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Contract Sep 29, 2023 Other Area(s) PME is seeking a bilingual (English/Spanish) Sales Coordinator to take inbound/outbound calls, assisting with back-end tasks. Position is fully remote and the hours of operations are M-F 6:00 am to 6:00 pm MST local time, however, shifts can vary based on business needs. Should have some flexibility with start/end times.
Must Have Skills:
The ability to work independently within a structured team is essential to the position. This will require a successful applicant to be self-starting, able to prioritize tasks, be a good communicator and flexible. Exemplary Customer Service skills is a MUST.
Job Description:
• Handles new broker applications, enrollment forms.
• Educates Brokers on plan benefits in all markets.
• Makes sure CMS requirements are being met in the aforementioned processes.
• Answers In-bound phone calls – Develop and maintain single point of contact by answering inquiries from National Brokers regarding application submittals, Medicare Advantage products, and supply requests and fulfillment.
Required Years of Experience:
1-3 Years with Medicare & Customer Service
Required Licensure / Education:
High school diploma or GED
Contract Sep 28, 2023 Administrative > • Effectively takes meeting minutes/notes by documenting key topics, decisions and action items.
> • Proficient in Microsoft office suite: PowerPoint, Excel, Word, Outlook etc.
> • Able to complete a repetitive process with consistency and accuracy (for example, weekly time monitoring / review)
> • Attention to detail
> • Ability to meet deadlines
> • Effectively manages time
> • Experience using JIRA, Alteryx, Confluence, or Power BI is a plus
> • Experience in healthcare is a plus
> • Experience in State and Local government is a plus
> • Experience in Medicaid is a plus
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Indianapolis, Indiana
Contract Sep 27, 2023 Healthcare Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement opportunities.
Assist with quality improvement initiatives in the service and clinical areas Coordinate, complete, and update management on clinical quality metrics and HEDIS processes and results
Establish and maintain an action plan to improve HEDIS scores Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
Collaborate with providers and internal departments on rate investigation and validation activities, including maintaining all evidences, documentations, and changes
Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality
Conduct quality audit and maintain all data and process controls to ensure compliance.
Education/Experience:
Bachelor’s degree in related field or equivalent experience.2-4 years of experience Indianapolis
Contract Sep 27, 2023 Healthcare Position Purpose: Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement. *This is a remote opportunity*
Education/Experience: High school diploma or equivalent. 0-2+ years of customer service or medical office experience. Experience with preserved medical record retrieval systems preferred. Billing or coding experience preferred. Beginner level Excel skills.
Responsibilities:
• Assist members with scheduling office visits with primary care provider.
• Retrieves charts from electronic medical record systems and compile medical records to send to other parties for coding.
• Requests medical records by making outbound phone calls to provider groups.
• Completes supplemental medical records requests using Excel files.
• Assist with providing updated member and provider information to vendors.
• Directs medical record requests to the responsible party.
• Resolves outstanding vendor pends within a timely manner by updating member and provider demographics and working with chart load issues.
• Ensure follow up on member appointments or other tasks designated.
• Assist with ad hoc requests. Marion, Indiana
Contract To Hire Sep 25, 2023 Administrative Job Summary
Data Capture Operator is responsible for the accurate capture of the alphabetic, numeric, or symbolic data from electronic images and/or source documents according to the custom developed software application including repair of incorrect data resulting from OCR process (optical character recognition results).
Work Schedule
Monday (9:00 am – 6:00 pm)
Tuesday (9:30 am – 5:30 pm)
Wednesday – Friday (9:00 am – 5:30 pm)
Duties and Responsibilities
The responsibilities of the Data Capture Operator are outlined as follows and no intended to be all inclusive:
Enters alphabetic, numeric, or symbolic data from electronic images utilizing the Captiva InputAccel software application to capture the appropriate data including repairing any rejected characters as a result of the OCR function.
Routes electronic data to next work flow process when completed or in the case of undefined documents or documents that are not able to be indexed, may need to route electronic image to next work flow process.
