Trabajos medicare advantage en Los Angeles, CaliforniaCrear alertas

Job DescriptionWe truly value our employees and are committed to their success! We offer long-term employment opportunities with job stability, as well as support and encouragement for career growth and advancement. Our comprehensive benefits package includes Health, Dental, and Vision insurance, Paid Time Off, 9 Paid Holidays, a 403(b) Retirement Plan with company matching, and company-paid Life Insurance. Join our team and experience a workplace culture that fosters teamwork, growth, and support! Los Angeles Jewish Health has been a trusted provider of senior healthcare for over 100 years, offering a wide range of services that prioritize excellence and Jewish values. We serve more than 4,000 seniors across our San Fernando Valley campuses, delivering personalized care tailored to each individual’s needs, from independent living to specialized healthcare programs. The responsibilities of the Skilled Nursing Billing Coordinator include, but are not limited to: Responsibilities: • Extensive knowledge of SNF Payers, including Medicare, Managed Care, Private Insurance, Long-Term Care Insurance, and Medi-Cal Managed Care., • Expertise in Medicare Billing Rules, UB04 coding, and billing/collection processes., • Proficient in navigating Medicare, Insurance, and Managed Care portals., • Deep understanding of Managed Care billing rules for both Medicare Advantage and Medi-Cal, including contract language and plan billing expectations., • Experience with Appeals, PDRs, and effective communication with plans., • Management of AR Aging Reports and follow-up for outstanding claims., • Conduct account audits and reviews to ensure billing accuracy., • Cash Posting and reconciliation, including ERA processing., • Experience with SNF Business Office functions such as census, cash deposits, insurance verifications, and month-end close. Education and Experience: • Minimum of 3-5 years of SNF Billing and Business Office experience in a high-volume setting., • High School Graduate or equivalent., • Strong computer skills, proficient in Excel & Word., • Excellent written and oral communication skills., • Demonstrated ability to document and follow up on accounts with precision., • Highly organized, detail-oriented, and able to handle challenging assignments with minimal supervision. Join Los Angeles Jewish Health and make a meaningful impact in the lives of seniors in our community. Become part of our compassionate team, dedicated to providing exceptional care and support. Apply today and start making a difference!

Reporting to the Assistant Director of Managed Care Contracting, this role evaluates complex commercial and government payer arrangements including Accountable Care Organizations, Centers of Excellence agreements, Medicare Advantage, Medi-Cal, hospital, medical group, and ambulatory contracts. The S

Come Join the Premier Infusion & Healthcare Family! At Premier we offer employees stability and opportunities for advancement. Our commitment to our core values of Compassion, Integrity, Respect and Excellence in People applies to our employees, our customers, and the communities we serve. This is a rewarding place to work! Premier Infusion and Healthcare Services is a preferred post-acute care partner for hospitals, physicians and families in Southern CA. Our rapidly growing home health and infusion services deliver high-quality, cost-effective care that empowers patients to manage their health at home. Customers choose Premier Infusion and Healthcare Services because we are united by a single, shared purpose: We are committed to bettering the quality of life for our patients. This is not only our stated mission but is what truly drives us each and every day. We believe that our greatest competitive advantage, our greatest asset are our employees, our Premier Family in and out of the office sets Premier apart. PREMIER BENEFITS - For FULL TIME Employees: • Competitive Pay, • 401K Matching Plan - Up to 4%, • Quarterly Bonus Opportunities, • Medical, Dental & Vision Insurance, • Employer Paid Life Insurance, • Short Term / Long Term Disability Insurance, • Paid Vacation Time Off, • Paid Holidays, • Referral Incentives, • Employee Assistance Programs, • Employee Discounts, • Fun Company Events Description of Responsibilities Under the direct supervision of a Clinical Pharmacist and consistent with California state pharmacy regulations to provide non-discretionary tasks, the Pharmacy Desk Technician prepares pharmacy orders for filling, maintains work areas, follows up on narcotic scripts, and enters medication profiles in a timely manner. Reporting Relationship Pharmacy Technician Assistant Manager Scope of Supervision None Responsibilities Include the Following: 1. Refills: · Placing calls to the patient to coordinate a timely and accurate delivery of pharmaceuticals and supplies. · Request lab results from doctors, laboratories, and home health agencies. · Process enteral refills. 1. Perform data entry: · Perform data entry of patient medication profiles and patient chart audits · Discharge patients from CPR+ at the end of therapy 1. Pharmacy Liaison: · Act as liaison for the Pharmacy department · Communicate with doctors, nurses, and hospitals regarding patient care · Perform triplicate request and being able to follow up in a timely matter · Being able to communicate well with the pharmacy staff and supervisor · Coordinate triplicate requests and their documentation as appropriate including exemption forms for all narcotic patients 1. Participate in surveys conducted by authorized inspection agencies., 2. Participate in the pharmacy’s Performance Improvement program as requested by the Performance Improvement Coordinator., 3. Participate in pharmacy committees when requested., 4. Participate in in-service education programs provided by the pharmacy., 5. Pursue continuing education programs appropriate to job responsibilities and certification requirements., 6. Report any misconduct, suspicious or unethical activities to the Compliance Officer., 7. Perform other duties as assigned by supervisor., 8. Comply with and adhere to the standards of this role as required by ACHC, Board of Pharmacy, Board of Nursing, Home Health Guidelines (Title 22), Medicare, Infusion Nurses Society, NHIA and other regulatory agencies, as applicable. The following functions require the professional judgment of a pharmacist and may not be performed by a pharmacy desk technician: • Acceptance of verbal prescriptions., • Certification of filled prescriptions., • Weighing or measuring active drug ingredients without verification by a pharmacist., • Reconstitution of prefabricated medication without verification by a pharmacist., • Entry of orders into the computer system without verification by pharmacist. Minimum Qualifications: 1. Organizational skills sufficient to maintain consistently accurate records., 2. Ability to evaluate options and to make efficient decisions., 3. Current knowledge of all applicable state and federal pharmacy laws, rules and regulations., 4. Computer skills that include proficiency with spreadsheets and use of the internet, as well as word processing, and efficient use of the internet and e-mail., 5. Ability to use good judgment and work with minimal direction., 6. Must possess excellent oral and written communication skills, with the ability to express technical issues in “layman” terms. Education and/or Experience: • Must have a High School diploma or Graduation Equivalent Diploma (G.E.D.) or Higher., • Licensed as a Pharmacy Technician in California preferred, • Possess and exercise advanced level of accuracy., • Minimum of 1-year retail pharmacy experience., • Home Infusion Experience preferred., • Basic knowledge of insurance, authorization, and billing. Equal Employment Opportunity (EEO) It is the policy of Premier Infusion Healthcare Services to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Premier Infusion Healthcare Services will provide reasonable accommodations for qualified individuals with disabilities. Job Type: Full-time Benefits: • Disability insurance, • Employee assistance program, • Employee discount, • Life insurance, • Opportunities for advancement, • Referral program Schedule: • 8 hour shift, • Monday to Friday, • Overtime, • Rotating weekends Work Location: In person

About us: Foodsmart is the leading Foodcare platform in the U.S., built to deliver nutrition-driven healthcare at scale. Powered by a national network of Registered Dietitians, Foodsmart combines personalized clinical nutrition care, behavior change tools, and food benefits to improve member health outcomes while lowering healthcare costs. Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver sustainable health outcomes. Through our highly personalized, digital platform, we guide more than 3 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money. Foodsmart seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing tangible access to nutritious food. In 2024, Foodsmart secured a $200 million investment from TPG’s Rise Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment helps us expand our reach, particularly to low-income workers who are disproportionately affected by diet-related diseases. At Foodsmart, our mission is to make nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment: 👥 Customer First - You start with the member and work backwards. 🚀 Make It Happen - You act with urgency, use data, and hold high standards. 🤝 One Team - You collaborate with respect and commit as a group. Whether you're a dietitian, a commercial leader, or a technologist, working at Foodsmart means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food. About the role: Referral volume is one of Foodsmart's most critical growth levers. Today, the company acquires members through three primary referral channels — healthcare system and clinical referrals (FQHCs, CHCs, pharma, hospital systems), food and retail ecosystem partners (food banks, SDOH organizations, enterprise retailers, food vendor marketplace participants), and community-based outreach (on-the-ground enrollment and awareness in high-density markets). These channels are currently managed across separate functions, creating alignment gaps and missed amplification opportunities. The VP of Partnerships will be the first leader to unify Foodsmart's three member referral-generating functions: institutional healthcare partnerships, food and retail ecosystem relationships, and community-based outreach under a single strategic architecture. As a foundational leader, the VP will guide and mentor the existing leads while strategically scaling the team's capabilities to support our expanding partnership ecosystem. Referral Growth Strategy Design and own the multi-year referral growth roadmap across all partnership verticals. Establish a shared volume framework that connects FQHC referrals, food ecosystem partnerships, and community enrollment into a unified measurement system. Identify which channels represent the highest-leverage bets by market and by population, and allocate resources accordingly. Institutional Partnership Development Personally lead the identification and structuring of new partnerships with Federally Qualified Health Centers (FQHCs), Community Health Centers (CHCs), pharma organizations, hospital systems, FindHelp, UniteUs, and other SDOH-adjacent platforms. These are complex, multi-stakeholder negotiations requiring fluency in clinical workflows, procurement processes, and population health goals. Team Leadership & Development Serve as a visionary leader and mentor to a high-performing team. Foster a culture of high performance, accountability, and continuous professional development, while thoughtfully expanding team capacity to meet future growth demands. Food & Retail Ecosystem Provide executive oversight for Foodsmart's food vendor partnerships and marketplace strategy, including national retailer relationships (Walmart, Amazon, Instacart) as well as community-level food bank and SDOH organizations. Work with the Sr. Director of Food Partnerships to build a differentiated marketplace value proposition that deepens member engagement and drives referral volume. Community Engagement Oversight Oversee the Director of Community Engagement and a field team responsible for awareness campaigns and enrollment drives in high-density markets. This vertical requires both operational accountability and strategic direction — ensuring community-level activation is tied to measurable enrollment outcomes rather than solely awareness metrics. Distribution & Channel Partnerships Develop and manage relationships with distribution and channel partners — including supplemental benefit platforms (Soda Health, Nations Benefits), benefit management platforms (Lynx), and others — that create access to new member populations at scale. This requires an understanding of how benefit platforms price, structure, and distribute services. Operating Cadence & Pipeline Management Build the operational infrastructure for this team: a shared CRM-based pipeline, segment-level performance tracking, a partner health scorecard, and a forecasting methodology that can be trusted by leadership. The VP will bring rigor and accountability to this function. Cross-Functional Alignment Work closely with the CGO, Chief Clinical Officer, product, and payer/provider sales teams to ensure partnership structures are consistent with clinical quality standards, network requirements, and member experience expectations. Referral volume only creates value if it converts to engaged, retained members. In Year 1, the VP of Partnerships will: • Develop and present a partnership strategy that prioritizes channels by market, population type, and conversion potential with near-term and long-term growth targets, • Provide mentorship to the current team and map out a thoughtful capacity-building plan to support long-term partnership growth, • Stand up a shared pipeline management system and partner performance framework, • Directly secure or re-structure at least 2–3 high-value institutional referral partnerships, • Assess and sharpen the food vendor marketplace strategy, • Establish operating norms and team accountability frameworks, and a strong management culture focused on coaching and enablement A Partnership Architect — not a manager of existing relationships, but a builder of new ones. You identify structural opportunities and create the frameworks that make them repeatable. Mission-Aligned — genuinely motivated by the intersection of food access, health equity, and healthcare delivery. You can speak to SDOH fluently because you care about it. Strategically rigorous with executional discipline — you can move between market-level strategy and pipeline spreadsheet accountability in the same meeting. Highly politically fluent — able to navigate the complexity of FQHC leadership teams, retail procurement organizations, pharma corporate affairs teams, and community health stakeholders with equal ease. Leader, strong builder and developer of talent — you elevate the people around you and create clarity, not dependency. Comfortable with ambiguity at scale — you can design structure where none exists and iterate quickly without losing direction. 12+ years of experience in strategic partnerships, business development, or growth leadership — with at least half of that in healthcare, digital health, or health-adjacent verticals 5+ years of management experience with a proven track record of guiding, mentoring, and effectively scaling capabilities within growing, high-performing teams Deep familiarity with the SDOH ecosystem: FQHCs, CHCs, food banks, community health workers, and the platforms that connect them (FindHelp, UniteUs, etc.) Experience navigating both institutional healthcare (payers, health systems, Medicaid/Medicare) and non-traditional partners (retailers, food companies, community organizations) A demonstrated track record of building partnership ecosystems — not just managing inherited ones — with measurable referral, enrollment, or revenue outcomes Operational capability: you have built pipeline management systems, run performance reviews, and held teams accountable to volume metrics Management consulting background is a meaningful differentiator for this role given the complexity of the organizational design and market segmentation work required Bachelor's degree required; Master's, MBA, or MPH strongly preferred $230,000 - $250,000 a year Role: VP, Partnerships Location: Remote, USA Base Salary Range: $230,000 - $250,000 + bonus + benefits Our salary ranges are determined by role, level, and location. Individual pay is determined by work location, job-related skills, experience, and relevant education or training. About our benefits and perks: ✅ Remote-First Company ✅ Unlimited PTO ✅ Flexible & remote location ✅ Healthcare Coverage (Medical, Dental, Vision) ✅ 401k & bonus ✅ Registered Dietitian Sessions Foodsmart is an Equal Opportunity Employer. It is our firm policy to extend equal employment and advancement opportunity to all applicants and employees without regard to race, color, national origin, citizenship status, religious creed, age, sex (including pregnancy, childbirth, breastfeeding, medical conditions related to pregnancy, childbirth and/or breastfeeding), gender, gender identity and expression, sexual orientation, marital status, disability (physical or mental) and/or a medical condition, genetic information, ancestry, veteran status or service in the uniformed services, and any other characteristic protected by applicable federal, state or local law. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

