Jobs in Waunakee Dane County Wi Online
2,425 positions found — Page 6
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JOB DESCRIPTION Job Summary
Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
•Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
Preferred Qualifications
• Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.
• Experience working with populations that receive waiver services.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
#PJHS
#HTF
Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
JOB DESCRIPTION Job Summary
Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
•Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
Preferred Qualifications
• Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.
• Experience working with populations that receive waiver services.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
#PJHS
#HTF
Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
JOB DESCRIPTION Job Summary
Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
•Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
Preferred Qualifications
• Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.
• Experience working with populations that receive waiver services.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
#PJHS
#HTF
Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
JOB DESCRIPTION Job Summary
Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Completes comprehensive member assessments within regulated timelines, including in-person home visits as required.
• Facilitates comprehensive waiver enrollment and disenrollment processes.
• Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care.
• Assesses for medical necessity and authorizes all appropriate waiver services.
• Evaluates covered benefits and advises appropriately regarding funding sources.
• Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns.
• Identifies critical incidents and develops prevention plans to assure member health and welfare.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements).
Required Qualifications
• At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
•Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work independently, with minimal supervision and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).
Preferred Qualifications
• Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.
• Experience working with populations that receive waiver services.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
#PJHS
#HTF
Pay Range: $24 - $46.81 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
This role focuses on delivering a high-quality, customer-first experience by providing product education, addressing customer needs, and ensuring satisfaction throughout the sales process.
The ideal candidate demonstrates professionalism, empathy, and strong communication skills while meeting performance and sales goals.
Key Responsibilities Conduct inbound and outbound sales calls with prospective and current customers Educate customers on product lines including ostomy, urology, Purewick, and related medical supplies Identify customer needs and recommend appropriate solutions Address and resolve customer concerns in a timely and professional manner Accurately document all interactions, issues, and resolutions in CRM and call tracking systems Meet or exceed performance targets, including call volume, sales goals, and customer satisfaction metrics Ensure compliance with company standards, including HIPAA regulations, insurance protocols, and call scripting guidelines Collaborate with internal teams to resolve order issues and provide seamless customer support Additional Responsibilities Communicate with customers via phone, email, and web chat Maintain accurate and detailed customer records to support follow-up and service quality Contribute to a positive, team-oriented work environment Perform additional duties as assigned Qualifications Education & Experience: High school diploma or GED required 1–2 years of related sales or customer service experience preferred Skills & Abilities: Strong verbal and written communication skills Ability to explain technical or medical product information clearly Basic to intermediate math skills (discounts, percentages, commissions) Strong problem-solving and critical-thinking abilities Proficiency in Microsoft Office (Word, Excel) and CRM systems Familiarity with call center or dialer systems preferred Work Requirements Availability to work occasional evenings, weekends, or overtime as needed Work Environment (Remote) Must work from a private, quiet, and distraction-free environment Reliable high-speed internet is required Ability to remain seated and use a computer and phone for extended periods Physical Requirements Regularly required to sit, speak, and listen Frequent use of hands for computer and phone work
*
Remote working/work at home options are available for this role.
- 8pm EST Monday
- Friday and 7am
- 430pm EST Sat and Sunday.
Set Rotation Start Date : May 11th or 18th Position Overview We are seeking an experienced Clinical Pharmacist Advisor – Medicare to join a high-performing, remote clinical review team.
This role focuses on prior authorizations, coverage determinations, and Medicare Part D reviews in a fast-paced, production-driven environment.
This is an excellent opportunity for pharmacists with managed care, PBM, or Medicare experience who thrive in a remote, independent workflow setting and are comfortable handling high-volume clinical case reviews .
Schedule Business Hours: Monday – Friday: 7:00 AM – 8:00 PM EST Saturday & Sunday: 7:00 AM – 4:30 PM EST Rotation: Set schedule (may include weekends) Training Schedule: Monday – Friday, 9:00 AM – 5:30 PM EST Key Responsibilities Perform prior authorization and coverage determination reviews in accordance with clinical guidelines and CMS regulations Evaluate medication requests, including formulary exceptions, step therapy, and quantity limits Process appeals and denial reviews with accurate clinical documentation Apply Medicare Part D knowledge to ensure compliance and timely decision-making Communicate with providers to obtain necessary clinical information and explain determinations Document decisions clearly, including rationale for approvals or denials Maintain productivity and quality standards in a high-volume, queue-based environment Required Qualifications Bachelor’s Degree in Pharmacy or PharmD Active Pharmacist License in good standing in state of residence Minimum 1+ year of experience in managed care, PBM, or prior authorization review Strong knowledge of Medicare Part D and pharmacy benefit structures Experience with: Prior authorizations Coverage determinations & appeals Clinical criteria and formulary reviews Preferred Experience Previous experience in PBM environments (e.g., Medicare or commercial plans) Background in organizations such as CVS/Caremark, OptumRx, Cigna, Walgreens, or similar Combination of retail pharmacy + managed care experience Experience working in a remote, production-based role Key Skills & Competencies Ability to manage high-volume case review queues with speed and accuracy Strong clinical decision-making and documentation skills Excellent provider communication and collaboration High level of attention to detail and compliance adherence Comfortable working independently in a remote environment with minimal supervision Strong computer proficiency and ability to navigate multiple systems simultaneously What Makes a Strong Candidate Successful candidates typically bring: Proven experience in Medicare pharmacy benefit review work A track record of handling time-sensitive clinical decisions Comfort working in remote, metrics-driven environments Ability to clearly communicate clinical decisions and alternatives to providers Readiness to hit the ground running with minimal ramp-up time Why Join Us? Fully remote opportunity Competitive hourly pay with contract-to-hire potential Structured training and support Opportunity to work with a leading clinical review team in the Medicare space INDJP .
