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JOB DESCRIPTION Job Summary The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for overseeing delegated activities to ensure compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and requirements pertaining to delegation agreements. Contributes to overarching strategy to provide quality and cost-effective member care. This position will support our Corporate Compliance business. The candidate must have an unrestricted LVN licensure. Candidates must be technologically proficient, self-directed, autonomous and experience working from home. Care Management & Waiver Service Auditing experience is highly preferred. Work hours: Monday - Friday 8:00am – 4:00pm Remote position Essential Job Duties • Coordinates, conducts and documents pre-delegation and annual assessments as necessary to comply with state, federal and National Committee for Quality Assurance (NCQA) guidelines, and other applicable requirements., • Distributes audit results letters, follow-up letters, audit tools and annual reporting requirement as needed., • Works with delegation oversight analytics representatives on monitoring performance reports from delegated entities., • Works with delegation oversight leadership to develop and maintain delegation assessment tools, policies and reporting templates., • Assists with preparation of delegation summary reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees., • Participates as needed in joint operation committees (JOCs) for delegated groups., • Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid, National Committee for Quality Assurance (NCQA) and/or other regulatory audits as needed. Required Qualifications • At least 3 years’ experience in health care, including 2 years’ experience in a managed care environment facilitating utilization reviews, or equivalent combination of relevant education and experience., • Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). The license must be active and unrestricted in state of practice., • Knowledge of audit processes and applicable state and federal regulations., • Ability to work effectively in a fast-paced, high-volume environment, maintain accuracy and meet established deadlines., • Ability to collaborate effectively with team members and internal departments., • Strong attention to detail with a focus on maintaining quality in all tasks., • Strong verbal and written communication skills., • Registered Nurse (RN). The license must be active and unrestricted in state of practice., • Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified Professional in Healthcare Quality (CPHQ). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $77,969 - $128,519 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job Description Mobile Healthcare Partners is seeking skilled Chronic Care Management Nurses (LVN, LPN, RN) Our office is located in Buffalo, New York but work can be on a Remote / Work From Home basis Mobile Healthcare Partners is a home-based primary care practice that specializes in geriatric healthcare, serving New York State. This role will be providing telephonic Care Management for patients throughout the health system under the direction of a patient’s provider. The CCM nurse utilizes nursing process to evaluate patient needs over the telephone and provide guidance and education to patients, adhering to organizational policies, procedures and guidelines. Provides high risk patients with chronic disease management and liaises between the patient, patient’s family or caregiver, provider, provider’s office, hospital, home care agency etc. This position is telephonic care coordination as directed by the patients provider. Responsibilities: • Cooperatively develop and integrate patient centered provider care plan and goals with the client/family and other providers, • Work collaboratively with team members to provide outreach and engagement with the patient, • Provide patient education to assist with self-management, • Identify gaps or barriers in treatment plans, • Coordinate care enrolled patients including scheduling appointments, • Coordinate referrals, • Coordinate community resources as needed (ie: home health, DME etc), • Educate members on disease processes, • Encourage members to make healthy lifestyle changes, • Actively maintain assigned caseload of patients, • Make outbound calls to assess members current health status, • Receive and respond to telephone calls from patients. Collecting health data and providing medical guidance under the direction of the patients provider, • Document calls according to established guidelines, • Connects patient’s care team together with updated information as received, • Participation in education and in-service programs, • Performs on-call for region that you are assigned, • Unrestricted and current license NYS License to practice as a LVN/LPN/RN, • 3 years of experience within Care Management setting or Case Coordinator either in the homecare, inpatient, physician practice or in-home case management setting, • Strong working knowledge of chronic disease states including chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease and congestive heart failure and basic medical management of these states, • Ability to identify problems and recommend solutions, • Experience working with Electronic Health Record (EHR), • 60 words per minute typing Work From Home setting Monday through Friday Day schedules Benefits after 30 days Company paid Short Term Disability 6 Paid Holidays 3 weeks of Time Off Mobile Healthcare Partners, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job Description Position Summary: The Licensed Practical Nurse (LPN) will act as a liaison between the Agency and various organizations (e.g. pharmacies, primary care) within the community. The LPN will also be responsible for providing education to youth/adolescents, adults, and guardians regarding mental health services, systems, medications, and side effects. This position functions within the outpatient mental health clinic. Competitive Pay Rate of $23-$26 per hour What does a day as an LPN look like at Child and Family Services? • Engage with clients to monitor vital signs and discuss medication benefits, • Coordinate with healthcare providers, pharmacies, and therapists for seamless psychiatric care, • Advocate for clients by handling prior authorizations and addressing any concerns with precision, • Manage medication processes, from consents to refills, while keeping detailed documentation, • Provide any information necessary for the proper dispensing of medication at home, and when needed, at school, • LPN from a recognized accredited school of nursing, • One years of nursing experience in an office/clinical setting is preferred, • Ability to relate well to children and families Competitive Pay Rate of $23-$26 per hour Schedule: 9AM-5PM Monday through Friday Monday + Wednesday - 330 Delaware Ave, Buffalo Tuesday, Thursday, + Friday - 3901 Genesee St, Cheektowaga CFS offers full-time employees the below benefits to support our employees and their families and help to create a healthy work environment. • Employer Paid Life Insurance, • Medical, Two Plan Options, • Dental, Two Plan Options, • Vision Insurance, • Wellness Program and Incentives, • Health Savings Account (HSA) and Quarterly Employer-Contributions, • Healthcare Flexible Spending Account (FSA), • Dependent Care FSA, • Employee Referral Bonus, • Qualifying Employer for Public Service Student Loan Forgiveness Program (PSLF)

