Integra Partners

Claims Inquiry Representative Location: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Remote Full-time Job Description: The Claims Inquiry Representative is responsible for responding to webform inquiries from providers and plan partners, reviewing Durable Medical Equipment (DME) claims for billing accuracy, investigating root causes, and delivering professional, timely solutions while maintaining compliance with legal, regulatory, and company policies including HIPAA. The role requires documentation maintenance, teamwork, adaptability, and the ability to meet productivity goals. Salary: $19.00/hour JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES - Demonstrate the ability to work effectively with multiple health plan payers and remain adaptable to varying daily assignments. - Perform additional duties as assigned to support team and organizational goals. - Foster a climate of teamwork and collaborative problem-solving within the workgroup. - Ensure a minimum internet bandwidth of 200 Mbps download speed is maintained to support daily job duties effectively. - Remain accountable for achieving daily productivity goals that meet or exceed the current production metrics. - Commit to adding value and making positive contributions to the company and department. - Be flexible and willing to adapt to changes within the work environment. - Meet consistent attendance and punctuality expectations as required. - Follow both written and verbal instructions accurately. - Understand and perform all duties in compliance with State and Federal regulations, as well as the policies and procedures of Integra Partners and its clients. - Be self-motivated and utilize available resources to investigate issues and resolve problems independently. - Respond to provider inquiries in a professional, thorough, and timely manner. - Maintain strong attention to detail in all aspects of the role to ensure accuracy and quality. EDUCATION: High school diploma required EXPERIENCE: - Prior medical billing experience. - Proficient in Microsoft Office (Word, Excel, Outlook) and able to learn new programs. - Knowledge of 1500 claim forms, DMEPOS services, ICD-10, HCPCS, and medical terminology. - Able to accurately review medical documents. - Self-motivated, works independently and effectively in a fast-paced team. - Strong organizational and critical thinking skills - Must be reliable and meet attendance expectations. Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

Title: Utilization Review Medical Director Location: Remote Department: Utilization Management Job Description: The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support Integra’s Utilization Management (UM) operations. This full-time, salaried role functions within a structured, high-volume authorization review queue and requires adherence to workflow timelines, clinical accuracy standards, and productivity expectations. The Medical Director ensures determinations are made in accordance with Medicare and Medicaid guidelines, health plan–specific criteria, internal policies, and regulatory requirements. This role is best suited for physicians who thrive in a process-driven environment and are committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director’s responsibilities include but are not limited to: - Conduct timely clinical reviews of DMEPOS authorization requests using applicable criteria, including LCDs, Medicaid Manuals, InterQual, MCG, internal medical policies, and health plan requirements. - Function within a real-time review queue and maintain continuous case throughput in alignment with organizational turnaround and productivity standards. - Evaluate clinical documentation, identify missing elements, and render determinations supported by clear clinical rationale. - Review cases escalated by UM staff and/or UM Leadership when criteria do not apply to the enrollee’s unique clinical situation or when clinical judgment is required. - When appropriate, consult with external board-certified reviewers, engage with ordering practitioners, or conduct additional clinical dialogue prior to rendering a determination. - Participate in Peer-to-Peer (P2P) discussions, including maintaining availability for scheduled appointment times. - Document all clinical decisions clearly, concisely, and consistently in accordance with internal SOPs, NCQA standards, and regulatory expectations. - Maintain inter-rater reliability and participate in periodic calibration reviews to support consistency across the UM program. - Serve as a clinical resource for UM team, providing guidance on clinical interpretation, criteria application, and complex case review. - Support internal and external audit activities as needed, including NCQA accreditation, health plan audits, and state Medicaid reviews. - Notify leadership of observed trends, potential quality concerns, or opportunities to strengthen criteria alignment or operational workflows. - Maintain up-to-date knowledge of Medicare, Medicaid, DMEPOS policies, clinical standards of care, and regulatory updates relevant to UM. Requirements: - MD or DO degree - Board certification in Internal Medicine, Family