong understanding of adult learning principles and instructional design.</li> <li>Proficiency in utilizing e-learning platforms and development research tools.</li> <li>Excellent communication, leadership, and collaboration skills.</li> <li>Passion for supporting the growth and well-being of staff.</li> <li>Ability to manage and balance multiple, highly visible projects simultaneously.</li> </ul> Preferred: <ul> <li>Master's degree in education, health or business or related field.</li> <li>Experience working with electronic documentation systems and/or other home health software systems.</li> </ul> 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

Sr Director, Clinical Learning & Development - Home Health

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>Network implementation manager.</li> <li>Configure custom, domestic, and direct-to-employer networks. </li> <li>Subject matter expert for network files, network IDs, and PPO codes.</li> <li>User Acceptance Testing for new implementations and issue resolution.</li> <li>Performs research for network issues and partners with EDI IT on resolution.</li> <li>Coordinates custom online provider directories.</li> </ul> Required Qualifications<ul> <li>2+ years healthcare industry experience.</li> <li>1+ year network operations or provider relations experience.</li> <li>Proficiency in Microsoft Office Suite (Word, Excel, Outlook, etc.).</li> </ul>Preferred Qualifications<ul> <li>1+ year of implementation management experience</li> <li>1+ year of vendor management experience</li> </ul> Education<ul><li> High School Diploma or GED</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $122,400.00This 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: 05/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Senior Network Analyst

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 TeamAs a member of our diverse and skilled North America Solution Consulting team, you will have the opportunity to communicate and demonstrate the power of Workday's applications to prospects and customers alike. It is this team's job to bring the value of Workday solutions to life and showcase how the world of work can be transformed. Along with working closely with our sales counterparts, this team also sits at the exciting intersection of our Product Management, Consulting Services, Marketing, and Value Management teams, providing exposure to various areas of the business.About the RoleThis is your chance to guide a world class Solution Consulting Team focused on Financials and responsible for selling to prospects and customers in State and Local government. You will be aided and surrounded by some of the first-rate and brightest people in the industry; people who care about our customers and care about assisting them accomplish the results they seek. You will oversee the performance and delivery in support to the sales organization within the region while contributing to the growth of the region and department. Open to traveling 30%About YouBasic Qualifications:<ul><li> Manager, Solution Consultant <ul> <li>5+ years in a sales-related role (sales, presales, value management, customer success, etc.) selling enterprise software</li> <li>2+ years of experience leading people and/or mentoring colleagues on sales opportunity strategy</li> <li>3+ years of working in or selling to Human Resources organizations or have practical HCM experience like Workforce Management, Benefit, comp etc.</li> </ul> Sr. Manager, Solution Consultant <ul> <li>7+ years in a sales-related role (sales, presales, value management, customer success, etc.) selling enterprise software</li> <li>4+ years of experience leading people and/or mentoring colleagues on sales opportunity strategy</li> <li>5+ years of working in or selling to Human Resources organizations or have practical HCM experience like Workforce Management, Benefit, comp etc.</li> </ul> </li></ul>Other Qualifications:<ul> <li>Excellent verbal and written communication skills</li> <li>Experience in a fast-paced work environment</li> <li>Strong problem-solving and critical thinking skills</li> <li>A track record of hiring and retaining innovative employees</li> <li>Consistent achievement or overachievement of assigned goals and targets</li> <li>Success in mentoring coworkers in ways that allowed them to learn new skills and achieve career goals</li> <li>Collaborative with those in other roles to work towards shared goals</li> <li>A history of using data to support your decision-making process</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="https://workdaybenefits.com/us/welcome-to-workday-benefits/prospective-workmates" target="_blank">click here</a>.Primary Location: USA.VA.McLean (Tyson's Corner) Primary Location Base Pay Range: $142,800 USD - $214,200 USD Additional US Location(s) Base Pay Range: $142,800 USD - $214,200 USDIf performed in Colorado, the pay range for this job is $ - $ USD based on min and max pay range for that role if performed in CO.The application deadline for this role is the same as the posting end date stated as below: 06/09/2025 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