Job Description UBMD Primary Care seeking part time LPN Quality Specialist (2 days per week) to work with care team members on meeting and maintaining quality measures set by payers and various regulatory programs. Will facilitate practice redesign efforts and support improved patient outcomes, as well as assist with increasing patient, provider and health care team satisfaction and efficiency within the practice. Will perform outreach to patients who have been recently discharged from the hospital or emergency room to reconcile medications, connect patient with appropriate follow up and answer questions about transition of care process. Conducts previsit planning on upcoming appointments to ensure necessary information is gathered for providers. Must have a current and valid NYS LPN license. Minimum of 2 to 3 years of experience working in an outpatient clinic or primary care practice preferred. Experience working on quality measures a plus! Must have excellent communication and multi-tasking skills. Knowledge of PCMH and patient education preferred. Position can be remote after training period with availability to be on site for meetings as needed. Schedule will be 7.5 hours on Tuesdays and Fridays OR Thursdays and Fridays. Pay range is $24 to $26/hour. Any offer of employment is contingent upon successful background check and drug screen. AA/EOE JOB DESCRIPTION POSITION TITLE LPN Quality Specialist LOCATION(S) 77 Goodell Street, Buffalo, NY 14203 REPORTS TO: Director of Quality Management FLSA STATUS: Non-Exempt/Hourly SALARY RANGE: $23/hour to $26/hour POSITION TYPE: Full Time SUPERVISORY REQUIREMENTS: N/A Job Summary: The LPN Quality Specialist (QS) is responsible for working with care team members to meet and maintain quality measures set by payers and various regulatory programs, facilitates practice redesign efforts and supports improved patient outcomes. The QS will assist with increasing patient, provider and health care team satisfaction, as well as efficiency within the practice. Essential Functions: • Works with Quality Improvement (QI) management team under the supervision of the Director of Quality Management (DQM)., • Pilots changes in workflows and new approaches to patient care (i.e. taking the lead on pre-visit planning, care coordination, hospital follow up). Reports successes and challenges so that new processes may be improved., • Supports practice change and encourages others to take an active role in the process., • Develops awareness of Plan Do Study Act cycles and how to use them to improve clinical practice and patient care., • Performs outreach to patients who have been recently discharged from the hospital or emergency room to reconcile medications, connect patient with appropriate follow-up, and answer questions about transition of care process., • Conducts pre-visit planning on upcoming appointments to ensure necessary information is gathered for providers., • Works with residents and medical students on the QI process., • Assists the practice in maximizing use of available health information technology resources in order to achieve improved patient outcomes and increased office efficiency in areas such as population management and registry functionality, planned care, care management and coordination of care, goal setting and action planning with patients, report of outcome measures and patient safety., • Assesses and documents practice progression throughout the transformation process., • Facilitates efficient, effective improvement team meetings., • Links the practice to available external resources such as consultants, web links and group learning opportunities in order to meet specific needs of the practice., • Collaborates with other healthcare professionals, community agencies, patient’s family members and others involved in a patient’s care, as appropriate., • Supports the Patient Centered Medical Home (PCMH) model of care, which is patient centered, physician led and team-based., • Represents UBMDFM by displaying a respectful and caring manner with patients and their families., • Independently problem solves and utilizes resources to obtain patient information when