Jobs in Covington La Wfh

Job Title : Medical Assistant/Technician (Hospital Corpsman) Category / Component : Enlisted • Both Overview Hospital Corpsmen assist healthcare professionals and provide medical and dental care to Sailors, Marines, and their families across clinics, hospitals, ships, and field units, gaining broad clinical, technical, and operational experience.

Key Responsibilities Perform emergency medical treatment for Sailors, Marines, and specialized units such as SEALs and Seabees; provide basic and emergency dental care and process dental X rays; serve as operating room technician and assist in surgery; administer preventive care and medications including immunizations and IVs; conduct physical exams and assist in diagnosing and treating diseases and injuries; maintain patient records, perform clinical tests, and support physicians and nurses in a wide range of specialties.

What to Expect Hands on patient care with shift work and possible on call duties; field training and deployments with Marine and expeditionary units and embarked medical departments on ships; continuous certification and recertification in areas such as basic life support, trauma care, and tactical combat casualty care; mix of clinic, ward, and field environments with rapid response in emergent situations and a strong emphasis on teamwork and readiness.

Work Environment Assignments in Navy hospitals and clinics, aboard aircraft carriers and other ships, with Marine units in garrison and field environments, and occasionally on submarines; work in exam rooms, wards, operating rooms, emergency departments, aid stations, and field medical sites; close integration with medical teams, line units, and joint or coalition partners.

Pathways, Training & Advancement Recruit Training followed by Hospital Corpsman A School at Fort Sam Houston, Texas; numerous advanced C schools that lead to Navy Enlisted Classifications in areas such as Independent Duty Corpsman, Fleet Marine Force, preventive medicine, surgical technology, respiratory therapy, pharmacy, radiology, laboratory, dental, and dive medicine; progressive professional development through leadership courses and warfare qualifications such as Fleet Marine Force and Surface, Aviation, or Expeditionary pins where applicable.

Direct enlistment into the Hospital Corpsman rating from civilian life; in service conversion for qualified Sailors from other ratings who meet screening and performance criteria; Reserve accession for prior service Hospital Corpsmen and select civilian medical professionals when manning needs allow.

Qualifications All Navy jobs require meeting general enlistment or commissioning standards, which typically include: Eligibility to serve in the United States Navy, which may involve United States citizenship or other legal residency and work status, depending on the program and current law and policy A high school diploma or equivalent for enlisted positions, and a bachelor's or qualifying professional degree for officer positions Meeting age limits that vary by program and are set in law and Navy policy.

Some communities have more restrictive age ranges Meeting medical, vision, and dental standards, including body composition and physical fitness requirements, with some jobs requiring more demanding standards Meeting character and conduct standards, including background screening Achieving required test scores for your program, such as the Armed Services Vocational Aptitude Battery for enlisted roles or officer qualification tests for officer programs Eligibility for a security clearance when required for your rating or designator Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter.

Additional qualifications for this job may include: United States citizenship or equivalent status as allowed by policy; high school diploma or equivalent; at least 17 years of age; interest in healthcare and willingness to work in clinical and field environments, potentially under stressful conditions; ability to meet medical, vision, and physical fitness standards required for medical and operational assignments.

Education Education benefits are available through standard Navy programs such as Tuition Assistance, the Post-9/11 GI Bill, ACE-recommended college credit for Navy training, Navy COOL-funded certifications, USMAP apprenticeships, and other Navy College Program opportunities.

Specific options depend on the Sailor's status, training, and current Navy policy.

Pay, Benefits & Service Pay, benefits, and service commitments follow standard Navy Active and/or Reserve policies for this type of role, including basic pay, allowances when eligible, health coverage, and retirement options.

Exact entitlements, special pays, and service obligations depend on program, component, years of service, and current law and Navy guidance.

Incentives Incentives such as bonuses, special pays, and loan repayment may be available at times for specific ratings or communities, but they change frequently and cannot be guaranteed.

Applicants must confirm current incentives and eligibility with an official Navy recruiter or authoritative Navy source.

Notes and Disclaimers This description is a general overview of typical duties, training, and opportunities in this community.

