You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Job Description Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT ***Highly preferred that candidate resides in the state of Georgia in either Richmond, Chatham, Muscogee, Dekalb, Fulton or surrounding areas. Role will require local travel.*** Position Purpose: Serves as a vital link between members and the healthcare system, focusing on improving health outcomes by identifying and closing care gaps. This role emphasizes community engagement, member education, and collaboration with providers and internal teams to ensure members receive timely, appropriate care and support. - Conduct outreach to members in the community to identify care gaps and connect them with appropriate healthcare services and resources. - Perform home visits or community-based assessments to evaluate member needs and identify social determinants of health that may prevent members from accessing preventive or follow-up care, and facilitate care coordination. - Serve as a member advocate by helping individuals navigate complex healthcare and social service systems. Assist with scheduling appointments, understanding care plans, and accessing benefits or entitlements, ensuring members receive the support needed to close care gaps and maintain continuity of care - Collaborate with providers to share quality performance data (e.g., HEDIS, CAHPS) and support improvement initiatives. - Educate members on preventive care, chronic condition management, and available community resources. - Document member interactions, care gap closures, and referrals in the appropriate systems. - Partner with internal departments (e.g., Quality, Care Management, Provider Relations) to align efforts and improve member outcomes. - Monitor and report on outreach effectiveness and care gap closure metrics. - Maintain compliance with state and federal regulations and organizational policies. - Participate in seasonal campaigns and quality initiatives to improve member engagement and health outcomes. - Serve as a community ambassador, building relationships with local organizations and stakeholders. - Performs other duties as assigned. - Complies with all policies and standards. Education/Experience: Bachelor's Degree Social Work, Public Health, Nursing, or related field; or equivalent experience required 2+ years In community health or healthcare quality required Experience working with health plan members and navigating community resources required Familiarity with Medicaid / Medicare programs and quality measures (e.g., HEDIS) required Strong communication and interpersonal skills Licenses/Certifications: LCSW- License Clinical Social Worker preferred RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred Pay Range: $27.02 - $48.55 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

The Billing and Posting Resolution Advocate is responsible for overseeing claims production, billing, follow-up, collections, and compliance with third party payer regulations. This position is responsible for daily oversight and management of process-based revenue cycle functions, including ongoing improvement to key revenue cycle indicators. These indicators include but are not limited to: A/R days, cash collection goals and posting, denials, underpayment and contract management activities related to patient account management. The Billing Manager should have comprehensive knowledge of revenue cycle operations. The position is responsible for personnel development and initiating disciplinary action according to policy. Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include: - Possess complete understanding of the billing/collection process to resolve complex, outstanding claims. - Ensures accounts are billed accurately and timely by providing proactive oversight and direction for billing and collections. - Provides operational oversight for the Billing Coordinator, mentoring them in their responsibilities - Maintains current knowledge of hospital billing systems and government payer systems, including applicable federal/state laws and regulations, as well as all aspects of third-party reimbursement policies and practices - Demonstrates ability to manage, train and motivate employees, as well as a professional attitude in relating to executive management, professionals and third-party insurance carriers. - Organizes and leads efforts to maximize operational efficiency and optimize reimbursement, as well as monitors denials and provides education and reporting to the areas regarding the effect of denials from their areas. - Reviews all statistical reports to monitor trends, determine operational deficiencies and implement corrective action plans as necessary - Pro-active communication/escalation of potential claims/unbilled accounts/issues to the Director - Exhibits excellent leadership and self-direction, good judgement in handling difficult situations and good organizational, time management, interpersonal and conflict resolution skills. - Assures that confidentiality of patient information is maintained without exception - Attends all required meetings and activities, maintaining a professional affiliation to stay abreast of current trends and changes in legislation and industry best practices. - Liaise with facility management and operates as the lead point of contact - Maintain employee time and attendance and scheduling demands - Responsible for accuracy of customer invoices, and creating the invoices monthly - Understanding the contract terms and insuring we stay within those terms - Performs all functions from the Management Expectations List - Performs all other duties assigned Minimum Requirements: Education/Experience/Certification Requirements - High school graduate or GED equivalent - 3 years previous hospital billing experience - Working knowledge of insurance regulations, procedure and diagnosis coding and automated insurance billing - Excellent communication (written and oral) and interpersonal skills - Excellent critical thinking, organizational and time management skills with a strong attention to detail, accuracy and follow through - Must be able to work through issues to resolution Preferred Qualifications: - Associates or Bachelor’s Degree - 2 years Medicare hospital billing experience Why join our team? - Work remotely with a work/life balance approach - Robust benefits offering, including 401(k) - Generous time off allotments - 10 paid holidays annually - Employer-paid short term disability and life insurance - Paid Parental Leave

