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Job Description SUMMARY: The Client Coordinator will support the Client Services Team in serving and responding to clients needs on a daily basis. Essential Duties and Responsibilities include the following. Other duties may be assigned. • Works on site with consistent attendance., • Consistent Attendance, • Data entry, • Daily Fulfillments, • Assist with Renewals, • Assist with Open Enrollments, • Discrepancy Resolving, • Process Incoming Faxes and Mail, • Assist With Outbound Calls, • Performs other duties and responsibilities as assigned by Management, • Monthly Checks and Balances Reporting, • Electronic Eligibility Processing, • Returned Mail, • Import Error Log, • Receive incoming requests for research from Account Executives and Client Managers., • Research all claim questions as requested, • Gather all necessary information for claim research purposes, • Provide timely and detailed responses to requestor(s), • Build strong relationships with Account Executives and Client Managers, • Build strong relationships with Claims Management personnel, • Manage claim research and details from beginning-to-end., • Responsible for obtaining necessary information completing all activity as required., • Make calls to providers as needed to gather or provide information as directed by Account Executives and Client Managers, • Review Summary Plan Descriptions/Documents for all benefit information as needed, • Exhibit strong technical knowledge of industry, products, and compliance requirements, including plan deductibles and dates, • Appropriately escalate issues and opportunities to Upper Management as needed., • Ensure proper handling of customer issues and concerns., • Navigate and understand BRMS claims system, • Administrative duties in support to Client Services team Knowledge, Skills, & Abilities: • Strong computer skills, including Word, Excel, and Outlook, • Excellent verbal and written communication skills, • Good analytical skills, • Positive problem-solving skills., • Ability to provide effective leadership in all aspects of position., • Must be dependable and maintain excellent attendance and punctuality., • Ability to grow with changing demands of the position and the company. Supervisory Responsibilities: This job has no supervisor responsibilities Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: High School diploma or G.E.D; and minimum of 6 months related experience and/or training; or equivalent and any combination of education, training, and/or experience, which demonstrates ability to perform the duties described Language Skills: Ability to read, speak, and write effectively in English. Ability to interpret documents such as plan documents, memos, letters, and procedure manuals. Ability to write routine reports, meeting notes, project documentation, and correspondence. Ability to speak effectively before customers or employees of organization. Ability to effectively address or resolve customer service issues within guidelines of the position. Mathematical Skills: Ability to add and subtract, multiply and divide with 10's and 100's. Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Certificates, Licenses, Registrations: Valid, class C license in state working with no adverse driving record. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit for extended periods in front of a computer. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. This position requires the employee to work in the office. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Company DescriptionEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs. One of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefitsEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs.\r\n\r\nOne of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefits

Job Description Summary: The Claims Examiner I is responsible for ensuring claims are coded and processed correctly and for meeting production requirements. Processes claims by performing the following duties. This Not a Remote Position Essential Duties and Responsibilities include the following. Other duties may be assigned. · Compares data on claim with internal policy and other company records to ascertain completeness and validity of claim. · Comprehensive understanding of employee benefits for medical, dental and vision plans. · Adjudicates medical claims, applies coordination of benefits as outlined in plan guidelines and works with providers to gather the necessary documents to make final payment determination on claims · Ensures all claims are coded properly. · Examines Summary Plan Document, claim adjustors' reports or similar claims/precedents to determine extent of coverage and liability. · Maintains high quality standards to avoid paying claim incorrectly. · Maintains productivity standards set by Management. · Refers most questionable claims for investigation to claim examiner II for review and processing. · Research and resolve paid and denied claims escalations from internal sources and/or TIPS ticketing system when assigned. · Works from the claims queue manager to process & releases claims for adjudication and payment within 3-5 days of receipt. · Performs other duties and responsibilities as assigned by Management. Knowledge, Skills, & Abilities: • Excellent written and verbal communication skills., • Strong analytical skills and problem-solving skills., • Must be dependable and maintain excellent attendance and punctuality, • Must be able to perform data entry operations quickly and accurately., • Ability to grow with changing demands of the position and the company., • Strong computer skills, including Word, Excel, and Outlook., • Successful candidates must have experience processing medical claims for an insurance company or third party administrator, • Must be highly proficient in ICD-10, CPT, and HCPCS codes. Supervisory Responsibilities: This job has no supervisory responsibilities. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: Associate's degree (A. A.) or equivalent from two-year college or technical school; Must have 3-5 years employee benefits industry experience or equivalent combination of education and experience. Language Skills: Ability to read, speak, and write effectively in English. Ability to interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports, meeting notes, project documentation, and correspondence. Ability to speak effectively before customers or employees of organization. Ability to effectively address or resolve customer service issues within guidelines of the position. Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs. Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized or non-standardized situations. Certificates, Licenses, Registrations: Valid, class C license in state working with no adverse driving record. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit for extended periods in front of a computer. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. This position requires the employee to work in the office. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Company DescriptionEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs. One of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefitsEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs.\r\n\r\nOne of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefits

Job Description Ideal for recent undergraduate or graduate-level candidates with Salesforce back-end development experience. Position Summary The Salesforce Development & Data Systems Associate provides technical support for the design, maintenance, and enhancement of Umoja’s Salesforce infrastructure. This role is focused on Salesforce back-end development, data architecture, and database management, supporting program operations and reporting needs across the organization. This position is ideal for a Salesforce-certified professional who wants real-world experience building and maintaining production of Salesforce systems in a mission-driven environment. The Associate will work closely with the Research & Evaluation team and program staff to ensure data systems are accurate, scalable, and aligned with organizational needs. Key Responsibilities: Salesforce & Systems Development (75%) • Support the development and maintenance of Salesforce back-end architecture, including objects, fields, relationships, validation rules, and automation (Flows, Process Builder, or Apex as appropriate)., • Assist in managing Salesforce data models, user permissions, profiles, and roles., • Build and maintain custom reports, dashboards, and data views to support internal reporting needs., • Support Salesforce integrations, imports, exports, and data syncing processes., • Perform data cleaning, deduplication, and integrity checks within Salesforce., • Document system configurations, workflows, and data standards., • Respond to internal Salesforce system requests, troubleshooting issues, and resolving data errors., • Support database management tasks using Excel, Google Sheets, or other data tools., • Assist with file uploads, structured data submissions, and quality assurance checks., • Provide technical support for related systems such as campus portals or data submission platforms. Work Expectations • 20–25 hours per week., • Approximately 50% in-office, with some flexibility., • Reports directly to the Senior Manager of Research & Evaluation. What This Role Offers • Hands-on experience building and managing real-world Salesforce systems., • Opportunity to deepen Salesforce development and data architecture skills., • Exposure to statewide higher-education and equity-focused initiatives., • A supportive environment for early-career technical professionals to grow., • Meaningful work that directly supports student success and institutional change. Requirements • Bachelor’s degree required; graduate-level students or master’s degree holders welcome., • Salesforce Administrator and/or Platform Developer I certification strongly preferred (required for hire or within first 3–6 months)., • Hands-on experience with Salesforce back-end configuration and development (academic, internship, or professional experience acceptable)., • Knowledge of database concepts (relational databases, data normalization, data integrity)., • Experience with data tools such as Excel or Google Sheets; familiarity with SQL or other database tools is a plus., • Strong attention to detail and ability to manage technical tasks independently., • Clear communication skills and ability to work with non-technical stakeholders. Hourly rate based on experience: $25–$30/hour. This is a 1099 Contractor position, no benefits offered.

