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Contract Sep 18, 2025 Healthcare Description
BKG is looking for a full-time LTSS Service/Care Coordinator – Clinician to join our team. This role offers a 50/50 split between travel and home-based work, with pay based on licensure. You’ll receive 80 hours of PTO after 90 days, 10 paid holidays, health, dental, and vision insurance, supplemental coverage options, and a 401k. If you enjoy making an impact in the community while also having time to work from home, this could be the perfect fit.
Full-Time LTSS Service/Care Coordinator – 50/50 Travel & Home | Pay Based on Licensure | PTO, 10 Paid Holidays, Full Benefits & 401k
Location: Marion county and surrounding counties spend 4-5 days per week in-person with patients, members or providers.
The LTSS Service/Care Coordinator Float – Clinician has overall responsibility for the member's case, IN PathWays for Aging program, as required by applicable state law and contract, contributes to the LTSS care/service coordination process by performing activities within the scope of licensure including, for example, assisting with telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.
How you will make an impact:
· Assists in identifying members for high-risk complications.
· Obtains clinical data and assists in identifying members that would benefit from an alternative level of care or other waiver programs.
· Verifies and interprets the information, conducts additional assessments, as necessary, and develops, monitors, evaluates, and revises the member's care plan to meet the member's needs.
· Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed, and in conjunction with the member and the health care team, to ensure cost effective and efficient utilization of health benefits.
· Decision making skills will be based upon the current needs of the members and require an understanding of disease processes and terminology and the application of clinical guidelines.
· Conducts initial assessments to include identification of desired home and community-based services and applicable providers to render services for those members invited to join the PathWays Waiver program.
· Supports coverage of caseloads as a float coordinator, as necessary.
Requirements
Minimum Requirements:
· Requires an RN, LSW, LCSW, or LMSW in accordance with applicable state law and Nursing Diploma or AS in Nursing or a related field and minimum of 2 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Care/Service Coordinator or similar role; or any combination of education and experience, which would provide an equivalent background.
· Experience working with older adults in care management, provider or other capacity, highly preferred
· Experience managing a community and/or facility-based care management case load, highly preferred
· Current, unrestricted RN, LSW, LCSW, LMSW (as allowed by state law) in applicable state(s) required.
· The health and safety of our associates, members, and communities is a top priority for Anthem. To minimize the risk of transmission of the COVID-19 virus and maintain a safe and healthy workplace, vaccination is required for this patient/member-facing role.
Preferred Skills, Capabilities and Experiences:
· May require state-specified certification based on state law and/or contract.
· Travels to worksite and other locations as necessary.
Salary Description
$39.90-$43.00/hr Contract Sep 18, 2025 Healthcare Description
BKG is looking for a full-time LTSS Service/Care Coordinator – Clinician to join our team. This role offers a 50/50 split between travel and home-based work, with pay based on licensure. You’ll receive 80 hours of PTO after 90 days, 10 paid holidays, health, dental, and vision insurance, supplemental coverage options, and a 401k. If you enjoy making an impact in the community while also having time to work from home, this could be the perfect fit.
Full-Time LTSS Service/Care Coordinator – 50/50 Travel & Home | Pay Based on Licensure | PTO, 10 Paid Holidays, Full Benefits & 401k
Location: Marion county and surrounding counties spend 4-5 days per week in-person with patients, members or providers.
The LTSS Service/Care Coordinator Float – Clinician has overall responsibility for the member's case, IN PathWays for Aging program, as required by applicable state law and contract, contributes to the LTSS care/service coordination process by performing activities within the scope of licensure including, for example, assisting with telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.
How you will make an impact:
· Assists in identifying members for high-risk complications.
· Obtains clinical data and assists in identifying members that would benefit from an alternative level of care or other waiver programs.
· Verifies and interprets the information, conducts additional assessments, as necessary, and develops, monitors, evaluates, and revises the member's care plan to meet the member's needs.
· Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed, and in conjunction with the member and the health care team, to ensure cost effective and efficient utilization of health benefits.
· Decision making skills will be based upon the current needs of the members and require an understanding of disease processes and terminology and the application of clinical guidelines.
· Conducts initial assessments to include identification of desired home and community-based services and applicable providers to render services for those members invited to join the PathWays Waiver program.
· Supports coverage of caseloads as a float coordinator, as necessary.
Requirements
Minimum Requirements:
· Requires an RN, LSW, LCSW, or LMSW in accordance with applicable state law and Nursing Diploma or AS in Nursing or a related field and minimum of 2 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Care/Service Coordinator or similar role; or any combination of education and experience, which would provide an equivalent background.