Responds to inquiries regarding the status of data capture, rejected character repair, or quality assurance phases of the data capture process.
Follows proper procedures, rules, and processes for data capture and quality assurance of the data as outlined in the procedures manual.
Utilizes appropriate and compliant safeguards to reasonably prevent the use or disclosure of confidential and protected information including Protected Health Information (PHI) and Personally Identifiable Information (PII) and reports any concerns to the Document Center Operations Manager.
Data Capture Operator must be a team player and required to assist the entire team in meeting the Key Performance Indicators (KPI) requirements.
90% of documents are scanned, indexed and entered into the database on the same business day of receipt by Doc Center if received prior to 7:15 pm.
90% of documents are scanned, indexed and entered into the database by Noon of the following business day if received after 7:15 pm.
100% of documents are scanned within two business days of receipt by Doc Center.
Competencies
To perform the job successfully, an individual should demonstrate the following competencies:
Quality: Demonstrates accuracy and thoroughness; looks for ways to improve and promote quality; applies feedback to improve performance; monitors own work to ensure quality. Must meet standards of quality that are required to meet the service levels and performance standards outlined in the SLA/KPI’s.
Quantity: Meets productivity standards; completes work in timely manner; strives to increase productivity; works accurately and efficiently.
Dependability: Follows instructions; responds to management direction; takes responsibility for own actions; maintains the production schedule requirements; commits to extended hours of work when necessary to reach daily production schedules and meets the daily service levels and performance standards; completes tasks on time or notifies supervisor of any potential delays or inabilities to meet the daily service levels and performance standards (SLA/KPI) requirements.
Adaptability: Adapts to changes in the work environment; manages competing demands; changes approach or method as directed by supervisor; exhibits ability to deal with change or unexpected events.
Job Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily, with or without accommodations. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Education/Experience
Previous work experience helpful.
High School Diploma or equivalent required.
Essential Functions: Knowledge, Skills, Abilities
Proficient computer skills
Ability to track work and document routinely
Manual dexterity with proficient hand-eye coordination
Excellent verbal communication skills
Regular and timely attendance on the job
Physical Demands and Work Environment
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to sit, talk, hear, and use hands to write, type, handle, or feel. Specific vision abilities required by this job include close vision. Specific lifting requirements include ability to lift and move trays weighing up to 20 pounds.
The noise level in the work environment is usually moderate and the work environment includes proximity to many individuals like a public environment.
Fort Wayne, Indiana
Contract Sep 21, 2023 Industrial We are looking for someone who is accurate, capable of documentation, inventory control, preparing shipments, basic computer skills, and able to work independently with a professional attitude and overall good work ethic.
Job Description:
Responsible for effective flow of finished goods from production to loading delivery vehicles, in keeping with customer specifications and service delivery standards. Ensure contents of each pallet and shipping box are correctly filled packaged, loaded and priority identified prior to leaving the facility. Serve as primary point of contact for shipping/receiving related activities.
• Create packing lists and bills of lading
• Schedule shipments, including contacting LTL carriers (less than truck load, such as XPO Logistics, etc.)
• Utilize 3M, UPS, and FedEx Third Party shipping software, including charge shipping costs to correct party
• Package and ship for the 3M SRG (Short-Run Graphics) program
• Build pallets per customer specification
• Alerting management when shipping supplies are needed well in advance of when they are needed
• Safe operation of forklift
• Refrain from distracting co-workers in the course of production/work
• Warehouse management
? Pull needed supplies from the off-site warehouse before product is needed onsite
? Move materials from on-site warehouse to production areas on-site as required
? Consolidate pallets in on-site warehouse where possible to create space and better organization
Main Areas of Responsibility
1. Shipping: Assemble loads for shipment. Ensure load placement is near shipping doors to minimize forklift travel and obstruction of other plant activities. Complete shipping request and other documentation (i.e. notice, manifest, packing slips, labels, customs paperwork, NAFTA, Bill of Lading, courier paperwork). Order trucks for pickup and ensure driver receives and signs required documentation upon arrival. Load shipment to correct tractor trailers in accordance with customer specifications. Ensure load is stable and secure for safe transit. Maintain safe distances and movement frequencies between workstations in preparation for shipment.
