Applicants must be located in TX, GA, PA, SC, or VA to be eligible for this role. The Eligibility Senior Representative performs specialized patient access functions requiring an advanced understanding of insurance benefits and internal processes to successfully liaise with Payers, Pharma, Physicians, and Patients. Rely on experience and knowledge of industry best practices to communicate knowledge of pending referrals that may have an adverse impact on company goals and the patient experience. Acts as a liaison between both internal and external resources to reduce client abrasion and facilitate the timely processing of referrals. This individual can proactively recognize cause and effect trends, identify and clarify patients’ needs, and work towards solutions. RESPONSIBILITIES: - Facilitate cross-functional resolution of drug coverage issues & proactively address, research & resolve issues impacting referral turn-around time. - Independently resolve basic patient claims issues using key subject matter knowledge. - Prepare and review claims to ensure accuracy to payer requirements, including but not limited to codes, dates, and authorizations. - Demonstrate technical proficiency in patient access functions. - Effectively collaborate with internal departments to resolve issues or provide any needed information, always using professional communication. - Contact benefit providers to gather policy benefits/limitations. - Coordinating and ensuring services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.). - Perform medical /pharmacy benefits verification requiring complex decision skills based on payer and process knowledge. - Provide expert assistance to internal and external clients on patient status. - Handle Escalations with an expert understanding of department policies and procedures. - Use discretion & independent judgment in handling patient or more complex client complaints, escalating as appropriate and when triaging as needed. - Complete other projects and additional duties as assigned. QUALIFICATIONS: - High school diploma or GED required, bachelor’s degree preferred. - 3+ years of relevant working experience. - 2 years of Health care experience with medical insurance knowledge and terminology and experience in patient access preferred. - Intermediate data entry skills and working knowledge of Microsoft Office, and Patient Access knowledge. - Pharmacy or healthcare industry experience is highly preferred, with prior exposure to Express Scripts (ESI) considered a strong advantage. - Experienced training and coaching less experienced staff with patience to explain details and processes repeatedly. - Excellent phone presentation and communication skills. - Demonstrated ability to handle challenging customers in a professional manner. - Ability to adapt to a dynamic work environment and make decisions with minimal supervision. - Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions. ABOUT THE DEPARTMENT Through our range of health care products and services offered, Accredo team members provide in-depth care for patients with chronic health conditions like hemophilia, oncology, rheumatoid arthritis and growth hormone deficiency. In addition to health care products, we provide comprehensive management services – including outcomes measurement, counseling, clinical care management programs, social services, and reimbursement services. By performing in these very high-touch roles, employees have a daily opportunity to make a positive impact on their patients’ lives. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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. Program Summary Join our Aetna care management team as we lead the way in providing exceptional care to dual eligible populations! You will have a life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in both Medicare and Medicaid. As a member of the care team, you will collaborate with members, the internal care team, healthcare providers, and community organizations to meet the complex healthcare and social needs of our members Be part of this exciting opportunity as we expand our DSNP services to transform lives in new markets across the country. Position Summary/Mission As a vital member of our Special Needs Plan (SNP) care team, the Care Coordinator (CC) is responsible for coordinating care for our members through close collaboration with the Care Manager, Social Worker, and other interdisciplinary team members. This role involves evaluating member needs through the annual Health Risk Survey, addressing social determinants of health (SDoH), coordinating care across the continuum, and closing gaps in preventive and health maintenance care. Key Responsibilities - Member Evaluation: Conduct the annual Health Risk Survey to support needs identification for the member’s Individual Plan of Care. - Risk Escalation: Inform the assigned care manager of newly identified health/safety risks or service needs - Care Coordination: Complete care coordination activities delegated by the care manager within an established timeframe. - Quality Issue Escalation: inform the assigned care manager and/or associate manager of any identified quality of care issues. - Advocacy: Passionately support the member’s care coordination needs and drive solutions to address those needs. - Member Engagement: Use problem-solving skills to find alternative contact information for members who are unreachable by care management. Employ motivational interviewing techniques to maximize member engagement and promote lifestyle changes for optimal health. - Monitoring and Documentation: Adhere to case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies. Essential Competencies and Functions - Meet performance and productivity metrics, including call volume, successful member engagement, and compliance with state/federal regulatory requirements. - Conduct oneself with integrity, professionalism, and self-direction. - Demonstrate a willingness to learn about care management within Medicare and Medicaid managed care. - Familiarity with community resources and services. - Navigate various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records. - Maintain strong collaborative and professional relationships with members and colleagues. - Communicate effectively, both verbally and in writing. - Exhibit excellent customer service and engagement skills. Work Expectations - Access to a private, dedicated space to conduct work effectively to meet the requirements of the position - Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted Required Qualifications - 2+ years in behavioral health, social services, or a related field relevant to the program focus - Proficient in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams) and capable of utilizing these tools effectively in the Care Management Coordinator role - Access to a private, dedicated space to conduct work effectively to meet the requirements of the position - Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted Preferred Qualifications - Case management and discharge planning experience - Managed care experience Education - High School Diploma with equivalent experience (REQUIRED) - Associate’s or Bachelor’s Degree or non-licensed master’s level clinician in behavioral health or human services (psychology, social work, marriage