· Experience working with older adults in care management, provider or other capacity, highly preferred
· Experience managing a community and/or facility-based care management case load, highly preferred
· Current, unrestricted RN, LSW, LCSW, LMSW (as allowed by state law) in applicable state(s) required.
· The health and safety of our associates, members, and communities is a top priority for Anthem. To minimize the risk of transmission of the COVID-19 virus and maintain a safe and healthy workplace, vaccination is required for this patient/member-facing role.
Preferred Skills, Capabilities and Experiences:
· May require state-specified certification based on state law and/or contract.
· Travels to worksite and other locations as necessary.
Salary Description
$39.90-$43.00/hr
Contract Sep 18, 2025 Healthcare Care Coordination Assistant Director
Location: Indianapolis, IN preferred (Hybrid for some travel throughout the year into Indianapolis – must be based in Central Indiana for onsite partner engagement as needed)
Hours: Monday-Friday 8-5
Benefits: Health, Dental, and Vision, supplemental insurance, 401k
80 hours of PTO after 90 days
10 paid holidays
Pay: $110,000/annual
We’re looking for a seasoned clinical leader to join our Care Coordination team as an Assistant Director. This role will support daily operations and lead cross-functional initiatives aimed at improving care outcomes for Medicaid members age 60+ as well as moderating work groups to keep maximum engagement and efficiency. You’ll work closely with the Care Coordination Director and other leaders across the organization to support compliance, manage interdisciplinary teams, and keep strategic projects moving forward.
This is a great fit for someone who is collaborative, detail-oriented, and passionate about person-centered care—especially in long-term services and supports (LTSS) and home-based care. Looking for someone who is flexible and able to pivot in an ever changing environment.
Key Responsibilities
Serve as a thought partner to the Care Coordination Director; help prioritize and execute department needs
Provide clinical advisement to managers and support change management efforts across the team
Support and sometimes lead cross-functional workgroups to maintain momentum on key initiatives
Monitor and manage escalations, ensuring appropriate clinical and operational follow-up
Act as a secondary business owner for multiple care coordination reports; assist with report interpretation and follow-through
Support audit preparation and ensure compliance with contract and regulatory requirements
Review and enhance desktop procedures for clinical workflows
Facilitate monthly membership reviews to assess staffing needs, case loads, and program capacity
Lead the Community Health Worker (CHW) referral process and oversee workflows in the nursing facility (NF) setting
Moderate focus groups and surface clinical concerns from the field by staying closely connected with Interdisciplinary Care Teams (ICTs) statewide
Required Qualifications
RN Licensure in Indiana (active and in good standing)
Minimum 5 years of clinical experience, preferably in community-based or long-term care settings
Proven leadership or supervisory experience with clinical teams, including staffing oversight
Experience with geriatric populations, behavioral health, substance use disorder (SUD), and LTSS
Strong background in care management, including interdisciplinary care team coordination
Hands-on experience with managed Medicare and/or Medicaid
Previous involvement in program implementation or operational rollouts
Proficiency in Microsoft Outlook, Excel, and Teams
Willingness and ability to travel within Indiana occasionally and be present onsite in Indianapolis as needed
Salary Description
$50-$54 Contract Sep 18, 2025 Healthcare Position Name: Grievance and Appeals Nurse
Location: Must Reside in Indiana, designated remote work position
Hours: Monday-Friday 8-5pm OR
Tuesday - Saturday (Saturday's are half days)
4 (9HR shifts) 7am-5:00pm
8am-6:00pm
9am-7:00pm
Pay $90,000k health, dental, and vision offered. 401k available. 80 hours of PTO and paid holidays
Job Description
Responsible for investigating and processing the most complex grievances and appeals requests from members and providers.
Primary duties may include, but are not limited to:
Conducts investigations and reviews of member and provider medical necessity appeals.
Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity.
Extrapolates and summarizes medical information for medical director, consultants and other external review.
Prepares recommendations to either uphold or deny appeal and forwards to Medical Director for approval.
Ensures that appeals and grievances are resolved timely to meet regulatory timeframes.
Documents and logs appeal/grievance information on relevant tracking systems and mainframe systems.
Generates written correspondence to providers, members, and regulatory entities.
Utilize leadership skills and serves as a subject matter expert for appeals/grievances/quality of care issues and is a resource for clinical and non-clinical team members in expediting the resolution of outstanding issues.
Requirements
Requires 2 years of experience in a managed care healthcare setting; or any combination of education and experience, which would provide an equivalent background.· Behavioral Health experience
Current active unrestricted RN license to practice as a health professional within the scope of licensure in IN·
Requires strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
MCG (Milliman Care Guidelines) experience
CMCN (Certified Managed Care Nurse) certification strongly preferred
AS required/BS in Nursing preferred.
