41 jobs found in plantation

Aetna Description: Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Schedule is standard business hours. And one weekend per month. Onsite position. 64206 Fundamental Components: Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function Background Experience: 3 years of clinical experience required Managed Care experience preferred RN with current unrestricted state licensure required. LICENSE Requires an RN with unrestricted active license. Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Education: Nursing - Registered Nurse Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

CVS Health Job Description The Operations Manager is a member of the Store Management team, and as such, fulfills the company purpose of helping people on their path to better health by driving store execution and performance while building consumer loyalty to CVS/pharmacy through a focus on excellent customer service. Under the supervision of the Store Manager, the Operations Manager will maintain an engaged, productive store team through strong leadership, demonstrating initiative and leading by example. The Operations Manager is responsible for supporting the Store Manager in the total leadership and strategic operation of a CVS/pharmacy store including: * Overall store management, supervision, and policy implementation * Sales and inventory management * Employee staffing, training, and development * Financial management * Customer service leadership Unlike the Store Manager in Training position, the Operations Manager position is not part of the CVS/pharmacy Retail Management Development Program. Operations Managers are not eligible for direct promotion to Store Manager. Candidates with a short-term goal of becoming a CVS Store Manager should instead apply for Store Manager in Training openings. Essential Functions: 1. Management * Lead others and work effectively with store crews * Supervise, assign and direct activities of the store's crew * Effectively communicate information to store crew and supervisors in an open and timely manner * Support Store Manager with actions plans for operational and service improvement 2. Customer Service * Assist customers with their questions, problems and complaints * Promote CVS customer service culture (greet, offer help, and thank) * Required Qualifications Deductive reasoning ability, advanced analytical skills and computer skills. Advanced communication skills, leadership, supervision, and influencing skill Ability to work a full-time flexible schedule, including some early morning, overnight and weekend shifts, to work overtime as needed, and to respond to urgent issues at the store when they arise Preferred Qualifications Experience as a retail manager or supervisor Education High school diploma or equivalent required Business Overview It's a new day in health care. Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all. We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability. CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT . We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team . Please note that we only accept applications for employment via this site. If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com . For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.

Aetna Description: Utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. 65319 Fundamental Components: Promotes/supports quality effectiveness of Healthcare Services and benefit utilization Utilizes clinical skills to support coordination, documentation and communication of medical services and/or benefit administration Collects information to support the process of rendering appropriate medical necessity/benefit determinations Identifies members for referral opportunities to integrate with other products, services and/or programs Utilizes clinical experience, criteria/guidelines, policies and procedures in support of making timely and accurate medical necessity/benefit determinations Background Experience: 2 years clinical experience required Claims experience is required Proficient with Microsoft applications LICENSE 2 years managed care experience. LPN/LVN with current unrestricted state licensure required. Requires LPN/LVN with unrestricted active license. Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Required Skills: Leadership - Collaborating for Results Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Aetna Description: Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources. Schedule Monday-Friday regular business hours. In office role. Travel up to 25% all of Miami Dade county. Residing in central Broward Country/North Miami County. (Pembroke Pines, Miramar, Davey, Coopers City, Plantation, Sunrise) 63730 Fundamental Components: Evaluation of Members: -Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. - Coordinates and implements assigned care plan activities and monitors care plan progress. Enhancement of Medical Appropriateness and Quality of Care: - Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes. - Identifies and escalates quality of care issues through established channels. -Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs. - Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. -Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. -Helps member actively and knowledgably participate with their provider in healthcare decision-making. Monitoring, Evaluation and Documentation of Care: - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Background Experience: Case management and discharge planning experience preferred 2 years experience in behavioral health, social services or appropriate related field equivalent to program focus Managed Care experience preferred Medicaid experience preferred Community mental health experience preferred Spanish is required. EDUCATION Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling). Potential Telework Position: No Percent of Travel Required: 25 - 50% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Aetna Description: Involved in initiative develops, ongoing client support for assigned initiatives that impact the delivery of products and services to the internal and external environment (See Family Summary). Interacts with external vendors, external consultants, consulting team members and/or matrixed staff as required in development of initiatives. Develops and supports transferring knowledge, best practices (external and internal), methodology and tools to client organizations. Participates as a team member, may develop concurrent initiatives based on resource requirements. 