2. Receiving: Offload incoming goods and store them safely in temporary locations. Move items to storage points. Take all reasonable precautions against shipping discrepancies on part of suppliers (e.g. metal, sheeting). Keep receiving area clear to avoid obstructing plant activities. Ensure space is maintained to offload incoming goods. Note missing/damaged/defective items on shipping papers from transport drivers, refusing the shipment if warranted through discussion with supervisor.
3. Palletizing: Ensure safe, efficient operation of palletizing equipment in movement of work orders per production schedule and shipping requirements. Stack pallets in pattern specified by the customer. Use hand wrapper to keep pallet stable during transit to wrapping machine. Wrap pallet securely and follow customer specifications (e.g. insert ID documents beneath wrap, place stickers or pallet numbers, weights, etc.).
4. Inventory: assist in physical inventory count such as checking contents of shipped product against purchase orders to verify stock and identify losses. Complete aluminum inspection procedures.
5. Record keeping: Maintenance of shipping/receiving related documentation. Ensure timely distribution to internal departments.
Desired Skills:
Microsoft Excel, Word New York
Contract Sep 12, 2023 Other Area(s) PME is looking for a bilingual Case Manager III (Licensed RN, LCSW, or LMSW) to be responsible for health care management and coordination of healthcare members. Candidates MUST reside in NYC Tri State area (New York, New Jersey, Connecticut) and be Licensed RN, LCSW, LMSW in NY STATE. Schedule is M-F, 8am-5pm EST | Mostly Remote as there will be some in person mandatory training.
Essentials
Conduct monthly calls to members and review/create person centered service plans and coordination of care.
Provides the Interdisciplinary Care Team (ICT) with assessment information and act as facilitator to ensure that members’ needs are met.
Develop an ICP/PCSP based on members’ clinical, behavioral, and social needs that addresses barriers to care.
Competently assesses members’ health status and ensures that member is receiving all necessary medical and supportive services.
Clarifies SWH plan medical benefits, policies and procedures for members, providers and community-based agencies.
Adhere to SWH documentation policies and procedures including documentation of clinical assessment activities and their effectiveness.
Maintain a comprehensive working knowledge of community resources, payer requirements, and network services for target population.
Required Education | Experience:
Bachelor’s degree in Nursing or Master’s degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree).
5-7 years of clinical experience with case management experience.
Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing. A combination of experience and education will be considered in lieu of LCSW or APSW.
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Louisville, Kentucky
Contract Sep 8, 2023 Administrative Administrative Specialist is responsible for ensuring that all new hire contractors and subcontractor personnel meet the requirements of the C2 Level of Trust Clearance, aligned with DoD directives
-Provide systems access to Government associates, subcontractors, and government staff with appropriate on-line applications via security passwords and access levels to ensure system integrity
- Responsible for the coordination, administration and auditing of systems access activities
-Granting access to EQIP system through data entry
-Troubleshooting system application issues by speaking with applicants and answering questions
**This is an onsite position in Louisville, KY. This position is a 6 month contract**
Responsibilities Include:
Data Entry
Gaining appropriate clearance levels for new hires
Provide systems access to associates, subcontractors, and government staff with appropriate on-line applications via security passwords and access levels to ensure system integrity
Experience with using MS Office (Outlook, Excel, Access, Word, etc…).
Ability to work out of multiple databases.
Act independently to work with associates needing to complete the Electronic Questionnaires for Investigations Processing (e-QIP) process.
Requirements
Qualifications:
Bachelor’s Degree preferred
2+ years of administrative experience.
Ability to demonstrate strong attention to detail
1+ year customer service experience
US Citizenship required
Expertise in customer service, written and verbal skills.