It does not replace official Navy instructions, policies, or contracts and does not guarantee specific assignments, training, incentives, or outcomes.

Actual opportunities depend on Navy needs, individual performance, screening results, and current law and policy.

Job Title : Medical Assistant/Technician (Hospital Corpsman) Category / Component : Enlisted • Both Overview Hospital Corpsmen assist healthcare professionals and provide medical and dental care to Sailors, Marines, and their families across clinics, hospitals, ships, and field units, gaining broad clinical, technical, and operational experience.

Key Responsibilities Perform emergency medical treatment for Sailors, Marines, and specialized units such as SEALs and Seabees; provide basic and emergency dental care and process dental X rays; serve as operating room technician and assist in surgery; administer preventive care and medications including immunizations and IVs; conduct physical exams and assist in diagnosing and treating diseases and injuries; maintain patient records, perform clinical tests, and support physicians and nurses in a wide range of specialties.

What to Expect Hands on patient care with shift work and possible on call duties; field training and deployments with Marine and expeditionary units and embarked medical departments on ships; continuous certification and recertification in areas such as basic life support, trauma care, and tactical combat casualty care; mix of clinic, ward, and field environments with rapid response in emergent situations and a strong emphasis on teamwork and readiness.

Work Environment Assignments in Navy hospitals and clinics, aboard aircraft carriers and other ships, with Marine units in garrison and field environments, and occasionally on submarines; work in exam rooms, wards, operating rooms, emergency departments, aid stations, and field medical sites; close integration with medical teams, line units, and joint or coalition partners.

Pathways, Training & Advancement Recruit Training followed by Hospital Corpsman A School at Fort Sam Houston, Texas; numerous advanced C schools that lead to Navy Enlisted Classifications in areas such as Independent Duty Corpsman, Fleet Marine Force, preventive medicine, surgical technology, respiratory therapy, pharmacy, radiology, laboratory, dental, and dive medicine; progressive professional development through leadership courses and warfare qualifications such as Fleet Marine Force and Surface, Aviation, or Expeditionary pins where applicable.

Direct enlistment into the Hospital Corpsman rating from civilian life; in service conversion for qualified Sailors from other ratings who meet screening and performance criteria; Reserve accession for prior service Hospital Corpsmen and select civilian medical professionals when manning needs allow.

Qualifications All Navy jobs require meeting general enlistment or commissioning standards, which typically include: Eligibility to serve in the United States Navy, which may involve United States citizenship or other legal residency and work status, depending on the program and current law and policy A high school diploma or equivalent for enlisted positions, and a bachelor's or qualifying professional degree for officer positions Meeting age limits that vary by program and are set in law and Navy policy.

Some communities have more restrictive age ranges Meeting medical, vision, and dental standards, including body composition and physical fitness requirements, with some jobs requiring more demanding standards Meeting character and conduct standards, including background screening Achieving required test scores for your program, such as the Armed Services Vocational Aptitude Battery for enlisted roles or officer qualification tests for officer programs Eligibility for a security clearance when required for your rating or designator Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter.

Additional qualifications for this job may include: United States citizenship or equivalent status as allowed by policy; high school diploma or equivalent; at least 17 years of age; interest in healthcare and willingness to work in clinical and field environments, potentially under stressful conditions; ability to meet medical, vision, and physical fitness standards required for medical and operational assignments.

Education Education benefits are available through standard Navy programs such as Tuition Assistance, the Post-9/11 GI Bill, ACE-recommended college credit for Navy training, Navy COOL-funded certifications, USMAP apprenticeships, and other Navy College Program opportunities.

Specific options depend on the Sailor's status, training, and current Navy policy.

Pay, Benefits & Service Pay, benefits, and service commitments follow standard Navy Active and/or Reserve policies for this type of role, including basic pay, allowances when eligible, health coverage, and retirement options.

Exact entitlements, special pays, and service obligations depend on program, component, years of service, and current law and Navy guidance.

Incentives Incentives such as bonuses, special pays, and loan repayment may be available at times for specific ratings or communities, but they change frequently and cannot be guaranteed.

Applicants must confirm current incentives and eligibility with an official Navy recruiter or authoritative Navy source.

