176 care associate jobs found in Augusta

Job Description As an Associate Consultant you will consult with clients on service line workflow and guide them through interdependencies and design decision impacts. You will provide solution oversight, direction, and expertise to stakeholders. You will drive client-specific solution configuration design to meet workflow requirements and make recommendations to clients. You will mitigate solution risks and issues. You will execute workflow and process improvement strategies. You will lead client meetings and events. You will drive internal team initiatives. Responsibilities Lead and support end-to-end revenue cycle implementations with a focus on charge services for federal healthcare clients (DoD, and potentially VA). Configure and customize Cerner Millennium solutions to meet the specific needs of federal reimbursement models and operational workflows. Collaborate cross-functionally with internal teams and external stakeholders, providing hands-on support during...

Become a part of our caring community and help us put health first Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that all benefits authorized meet medical necessity and other Medicare and/or Medicaid criteria if applicable, to promote cost-effective delivery of health care services. Share your talents and develop your skills all while doing your part to improve the lives of others. Essential Duties and Responsibilities: Review PA requests for home health services, durable medical equipment, outpatient therapies, skilled nursing facility therapies, and all outpatient procedures pursuant to applicable Medicare and Medicaid criteria, iCare guidelines, and PA Department policies and procedures. Review PA requests for inpatient medical stays, skilled nursing facility stays, long term acute hospital stays, inpatient...

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...

Become a part of our caring community and help us put health first The Software Engineer 2 codes software applications based on business requirements. The Software Engineer 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Software Engineer 2 standardizes the quality assurance procedure for software. Oversees testing and debugging and develops fixes. Researches complaints and makes necessary adjustments and/or recommendations to resolve complex software related issues. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's Degree in Computer...

Become a part of our caring community and help us put health first The Lead Systems Engineer is responsible for design, analysis, configuration and maintenance of complex systems software solutions in a virtual environment, based on a thorough knowledge of systems engineering and programming concepts and techniques. Systems software engineering/programming is a specialized area of software engineering/programming focused on software that operates/controls computer hardware and provides a platform for running end user applications. Includes operating systems, device drivers, utilities, and software; development tools (e.g., assemblers, compilers, etc.). The Lead Systems Engineer works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Virtualization Engineer is responsible for architecting, implementing, and maintaining enterprise-grade virtual environments that support the organization's critical applications and services. This...

Become a part of our caring community and help us put health first The Care Manager, Telephonic Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration. The work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. Work schedule can be between 8am-6:30pm EST. The Care Manager Telephonic Nurse uses clinical knowledge, communication skills, and independent critical thinking skills to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their...

Become a part of our caring community and help us put health first The Senior Product Manager Conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Senior Product Manager is a senior individual contributor who orchestrates complex, cross-platform technology initiatives that advance enterprise strategy and operational reliability. As a Senior Product Manager, you will plan and manage the enhancement and/or integration of the business products with a special focus on clinical care management and technology solutions. This role is pivotal in translating business vision into scalable technology solutions, ensuring seamless integration across platforms such as clinical care management platforms, telephony, data systems, and enterprise architecture. The Senior Product Manager will...

The UMB Alternative Investments - Support team provides support to the development of the software used by our Fund Accountants, external Alternative Investment client teams, and Investors to manage the investment portfolio. This robust software allows them competitive advantages within the Alternative Investments industry which continues to evolve and provides exciting opportunities for individuals to learn new skills, administer new tools, and grow their career. As a Senior Software Engineer , you will be providing full-stack development support and enhancements for UMB's Alternative Investments web applications including various other applications. You will work closely with the team to design and build enterprise-level solutions. You will look for ways to assist in improving development efficiency and implementing best practices. This is a subset of the overall responsibilities which involves other multiple initiatives as assigned by IT leadership. This role is...

Corporate Compliance Services partners with UMB management in its obligation to effectively manage compliance and related risks within the UMB family of corporations. This team provides timely, accurate, and seasoned judgment related to regulatory compliance risk, suggests strategies for mitigating risk, promotes a strong culture of compliance, and fulfills regulatory expectations of administering effective compliance monitoring and other mandated programs. As a Compliance Testing Analyst, you will carry out the testing function of UMB Financial Corporation's Compliance Management System. This position will conduct transaction testing to validate regulatory compliance of consumer and commercial loan and deposit products and services. You will have the opportunity to participate in meetings with business units, individually or in a group, to identify gaps within current practices and regulatory requirements. You will identify and communicate compliance deficiencies and...