Requirements:
Bachelor degree preferred
Must be able to pass a Federal background check and drug screen
Must meet all requirements to receive C2 Level of Trust
Experience utilizing Microsoft Office Suite applications
Comfortable with high levels of data entry
PME is an Equal Employment Opportunity Employer and does not discriminate based on race, color, religion, national origin, gender, sexual orientation, gender identity, age, physical or mental disability, genetic factors, or military/veteran status. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status or on the basis of disability. Indianapolis, Indiana
Contract Sep 7, 2023 Healthcare Act in a liaison role with Medicaid members to ensure appropriate care is accessed as well as provide social assessments and member education for Medicaid members. Will live and work in Indiana.
• Create a positive experience and relationship with the Medicaid members
• Keep the member out of the hospital by supporting regular visits to their primary physician
• Keep member actively engaged with their primary physician
• Complete New Member process (Welcome Call, Demographic Research, Medical Screenings, and scheduling Health Risk Assessments for members)
• Keep the member out of the hospital by supporting regular visits to their primary physician
• Keep member actively engaged with their primary physician
• Support the member to access their healthcare benefits
• Provide member education
• Support transitions of care
• Partner with care team when needed (community, providers, internal staff)
• Knowledge and continued learning of community cultures and values
• Will seek out members that have had minimal contact with the organization and try to re-establish relationships
• Proactively engage the member to manage their care
• Provide member education
• Support transitions of care
• Help to keep members compliant with their care plans
• Partner with care team (community, providers, internal staff)
• Knowledge and continued learning of community cultures and values
• Conduct individual - level assessments to capture member's current health care needs (e.g. Transitions of Care, Health Risk assessments)
• Engage member to participate in the assessment process and collaboratively develop plan of care based on their individual needs, preferences, and objectives
Requirements
Required:
• Resided within the local community for 2+ years
• Knowledge of culture and values of community
• Familiarity with the resources available in the community
• Reliable transportation that will enable you to travel to client and/or patient sites within a designated area
• Ability to travel locally (up to 75%)
• Availability to work Monday through Friday, 8 AM to 5 PM
• Bachelor’s degree (or higher) in Social Work and/or Health Care Administration
• Licensed Practical Nurse (LPN), Certified Nursing Assistant / Home Health Aide, Medical Assistant
• CHW Accreditation
• Experience working in Managed Care
• Knowledge of Medicaid population
• Bilingual in Spanish and English
Contract Aug 21, 2023 Other Area(s) PME is looking for a bilingual (English|Mandarin or Cantonese) Case Manager III with MLTC experience to be responsible for health care management and coordination of healthcare members. Candidates may live within the United States; however, they need to have a NY licensee to work with NY members. Schedule is M-F, 8am-5pm EST | 100% Remote ** MUST reside in EST time zone and be fluent in English/Mandarin or Cantonese. High potential for temp to perm opportunity.
Essentials
Provides the Interdisciplinary Care Team (ICT) with assessment information and act as facilitator to ensure that members’ needs are met.
Develop an ICP/PCSP based on members’ clinical, behavioral, and social needs that addresses barriers to care.
Competently assesses members’ health status and ensures that member is receiving all necessary medical and supportive services.
Modify ICP/PCSP as appropriate to member’s needs and progress.
Manage care transitions through effective and timely communication necessary for member care and discharge planning.
Clarifies SWH plan medical benefits, policies and procedures for members, providers and community-based agencies.
Prepare for and participate in clinical case reviews to share best practices.
Adhere to SWH documentation policies and procedures including documentation of clinical assessment activities and their effectiveness.
Maintain a comprehensive working knowledge of community resources, payer requirements, and network services for target population.
Required Education | Experience:
Bachelor’s degree in Nursing or Master’s degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree).
5-7 years of clinical experience with case management experience.
Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing. A combination of experience and education will be considered in lieu of LCSW or APSW.
Experience with Geriatric Population in preferred but not mandatory
Must be able to fluently speak any of the following languages: English/Korean/Mandarin, or Cantonese.