63458 Fundamental Components: Develops and supports thorough business case and external customer value analysis to determine selection, prioritization positioning and approach for broadest range of potential solutions (e.g., outsourcing, process improvements, technology solutions) Participates in and supports metrics integration and execution for optimal results. Communicates compelling and concise results to empower client groups in decision making process regarding project opportunities Supports initiative planning as required. Supports engagement using a disciplined repeatable methodology Gathers, analyzes and synthesis business intelligence to drive achievement of less complex strategic business objectives Background Experience: College Degree required. Additional Job Information: Aetna International is looking for a dynamic, creative individual to independently lead projects and end to end data analytics work to improve the plan sponsor services department. The job will require the individual to assess data sets available vs missing to conduct analysis, drive process changes/ IT projects to develop accumulation of data, building of reports thru access queries or other means, and presenting data to Aetna International mgmt stakeholders to assess current business results and identify opportunities. This is a unique role, so individual will be partnering with many stakeholders but primarily working independently on actual project execution. Seeking individual who is looking to learn and implement actual tools within the department such as Quickbase, Power BI dashboards, etc for purposes of driving more metrics based processes across the organization. The right candidate will be provided large opportunity for growth and exposure within the Aetna International organization. Required Skills: General Business - Consulting for Solutions, General Business - Ensuring Project Discipline, General Business - Turning Data into Information, Technology - Justifying the Business Case, Technology - Selecting and Applying Technology Solutions Technology Experience: Database - Microsoft Access, Desktop Tool - Microsoft Visio, Development Language - SQL Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Aetna Description: Responsible for providing direction and leadership to a regionally-aligned team of Account Client Managers. 65098 Fundamental Components: (*) Develops business strategies to successfully manage renewals and ensure customer satisfaction. (*) Implements operational plans in support of achieving renewal, customer satisfaction, revenue, and earnings objectives. (*) Supports team in developing productive and collaborative internal partnerships to create a comprehensive growth and service strategy for an assigned book of business. (*) Ensures alignment with customer's objectives, financial position, and employee benefit strategy while providing cross-selling opportunities and profitable revenue and growth. (*) Regularly provides updates to senior leadership on operational successes or improvement areas within regionally-aligned team. (*) Manages, develops, and cultivates relationships with constituents as appropriate. (*) Partners with team members as appropriate in meetings with clients to professionally represent Aetna in the marketplace; articulates how Aetna's products and services can contribute to clients' objectives. (*) Recruits, develops and retains a diverse workforce. (*) Sets, communicates, implements, and monitors performance metrics within assigned team; aligns assigned performance measures with company objectives. Background Experience: (*) Previous experience managing cross-functional, self-directed teams. (*) 7-10 years progressively responsible account management experience within the health insurance industry. (*) Bachelor's degree desired or equivalent work experience. (*) Prior experience working with providers to optimize their practices strongly preferred. Potential Telework Position: Yes Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Aetna Description: Manage the National Sales team at CareFree Insurance Services. 64026 Fundamental Components: Responsible for activity of the sales team to assure the recruiting, training, product knowledge and independent sales agents and production is increasing to meet goals. THIS POSITION CAN BE LOCATED IN ANY STATE Background Experience: Experience in an independent brokerage system that has experience in Medicare Advantage with multiple carriers. The candidate should have experience in building and maintaining independent distribution and have experience in sales, relationship development, product expertise and strong sales management. Licensed/Life and Health Insurance Strong Leadership skills Additional Job Information: The candidate should have experience in managing sales employees to generate sales from independent Medicare Sales agents. Required Skills: General Business - Ensuring Project Discipline, Leadership - Developing and Executing Strategy, Sales - Cultivating Distribution Channels Desired Skills: Leadership - Engaging and Developing People, Sales - Selling Products and Services, Service - Working Across Boundaries Functional Skills: Sales & Service - Distribution channel management Potential Telework Position: Yes Percent of Travel Required: 25 - 50% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately. #LI-JM1