Medicine, or Physical Medicine & Rehabilitation - Eligible for participation in Medicare, Medicaid, and other federally funded programs; no current or past OIG or state sanctions - Experience performing utilization management or clinical review activities - Strong written and verbal communication skills with emphasis on documentation accuracy - Ability to work effectively in a high-volume, queue-based workflow with daily review expectations - Familiarity with electronic UM systems and authorization platforms - Experience with DMEPOS reviews - Experience with NCQA UM accreditation standards - Prior UM experience for MLTC, Medicaid, or Medicare Advantage plans Working Conditions and Additional Expectations: - Full-time remote role requiring consistent availability during standard business hours and responsiveness to daily assignments. - Case volume and mix vary; continuous throughput and timely review completion are required. - Must maintain a quiet, secure, and compliant environment for reviewing PHI and participating in P2P calls. - Secondary employment or consulting arrangements are permitted only if they do not interfere with the full-time expectations and require disclosure/approval. - Daily accountability measures, productivity monitoring, and adherence to all UM workflows are required. Salary: 250,000.00/Annually Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

Title: Quality Assurance Analyst Location: Remote Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Department: Operations Job Description: The Quality Assurance Analyst is responsible for monitoring and documenting production quality in support of the departmental goals and initiatives. The Quality Assurance Analyst evaluates both verbal and written customer contact. The Analyst participates in the design of all quality monitoring formats and quality standards. The Quality Assurance Analyst will fairly and consistently review the calls, emails, claims, etc. of our team for accuracy and provide coaching for success in executing superior service and quality to our customers. The Quality Assurance Analyst documents the production quality results and effectively presents and facilitates discussions, providing feedback and trend data to the Management team to drive continuous improvement. JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES QUALIFICATIONS: - Minimum of 1 year of experience performing Quality Assurance in a call center or other production-oriented service operations environment (or equivalent education and experience) - Desire and capability to emerge as a leader within the Operations team - Consistent track record of 95% + in Quality and Production scores in current/previous roles - Proficient understanding of QA methodologies and quality monitoring practices - Demonstrated ability to rapidly gain product, process and tools knowledge and effectively communicate it to employees - Ability to analyze data to identify root causes of quality issues and propose actionable solutions - Excellent communication skills including listening, interpersonal, verbal, written, spelling and grammar - Ability to coach/motivate employees with tact in order to facilitate optimal performance - Must exhibit leadership capabilities and interpersonal skills - Maintain confidential information and abide by necessary rules and regulations - Strong organizational, problem-solving, and analytical skills - Manage conflicting priorities while clearly communicating and managing expectations - Proficiency in Word, Excel and PowerPoint for presentations and reports - Flexible and able to multitask and work with changing priorities with enthusiasm - Self-motivated, detail-oriented and prepared to work independently or as an active team player - Ability to remain focused and motivated during the auditing process - Healthcare experience is a MUST - Fluent in Spanish and English preferred What will you learn in the first 6 months? - You will learn the function of the Quality Assurance team within the Operations organization. - You will fully understand your job role and responsibilities and which tools assist you in your position - Familiarized with Integra’s QA platform (Genie) and how to navigate through it. Including how to adjudicate an audit appeal - Subject matter expert in the Policy and Procedures for the department(s) you audit - During this time, you will set measurable goals for personal development and growth. What will you achieve in 12 months? - You will be fully integrated with your job, company and team. - You will be contributing your skills and knowledge to meeting your department's goals. - You will become confident in leading meetings with Interdepartmental Management teams and presenting complex concepts related to quality analysis EDUCATION: - Bachelor’s Degree preferred or equivalent experience Salary: 22.00/Hour Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

