The representative manages inbound and outbound inquiries from members and providers regarding health plan benefits, eligibility, claims, and billing. They are responsible for resolving issues, documenting interactions in the CRM, and collaborating with internal teams to ensure accurate and empathetic support.
The role involves leading the technical direction and architecture of the backend platform while remaining hands-on with Node.js and TypeScript service development. Responsibilities include mentoring junior engineers, establishing coding standards, and ensuring high-availability, HIPAA-compliant system performance.
The representative manages inbound and outbound inquiries from members and providers regarding health plan benefits, eligibility, claims, and billing. They are responsible for resolving issues at first contact, documenting interactions in the CRM, and collaborating with internal teams to address complex situations.
The representative manages inbound and outbound inquiries from members and providers regarding health plan benefits, eligibility, claims, and billing. They are responsible for resolving issues, documenting interactions in the CRM, and collaborating with internal teams to ensure accurate information delivery.
The RN Care Coordinator delivers comprehensive, member-centered care coordination and develops individualized care plans for a commercial health plan population. They also facilitate member engagement, provide education on benefits and digital health solutions, and support utilization review processes.
The Senior Software Engineer will lead the technical direction and architecture for the Node sub-team while remaining hands-on with frontend, mobile, and backend development. They are responsible for mentoring junior engineers, establishing coding standards, and ensuring high-availability and security across the platform.
The RN Integrated Care Coordinator performs clinical reviews, prior authorizations, and discharge planning to ensure quality outcomes and appropriate utilization of services. They collaborate with medical directors and providers to manage care coordination and resolve clinical quality issues.