Job DescriptionDirect Counsel is seeking an experienced and detail-oriented Senior Conflicts Analyst to join the conflicts and risk management team at a respected national law firm. This is a high-level opportunity for a seasoned professional who thrives in a fast-paced environment, enjoys solving complex problems, and takes pride in ensuring the ethical integrity and operational excellence of a leading firm.About the Role The Senior Conflicts Analyst will play a key role in supporting the firm’s Risk Management Department by reviewing, analyzing, and resolving potential conflicts of interest for new business, new hires, and firmwide engagements. This position requires sound judgment, exceptional analytical skills, and the ability to communicate complex findings clearly and professionally to attorneys and firm leadership. Key Responsibilities New Business Conflicts Analysis: * Review and analyze conflict check requests for new and existing clients and matters. * Collaborate with billing attorneys, legal assistants, and other firm personnel to clear conflicts efficiently under the supervision of Conflicts Attorneys. New Hire Conflicts Analysis: * Evaluate potential conflicts related to lateral hires and new employees. * Communicate confidentially with candidates and implement appropriate ethical walls and screening procedures. Waivers & Ethical Walls: * Draft, circulate, and track conflict waivers as needed. * Build, monitor, and disable ethical walls in compliance with firm policies. Database Management & Systems Maintenance: * Maintain and enhance accuracy of conflicts databases by identifying and correcting inconsistent party information. * Assist with large-scale data projects and suggest system improvements to enhance workflow and efficiency. * Serve as a resource for attorneys and staff regarding conflicts and intake software questions. Process Improvement & Collaboration: * Identify and recommend improvements to conflicts procedures, tools, and policies. * Work closely with the Risk Management and IT teams to ensure systems and processes align with firm goals and compliance standards. Qualifications * 8–10 years of experience in conflict analysis within a large law firm required. * Proficiency with Intapp Open strongly preferred; Intapp Open Administrator certification a plus. * Experience with 3E, iManage, and Intapp Walls or similar database systems highly desirable. * Excellent analytical, research, and communication skills, with the ability to deliver objective, concise, and professional advice. * Ability to handle sensitive or confidential issues with discretion and professionalism. * Proven success managing competing priorities while delivering timely and accurate results. Compensation & Benefits * Salary Range: $100,000 – $120,000 annually (commensurate with experience). * Comprehensive Benefits: Health, dental, vision, 401(k), profit sharing, and more. * Flexible Work Options: Hybrid and remote-friendly arrangements available. * Professional Environment: Collaborative culture that values excellence, innovation, and integrity. About Direct Counsel Direct Counsel partners with leading law firms and corporate legal departments across the country to connect top-tier legal professionals with outstanding career opportunities. We are committed to advancing the careers of talented professionals while supporting our clients with exceptional service and insight. If you’re a Senior Conflicts Analyst looking for an opportunity to take your expertise to a top national platform, we’d love to hear from you. Apply today by sending your resume to

Job Description Summary: The COBRA Admin performs administrative duties to administer COBRA in accordance with all applicable state, federal, and carrier requirements. Support COBRA group members. Essential Duties and Responsibilities include the following. Other duties may be assigned. • Assist in administration of COBRA and employee status changes., • Enter qualifying events, print election forms, and generate HIPAA certificates., • Process new COBRA enrollments, which include sending all necessary notifications and setting up the appropriate accounts., • Enter employee information received from clients into COBRA system., • Create enrollment packets for individuals qualifying for COBRA., • Bill individuals for COBRA payment., • Collect payments from COBRA participants and post to system., • Handles low level customer service internal and external phone calls and e-mail inquiries from participants, clients and carriers., • Receive and respond to letters, memos and other inquiries concerning enrollment, payment schedule, and termination of COBRA benefits., • Process, collate, and mail Department of Labor Initial Notices., • Mail Premium Due Notices, returning mail, or returning checks to clients who have made inaccurate payments., • Process COBRA terminations and generate appropriate paperwork., • Generate Group Weekly reports., • Ensure compliance with federal and state COBRA regulations., • Communicate with all levels of internal associates as well as management., • Perform additional duties as assigned by Management. Knowledge, Skills, & Abilities: • Strong sense of urgency., • Must demonstrate initiative, ability to be self-directed, as well as work effectively as part of a team., • Must use common sense and logic, • Must pay attention to details, • Ability to meet deadlines and multitask., • Intermediate Excel skills and ability to learn proprietary software., • Excellent customer service skills., • Ability to perform data entry accurately, timely, and in excess of 90% of work day., • Effective communication skills, including ability to read and write in English., • Ability to assess and resolve problems and know when to escalate issues to management., • Proficient in Microsoft Word and Outlook., • Experience and understanding of COBRA management, rules, and regulations a plus. Supervisory Responsibilities: This job has no supervisory responsibilities. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: High school or G.E.D. equivalent; and one to two years related experience and/or training; and/or equivalent combination of education and experience. Language Skills: Ability to read, speak, and write effectively in English. Ability to interpret documents such as statements, invoices, Summary Plan Documents, memos, letters, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before customers or employees of organization. Ability to effectively address or resolve customer service issues within guidelines of the position. Mathematical Skills: Ability to add and subtract, multiply and divide with 10's and 100's. Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit for extended periods in front of a computer. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. This position requires the employee to work in the office. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Company DescriptionEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs. One of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefitsEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs.\r\n\r\nOne of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefits

Job Description Summary: The Care Management Assistant (CMA) supports the Care Management Coordinators with administrative and clerical duties in an effort to meet mandated deadlines relating to utilization review. As the first point of contact for our members, the CMA will be responsible for answering telephone calls, processing faxes, and entering authorization for review. This is a high-volume desk. Essential Duties and Responsibilities include but are not necessarily limited to the following. Other duties may be assigned. • Maintain strict HIPAA Confidentiality; follow all internal policies and procedures to maintain the confidentiality for all members and member data., • Answer a high volume of telephone calls., • Provide high quality general administrative services and support to the entire department., • Work independently on assigned tasks and activities, based on established policies and procedures., • Receive, log and distribute mail correspondence., • Adhere to exact deadlines; determination letters must be sent out to the appropriate parties within 24 hours of the medical determination., • Manage the department’s email accordingly., • Handle a variety of basic office tasks such as; filing, faxing, copying, scanning etc., • Enter requests into the Medical Utilization Review system with accuracy and completeness (99% of the time)., • Adhere to exact deadlines; determination letters must be sent out to the appropriate parties within 24 hours of the medical determination., • Remain in contact with Care Management staff, other BRMS staff/departments, provider’s offices and members., • Perform other duties and responsibilities as assigned by the Management. Knowledge, Skills, & Abilities: • Strong communication skills, effective and accurate written and verbal form., • Strong customer service-oriented skills for both internal staff and external clients., • Strong organizational skills which support timely and well documented action to manage concurrent deadlines and multiple priorities., • Keyboarding skills and the ability to utilize computer equipment and software are required as is experience with other types of standard office equipment., • Strong working knowledge of Microsoft Office, excel, windows-based products and software specific to document scanning., • Medical terminology preferred., • Ability to work independently and within a team environment., • Must be able to work within core hours of operation Tuesday-Saturday 8:00 am-5:00 pm in the office. Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: High School diploma or G.E.D and minimum of one to two years administrative experience within the medical or insurance field; or equivalent and any combination of education, training, and/or experience, which demonstrates ability to perform the duties described. Language Skills: Ability to read, speak, and write effectively in English. Ability to interpret documents such as safety rules, memos, letters, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively with customers or fellow employees within the organization. Ability to effectively address or resolve customer service issues within guidelines of the position. Mathematical Skills: Ability to add and subtract, multiply and divide with 10's and 100's. Supervisory Responsibilities: This job has no supervisory responsibilities. Certificates, Licenses, Registrations: n/a Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to sit for extended periods of time; view and input data on PC for extended periods of time. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand or stoop; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Company DescriptionEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs. One of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefitsEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs.\r\n\r\nOne of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefits

Job Description SUMMARY: The Medical Case Management Nurse (MCM Nurse) provides a variety of services with respect to medical care review, cost containment, claims review, appeals and grievances, and analytical reporting. As part of our Medical Management Team, the MCM Nurse employs best practices and principles to ensure high quality and cost-effective assurance standards. Essential Duties and Responsibilities include the following. Other duties may be assigned. • Works on site with consistent attendance., • Conducts case reviews for appropriateness/quality of treatment and bill accordingly by group concurrently., • Tracks and reports all hours by group and patient for current Case Management patients currently in treatment, • Develops Case Management reporting and tracking of members with trigger diagnosis history currently not in treatment and develops treatment plans to save the member and group benefit dollars., • Maintains communication between insured, medical provider, and insurance company., • Develop strategy, goals, & objectives for each new client., • Provides statistical case reviews and generates utilization reports, • Examine DRG pre-certification, certification of admissions, and continued stay., • Act as a liaison between Medical and Claims departments regarding medical review issues., • Communicate with other departments and personnel to facilitate proper adjudication of claims., • Review medical information from various out of state facilities for medical