The Scrum Master is a servant-leader and accountable owner of delivery health for one or more Agile teams. Reporting directly to the CIO, this role is responsible for ensuring disciplined Scrum execution, owning sprint predictability and flow health, and driving continuous improvement through data-driven insights and proactive intervention. The Scrum Master partners closely with Project Managers, Product Owners, Engineering Leads, and cross-functional stakeholders to enable high-performing teams, remove impediments, and ensure delivery commitments are met with consistency and transparency within Integra’s project governance model. JOB QUALIFICATIONS:KNOWLEDGE/SKILLS/ABILITIES The Scrum Master’s responsibilities include but are not limited to: - Agile Facilitation & Execution - Lead all Scrum ceremonies (Sprint Planning, Daily Standups, Sprint Reviews, Retrospectives) with discipline, purpose, and clear outcomes - Ensure sprint goals are clearly defined, achievable, and aligned with product and business objectives - Enforce Definition of Ready and Definition of Done standards to protect sprint integrity - Track sprint progress using velocity trends, burndown, throughput, and blocker dashboards to maintain delivery consistency and forecast accuracy - Accountability & Ownership - Own sprint delivery health and predictability for assigned teams, including commitment reliability and flow efficiency - Champion team accountability for sprint commitments—reinforcing the principle of “finish what we start” - Proactively intervene when delivery metrics degrade, using coaching, facilitation, and escalation as appropriate - Track, analyze, and escalate recurring story point slippage, rollover, aging work items, and delivery risks - Facilitate root cause analysis when commitments are missed and ensure corrective actions are implemented and measured for impact - Escalate impediments using a tiered escalation model—partnering first with the Project Manager, then IT Leadership/Directors, and engaging the CIO when issues are systemic, unresolved, or require executive intervention - Team Enablement & Coaching - Coach teams on Agile principles, Scrum best practices, and self-organization - Foster psychological safety while maintaining high standards for accountability and delivery discipline - Drive a culture of constructive feedback, continuous improvement, and ownership - Support individual and team growth through mentorship, pairing, and skill development - Delivery Culture, Metrics & Transparency - Own and maintain delivery dashboards that reflect sprint health, velocity stability, rollover trends, and throughput - Ensure delivery metrics are accurate, transparent, and used to drive behavior change—not just reporting - Partner closely with Project Managers to align team execution with project plans, milestones, and dependencies - Support stakeholder communication by providing team-level insights, delivery health data, and risk signals, while Project Managers retain primary accountability for external and cross-functional delivery communications - Promote transparency of work across teams and stakeholders through consistent metrics, visibility, and reporting SUCCESS METRICS - The Scrum Master is directly accountable for maintaining and improving the following delivery outcomes: - Sprint commitment vs. completion rate within agreed tolerance - Reduction in rollover and aging story points over time - Team velocity stability and improvement - Retrospective action follow-through and measurable impact - Stakeholder confidence in delivery predictability and transparency EDUCATION: Bachelor’s degree or equivalent experience EXPERIENCE: - Proven experience as a Scrum Master in a fast-paced, cross-functional environment - Strong command of Agile frameworks, delivery metrics, and flow-based thinking - Comfortable owning delivery outcomes while operating within a structured project governance model - Excellent facilitation, coaching, and conflict-resolution skills - Highly data-driven with a relentless focus on outcomes, accountability, and continuous improvement SALARY: $105,000/annually Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

The Clinical Quality Analyst is responsible for monitoring, auditing, and documenting both clinical and non-clinical production quality in support of departmental goals and organizational standards. This role evaluates clinical documentation and decision-making across operational areas that require regulatory oversight, client-specific requirements, and compliance with medical policy, with an emphasis on accuracy, completeness, documentation quality, adherence to clinical and operational guidelines, and alignment with applicable regulatory and client standards. As needed, the role also performs non-clinical audits, including reviews of customer service interactions, system documentation, claims, administrative workflows, and other operational processes. The Clinical Quality Analyst participates in the development of quality monitoring formats and standards, ensuring fair and consistent evaluation practices across clinical and operational functions. This role provides clear, constructive feedback to team members and leadership, supports coaching efforts, and collaborates cross-functionally to identify trends, recommend solutions, and drive continuous improvement. The Clinical Quality Analyst documents audit results, prepares quality reports, and facilitates discussions