ServiceMaster For more than 85 years, Terminix has built a reputation as one of the nation's leading providers of termite and pest control services, safeguarding over 3 million homes and businesses against all types of pests in 47 states and 14 countries. What is this role about? Our Pest Technicians serve in a key front-line role and are the very heart of what we do. It's all about providing outstanding service delivery of Terminix products to valued customers within your assigned territory. What does a "Day-in-the-Life" look like? Equipped with a company vehicle and excellent industry training, Pest Techs are out in the neighborhoods Terminix serves visiting residential customers and performing their pest control treatments. Pest Technicians also offer customers on their route additional products and services that may be beneficial, which presents a great opportunity to earn commissions on top of a very attractive base salary. Here are a few more specifics of what you would be doing each day: Applying pesticides to structures according to schedule, safety procedures and label instructions. Responding on a timely basis to customers' requests for telephone and in-person service calls + calling customers to confirm scheduled services. Identifying and acting upon opportunities to sell additional Terminix products or services What do I need to be successful? Being a high school graduate/having a GED and a valid driver's license are both requirements Prior industry experience is great, but not required. The following are much more important... You are personable and enjoy interacting with customers You are self-motivated and have a strong work ethic You can effectively present information to customers one-on-one and in small groups You are detailed oriented and understand the importance of safety You have a good aptitude for basic math-- necessary for doing calculations related to sales and service Of course, given our business, you should be comfortable working outside and in confined spaces like crawl spaces and attics For safety reasons (rebreathers have be able to seal to your face) our Pest Techs aren't able to have facial hair Why should I choose Terminix? In addition to being part of an iconic brand with a rich 85 year history, here are some other highlights of what we offer members of the Terminix Team. Comprehensive training and licensure, all paid by the company Highly competitive compensation - earning potential of $30,000-50,000 in first year. Company provided vehicle (that you can take home with you at night) and gas card Opportunities for advancement and career growth - including paths into management level roles Medical, dental and vision coverage + discounts on ServiceMaster brands Short/long-term Disability and Life Insurance Paid time off Disclaimer The above statements are intended to describe the general nature of the work being performed by employees assigned to this classification; they are not an exhaustive list of all responsibilities, duties and skills required for the position. Terminix and ServiceMaster are committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action-Employer, making decisions without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability status, age, marital status, protected veteran status or any other protected class.

CVS Health Job Description As the Director, Retail Customer Care, you will be responsible for front end operations of the CVS Multi-dose Packaging program, a market differentiator for CVS Pharmacy. This is an instrumental leadership role, responsible for the leadership and development of an effective operations organization to support and sustain rapid growth at multiple call center locations with over 500 pharmacist and technician agents. Excellent communication and management skills with the ability to build, develop, and lead a high-performing team are paramount to the role. Patient growth and retention will be a primary target; achieved through a seamless, defect free experience provided by the Multi-dose team. Teamwork skills and the ability to work cross-functionally with internal business partners are also critical; commonly interacting with Senior Leaders in Pharmacy Operations, Retail Pharmacy stores and the Multi-dose pharmacies. You need to have a passion for healthcare, with customer and clinical experience. The ability to manage individual state regulatory requirements with an agile attitude that quickly responds to unpredictability, in order to meet production deadlines. A continuous improvement mindset as we further define the MDP systems and processes to build a billion dollar business and establish CVS as a leader in this highly competitive market. Required Qualifications - 8+ years of experience in operations and/or customer experience - Ability to travel 25% Preferred Qualifications - Ability to lead diverse work groups in a highly professional and specialized work environment - Knowledge of pharmacy programs and preferably RxConnect - Strong organizational, analytical, communication and operational skills - Strong knowledge of Microsoft Office applications; PowerPoint, Excel, Word, Access, Visio - Experience in healthcare or the retail pharmacy business - Possess a demonstrated results-oriented approach - Strong analytical and problem solving skills Education Bachelor's Degree or equilvant work experience Business Overview It's a new day in health care. Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all. We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability. CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT . We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team . Please note that we only accept applications for employment via this site. If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com . For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352 .