Bronx, New York
Contract Aug 16, 2023 Other Area(s) PME is seeking an RN Care Manager to conduct UAS Assessments to support care management. Candidates will be assigned a minimum of 13-15 cases per week. The position will be a field position, and candidates must be local to Westchester/Bronx/New Rochelle/Manhattan in New York as field visits will be completed within these territories. ***MUST be UAS Certified and bilingual (Chinese, Korean, Bengali, Spanish).
Essential Functions/Responsibilities:
UAS Certified RN licensed in the state of NY.
Conduct face to face assessments of members’ functional status, medical, behavioral, psychosocial and community resource needs.
Provides the Interdisciplinary Care Team (ICT) with assessment information and acts as facilitator to ensure that members’ needs are met.
Develop an ICP/PCSP based on members’ clinical, behavioral, and social needs that addresses barriers to care.
Competently assesses members’ health status and ensures that member is receiving all necessary medical and supportive services.
Manage care transitions through effective and timely communication necessary for member care and discharge planning.
Clarifies SWH plan medical benefits, policies and procedures for members, providers and community-based agencies.
Maintain a comprehensive working knowledge of community resources, payer requirements, and network services for target population.
Skills/Aptitudes:
Strong professional level of knowledge and comprehensive clinical assessment skills in the adult population and chronic disease management
Ability to work independently and maintain flexibly in fast paced environment.
Excellent communication skills
Self-starter with high level of accountability and responsibility for outcome of care
Strong computer skills: competent in Microsoft Office Products (Outlook, Word, Excel)
Ability to analyze data and use it to improve care delivery.
Required Education:
Bachelor's Degree (a combination of experience and education will be considered in lieu of degree).
Required Licensure/Certification:
NY State RN License in good standing.
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
Indianapolis, Indiana
Contract May 9, 2023 Healthcare Seeking a CNA to work as PRN (on as needed basis). CNA will accurately administer authorized medications and treatments. Conducts and assists with nursing programs as assigned. Performs a variety of tasks associated with the daily care and treatment of patients. Works under the clinical supervision of a licensed nurse to provide patient care, helping patients meet their physical and emotional needs.For Day/nigh
Job Responsibilities:
Administers and documents authorized medications and treatments per hospital policies and procedures.
Reports side effects of medications to RN.
Recognizes the potential need for a prn medication and reports the need to RN.
Follows controlled substance procedures.
Carries out or assists with physical care of patients including bathing, feeding, taking vital signs, heights, weights and other activities of daily living as indicated.
Maintains current CPR and Bridge Building certifications.
Initiates and participates in therapeutic interventions by using principles of de-escalation, redirection and approved Bridge Building techniques for prevention and management of behavior.
Escorts patients to and from therapies, and other areas of the hospital for treatment and programming.
Escorts and/or drives patients to off-grounds appointments and activities.
Observes patients’ physical condition and reports changes to the RN.
Appropriately and accurately reports pertinent information, both verbal and written.
Appropriately applies skills in psychosocial care of patients: Encourages patients and interacts with them to socialize and participate in activities and programming.
Serves as a role model for appropriate behavior to patients.
Demonstrates the ability to deal therapeutically with adverse behavior.
Recognizes psychiatric emergencies and intervenes appropriately.
Participates in conducting active treatment programs.
Provides care according to treatment plan objectives and goals.
Observes and accurately documents on medical record and flow sheets, using proper format and terminology.
Follows safety standards and precautions, policies, procedures and regulations.
Safely demonstrates the ability to apply restraint/seclusion procedures per policy.
Demonstrates consistent interactions and approaches with patients and co-workers, promoting dignity and respect.
Demonstrates the ability to set appropriate healthy boundaries and limitations according to individual treatment plans.
Properly and consistently utilizes standard precautions.
Completes unit housekeeping duties as assigned/indicated.
Serves on hospital committees and work groups as requested.
Attends required hospital/department in services.
Job Requirements:
High school diploma or GED
Basic computer skills are required.
Maintain current CPR
Bridge Building certification.