Notes and Disclaimers This description is a general overview of typical duties, training, and opportunities in this community.

It does not replace official Navy instructions, policies, or contracts and does not guarantee specific assignments, training, incentives, or outcomes.

Actual opportunities depend on Navy needs, individual performance, screening results, and current law and policy.

Job Title : Medical Assistant/Technician (Hospital Corpsman) Category / Component : Enlisted • Both Overview Hospital Corpsmen assist healthcare professionals and provide medical and dental care to Sailors, Marines, and their families across clinics, hospitals, ships, and field units, gaining broad clinical, technical, and operational experience.

Key Responsibilities Perform emergency medical treatment for Sailors, Marines, and specialized units such as SEALs and Seabees; provide basic and emergency dental care and process dental X rays; serve as operating room technician and assist in surgery; administer preventive care and medications including immunizations and IVs; conduct physical exams and assist in diagnosing and treating diseases and injuries; maintain patient records, perform clinical tests, and support physicians and nurses in a wide range of specialties.

What to Expect Hands on patient care with shift work and possible on call duties; field training and deployments with Marine and expeditionary units and embarked medical departments on ships; continuous certification and recertification in areas such as basic life support, trauma care, and tactical combat casualty care; mix of clinic, ward, and field environments with rapid response in emergent situations and a strong emphasis on teamwork and readiness.

Work Environment Assignments in Navy hospitals and clinics, aboard aircraft carriers and other ships, with Marine units in garrison and field environments, and occasionally on submarines; work in exam rooms, wards, operating rooms, emergency departments, aid stations, and field medical sites; close integration with medical teams, line units, and joint or coalition partners.

Pathways, Training & Advancement Recruit Training followed by Hospital Corpsman A School at Fort Sam Houston, Texas; numerous advanced C schools that lead to Navy Enlisted Classifications in areas such as Independent Duty Corpsman, Fleet Marine Force, preventive medicine, surgical technology, respiratory therapy, pharmacy, radiology, laboratory, dental, and dive medicine; progressive professional development through leadership courses and warfare qualifications such as Fleet Marine Force and Surface, Aviation, or Expeditionary pins where applicable.

Direct enlistment into the Hospital Corpsman rating from civilian life; in service conversion for qualified Sailors from other ratings who meet screening and performance criteria; Reserve accession for prior service Hospital Corpsmen and select civilian medical professionals when manning needs allow.

Qualifications All Navy jobs require meeting general enlistment or commissioning standards, which typically include: Eligibility to serve in the United States Navy, which may involve United States citizenship or other legal residency and work status, depending on the program and current law and policy A high school diploma or equivalent for enlisted positions, and a bachelor's or qualifying professional degree for officer positions Meeting age limits that vary by program and are set in law and Navy policy.

Some communities have more restrictive age ranges Meeting medical, vision, and dental standards, including body composition and physical fitness requirements, with some jobs requiring more demanding standards Meeting character and conduct standards, including background screening Achieving required test scores for your program, such as the Armed Services Vocational Aptitude Battery for enlisted roles or officer qualification tests for officer programs Eligibility for a security clearance when required for your rating or designator Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter.

Additional qualifications for this job may include: United States citizenship or equivalent status as allowed by policy; high school diploma or equivalent; at least 17 years of age; interest in healthcare and willingness to work in clinical and field environments, potentially under stressful conditions; ability to meet medical, vision, and physical fitness standards required for medical and operational assignments.

Education Education benefits are available through standard Navy programs such as Tuition Assistance, the Post-9/11 GI Bill, ACE-recommended college credit for Navy training, Navy COOL-funded certifications, USMAP apprenticeships, and other Navy College Program opportunities.

Specific options depend on the Sailor's status, training, and current Navy policy.

Pay, Benefits & Service Pay, benefits, and service commitments follow standard Navy Active and/or Reserve policies for this type of role, including basic pay, allowances when eligible, health coverage, and retirement options.

Exact entitlements, special pays, and service obligations depend on program, component, years of service, and current law and Navy guidance.