Salary Description
90,000 Contract Sep 17, 2025 Call Center Job Title: Customer Service Representative (Outbound)
Location: Indianapolis, IN (Remote)
Pay: $14hr
A customer service representative, or CSR, will act as a liaison, provide services information, and resolve any emerging problems that our customer accounts might face with accuracy and efficiency. The best CSRs are genuinely excited to help customers. They’re patient, empathetic, and passionately communicative. They love to talk. Customer service representatives can put themselves in their customers’ shoes and advocate for them when necessary. Problem-solving comes naturally to customer care specialists. They are confident at troubleshooting and investigate if they don’t have enough information to resolve customer complaints. The target is to ensure excellent service standards, respond efficiently to customer inquiries and maintain high customer satisfaction.
Each representative will be a part of an incentive program that pays out weekly (in addition to base pay)
Must be able to work a fixed 8 hr shift between 8am-8pm
Candidate must reside in Indiana
All equipment will be provided to each representative to work remotely
Requirements:
Manage large amounts of outgoing calls to welcome members
Identify and assess customers’ needs to achieve satisfaction
Build sustainable relationships and trust with customer accounts through open and interactive communication
Provide accurate, valid, and complete information by using the right methods/tools
Meet personal/customer service team targets and call handling quotas
Handle customer complaints, provide appropriate solutions and alternatives within the time limits; follow up to ensure resolution.
Keep records of customer interactions, process customer accounts and file documents
Follow communication procedures, guidelines, and policies
Take the extra mile to engage customers
Ability to create and maintain a professional remote work environment/area
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. Contract Sep 16, 2025 Other Area(s) Medicaid Housing Coordinator Job Description
Location: This position is remote and requires some travel to residency sites as necessary. Residency in Indiana is required.
We are looking for a driven and empathetic individual who is committed to making a difference in the lives of our members. If you are passionate about affordable housing and possess the qualifications we seek, we encourage you to apply and become part of a team striving to create lasting positive change.
Position Summary:
We are seeking a compassionate and dedicated Medicaid Housing Coordinator to join our team. This role will focus on improving housing solutions for our Medicaid members experiencing housing instability. The ideal candidate will work collaboratively with community partners, healthcare providers, government agencies and internal teams to ensure access to safe and affordable housing for clients. The ideal candidate will have a strong understanding of Medicaid policies, housing resources, and case management practices.
Key Responsibilities include, but are not limited to:
Lead the design, implementation, and oversight of housing programs aimed at supporting Medicaid members facing homelessness.
Act as a subject matter expert, offering guidance and solutions to internal teams on housing-related challenges.
Collaborate with interdisciplinary teams to provide holistic and integrated service delivery to members.
Cultivate and maintain strong partnerships with shelters, housing providers property developers, and local authorities to expand housing options.
Customize housing solutions to meet the unique needs of members, ensuring accessibility and sustainability.
Monitor and evaluate program effectiveness, making data-driven adjustments as needed.
Provide training and support to case management teams on housing resources and transition strategies.
Serve as a liaison with community organizations and stakeholders to address housing issues and identify opportunities for collaboration.
Requirements
Minimum Requirements:
Bachelor’s degree in Social Work, Human Services, Public Health, Urban Planning, or a related field. Equivalent experience will be considered.
A minimum of 2 years of experience in case management, housing coordination, or a similar role.
Knowledge of Medicaid regulations and eligibility requirements.
Experience working with diverse populations, including individuals with disabilities and low-income families.
Excellent communication, organizational, and interpersonal skills.
Ability to work independently as a part of a team in a dynamic environment.
Valid driver’s license and reliable transportation for travel to client meetings and housing sites
Preferred Qualifications:
Licensed Social Worker (LSW) certification.
Familiarity with local housing resources, services, and community-based organizations.
Bilingual or multilingual abilities.
Experience in developing or managing affordable housing projects.
Familiarity with Medicaid programs and Social Determinants of Health (SDoH).
Strong organizational, communication, and interpersonal skills.
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Contract Sep 15, 2025 Other Area(s) Medicaid Housing Coordinator Job Description
Location: This position is remote and requires some travel to residency sites as necessary. Residency in Indiana is required.
We are looking for a driven and empathetic individual who is committed to making a difference in the lives of our members. If you are passionate about affordable housing and possess the qualifications we seek, we encourage you to apply and become part of a team striving to create lasting positive change.
Position Summary:
We are seeking a compassionate and dedicated Medicaid Housing Coordinator to join our team. This role will focus on improving housing solutions for our Medicaid members experiencing housing instability. The ideal candidate will work collaboratively with community partners, healthcare providers, government agencies and internal teams to ensure access to safe and affordable housing for clients. The ideal candidate will have a strong understanding of Medicaid policies, housing resources, and case management practices.