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Is your passion helping others? Are you a dynamic communicator? A team player? Do you thrive in a fast-paced environment? If so, we are looking for you! The Healthy Outcomes Team is a health advocacy team looking for dedicated friendly colleagues to help the Medicare population learn about and complete important health screenings and activities. As a Health Advocate on the Healthy Outcomes Team, you will interact with members telephonically to inspire healthy behaviors. Our goal on each call is to give every member a clear understanding of their benefits for specific screenings and medications. You will talk to providers and members to assist with important health services, medications, and resources to improve Star health outcomes. Your key responsibilities are: - Inbound and outbound calls to members and providers to help getting services like healthcare visits, screenings, vaccinations, or medication refills. - Working through barriers that stand in the way of our members’ good health - Delivering the best member experience through professional empathetic conversations - Provide important education to members to help them make good health decisions that improve their health - Accurately document conversations in the member’s health record Your key abilities are: - High-energy engagement to provide exceptional service - Empathetic, curious, with an enthusiasm for learning - Knowledge retention and recall to answer questions and resolve issues - Desire to understand and meet our members’ needs and escalate issues for resolution - Speed and efficiency to meet business metrics and goals. - Ability to handle pressure and to stay calm and positive in all situations - Ability to work independently, apply critical thinking skills when needed, multitask with ease, and demonstrate professionalism in all interactions. - Ability to absorb and apply new and changing information. - Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment Required Qualifications - Professional communication skills - Strong active listening and interpersonal skills - High computer literacy, including ability to troubleshoot issues - Proficiency with Windows and web-based applications and digital communication tools - Reliable high-speed internet connection (at least 50mbps) and suitable remote workspace - Hard wired connectivity to computer is required (DSL, satellite, and wireless broadband are not permitted) Preferred Qualifications - Bilingual or multilingual candidates heavily preferred. - Experience with HEDIS screening measures - Experience with behavior change - 2+ years’ experience with call center or outreach involving members/consumers - 3+ years’ experience in a healthcare setting - Medical certification (certified nursing assistant, medical assistant, etc.) Education High School diploma or equivalent preferred but not required. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $31.30 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 03/28/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

You could be the one who changes everything for our 28 million members as a Customer Care professional at Centene. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. This is a remote position and the available shifts start between 8:00am and 10:30am EST. Position Purpose: Serves as the first-line advocate that focuses on resolving inquiries, issues, or concerns for members and/or providers. Leverages a variety of communication channels to provide members and/or providers with timely, accurate, and personalized support on routine complaints. - Receives and responds to routine member and/or provider inquiries, requests and/or concerns in an accurate and timely manner - Mitigates and prevents complaints from being escalated to resolve in initial contact - Serves as the front-line resolution advocate on various member and/or provider inquiries, requests, or concerns - Resolves basic problems by communicating the requested information regarding the assessment of the member or provider needs, understanding the cause, and determining if problems need to be routed to other departments for further resolution - Maintains performance and quality standards based on established contact center metrics - Provides customer service in a high pace contact center environment over the phone, via live chats and emails - Documents all member or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications - Remains up-to-date and adheres to quality standards, regulation, and all other policies to ensure quality, consistency, and compliance - Performs other duties as assigned - Complies with all policies and standards Education/Experience: Requires a High School diploma or GED. Entry-level position typically requiring little or no previous experience. Experience interacting and multitasking using multiple systems and programs simultaneously preferred. Pay Range: $16.35 - $23.46 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act