Receive, process, and review all prior authorization requests received through fax, phone, or electronic prior authorization systems in accordance with all regulatory and accreditation requirements Properly apply clinical policy criteria to the review of prior authorization requests Review and interpret member's eligibility, claim history, and Pharmacy Program information

The Manager of Risk Adjustment and Trend Analytics is a key member of the Finance management team. Under supervision of the V.P of Financial Planning and Performance Analysis, the Manager oversees risk adjustment analysis primarily related to the MassHealth Medicaid and New Hampshire Medicaid lines of business, directly impacting and improving the revenue for these produc

The Operations Trainer develops a wide variety of training programs and materials to support the Claims, Call Center, and Enrollment teams. The trainer researches, develops, and facilitates in house training courses for new and existing employees. Develops training competency tools that will ensure the quality, consistency and timeliness of department activities. Maintain

Reporting to the Manager of Consumer Sales and Performance, the Broker Account Executive is a licensed sales professional with experience in Medicare/Medicare Advantage and individual ACA markets and is responsible for building and managing relationships with WellSense's contracted brokers. The Broker Account Executive provides strategy support and product training broker

This is an exciting opportunity to work for one of the top law firms in the U.S.! Davis Wright Tremaine LLP is looking for an Attorney Training Specialist to join our team in our Seattle office. We offer a hybrid work engagement with three days o f remote work, and two days in office. Under the guidance of the Senior Manager, Attorney Training and CLE Compliance, the Atto

The Ackerly at Timberland If you're looking for a job that goes beyond the basics to deliver purpose and joy, you'll find it here! Welcome to Leisure Care, where employees are here to inspire today's older adults to embrace joy and purpose in their lives while doing the same in their own. For nearly 50 years, we've been reimagining and reinventing what it means to work in

The Village at Unity Hamlet If you're looking for a job that goes beyond the basics to deliver purpose and joy, you'll find it here! Welcome to Leisure Care, where employees are here to inspire today's older adults to embrace joy and purpose in their lives while doing the same in their own. For nearly 50 years, we've been reimagining and reinventing what it means to work i

The Village at Unity Hamlet Our care based services and superstar employees (like you!) inspire new and creative ways of serving our residents and their families. Our employees are the heart of Leisure Care communities, working together to provide exceptional care to support our residents so they can show up as their best selves every day. With the best benefits in the biz

The Ackerly at Sherwood If you're looking for a job that goes beyond the basics to deliver purpose and joy, you'll find it here! Welcome to Leisure Care, where employees inspire today's older adults to embrace joy and purpose in their lives while doing the same in their own. For nearly 50 years, we've been reimagining and reinventing what it means to work in senior living,

The Woodlake At Leisure Care managed communities our hospitality based care services and superstar employees (like you!) inspire new and creative ways of doing business and serving our residents and their families. Our employees are the heart of Leisure Care communities, working to make our communities feel just like home. Our teams work together to bring premier dining, p

The Azalea at Cinnaminson Guest Services At Leisure Care managed communities, our hospitality based care services and superstar employees (like you!) inspire new and creative ways of doing business and serving our residents and their families. Our employees are the heart of Leisure Care communities, working to make our communities feel just like home. Our teams work togeth

MacKenzie Place Fort Collins If you're looking for a job that goes beyond the basics to deliver purpose and joy, you'll find it here! Welcome to Leisure Care, where employees inspire today's older adults to embrace joy and purpose in their lives while doing the same in their own. For nearly 50 years, we've been reimagining and reinventing what it means to work in senior li

The Village at Unity Our hospitality based care services and superstar employees (like you!) inspire new and creative ways of doing business and serving our residents and their families. Our employees are the heart of Leisure Care communities, working to make our communities feel just like home. Our teams work together to bring premier dining, personalized fitness, and eng

The Woodlake Our hospitality based care services and superstar employees (like you!) inspire new and creative ways of doing business and serving our residents and their families. Our employees are the heart of Leisure Care communities, working to make our communities feel just like home. Our teams work together to bring premier dining, personalized fitness, and engaging ac

The Ackerly at Reed's Crossing At Leisure Care managed communities, our hospitality based care services and superstar employees (like you!) inspire new and creative ways of doing business and serving our residents and their families. Our employees are the heart of Leisure Care communities, working to make our communities feel just like home. Our teams work together to brin