with stakeholders to support service excellence and operational effectiveness across the organization JOB QUALIFICATION: KNOWLEDGE/SKILLS/ABILITIES The Clinical Quality Assurance Analyst responsibilities include but are not limited to: - Audit clinical reviews and documentation, including medical necessity determinations, regulatory compliance, and adherence to medical policy - Ensure adherence to clinical guidelines, payer policies, and industry standards (NCQA, URAC, CMS, state and federal regulations.) - Complete and document audits using standardized quality monitoring tools - Collaborate with clinical and operational leadership, as well as training teams, to support targeted coaching, process improvement, and the development of content-based training that equips personnel with the skills needed for success - Maintain compliance with HIPAA and confidentiality requirements - Support special audits, regulatory readiness activities, and ad hoc analysis requests - Perform non-clinical audits as needed · Participate in and support the design of quality monitoring forms and quality standards - Record evaluations utilizing departmental quality monitoring forms - Collect, evaluate, report on, and track operational data against performance metrics - Prepare and analyze quality reports for management review - Prepare and facilitate quality calibration sessions with designated department leads - Facilitate meetings and prepare presentations related to insight analysis - Monitor trends and provide input or feedback on the information reported on - Identify, analyze, and share ways to optimize the quality monitoring process - Complete all evaluations, reports, and employee coaching sessions on a timely basis - Ability to learn new systems, tools, and methodologies as needed and continue progressing in a dynamic environment - Support ad hoc quality monitoring, reporting, and analysis activities based on operational needs - Work and communicate cross-departmentally QUALIFICATIONS: - Active, unrestricted LPN/LVN or RN license - Minimum 2 years of experience in Utilization Management or related clinical operations in a healthcare or managed care setting - Minimum of 1 year of experience performing Quality Assurance in a call center or other production-oriented service operations environment (or equivalent education and experience) - Strong knowledge of clinical review processes, regulatory requirements, and medical necessity criteria (e.g., InterQual, MCG) - Familiarity with UM software platforms and audit tools - Proficient understanding of QA methodologies and quality monitoring practices - Demonstrated ability to rapidly gain product, process, and tools knowledge and effectively communicate it to employees - Ability to analyze data to identify root causes of quality issues and propose actionable solutions - Excellent communication skills including listening, interpersonal, verbal, written, spelling, and grammar - Ability to coach/motivate employees with tact in order to facilitate optimal performance - Must exhibit leadership capabilities and interpersonal skills - Maintain confidential information and abide by necessary rules and regulations - Strong organizational, problem-solving, and analytical skills - Manage conflicting priorities while clearly communicating and managing expectations - Proficiency in Microsoft Office (Word, Excel, PowerPoint) for presentations and reports - Flexible and able to multitask and work with changing priorities with enthusiasm - Self-motivated, detail-oriented, and prepared to work independently or as an active team player - Ability to remain focused and motivated during the auditing process - Consistent track record of 95%+ in Quality and Production scores in current/previous roles - Experience conducting clinical or non-clinical audits or quality assurance reviews What will you learn in the first 6 months? - You will learn the function of the Quality Assurance team within the Operations organization. - You will fully understand your job role and responsibilities and which tools assist you in your position - Familiarized with Integra’s QA platform (Genie) and how to navigate through it. Including how to adjudicate an audit appeal - Comprehensive understanding of Integra’s Utilization Management workflows and QA processes - Subject matter expert in the Policy and Procedures for the department you audit - During this time, you will set measurable goals for personal development and growth. What will you achieve in 12 months? - You will be fully integrated with your job, company and team. - You will be contributing your skills and knowledge to meeting your department's goals. - You will become confident in leading meetings with Interdepartmental Management teams and presenting complex concepts related to quality analysis EDUCATION: Bachelor’s degree in nursing Healthcare Quality Certification (e.g., CPHQ) or willingness to obtain within 12 months Salary: 70,000/Annually Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