This role requires working in the office five days per week.Impresiv Health is seeking an experienced Health Plan Pharmacist to support Medicare Advantage pharmacy operations, clinical programs, and regulatory compliance initiatives.This role serves as a subject matter expert in pharmacy benefit man

Job DescriptionOverview Seoul Medical Group (SMG) is seeking a highly analytical and detail-oriented Manager, Payor Contract Integrity & Delegation Operations to serve as the operational bridge between payors, contracting, healthcare economics, finance, and MSO teams. This role is responsible for ensuring that capitation payments and claims-based reimbursements are accurate and aligned with contracted terms, and that delegated, capitated risk contracts are implemented correctly within MSO systems and Delegated Configuration, including DOFR alignment. The individual will not perform system configuration directly but will project manage implementation, validate alignment to contract terms, and coordinate cross-functional communication to ensure financial and operational accuracy. Key Responsibilities • Serve as primary liaison with payors to identify and resolve capitation discrepancies, claims underpayments, and overpayments., • Partner with Healthcare Economics and Finance to reconcile capitation models against actual payment files., • Analyze payment variances and validate alignment to contracted rates, attribution models, and DOFR terms., • Escalate discrepancies to payors and manage issue resolution through completion., • Translate contract language (risk terms, DOFR allocations, carve-outs, fee schedules) into implementation requirements., • Partner with Payor Contracting to ensure newly executed contracts are accurately operationalized., • Coordinate with the AMM MSO team and Delegated Configuration teams to ensure capitated contracts are configured properly., • Project manage contract implementation timelines and ensure cross-functional alignment., • Validate system configuration reflects negotiated contract terms prior to go-live., • Develop structured processes for post-implementation validation of capitated and delegated contracts., • Identify financial risk exposure due to misconfiguration or payment inaccuracies., • Support audit readiness related to delegated and capitated arrangements.Qualifications, • Bachelor’s degree required; advanced degree preferred., • 5+ years of experience in payor contracting operations, healthcare economics, capitation reconciliation, delegated risk operations, or MSO finance., • Strong working knowledge of capitated payment structures, risk-bearing provider contracts, and DOFR frameworks., • Demonstrated experience managing cross-functional implementation projects., • Strong Excel and financial analysis skills.Preferred Qualifications, • Experience within an IPA, MSO, health plan, or delegated risk organization., • Familiarity with delegated configuration systems and contract loading workflows., • Exposure to Medicare Advantage financial models, Stars, or risk adjustment., • Experience resolving payment disputes with payors. AMM BENEFITS When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first: • Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan., • Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe., • Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future., • Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work., • Career Development: Tuition reimbursement to support your education and growth.

Job Description Position Summary The Provider Configuration Supervisor is responsible for leading and overseeing all day-to-day provider and contract configuration activities within the claims adjudication system (EZCAP) for a fully delegated IPA/MSO operating under Full-Risk Medicare Advantage and Value-Based Care contracts. This role ensures that providers, facilities, contracts, fee schedules, DOFRs (Delegated Organization Financial Responsibility), benefit configurations, and claims payment rules are configured accurately, timely, and in alignment with executed contracts, delegation agreements, and financial models. The Supervisor leads configuration analysts, enforces configuration standards, mitigates downstream claims risk, and ensures claims are clean, payable, and audit-defensible. This is a mission-critical role: configuration errors directly result in incorrect provider payments, financial leakage, disputes, regulatory exposure, and provider dissatisfaction. Core Accountability Own the integrity, accuracy, and operational readiness of all provider and contract configuration within EZCAP to support clean claims adjudication under full-risk, delegated value-based contracts. Key Responsibilities 1. Claims System Configuration Leadership (EZCAP) • Lead and supervise all provider, contract, and financial configuration activities within EZCAP., • Ensure accurate setup and maintenance of:, • Providers (PCPs, Specialists, Facilities, Ancillaries), • Provider hierarchies and affiliations (TIN, billing NPI, rendering NPI), • Payor contracts and sub-contracts, • DOFRs (Delegated Organization Financial Responsibility), • Provider Fee Schedules / Fee Sets, • Capitation arrangements, • Risk pools, withholds, and bonus configurations, • Global and partial delegation logic, • Own configuration logic that determines who pays whom, how much, and under what rules. 1. DOFR & Financial Responsibility Configuration • Configure and maintain DOFR structures reflecting:, • IPA vs Health Plan responsibility, • PCP vs Specialist responsibility, • In-network vs out-of-network scenarios, • Facility vs professional claim logic, • Ensure DOFR logic aligns with:, • Delegation agreements, • Health plan contracts, • Provider contracts, • Internal financial models and actuarial assumptions, • Partner with Finance and Actuarial teams to validate financial accuracy. 1. Provider Fee Set & Contract Configuration • Oversee configuration of:, • Fee-for-service schedules, • Case rates, • Percent-of-charge models, • Flat fee arrangements, • Custom carve-outs, • Ensure fee sets align precisely with executed provider contracts and amendments., • Manage retroactive configuration changes with appropriate impact analysis and documentation. 1. Team Leadership & Supervision • Supervise configuration analysts and specialists including:, • Work assignment and prioritization, • Training and onboarding, • Quality control and peer review, • Performance management, • Establish configuration standards, SOPs, and naming conventions., • Serve as escalation point for complex configuration scenarios and claims issues. 1. Cross-Functional Coordination • Partner closely with:, • Credentialing (provider readiness), • Contracting (interpretation of provider and payor contracts), • Claims Operations (claims outcomes and issue resolution), • Finance / Actuarial (payment accuracy and financial modeling), • Provider Disputes (root cause resolution), • Compliance (audit and delegation oversight), • Translate contract language into executable system logic. 1. Claims Readiness & Issue Resolution • Support claims production by ensuring configuration is:, • Complete prior to provider go-live, • Tested and validated, • Participate in claims triage for:, • Underpayments, • Overpayments, • Misrouting of financial responsibility, • Perform root-cause analysis of configuration-driven claims defects and implement corrective actions. 1. Audit, Compliance & Delegation Readiness • Ensure configuration is audit-defensible for:, • Health plan delegation audits, • Internal compliance reviews, • CMS or regulatory inquiries, • Maintain documentation for configuration decisions, overrides, and exceptions., • Support Corrective Action Plans (CAPs) related to configuration findings. 1. Change Management & Configuration Governance • Establish and enforce configuration change control processes., • Review and approve:, • New provider builds, • Contract amendments, • Retroactive configuration changes, • Maintain configuration logs and version tracking., • Ensure changes are communicated to downstream teams (claims, finance, provider relations). 1. Reporting & Performance Oversight • Track and report configuration KPIs including:, • Provider build turnaround time, • Contract configuration cycle time, • Configuration defect rate, • Claims rework attributable to configuration, • Provide regular operational updates to the Senior Director of MSO Operations. Qualifications Education • Bachelor’s degree in Healthcare Administration, Business, Finance, Information Systems, or related field preferred., • Equivalent experience in delegated claims configuration accepted. Experience • 6+ years of healthcare claims configuration experience in an IPA, MSO, or health plan., • 3+ years of hands-on EZCAP configuration experience required., • 2+ years of supervisory or lead experience strongly preferred., • Deep experience in delegated, full-risk Medicare Advantage environments required., • Proven experience configuring DOFRs, provider fee sets, and complex payment logic. Technical Expertise • Advanced EZCAP configuration knowledge:, • Provider builds, • Contract loading, • DOFR logic, • Fee schedules, • Strong understanding of:, • Medicare Advantage delegation models, • Claims adjudication workflows, • Provider payment methodologies, • Advanced Excel and analytical skills. Core Competencies • Exceptional attention to detail, • Strong systems and financial logic thinking, • Ability to interpret contracts into executable system rules, • Leadership and coaching capability, • High accountability and ownership mindset, • Strong cross-functional communication, • Comfort operating in high-risk, audit-exposed environments Key Performance Indicators (KPIs) • Claims paid correctly on first pass, • Configuration error rate, • Provider build and contract setup turnaround time, • Reduction in configuration-related disputes, • Audit findings related to configuration, • Team productivity and quality metrics AMM BENEFITS When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first: • Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan., • Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe., • Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future., • Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work., • Career Development: Tuition reimbursement to support your education and growth.