Aetna Description: We are looking for a professional that is dynamic, energetic, intelligent, articulate, a self-starter, takes initiative, quick learner and adept at project management. 62495 Fundamental Components: Develops and executes customer product/plan administration: Meets with customers as needed to discuss service levels and expectations, share process improvements, discuss operation of plans, identify gaps in service levels, determine root causes and develop solutions. Demonstrate sufficient knowledge and experience to appropriately initiate, plan, execute, monitor and achieve growth/renewal objectives within specified timelines. Collaborates with sales and account management team to assists in preparation and delivery of responses to public procurement requests Identifies barriers to customer specific service issues, identifies solutions and leads resolution of issues working with other areas to implement. Responds to customers' requests for claim analysis, plan design changes, and benefit questions and clarifications. Engage with broker/consultant to meet client/market needs. Background Experience: 1-3 years of sales support/client service experience Must be well organized, detail-oriented, and have excellent time management skills Project management experience and ability to meet deadlines on time Health insurance industry experience is a plus Bachelor's degree or equivalent work experience. Additional Job Information: Valid driver's license in good standing. Demonstrated ability to consult strategically on broad HR initiatives. Overnight travel as needed. Excellent project management, organizational and presentation skills. Strong team player, able to handle multiple assignments and responsibilities simultaneously. Required Skills: Sales - Knowing Customers, Service - Creating a Differentiated Service Experience, Service - Handling Service Challenges Desired Skills: General Business - Communicating for Impact, General Business - Consulting for Solutions, General Business - Maximizing Work Practices Functional Skills: Sales & Service - Account Management, Sales & Service - Sales administration, support, reporting Technology Experience: Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft PowerPoint, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel Education: Insurance - Life and Health Insurance License Potential Telework Position: No Percent of Travel Required: 25 - 50% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests

Provide customers (both internal and external) requested parts and accessories in a timely manner. In addition to specifying the correctly needed items, the Parts Counterperson is responsible to solicit additional sales; charges out merchandise using the Dealer Management System, follow-up on special orders, tag, store and process warranty parts, assist in conducting inventory cycle counts and keep inventory area, parts counter and retail area/displays clean and orderly.

Provide customers (both internal and external) requested parts and accessories in a timely manner. In addition to specifying the correctly needed items, the Parts Counterperson is responsible to solicit additional sales; charges out merchandise using the Dealer Management System, follow-up on special orders, tag, store and process warranty parts, assist in conducting inventory cycle counts and keep inventory area, parts counter and retail area/displays clean and orderly.

Aetna Description: Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. Standard business hours Monday-Friday only. Travel is 25-50% into Miami-Dade county. 64691 Fundamental Components: Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Background Experience: 3 years clinical practice experience Pediatric/OB/Maternity experience required Case Management in an integrated model preferred Bilingual required (Spanish or Haitian Creole) LICENSE RN with current, active unrestricted state licensure required. Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Education: Nursing - Registered Nurse Potential Telework Position: No Percent of Travel Required: 25 - 50% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Aetna Description: This is a work from home (telework) position. Oversight and Management of clinical team processes including the organization and development of high performing teams. 64121 Fundamental Components: Reinforces clinical philosophy, programs, policies and procedures. Communicates strategic plan and specific tactics to meet plan. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes. Accountable for meeting the financial, operational and quality objectives of the unit. May be accountable for the day-to-day management of teams for appropriate implementation and adherence with established practices, policies and procedures if there is not supervisor position Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors. Develop, initiate, monitor and communicate performance expectations. May act as a single point of contact for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers. Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills. Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams. Consistently demonstrates the ability to serve as a model change agent and lead change efforts. Accountable for maintaining compliance with policies and procedures and implements them at the employee level. Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes. Background Experience: Active unrestricted State Licensure in applicable functional area. (eg RN) 5 or more years in clinical area of expertise required BSN preferred Additional Job Information: This position can be located in FL, PA, LA, GA, KS, MO Technology Experience: Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel Education: Nursing - Registered Nurse Potential Telework Position: Yes Percent of Travel Required: 10 - 25% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Aetna Description: Mission: To increase member satisfaction, retention, and growth by efficiently delivering competitive services to members and providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes. Maintains oversight of the local Service Center management function. Responsible for the efficiency/quality of monitoring volumes. Conducts arrival pattern forecasting activities and forecasts scheduling/hiring /headcount needs. Recognizes and recommends operational improvements. 