necessity., • Maintain medical standards for all clients., • Communication with hospitals, physicians, and subscribers regarding certification of hospital admissions and outpatient services., • Meets with Management team about current processes and implementing new processes, • Develops relationships with physicians, healthcare service providers, and internal and external customers to help improve health outcomes for members., • May access and consult with peer clinical reviewers, Medical Directors and/or delegated clinical reviewers to help ensure medically appropriate, quality, cost effective care throughout the medical management process., • Educates the member about plan benefits and contracted physicians, facilities and healthcare providers. Refers treatment plans/plan of care to peer clinical reviewers in accordance with established criteria/guidelines and does not issue medical necessity non-certifications., • Maintains compliancy with regulation changes affecting utilization management., • Reviews patients’ records and evaluates patient progress., • Documents review information in computer. Communicates results to the appropriate parties and enters the appropriate billing information for services., • Responds to complaints per UR guidelines., • Records and reports all information within scope of authority, • Performs analytical reporting from a variety of reports, client charts and other documents and participates in developing strategies for medical cost containment, maintaining quality of care and client satisfaction. The MCM Nurse will participate in the following activities either in tandem or at the direction of the department supervisor or management team: • Actively participate with management to develop business process analyses, • Develop recommendations for appropriate solutions., • Validate and perform quality assurance., • Create or revise analytical approaches to reflect current priorities and circumstances., • Develop, analyze, and implement project plans. Mobilize project teams., • Develop plans or proposals that include cost/benefit analysis, policy, and financial, operational, and organizational implications., • Exercise discretion, tact, and judgment when working with internal and/or external departments. Knowledge, Skills, & Abilities: • Working knowledge of ICD-10, HCPCS and CPT coding., • Excellent communication skills, both verbally and in writing are critical., • Knowledge of principles, practices and current trends in nursing as well as best practices in quality assurance., • Knowledge and application of state and federal laws, statutes, and regulations; excellent analytical skills; ability to work as part of a team and be self-directed; and intermediate knowledge of Word and Excel., • Experience in project consulting, analysis, and management., • Communication qualifications include demonstrated verbal and written communication skills and ability to present information effectively, tailor presentations to a wide variety of audiences (including executive management), present complex concepts and recommendations clearly for management decision-making purposes., • Ability to comprehend, interprets, and applies BRMS policies; ability to continually adjust in a dynamic environment; and ability to work as a member of a team., • Must be able to work within core hours of operation Tuesday – Saturday 8:00 am-5:00 pm On-Site. Supervisory Responsibilities: No supervisory responsibilities for this position. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: Graduate from accredited school of nursing with at least two years acute clinical experience with at least one year of case management or utilization review experience. Language Skills: Ability to read, speaks, and writes effectively in English. Ability to interpret documents such as safety rules, memos, letters, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before customers or employees of organization. Ability to effectively address or resolve customer service issues within guidelines of the position. Mathematical Skills: Ability to add and subtract, multiply and divide with 10's and 100's. Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Certificates, Licenses, Registrations: Current California RN or LVN License: REQUIRED National Medical Case Management Certification: Preferred Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit for extended periods in front of a computer. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. This position requires the employee to work in the office. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Company DescriptionEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs. One of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefitsEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs.\r\n\r\nOne of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefits

Job Description Apply Here: Schedule This position is eligible for a hybrid work schedule, with a minimum of three (3) days in-office based out of our West Sacramento office and two (2) days working remotely. Summary Under general supervision from the Director, Conferences, the Registrar performs a variety of complex database, registration and administrative support duties requiring thorough knowledge of departmental policies, procedures and operations. This position is responsible for managing data systems, supporting event registration processes, responding to member inquiries, maintaining accurate records, assisting with financial processing and providing high-level customer service. The role involves collaboration across departments, coordination with internal and external stakeholders and occasional travel to support statewide events; performs other duties as assigned. Essential Duties & Responsibilities • Perform administrative, analytical and customer support tasks for internal departments and external stakeholders., • Provide technical and administrative support related to event registration and data management., • Administer and maintain accurate records in customer relationship management (CRM) systems and event applications (Cvent)., • Create and manage events within the Association’s customer relationship management (CRM) system, ensuring all configurations, fees, and settings are accurate prior to