Company : Highmark Inc. Job Description : JOB SUMMARY This job provides front line staff guidance, ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. The incumbent responds to physician and pharmacy network provider inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network providers to evaluate, educate and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. ESSENTIAL RESPONSIBILITIES Communicate effectively with physician and pharmacy network providers to ensure that the needs of the...

Become a part of our caring community and help us put health first The Field Marketing Executive plays a crucial role in driving lead generation and supporting the local sales team through grassroots marketing, community outreach, and event execution. The Field Marketing Executive works directly in the field to identify opportunities, build relationships, and activate strategies that contribute to sales growth, branding, and increased community presence. Ultimately, the Field Marketing Executive contributes to market growth objectives. The Field Marketing Executive works with agents and their leaders to create plans that drive new enrollments, increase retention of existing members, and build meaningful relationships with community organizations and influencers. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable...

Become a part of our caring community and help us put health first The Software Engineer 2 codes software applications based on business requirements. The Software Engineer 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Software Engineer 2 standardizes the quality assurance procedure for software. Oversees testing and debugging and develops fixes. Researches complaints and makes necessary adjustments and/or recommendations to resolve complex software related issues. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's Degree in Computer...

The UMB Alternative Investments - Support team provides support to the development of the software used by our Fund Accountants, external Alternative Investment client teams, and Investors to manage the investment portfolio. This robust software allows them competitive advantages within the Alternative Investments industry which continues to evolve and provides exciting opportunities for individuals to learn new skills, administer new tools, and grow their career. As a Senior Software Engineer , you will be providing full-stack development support and enhancements for UMB's Alternative Investments web applications including various other applications. You will work closely with the team to design and build enterprise-level solutions. You will look for ways to assist in improving development efficiency and implementing best practices. This is a subset of the overall responsibilities which involves other multiple initiatives as assigned by IT leadership. This role is...

Become a part of our caring community and help us put health first The Financial Planning & Analysis Lead analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. The Financial Planning & Analysis Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Financial Planning & Analysis Lead collects, compiles, verifies, and analyzes financial information and economic indicators so that senior management has accurate and timely information for making strategic and operational decisions on, for example, acquisitions, investments, capital expenditure, divestitures, mergers, or the sale of assets. Analyzes the financial implications of proposed investments or other transactions so that senior managers can evaluate alternatives against the organization's business objectives. Evaluates industry, economic, financial, and market trends to forecast...

Become a part of our caring community and help us put health first The Senior Clinical Recruiter plays a critical role in driving talent acquisition efforts across multiple business units. As a strategic partner, the Senior Recruiter leads full-cycle recruitment, from the initial strategy sessions with business leaders to the final offer stage. This role involves deep collaboration with key stakeholders, ensuring alignment on sourcing strategies, talent pipelines, and long-term hiring plans. With a consultative approach, the Senior Recruiter delivers tailored solutions, utilizing advanced recruitment technologies to enhance the candidate experience and meet the organization's evolving talent needs. The Senior Clinical Recruiter places advertisements, attends career days, job fairs and student and RN conventions. Coordinates in-house recruitment efforts. Interviews candidates and refers them to appropriate clinical service. Begins to influence department's strategy. Makes...

Job Description Ready to make an impact? Oracle's Global Environment, Health & Safety (EHS) team might be looking for you. We are a group of dynamic, innovative, diverse individuals striving to provide the best work environment and customer service to our colleagues. We provide a modern workspace with an emphasis on our co-workers' safety. You will interact with senior leaders, colleagues, vendors, and others, while working for the leader in cloud services. Come and join us! Oracle is seeking an experienced Data Center Construction Safety Advisor (Americas) to lead the implementation of a comprehensive construction safety program for data center construction projects. This role involves creating and customizing EHS program documentation, including standards, policies and procedures tailored to the unique challenges of operating data centers. The ideal candidate will have expertise in key safety areas such as construction safety, Lockout/Tagout (LOTO), Arc Flash,...