Key Responsibilities include, but are not limited to:
Lead the design, implementation, and oversight of housing programs aimed at supporting Medicaid members facing homelessness.
Act as a subject matter expert, offering guidance and solutions to internal teams on housing-related challenges.
Collaborate with interdisciplinary teams to provide holistic and integrated service delivery to members.
Cultivate and maintain strong partnerships with shelters, housing providers property developers, and local authorities to expand housing options.
Customize housing solutions to meet the unique needs of members, ensuring accessibility and sustainability.
Monitor and evaluate program effectiveness, making data-driven adjustments as needed.
Provide training and support to case management teams on housing resources and transition strategies.
Serve as a liaison with community organizations and stakeholders to address housing issues and identify opportunities for collaboration.
Requirements
Minimum Requirements:
Bachelor’s degree in Social Work, Human Services, Public Health, Urban Planning, or a related field. Equivalent experience will be considered.
A minimum of 2 years of experience in case management, housing coordination, or a similar role.
Knowledge of Medicaid regulations and eligibility requirements.
Experience working with diverse populations, including individuals with disabilities and low-income families.
Excellent communication, organizational, and interpersonal skills.
Ability to work independently as a part of a team in a dynamic environment.
Valid driver’s license and reliable transportation for travel to client meetings and housing sites
Preferred Qualifications:
Licensed Social Worker (LSW) certification.
Familiarity with local housing resources, services, and community-based organizations.
Bilingual or multilingual abilities.
Experience in developing or managing affordable housing projects.
Familiarity with Medicaid programs and Social Determinants of Health (SDoH).
Strong organizational, communication, and interpersonal skills.
Contract Sep 12, 2025 Healthcare
Outreach Resources: Provide resources who are trusted members of the communities served and/or have an unusually close understanding of the communities to facilitate access to health care services, improve the quality and cultural competency of those services, and improve member health outcomes. Outreach Coordinator Resources work to increase health literacy, reduce costs of services, and improve care.
Pay Rate $20.00 hrly.
Monday - Friday 8:00-5:00 pm
Work remotely and local Travel is required
Job Description
The overall approach for outreach workers is fluid and flexible based on identified quality and member outcome needs. The primary focus of the Outreach resources will be as follows:
Understand Member history and the physical, behavioral, and social factors that may be leading to less-than-ideal health outcomes or persistent gaps in care.
Utilize a whole health approach when interacting with Members and caregivers.
Working with Case Management to place outreach resources at point of care facilities to better facilitate member engagement and action.
Facilitate real time gap closure initiatives including but not limited to immunizations, telehealth visits, A1c tests, lead tests, and blood pressure readings.
Pivot priorities as necessary month to month based on HEDIS performance.
Engage member in care coordination and case management as necessary.
Educate member on health care benefits and services and monitor for over and/or underutilization.
Requirements:
Vaccinated Covid and Flu
Home Visits Required
Driver’s License required
High School Diploma/GED required
Preferred:
Community Outreach Experience preferred
Contract Sep 12, 2025 Healthcare Outreach Resources: Provide resources who are trusted members of the communities served and/or have an unusually close understanding of the communities to facilitate access to health care services, improve the quality and cultural competency of those services, and improve member health outcomes. Outreach Coordinator Resources work to increase health literacy, reduce costs of services, and improve care.
Pay Rate $20.00 hrly.
Monday - Friday 8:00-5:00 pm
Work remotely and local Travel is required
Job Description
The overall approach for outreach workers is fluid and flexible based on identified quality and member outcome needs. The primary focus of the Outreach resources will be as follows:
Understand Member history and the physical, behavioral, and social factors that may be leading to less-than-ideal health outcomes or persistent gaps in care.
Utilize a whole health approach when interacting with Members and caregivers.
Working with Case Management to place outreach resources at point of care facilities to better facilitate member engagement and action.
Facilitate real time gap closure initiatives including but not limited to immunizations, telehealth visits, A1c tests, lead tests, and blood pressure readings.
Pivot priorities as necessary month to month based on HEDIS performance.
Engage member in care coordination and case management as necessary.
Educate member on health care benefits and services and monitor for over and/or underutilization.
Requirements:
Vaccinated Covid and Flu
Home Visits Required
Driver’s License required
High School Diploma/GED required
Preferred:
Community Outreach Experience preferred
Contract Sep 10, 2025 Healthcare Job Summary:
Our client is seeks a compassionate Primary Care Physician to provide comprehensive medical care to our long-term psychiatric patient population (ages 18–80+). This unique role emphasizes long-term physician-patient relationships in a collaborative, multidisciplinary environment. Unlike traditional hospitalist roles, you’ll manage a small panel of patients (60–80 total, with
Key Responsibilities:
Deliver primary care services to adults with severe mental illness, including preventive care, chronic disease management, and acute interventions.