patient is unable to communicate., • Coordinates timely follow up of patient requests for services regarding prescription requests, referrals, diagnostic testing and appointments for sick visits., • Provides patient with education materials, distribution of resource literature from insurance carriers and community service recommendations., • Ability to work at least 35 hours per week on a regular basis, except during times when paid time off is requested and approved., • Reviews and addresses daily tasks as assigned., • Complies with all OSHA regulations when in a clinic setting., • Applies and actively shares knowledge, expertise and best practices with team., • Accepts and readily adapts to changing priorities, new ideas, strategies, procedures and methods., • Reviews company email on at least a daily basis in order to receive and address notifications and/or other pertinent information in a timely manner., • Any other duties as requested or assigned by the DQM and/or other management representative. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice., • May be required to travel to other UBMDFM location(s) dependent on company need. Education: Graduation from an accredited school of nursing or certified LPN program. Valid NYS LPN license. Experience: At least two (2) to three (3) years of experience working in an outpatient clinic or primary care practice. Experience in working on quality measures preferred. Knowledge, Skills & Abilities: Excellent communication skills with all levels of a physician practice including management, physicians and patients. Excellent attention to detail, multi-tasking and organization skills required. Knowledge of PCMH and patient education preferred. Maintains competence through continuing education and/or inservice training. Working/Environment Conditions: • Position is in a well-lit, fast-paced, clean office environment., • Office noise level will be mild to moderate most times., • Moderate/average indoor temperatures., • Travel to various sites via use of personal vehicle, if needed., • Potential for occupational health exposures/hazards when in a clinic setting. Physical Requirements: 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 disability to perform the essential functions. • Prolonged periods of sitting or standing at a workstation in order to perform duties on a computer., • While performing the duties of this job, the employee will be regularly required to sit, talk, hear and use hands and fingers to operate a computer and/or telephone keyboard., • Specific vision abilities required by this job include close vision requirements due to computer work., • Light lifting (up to 5 pounds) may be required., • Regular, predictable attendance is required., • Ability to uphold the stress of assisting patients of diverse backgrounds., • Ability to communication clearly and effectively with patients., • Manual dexterity to operate standard office machines/equipment such as computers, printers, multi-line phone, photocopier, fax system, scanner and/or calculator. UBMD Primary Care is an equal employment opportunity (EEO) employer. We are committed to the principles of equality in employment and opportunity for all employees without regard to race, color, citizenship status, national origin, ancestry, gender or expression whether or not such gender identity or expression differs from the employee’s physical sex as assigned at birth (including transgender status), sexual orientation, age, weight, religion, creed, physical or mental disability, predisposing genetic characteristics and information, marital status, familial status, domestic violence victim status, veteran status, military status, political affiliation or any other factor and/or status protected by law. We expect all employees to adhere to these principles of equality which apply to all aspects of the employment relationship including hiring, job selection, job assignment, compensation, corrective action, termination, access to benefits and training and other privileges of employment. UBMD Primary Care is a smoke-free and drug-free workplace in compliance with local, state and/or federal guidelines.