As the Commercial Implementation Specialist , you will be responsible for leading and coordinating all aspects of the project life cycle with responsibility for the client journey through the implementation of new clients in Commercial Bank, supporting Treasury Management onboarding efforts across the entire Commercial footprint which includes set up of programs and any design. How you will spend your time: You will onboard Treasury Management services for new clients to the bank, client projects with extended time frames, and technical client setups. You will manage the onboarding by identifying and coordinating appropriate bank resources by partnering with internal areas/departments to ensure services are onboarded properly. You will provide consultation for TMO and their clients in the program design and implementation process, as well as data extract design for data integration with clients' internal systems. You will translate client needs...

Job Info POSITION: Customer Care Representative NUMBER OF OPEN POSITIONS: 4 LOCATION: CMP - ME - Augusta - General Office STARTING RATE: $25.88/Hourly Responsibilities Handles all phases of customer inquiries received by telephone or by correspondence (physical or electronic). Processes applications for service and extension of facilities. Responds to customer inquiries and complaints (i.e. bill payment, usage inquiries, account updates, service, credit and collections) in a customer focused manner. Responds to maintenance concerns and emergencies during storm restoration. Resolves customer problems and complaints utilizing established procedures and policies, which include regulatory guidelines (customer may include attorney, collection vendors, and/or insurance companies). Records online entries of customer transactions into set operating systems. Provides account information to customers and explains bill service policies and customer rights. Able...

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. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact your own income potential? If so, we are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate beneficiaries...

Become a part of our caring community and help us put health first The Senior Pharmacy Contracting Professional conducts all aspects of pharmaceutical contracting and pricing including development, implementation, and maintenance. The Senior Pharmacy Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Pharmacy Contracting Professional ensures contract compliance and performs analysis regarding pharmacy claims and purchasing data to identify future contracting opportunities. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Use your skills to make an impact Required Qualifications Bachelor's...

Become a part of our caring community and help us put health first Humana's Health Quality and Stars organization is seeking a Senior Data Quality/Integrity Engineer to deliver quality and value in a fast-paced, dynamic environment. The successful candidate will be self-directed, highly-engaged, and will demonstrate expertise and business intelligence in supporting execution of the HEDIS program and related activities, all within tightly regulated requirements and timelines. This will require building and maintaining strong relationships with corporate and market teams, including IT, Quality Operations and Compliance, and Risk Adjustment, as well as vended partners. The Senior HEDIS Operations & Quality Professional supports all aspects of the non-standard supplemental (NSS) program; including: systems readiness, process improvements, resource deployment, technology implementation, and data management/reporting. The Senior HEDIS Operations & Quality Professional...

Become a part of our caring community and help us put health first The Workforce Management Professional 1 applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, talent management, diversity and human resource compliance). The Workforce Management Professional 1 work assignments are often straightforward and of moderate complexity. The Workforce Management Professional 1 assesses organizational staffing and identifies requirements and solutions to meet workforce objectives. Provides analysis of talent and staffing needs based on strategic planning at the enterprise level. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented...

Become a part of our caring community and help us put health first Humana's Marketing organization is seeking an experienced Senior Associate, Campaign Strategy to join the team working remote. Are you a strategic thinker who thrives on turning insights into action? As the Senior Associate, Campaign & Brand Strategy (internally known as a Senior Associate, Brand Management) , you'll support the development of integrated marketing campaigns that drive awareness, engagement, and growth across Humana's lines of business. You'll collaborate with cross-functional teams to ensure campaigns are insight-driven, member-centric, and aligned with enterprise priorities. Key Role Functions Support the development of multi-channel campaign strategies across Medicare, Medicaid, and Commercial lines of business Translate business objectives and audience insights into actionable campaign briefs and messaging frameworks Collaborate with Brand, Media, Creative, and...

Become a part of our caring community and help us put health first The Network Operations Coordinator 4 maintains provider relations to support customer service activities through data integrity management and gathering of provider data needed for service operations. The Network Operations Coordinator 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Network Operations Coordinator 4 manages provider data for health plans including but not limited to demographics, rates, and contract intent. Operates within fast-paced environment with ability to manage and meet strict regulatory deadlines. Manages provider audits, provider service and relations, credentialing, and contract management systems. Executes processes for intake and manage provider perceived service failures. Decisions are regarding the daily priorities for an administrative work group and/or...