At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place. Job Description: Patient Care Representative Full-Time Remote The Call Center Representative position is part of the broader Elara Caring Caretinuum initiative, and is responsible for customer relations, customer needs follow up, virtual healthcare processing, taking referrals, performing data entry, answering inquiries, and disseminating information about the agency to prior customers. The incumbent establishes and maintains effective and efficient systems for customer relations, working through patient needs and requests, patient referrals, data entry, and communications to support the Caretinuum mission and values, as consistent with the overall mission of Elara Caring. This position assists with daily virtual operations of the agency, including coordinating referrals, virtual healthcare processing, and maintaining communication between Clinical Supervisors and liaisons and the agency. At Elara Caring, we care where you are and believe the best place for your care is where you live. We know there’s no place like home, and that’s why our teams continue to provide high-quality care to more than 60,000 patients each day in their preferred home setting. Wherever our patients call home and wherever they are on their health journey, we care. Each team member has a part to play in this mission. This means you have countless ways to make a difference as a Call Center Representative by keeping a team of elite healthcare professionals operational. To continue to be an industry pioneer delivering unparalleled care, we need a Call Center Representative who shares our commitment to distinction and progress. Are you one of them? If so, apply today! Why Join the Elara Caring mission? - Work in a collaborative environment. - Be rewarded with a unique opportunity to make a difference - Competitive compensation package - Tuition reimbursement for full-time staff and continuing education opportunities for all employees at no cost - Opportunities for advancement - Comprehensive insurance plans for medical, dental, and vision benefits - 401(K) with employer match - Paid time off, paid holidays, family, and pet bereavement - Pet insurance What is Required? - Associate Degree in Business Administration, Human Services, or related field is preferred - 1 year of medical technology experience working in a health care setting is required - Knowledge of Medicare and Medicaid payment guidelines and third-party payors is preferred - Strong communication, problem solving, and organizational skills This is not a comprehensive list of all job responsibilities; a full job description will be provided. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Equal Employment Opportunity: We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. If you require assistance due to a disability in the application or recruitment process, please submit a request via email at recruiting@elara.com. Pay & Benefit Information: Compensation for this role will be determined based on a variety of factors, including qualifications, skills, competencies, and relevant experience. Elara offers a broad range of benefits. Learn more at https://careers.elara.com/us/en/benefits EVerify: Elara Caring participates in E-Verify after a job offer is accepted and Form I-9 completed.

• Perform preventive maintenance and repairs on biomedical equipment • Install and configure medical systems • Troubleshoot equipment failures • Support medical equipment inventory management

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.