Job DescriptionDescription: The Skilled Nursing Admissions Coordinator is responsible for managing the resident intake and admission process for the 59-bed Skilled Nursing Facility at Hollenbeck Palms, ensuring full regulatory compliance and completion of all required admission documentation. This role serves as the primary liaison between hospitals, referral sources, families, and the interdisciplinary clinical team to facilitate timely, appropriate, and compliant admissions. The Admissions Coordinator reviews and evaluates referrals, verifies Medicare, Medi-Cal (Medicaid), and managed care insurance eligibility, and coordinates room assignments and admission logistics. This position plays a critical role in supporting census stability, revenue cycle integrity, and resident satisfaction by ensuring a smooth and professional transition into the Skilled Nursing Facility. The role requires a strong understanding of Skilled Nursing Facility reimbursement models, admission criteria, and California regulatory requirements. Essential Duties and Responsibilities • Serve as the primary point of contact for all Skilled Nursing referrals from hospitals, physicians, case managers, internal campus transfers, and community sources., • Review referral documentation, including clinical, financial, and insurance information, to determine eligibility and appropriateness for admission., • Coordinate admission approvals with the SNF Administrator, Director of Nursing, and interdisciplinary team., • Facilitate timely and compliant admissions, ensuring completion of all required documentation, consent forms, and regulatory disclosures., • Coordinate admissions logistics, including bed availability, room assignment, transportation, and handoff communication., • Provide professional tours and orientation to prospective residents and families. Financial and Insurance Verification • Verify insurance coverage, including Medicare, Medi-Cal, managed care, and private pay eligibility prior to admission., • Coordinate with billing and business office to ensure accurate financial clearance and payer authorization., • Ensure accurate documentation to support compliance and reduce risk of denied claims or delayed reimbursement. Referral and Relationship Management • Develop and maintain positive relationships with hospital discharge planners, physicians, case managers, and referral partners., • Respond promptly to referral inquiries to support timely admissions and census goals., • Represent Hollenbeck Palms professionally in communications with referral sources and the community. Interdisciplinary Collaboration • Collaborate with nursing, social services, therapy, and business office teams to ensure appropriate admissions and continuity of care., • Participate in census, admissions, and discharge planning meetings as required., • Communicate admission timelines and resident needs to interdisciplinary staff. Documentation and Regulatory Compliance • Maintain accurate records of referrals, admissions, and census activity., • Ensure compliance with federal and California regulations, including CMS, California Department of Public Health (CDPH), and patient rights requirements., • Maintain confidentiality of protected health information in accordance with HIPAA and facility policies. Customer Service and Resident Experience • Provide compassionate and professional communication with residents and families during the admission process., • Ensure a welcoming, respectful, and supportive admission experience aligned with Hollenbeck Palms’ nonprofit mission and resident-centered values., • Follow up with residents and families after admission to ensure successful transition.Requirements:, • Minimum five (5) years of healthcare intake, admissions, or care coordination experience, preferably in a Skilled Nursing Facility, hospital, or post-acute care setting., • Strong knowledge of Skilled Nursing Facility reimbursement models, including Medicare Part A, Medicare Advantage, Medi-Cal, and managed care plans., • Demonstrated experience managing the full admissions process, including referral review, insurance verification, and admission documentation., • Working knowledge of federal and California regulatory requirements related to SNF admissions, patient rights, and documentation compliance., • Excellent organizational, communication, and interpersonal skills with the ability to coordinate across clinical, administrative, and external stakeholders., • Proficiency in electronic health records and Microsoft Office applications. Preferred · Experience with Ensocare is highly desirable · Experience in a nonprofit healthcare organization or Continuing Care Retirement Community (CCRC). · Knowledge of PointClickCare or similar SNF electronic medical record system. · Experience working with hospital discharge planners and case managers.

Job DescriptionDescriptionWe are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our IPAs across the nation. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You’ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success. We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience! Our Values: • Put Patients First, • Empower Entrepreneurial Provider and Care Teams, • Operate with Integrity & Excellence, • Be Innovative, • Work As One Team What You'll Do • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company, • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC), • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines, • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation, • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing, • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements., • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives., • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work., • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager., • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I, • Other duties as assigned Qualifications • Must be open to traveling to provider sites within Connecticut and possibly surrounding areas. Reliable transportation and valid Driver’s License required, • Certified Professional Coder (CPC) AND Certified Risk Adjustment Coder (CRC) certifications from AAPC, • 3-5+ years of experience in risk adjustment coding and billing experience, • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook, • Excellent presentation, verbal and written communication skills, and ability to collaborate, • Must possess the ability to educate and train provider office staff members, • Proficiency with healthcare coding softwares and Electronic Health Records (EHR) systems., • Strong knowledge with PowerPoint, preparing presentations, and public speaking, • Strong experience with Excel - reports, pivot tables, VLOOKUP, etc.You're great for this role if:, • Strong billing knowledge and/or Certified Professional Biller (CPB) through AAPC highly preferred, • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage, • Experience with multiple EMR/EHR systems, • Experience with Monday.com and PowerBI, • Ability to work independently and collaborate in a team setting, • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting Environmental Job Requirements and Working Conditions • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors., • This role will be fully remote and likely work in CST hours, however, some work across time zones may be necessary., • This is a full-time position, M-F 830-5. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.

Job Description The WelbeHealth PACE program helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. It’s our mission to serve the most vulnerable seniors with better quality and compassion in a value-based model. The Senior Care Advisor helps assess PACE eligibility by fostering relationships with prospective participants, their family members, and their caregivers. A trusted telephonic resource, the Senior Care Advisor helps guide seniors who may qualify for the PACE program through the enrollment process with WelbeHealth. The Senior Care Advisor will collaborate with market leaders, members of the clinical team, and others to get seniors all the way to enrollment, which may include assisting prospective participants with the Medi-Cal application process. Other tasks will include answering inbound and doing follow-up calls, as well as outbound calls to online leads. Essential Job Duties: • Display great patience, empathy, and show “courage to love” on every call; build strong relationships with prospective participants, caregivers and independent outreach associates who may need assistance with participant enrollment, • Support inbound campaigns, answer questions, and find underlining needs of prospective participants, educating them about PACE services and benefits to expand our mission to help more seniors in the communities we serve, • Make outbound calls to prospective participants that have indicated an interest in learning more about WelbeHealth PACE (not cold calls), • Effectively manage leads that require follow-up calls, • Maintain the highest level of service on all calls, both inbound and outbound Job Requirements: • Associate’s degree preferred; or two (2) years of relevant experience may be substituted in lieu of degree, • Minimum of one (1) year of experience in tele sales, customer services sales, Medicare or PACE sales experience preferred, • Experience using CRM systems (Salesforce or other similar CRM system), • Medicare Advantage or PACE experience preferred, • Medi-Cal knowledge preferred Benefits of Working at WelbeHealth: Apply your sales expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for. • Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days, • Medical Insurance Coverage (Medical, Dental, Vision), • Advancement opportunities - we’ve got a track record of hiring and promoting from within, meaning you can create your own path, • And additional benefits Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications. Compensation Offering$26.89—$35.50 USD COVID-19 Vaccination Policy At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations. Our Commitment to Diversity, Equity and Inclusion At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law. Beware of Scams Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to fraud.report@welbehealth.com

Job Description Position Summary We are seeking a purpose-driven, strategic Sr. Manager of Marketing/Director of Marketing to serve as the marketing right hand to the Chief Brand & Experience Officer at SMG (Seoul Medical Group) — a leading healthcare organization serving the Asian American community across Korean, Chinese, and Vietnamese populations. In this role, you will manage day-to-day relationships with external marketing agencies, drive consumer-facing campaigns, and partner cross-functionally to execute the brand narrative under the direct guidance of the CBxO. This is a unique opportunity to operate at the intersection of brand strategy and execution in a high-growth, mission-driven organization rapidly expanding its reach across Korean, Chinese, and Vietnamese communities. Key Responsibilities • Execute the SMG brand narrative as defined by the CBxO — ensuring shared values, vision, and commitment to care are consistently expressed across all channels and communities., • Lead the day-to-day management of external marketing agencies, ensuring aligned strategy, clear messaging, and measurable outcomes across all media channels., • Develop and execute culturally attuned, consumer-facing campaigns — especially during Medicare Advantage enrollment periods (OEP, AEP, SEP)., • Work cross-functionally with internal teams (digital, community, broker engagement, brand, provider relations) to ensure messaging consistency and campaign support., • Partner closely with insurance brokers and healthcare partners — serving as the key marketing liaison to sales channels and strategic health system relationships, ensuring brand messaging supports enrollment goals and partner alignment., • Serve as the operational owner of brand execution — translating CBxO-defined brand architecture, voice and tone, and community storytelling guidelines into day-to-day campaign and agency work across Korean, Chinese, and Vietnamese audiences., • Monitor campaign performance, generate insights, and optimize results across traditional and digital channels., • Ensure operational excellence in budgeting, timeline management, and internal approvals. Qualifications • 7–12 years of experience in consumer marketing, with a strong background in agency management and multicultural brand strategy., • Prior experience in healthcare, Medicare Advantage, or mission-driven sectors preferred., • Demonstrated ability to manage external agency relationships, hold vendors accountable to outcomes, and translate strategic direction into executed campaigns., • Passion for community-focused storytelling, empathy-driven messaging, and inclusive branding., • Excellent communicator and collaborator across cross-functional teams., • Korean language proficiency a plus, but not required. Chinese and Vietnamese language skills a plus AMM BENEFITS When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first: • Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan., • Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe., • Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future., • Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work., • Career Development: Tuition reimbursement to support your education and growth., • Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!

Job Description The WelbeHealth PACE program helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. It's our mission to serve the most vulnerable seniors with better quality and compassion in a value-based model. The Senior Care Advisor helps assess PACE eligibility by fostering relationships with prospective participants, their family members, and their caregivers. A trusted telephonic resource, the Senior Care Advisor helps guide seniors who may qualify for the PACE program through the enrollment process with WelbeHealth. The Senior Care Advisor will collaborate with market leaders, members of the clinical team, and others to get seniors all the way to enrollment, which may include assisting prospective participants with the Medi-Cal application process. Other tasks will include answering inbound and doing follow-up calls, as well as outbound calls to online leads. Essential Job Duties: • Display great patience, empathy, and show "courage to love" on every call; build strong relationships with prospective participants, caregivers and independent outreach associates who may need assistance with participant enrollment, • Support inbound campaigns, answer questions, and find underlining needs of prospective participants, educating them about PACE services and benefits to expand our mission to help more seniors in the communities we serve, • Make outbound calls to prospective participants that have indicated an interest in learning more about WelbeHealth PACE (not cold calls), • Effectively manage leads that require follow-up calls, • Maintain the highest level of service on all calls, both inbound and outbound Job Requirements: • Associate's degree preferred; or two (2) years of relevant experience may be substituted in lieu of degree, • Minimum of one (1) year of experience in tele sales, customer services sales, Medicare or PACE sales experience preferred, • Experience using CRM systems (Salesforce or other similar CRM system), • Medicare Advantage or PACE experience preferred, • Medi-Cal knowledge preferred Benefits of Working at WelbeHealth: Apply your sales expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for. • Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days, • Medical Insurance Coverage (Medical, Dental, Vision), • Advancement opportunities - we've got a track record of hiring and promoting from within, meaning you can create your own path, • And additional benefits Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications. Compensation Offering$26.89—$35.50 USD COVID-19 Vaccination Policy At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations. Our Commitment to Diversity, Equity and Inclusion At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law. Beware of Scams Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to fraud.report@welbehealth.com