64688 Fundamental Components: Analyzes Service center trends, including volume, arrival patterns, staff productivity, and resource allocation. Align work arrivals with staff to achieve schedule optimization. Utilizes reports and coordinates and completes capacity planning with service centers. Conducts arrival pattern forecasting and schedule planning to help meet business unit objectives. Develops, monitors and reviews performance reports and service performance trends for each assigned service areas against the plan and recommends specific actions or remedies as necessary. Participate and supports testing of toll free set up and routing as well as identify and report suspected toll free routing issues. May provide on-the-job training for WCA's and WFM Orientation for Service Staff Leadership and internal Staff. Monitors performance of staff members according to established standards. Background Experience: At least 1 to 2 years of experience in service center environment Associates Degree or equivalent experience Additional Job Information: Solid written and oral communication skills. Strong project management skills (financial, analytical, planning and implementation). Solid leadership skills including staff development. Outstanding customer service skills are required. Prioritizes tasks effectively. Well organized. Negotiation skills. Technical skills. Problem solving skills. Customer Focus and Relationship Building Potential Telework Position: No Percent of Travel Required: 10 - 25% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Aetna Description: The Clinical Liaison is clinical leader in the Medicaid plan focusing on integrating member care, clinical coordination, leading the development, implementation and ongoing monitoring of program and quality initiatives to address the needs of Aetna members. They represent the plan and collaborate with State governments, key stakeholders, community organizations, advocacy groups as well as the Medicaid Plan's Chief Medical Officer and leadership team to enhance the quality of services provided to Aetna members and to ensure adherence to performance targets of the business area. Onsite role in the Aetna Plantation, FL office. Standard business hours only. 64725 Fundamental Components: Partners with Plan executive leadership team to provide overall vision and leadership across all Plan activities. Serves as a key resource regarding any issues related to the integration of member care across departments. Consults with Plan executive management regarding physical and behavioral health clinical issues as they relate to medical management (UM, CM, DM) provider and system of care issues, behavioral health and human services system issues including critical stakeholders such as various departments of state government, provider organizations, advocacy organizations, etc. Partners with Aetna Medicaid's regional psychiatrist(s) to manage and oversee ICM within the health plan. Provides consultation to support physicians at other Medicaid Plans. Participates in organizational planning, including strategic plans, business plans, and new product development. Elicits staff input related to their job functions and leverages errors and failure to reach performance targets as opportunities for organizational learning and improvement. Supports and encourages CM, UM and DM staff to function as interdisciplinary team, with requisite range and depth of subject matter expertise to meet the needs of the covered population. Represents Plan to relevant external stakeholders, such as state government officials, providers/vendors, & advocacy groups with regard to quality improvement initiatives, integrating member care, health plan success, and innovative care strategies. With the plan's physician leader, co-facilitates interdisciplinary case rounds to address the needs of members with complex clinical presentations, identifies opportunities for improving rounds, and works with the clinical leadership team to optimize the value of rounds to the clinical staff. Demonstrates knowledge about established and evolving biomedical, clinical, epidemiologic and social-behavioral sciences and the application of this knowledge to member care. Participate in and support process improvement initiatives within care management and across broader Plan operations. Background Experience: 5 years experience in a clinical setting. (behavioral health & hospital) 2 years of managed care experience. 2 years management experience. Management experience in a clinical setting preferred. 3 years complex case work experience, preferably in managed care environment in a community or institutional setting. For Clinical Services Managers in other areas: 5 years experience including clinical, supervisory and/or administrative role Strong verbal and written communication skills and the ability to communicate effectively with all levels of management. Experience in handling mental health and psychiatric care, family situations, relationship concerns. Experience working with managed and non-managed health care benefits. Experience with third party relationships, including local community building efforts, governmental and regulatory authorities. Supervisory, management and administrative experience, excellent consultative and communication skills, analytical ability, decisiveness, strong judgment and the ability to work effectively with client and IT management and staff and vendors. EDUCATION & LICENSE Master's degree in social work and license required (LCSW) or Licensed