Manager, Solution Consultant - Workday Financials - State and Local Government

CompanyCox Automotive - USAJob Family GroupSalesJob ProfileClient Solu Spec II - Express - CAIManagement LevelIndividual Contributor Flexible Work Option Can work remotely but need to live in the specified city, state, or regionTravel %NoWork ShiftDayCompensationCompensation includes a base salary of $49,400.00 - $74,200.00. The salary rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's experience. In addition to the salary range identified herein, this role is also eligible for an annual incentive/commission target of $15,000.00.Job DescriptionA Client Solutions Specialist II functions as a member of the Manheim Express team for a designated geographical territory. Primary responsibilities of the role include providing accurate and complete documentation of overall vehicle condition within the parameters of a Manheim Express Inspection and driving incremental business growth within their assigned territory. They will collaborate with the field sales team, auction team members, and other Cox Automotive business units to create and execute a growth strategy.In addition to providing quality vehicle inspections, this client-facing role will take a consultative approach in educating franchise and independent automotive dealers about the Manheim Marketplace, as well as advising them in the utilization of digital wholesale solutions, including Manheim Express and OVE. The Client Solutions Specialist II will provide additional value to our clients by providing outstanding personalized customer service and exceeding the client’s expectations. PRIMARY DUTIES/KEY RESPONSIBILITES<ul> <li>Locate, start, move, and inspect vehicles on dealers’ lots safely.</li> <li>Conduct thorough assessment of vehicle condition following the Manheim Express Inspection process.</li> <li>Verify vehicle identification and enter accurate vehicle information into the inspection system (ie. VIN, mileage, and sub series)</li> <li>Inspect and record vehicle equipment and options, including damage and missing or inoperable items.</li> <li>Inspect and record vehicle exterior condition, including tires, frame, glass, panels, and mechanical components.</li> <li>Inspect and record vehicle interior condition, including seats, dashboard, infotainment system, and options.</li> <li>Perform basic mechanical inspections on vehicles including powertrain, drivetrain, structural, and electrical components.</li> <li>Functions as a team player and work closely with other team members, sales and auction partners, and our client care staff to create a superior client experience.</li> <li>Utilize Salesforce for planning, tracking, and reporting. </li> <li>Inform, educate, and advise dealers regarding policies, procedures, and marketplace strategies.</li> <li>Develop and strengthen relationships with dealers over the phone, online, and in-person.</li> <li>Reviews customers’ performance and recommends solutions for improving conversion rate and/or market share.</li> <li>Partners with sales team in educating and training dealers on Manheim Express products and services.</li> <li>Identifies opportunities for growth and presents Manheim Express as a solution for new and existing clients</li> <li>Demonstrates professionalism and sincere appreciation for client relationships.</li> <li>Strive to consistently improve the client experience by providing high levels of customer service. </li> <li>Generates leads to other Cox Automotive business units.</li> <li>Visibly demonstrates safety commitment by following all safety and health procedures and modeling the behaviors related to such. Actively participate in support of all safety activities aligned with Safety Excellence.</li> <li>Performs other duties as assigned by management.</li> </ul>REQUIRED EXPERIENCE &amp; SPECIALIZED KNOWLEDGE AND SKILLS<ul> <li>BA/BS degree and 2 years work related experience; or an equivalent combination of education and work-related experience.</li> <li>Automotive knowledge preferred.</li> <li>3+ years Auction experience or dealership experience preferred.</li> <li>Valid driver’s license and safe driving record required.</li> <li>Reliable transportation is required. Mileage reimbursed.</li> <li>Effective communication (written and verbal) and interpersonal skills required.</li> <li>Strong technical aptitude.</li> <li>Must be detail orientated.</li> <li>Experience in navigating handheld and other documentation devices preferred.</li> <li>Motivated to work independently with remote supervision.</li> <li>Ability to multitask, follow directions and take instruction is required.</li> <li>Body, paint, and mechanical repair knowledge helpful. </li> <li>Familiarity with unibody and full-frame helpful.</li> <li>Ability to lift and hold at least 30 lbs. at waist level for an extended period of time.</li> <li>Regularly required to stand, walk, talk, and hear.</li> <li>Frequently required to crouch, bend, and kneel to look at side or underneath car. Strength to lift hood or trunk. Bend while performing audits. Reach inside or underneath vehicle. </li> <li>Near vision abilities required to find dings and scratches, paint work, hail damage, frame/unibody, other exterior damage and Interior damage. Able to identify exterior or interior colors.</li> <li>Ability to deal with different lighting (i.e. exterior and interior lighting, natural and artificial light)</li> <li>Exposure to moderate noise level, may be exposed to fumes and odors.</li> <li>Requires physical ability and mental acuity to execute the duties of the position successfully within required timeframes to meet business requirements.</li> <li>Ability to engage customers in a consultative manner.</li> <li>Solid computer skills, including ability to use Internet and MS Office effectively.</li> <li>Ability to adapt to and work effectively within a constantly changing environment.</li> <li>Excellent customer service and problem-solving skills required.</li> <li>Ability to perform repetitive tasks; manual dexterity.</li> </ul>Drug TestingTo be employed in this role, you’ll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited.BenefitsThe Company offers eligible employees the flexibility to take as much vacation with pay as they deem consistent with their duties, the company’s needs, and its obligations; seven paid holidays throughout the calendar year; and up to 160 hours of paid wellness annually for their own wellness or that of family members. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells – or simply uses – cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer – All qualified applicants/employees will receive consideration for employment without regard to that individual’s age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. <h3> </h3>