Incentives Incentives such as bonuses, special pays, and loan repayment may be available at times for specific ratings or communities, but they change frequently and cannot be guaranteed.

Applicants must confirm current incentives and eligibility with an official Navy recruiter or authoritative Navy source.

Notes and Disclaimers This description is a general overview of typical duties, training, and opportunities in this community.

It does not replace official Navy instructions, policies, or contracts and does not guarantee specific assignments, training, incentives, or outcomes.

Actual opportunities depend on Navy needs, individual performance, screening results, and current law and policy.

The Store Manager leads the store's executive team in exceeding sales and profitability goals while driving top-line results. This role develops a high-performing team through leadership, communication, and fostering a culture of accountability and engagement. The Store Manager requires a competitive drive and entrepreneurial confidence to excel in a fast-paced, results-driven environment, delivering best-in-class associate and customer experiences. This is an exempt position, with monthly and quarterly bonus eligibility.

What You Will Do

• Demonstrate a high level of ownership, accountability, and initiative in achieving store objectives and driving the accomplishment of company goals.
• Conduct weekly workload planning meetings to ensure store leadership team plans and executes workload activities and strategies aligned with people, process, customer, and product priorities.
• Develop action plans and regularly review strategies with the store team and regional business partners. Set clear priorities, communicate expectations, model key behaviors, and provide effective coaching to drive performance and results.
• Manage annual expense budgets to achieve profit goals. Ensure effective scheduling that aligns staffing with business needs and places the right people in the right roles at the right time.
• Elevate merchandising and visual standards, tailored to the store’s unique needs and consistently set to brand guidelines. Manage operational efficiency to ensure products are processed, presented, and priced accurately.
• Ensure compliance with loss prevention, product protection standards, safety guidelines, and security protocols. Lead shortage control efforts by effectively managing asset protection initiatives and overall store operations.
• Ensure each department has a strategic hiring plan to fill open positions timely, actively supporting recruiting and interviewing efforts. Facilitate team career development conversations to ensure a ready-now bench of store talent.
• Ensure structured onboarding completion to prepare your team to deliver service, selling, and operational excellence, while leading continuous learning efforts to drive ongoing growth and performance.
• Build meaningful team connection, foster positive store culture, and champion retention and engagement through recognizing associate value and contributions.
• Lead the adoption and optimization of store systems and processes. Help the team navigate competing priorities and change by providing context, guidance, and support to adapt and execute effectively.

Skills And Abilities

• Ability to successfully apply analytics, experience, and judgement to make timely and effective business, people, and profitability decisions.
• Skills and experience to perform in the role and a commitment to continuously learn.
• Ability to develop others through mentorship, effective communication, and side-by-side coaching.
• Self-directed and able to work with minimal supervision in a deadline-driven environment.
• Communicate with excellence.
• 3+ years of Retail Store Management experience and a dedication to customer experience excellence.
• Available to work a flexible schedule based on business needs, including nights, weekends, and holidays.
• Comfortable with technology, including smartphones, tablet computers and Windows-based operating systems.
• Must regularly move around all store areas and be accessible to customers.
• Must bend, reach, stretch for product as well as lift, carry, and move at least 40 lbs.

The job posting highlights the most relevant / essential responsibilities and requirements of the role. It is not all-inclusive. There may be additional duties, responsibilities, and qualifications for this job.

#IND3

#LI-KH3

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate.  We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. 

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters.  Come make a difference at Ochsner Health and discover your future today! 

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.
 

Education 

Required - Associate's Degree

Preferred- Bachelor's Degree

Work Experience

Required - None.

Certifications

Required - Current License as a Respiratory Therapist in the state of practice
Certification by the National Board of Respiratory Care as a Registered Respiratory Therapist
Basic Life Support (BLS) from the American Heart Association

Advanced Cardiac Life Support (ACLS) must be obtained within 90 days of hire

Knowledge Skills and Abilities (KSAs)

• Must have computer skills and dexterity required for data entry and retrieval of information.
• Effective verbal and written communication skills and the ability to present information clearly and professionally.
• Must be proficient with Windows-style applications, various software packages specific to role and keyboard.
• Strong interpersonal skills.