and family therapy, counseling) or equivalent experience (PREFERRED) Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $21.10 - $40.90 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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 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: 04/18/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At Accendra Health, we understand that healthcare is complex, and we’re here to make it easier. We help deliver care beyond traditional settings, making essential products and services more accessible through every stage of life. As part of the care team, our teammates play a critical role in delivering personalized, long-term care for the patients we serve. With deep expertise promoting health outside the hospital and a presence in communities nationwide through our Apria and Byram Healthcare brands, Accendra Health does more than just deliver the essentials. If you’re interested in meaningful work with impact, explore our career opportunities and join us in our purpose of Bringing Care To Life™. The anticipated salary range for this position is $17.67 - $18.89 hourly. The actual compensation offered may vary based on job related factors such as experience, skills, education and location. Patient Qualification Specialist JOB SUMMARY The Patient Qualification Specialist will provide excellent customer service and product information, solutions and relevant details to patients and providers. Most importantly, this position provides above and beyond communication with our patients so that they feel heard, understood, valued and more connected with Apria. Key responsibilities for creating a positive, patient-centric environment include: - Evangelize our customers and turn our disgruntled patients into our biggest fans. - Support our Field teams, Operations and Sales, by delivering timely feedback that empowers our teams to deliver exceptional patient experiences. - Critically problem-solve common complaints by flagging trends and partnering cross-functionally to recommend and implement preventative measures. - Proactively create a better patient experience. - Be a champion of the employee experience and drive our unique company culture. - Support the development and implementation of employee programs that nurture our company's core values to engage employees and create a positive culture. ESSENTIAL DUTIES AND RESPONSIBILITIES - Responsible for supporting hundreds of local branch offices across the country by reviewing new patients orders and documentation submitted by referral sources in order to obtain required documentation and clinical requirements of individual health insurance plans, allowing our patients to maximize their available health plan benefits and to receive the much-needed care as soon as possible. - Requests health plan authorizations/information as required; either electronically or verbally. - Demonstrates and ability to develop business relationships within the field leadership through close collaboration, partnership, engagement and communication. - Performs other duties as required. SUPERVISORY RESPONSIBILITIES - N/A MINIMUM REQUIRED QUALIFICATIONS Education and/or Experience - High school degree or equivalent - 1-3 years’ experience in healthcare/health insurance industry desired SKILLS, KNOWLEDGE AND ABILITIES - Patient-Focused: You start with the patient and work backwards. You invest the time and energy to understand the patients’ objectives, then tie all your activities directly to the achievement of those objectives. - Action-Oriented: You thrive as a self-starter who proactively senses and responds to problems and opportunities and requires minimal supervision. - Collaborative: You love teamwork. Your colleagues love having you on the team. You work well across functions and groups. - An Effective Communicator: You write and speak clearly, concisely and with a spirit of partnership. You actively inform and inspire with your messaging. You speak plainly and are transparent with your business colleagues. - Energetic & Passionate: Your passion and energy for health and well-being is deeply founded in your desire to help others and to be a positive role model. - Relationship Builder: You excel in getting people involved and building a network of contacts that allow you to multiply your influence on the organization. Computer Skills - Intermediate skills in Access, Excel, PowerPoint, MS Project, Visio, Word Language Skills - English (reading, writing, verbal) Mathematical Skills - Intermediate level mathematical proficiency, with a strong ability to understand, interpret and develop spreadsheet data. PHYSICAL DEMANDS This is a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability to adjust focus. It also may require occasional lifting, carrying, walking, climbing, kneeling, bending/stooping, twisting, pulling/pushing, walking, bending, stooping, and reaching above the shoulder. This position also may require the occasional lifting of equipment up to 50 lbs. - This position is remote and requires a distraction free environment - Required to be in a home office/workspace during scheduled work hours OTHER INFORMATION The essential duties and responsibilities, physical requirements, and work environment described above are representative of those typically required for this position but may vary depending on staffing and business needs at specific locations. The inclusion or omission of a specific duty or physical requirement is, therefore, not determinative of whether that function is essential to a specific individual’s position. Reasonable accommodations will be provided to assist or enable qualified individuals with disabilities to perform essential functions. PLEASE NOTE: This is a remote position which is US-based. This role requires individuals to physically reside and work within the United States. Company systems and equipment are monitored for security and other purposes and removal of Company equipment outside of the United States is not permitted without prior authorization. Teammate Benefits As an Accendra Health employee, you have choices to fit your life. Our comprehensive benefits program is designed to meet you where you are — through all of life’s stages. We’ve got you and your family covered with benefits that support your health, finances, and overall wellness. Our benefits program includes: - Medical, dental, and vision care coverage - Paid time off plan - 401(k) Plan - Flexible Spending Accounts - Basic life insurance - Short-and long-term disability coverage - Accident insurance - Teammate Assistance Program - Paid parental leave - Domestic partner benefits - Mental, physical, and financial well-being programs If you feel this opportunity could be the next step in your career, we encourage you to apply. Accendra is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, sex, sexual orientation, genetic information, religion, disability, age, status as a veteran, or any other status prohibited by applicable national, federal, state or local law. Note: Accendra is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at our Company via email, the Internet, or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of our Company. No fee will be paid in the event the candidate is hired by our Company as a result of the referral or through other means.