Behavioral Health Clinician (LPC, LMFT, PhD, or Psy.D), or RN who specializes in behavioral health with current unrestricted state licensure required. Education: Mental Health - Licensed Clinical Social Worker, Mental Health - Licensed Professional Counselor Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Comcast Comcast brings together the best in media and technology. We drive innovation to create the world's best entertainment and online experiences. As a Fortune 50 leader, we set the pace in a variety of innovative and fascinating businesses and create career opportunities across a wide range of locations and disciplines. We are at the forefront of change and move at an amazing pace, thanks to our remarkable people, who bring cutting-edge products and services to life for millions of customers every day. If you share in our passion for teamwork, our vision to revolutionize industries and our goal to lead the future in media and technology, we want you to fast-forward your career at Comcast. Xfinity Retail Store Summary: Our XFINITY Retail Stores represents a significant sales and service channel in the company serving over 30 million customers every year. Join us as we continue to evolve into a world-class national retailer, bringing together immersive in-store sales and service experiences. Our stores have always been a place where customers could find a friendly expert to help with routine service. Now we are so much more! Our stores have become a place where customers can experience our products and services in convenient locations. Additionally, customers can purchase the latest consumer electronics products that enhance home entertainment, home connectivity and their mobile experiences Position Summary Being the face of XFINITY, our Retail Sales & Service Consultants are responsible for assisting customers with all aspects sales and service ensuring an excellent customer experience. Using your knowledge, tools & technology along with a passion and desire to help; you will customize a unique solution to each customer. Product & service offerings include: XFINITY TV XFINITY Internet XFINITY Voice XFINITY Home XFINITY Mobile Core Responsibilities - Provide superior customer service with all customer interactions. - Deep understanding of XFINITY products and services; effectively inform and educate customers. - Provide product demonstrations to illustrate to customers how XFINITY products and services improve the customers’ lives. - Understand XFINITY products capabilities and how they outperform the competition. - Evaluate customer’s potential product needs and tailor XFINITY solution to meet customer video, data, voice, connected home and Comcast mobile requirements. - Position devices, mobile devices and 3rd party accessories as part of core product offering. - Set high standard by meeting or exceeding sales & customer satisfaction goals. - Support store operations including inventory, equipment transactions and payment activity. - Thrive in a fast paced, high-energy, rapidly changing environment. - Responsible for immersive customer onboarding experience ensuring the customer fully understands how to use XFINITY products and services including XFINITY Apps. - Complies with all operational policies and procedures and Comcast code of conduct - Completes all courses in the training curriculum. - Must be able to work a flexible schedule that includes evenings, weekends and certain holidays. May be asked to work in alternate XFINITY Stores outside of home base store. Regular, consistent and punctual attendance. - Requires travel throughout the store to greet and direct customers, perform product demo at various stations. - Drop-off and pick-up equipment for customers back of house. - Other duties and responsibilities as assigned. Key Qualifications - High School Degree or Equivalent - Generally requires 1-3 years related experience; prefer consumer electronics/wireless retail sales experience - Must enjoy interacting with people - Committed to providing world class customer experience - Warm & engaging-ability to develop rapport quickly - Positive, “I can help you with that” attitude - Genuinely curious about customer needs - Solution orientated - Strong communication skills - Consultative selling approach - Passion for technology - Desire to learn - Ability to excel in dynamic environment Comcast is an EOE/Veterans/Disabled/LGBT employer

Comcast Comcast brings together the best in media and technology. We drive innovation to create the world's best entertainment and online experiences. As a Fortune 50 leader, we set the pace in a variety of innovative and fascinating businesses and create career opportunities across a wide range of locations and disciplines. We are at the forefront of change and move at an amazing pace, thanks to our remarkable people, who bring cutting-edge products and services to life for millions of customers every day. If you share in our passion for teamwork, our vision to revolutionize industries and our goal to lead the future in media and technology, we want you to fast-forward your career at Comcast. Xfinity Retail Store Summary: Our XFINITY Retail Stores represents a significant sales and service channel in the company serving over 30 million customers every year. Join us as we continue to evolve into a world-class national retailer, bringing together immersive in-store sales and service experiences. Our stores have always been a place where customers could find a friendly expert to help with routine service. Now we are so much more! Our stores have become a place where customers can experience our products and services in convenient locations. Additionally, customers can purchase the latest consumer electronics products that enhance home entertainment, home connectivity and their mobile experiences Position Summary Being the face of XFINITY, our Retail Sales & Service Consultants are responsible for assisting customers with all aspects sales and