54 care associate jobs found in Nashville

Become a part of our caring community and help us put health first The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. Earn a $5,000 hiring bonus! Bonus is paid after 180 days of employment; you must be employed until that date to be eligible to receive the payment." Location: Remote - United States Schedule: 8-hour shifts, Monday through Friday, between 10:30 AM and 11:00 PM EST OR 10-hour shifts, Tuesday through Friday, between 10:30 AM and 11:00 PM EST Required to work every 5th Saturday Required to work 1 company holiday...

Become a part of our caring community and help us put health first The Risk Management Professional 2 identifies and analyzes potential sources of loss to minimize risk. The Risk Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines and procedures. As a Risk Management Professional 2 - HCPR Compliance, you will work with HCPR Operations to ensure operational processes are complaint with appropriate regulations and report data that accurately reflects operations. In this role you will: In this role you will: Develop data universe generation guidelines (DUGG) for audit universes by interpreting protocols/guidance and reconciling it to processes/system logic Produce monthly...

Become a part of our caring community and help us put health first The Project Management Lead manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Project Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Project Management Lead designs, communicates, and implements an operational plan for completing the project; monitors progress and performance against the project plan; takes action to resolve operational problems and minimize delays. Identifies, develops, and gathers the resources to complete the project. Prepares designs and work specifications; develops project schedules, budgets and forecasts; and selecting materials, equipment, project staff, and external contractors. Communicates with other operational areas in the organization to secure specialized resources and contributions for the project. Conducts meetings and prepare reports to communicate the...

Become a part of our caring community and help us put health first The Director, Home Health Risk Management identifies and analyzes potential sources of risk, proactively ensuring controls and processes are in place to reduce risk. The Director, Home Health Risk Management requires an in-depth understanding of how organization capabilities interrelate across the Home Health segment. The Director of Risk Management for Home Health will be responsible for development and implementation of controls and cost-effective approaches to minimize risks to the organization as well as estimating the potential consequences of risks. Assesses and communicates information regarding business risks with functions across the organization. Their focus will be on CenterWell risk assessments, issue management, auditing and monitoring. Areas of oversight will include CenterWell Home Health, OneHome, as well as new growth initiatives. This role requires an in-depth understanding of Home Health...

Under general direction, the Treasury Management (TM) Sales Analyst supports the Treasury Management Officers (TMOs) in growing TM revenue. This position is responsible for the creation, analysis and delivery of proposals, RFPs, and sales presentations. The TM Sales Analyst performs pre-call planning, preparation and participates in joint sales calls with TMOs and Commercial Bankers. The TM Sales Analyst provides a high level of internal customer support through understanding and driving the sales culture and vision of the organization within the member banks, maintaining and delivering reporting and metrics; and managing all additional aspects of sales support in the sub lines of business. How you will spend your time: Develop proformas, proposals and customer profitability analysis for Treasury opportunities Prepare pre-call planning prep and materials for TM client and prospect meetings Coordinate proposal responses and works across business lines to...

Become a part of our caring community and help us put health first Encounter Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission processes. Takes ownership by applying professional standards, regulations, and strategies within their work area. Independently sets priorities and makes decisions on work approach while following established direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Humana's Encounter Data Management (EDM) team is seeking an Encounter Data Management Professional that has experience with business processing and data...

Become a part of our caring community and help us put health first Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to assist with any barriers to accessing services; education and initial registration into ECHO registration portal for active duty family members; assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility, referrals, etc.; and identification of ABA providers and researching necessary resources to support the beneficiary. KEY ACCOUNTABILITIES Assist beneficiaries with...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Capital One. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Director, Technical Program Management - Capital One Software (Remote) Ever since our first credit card customer in 1994, Capital One has recognized that technology and data can enable even large companies to be innovative and personalized. As one of the first large enterprises to go all-in on the public cloud, Capital One needed to build cloud and data management tools that didn’t exist in the marketplace to enable us to operate at scale in the cloud. And in 2022, we publicly...

Position Overview At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve. We are all united in delivering the best experience for our customers. We work together each day to foster an inclusive workplace culture where all of our employees feel respected, valued and have an opportunity to contribute to the company's success. As a Treasury Management Officer II within PNC's Treasury Management Commercial Sales organization, you will be based in Nashville TN. This position is primarily based in a PNC location. Responsibilities require time in the office or in the field on a regular basis. Some responsibilities may be performed remotely, at manager's discretion. PNC will not provide sponsorship for employment visas or participate in STEM OPT for this position. Job Description Coordinates relationship management activities with new and/or existing clients in a book of business to grow sales, revenue and market share with...