Work part-time from home and earn up to $750 per week. Remote Work From Home Customer Service Representative Agent - Part Time Market Research Panelists Our company is seeking individuals to participate in National & Local Paid Focus Groups, Clinical Trials, and Market Research assignments. No commu

Competitive salary / 100% paid PPO Medical, dental & vision / 401k match / PTO / Home office budget - As a Customer Support Specialist at Paradigm, you will: Provide exceptional customer service to clients via phone and email; Troubleshoot and resolve customer inquiries and issues in a timely manner

Customer Support / Remote] - Anywhere in U.Up to $20 per hour - As a Customer Service Rep at Promenade, you will: Provide friendly, efficient, and accurate Tier 1 support to our customers and floral partners via phone and email; Listen to customer inquiries, diagnose issues, and provide helpful solu

Customer Service / Remote] - Anywhere in U.Medical, dental & vision / PTO / WFH Stipend / Equipment provided - As a Customer Experience Advocate at SRPSupport, you will: Provide exceptional customer service to clients through various channels such as phone, email, and chat; Answer incoming customer

Customer Service / Fully Remote] - Anywhere in U.Competitive compensation / Company provided laptop, monitor & accessories - As a Customer Care Rep you'll: Be the first responder of customer inquiries via phone, email, and chat; Listen, identify, and assess each customer's need to offer a solution t

Customer Service / Remote] - Anywhere in U.Up to $70K per year / Medical, dental & vision / PTO - As a Customer Experience Specialist at Topicals, you will: Provide exceptional customer service through various channels such as phone, email, and chat; Handle customer inquiries and complaints with emp

Customer Service / Remote] - Anywhere in U.Competitive pay + bonuses / PTO / Employee discount + clothing allowance - As a Customer Experience Agent at Rhone, you will: Provide professional customer support at all times while serving as a front line, go-to resource for all customer needs and inquiri

Customer Service / Fully Remote] - Anywhere in U.Health, dental, and vision / 401k / PTO - As a Member Support Specialist you'll: Be on the front lines of the Member experience; Support Members in the Wellth program with any questions/issues that may arise regarding their program and address any tec

Competitive pay / Medical, dental & vision / 401k / PTO - As a Customer Service Rep at GRT Financial, you will: Handle inbound/outbound calls and emails from clients regarding their accounts; Provide excellent customer service by addressing and resolving customer inquiries and concerns; Update and m

Health, dental & vision / 401k matching / PTO - As a Member Service Specialist at Workit Health, you will: Go above and beyond to provide world-class member experience to individuals interested in signing up for the program, and throughout the members journeys at Workit Health; Communicate and provi

Customer Service / Remote] - Anywhere in U.K per year / Medical, dental & vision / 401k match / PTO / Employee discount - As a Customer Care Associate at Levi Strauss, you will: Resolve customer inquiries and complaints in a timely and professional manner; Provide exceptional customer service throug

Customer Service / Remote] - Anywhere in U.Up to $20 per hour - As a Customer Support Rep you'll: Answer inbound calls, emails, and chats, and take required actions to assist the customers; Anticipate customers' potential needs, and determine appropriate response; Provide comprehensive and accurate

Handle inbound dispatch calls; Resolve issues and escalate as needed; Create and assign work orders to technician offices; Process and manage inventory requests from technician offices; Provide order status updates to internal departments; Work directly with customers to coordinate payments for hard

Customer Service / Remote] - Anywhere in U.Up to $50K per year / Medical, dental & vision / 401k / PTO - As a Customer Support Associate at CreativeX, you will: Manage incoming customer inquiries via email and chat; Provide timely and accurate responses to customer questions and concerns; Troublesho