The Quality Assurance Analyst is responsible for monitoring and documenting production quality in support of the departmental goals and initiatives. The Quality Assurance Analyst evaluates both verbal and written customer contact. The Analyst participates in the design of all quality monitoring formats and quality standards. The Quality Assurance Analyst will fairly and consistently review the calls, emails, claims, etc. of our team for accuracy and provide coaching for success in executing superior service and quality to our customers. The Quality Assurance Analyst documents the production quality results and effectively presents and facilitates discussions, providing feedback and trend data to the Management team to drive continuous improvement. JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES QUALIFICATIONS: - Minimum of 1 year of experience performing Quality Assurance in a call center or other production-oriented service operations environment (or equivalent education and experience) - Desire and capability to emerge as a leader within the Operations team - Consistent track record of 95% + in Quality and Production scores in current/previous roles - Proficient understanding of QA methodologies and quality monitoring practices - Demonstrated ability to rapidly gain product, process and tools knowledge and effectively communicate it to employees - Ability to analyze data to identify root causes of quality issues and propose actionable solutions - Excellent communication skills including listening, interpersonal, verbal, written, spelling and grammar - Ability to coach/motivate employees with tact in order to facilitate optimal performance - Must exhibit leadership capabilities and interpersonal skills - Maintain confidential information and abide by necessary rules and regulations - Strong organizational, problem-solving, and analytical skills - Manage conflicting priorities while clearly communicating and managing expectations - Proficiency in Word, Excel and PowerPoint for presentations and reports - Flexible and able to multitask and work with changing priorities with enthusiasm - Self-motivated, detail-oriented and prepared to work independently or as an active team player - Ability to remain focused and motivated during the auditing process - Healthcare experience preferred - Fluent in Spanish and English preferred What will you learn in the first 6 months? - You will learn the function of the Quality Assurance team within the Operations organization. - You will fully understand your job role and responsibilities and which tools assist you in your position - Familiarized with Integra’s QA platform (Genie) and how to navigate through it. Including how to adjudicate an audit appeal - Subject matter expert in the Policy and Procedures for the department(s) you audit - During this time, you will set measurable goals for personal development and growth. What will you achieve in 12 months? - You will be fully integrated with your job, company and team. - You will be contributing your skills and knowledge to meeting your department's goals. - You will become confident in leading meetings with Interdepartmental Management teams and presenting complex concepts related to quality analysis EDUCATION: - Bachelor’s Degree preferred or equivalent experience Salary: 22.00/Hour Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key role in collaborating with our Medical Director to perform benefit and medical necessity reviews and appeals within an NCQA-compliant UM program. Salary: $60,000.00/annual JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse’s responsibilities include but are not limited to: - Perform pre-service and post service UM authorization reviews utilizing federal and state mandates, plan benefit language and NCDs/LCDs as criteria for medical necessity reviews - Work with non-clinical team to obtain additional clinical information, as needed - Approve requests that meet eligibility, benefit, and medical necessity criteria - Refer cases to the Medical Director that do not meet medical necessity criteria - Refer cases to independent consultants or IROs, when necessary - Communicate outcomes of UM authorization reviews, both verbally and in writing - Process administrative and clinical appeals and refer as needed to the Medical Director - Maintain compliance with all accrediting agency standards such as NCQA, CMS and State agencies - Strong organizational skills, ability to adapt quickly to change and desire to work in a fast-paced environment - Team oriented and self-motivated with a positive attitude - Performs other duties as assigned EDUCATION: Active, Licensed Vocational Nurse, or Licensed Practical Nurse license EXPERIENCE: - Minimum of 3 years of nursing in an acute or outpatient setting - Minimum of 2 years of UM experience in a managed care, payor environment - Experience with Medicare and Medicaid (not required, but highly desirable) - Experience with UM authorizations and appeals for DMEPOS (not required, but highly desirable) - Experience with Medical Necessity Criteria including but not limited to InterQual, CMS guidelines, health plan medical policies, etc. - Experience writing denial letters is preferred - Verbal and written communication skills to convey information clearly and consistently Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