Job Duties

• Performs routine and advanced therapeutic procedures according to established policy and procedure.
• Reviews and documents all clinical information regarding each patient.
• Educates patients and co-workers on procedures and treatment plans.
• Performs diagnostic procedures.
• Provides care based on physical; psycho/social, educational, safety and related criteria, appropriate to the age of patient served in assigned area.
• Adapts behavior to the specific patient population, including but not limited to: respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style.

Other related duties as required.  The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.

This employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
 

Physical and Environmental Demands
The physical demands 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.

Very Heavy Work - Exerting in excess of 100 pounds of force occasionally, and/or in excess of 50 pounds of force frequently, and/or in excess of 20 pounds of force constantly to move objects. Physical Demand requirements are in excess of those for Heavy Work.  (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.

Mechanical lifting devices (carts, dollies, etc.) or team lifts should be utilized.
Must be able to stoop, bend, reach and grab with arms and hands, manual dexterity.
Must be able to sit or stand for prolonged periods of time.
Must be able to travel throughout and between facilities.
Must be able to work a flexible work schedule (24/7, weekend, holiday, on call availability). 

Duties performed routinely require exposure to blood, body fluid and tissue.

The incumbent works in a patient care area; works in an area where patients enter; works directly with patients; and/or works with specimens that could contain diseases. There may be an occupational risk for exposure to all communicable diseases.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.

Are you ready to make a difference? Apply Today!

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Please refer to the job description to determine whether the position you are interested in is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New York, Vermont, Washington, and Washington D.C.

Ochsner Health endeavors to make our site accessible to all users.  If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 5 select option 1) or  . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class, including protected veterans and individuals with disabilities.

Want to make extra money on YOUR schedule? Join our exclusive list of research study participants and start earning extra income today!

Perfect for anyone seeking remote, part-time, or temporary work, these opportunities require no previous experience and offer unmatched flexibility. Choose the studies that suit you best—whether online, in-person, or over the phone—and get paid for sharing your opinions.

Don't miss out on this chance to turn your free time into valuable earnings!

Participants are needed on a wide range of topics such as:

• Health Issues (Research for cures and new medications to treat ailments)
• Consumer Products (Your experience with consumer products)
• Shopping (Shopping experiences)
• Internet Usage (How you use the internet)
• Vehicles (recreational vehicles and automobiles)
• Employment (Various types of jobs or career fields)
• Food & Beverages (the consumption of various foods and beverages)
• Entertainment (About TV, movies or video games)
• Social Media (the use of different social media platforms)
• Financial (Banking and investing)
• Retirement (Planning what, when and how)
• Gender (studies based on your gender)
• Housing (Renters or Homeowners)

Compensation:

• Earn up to $250+ in Just ONE Hour! (Focus Group Session)
• Earn up to $3,000+ (Multi-Session Studies)

Benefits:

• Flexibility to take part in discussions online or in-person.
• No commute needed if you choose to work from home.
• No minimum hours. You can do this part-time or full-time
• Enjoy free samples from our sponsors and partners in exchange for your honest feedback of their products.
• You get to review and use new products or services before they are launched to the public.

Qualifications:

• Speak and/or read English
• Must be 18yrs old or older
• Must have either a phone, computer or tablet with internet connection

Experience:

• Start Immediately - No Experience Needed! Anyone Can Participate!

Education:

• Open to all education levels - Your opinion matters!

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

Job Description:

About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job Description:

BroadPath, a Sagility Company, is hiring UM RN Appeals Coordinator to join our remote team! Claims Processors are responsible for the accurate and timely entry, review, and resolution of medical claims ranging from simple to moderately complex. This includes reviewing front-end claims and validating information submitted by patients or providers seeking reimbursement from the insurance company. All claim processing must align with CMS guidelines and client-specific policies and procedures.

Schedules, pay rates, and program details may vary based on business needs and client assignment.