launch., • Consistently updates membership information within the CRM, including annual roster maintenance and verification with member agencies., • Perform event audits for accuracy and completeness, including registration data, payments, membership status, and financial reconciliation across multiple systems., • Lead onsite registration operations and support at the Association’s conferences and events, exercising independent judgment to make timely and appropriate customer service or logistical decisions as needed., • Collaborate with external vendors on multiple registration and event management software., • Resolve customer service requests and technical issues within registration and event management software., • Research, compile, organize, and analyze data for reports, special projects and operational needs., • Prepare and process reports, documents, agendas, meeting minutes and communication materials., • Respond to inquiries, concerns, and complaints from members, staff, and the public with professionalism and timely resolution., • Ensure data integrity through regular audits, updates and maintenance of internal systems., • Troubleshoot and resolve database and registration system issues in coordination with IT support., • Develop and maintain forms, templates and tracking systems aligned with department requirements., • Coordinate logistics and provide on-site support for events and meetings across California., • Maintain confidentiality and accuracy in processing sensitive information., • Review and edit written materials for accuracy and clarity., • Adhere to organizational values, policies and timekeeping practices., • Work occasional overtime, evenings, weekends, and holidays as needed., • Limited vacation permitted during peak periods., • Perform other duties as assigned. Qualifications • Any combination of training and experience equivalent to an associate degree or higher with major coursework in business administration, management, finance, accounting, or a related field, and three (3) years of progressively responsible administrative experience. Experience in education, legislative, or nonprofit settings is preferred., • Knowledge of organizational structure and functions of nonprofit organizations, boards and commissions., • Applies applicable federal, state, and local laws and procedures relevant to assigned responsibilities., • Utilizes event applications (Cvent), Customer relationship management (CRM) systems and database with administrator level experience., • Event registration and data collection procedures., • Standard office practices, software and equipment., • Business writing, proofreading and formatting of reports and correspondence., • Effective customer service principles and practices., • Business mathematics, statistical analysis and financial data management., • Interpret and apply organizational policies, procedures and regulations., • Perform accurate data entry, analysis and reporting., • Communicate effectively and professionally in writing, in person and by phone., • Prioritize multiple tasks and meet deadlines under minimal supervision., • Demonstrates strong critical thinking and problem-solving skills., • Provides exceptional customer service and maintains professionalism under pressure., • Makes quick, informed decisions in fast-paced or live event environments., • Diagnose and resolve registration and data system issues., • Provide clear and responsive customer service to a variety of stakeholders., • Organize and maintain accurate records and filing systems., • Proofread and edit written materials for clarity, accuracy, and grammar., • Travel within California to support events, including occasional overnight stays., • Follow organizational health and safety guidelines and practices., • Uses event management software, registration systems, and office applications efficiently., • Ability to complete basic business mathematics and statistical techniques for event analysis and reporting., • Effective communication techniques for providing customer service and collaborating with stakeholders., • The office environment is primarily sedentary, in a controlled office environment with moderate noise levels and no direct exposure to hazardous physical substances., • Ability to sit at a computer for extended periods, use office equipment and lift up to 25 pounds., • Must be able to bend, stoop, kneel, reach, push, and pull drawers open and closed in the execution of their duties., • Limited vacation during peak periods., • Ability to occasionally travel is required for conferences, training, workshops and meetings throughout California, including overnight stays., • Occasional overtime, including evenings, weekends and holidays, may be necessary based on event schedules., • Employee is personally responsible for following health and safety guidelines, instructions and policies. Why Join CSBA? • Opportunity to support impactful programs and initiatives that serve education leaders across California., • CSBA promotes internal career growth and provides opportunities for advancement., • Collaborative and mission-driven work environment., • Competitive salary and benefits package. If you are an event coordinator experienced with registration for events with a passion for program management and a drive to make an impact, we encourage you to apply and join our team! Benefits At CSBA, we proudly offer competitive compensation and benefits, including medical, dental and vision coverage for employees and dependent children, insurances and California Public Employees Retirement System (CalPERS), and more: • Comprehensive medical, dental and vision plans:, • Medical through Kaiser (Platinum HMO plan) and Blue Shield (Platinum HMO, Silver PPO, and HDHP with HSA)., • Dental - Delta Dental, • Vision – VSP, • CSBA offers a hybrid work schedule, with a minimum of three (3) days in-office based out of our West Sacramento office and two (2) days working remotely., • Membership in the CalPERS retirement system:, • Classic membership tier (2% @ 55; 7% employee contribution and 11.54% employer contribution), • PEPRA membership tier (2% @ 62; 8.25% employee contribution and 8.27% employer contribution), • Employer-paid Life and AD&D insurance, • Employer-paid Short- and Long-Term Disability