Job Profile Position Overview At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve. We are all united in delivering the best experience for our customers. We work together each day to foster an inclusive workplace culture where all of our employees feel respected, valued and have an opportunity to contribute to the company’s success. As a Treasury Management Officer II within PNC's Treasury Management Commercial Sales organization, you will be based in Nashville TN. This position is primarily based in a PNC location. Responsibilities require time in the office or in the field on a regular basis. Some responsibilities may be performed remotely, at manager’s discretion. PNC will not provide sponsorship for employment visas or participate in STEM OPT for this position. Job Description Coordinates relationship management activities with new and/or existing clients in a book of business to grow sales, revenue and market share...

The UMB Governance organization within Enterprise Technology Services (ETS) is comprised of IT leaders, project managers, architects, software engineers, and analysts coming from diverse background and experiences. Functionally, the Governance Organization provides guidance and oversight to IT processes, projects, capacity, and risk management functions to ensure appropriate strategies, policies and controls are executed effectively and efficiently. We share a strong commitment to ensure our enterprise-level systems are performing at peak capacity and we believe in fully supporting each other to achieve this goal. As a Senior Project Manager , you will lead multiple enterprise projects interacting with cross-functional teams comprised of internal & external technical contributors, IT managers and various other stakeholders. More specifically, you will provide project leadership for new system or feature implementations, systems upgrades, conversions, and migrations. You...

Job Description We are seeking a dynamic and results driven Manager, Consulting Services to lead and develop a high-performing team while driving strategic initiatives that align with our organizational goals. This role requires a strong leader with expertise in learning and associate management, financial accountability for a portion of revenue and/or margin, excellent communication skills, and a passion for fostering collaboration and innovation. If you thrive in a fast-paced environment excel and managing budgets and resources and are committed to driving operational and financial success, we invite you to join our team. Responsibilities Ability to motivate, coach and develop team members Experience in building a high-performing team and fostering collaborative culture Strong decision-making and problem-solving skills Proven ability to set goals, measure progress and drive results Experience in revenue and/or margin management, resource...

SENIOR RELATIONSHIP MANAGER-HEALTHCARE LENDING (REMOTE) The Commercial Banking team actively calls on businesses that typically have annual revenue up to $500MM. The objective of the group is to earn the title of trusted advisor and help these companies grow and prosper in our communities. This is an opportunity to be an early stage, integral member of a healthcare team and platform with aggressive growth plans. As the Sr. Relationship Manager-Healthcare Lending, you will be responsible for increasing the Bank's profitability by cultivating new commercial relationships and the expansion/retention of existing relationships. In this role you must utilize your credit acumen and be knowledgeable in non-credit products such as treasury management, virtual card, trust, etc. Successful candidates for this role will be resilient, agile, accountable, driven and self-motivated with the ability to operate independently and autonomously. This is a hands-on, team driven, roll up your...

As the Operations Manager II within Operational Risk team *, * you will collaborate across all business lines within UMB, to execute the overall strategy and direction of risk mitigation activities for Enterprise Bank Operations while delivering high level service to internal and external customers. Effective collaboration and communication with business partners, managers, and co-workers will ensure successful execution. This role is hybrid (Mon through Thu on-site / Fri remote) for candidates in the Kansas City, MO or Dubuque, IA metropolitan areas and open to qualified remote candidates outside of the Kansas City and Dubuque areas but only within the US. How you'll spend your time: Own and actively monitor expenses, consistently striving to operate at or below current budget levels. Obtain and develop material knowledge of area functions that allows for informed and deliberate decision-making. Monitor and ensure the creation, maintenance and...

Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. IFG is a subsidiary of Humana The Senior Organization Effectiveness Professional optimizes the effectiveness of a company, business unit, or team. Analyze the internal structure of the organization and create strategies to maximize employee work output and effectively utilize employee skills. The Senior Organization Effectiveness Professional work assignments involve moderately complex to complex...

The Commercial Card Product Group manages payment solutions for the Bank's clients, including small businesses and corporations. As the Payables & Business Card Product Manager, you will be a thought leader around the execution to expand and develop strategy to support UMB's Payables and Business Banking card solutions. Your primary focus will be Integrated Payables solutions for all segments under Commercial Banking with input from stakeholders and cross-functional teams. You will also engage with Supplier Enablement networks and analysis to increase customer spending for the Payables program, conduct market research and competitive analysis, define product features and functionality, and many other critical activities. This is a subset of the overall responsibilities which involves other multiple initiatives as assigned by Bank Product leadership. This role is hybrid (Mon thru Thu on-site / Fri remote) for candidates in the Kansas City metropolitan area and open...