Compensation Highlights

• Base Pay: up to $50 per hour
• Pay frequency: Weekly pay

Schedule Highlights

• Training Schedule: 2 weeks, Monday – Friday; 8:00 AM - 5:00 PM CST

• Production Schedule: Monday – Friday; 8:00 AM - 5:00 PM CST (Flexible)

Responsibilities

A. Performs necessary review to ensure compliance with HHSC and other regulatory entities

• Collaborate: Partners with the physician team to identify strategies for action and determine appropriate guideline citations or responses based on the category of denial
• Develop: Creates training materials and examples for nursing staff to enhance understanding of criteria application, benefit use, and the appeal, External Medical Review (EMR), and Fair Hearing processes
• Coordinate: Ensures continuity of care needs are met and advocates on behalf of Members and families for out-of-network authorization approvals
  Implement: Identifies problems, barriers, and opportunities within processes and develops resolutions or revisions as needed
• Evaluate: Conducts quarterly assessments of appeal status and program activities, preparing reports for both the State of Texas and internal review
• Analyze: Reviews requests against regulatory and decision-making guidelines and benefit allowances, implements actions in collaboration with the physician reviewer panel, and monitors timeliness, decision-making, and processing of appeals, EMRs, and State Fair Hearings in accordance with regulatory and accrediting standards

B. Performs all necessary communication and documentation functions

• Communicates with internal staff, Members/LARs, physicians, hospital representatives, and other
• Providers regarding case status, due process, rationale, and regulatory requirements
• Coordinates Fair Hearing requests through TIERS when a Member/LAR or Provider requests an EMR or Fair Hearing
• Utilizes an Independent Review Organization as needed for specialty or external reviews
• Oversees documentation and recordkeeping of all case communications in compliance with accrediting requirements
• Documents all activities and interactions in electronic and event tracking systems
  Generates appeal determination letters as appropriate

C. Collaborates with clinical reviewers, medical directors, external physician reviewers, and network Providers

• Communicates with physicians on each case to establish the most appropriate course of action
• Provides education to nurse and therapist reviewers regarding appeal updates and process changes
• Maintains flexibility in scheduling, including evenings and weekends, to address pharmacy-related denials
• Educates physician reviewers and clinical review staff on managed care and Medicaid policies and procedures

D. Conducts staff and medical director audits on appeal activities

• Assists with appeal file preparation for NCQA file reviews
• Supports the development of corrective action plans based on trended audit findings

E. Provides data for internal and external reporting

• Analyzes quarterly trends in appeal types and sources
• Reports appeal activity, type, and resolution, ensuring timely communication standards are met
• Assists with state reporting in the required format and ensures timely submission to HHSC to avoid financial penalties

Knowledge and Skills

• Demonstrates proficiency in applying advanced principles, concepts, and techniques central to nursing and ancillary therapy services within managed care, with emphasis on complex pediatrics and obstetrics
• Ability to comprehensively assess Member and family medical needs, develop and implement plans of care, provide ongoing evaluation and monitoring, and deliver education to Members, families, Providers, and staff
• Exemplary verbal and written communication skills, with proficiency in computer operation, word processing programs, fax machines, photocopiers, and multi-line telephones
• Strong customer service orientation and advanced interpersonal communication skills with all levels of internal and external stakeholders, including medical staff, patients and families, clinical personnel, support staff, outside agencies, and community partners

Qualifications

• RN license in an eNLC (Enhanced Nurse Licensure Compact) state with multistate privileges
• 3+ years Nursing experience
• 1+ years’ Utilization Management experience
• Familiarity with medical terminology, utilization management guidelines, and clinical documentation standards
• Proficiency in Microsoft Office and experience working with healthcare systems or electronic medical records
• Strong organizational and time management skills with the ability to work independently
• Excellent written and verbal communication skills

At BroadPath, a Sagility Company, we believe that transparency, authenticity, and collaboration are the keys to building strong, connected remote teams. If you are someone who values open communication, connection, and teamwork, you will thrive in our environment where showing up authentically matters.

Benefits:

• Medical, Dental, and Vision coverage.
• Life Insurance.
• Short-Term and Long-Term Disability options.
• Flexible Spending Account (FSA).
• Employee Assistance Program.
• 401(k) with employer contribution.
• Paid Time Off (PTO).
• Tuition Reimbursement.