Job Description Position Overview We are seeking a highly technical, hands-on operational executive to serve as our Senior Director of MSO – Claims Operations & Provider Configuration. This position requires candidates to be based in Southern California. This role requires a true Subject Matter Expert (SME) with deep, end-to-end expertise in claims operations within a fully delegated, full-risk Medicare Advantage environment. Direct, hands-on EZCAP experience is required. This is not a high-level oversight position. The ideal candidate can speak in detail about adjudication logic, denial trends, provider configuration dependencies, and the operational issues they have personally resolved. This leader will own claims accuracy, configuration integrity, financial alignment, and measurable KPI performance across the MSO. Key Responsibilities End-to-End Claims Operations Ownership • Oversee the full claims lifecycle: intake, validation, adjudication, pricing, payment, adjustments, reprocessing, and reporting, • Ensure high first-pass adjudication rates and CMS-compliant turnaround times, • Monitor denial trends and implement structured root cause corrective actions, • Serve as executive escalation point for complex claims and systemic issues, • Align claims operations with capitation models, IBNR, MLR, and risk pool performance Provider Configuration & EZCAP Governance • Own provider configuration within EZCAP, including:, • Demographics, • Contract terms, • Fee schedules, • Risk arrangements, • Delegation indicators, • Effective dates and terminations, • Establish configuration QA, validation, and change control governance, • Prevent mispricing, claims leakage, and downstream financial exposure, • Ensure system integrity across payor transitions, growth, and new market expansion Performance Management & Operational Improvement • Improve measurable KPIs including:, • First-pass adjudication rate, • Claims accuracy rate, • Turnaround time (clean vs. non-clean), • Rework percentage, • Configuration error rate, • Conduct root cause analysis on systemic operational issues, • Design and operationalize scalable, sustainable solutions, • Build dashboards and performance reporting for executive leadership Financial & Regulatory Stewardship • Ensure claims payments align with contract terms and value-based arrangements, • Mitigate overpayment, underpayment, and compliance risk, • Lead audit readiness for CMS and health plan delegation oversight, • Partner with Finance and Actuarial on trend analysis and cost variance drivers Leadership & Team Development • Lead managers and SMEs across claims and configuration teams, • Build a metrics-driven, high-accountability culture, • Coach leaders on technical problem-solving and escalation management, • Ensure operational readiness for audits, system upgrades, and organizational growth Required Qualifications • Must be based in Southern California, • 10+ years of healthcare claims operations experience, • 5+ years in senior leadership managing managers and complex teams, • Direct, hands-on EZCAP experience (required), • Demonstrated expertise in:, • Claims adjudication logic, • Provider configuration and fee schedules, • Delegated Medicare Advantage models, • CMS regulatory requirements, • Proven experience in a fully delegated, full-risk Medicare Advantage environment, • Strong root cause analysis and process optimization background, • Documented success improving claims KPIs and reducing operational leakage Preferred Qualifications • Master’s degree (MBA, MHA, or related field), • Multi-state IPA/MSO experience, • Experience supporting rapid growth, new market expansion, or M&A integrations, • Background in operational automation or system optimization initiatives Core Competencies • Deep technical and operational expertise (not surface-level oversight), • Financial and analytical acumen, • Strong executive judgment and escalation management, • Ability to translate complexity into scalable execution, • Calm, decisive leadership under pressure AMM BENEFITS When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first: • Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan., • Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe., • Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future., • Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work., • Career Development: Tuition reimbursement to support your education and growth.

Job DescriptionBenefits: • Employee discounts, • Training & development, • Wellness resources Company Snapshot Health Atlast is a high-volume, integrated, multi-disciplinary healthcare organization in West Los Angeles. We operate under real-world payer scrutiny and expect operational excellence. This is not entry-level billing and not a training role. Role Summary (Read Carefully) We are hiring a seasoned Medical Billing Specialist with direct, hands-on experience billing PM&R-based services in an outpatient, multi-provider environment. This role is not suitable for candidates whose background is limited to: • Hospital billing, • Ambulance billing, • Pharmacy, • Psychiatry / Behavioral Health, • Sober Living / Substance Abuse If that is your background, do not apply. Required Experience (Non-Negotiable) • Minimum 35 years of recent medical billing experience in outpatient PM&R settings, • Proven billing experience in ALL or MOST of the following:, • Physical Therapy, • Chiropractic, • Acupuncture, • General Medicine, • Durable Medical Equipment (DME), • Daily use of CPT, ICD-10, and HCPCS (timed codes included), • Demonstrated success with denial management, appeals, and AR follow-up, • Strong payer experience (commercial, Medicare, Medicare Advantage) Core Responsibilities • End-to-end claim submission for multi-disciplinary services, • Aggressive follow-up on unpaid, underpaid, or denied claims, • Root-cause analysis of denials with corrective action, • Insurance eligibility and benefit verification, • Accurate posting, reconciliation, and documentation, • Patient billing communication when required, • Maintain strict HIPAA and compliance standards, • Collaborate with clinical and front-office teams to resolve billing gaps Ideal Candidate Profile • Detail-driven and process-oriented, • Comfortable working in a fast-paced, high-accountability environment, • Understands timed vs untimed codes and medical necessity, • Can work independently without constant oversight, • Takes ownership of outcomes, not just tasks Compensation • $20 $28/hour, based on verified, relevant experience, • No flexibility for unrelated billing backgrounds Schedule • Full-time, • On-site only (West Los Angeles) Application Instructions (Important) To be considered: • Submit your resume, • Include a brief cover letter specifically outlining your experience with PM&R / PT / Chiro / Acupuncture billing Applications without relevant specialty experience will not be contacted.

Job Description A HEDIS/Risk Adjustment Coordinator is a healthcare quality and data-management professional who helps health plans, medical groups, and provider organizations improve quality scores and ensure accurate documentation of patient conditions for reimbursement and reporting. Position Summary The HEDIS/Risk Adjustment Coordinator supports quality improvement and revenue optimization initiatives by coordinating activities related to HEDIS measures and Risk Adjustment programs. This role ensures accurate clinical documentation, medical record collection, and provider engagement to meet regulatory and organizational goals. Key Responsibilities -Coordinate HEDIS and Risk Adjustment chart review and medical record retrieval projects. -Review medical records to identify gaps in HEDIS quality measures. -Monitor quality metrics and risk adjustment performance reports. -Track and report progress on quality improvement activities. -Educate providers and staff regarding HEDIS requirements and coding guidelines. -Assist with audits conducted by health plans and regulatory agencies. -Maintain compliance with privacy regulations, including HIPAA requirements. -Use electronic health record (EHR) systems and population health management tools to identify care gaps. -Schedule and coordinate provider outreach and patient interventions when necessary. -Additional assignments assigned by supervisor. Required Qualifications -High school diploma -Strong organizational, communication, and analytical skills. -Proficiency with Microsoft Office applications Preferred Qualifications -Experience working with Medicare Advantage, or managed care populations. -Experience in healthcare administration, medical records, quality improvement, or managed care preferred but not required. Company DescriptionS&S Management Inc is a Management Services Organization (MSO).S&S Management Inc is a Management Services Organization (MSO).

Job Description A highly regarded and well-respected national healthcare organization is seeking a transformational Vice President, Internal Audit to lead enterprise-wide audit, risk, and control strategy within a highly regulated Medicare Advantage environment. Remote or Hybrid Available $300-$420K Total Comp (base + annual bonus) + additional annual equity The selected executive will serve as a strategic advisor to executive leadership and the Audit Committee, driving SOX governance, enterprise risk management, operational audit excellence, and regulatory readiness across a complex healthcare platform serving Medicare Advantage members nationwide. Key areas of focus include: • SOX 404 leadership and internal control transformation, • Enterprise risk assessment and Board-level reporting, • Medicare Advantage regulatory oversight, including RADV and encounter data integrity, • Operational and IT audit leadership across finance, claims, pharmacy, medical management, and technology, • Governance of outsourced audit partnerships, • Building a culture where accountability and controls are embedded into daily operations Qualifications: • 15+ years of progressive audit, controls, or risk leadership experience, • Deep expertise within Medicare Advantage, managed care and/or healthcare insurance environments, • Prior experience in Big 4 or national public accounting firm required, • Strong command of CMS regulations, PCAOB standards, SEC reporting, and COSO frameworks, • Executive presence with proven Audit Committee and Board interaction experience, • Ability to influence senior stakeholders while maintaining independence and objectivity, • This is a highly visible leadership opportunity with direct enterprise impact supporting regulatory integrity, operational excellence, and improved healthcare outcomes.

Job Description Arrowhead Pharmaceuticals, Inc. (Nasdaq ARWR) is a commercial stage biopharmaceutical company that develops medicines that treat intractable diseases by silencing the genes that cause them. Using a broad portfolio of RNA chemistries and efficient modes of delivery, Arrowhead therapies trigger the RNA interference mechanism to induce rapid, deep, and durable knockdown of target genes. RNA interference, or RNAi, is a mechanism present in living cells that inhibits the expression of a specific gene, thereby affecting the production of a specific protein. Arrowhead's RNAi-based therapeutics leverage this natural pathway of gene silencing. Arrowhead is focused on developing innovative drugs for diseases with a genetic basis, typically characterized by the overproduction of one or more proteins that are involved with disease. The depth and versatility of our RNAi technologies enables us to potentially address conditions in virtually any therapeutic area and pursue disease targets that are not otherwise addressable by small molecules and biologics. Arrowhead is leading the field in bringing the promise of RNAi to address diseases outside of the liver, and our clinical pipeline includes disease targets in the liver and lung with a promising pipeline of preclinical candidates. Arrowhead's corporate headquarters is in Pasadena, CA with research and development teams in Madison, WI & San Diego, CA, and a state of the art manufacturing facility in Verona, WI. Our employees are nimble, science-driven innovators who are collaborating to bring new therapies to patients in need. The Position Arrowhead's Market Access team is expanding its capabilities to support current and future product launches. The Director, Contracts & Pricing is a critical leadership role responsible for developing, optimizing, and executing pricing and contracting strategies across all stages of the Arrowhead product lifecycle. This individual will help ensure competitive positioning, maximize patient access, and enhance overall brand and enterprise value. The position reports to the Executive Director, Market Access. This role is based in Pasadena, California, with an expectation to be in the office five days a week. Responsibilities • Support the development and execution of pricing and contracting strategies for pre-launch and in-market brands, aligned with overarching commercial goals, • Lead the creation of clear, compelling business cases to secure approval for major contracting initiatives, • Continuously monitor market dynamics, policy changes, and competitor pricing to inform recommendations and maintain competitive advantage, • Collaborate cross-functionally with Legal, Sales, Finance, and other functions to refine pricing and contracting strategies and ensure optimal product commercialization and profitability, • Support the Payer Team during key customer engagements and negotiations, representing pricing and contracting as needed, • Provide pricing and reimbursement insights to help evaluate U.S. policy and legislative developments, • Partner with Finance to support quarterly close processes, including discount forecasting, GTN analytics, and utilization by contract segment, • Drive continuous improvement and innovation in pricing and contracting processes, tools, and governance, • Ensure compliance with all federal, state, and company policies related to pricing, contracting, and market access activities Requirements • Bachelor's degree in finance, economics, accounting, • 10+ years of experience in the biotech or pharmaceutical industry, including at least 5+ years in Market Access, Contracts & Pricing, or related functions., • Extensive experience building, leading, and executing pricing and contracting strategies within the pharmaceutical or biotechnology industry, • Deep expertise in pricing and contracting analytics, including GTN forecasting and modeling, • Proven experience developing contract proposals, including financial modeling, ROI assessments, and evaluation of GTN implications, along with demonstrated negotiation strategy capability, • Strong understanding of pharmaceutical contract administration systems and reporting across payer, provider, government, specialty pharmacy, and distribution channels, • Expert knowledge of pharmacy benefits; Medicare FFS and Managed Care; Medicaid; and federal purchasing programs (e.g., VA/DoD, 340B)., • Subject-matter expertise in the Inflation Reduction Act (IRA), including financial risks and strategic opportunities for manufacturers, • Excellent verbal, written, and presentation skills, with the ability to translate complex concepts for diverse audiences, • Exceptional attention to detail, with the ability to work independently and collaboratively across cross-functional teams, external partners, and vendors, • Willingness to travel as needed to engage with customers, as required Preferred • Advanced degree (e.g., MBA or Master's in a related field)., • Passion for science-driven storytelling and an interest in Arrowhead's mission to advance RNAi-based therapeutics.California pay range $230,000—$250,000 USD Arrowhead provides competitive salaries and an excellent benefit package. Candidates must have current, valid authorization to work in the country where this role is located. California Applicant Privacy Policy

