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Shift: 7am to 10pm CST - 8 hours per day expected, *Possible weekend shifts* The clinical pharmacist is an operation-based role that conducts clinical reviews of medical data collected to perform prior authorization for specialty medications. The clinical pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. This role will be carried out to support systems and take inbound calls from physicians or members regarding their pending, approved, or denied prior authorizations.
Location : Wilkes-Barre, PA 18702 Shift: Training: Mon-Fri 9:00am-5:30pm EST, Hours vary 7:00am-5:30pm EST Mon-Fri some Sat No pre-scheduled PTO during first 6–8 weeks This position involves extensive member contact via the telephone. Handles inbound/outbound calls from participants and/or prescribers when needed to start and process order requests. Ability to research and investigate orders using Compass and LINKS. Research issues sent by Customer Care, Account Managers, internal customers and Quality Assurance related to customer service experience. Notifying requestor of decisions, changes, or other relevant information pertaining to request/inquiry. Responsible for researching and resolving payment issues. Call to offer direct sales of medications to participants and post payments to the proper account. Perform required transactions to complete mail order prescriptions. Follow through standard operating procedures, problem-solving and troubleshooting within guidelines.
Location : Phoenix, AZ 85040 Shift: Mon-Fri with rotating Saturday shifts. Hours of operation 6-430pm. Training: Mon-Fri 6am to 230pm. This position involves extensive member contact via the telephone. Handles inbound/outbound calls from participants and/or prescribers when needed to start and process order requests. Ability to research and investigate orders using Compass and LINKS. Research issues sent by Customer Care, Account Managers, internal customers and Quality Assurance related to customer service experience. Notifying requestor of decisions, changes, or other relevant information pertaining to request/inquiry. Responsible for researching and resolving payment issues. Call to offer direct sales of medications to participants and post payments to the proper account. Perform required transactions to complete mail order prescriptions. Follow through standard operating procedures, problem-solving and troubleshooting within guidelines.
Location : Phoenix, AZ 85040 Shift: Mon-Fri with rotating Saturday shifts. Hours of operation 6am-6pm. Training: Mon-Fri 6am to 230pm Exciting opportunity for Certified Pharmacy Technicians to work in a complex, high impact customer service role for our Participant Services department.
Shift: Training Period: First 8 weeks – no time off or vacations allowed Shift Range: Between 8:00 AM – 8:00 PM CST Weekend Requirement: Candidates must work one weekend day (either Sunday–Thursday or Tuesday–Saturday) This position is a 100% remote, work from home opportunity and will not be patient facing however need LVN with Prior Authorization experience.
Location : Woonsocket, RI 02895 Shift: Business, Hours and this is a hybrid role requiring in-office work in Woonsocket, RI on Tuesday & Wednesday. Remote work from home on Monday, Thursday & Friday. The Accounts Payable Analyst will be called upon to execute a variety of AP responsibilities based on evolving department and business needs. These include executing priority payments, reviewing invoices, vendor account maintenance, printing/processing checks, and triaging mail received in-office. The Accounts Payable Analyst will also support offshore AP teams by analyzing and researching open invoices, deductions, discrepancies, and quality assurance; working with the team to communicate with vendors and all departments within the organization to address requests and inquiries; collaborating with our offshore counterparts; and other support tasks as needed.
Location (mandatory): Menlo Park, CA. We are seeking an experienced Data Engineer to join our Sales Data Engineering team within the Monetization division. In this role, you will design and develop scalable data pipelines and architectures that support the sales organization working with advertisers. You will collaborate cross-functionally to deliver end-to-end data solutions, build key metrics, and create dashboard insights critical for business performance in Q4 and Q1. This position offers the opportunity to work at the intersection of data engineering and business impact, providing actionable insights that directly influence revenue and strategic decision-making. Minimum Requirements: • Bachelor's degree in Computer Science or related field • 5+ years of experience as a Data Engineer • Strong knowledge of SQL and programming languages such as Python or Java • Experience with big data technologies such as Hadoop, Spark, or Kafka • Knowledge of data modeling and database design principles • Experience with cloud-based data platforms such as AWS. • Excellent problem-solving skills and attention to detail
Location : Denton, Flower Mound, Keller, Arlington, Mansfield & Fort Worth in TEXAS State Shift: M-F 8-5 This position is work from home and will require home visits and possible visits to Nursing Facility. Local travel with 50-75% of areas in Denton, Flower Mound, Keller, Arlington, Mansfield & Fort Worth in TEXAS State Candidate must reside in TX and area of coverage. Minimum 2 years of clinical experience. Able to travel 50-60% of their time to meet members face to face and surrounding counties/areas
Location : Atlanta, GA 30345 Shift: Mon-Fri 8:30-5:00pm This position takes in-coming calls from members, providers, etc providing professional phone assistance to all callers. This role also helps prepare medications (counting, applying labels) for pharmacist final verification along with any other pharmacy technician job functions.
Location (mandatory): Allen, TX Shift timings: • This role will require designing and building scalable backend services, authoring, and maintaining proper code, documentation and creating and following an effective process for partner engagement. • An ideal candidate will bring to the table a solid set of technical skills and experience in the scalable backend services space. Minimum qualifications: • Software engineer with 4-5 years of backend development experience around building, maintaining, and scaling backend infra and working on large scale systems that serve large number of users. • Software development experience in languages and environments such as Java, Native Development Kit (C++) and/or PHP. • Experience with distributed systems. • Experience with designing, building, and maintaining scalable backend services and API endpoints. • Experience with SQL and no-SQL databases, GraphQL and REST APIs. • Proven experience, communication, analytical, collaboration, and problem-solving skills.
What does the ideal candidate look like? • Experience in IP or Optical network deployment, with a focus on program management, process improvement, and technical expertise. • Proven track record of delivering large-scale IP or Optical network infrastructure projects on time, within budget, and to required quality standards. • Strong technical expertise in IP or Optical networking protocols, architectures, and technologies. Excellent leadership, communication, and interpersonal skills. • Ability to work in a fast-paced environment, prioritizing multiple projects and deadlines. • Strong analytical and problem-solving skills, with experience in data-driven decision making. Day to day: • Provide technical and operational guidance and oversight to IP or Optical network deployments ensuring that projects are delivered on time and with quality. • Facilitate technical discussions with cross-functional teams to identify solutions, mitigate risks, and drive innovation. • Build and execute comprehensive deployment program scope, schedules, resource allocation, and ensure successful delivery of IP or Optical network deployment projects. • Define, track, and analyze key performance indicators (KPIs) such as deployment speed, quality, efficiency, and SLAs to measure program success. • Manage relationships with vendors and partners, ensuring that they meet contractual obligations and deliver high-quality services. • Collaborate with internal stakeholders including Data center engineers, Network engineers, and operations, to ensure alignment and effective communication throughout the project lifecycle. • Establish and maintain regular reporting to senior management and stakeholders, providing insights into program performance, risks, and opportunities. The ideal candidate will have: • Technical expertise with IP or Optical networking protocols, architectures and technologies including BGP, TCP/IP, SNMP, GRE, or MPLS. • Operational Efficiency to manage large-scale network deploy