Become a part of our caring community and help us put health first The Principal Product Manager Conceives of, develops, delivers, and manages products for customer use. The Principal Product Manager provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. A high-performing, independent role dedicated to tackling cross-team, cross-functional technology and analytics problems in with a focus on innovation, action, and speed-to-market. Primary focus will be on ensuring complete and accurate diagnosis and follow up for our members. This role will work with 2-5 developers within our team on high-profile projects. Responsibilities will include partnering with the business, gathering requirements, developing project plan including resource needs, supervising project execution, hands-on development and analysis as appropriate, customer feedback loop, executive presentation. Critical skills include independent project...

Become a part of our caring community and help us put health first At Humana, we are focused on the elimination of unjust, avoidable and unnecessary barriers in health and health care. The Data Manager 2 (DM2), reporting to the Health Equity Strategy Lead, supports the whole-person, integrated care model for members in our Medicaid and Medicare market to help build the toolkit for equitable population health. In particular, we partner with executives, managers and other leads to advance Care Management, Quality Improvement, Community Engagement, Marketing, Health Economics and Finance to bring a greater understanding of factors that apply to wellbeing from a view of physical, behavioral and spiritual health. The Data Manager 2 supports all aspects of configuration control, data management, and deficiency reporting. The Data Manager 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action....

Become a part of our caring community and help us put health first The Customer Success Manager is a key leadership role responsible for ensuring customer retention through proactive engagement, strategic initiatives, and operational excellence. This role works collaboratively to ensure alignment and consistent performance, managing up to 25 Customer Success Agents to deliver on retention objectives and test new business initiatives. The Customer Success Manager plays a critical role in driving customer retention through proactive engagement with customers and the implementation of strategic retention initiatives. In addition to core retention campaigns and allegation mitigation, the role supports Call Quality for their team, contributes to broader enterprise value by test & learning new initiatives, and can be part of building something from the ground up. The Customer Success Manager should be ready to receive objectives and determine approach, resources, goals, and...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title North Carolina Senior Project Manager / Operations Lead - Remote Job Description The North Carolina Senior Project Manager is responsible for orchestrating all activities for the North Carolina Medicaid PBM account implementation and projects throughout the life of the business. This includes activities that support both the MES Project in addition to PBM Operations and Maintenance. This role coordinates multi-vendor incident, change, release management. Interfaces with all technology deployments as the lead. Develops and manages all related project plans and schedules. This will include multiple complex projects, working in concert with leadership, business, IT and other project stakeholders to meet the overall project...

Job Description The Strategic Analytics & Adoption team is seeking an experienced people manager to lead a team of Adoption Managers who play a critical role in maximizing customer and caregiver value. This manager will lead and deliver core organizational initiatives and will be responsible for the oversight, leadership, and development of Adoption Managers to meet team and organizational goals. Responsible for managing the three main pillars of a practice: people management, portfolio/delivery management and sales enablement. Has profit and loss responsibility or financial/expense management of practice. This position will manage financials, operations, and other capital for complex projects based on contract terms, sales and client management/oversite, and propose resolution strategies for project risks, escalating as appropriate. As a leader on the team, they will analyze and report to internal and external client stakeholders on progress, key performance...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we CARE through our values, Sustainability initiatives and inclusive corporate culture. Our Personal Lines Sales team is seeking an Associate Territory Sales Manager/Sales Support to work in Nashville, TN. This is a full-time/exempt role. POSITION OVERVIEW: Partner with the Territory Sales Manager in the coordination and execution of agency prospecting, agency on boarding, agency training, and meeting set up, and agency marketing designed to improve agency satisfaction, CSR loyalty and engagement. Provide the CSR/Agency with training on all Hanover systems including billing and POS. Work closely with the TSM’s to improve new business results and increase conversion rates on consolidations. Responds to agent service questions and coordinate in resolving problems with Underwriting and First Contact....

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Humana, Inc.. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Become a part of our caring community and help us put health first At Humana, our Medicaid Clinical Enablement team is dedicated to designing, developing, and implementing innovative learning solutions for clinical associates across Medicaid markets. As a Manager of Learning (Manager, Learning Design) within Clinical Operations, you will collaborate with enterprise leaders and key stakeholders to lead a high-performing team in crafting learning experiences that empower our...

Become a part of our caring community and help us put health first The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. Where You Come In The Manager, Fraud and Waste coordinates investigation with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and...