service ensuring an excellent customer experience. Using your knowledge, tools & technology along with a passion and desire to help; you will customize a unique solution to each customer. Product & service offerings include: XFINITY TV XFINITY Internet XFINITY Voice XFINITY Home XFINITY Mobile Core Responsibilities - Provide superior customer service with all customer interactions. - Deep understanding of XFINITY products and services; effectively inform and educate customers. - Provide product demonstrations to illustrate to customers how XFINITY products and services improve the customers’ lives. - Understand XFINITY products capabilities and how they outperform the competition. - Evaluate customer’s potential product needs and tailor XFINITY solution to meet customer video, data, voice, connected home and Comcast mobile requirements. - Position devices, mobile devices and 3rd party accessories as part of core product offering. - Set high standard by meeting or exceeding sales & customer satisfaction goals. - Support store operations including inventory, equipment transactions and payment activity. - Thrive in a fast paced, high-energy, rapidly changing environment. - Responsible for immersive customer onboarding experience ensuring the customer fully understands how to use XFINITY products and services including XFINITY Apps. - Complies with all operational policies and procedures and Comcast code of conduct - Completes all courses in the training curriculum. - Must be able to work a flexible schedule that includes evenings, weekends and certain holidays. May be asked to work in alternate XFINITY Stores outside of home base store. Regular, consistent and punctual attendance. - Requires travel throughout the store to greet and direct customers, perform product demo at various stations. - Drop-off and pick-up equipment for customers back of house. - Other duties and responsibilities as assigned. Key Qualifications - High School Degree or Equivalent - Generally requires 1-3 years related experience; prefer consumer electronics/wireless retail sales experience - Must enjoy interacting with people - Committed to providing world class customer experience - Warm & engaging-ability to develop rapport quickly - Positive, “I can help you with that” attitude - Genuinely curious about customer needs - Solution orientated - Strong communication skills - Consultative selling approach - Passion for technology - Desire to learn - Ability to excel in dynamic environment Comcast is an EOE/Veterans/Disabled/LGBT employer

Aetna Description: Provide oversight for medical policy implementation. Participate in the development, implementation, and evaluation of clinical/medical programs. 64202 Fundamental Components: Expands Aetna's medical management programs to address member needs across the continuum of care Supports the Medical Management staff ensuring timely and consistent responses to members and providers. Oversees utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise Background Experience: 2-3 years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. Active and current state medical license without encumbrancesM.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience. Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Aetna Description: Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Services Programs. Promotes/supports quality effectiveness of Healthcare Services. 64230 Fundamental Components: Performs intake of calls from providers regarding services via telephone, fax, EDI. Utilizes QNXT and other Aetna system to build, research and enter member information. Screens requests for appropriate referral to medical services staff. Approve services that do not require a medical review in accordance with the benefit plan. Performs non-medical research including eligibility verification, COB, and benefits verification. Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., claim administrators, Plan Sponsors, and third party payers as well as member, family, and health care team members respectively) Protects the confidentiality of member information and adheres to company policies regarding confidentiality Communicate with Aetna Case Managers, when processing transactions for members active in this Program Supports the administration of the precertification process in compliance with various laws and regulations, URAQ and/or NCQA standards, where applicable, while adhering to company policy and procedures. Places outbound calls to providers under the direction of Medical Management Nurses to obtain clinical information for approval of medical authorizations. Uses Aetna Systems such as QNXT, ProFAX, ProPAT, and Milliman Criteria. Communicates with Aetna Nurses and Medical Directors, when processing transactions for members active in this Program. Sedentary work involving significant periods of sitting, talking, hearing and keying. Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor. Working environment includes typical office conditions. Background Experience: 2-4 years experience as a medical assistant, office assistant or other clinical experience preferred but not required. Knowledge of QNXT and CPT/HCPCS codes preferred. High School Diploma or G.E.D. Additional Job Information: Effective communication, telephonic and organization skills.Familiarity with basic medical terminology and concepts used in care management.Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.Ability to effectively participate in a multi-disciplinary team including internal and external participants. Required Skills: General Business - Applying Reasoned Judgment, Service - Creating a Differentiated Service Experience, Service - Handling Service Challenges Desired Skills: General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen, Service - Providing Solutions to Constituent Needs Potential Telework Position: No Percent of Travel Required: N/A EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.