About Us ADVI Health: Expert Advice. Clear Vision. Since 2013, clients have sought ADVI Health’s expert advice, informed by data and guided by a clear vision of the complex intersection of life sciences/healthcare innovation, economics, policy, and patient impact. Our aim is to be the leading and most knowledgeable go-to-market access and commercialization partner for life sciences and healthcare innovators, worldwide. We are a collaborative team of consultants and advisors, all of whom are veterans of top healthcare and life sciences organizations, the federal government, state government, top consultants, nonprofits, commercial payers, or data and analytics companies. Our work cuts through complexity across asset, franchise, corporate, and executive level strategy, shapes markets, and enables therapies to launch faster, smarter, and at scale in multiple therapeutic areas, lifecycle stages, and areas of the world. Our global client roster includes biopharma manufacturers, MedTech, precision medicine diagnostics and tools companies, and cancer provider and patient organizations, from the C-suite down and across the product lifecycle. We solve complicated problems with data-informed commercialization, market access, and policy expertise. Based in Washington, DC and Austin, TX, the company delivers insight- and data-informed advice and vision for leaders in healthcare business and policy. ADVI offers a comprehensive perspective by integrating business, policy, and science to find creative solutions through data, learned insight, and compelling strategy to help clients make decisions across all healthcare segments. ADVI is at the forefront of healthcare delivery transformation, payment reform, public and private payer coverage, and healthcare merger and acquisition deal flow within the US and abroad. To learn more... visit us at www.advi.com *Candidates must be legally authorized to work full time in the United States at the time of their hire. ADVI does not offer employment sponsorships now or in the future. Join Us Our clients are pharmaceutical and biotech companies that are bringing new technology and products to market. The person in this role understands the nuances of health policy debates and has experience creating, assessing or advocating for policy changes at the federal, state, or commercial levels. As a member of the Policy Consulting Team, you will monitor, analyze, curate, and present on important federal and state issues that impact our client’s business imperatives, including reforms related to drug pricing, coverage, reimbursement and benefit design across public and private payers. The Policy Solutions team is steeped in Medicare and Medicare Advantage policy and payment, Medicaid and state health policy, as well as Exchange and employer plan policy issues. The team analyzes evolving commercial payer activities and utilization management concerns. Collectively, ADVI solutions team members work seamlessly with one another to answer our clients’ most pressing business needs and deliver solutions to excel their business. Key Responsibilities • Conduct quantitative and qualitative policy analyses (e.g., coverage, reimbursement, regulatory, and legislative research) to support client projects and internal insights., • Manage assigned projects by developing workplans, tracking timelines, coordinating resources, and supporting budget management to ensure timely, high-quality delivery., • Support client engagements by preparing analyses, materials, and presentations, and participating in client meetings to discuss findings and implications., • Translate analytical results into clear summaries and actionable insights, while coaching Associates and Senior Associates and contributing to overall quality standards. Requirements Core Competencies: Excel-Based Modeling & Analysis – Develop and maintain structured Excel models to support policy, reimbursement, and regulatory analyses; ensure accuracy, transparency, and clear documentation of assumptions. Project Management – Organize and manage project tasks, timelines, and deliverables across multiple workstreams; effectively balance priorities and support on-time, on-budget execution. Consultative Insight – Apply policy knowledge and analytical judgment to interpret findings, identify implications, and contribute thoughtful input to client discussions and recommendations. Client Communication – Support client relationships by preparing clear, well-organized materials and participating in client meetings to explain analyses and respond to questions. Quality Assurance – Review analyses and deliverables for accuracy, consistency, and adherence to firm standards; proactively identify issues and support continuous improvement. Decision-Making Scope The Policy Consultant operates with moderate to high independence. The Policy Consultant leads projects and makes day-to-day decisions regarding clients and project deliverables. Utilization This is a billable utilization role, with expectations aligned to client delivery and revenue contribution. Experience and Qualifications • 4+ years of relevant professional experience with a preferred background in consulting., • Experience modeling the effects of legislation and regulations affecting pharmaceutical manufacturers, • Recent and relevant experience in legislative, regulatory, and/or government policy environments, including hands-on work with healthcare policy analysis, monitoring, or stakeholder engagement., • Excel-based quantitative modeling skills required, • Ability to create interactive Excel-based tools for client decision-making preferred, • Advanced degree(s) may substitute for work experience Location Candidates can be based anywhere in the U.S., with a preference for those operating in the Eastern or Central Standard Time Zone. Candidates based in Washington, DC or Austin, TX, will have the option of hybrid work arrangements. Compensation and Benefits We understand compensation is an important factor as you consider the next step in your career. At ADVI, we are committed to equitable pay practices and increased transparency in our compensation programs. Additional details regarding compensation philosophy and benefits will be shared by the recruiter during the interview process. ADVI’s Total Compensation Package includes: Target Base Salary Range: $100,000-$125,000. Placement within the range is determined by experience, expertise, and internal equity. Incentive Compensation: Eligible for an annual performance-based bonus aligned to individual and company performance. Benefits: ADVI offers an outstanding benefits package, including the following: • Medical, dental, and vision insurance, • 8 paid holidays, including one ADVI Anniversary Day per calendar year, • 401(k) retirement savings with a safe harbor contribution match, • Company funded Health Reimbursement Account, • Life and short-term and long-term disability insurance, • Paid vacation and sick leave Diversity Statement ADVI’s commitment to diversity, equity, inclusion, and collaboration is key to building extraordinary teams. We hire people with exceptional talents, abilities, and potential, then build an environment where you can become the best version of yourself. Our Vision To be the leading and most knowledgeable go-to-market access and commercialization partner for life sciences and healthcare innovators worldwide. Our Mission To provide life science and healthcare innovators the benefit of our team’s wisdom, empathy, and creativity that, through data-informed strategy, generates evidence to optimize outcomes and, through tech-enabled access solutions, creates opportunities and expands care. Our Values Act with Integrity Strive for Excellence Make an Impact Think smart, Stay curious Celebrate the Journey, not just the results We look forward to hearing from you! #LIR

Your Opportunity The Quality Performance Specialist is responsible for supporting quality performance improvement across a network of practices participating in value-based care contracts, including MSSP, ACO REACH, Medicare Advantage, Commercial, and Medicaid programs. This role serves as a key partner to practices, providing education, performance insights, and strategic guidance to improve quality outcomes, documentation accuracy, and care delivery workflows. The Specialist works closely with internal teams and external stakeholders to ensure alignment between payer requirements, practice operations, and patient outreach efforts. What you will do Practice Performance & Improvement Planning Identify high-impact opportunities for improvement and develop actionable, practice-specific performance plans Lead quarterly quality performance reviews for assigned practices, with monthly engagements for prioritized or underperforming practices Implement targeted interventions for practices with gaps in quality performance or operational barriers Coordinate closely with Practice Transformation and other practice-facing teams to ensure aligned communication and strategy Education & Workflow Optimization Provide ongoing education to providers and practice staff on quality measures, value-based care requirements, and performance expectations Support CPT II coding education and adoption, particularly for private payer contracts Assist in the development and dissemination of educational materials, tip sheets, and training resources Guide practices in optimizing workflows related to preventive care, chronic disease management, and patient engagement Coach practices on gap closure strategies and integration of quality measures into daily operations Data Integrity & Quality Reporting Troubleshoot discrepancies between EHR data, internal reports, and payer-reported performance Identify and escalate EHR data integrity or feed issues to analytics and IT teams Conduct focused chart reviews to validate documentation accuracy and identify opportunities for improvement Support the collection and validation of quality data needed to close care gaps across all lines of business Assist with quality reporting and submission processes to ensure completeness, accuracy, and optimal performance Payer Alignment & Cross-functional Collaboration Work across all lines of business to ensure consistent understanding and execution of quality strategies Participate in payer-hosted quality meetings and incorporate updates into practice education and internal workflows Collaborate with internal teams to align patient outreach strategies with practice needs and priorities What Will Make You Successful Here Minimum of 3 years of experience in healthcare quality, population health, value-based care, or ambulatory practice operations Experience working with quality programs such as MSSP, ACO REACH, Medicare Advantage (HEDIS/Stars), or Commercial/Medicaid quality initiatives Experience supporting or engaging directly with primary care practices or provider groups Familiarity with EHR systems, clinical documentation workflows, and quality reporting processes Strong understanding of quality measures, gap closure strategies, and value-based care principles Ability to interpret data and translate insights into actionable recommendations for practices Excellent communication and presentation skills, with the ability to educate providers and clinical staff effectively Strong problem-solving skills with the ability to troubleshoot data and workflow issues Ability to manage multiple priorities and work independently in a remote environment Collaborative mindset with strong cross-functional partnership skills Preferred Qualifications Experience with CPT II coding and documentation optimization strategies Knowledge of eCQMs, digital quality measures, and electronic reporting requirements Experience conducting chart reviews or supporting quality audits Background in primary care clinical operations or care delivery workflows Advanced proficiency in Excel or experience with healthcare analytics and reporting tools Certification in healthcare quality (e.g., CPHQ) or a related field Perks/Benefits Competitive base compensation Annual bonus potential Health benefits effective on start date Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary 5 sick days and unlimited (or generous) paid "Vytal Time" after your first 90 days Company paid STD/LTD Technology setup Ability to help build a market leader in value-based healthcare at a rapidly growing organization Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information. We will also never ask for you to purchase anything; nor will we every interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @_