Remote working/work at home options are available for this role.
HOURS ARE 7am
- 8pm EST Monday
- Friday and 7am
- 430pm EST Sat and Sunday) As a Clinical Pharmacist Advisor – Medicare, you will: Support Medicare Part D members and providers with pharmacy benefit requests Ensure accurate case setup and clinical review for decisioning Contact providers to obtain clinical details when necessary Follow CMS-mandated timelines, departmental productivity, and quality standards Apply clinical judgment using compendia, evolving work instructions, and Medicare guidance Participate in development discussions with supervisors for continuous improvement Remote Medicare Clinical Pharmacist Compensation · The pay for this position is $53.00/hr · Benefits are available to full-time employees after 90 days of employment · A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates Remote Medicare Clinical Pharmacist Highlights · This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs Required Availability: is 7am
- 8pm EST Monday
- Friday and 7am
- 430pm EST Sat and Sunday) Remote Medicare Clinical Pharmacist Responsibilities · Accurately set up Medicare Part D cases for members and providers.
· Review clinical information and documentation to support decision-making.
· Contact providers to obtain additional clinical details when needed.
· Ensure all case decisions comply with CMS Medicare guidelines and compendia resources.
· Adhere to departmental productivity, quality standards, and CMS-mandated timelines.
· Maintain thorough and clear documentation of all case activities.
· Utilize multiple computer applications efficiently, often across dual screens.
· Participate in training, development discussions, and feedback sessions with supervisors.
· Support continuous improvement initiatives within the team.
· Work independently while maintaining high attention to detail and accuracy.
· Demonstrate engagement, professionalism, and a positive attitude in all interactions.
Remote Medicare Clinical Pharmacist Requirements · Education: Bachelor’s in Pharmacy or PharmD required · Licensure: Active license in state of residence · Technical Skills: Proficiency in Excel, Word, PowerPoint, Access, and Visio preferred · Experience: Previous experience in Managed Care / PBM environment Join a team that is helping keep communities healthy across the country.
Apply with A-Line Staffing today to take part in this impactful healthcare initiative!
Remote working/work at home options are available for this role.
Mindlance is here to help you to find the perfect fit with just the right company.
Currently, we are seeking an Accounts Payable Clerk for an exciting career growth opportunity.
Make your next big career move with the kind of position that will allow you to be genuinely passionate about the work you do! Our recruiters will work closely with you to help you get the edge over the competition.
Let Mindlance advocate for you – apply today! “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.” Job Title: IAM Engineer Job Category: IT Industry: Airlines Job Location: Remote Pay rate: $ $70-78/hr on w2 Duration: 7+ Months IAM Engineer Job Description Job Details: Notes: Strong Microsoft EntraID experience and passwordless multi-factor authentication experience.
Top 5 Skill sets · Configuring authentication (OIDC, SAML, OAuth) for applications · Microsoft Entra conditional access policies · Experience with enabling MFA and SSO · Migration of applications between Identity Platforms/Providers · Developing automation/scripts to support onboarding of applications and users to Identity platforms Nice to have skills or certifications: · Duo Experience, Microsoft Entra, Oracle Access Manager · Enable Microsoft Entra app proxy · CISSP or Azure Certifications · This is a senior-level position that will execute the implementation of designs and requirements provided by IAM architects · and analysts and ensures that IAM capabilities and services are successfully integrated within systems across the · organization while also providing ongoing support and maintenance as needed for IAM processes and technology.
Job Summary The IAM Security Engineer is responsible for implementing, integrating, and supporting authentication and authorization solutions aligned with Cybersecurity and Digital Risk (CDR) principles.
This role focuses on protecting enterprise data, reducing security risk, and enabling secure access for the Client workforce.
The Senior IAM Engineer will lead the implementation and support of modern enterprise Workforce IAM systems.
They will collaborate closely with cross-functional development teams, architects, analysts, and business stakeholders to ensure secure identity solutions are integrated throughout the product lifecycle.
This role serves as a key technical contact for IAM authentication and authorization services across the organization.
Essential Job Accountabilities (Core responsibilities accounting for 10% or more of the role) 1.
IAM Platform Implementation & Support (40%) · Implement, administer, and support workforce IAM platforms including Oracle Access Manager (OAM), Microsoft Entra, and Duo.