Collaborate closely with psychiatrists, psychiatric NPs, nurses, and treatment teams to integrate medical and behavioral health care.
Develop personalized care plans for patients with extended lengths of stay (months to years).
Document care in compliance with TJC standards and participate in quality improvement initiatives.
Mentor and support clinical staff as needed.
Requirements:
Medical Degree (MD/DO) with board certification/eligibility in Family Medicine, Internal Medicine, or Med-Peds.
Preferred: Full, unrestricted Missouri medical license (will consider unlicensed applicants completing training).
Experience in primary care, geriatrics, or chronic disease management preferred; new graduates welcome.
Ability to thrive in a team-based setting with psychiatrists and behavioral health professionals.
Contract Sep 10, 2025 Healthcare Licensed Practical Nurse (LPN), Washington, DC
shifts are structured as split shifts. A staff member may work up to two split shifts per day. For example:
AM Shift: 5:00 AM – 9:30 AM
PM Shift: 3:30 PM – 7:00 PM
Position Summary:
We are seeking a compassionate and dedicated Licensed Practical Nurse (LPN) to provide essential medical support and supervision during the transportation of school-aged students with special needs. This critical role ensures the health, safety, and well-being of our most vulnerable students while they are in transit to and from school. The ideal candidate will be a skilled clinician with a calm demeanor, able to respond to medical needs and manage the unique challenges of a mobile environment.
Key Responsibilities
Direct Patient Care & Medical Support:
Provide direct nursing care to students with special needs as prescribed and in accordance with state LPN practice acts and district policies.
Monitor students' physical and emotional status throughout transport, identifying and responding to changes in condition.
Manage and respond to medical emergencies and follow established emergency action plans.
Operate and maintain specialized medical equipment (e.g., ventilators, oxygen tanks, feeding pumps, monitors) securely within the vehicle.
Safety & Compliance:
Ensure all students are properly secured in their safety restraints, car seats, or wheelchair security systems according to state law and individual student plans.
Maintain a clean, sanitized, and safe environment on the bus to prevent the spread of infection.
Adhere strictly to HIPAA and FERPA regulations, maintaining student confidentiality at all times.
Communication & Documentation:
Communicate effectively with parents/guardians at pickup and drop-off regarding the student's condition, needs, or any incidents that occurred during transport.
Provide a clear and concise report to school nurses, teachers, and aides upon arrival at school and at the end of the day.
Maintain accurate, detailed daily logs of care provided, student observations, medication administration, and incident reports.
Operational Duties:
Ride the school bus or specialized transport vehicle on assigned routes.
Assist the bus driver with loading, unloading, and positioning of students.
Manage student behavior to ensure a safe and calm environment for all riders.
Qualifications Required:
Current and valid Licensed Practical Nurse (LPN) license in the state of District of Columbia.
Current CPR and First Aid certification.
Valid driver's license with a clean driving record.
Minimum of 1-2 years of nursing experience, preferably in school nursing, emergency care, or with individuals with special needs.
Ability to lift, position, and assist students of various sizes and with physical disabilities (e.g., transferring to and from wheelchairs).
Preferred:
Experience in a school setting or with pediatric patients.
Knowledge of common childhood disabilities and medical conditions.
Training in behavior management or de-escalation techniques.
Skills & Abilities:
Exceptional clinical assessment and critical thinking skills.
Strong interpersonal and communication skills to interact with children, parents, and school staff effectively.
Patience, empathy, and a nurturing demeanor.
Ability to remain calm and make sound decisions under pressure in a mobile environment.
High level of organization and attention to detail for documentation and compliance.
Working Conditions
Work is performed primarily inside a school transportation vehicle.
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Data & Operations Analyst
Location: Remote within Indiana 25% Travel
Hours: Standard business hours M-F 8am-5pm
Benefits: Health, dental, and vision benefits, 80 hours of PTO, 10 paid holidays, 401k, and supplemental insurance
About the Role
As the LTSS Provider Data & Operations Analyst, you’ll be the go-to expert for ensuring the accuracy, integrity, and optimization of provider data that powers our Long-Term Services and Supports (LTSS) network. Your work will directly impact how providers are onboarded, supported, and connected to the individuals they serve.
You’ll analyze complex datasets, resolve data issues, improve processes, and work closely with both internal teams and external partners to ensure smooth operations and regulatory compliance. This is a role for someone who is detail-oriented, analytical, and collaborative — with the drive to turn data into actionable insights that improve outcomes.
What You’ll Do
Analyze LTSS provider data to track performance, identify trends, and create actionable reports for leadership and partners.