About us: Foodsmart is the leading Foodcare platform in the U.S., built to deliver nutrition-driven healthcare at scale. Powered by a national network of Registered Dietitians, Foodsmart combines personalized clinical nutrition care, behavior change tools, and food benefits to improve member health outcomes while lowering healthcare costs. Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver sustainable health outcomes. Through our highly personalized, digital platform, we guide more than 3 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money. Foodsmart seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing tangible access to nutritious food. In 2024, Foodsmart secured a $200 million investment from TPG’s Rise Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment helps us expand our reach, particularly to low-income workers who are disproportionately affected by diet-related diseases. At Foodsmart, our mission is to make nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment: 👥 Customer First - You start with the member and work backwards. 🚀 Make It Happen - You act with urgency, use data, and hold high standards. 🤝 One Team - You collaborate with respect and commit as a group. Whether you're a dietitian, a commercial leader, or a technologist, working at Foodsmart means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food. About the role: The Revenue Cycle Operations team is a mission-critical function responsible for converting care delivered into cash collected. As a digital health company operating at speed and scale, we rely on a disciplined, relentless revenue cycle to fuel growth—and this role sits at the center of that engine. We are hiring a Director of Revenue Cycle Management to lead and scale our collections and accounts receivable function. The Sr. Manager will own performance outcomes across the full billing and collections lifecycle, driving accountability, resolving complex payer issues, and ensuring AR is aggressively and accurately worked to resolution. The ideal candidate is a builder and a closer—someone who thrives in ambiguity, takes full ownership, and pushes past obstacles rather than waiting for direction. You will be expected to independently identify gaps, design solutions, and lead a high-performing team that executes with urgency and precision. This role requires a leader who can negotiate effectively with payers, set a high bar for execution, and instill a culture of accountability, persistence, and results. If you are energized by responsibility, motivated by measurable impact, and ready to run a highly effective revenue cycle function with autonomy and ambition, this role offers the opportunity to make a direct and lasting impact on the company’s financial performance. • Own the end-to-end collections process: develop, maintain, and be held accountable for high-accuracy collections forecasts, ensuring senior leadership has clear visibility into cash flow., • Build and enforce a high-discipline collections engine from the ground up. This includes (but is not limited to) standardizing recovery cadences, eliminating revenue leakage points, and institutionalizing a "zero-loss" mentality to achieve and maintain best-in-class net collection rates., • Identify bottlenecks and design/implement workflows that aggressively reduce denials and shorten the AR lifecycle., • Strategically partner with the growth teams during contract negotiation to set up clients for success., • Serve as the ultimate "closer" for complex billing disputes, working directly with health plan partners to resolve systemic payment issues and negotiate favorable settlements., • Act as the primary point of escalation for clients, translating complex billing hurdles into clear, actionable updates, building trust through relentless transparency and results., • Partner with Finance, Legal, and Ops to ensure billing strategies are perfectly synced with company growth., • Drive the team’s KPIs. You will track recovery rates and payer behavior, using data to pivot strategies in real-time., • Lead the team who manages the end-to-end customer billing processes and experience and all billing communications, ensuring a seamless process for both patients and health plans., • A fearless problem-solver who takes immediate ownership of the landscape: assessing current state, designing a new strategy and process, and executing on that strategy., • A high-initiative self-starter who thrives on autonomy, possessing the discipline to own your day-to-day and drive results without the need for oversight., • A fierce advocate for Foodsmart, driving collections efforts for the organization with a constant focus on our bottom line., • A player-coach, driving a team to maximum productivity while directly contributing to those efforts., • An adaptable and collaborative professional, able to evolve with the business and work well cross-functionally., • 8+ years of expertise in revenue cycle management, with 2-3 years of management experience., • Exceptional negotiation and conflict-resolution skills; experience working closely with health plan partners to resolve payment issues favorably., • Deep expertise with CMS regulations and commercial payer behaviors., • Experience working with different EMR and RCM softwares, as well as a diverse set of health plan portals; system migration experience a plus, • Tangible outcomes throughout your career and proven curiosity to enhance systems and processes for improved claims collections and data visibility. $150,000 - $170,000 a year Role: Director, Revenue Cycle Management Location: Remote, USA Base Salary Range: $150,000 - $170,000 + bonus Our salary ranges are determined by role, level, and location. Individual pay is determined by work location, job-related skills, experience, and relevant education or training. About our benefits and perks: ✅ Remote-First Company ✅ Unlimited PTO ✅ Flexible & remote location ✅ Healthcare Coverage (Medical, Dental, Vision) ✅ 401k & bonus ✅ Registered Dietitian Sessions Foodsmart is an Equal Opportunity Employer. It is our firm policy to extend equal employment and advancement opportunity to all applicants and employees without regard to race, color, national origin, citizenship status, religious creed, age, sex (including pregnancy, childbirth, breastfeeding, medical conditions related to pregnancy, childbirth and/or breastfeeding), gender, gender identity and expression, sexual orientation, marital status, disability (physical or mental) and/or a medical condition, genetic information, ancestry, veteran status or service in the uniformed services, and any other characteristic protected by applicable federal, state or local law. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

About Us: Foodsmart is the leading Foodcare platform in the U.S., built to deliver nutrition-driven healthcare at scale. Powered by a national network of Registered Dietitians, Foodsmart combines personalized clinical nutrition care, behavior change tools, and food benefits to improve member health outcomes while lowering healthcare costs. Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver sustainable health outcomes. Through our highly personalized, digital platform, we guide more than 3 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money. Foodsmart seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing tangible access to nutritious food. In 2024, Foodsmart secured a $200 million investment from TPG’s Rise Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment helps us expand our reach, particularly to low-income workers who are disproportionately affected by diet-related diseases. At Foodsmart, our mission is to make nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment: 👥 Customer First - You start with the member and work backwards. 🚀 Make It Happen - You act with urgency, use data, and hold high standards. 🤝 One Team - You collaborate with respect and commit as a group. Working at Foodsmart means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food. About the Role: We're hiring a Staff Product Manager to own and scale Foodsmart's Food Access & Benefits platform — the product area that powers our expanding portfolio of food programs, health benefits management, and ancillary services that extend Foodsmart's impact beyond nutrition counseling. Health plans that service Medicaid and Medicare populations are increasingly looking to partners like Foodsmart who can manage the complexity of delivering complex and interconnected services associated with food benefit and food-as-medicine clinical intervention offerings to their members. Foodsmart is uniquely positioned to serve these client and member needs and we are aggressively building our product and service portfolio. As the product lead for Food Access & Benefits platform, you'll be responsible for the systems and capabilities that underpin how members access food benefits, how employers and health plans administer those benefits, and how Foodsmart launches and scales new service lines in an environment with multiple stakeholders, regulatory considerations, and operational dependencies. You'll translate messy, multi-party operational complexity into clean, scalable product — launching new services that create real value for members & clients while driving impact on the business. This role is ideal for a product leader who has launched products in operationally intensive domains — someone who can navigate the complexity of health benefits, food access programs, and partner ecosystems while bringing PM rigor and strategic clarity to a space that has historically been driven by operations alone. You’re also excited bringing new services to market, establishing product market fit, and driving meaningful impact for the business. Service Line Ownership & Product Execution • Own the roadmap for the Food Access & Benefits pod end-to-end — from discovery through launch and iteration — across food access programs, health benefits administration, and new service lines, • Have the skills and capabilities to (quickly) become an expert in the Food & Food Benefits ecosystem through research, interviews and building relationships with thought leaders., • Translate complex operational workflows and multi-party requirements into scalable, well-defined product capabilities — building for repeatability rather than one-off implementation, • Design and advocate for the member experience – turning something that can often times feel logistically burdensome into a moments of delight, • Partner with Engineering, Partnerships, and Operations to define the systems architecture that allows Foodsmart to configure, launch, and manage benefits programs at scale across diverse client types, • Balance the urgency of client-driven timelines with the discipline of building platform capabilities that compound over time Client & Operational Collaboration • Design and own the product systems that configure, launch, and manage benefits programs for members and clients, • Build the tools and workflows that Client Success, Partnerships, and Clinical Operations rely on to run food access and benefits programs, • Partner with product marketing and commercial teams to shape go-to-market for new services Platform & Strategic Contribution • Set the strategy for the Food Access & Benefits pod with full autonomy, while maintaining tight alignment with the CPO and cross-functional leadership, • Advocate for operational scalability and configurability across all product decisions — building Foodsmart's capacity to offer more services to more clients with less implementation overhead, • Influence adjacent pods and platform architecture to ensure food access and benefits capabilities are embedded appropriately in the broader member journey, • Contribute to cross-pod planning and portfolio prioritization, bringing the service line and operational lens into broader roadmap discussions, • Operationally fluent — you understand how complex, multi-party service programs actually run, and you build products that make them more reliable and scalable, not just more feature-rich, • A structured problem-solver who brings PM rigor to operationally heavy domains — you document requirements clearly and manage dependencies explicitly, • Comfortable with ambiguity in new service areas — you can define the problem space, identify what you don't know, and make progress with incomplete information, • A trusted partner to operational and commercial stakeholders — you earn credibility by understanding their world deeply and delivering solutions that actually reduce their burden, • Data-driven with strong execution instincts — you know when to move fast and when to slow down and validate, and you use metrics to tell the difference, • Collaborative and low-ego: you build strong relationships across a complex stakeholder landscape and know when to lead versus when to align, • A passion for addressing the chronic challenges associated with providing low income populations with proper food access and nutrition programs, • 7+ years of product management experience, with meaningful time spent in B2B or B2B2C environments where you owned operationally complex product areas, • A track record of launching new products or service lines end-to-end — not just iterating on existing features, but standing up net-new capabilities in complex operational environments, • Direct experience working alongside Implementation, Operations, or Client Success teams to build products that real operational users depend on, • Experience building and launching products in close partnership with commercial and go-to-market teams — including enablement, rollout planning, and post-launch iteration, • Experience in AI-enabled product development processes and tools, • Nice-to-Haves:, • Experience with benefits management platforms, employer health benefits, or government health program operations, • Exposure to food retail, food ordering, or supply chain partnerships in a digital health or consumer health context $165,000 - $205,000 a year Role: Staff Product Manager — Food Access & Benefits Location: Remote, USA Base Salary Range: $165,000 – $205,000 + bonus + benefits Our salary ranges are determined by role, level, and location. Individual pay is determined by work location, job-related skills, experience, and relevant education or training. About our benefits and perks: ✅ Remote-First Company ✅ Unlimited PTO ✅ Flexible & remote location ✅ Healthcare Coverage (Medical, Dental, Vision) ✅ 401k & bonus ✅ Registered Dietitian Sessions Foodsmart is an Equal Opportunity Employer. It is our firm policy to extend equal employment and advancement opportunity to all applicants and employees without regard to race, color, national origin, citizenship status, religious creed, age, sex (including pregnancy, childbirth, breastfeeding, medical conditions related to pregnancy, childbirth and/or breastfeeding), gender, gender identity and expression, sexual orientation, marital status, disability (physical or mental) and/or a medical condition, genetic information, ancestry, veteran status or service in the uniformed services, and any other characteristic protected by applicable federal, state or local law. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Job Title: Remote Medical Sales Representative Location: Remote (US-based) Job Type: 1099 Contract Position (Commission-based, no base salary) Job Summary Our client is seeking a motivated and experienced sales professional to join their team in promoting Remote Therapeutic Monitoring, Remote Patient Monitoring, and Remote Chronic Care Management solutions to healthcare providers. Key Responsibilities: • Share their remote care solutions with independent practices and pharmacies, • Collaborate with healthcare providers to improve patient care and outcomes, • Work with Medicare Plan B beneficiaries and advantage plans, • Set up in-person meetings and make sales calls, • Build and manage your own sales team (opportunity for growth) Requirements: • 2+ years of medical or pharmaceutical sales experience, • Excellent communication and sales skills, • Ability to work independently and remotely, • Four-year college degree (exceptional experience may be considered), • Passion for medical sales and helping people What We Offer: • Uncapped commissions with potential earnings of $300k to $2.1M, • Highest commission rates in the industry, • Opportunity to build your own sales team, • Salesforce support and 10 rolling leads to help you succeed, • Flexible work arrangement (full-time, part-time, or supplemental to current role)

Job Description About the role: We’re seeking detail-oriented professionals to support a high-impact initiative within our Network Management team during a critical growth period. This is a great opportunity for candidates who enjoy fast-paced environments, structured outreach work, and contributing to meaningful healthcare operations. In this role, you’ll play a key part in supporting major projects tied to provider data accuracy, compliance, and membership growth across multiple health plan products. What You’ll Be Doing: Conduct outreach to 4,000+ healthcare providers to support the collection of 14,000 medical records Verify and update provider demographic information for 8,000+ providers across multiple health plans Assist with the distribution of 100+ provider contract amendments Support collection of Medicare compliance attestations Help process hundreds of Health Plan ID resubmissions, a critical component of network growth Maintain accurate records and ensure all data is entered and tracked properly What we're looking for: ✅ Previous healthcare experience in a patient facing or administrative setting ✅ Strong data entry and administrative support experience ✅ Background in call center, customer service, or high-volume outreach ✅ Comfortable working with Microsoft Office (especially Excel) ✅ Excellent phone etiquette and communication skills ✅ High attention to detail and ability to manage multiple tasks Job Type & Location This is a Contract position based out of Northridge, CA. Pay and Benefits The pay range for this position is $22.00 - $23.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision, • Critical Illness, Accident, and Hospital, • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available, • Life Insurance (Voluntary Life & AD&D for the employee and dependents), • Short and long-term disability, • Health Spending Account (HSA), • Transportation benefits, • Employee Assistance Program, • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Northridge,CA. Application Deadline This position is anticipated to close on Jun 24, 2026. About TEKsystems We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.