BroadPath, a Sagility Company, may conduct background checks, previous employment verifications, and education verifications, based on position requirements

Diversity Statement

At BroadPath, a Sagility Company, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!

Equal Employment Opportunity/Disability/Veterans

If you need accommodation due to a disability, please email us at . This information will be held in confidence and used only to determine an appropriate accommodation for the application process

BroadPath, a Sagility Company is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.

Compensation: BroadPath a Sagility Company has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.

Location:

Director of Sales-Shop At Home (Paramus)

Key member of the sales leadership team, Director of Sales-Shop At Home is the general manager of the in-home business unit servicing markets without Blinds To Go showrooms (BTG Partners Program). Directly managing and working closely with shop-at-home outside contractors, installers and collaborating with other senior managers, he/she will develop and implement systems and processes that support rapid growth of this business. He/she must be a good recruiter and manager of outside sales people and have excellent communication skills.

Key Responsibilities

• Recruit, manage and drive growth of shop-at-home (SAH) business in markets without BTG showrooms (BTG Partners)
• Actively recruit and on-board outside contractors with experience in window treatments
• Work with merchandising and marketing to develop programs, tools that improve BTG Partners performance
• Work with business support groups to provide ongoing operation support to BTG partners
• Work with installation managers to build installation network and maintain excellent service levels in remote markets
• Help identify and qualify installers as needed
• Measure installation service levels
• Work with stores leadership to identify additional opportunities for BTG Partners Program

Key Requirements

Bachelors in business or related field

10+ years experience including:

• Operating experience in retail or multi-location service business
• In-home sales and management experience
• Experience managing 3rd-party service providers
• Strong interpersonal and communication skills
• High energy and strong motivation skills
• Very strong customer service, problem-solving and follow-up skills
• Ability to identify root causes and solve issues with a high sense of urgency
• Ability to build cross-functional relationships
• Experience working independently, but also as part of a team

Integrating senior manager into the existing business and culture is critical. We will work with him/her to develop an integration plan that sets up the new manager for success at BTG.

Development plan will be individualized, and will include time in our stores to gain a first-hand appreciation of our customer service requirements and to develop key relationships in the field.

Are you a detail-oriented individual with a passion for research and a good understanding of national and local geography? This freelance opportunity allows you to work at your own pace and from the comfort of your own home.

A Day in the Life of an Online Data Analyst:

In this role, you will be working on a project aimed at enhancing the content and quality of digital maps that are used by millions of people worldwide

Completing research and evaluation tasks in a web-based environment such as verifying and comparing data, and determining the relevance and accuracy of information.

Join us today and be part of a dynamic and innovative team that is making a difference in the world!

TELUS Digital AI Community

Our global AI Community is a vibrant network of 1 million+ contributors from diverse backgrounds who help our customers collect, enhance, train, translate, and localize content to build better AI models. Become part of our growing community and make an impact supporting the machine learning models of some of the world’s largest brands. 

Qualification path

No previous professional experience is required to apply to this role, however, working on this project will require you to pass the basic requirements and go through a standard assessment process. This is a part-time long-term project and your work will be subject to our standard quality assurance checks during the term of this agreement. 

Basic Requirements

• Full Professional Proficiency in Punjabi and English language
• Being a resident in The United States or the last 2 consecutive years and having familiarity with current and historical business, media, sport, news, social media, and cultural affairs in India
• Ability to follow guidelines and conduct online research using search engines, online maps, and website information

Flexibility to work across a diverse set of task types, including maps, news, audio tasks, and relevance

Daily access to a broadband internet connection, computer, and relevant software

Assessment

In order to be hired into the program, you’ll take an open book qualification exam that will determine your suitability for the position and complete ID verification. Our team will provide you with guidelines and learning materials before your qualification exam. You will be required to complete the exam in a specific timeframe but at your convenience.

Equal Opportunity

All qualified applicants will receive consideration for a contractual relationship without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. At TELUS Digital AI, we are proud to offer equal opportunities and are committed to creating a diverse and inclusive community. All aspects of selection are based on applicants’ qualifications, merits, competence, and performance without regard to any characteristic related to diversity.