Conduct regular audits to identify data discrepancies, assess downstream impacts, and implement corrections.
Build dashboards and visual tools to support decision-making and monitor provider network health.
Serve as the Subject Matter Expert for LTSS provider data load requirements, ensuring accuracy and consistency across systems.
Partner with LTSS Provider Relations leadership to make provider data updates and resolve related issues.
Maintain alignment between Facets, SPS, and other downstream systems to prevent data conflicts.
Manage and resolve provider data tickets submitted by the local LTSS Provider Relations team.
Collaborate with operations teams to improve provider data workflows and service delivery processes.
Work closely with Provider Data Solutions (PDS) teams to align policies, procedures, and desktop processes.
Lead provider data review meetings to discuss audit results, upcoming changes, roster submissions, and DART loads.
Requirements
Minimum Qualifications
Bachelor’s degree in Health Administration, Data Analytics, or related field (Master’s preferred).
2–3 years of experience in data management, healthcare operations, or similar role.
Proficiency in Excel and experience with SQL, Tableau, or similar data tools.
Understanding of LTSS programs, provider operations, and related regulations.
Strong communication skills and the ability to work with multiple teams.
Exceptional attention to detail and a commitment to data integrity.
Preferred Skills
Healthcare industry experience, ideally with LTSS or Medicaid programs.
Experience with Snowflake and/or advanced SQL queries.
Strong Excel skills, including pivot tables, lookups, and data modeling.
Ability to manage multiple priorities independently.
Project leadership experience.
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Representative
Location: Remote within Merrillville and surrounding counties — 50% travel required
Schedule: Standard business hours M-F 8am-5pm
About the Role
As an LTSS Provider Representative, you’ll be the primary connection between our health plan and the LTSS provider network. You’ll help providers navigate processes, resolve operational challenges, and access the resources they need to deliver high-quality care. This role blends relationship-building, problem-solving, and education to support provider growth, retention, and compliance.
What You’ll Do
Build and maintain strong relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits.
Share program updates, administrative changes, and training opportunities.
Support providers in resolving claims, service, and operational issues by connecting them with the right internal teams.
Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs.
Partner with contracting and other departments to recruit, onboard, and retain LTSS providers.
Lead or participate in provider education sessions, webinars, and office hours.
Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements.
Assist with provider recruitment strategies to meet network needs in assigned regions.
Provide data and insights during contract negotiations.
Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations.
Requirements
Minimum Requirements
Bachelor’s degree preferred and at least 3 years of customer service experience in a provider environment or as a trainer.
Or an equivalent combination of education and experience.
Strong skills in communication, organization, and accountability and comfortable in a team environment
Preferred Skills & Experience
Experience working directly with providers to develop strategies that improve outcomes.
Strong Medicaid LTSS claims knowledge.
Proficiency in Microsoft Office, especially PowerPoint and Excel.
Comfortable presenting to groups of various sizes.
Prior experience in community/home care
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Representative
Location: Remote within Salem and surrounding counties — 50% travel required
Schedule: Standard business hours M-F 8am-5pm
About the Role
As an LTSS Provider Representative, you’ll be the primary connection between our health plan and the LTSS provider network. You’ll help providers navigate processes, resolve operational challenges, and access the resources they need to deliver high-quality care. This role blends relationship-building, problem-solving, and education to support provider growth, retention, and compliance.
What You’ll Do
Build and maintain strong relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits.
Share program updates, administrative changes, and training opportunities.
Support providers in resolving claims, service, and operational issues by connecting them with the right internal teams.
Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs.
Partner with contracting and other departments to recruit, onboard, and retain LTSS providers.
Lead or participate in provider education sessions, webinars, and office hours.
Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements.
Assist with provider recruitment strategies to meet network needs in assigned regions.
Provide data and insights during contract negotiations.
Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations.
Requirements
Minimum Requirements
Bachelor’s degree preferred and at least 3 years of customer service experience in a provider environment or as a trainer.
Or an equivalent combination of education and experience.
Strong skills in communication, organization, and accountability and comfortable in a team environment
Preferred Skills & Experience
Experience working directly with providers to develop strategies that improve outcomes.
Strong Medicaid LTSS claims knowledge.
Proficiency in Microsoft Office, especially PowerPoint and Excel.
Comfortable presenting to groups of various sizes.
Prior experience in community/home care
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Representative
Location: Remote within Fort Wayne and surrounding counties — 50% travel required
Schedule: Standard business hours M-F 8am-5pm
About the Role
As an LTSS Provider Representative, you’ll be the primary connection between our health plan and the LTSS provider network. You’ll help providers navigate processes, resolve operational challenges, and access the resources they need to deliver high-quality care. This role blends relationship-building, problem-solving, and education to support provider growth, retention, and compliance.