· Design, configure, and troubleshoot authentication and authorization solutions throughout the SDLC.
· Support automated migration of applications from Oracle Access Manager to Microsoft Entra.
· Onboard and integrate new applications with Microsoft Entra.
· Perform detailed root cause analysis of IAM issues and implement preventative solutions.
· Engineer scalable, secure, and high-performance IAM solutions.
2.
IAM Process Engineering & Automation (20%) · Develop, enhance, test, document, and maintain IAM integration processes.
· Simplify and automate access management workflows to improve user experience.
· Architect and implement accelerators and automation enablers for IAM operations.
· Identify optimization opportunities and execute strategies to improve efficiency, scalability, and service delivery.
Job Title: IAM Engineer Job Category: IT Industry: Airlines Job Location: Remote Pay rate: $ $70-78/hr on w2 Duration: 7+ Months Email Qualified Resumes to: IAM Engineer Job Description Job Details: Notes: Strong Microsoft EntraID experience and passwordless multi-factor authentication experience.
Top 5 Skill sets · Configuring authentication (OIDC, SAML, OAuth) for applications · Microsoft Entra conditional access policies · Experience with enabling MFA and SSO · Migration of applications between Identity Platforms/Providers · Developing automation/scripts to support onboarding of applications and users to Identity platforms Nice to have skills or certifications: · Duo Experience, Microsoft Entra, Oracle Access Manager · Enable Microsoft Entra app proxy · CISSP or Azure Certifications Job Summary The IAM Security Engineer is responsible for implementing, integrating, and supporting authentication and authorization solutions aligned with Cybersecurity and Digital Risk (CDR) principles.
This role focuses on protecting enterprise data, reducing security risk, and enabling secure access for the Client workforce.
5.
Metrics, KPIs & Operational Support (10%) · Support delivery of IAM metrics and KPIs through system analysis and integrations.
· Provide ongoing operational support and maintenance for IAM services and processes.
Required Qualifications & Experience IAM & Security Expertise · In-depth knowledge of Workforce IAM, Single Sign-On (SSO), and Multi-Factor Authentication (MFA).
· Proven experience onboarding SSO applications and integrating MFA with cloud-based identity providers.
· Strong understanding of modern authentication protocols and standards: o FIDO2, SAML, OAuth, OIDC, Kerberos, Federation · Hands-on experience with: o Passwordless authentication o API Gateways o SCIM connector development o Identity platforms such as Microsoft Entra, Duo, Oracle Access Manager, Ping Identity, Okta, or ForgeRock Compliance & Risk · Practical knowledge of compliance and regulatory frameworks: o SOX, PCI, FAA, GDPR, PII · Strong understanding of Zero Trust architecture, adaptive risk-based authorization, identity proofing, and verification technologies.
· Familiarity with security frameworks and governance standards: o ISO, NIST, CSA Controls Matrix Technical & Industry Experience · Experience with large-scale identity transformation initiatives, including migration from on-premise to cloud-based IAM services.
· Prior experience implementing passwordless technologies in large enterprise environments.
· Experience supporting IAM functions within the airline or transportation industry (preferred).
· Exposure to AI/ML, algorithm development, or automation-driven technical solutions (preferred).
Software Development & Delivery · Expertise in modern software development lifecycles and Agile methodologies.
· Experience with automated cloud infrastructure deployment.
Core Competencies · Strong written and verbal communication skills; ability to communicate with both technical and non-technical audiences.
· Excellent attention to detail with qualitative and quantitative data.
· Strong analytical and problem-solving skills with the ability to adapt quickly to changing priorities.
· Demonstrated initiative and ownership of deliverables and outcomes.
Remote working/work at home options are available for this role.
This role requires strong clinical judgment, attention to detail, and the ability to work efficiently in a fast paced, productivity driven environment.
You will collaborate with providers, apply Medicare guidelines, and ensure timely and accurate documentation of all cases.
Key Responsibilities: • Review Medicare appeals cases for accuracy and completeness • Evaluate clinical documentation and internal notes for case decisioning • Perform outbound outreach to providers to obtain additional clinical information • Ensure compliance with CMS Medicare guidelines and mandated timelines • Utilize drug compendia resources and internal systems for decision making • Maintain high productivity and quality standards • Accurately document all case activity and decisions • Participate in coaching, feedback sessions, and continuous improvement initiatives Required Qualifications: • Bachelor’s degree in Pharmacy or PharmD required • Active Pharmacist license in good standing in state of residence • Ability to work independently in a remote environment • Strong attention to detail and organizational skills • Verifiable High School Diploma or GED required Preferred Qualifications: • Experience in Managed Care or PBM environment • Knowledge of Microsoft Access, PowerPoint, and Visio Required Candidate Submissions (Must Be Included on Resume): • Internet speed test • Screenshot of active Pharmacist license showing name, state, and expiration date Additional Details: • Virtual interviews conducted via Microsoft Teams • Opportunity for full time employment based on performance Contact Information: Taryn Davis 469-342-1411 .
Remote working/work at home options are available for this role.