Cox Communications

Client Solutions Specialist II (Manheim Express, Seattle, WA)

Cox Automotive Inc.

Overview Are you looking for a rewarding career as a Payor Contract Manager? 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. Attractive pay <ul> <li>$80 - $112K</li> <li>Bonus eligible</li> </ul> Enjoy many perks and benefits <ul> <li>A full benefits package (with affordable health insurance options.)</li> <li>401k with a match.</li> <li>Up to $500 in wellness rewards and up to $1,200 in free healthcare services paid for by Amedisys yearly.</li> <li>Mental health support.</li> <li>Infertility coverage, adoption reimbursement and paid parental leave.</li> <li>Paid time off and paid holidays.</li> <li>And more.</li> </ul> Don't just take it from us "After working for Amedisys for almost 5 years I feel that from the CEO on down, there is a culture of sincerely wanting to be a great employer - and it shows. The pay is above average, the benefits are great, and the paid time off is generous."- Amedisys employee Why Amedisys Amedisys is a leading provider of home health, hospice, and high-acuity care, dedicated to helping patients and families navigate the complex healthcare system. With a focus on compassionate, patient-centered care, you would be joining a team of professionals committed to improving the lives of those they serve. Responsibilities <ul> <li>Responsible for achieving prioritized contracting targets for market.</li> <li>Collaborates with director and payor contracting to achieve regional/market goals and contract targets.</li> <li>Accountable for a service line strategy (e.g., home health, hospice, personal care or ACO), including understanding and informing standard rate logic, language, and business requirements to inform and influence portfolio strategies.</li> <li>Ensures successful execution of projects for the payor contracting team including, but not limited to, payor contracting initiatives that are associated with global contract/coding updates and merger/acquisition activity.</li> <li>Completes contracting efforts associated with addition/termination of locations/markets.</li> <li>Reviews, vets, and prioritizes requests for new contracts.</li> <li>Preps initial due diligence documentation and recommended action plan for regional leadership team/director/senior vice president as required.</li> <li>Conducts market research to proactively identify risks/opportunities to inform market strategies.</li> <li>Maintains relationships with vendors, payors and other third parties in order to enhance strategic relationships.</li> <li>Monitors and maintains database and related contracting information system payor files for accurate and timely claims processing.</li> <li>Performs other duties as assigned.</li> </ul> Qualifications Requirements <ul> <li>Bachelor's degree in business or related field.</li> <li>Five years of experience in managed care contracting and contract-related accountabilities in or around home health, hospice, health plan or large health care system.</li> </ul> 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.