Customer Support / Remote] - Anywhere in U.Up to $60K per year / Health, dental & vision / 401k match / PTO / Mac computers + WFH stipend / Monthly internet & phone reimbursement - As a Customer Service Associate, you will: Act as a professional brand ambassador by promptly responding to client inqu

Customer Support / Remote] - Anywhere in U.Medical, dental & vision / 401k match / PTO - As a Customer Service Coordinator at One Call, you will: Answer incoming calls and respond to customer inquiries in a timely and professional manner; Provide exceptional customer service by actively listening an

Customer Service / Remote] - Anywhere in U.Medical, Dental, and Vision / PTO / 401k Match - As a Device Support Specialist at Modivcare, you will: Troubleshoot and resolve technical issues for customers using Modivcare devices; Provide excellent customer service by assisting with inquiries and conce

Customer Service / Remote] - Anywhere in U.Up to $20 per hour - As a Customer Support Rep you'll: Answer inbound calls, emails, and chats, and take required actions to assist the customers; Anticipate customers' potential needs, and determine appropriate response; Provide comprehensive and accurate

Customer Service / Remote] - Anywhere in U.Medical, dental & vision / PTO / WFH Stipend / Equipment provided - As a Customer Experience Advocate at SRPSupport, you will: Provide exceptional customer service to clients through various channels such as phone, email, and chat; Answer incoming customer

Call Center / Remote] - Anywhere in U.Up to $24 per hour / Medical, dental & vision / 401k / PTO - As a Customer Service Rep at Equip, you will: Answer inquiry calls, emails, web forms, etc.Respond to inquiries quickly and efficiently while routing inquiries to appropriate departments; Collect patie

Customer Service / Remote] - Anywhere in U.Competitive salary / Health, dental & vision / PTO - As a Customer Experience Specialist, you will: Communicate with customers via phone, email, and text to provide exceptional customer service; Troubleshoot and resolve customer inquiries and issues in a ti

Customer Service / Remote] - Anywhere in U.Competitive pay & benefits - As a Customer Support Specialist at Atarim, you will: Communicate with customers via email and chat to provide outstanding support and resolve any issues they may have; Maintain accurate records of customer interactions and tran

Customer Service / Remote] - Anywhere in U.Up to $78K per year - As a Customer Experience Rep at Alt, you will: Engage with collectors through chat, email, and phone support, providing knowledgeable assistance regarding the auction process, card valuations, and other platform functionalities; Handle

Up to $60K per year - As a Customer Support Specialist at January, you will: Manage inbound calls, emails, and texts from callers with the objective of addressing their account needs; Use ZenDesk to document communications, analyze user problems, resolve basic issues, and facilitate payments on beha

Customer Service / Remote] - Anywhere in U.Up to $26 per hour / Health, dental & vision / 401k matching / PTO / Equipment provided - As a Customer Support Specialist at Mudflap, you will: Communicate effectively with customers to provide timely and accurate resolutions to their inquiries; Maintain a

Customer Service / Fully Remote] - Anywhere in U.Competitive compensation / Company provided laptop, monitor & accessories - As a Customer Care Rep you'll: Be the first responder of customer inquiries via phone, email, and chat; Listen, identify, and assess each customer's need to offer a solution t

Customer Support / Remote] - Anywhere in U.Competitive pay / Health insurance / 401k / PTO - As a Customer Service Coordinator at Cennox, you will: Manage customer inquiries via phone, email, and chat; Provide excellent customer service by resolving issues and answering questions promptly and accura

Customer Service / Fully Remote] - Anywhere in U.Competitive compensation / Company provided laptop, monitor & accessories - As a Customer Care Rep you'll: Be the first responder of customer inquiries via phone, email, and chat; Listen, identify, and assess each customer's need to offer a solution t

Up to $24 per hour / Medical, dental & vision / 401k match / PTO - As a Customer Service Rep at Copart, you will: Manage incoming calls and emails from customers, responding promptly and professionally; Provide accurate and timely information to customers regarding their inquiries and concerns; Reso