What You’ll Do
Build and maintain strong relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits.
Share program updates, administrative changes, and training opportunities.
Support providers in resolving claims, service, and operational issues by connecting them with the right internal teams.
Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs.
Partner with contracting and other departments to recruit, onboard, and retain LTSS providers.
Lead or participate in provider education sessions, webinars, and office hours.
Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements.
Assist with provider recruitment strategies to meet network needs in assigned regions.
Provide data and insights during contract negotiations.
Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations.
Requirements
Minimum Requirements
Bachelor’s degree preferred and at least 3 years of customer service experience in a provider environment or as a trainer.
Or an equivalent combination of education and experience.
Strong skills in communication, organization, and accountability and comfortable in a team environment
Preferred Skills & Experience
Experience working directly with providers to develop strategies that improve outcomes.
Strong Medicaid LTSS claims knowledge.
Proficiency in Microsoft Office, especially PowerPoint and Excel.
Comfortable presenting to groups of various sizes.
Prior experience in community/home care
Contract Sep 9, 2025 Healthcare Medical Claims Processor I to be responsible for the accurate and timely processing of claims. Support the overall quality effectiveness to ensure that all claims are processed accurately and complete to ensure appropriate adjustment code usage, and payment rate.
Schedule: Monday-Friday, 8:00 AM-5:00 PM during Training
Location: 160 Dozier Blvd Florence, SC 29501
Pay: Weekly pay
Research and processes claims according to business regulation, internal standards and processing guidelines.
Verifies the coding of procedure and diagnosis codes.
Resolve system edits, audits and claims errors through research and use of approved references and investigative sources.
Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
Required Skills and Abilities:
Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills.
Required Software and Tools:
Basic office equipment. Proficient in word processing and spreadsheet applications. Proficient in database software.
Required Education:
High School Diploma or equivalent
Required Work Experience:
1 year-of experience in a healthcare or insurance environment.
Preferred Skills and Abilities:
Ability to use complex mathematical calculations.
Contract Sep 9, 2025 Healthcare Title: LTSS Provider Representative
Location: Remote within Evansville and surrounding counties — 50% travel required
Schedule: Standard business hours M-F 8am-5pm
About the Role
As an LTSS Provider Representative, you’ll be the primary connection between our health plan and the LTSS provider network. You’ll help providers navigate processes, resolve operational challenges, and access the resources they need to deliver high-quality care. This role blends relationship-building, problem-solving, and education to support provider growth, retention, and compliance.
What You’ll Do
Build and maintain strong relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits.
Share program updates, administrative changes, and training opportunities.
Support providers in resolving claims, service, and operational issues by connecting them with the right internal teams.
Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs.
Partner with contracting and other departments to recruit, onboard, and retain LTSS providers.
Lead or participate in provider education sessions, webinars, and office hours.
Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements.
Assist with provider recruitment strategies to meet network needs in assigned regions.
Provide data and insights during contract negotiations.
Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations.
Requirements
Minimum Requirements
Bachelor’s degree preferred and at least 3 years of customer service experience in a provider environment or as a trainer.
Or an equivalent combination of education and experience.
Strong skills in communication, organization, and accountability and comfortable in a team environment
Preferred Skills & Experience
Experience working directly with providers to develop strategies that improve outcomes.
Strong Medicaid LTSS claims knowledge.
Proficiency in Microsoft Office, especially PowerPoint and Excel.
Comfortable presenting to groups of various sizes.
Prior experience in community/home care
Contract Aug 26, 2025 Healthcare Healthcare Claims Processor I to be responsible for the accurate and timely processing of claims. Support the overall quality effectiveness to ensure that all claims are processed accurately and complete to ensure appropriate adjustment code usage, and payment rate.
Schedule: Monday-Friday, 8:00 AM-5:00 PM during Training
Location: 8733 Highway 17 Bypass, Myrtle Beach
Pay: Weekly pay
Research and processes claims according to business regulation, internal standards and processing guidelines.
Verifies the coding of procedure and diagnosis codes.
Resolve system edits, audits and claims errors through research and use of approved references and investigative sources.
Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
Required Skills and Abilities:
Strong analytical, organizational and customer service skills. Strong oral and written communication skills. Proficient spelling, punctuation and grammar skills. Good judgment skills. Basic business math skills.
Required Software and Tools:
Basic office equipment. Proficient in word processing and spreadsheet applications. Proficient in database software.
Required Education:
High School Diploma or equivalent
Required Work Experience:
1 year-of experience in a healthcare or insurance environment.