Payor Contract Manager - Remote

NOC Analyst (Technical Incident Management) What you can expect As a NOC Analyst at Zoom, you'll work in a 24/7 operational environment with rotating shifts, monitoring system alerts and managing incidents in real-time. You'll collaborate with global teams using advanced monitoring tools, handle high-pressure situations, and make quick decisions to maintain service stability. The role demands multitasking and communication skills while offering growth opportunities through hands-on experience with enterprise systems and cloud technologies. About the Team As a member of the global NOC team, you will be responsible for maintaining Zoom services operational and monitoring Infrastructure &amp; AWS cloud technologies. You will ensure the uptime of Zoom applications and utilize analytical tools to evaluate internal &amp; external KPI/SLA metrics. Our monitoring tools are essential for identifying, detecting, and resolving issues to maintain smooth operations. What we’re looking for • 5+ years of proven incident management expertise in handling customer-impacting situations. • Have demonstrated ability to manage high-intensity incidents and drive effective resolutions. • Have the ability and understanding of infrastructure, including multi-cloud environments. • Have solid knowledge of application deployments in DevOps environments. • Have advanced proficiency with enterprise monitoring tools (Grafana, Splunk). • Have experience with ITSM workflow and process implementation. • Have practical experience in Jira report creation. • Be able to track record in managing change control and incident review meetings.Ways 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. Find room to grow with opportunities to stretch your skills and advance your career in a collaborative, growth-focused environment. Our Commitment​At Zoom, we believe great work happens when people feel supported and empowered. We’re committed to fair hiring practices that ensure every candidate is evaluated based on skills, experience, and potential. If you require an accommodation during the hiring process, let us know—we’re here to support you at every step.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

NOC Analyst

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 Complete escalated Grievance and Appeal cases submitted by state and federal regulatory bodies. Required Qualifications<ul><li>2-3 years of must have experience processing health insurance grievance and appeal cases.</li></ul> Preferred Qualifications<ul><li>Compliance experience</li></ul><ul><li>Regulatory experience Medicare and Medicaid.</li></ul> Education<ul><li>High School Diploma or GED Required</li></ul>Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $112,200.00This 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: 06/04/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Grievance and Appeal - Senior Analyst

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.Effectively manages competitive and complex contractual relationships with TPAs and/or business partners in Europe, APAC, Africa and Middle East excluding Americas region in support of international network, medical cost management and overall claim/customer service strategies. Provide concierge level of service to our members via timely provision of required network access and proactive management of network relationships to ensure seamless direct settlement access. Job Responsibilities:<ul> <li>Manage TPA relationship with external vendors and own overall relationship with assigned TPAs in Europe, Africa, Middle East and APAC region.</li> <li>Oversee and manage contractual relationship with assigned TPA(s).</li> <li>Manage Third Party Risk Governance process for your assigned TPA(s).</li> <li>Manage ongoing Aetna compliance review process for your assigned TPA(s).</li> <li>Manage monthly billing / submission of TPA invoices for timely payment</li> <li>Ensure TPA networks are timely reviewed and uploaded on internal Aetna systems.</li> <li>Ensure TPA guides, country guides and other internal materials are timely updated and up to date.</li> <li>Ensuring streamline member experience at each country level. Evaluate network options, network efficacies and optimize network utilization to increase direct billing.</li> <li>End to end ownership of operational issues originating from assigned TPAs and work towards swift resolutions.</li> <li>Effectively negotiates and manages complex, competitive contractual relationships with providers/vendors according to prescribed guidelines in support of global and regional network strategies. Expand International provider network by contracting new direct pay providers and manage overall contracting process.</li> <li>Act as a Subject matter expert to assist internal sales, account management and sales support team on network and TPA questions / inquiries. Support sales as a subject matter expert on external broker / client calls.</li> <li>Oversee and manage any operational issues and queries regarding your assigned TPA(s).</li> <li>Manage day to day provider operations, either direct or through network business partners. Ensures operational efficiency for all network processes and infrastructure through proactive provider education and collaboration with Aetna International Service Operations</li> <li>Executes regional-specific strategies and tactics in response to market expectations</li> <li>Executes client-specific strategies and tactics for key expatriate clients.</li> <li>Responsible for understanding and managing medical cost issues and initiating appropriate action from the provider perspective</li> <li>Key contributor to enhanced provider service solution like provider portal and other digital solution, including development and/or management of process and technical support.</li> <li>Initiate legal reviews as needed; ensure all required reviews completed by appropriate functional areas</li> </ul>Required Qualifications:<ul> <li>Benefits Management/Interacting with Medical Professionals</li> <li>Strong project management skills</li> <li>Prior client facing experience.</li> <li>Managing vendor relationships</li> <li>General Business/Demonstrating Business and Industry Acumen</li> <li>Sales/Managing Competitive Networks</li> </ul>Preferred Qualification:<ul> <li>Leadership/Fostering a Global Perspective</li> <li>Health Insurance understanding / business negotiations</li> <li>Service/Demonstrating Service Discipline</li> </ul>Education<ul><li>Bachelors 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. 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: 06/21/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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