JOB SUMMARY: Integra Partners works with hundreds of healthcare providers of durable medical equipment, orthotics and prosthetics to help facilitate the care of thousands of patients per year. To ensure we are operating at the highest professional standard for our network of patients, health plans and providers, we are seeking dynamic individuals to come join our call center as Bilingual Customer Service Representatives. As the first point of contact for inquiries from our external partners and patients, this role will also be tasked with managing a large volume of important documents that ensure our business runs smoothly. To WOW our customers, you are driven by providing a best-in-class client experience for all parties both internally and externally, you take great pride in operating in a client-facing environment and value working cross-functionally to deliver innovative client and member-focused solutions. Starting Pay: $19.00/hour JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES: The Bilingual Customer Service Representative’s responsibilities include but are not limited to: Managing our Spanish-speaking patient, health plan or healthcare providers needs by telephone or email. Routing health plan representatives and providers to appropriate internal resources. Handle and resolving customer questions and/or issues. Routing fax and mail correspondence to appropriate resource. Answering on average 50 – 60 calls per day. Maintaining a 90% or higher quality assurance score on calls. Keeping all email turnaround time to one (1) day or less. EDUCATION: High School diploma required or equivalent EXPERIENCE: · Exceptional communication skills – verbal and written / English and Spanish fluency (verbal and written) is a must · Computer skills – Microsoft Word, Excel and ability to type 45 wpm · Highly detail oriented with an emphasis on accuracy · Maintains an attitude of responsibility, ownership and accountability · High energy and passion · Customer / Client Focused · Have a pleasant telephone personality · Conduct yourself in a courteous, helpful, and professional manner at all times when dealing with patients, co-workers, supervisors and or the public · Outstanding organizational and multitasking abilities · Active listener with excellent communication skills · Sound judgement and critical thinking · Passion for your work and the mission of the company · Motivated and able to work independently within a fast paced, team environment · Prior experience in a call center preferred · Healthcare / DME O&P experience preferred · Must follow policies regarding attendance and punctuality · Ability to work overtime as required Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

Integra Partners works with hundreds of healthcare providers of durable medical equipment, orthotics and prosthetics to help facilitate the care of thousands of patients per year. To ensure we are operating at the highest professional standard for our network of patients, health plans and providers, we are seeking dynamic individuals to come join our call center as Customer Service Representatives. As the first point of contact for inquiries from our external partners and patients, this role will also be tasked with managing a large volume of important documents that ensure our business runs smoothly. To WOW our customers, you are driven by providing a best-in-class client experience for all parties both internally and externally, you take great pride in operating in a client-facing environment and value working cross-functionally to deliver innovative client and member-focused solutions. Job Responsibilities and Duties - Handle and resolve customer questions and concerns; you’ll answer 50-60 calls per day on average - Provide detailed notes and follow-up information in the CRM during each call - Research and respond to inquiries using our internal systems, CRM, and other software programs - Manage other patient, health plan, or healthcare providers needs and escalate as required - Route health plan representatives and providers to appropriate internal resources - Maintain a 90% or higher quality assurance score on calls What will you learn in the first 30 days? - In your first 30 days you will learn the function of the call center within the company and go through a comprehensive training program - You will fully understand your job role and responsibilities, and which tools assist you in your position. - You will be able to answer basic inquiries and questions, as well as how to escalate inquiries to other representatives and departments What will you achieve in the first 90 days? - You will be able to answer complex questions or know where to get answers or support. - You will be contributing your skills and knowledge to meet your department’s metrics and goals. - You will receive feedback and coaching from our Quality Assurance team to ensure you adhere to company policies and are providing exceptional customer service. - You will have regular monthly one-on-one meetings with leaders for mutual feedback and have initiated your personal development plan. Starting Pay: $18.00/hour Knowledge/Skills/Abilities - Able to