Customer Service / Fully Remote] - Anywhere in U.Competitive compensation / 100% employer paid medical & dental / PTO / 401K / Company provided laptop, monitor & accessories - As a Customer Care Rep you'll: Be the first responder of customer inquiries via phone, email, and chat; Listen, identify, an

Customer Service / Remote] - Anywhere in U.As a Customer Experience Coordinator at Ro, you will: Respond to member inquiries across email and internal platforms, and able to support inbound/outbound calls as requested; Help with member onboarding, product education, and general troubleshooting acros

Customer Service / Remote] - Anywhere in U.Up to $42K per year + bonuses / Medical, dental & vision / 401k / PTO - As a Member Service Coordinator, you will: Conduct member outreach (telephonic, text and email) to schedule and confirm appointments; Effectively leverage practice management systems, E

Medical, dental & vision / 401k / PTO - As a Customer Support Specialist at Vori Health, you will: Respond to and resolve incoming messages, calls, and tickets from patients and team members, using discretion and responding in a timely and hospitable manner to meet our world-class service levels; Pr

Customer Service / Remote] - Anywhere in U.Up to $20 per hour / Health, dental & vision / 401k / PTO - As a Customer Experience Specialist at CAVA Group, you will: Manage and respond to customer inquiries through various communication channels; Provide exceptional customer service by actively listen

Competitive Pay - As a Customer Support Rep you'll: Help customers with technical and non-technical inquiries across multiple channels (Email and Live Chat); Engage in meaningful conversations with customers and problem-solve when things don't go quite right; Ensure customer satisfaction by meeting

Customer Service / Remote] - Anywhere in U.Medical, Dental, and Vision / PTO / 401k Match - As a Device Support Specialist at Modivcare, you will: Troubleshoot and resolve technical issues for customers using Modivcare devices; Provide excellent customer service by assisting with inquiries and conce

Monthly internet & phone stipend / PTO - As a Member Service Agent at Omada Health, you will: Manage a high volume of inbound and outbound calls and emails from members and healthcare providers; Provide excellent customer service by addressing inquiries, resolving issues, and escalating concerns as

Customer Service / Remote] - Anywhere in U.Up to $55K per year / Comprehensive benefits - As a Care Experience Specialist at Charlie Health in the Customer Service sector, you'll: Communicate effectively and compassionately with clients and their families; Provide timely and accurate information to

Customer Service / Remote] - Anywhere in U.Up to $22 per hour + bonuses / Health, dental & vision / 401k / PTO - As a Customer Experience Associate at Bold, you will: Manage a high volume of customer inquiries through various channels such as phone, email, and chat.Monitor and respond to customer re

Customer Service / Remote] - Anywhere in U.K per year / Medical, dental & vision / 401K / PTO - As a Customer Support Specialist at Second Nature, you will: Respond to customer service emails, calls and chats with a customer centric attitude; Resolve issues with urgency, notifying the customer if it

Customer Support / Remote] Anywhere in U.Up to $65K per year / Extremely flexible hours - As a Customer Service Agent you'll: Book air and ground transportation for clients; Research and locate the best pricing and options for clients based on their needs; Book hotel reservations for clients in thei

Competitive pay - As a Client Support Specialist at Baylor Genetics, you will: Communicate effectively with clients via phone, email, and chat to provide exceptional customer service; Collect and document client information accurately and efficiently to ensure prompt resolution of inquiries; Utilize

Customer Service / Remote] - Anywhere in U.Competitive pay / Benefits - As a Leave Specialist you'll: Drive success through initial customer kickoff and provide a supportive, personalized end-to-end leave of absence experience for customers using a combination of tools to manage, communicate and upd

K per year / Medical, dental & vision / 401k / PTO / Remote worker stipend - As a Customer Advocate at Sana, you will: Provide accurate and easy-to-understand guidance in the complex world of health insurance and employer benefits across multiple channels (phone, text, chat, and email); Assist membe