insurance, • Optional supplemental 457 retirement savings available, • Flexible Spending Account (FSA) Medical and Dependent Care, • Employee Assistance Program, • Perks at Work savings program, • Learning and Development, • Social Events: All-Staff luncheon events, Coffee & Learn, • Paid Time Off:, • Vacation: Accrues 10 days annually for hourly employees and 15 days annually for salary employees. The rate at which you accrue will increase annually with years of service., • Floating holidays: 32 hours annually accrue date of hire., • Separate sick leave accrual: 8 hours accrued monthly., • Holiday: 10 CSBA recognized holidays annually, • December Office Closure: During the latter part of December each year CSBA closes its office. During this time, employees are paid for 6 days in addition to the December 25 and January 1 holiday., • Sabbatical Program: Employees with at least seven (7) years of continuous full-time employment in their current period of service are eligible for up to four (4) weeks of paid leave. CSBA’s operation hours are 8:00 a.m.– 5:00 p.m. CSBA currently offers a hybrid work schedule for eligible positions. CSBA is headquartered in West Sacramento. About CSBA The California School Boards Association is a nonprofit education association representing the governing boards who oversee public school districts and county offices of education. With a membership of nearly 1,000 educational agencies statewide, CSBA brings together school governing boards to advocate for effective policies that advance the education and well-being of the state’s more than 6 million school-age children. CSBA provides policy resources and training to members and represents the statewide interests of public education through legal, political, legislative, community, and media advocacy. CSBA employees are highly skilled, with a desire to excel and help strengthen school board governance and maximize student achievement. They are strategic in their trade, embrace challenges, and offer new and innovative ideas. CSBA creates a supportive, dynamic environment for its employees to grow and succeed. Our core values of integrity, collaboration, accountability, respect, excellence, service, and innovation guide the way to achieving the Association’s goals. Apply Today If you are ready to take the next step in your career and contribute to meaningful work, apply today! We are excited to hear how your expertise can further our mission and advance the education and well-being of the state’s more than 6 million school-age children in public education in California. Equal Opportunity Employer CSBA is an equal opportunity employer. It does not discriminate against employees or applicants based on any characteristic protected by state or federal law. Equal employment opportunity will be extended to all persons in all aspects of the employer/employee relationship. CSBA prohibits any CSBA employee, consultant, and any CSBA agent, including unpaid interns and volunteers, Board members, independent contractors or any other agent from discriminating against any other employee or job applicant on the basis of the person's actual or perceived race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, genetic information, pregnancy, national origin, ancestry, age (over 40), marital status, physical or mental disability, medical condition, military or veteran status, reproductive health decision making or any other characteristic protected by state or federal law. E-Verify This employer participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. Employers can only use E-Verify once you have accepted a job offer and completed the Form I-9. E-Verify Works for Everyone 888-897-7781 dhs.gov/e-verify

Job Description SUMMARY The Care Management Coordinator (CMC) supports an assigned Medical Care Management Nurse. Essential Duties and Responsibilities include but are not necessarily limited to the following. Other duties may be assigned. • Works on site with consistent attendance · Contacts members by phone, mail, or email as directed by Medical Care Management Nurse. · Responsible for generating reports and documents that pertain to member case management. · Act as liaison between the reinsurance department and assigned Nurse Care Management team regarding various reports in the claims/UR system. · Act as point of contact between Client Management and Nurse Care Manager. • Contact providers to obtain diagnostic test results for members in Medical Case Management, • Maintain strict HIPAA Confidentiality; follow all internal policies and procedures to maintain the confidentiality for all members and member data., • Follow written criteria, policies and procedures in reviewing and processing daily referrals for outpatient and inpatient medical care as needed to back up UR Coordinator., • Remain in constant daily contact with other Care Management Department., • Work independently on assigned tasks and activities, based on established policies and procedures., • Perform other duties and responsibilities as assigned by the Management. Knowledge, Skills, & Abilities: • Strong communication skills, effective and accurate written and verbal form., • Ability to evaluate and comprehend clinical documentation., • Strong customer service oriented skills for both internal staff and external clients., • Strong organizational skills which support timely and well documented action to manage concurrent deadlines and multiple priorities., • Keyboarding skills and the ability to utilize computer equipment and software are required as is experience with other types of standard office equipment., • Strong working knowledge of Microsoft Office, excel, windows based products and software specific to document scanning., • Medical terminology required., • Working knowledge of ICD-10, HCPCS and CPT coding., • Ability to work independently and within a team environment., • Knowledge and ability to utilize evidence based medical guidelines., • Durable Medical Equipment knowledge preferred., • Must be able to, with reasonable accommodation, sit for extended periods of time; view and input data on PC for extended periods of time; stand, stoop, lift, carry and walk on an intermittent basis., • Must be able to work within core hours of operation 8 am to 5 pm, Tues- Sat. Supervisory Responsibilities: This job has no supervisory responsibilities. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: High School diploma or G.E.D, college degree preferred; and minimum of two to four years medical or insurance experience; or equivalent and any combination of education, training, and/or experience, which demonstrates ability to perform the duties described. Language Skills: Bilingual Spanish/English preferred. Ability to read, speaks, and writes effectively in English. Ability to interpret documents such as safety rules, memos, letters, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before customers or employees of organization. Ability to effectively address or resolve customer service issues within guidelines of the position. Mathematical Skills: Ability to add and subtract, multiply and divide with 10's and 100's. Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Certificates, Licenses, Registrations: N/A Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit for extended periods in front of a computer. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. This position requires the employee to work in the office. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Company DescriptionEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs. One of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefitsEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs.\r\n\r\nOne of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefits

Responsibility for the evaluation of database software purchases Supervision of modifications to any existing database software to meet the needs of their employer Responsibility for maintaining the integrity and performance of company databases Must guarantee that data is stored securely and optima

Job Description Summary: The Client Manager 1 works closely with the Account Executive to service a portion of the BRMS client base. The Client Manager 1 is the day-to-day point of contact for each client account. The CM 1 strives to ensure service levels and expectations are being met by executing regular and proactive communication with all client administration and upper level on a day-to-day basis. Essential Duties and Responsibilities include the following. Other duties may be assigned. • Organize regularly scheduled communications with all existing clients and internal contacts to determine how BRMS can meet their business needs., • Review accounts on a monthly basis., • Build strong relationships with clients’ HR teams, senior managers, and other key stakeholders., • Manage BRMS client and benefit plan renewals from beginning-to-end with input from the AE., • Responsible for obtaining and revising necessary information on the account and completing all activity as required., • Work on new client implementations., • Prepare, Manage and understand and provide critical review of monthly reports, • Ensure execution of contract and any renewal adjustments by working with finance and sales., • Exhibit strong technical knowledge of industry, products, and compliance requirements, including plan deductibles and dates, • Work internally to create and maintain plan documents., • Mediate between client and carrier., • Create and update plan documents during and after Implementation, • Create and update ID cards during and after Implementation, • Maintain PPO Network contract application and Plan Cost Reports, • Respond to Anthem Blue Cross Utilization Management update requests, • Appropriately escalate issues and opportunities to Upper Management as need be. · Conduct ongoing training to team members to make certain the quality of service delivered to BRMS customers achieves and exceeds company and productivity standards. • Review daily and monthly reports, transactions, and trends, and provide feedback to team members and Upper Management, • Performs other duties and responsibilities as assigned by Management. Knowledge, Skills, & Abilities: • Subject-matter expert within field., • Excellent verbal and written communication skills., • Strong analytical skills., • Positive problem-solving skills., • Display a polished and professional appearance at all times, • Strong computer skills, including Word, Excel and Outlook. Supervisory Responsibilities: This job has no supervisor responsibilities Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: High School Degree or G.E.D.; and minimum of two years experience working in a related Customer Support Role; or equivalent combination of education, training, and/or experience in self-funded employee benefits industry, which demonstrates ability to perform the outlined duties above. Language Skills: Ability to read, speak, and write effectively in English. Ability to interpret documents such as safety rules, memos, letters, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before customers or employees of organization. Ability to effectively address or resolve customer service issues within guidelines of the position. Mathematical Skills: Ability to add and subtract, multiply and divide with 10's and 100's. Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Certificates, Licenses, Registrations: Valid, class C license in state working with no adverse driving record. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit for extended periods in front of a computer. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. This position requires the employee to work in the office. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Company DescriptionEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs. One of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefitsEstablished in 1993, Benefit & Risk Management Services, Inc. (BRMS) is a leading benefit administrator and healthcare risk manager that delivers innovative technology and administration solutions to control rising healthcare costs.\r\n\r\nOne of the first to introduce employee benefit administration technology solutions, our services are powered by our exclusive Virtual Benefits Administration System (Vbas) a proprietary database and administration system that allows employers to save time and money by automating management of the benefit supply chain and empowering employees to self-service their benefits

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