prioritize, organize with excellent attention to detail and problem-solving skills. - Sound judgement and critical thinking - Must be reliable, highly motivated self-starter, able to multitask and work independently within a fast-paced, team environment. - Conduct yourself in a courteous, helpful, and professional manner - Ability to work overtime as required - Must follow policies regarding attendance and punctuality - Maintain a climate of teamwork and collaborative problem solving - Add value and positive contributions towards the company and department culture Required Experience - At least 1-year previous experience in a customer service role - Previous call center and/or healthcare experience preferred - Ability to type at least 40 words per minute (WPM) - Proficiency using a Microsoft Windows operating system - Proficiency using Microsoft Outlook, Word, internet browsers, and web-based applications - Proficient verbal and written English communication skills - Detail-oriented and accurate in your work - Ability to conduct yourself in a courteous, helpful, and professional manner - Active listening skills - Ability to work assigned schedules and follow policies regarding attendance and punctuality - High-speed home internet connection - A private workspace within the home free from distractions - Ability to handle confidential and protected health information in accordance with company policies and procedures Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

The Operations Program Coordinator serves as a strategic advisor and operational partner, ensuring alignment between the COO’s priorities and organizational execution. This role combines project leadership with analytical expertise to ensure successful execution of initiatives, improves operational efficiency, scalability, and organizational performance to drive long term strategy. JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES Key Responsibilities - Strategic Planning & Execution - Partner with the COO to define and implement operational strategies aligned with corporate objectives. - Track progress on strategic initiatives and ensure timely delivery of key milestones. - Assist the COO in evaluating business processes and recommending improvements. - Support strategic planning efforts, including modeling and forecasting. - Operational Oversight - Provide guidance and oversight for projects within Service Operations, Production Management, Medical Management, and Service Excellence. - Identify and resolve operational bottlenecks to improve scalability and efficiency. - Collect, analyze, and interpret operational data to identify trends, gaps, and opportunities. - Executive Communication/Reporting - Draft and manage internal and external communications on behalf of the COO. - Prepare presentations, reports, and updates for executive leadership and board meetings. - Track KPIs and provide actionable insights to the COO. - Meeting & Event Management - Coordinate leadership summits, operating committee meetings, and strategic reviews. - Develop agendas, manage materials, and ensure accurate follow-up on action items. - Cross-Functional Collaboration - Act as liaison between the COO and senior leadership teams to ensure alignment and accountability. - Foster collaboration across departments to achieve organizational goals. - Facilitate communication between the COO and project teams. - Special Projects - Lead or support high-priority projects that enhance operational performance and organizational growth. - Develop project plans, timelines, and deliverables; monitor progress and mitigate risks. Qualifications - Bachelor’s degree in Business, Finance, Operations, or related field. - 1-3 years of experience in project management, business analysis, or operations. - Strong analytical and problem-solving skills. - Proficiency in project management tools and data visualization platforms. - Excellent communication and stakeholder management abilities. - Experience in healthcare or corporate operations is a plus. Core Competencies - Project Management - Analytical Thinking - Strategic Planning - Communication & Influence - Operational Excellence Performance Metrics - On-time delivery of projects aligned with COO priorities. - Accuracy and clarity of analytical reports and dashboards. - Positive feedback from stakeholders on collaboration and communication. - Demonstrated improvements in operational efficiency. Salary: $65,000/annually Benefits Offered - Competitive compensation and annual bonus program - 401(k) retirement program with company match - Company-paid life insurance - Company-paid short term disability coverage (location restrictions may apply) - Medical, Vision, and Dental benefits - Paid Time Off (PTO) - Paid Parental Leave - Sick Time - Paid company holidays and floating holidays - Quarterly company-sponsored events - Health and wellness programs - Career development opportunities Remote Opportunities We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits. Integra Partners is a wholly owned subsidiary of Point32Health. With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you. Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.