Licensed Mental Health Counselor (LMHC) Wage: Up to $117.73/hour Licensed Mental Health Counselor — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required. About you ? You're a fully-licensed Mental Health Counselor at a Master's level or above with LMHC, LPCMH, or LIMHP licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. ? You're ready to launch a private practice, or grow your existing business by taking insurance. About Headway Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need. How Headway supports providers Start taking insurance, stress-free: Get credentialed for free in multiple states in as little as 30 days and start seeing covered clients sooner. Built-in compliance Stay compliant from day one with audit support and ongoing resources. Expansive coverage: Work with the plans that most clients use, including Medicare Advantage and Medicaid. Increase your earnings: Secure higher rates with top insurance plans through access to our nationwide insurance network. Dependable payments: Build stability in your practice with predictable bi-weekly payments you can count on. Built-in EHR features Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more. Free continuing education Nurture your long-term professional goals and earn CEUs with complimentary courses on Headway Academy. How Headway supports your clients Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Please note: At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license.

About us: Foodsmart is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Our platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. Through our highly personalized, digital platform, we guide our 2.2 million members—including those in employer-sponsored health plans, regional and national Medicaid managed care organizations, Medicare Advantage plans, and commercial insurers—on a tailored journey to eating well while saving time and money. Foodsmart seamlessly integrates dietary assessments and nutrition counseling with online food ordering and cost-effective meal planning for the entire family, optimizing ingredients both at home and on the go. We partner with national and regional retailers across the U.S., many of whom accept SNAP/EBT, making healthier food more accessible. Additionally, we assist members with SNAP enrollment and management, providing tangible access to nutritious food. In 2024, Foodsmart secured a $200 million investment from TPG’s Rise Fund, which supports entrepreneurs dedicated to achieving the United Nations’ Sustainable Development Goals. This investment will help us expand our reach, particularly to low-income workers who are disproportionately affected by diet-related diseases. At Foodsmart, our mission is to make nutritious food accessible and affordable for everyone, regardless of economic status. We are committed to a set of core values that shape our culture and work environment: 👥 Customer First - You start with the member and work backwards. 🚀 Make It Happen - You act with urgency, use data, and hold high standards. 🤝 One Team - You collaborate with respect and commit as a group. Whether you're a dietitian, a commercial leader, or a technologist, working at Foodsmart means being part of a team that is passionate, supportive, and driven by a shared purpose. Join us in transforming the way people access and enjoy healthy food. About the role: Foodsmart is seeking compassionate and mission-driven Registered Dietitians (RDs) with active Certifications in New York to join our growing Foodsmart Nutrition Network. As a Foodsmart RD, you’ll deliver virtual Medical Nutrition Therapy (MNT) and personalized care to members—many of whom are Medicaid participants or facing food insecurity. This is a unique opportunity to make a measurable impact on health equity—empowering individuals and families to live healthier lives through access, affordability, and education. Candidates must reside in and work within the US. • Booked Schedule: We keep your calendar full and handle all the admin and billing, so you can focus on your sessions., • Paid Onboarding: Earn $600-850 for completing our training program for 1099s (paid after 60 days of seeing patients), • Mission with impact: Be part of a nationwide effort to make nutritious food accessible to all, including Medicaid and underserved populations., • Flexibility: 100% remote with scheduling options that fit your life., • Technology that empowers: Use our proprietary platform to connect with patients, track outcomes, and guide long-term success., • Collaborative community: Join a supportive network of RDs who share your passion for helping people live better through food., • Ongoing education: We offer CPEU webinars on a monthly basis for internal RDs., • Help members stretch their food budgets and make the most of what they have, • Guide access to affordable, healthy groceries through our online marketplace, • Connect members with local food and nutrition resources, • Support sustainable meal planning and healthy habits for families, • Deliver MNT to manage or prevent chronic conditions, • Provide personalized virtual nutrition care via secure video and messaging, • Active credentialing as a Registered Dietitian by the Commission on Dietetic Registration (CDR) and Licensed Dietitian, • An active state license in NY, • Willingness to obtain state licenses in high demand states (reimbursed by Foodsmart), • Ability to work in the U.S., • A computer, high speed internet and a smart phone, • At least 10 hours of weekly availability for patients (weekends and evenings count!), • $48 for a 1-hour visit; Most of our visits are scheduled for one hour., • $52 for those bilingual in English/Spanish or English/Vietnamese $48 - $52 an hour$48 for a 1-hour visit; $12 per 15-minute unit for Medical Nutrition Therapy (MNT). $52 for those bilingual in English/Spanish or English/Vietnamese ($13 per unit)Foodsmart is an Equal Opportunity Employer. It is our firm policy to extend equal employment and advancement opportunity to all applicants and employees without regard to race, color, national origin, citizenship status, religious creed, age, sex (including pregnancy, childbirth, breastfeeding, medical conditions related to pregnancy, childbirth and/or breastfeeding), gender, gender identity and expression, sexual orientation, marital status, disability (physical or mental) and/or a medical condition, genetic information, ancestry, veteran status or service in the uniformed services, and any other characteristic protected by applicable federal, state or local law.We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

ESSENTIAL FUNCTIONS • Serve as the primary RCM strategic partner for assigned markets and physician groups, • Monitor and analyze key performance indicators including charge lag, denial rates, AR aging, AR >90 days, and net collection rate, • Lead monthly and quarterly revenue cycle reviews with market leadership and providers, • Identify root causes of revenue leakage and assist in developing corrective action plans, • Drive reduction in controllable denials through payer-specific analysis and operational collaboration, • Partner with cross-functionally with key revenue cycle stakeholders to proactively identify and resolve issues impacting revenue integrity and reimbursement performance., • Support new market onboarding and RCM ASA integrations, • Escalate systemic issues to executive leadership with proposed solutions, • Participate in cross-functional revenue cycle initiatives and performance improvement projects EDUCATION Preferred: • BA or BS Degree, • CPC, CPB, CRCR, or other revenue cycle certification preferred EXPERIENCE • Minimum 5–7 years of progressive experience in healthcare revenue cycle management, • Experience working with physician practices, ambulatory surgery centers, or musculoskeletal service lines preferred, • Demonstrated experience analyzing financial and operational performance metrics, • Experience leading cross-functional initiatives and presenting to executive leadership REQUIREMENTS • Ability to travel periodically to assigned markets, • Strong understanding of payer reimbursement methodologies including Medicare Advantage, Commercial, Medicaid, and Workers’ Compensation, • Advanced proficiency in Microsoft Excel and reporting tools, • Ability to manage multiple markets and priorities simultaneously KNOWLEDGE • Revenue cycle workflows from front-end through denial resolution and collections, • CPT/HCPCS coding fundamentals and modifier usage, • Accounts receivable management strategies, • Regulatory compliance related to revenue cycle operations SKILLS • Advanced analytical and financial interpretation skills, • Executive-level presentation and communication skills, • Strong problem-solving and critical-thinking abilities, • Data visualization and dashboard development, • Cross-functional collaboration and relationship management, • Project management and organizational skills ABILITIES • Ability to translate complex financial data into actionable insights, • Ability to build trust with providers and operational leaders, • Ability to prioritize high-impact initiatives in fast-paced environments ENVIRONMENTAL WORKING CONDITIONS • Remote work environment, • Periodic travel to practice locations, • Frequent computer use and virtual meeting participation

Date Posted: June 18, 2025 The _ seeks a part-time contract SAS Programmer to support the Research and Cost Trends (RCT) department in updating and maintaining the data infrastructure used to prepare the All-Payer Claims Database (APCD), advise on structural changes to case-mix and evaluate existing tools used in analytic file creation. This is an opportunity for a detail-oriented, skilled SAS coder with previous experience working with health insurance enrollment files, medical claims, and pharmacy claims, as well as datasets maintained by the Massachusetts Center for Health Information and Analysis (CHIA). The SAS Programmer will join the Research and Cost Trends (RCT) department and will report directly to the Manager of Research and Cost Trends. Duties of the position may include, but are not limited to: Updating programs to allow for changes in new releases of the All-Payer Claims Database (APCD); Advising and creating best practices to integrate CHIA’s Master Patient Index (MPI) that is updated on a quarterly basis and allows linking across APCD and case-mix; Integrating the 3M Core Grouping Software into the analytic pipeline; Integrating the HHS-HCC risk adjustment model into the analytic pipeline; Validating HPC’s methods for processing MassHealth ACO/MCO/FFS claims; Helping integrate MassHealth MCO processing into commercial processing such that both sets of claims can be processed simultaneously; Identify and eliminate outdated SAS code in programs to help reduce confusion for future processors; Advising HPC on processing Medicare Advantage claims and make changes to existing programs as needed to allow for Medicare Advantage analytic file creation; and Providing ongoing on-demand support for technical issues The HPC operates a hybrid work schedule, with employees splitting their time between the downtown Boston office and remote work. Desired Qualifications: Advanced Degree in Computer Science, Information Systems Management, or related field; At least 5 years of experience with SAS programming, data infrastructure maintenance, and analytic file creation; Previous experience working with claims data such as Center for Health Information Analysis All-Payer Claims Database preferred; Excellent oral, written, and interpersonal skills and the ability to work in groups; The ability to balance multiple and competing priorities in a fast-paced work environment; A commitment to fostering an inclusive workplace that promotes collaboration amongst diverse viewpoints, facilitates cooperation and teamwork, and supports constructive resolution of conflicts; A strong interest in public service and desire to advance a more transparent, accountable, and equitable health care system for all Massachusetts residents. Candidates must be eligible to work in the United States. Compensation and Benefits Compensation Range $140-$155 per hour worked, up to 20 hours of work a week. An initial maximum contract obligation of 120 hours. Compensation is commensurate with experience. The HPC may adjust title, responsibilities, and compensation depending on the experience and expertise of the individual selected. This is a contract position for up to one year of work. This position is not eligible for benefits other than limited sick leave. Our Commitment: The HPC is committed to a policy of non-discrimination and equal employment opportunity. We recognize that diversity in the workplace is a source of strength, vital to its ability to effectively advance its mission. The HPC is committed to: Actively promoting diversity in our workforce, including greater racial and ethnic diversity, at all levels of the organization; Fostering a work environment in which all employees are inspired to do their best, strengthened by their different perspectives, backgrounds, and experiences; Ensuring that no employee’s growth, achievement, or advancement is hindered because of race, ethnicity, sex, sexual orientation, religion, age, genetic information, gender identity, pregnancy, veteran status, or disability; Holding ourselves to a high standard of inclusion and opportunity that will serve as a model for other public and private employers throughout the Commonwealth; Promoting our core values of equal opportunity, equal justice, and inclusion in HPC actions and initiatives.