About Pacaso: Pacaso exists to enrich lives by making second home ownership possible and enjoyable for more people. Our innovative co-ownership model is the easiest, smartest and most responsible way for people to experience the joy of a second home. We provide all the benefits of true ownership without the hassles through our simplified financial structure, easy and equitable scheduling, and dedicated local property management.Founded by former Zillow executives, Pacaso has facilitated over $1 billion in gross real estate transactions and service fees across more than 40 markets nationwide, as well as internationally in Paris, London, and Cabo. We have been featured in The New York Times, Wall Street Journal, Fortune, Forbes, CNBC and more.Pacaso is a certified Great Place to Work and has received numerous accolades for its workplace culture. Fortune and Great Place To Work named Pacaso to the 2024 Best Workplaces in Real Estate list. In 2023, Pacaso was recognized as a Best Workplace in the Bay Area™, and in 2022, it ranked among the Best Medium Workplaces™, Best Workplaces for Real Estate™, and Best Workplaces for Millennials™. Additionally, Pacaso was ranked #6 on Glassdoor's 2022 list of Best Places to Work and was one of LinkedIn's top startups in 2022. The Owner Experience Agent is the front line of the Pacaso owner journey, delivering high-touch, concierge-level service across phone, email, chat, text, and AI-supported channels. Operating within a 24/7 support environment, this role supports approximately 2,000 owners and serves as the first point of contact for all inquiries, issues, and stay-related needs. Agents diagnose concerns, resolve the majority remotely, and coordinate cross-functionally when necessary — maintaining full ownership through resolution. Core Responsibilities Owner Relationship Management & Case Ownership - Serve as the primary point of contact for all owner inquiries - Deliver empathetic, confident, and personalized service aligned with Pacaso’s luxury standards - Take end-to-end ownership of cases, ensuring clear communication and resolution - Maintain detailed documentation of owner preferences, history, and case notes to ensure seamless continuity across shifts - Build trusted, long-term relationships through proactive updates and consistent follow-through Issue Resolution & Stay Support - Troubleshoot home systems and operational issues using playbooks and home-specific knowledge - Resolve the majority of issues without escalation - Partner with downstream teams (Asset Management, Accounting, Legal, Experience Managers, etc.) when needed, maintaining accountability for outcomes - Provide real-time support during owner stays, including urgent maintenance, housekeeping coordination, access needs, and concierge-style requests - Remain calm and solution-oriented during high-pressure in-stay situations Operating Standards - Meet or exceed service-level expectations for responsiveness, resolution time, and owner satisfaction - Participate in 24/7 shift coverage, including weekends, holidays, and on-call rotations - Contribute to continuous improvement of workflows, playbooks, and service standards - Uphold Pacaso’s luxury brand standards in every interaction Qualifications - 3–5+ years of experience in hospitality, luxury property management, concierge services, or high-end customer support - Experience supporting high-value clients or owners with elevated expectations - Strong troubleshooting and critical-thinking skills - Calm, professional presence under pressure - Excellent written and verbal communication skills - Comfortable working in a 24/7 support environment (shift work) You’ll love working at Pacaso because of our ... - Competitive salary and stock options. - Unlimited, flexible PTO for exempt employees. - Excellent medical, dental and vision insurance. - Sponsored memberships to One Medical, Ginger and Carrot. - 401(k) to help you save for the future. - Paid maternity and paternity leave. - Generous home office stipend and monthly cell phone reimbursement. - Quarterly remote team building events and L&D opportunities. Pacaso encourages applications from people of all races, religions, national origins, genders, sexual orientations, gender identities, gender expressions and ages, as well as veterans and individuals with disabilities.