Preferred Skills and Abilities:
Ability to use complex mathematical calculations. Contract Aug 21, 2025 Administrative Job Title: Data Capture Specialist
Location: Marion, Indiana
Work Schedule (Part-Time): Monday: 9:00 AM – 6:00 PM
Wednesday: 9:00 AM – 5:30 PM
Friday: 9:00 AM – 5:30 PM
Pay: $14.85hr (Weekly Pay)
Job Summary:
The Data Capture Specialist is responsible for accurately keying information and scanning various documents.
Duties and Responsibilities:
Accurately enter alphabetic and numeric data from electronic images with speed and precision
Read, analyze, and classify documents according to specified criteria
Operate and maintain scanning equipment, including making adjustments to ensure optimal image quality
Review completed work and follow company quality control procedures to ensure accuracy standards are met
Support the team in meeting daily/monthly KPIs and SLAs
Follow proper procedures for data capture and QA
Maintain confidentiality and comply with PHI/PII safeguards, reporting any concerns promptly
Requirements:
High school diploma or equivalent
Proficiency in MS Office (Word, Outlook, Teams, SharePoint)
Excellent typing skills (touch, 10-key, 45+ WPM)
Ability to pass reference checks, drug screen, and background check
Contract Aug 21, 2025 Administrative Job Title: Data Capture Specialist
Location: Marion, Indiana
Work Schedule (Part-Time): Monday: 1:00 PM – 6:00 PM
Tuesday – Friday: 1:00 PM – 5:30 PM
Pay: $14.85hr (Weekly Pay)
Job Summary:
The Data Capture Specialist is responsible for accurately keying information and scanning various documents.
Duties and Responsibilities:
Accurately enter alphabetic and numeric data from electronic images with speed and precision
Read, analyze, and classify documents according to specified criteria
Operate and maintain scanning equipment, including making adjustments to ensure optimal image quality
Review completed work and follow company quality control procedures to ensure accuracy standards are met
Support the team in meeting daily/monthly KPIs and SLAs
Follow proper procedures for data capture and QA
Maintain confidentiality and comply with PHI/PII safeguards, reporting any concerns promptly
Requirements:
High school diploma or equivalent
Proficiency in MS Office (Word, Outlook, Teams, SharePoint)
Excellent typing skills (touch, 10-key, 45+ WPM)
Ability to pass reference checks, drug screen, and background check
Contract To Hire Aug 12, 2025 Healthcare Claims Customer Service Advocate II to be responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures.
Schedule: Monday-Friday, 8:00 AM-5:00 PM during Training
Location: 8733 Highway 17 Bypass, Myrtle Beach
Pay: Weekly pay
• Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Handles situations which may require adaptation of response or extensive research. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.
• Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards.
• Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and reports potential fraud and abuse situations.
Required Skills and Abilities:
Good verbal and written communication skills. Strong customer service skills. Good spelling, punctuation and grammar skills. Basic business math proficiency. Ability to handle confidential or sensitive information with discretion.
Required Software and Other Tools:
Microsoft Office. Work Environment: Typical office environment.
Required Education:
High School Diploma or equivalent
Required Work Experience:
2 years of customer service experience including 1-year claims or appeals processing OR Bachelor's Degree in lieu of work experience. Contract Jun 30, 2025 Administrative Job Summary
Data Capture Specialist is responsible for the accurate keying of information and scanning various documents.
Pay: 14.85/hour
Onsite Position - Marion, IN
Duties and Responsibilities
The responsibilities of the Data Capture Operator are outlined as follows and no intended to be all inclusive:
Accurately entering alphabetic and numeric data from electronic images with speed and accuracy utilizing software application to capture the appropriate data.
Reading, analyzing, and classifying documents based on certain assigned criteria.
Operating and maintaining scanning equipment, including processing documents through scanner and making appropriate adjustments to improve image capture.
Reviewing completed work and administering the company’s quality control procedures to ensure work is at or above required accuracy rates.
Assisting entire team in meeting daily and monthly KPIs and SLAs.
Following proper procedures, rules, and processes for data capture and quality assurance of data.
Utilizing appropriate and compliant safeguards to reasonably prevent the improper use or disclosure of confidential and protected information which may include Protected Health Information (PHI) and/or Personally Identifiable Information (PII) and reporting any concerns to manager.
Knowledge, Skills, and Abilities
High School Diploma or equivalent required.
Proficiency is MS Office (Word, Outlook, Teams, SharePoint).
Excellent typing skills—touch, 10 key, 45 wpm
Ability to pass reference checks, drug screen, and background checks.
Work Schedule
Monday: 9:00 a.m. - 6:00 p.m.
Tuesday: 9:30 a.m. - 5:30 p.m.
Wednesday through Friday: 9:00 a.m. - 5:30 p.m.