Licensed Clinical Social Worker (LCSW) Wage: Up to $117.73/hour Licensed Clinical Social Worker — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required. About you ? You're a fully-licensed Clinical Social Worker at a Master's level or above with LCSW, LICSW, or LCSCW licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. ? You're ready to launch a private practice, or grow your existing business by taking insurance. About Headway Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need. How Headway supports providers Start taking insurance, stress-free: Get credentialed for free in multiple states in as little as 30 days and start seeing covered clients sooner. Built-in compliance Stay compliant from day one with audit support and ongoing resources. Expansive coverage: Work with the plans that most clients use, including Medicare Advantage and Medicaid. Increase your earnings: Secure higher rates with top insurance plans through access to our nationwide insurance network. Dependable payments: Build stability in your practice with predictable bi-weekly payments you can count on. Built-in EHR features Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more. Free continuing education Nurture your long-term professional goals and earn CEUs with complimentary courses on Headway Academy. How Headway supports your clients Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Please note: At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license.

Licensed Clinical Psychologist Wage: Up to $134/hour Licensed Clinical Psychologists — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required. About you ? You're a fully-licensed Clinical Psychologist at a Master's level or above with PSY, PSYP, or PsyD licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. ? You're ready to launch a private practice, or grow your existing business by taking insurance. About Headway Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need. How Headway supports providers Start taking insurance, stress-free: Get credentialed for free in multiple states in as little as 30 days and start seeing covered clients sooner. Built-in compliance Stay compliant from day one with audit support and ongoing resources. Expansive coverage: Work with the plans that most clients use, including Medicare Advantage and Medicaid. Increase your earnings: Secure higher rates with top insurance plans through access to our nationwide insurance network. Dependable payments: Build stability in your practice with predictable bi-weekly payments you can count on. Built-in EHR features Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more. Free continuing education Nurture your long-term professional goals and earn CEUs with complimentary courses on Headway Academy. How Headway supports your clients Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Please note: At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license.

Licensed Marriage and Family Therapist (LMFT) Wage: Up to $117.73/hour Licensed Marriage and Family Therapist — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required. About you ? You're a fully-licensed Marriage and Family therapist at a Master's level or above with LMFT, LMFTS, or LCMFT licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. ? You're ready to launch a private practice, or grow your existing business by taking insurance. About Headway Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need. How Headway supports providers Start taking insurance, stress-free: Get credentialed for free in multiple states in as little as 30 days and start seeing covered clients sooner. Built-in compliance Stay compliant from day one with audit support and ongoing resources. Expansive coverage: Work with the plans that most clients use, including Medicare Advantage and Medicaid. Increase your earnings: Secure higher rates with top insurance plans through access to our nationwide insurance network. Dependable payments: Build stability in your practice with predictable bi-weekly payments you can count on. Built-in EHR features Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more. Free continuing education Nurture your long-term professional goals and earn CEUs with complimentary courses on Headway Academy. How Headway supports your clients Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Please note: At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license.

About Brillio: Brillio is one of the fastest growing digital technology service providers and a partner of choice for many Fortune 1000 companies seeking to turn disruption into a competitive advantage through innovative digital adoption. Brillio, renowned for its world-class professionals, referred to as "Brillians", distinguishes itself through their capacity to seamlessly integrate cutting-edge digital and design thinking skills with an unwavering dedication to client satisfaction. Brillio takes pride in its status as an employer of choice, consistently attracting the most exceptional and talented individuals due to its unwavering emphasis on contemporary, groundbreaking technologies, and exclusive digital projects. Brillio's relentless commitment to providing an exceptional experience to its Brillians and nurturing their full potential consistently garners them the Great Place to Work® certification year after year. Product manager • CSPO, • Product Management: Senior Software Development Lead Job Description: Senior Product Manager – Payment IntegrityRole Overview· The Senior Product Manager – Payment Integrity will lead the strategy, roadmap, and execution for products and capabilities that ensure accurate, compliant, and cost efficient payments across the organization. This role drives initiatives that prevent incorrect payments, improve claims accuracy, optimize reimbursement processes, and enhance overall financial integrity. You will collaborate with engineering, operations, analytics, compliance, and external stakeholders to deliver solutions that reduce payment leakage and improve operational performance. Key ResponsibilitiesProduct Strategy & Vision· Define and own the end to end product vision and multi year roadmap for Payment Integrity products (pre payment, post payment, claims analytics, audit workflows, rules engines, etc.).· Identify market, regulatory, and industry trends to shape strategic product decisions.· Develop business cases, cost–benefit analyses, and value propositions for new capabilities.Execution & Delivery· Lead cross functional teams (engineering, data science, claims operations, finance) to deliver scalable Payment Integrity solutions.· Translate business needs into actionable product requirements, user stories, and acceptance criteria.· Prioritize the product backlog using a data driven approach while balancing long term strategy and short term wins.· Drive iteration planning, sprint reviews, and release cycles with engineering.Operational & Financial Impact· Ensure solutions reduce payment leakage, improve claims accuracy, and support audit effectiveness.· Partner with finance and operations to track product performance through KPIs such as overpayment recovery rate, detection yield, cost avoidance, and operational efficiency.· Continuously optimize rules engines, fraud/waste/abuse detection algorithms, and workflow systems.Stakeholder Management· Work closely with internal teams (Compliance, Legal, Provider Management, Medical Policy) to ensure solutions meet regulatory and audit requirements.· Partner with external vendors, payment integrity service providers, and technology partners.· Communicate product vision, updates, and performance metrics to senior leadership.User Experience & Product Quality· Advocate for intuitive user experiences for auditors, analysts, clinicians, and claims processors.· Ensure robust product documentation, training materials, and operational readiness.· Drive continuous improvement by collecting user feedback and monitoring adoption.Required Qualifications· 6+ years of product management experience, preferably in healthcare, insurance, payment integrity, claims processing, or fintech risk & controls.· Strong understanding of claims lifecycle, reimbursement methodologies, pre payment edits, post payment audits, and fraud/waste/abuse detection.· Experience working with engineering, analytics, and data science teams.· Proficient with data analysis, KPI development, and financial impact modeling.· Exceptional communication, stakeholder management, and leadership skills.· Ability to prioritize in a fast paced environment with competing demands. Preferred Qualifications· Experience with payment integrity platforms, claims adjudication systems, workflow tools, or rules engines.· Background in healthcare regulations (CMS, Medicare/Medicaid guidelines, ICD/CPT coding).· Exposure to machine learning based anomaly detection or predictive models.· Product certifications (CSPO, Pragmatic PM, AIPMM, etc.).· MBA or equivalent experience in strategy-heavy roles.Success Measures· Reduction in payment leakage and increase in cost avoidance.· Improved claims accuracy and audit efficiency.· Delivery of high impact features aligned with roadmap timelines.· Strong adoption$75 - $78 an hourKnow more about Brillio : https://www.brillio.com/join-us/ PPE: https://www.brillio.com/platform-and-product-engineering/ Equal Employment Opportunity DeclarationBrillio is an equal opportunity employer to all, regardless of age, ancestry, colour, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation. #LI-PS1 Know what it’s like to work and grow at Brillio: _We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Receptionist (Bilingual Mandarin).Arcadia Office - Arcadia, CA 91007.Hourly Position Type Full Time.Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membershi

STI is looking for a BI Developer to support the launch and reporting needs of a new Medicare Advantage health plan. The ideal candidate will possess 5+ years of Medicare Advantage experience and strong SQL skills, with familiarity in Epic Tapestry and Clarity.

Take on a high-impact role within a world-class health organization. Help drive the continued delivery of exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you'll provide direct management to a team of UM coordinators and nurses. You'll work closely with Medicare Advantage leadership to plan, execute, and manage various initiatives related to UM administrative, operational, and strategic objectives. You'll demonstrate leadership and effective communication by fostering collaborative relationships with peers, co-workers, and staff. You'll be responsible for overseeing and coordinating the following major functions: • Pre-service Authorizations/Denial Letters, • Concurrent Review, • Continuity of Care, • Retro Claims, • Retrospective Review, • Referral Automation Business Rules/Configuration Salary Range: $ 116,300 - $264,600 Annually Job Qualifications: • Bachelors of Science, Nursing (BSN) degree required

Knowledgeable of Medicare Advantage delegation oversight requirements and regulatory drivers (CMS, DMHC, NCQA).

Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. At Clever Care, you'll have the opportunity to make a real difference, shape the future of

Reporting to the Associate Director of Delegation Oversight and Systems, the Delegation Oversight Manager will lead the day-to-day management and execution of our health plan's Delegation Oversight program.This critical role ensures that delegated entities, including Independent Physician Associatio

UCLA Health is seeking a Clinical Documentation Integrity Specialist to manage Medicare Advantage risk adjustment coding.

Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan.

Reporting to the Associate Director of Delegation Oversight and Systems, the Delegation Oversight Manager will lead the day-to-day management and execution of our health plan's Delegation Oversight program.This critical role ensures that delegated entities, including Independent Physician Associatio

Deep expertise in implementing or upgrading core claims platforms (QNXT strongly preferred). This includes a strong understanding of claims adjudication systems/workflows, Medicare Advantage operations, and CMS regulatory/reporting requirements. Title: IT Project Manager (Claims Platform Implementat

Job Description Description Conduct high-volume provider outreach (4,000+ providers) to support the collection of approximately 14,000 medical records (2023 data), ensuring timely and accurate retrieval. Validate and maintain provider demographic data for 8,000+ providers across multiple health plan products, ensuring data accuracy and compliance. Process and distribute 100+ provider contract amendments related to new product implementations, ensuring proper documentation and tracking. Support the collection and tracking of Medicare Compliance Attestations, ensuring all required documentation is completed and submitted within deadlines. Assist with Health Plan ID resubmissions (several hundred records), playing a critical role in maintaining provider network integrity and supporting organizational growth initiatives. Job Type & Location This is a Contract position based out of Canoga Park, CA 91304. Pay and Benefits The pay range for this position is $22.00 - $23.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision, • Critical Illness, Accident, and Hospital, • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available, • Life Insurance (Voluntary Life & AD&D for the employee and dependents), • Short and long-term disability, • Health Spending Account (HSA), • Transportation benefits, • Employee Assistance Program, • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Canoga Park,CA 91304. Application Deadline This position is anticipated to close on Jun 26, 2026. About TEKsystems We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.

Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of between $25 / hr.There is no payment required in order to apply or to work as an In-Home Usage Tester.You