The specialist is responsible for coordinating claim activities, resolving rejected invoices, and ensuring timely reimbursement of receivables. They also analyze outstanding accounts, clear payment variances, and provide support to agency personnel regarding claims processing.
The Outbound Tele Sales Agent is responsible for conducting outbound calls to members to promote and schedule virtual healthcare appointments. They must maintain detailed records in the CRM system and collaborate with team members to meet scheduling targets.
The Senior Process Improvement Professional will lead the design and implementation of new operational processes to support interoperability and medical documentation chase work. This role acts as a subject matter expert, partnering with business, product, and IT teams to define workflows and ensure operational excellence.
The Senior Product Manager will drive innovation by leading product research and discovery efforts in collaboration with internal and external stakeholders. They will manage the end-to-end product lifecycle, conduct opportunity assessments, and translate business strategy into consumer-facing solutions.
The Workforce Management Manager leads a team of analysts to develop strategic insights and optimize staffing levels for pharmacy call center and mail order operations. They are responsible for managing intraday performance, collaborating with stakeholders to improve efficiency, and overseeing vendor performance metrics.
Provide virtual primary care services, including Medicare wellness visits and acute same-day visits, while collaborating with a team to ensure high-quality patient outcomes. Maintain accurate medical records and ensure compliance with clinical policies and regulatory standards.
The Consultative Coder provides medical coding expertise to support clinical staff by ensuring documentation supports diagnostic and procedural coding. They also build relationships with clinicians, identify documentation improvement opportunities, and collaborate on HEDIS gaps and payer chart reviews.
The MSO Growth Lead is responsible for developing and executing sales strategies to recruit primary care practices into the CenterWell IPA network. This role involves facilitating complex negotiations and building partnerships to achieve membership and revenue growth targets.
The Sr. Specialty Pharmacy Sales Executive engages with physician offices to influence the routing of specialty drug prescriptions to CenterWell Specialty Pharmacy. This role involves managing a sales territory, building relationships with office staff, and providing education on pharmacy benefits and medication options.
The pharmacist will conduct inbound and outbound calls to assess patient conditions, manage medication therapy, and develop comprehensive care plans. They are responsible for reviewing prescriptions for accuracy and providing medication education to patients with serious or rare health conditions.
The RN Care Navigator assesses member needs and facilitates access to resources to achieve optimal wellness and resolve barriers to care. They conduct transitions of care management, provide patient education, and coordinate with interdisciplinary teams to support holistic health goals.
The Patient Care Coordinator will maintain contact with healthcare facilities to provide updates on company services and collaborate with program staff. They will also assist in processing physician orders and participate in the company's tuberculosis screening program.
The representative addresses incoming inquiries via phone, digital, or written channels to resolve customer issues and provide benefit information. They are responsible for recording interaction details and escalating unresolved grievances according to established policies.
The analyst oversees facility licensing, certification processes, and ensures ongoing regulatory compliance with federal, state, and local healthcare regulations. They are responsible for managing Medicaid and Medicare enrollment activities and conducting research to support organizational initiatives.
The Senior Product Manager will manage and evolve a portfolio of AI products across CenterWell's segments to drive strategic reuse and consistency. They will partner with executive stakeholders to identify synergies, define success metrics, and ensure all solutions align with human-centered design principles.
The Principal Product Manager will define the roadmap for Clinical Intelligence and identify high-value AI opportunities across Home Health, Primary Care, and Pharmacy segments. They will partner with cross-functional teams to translate enterprise needs into scalable, interoperable product capabilities that improve patient outcomes.
The Director of Data Science will lead a technical team to develop and validate AI/ML models for CenterWell's portfolio, ensuring alignment with product priorities and operational efficiency. They will partner with cross-functional teams including IT, clinical, and product management to integrate AI solutions into healthcare workflows.
The Clinical Care Oversight Professional 1 provides clinical support for patient assessments and facilitates access to resources to maintain optimal wellness. They manage straightforward work assignments while following established procedures and professional standards.
The Risk Adjustment Coding Analyst provides operational and analytical support by developing dashboards, monitoring performance trends, and summarizing data for leadership decision-making. They partner with teams to resolve data issues, ensure compliance, and improve reporting processes through clear business narratives.
The E-Referral & Vendor Optimization Lead manages electronic referral workflows and oversees relationships with over 90 vendors to ensure efficient patient intake. This role involves driving process simplification, negotiating service level agreements, and providing strategic leadership to improve organizational performance.
The Clinical Pharmacist will manage medication therapy for high-risk patients with chronic conditions and collaborate with a multidisciplinary care team to optimize patient outcomes. Responsibilities include conducting medication reconciliations, providing patient education, and supporting quality measures within the clinic's EMR system.
The role focuses on analyzing patient experience data from various sources to drive continuous improvement projects across pharmacy services. It involves translating complex data into actionable insights and collaborating with cross-functional teams to resolve systemic experience issues.
Lead strategic initiatives focused on productivity, pay structure, and workforce management within the home health business portfolio. Act as a bridge between data, operations, and HR to translate quantitative and qualitative insights into actionable business strategies.
The pharmacist will manage medications for high-risk patients with chronic conditions and collaborate with multidisciplinary healthcare teams to improve patient outcomes. Responsibilities include conducting medication reconciliations, providing patient counseling, and supporting quality measures like CMS Stars and HEDIS.
