Become a part of our caring community and help us put health first As a RN Care Manager, you will enjoy a true work-life balance with no night or weekend shifts. Reporting to the Manager of Care Coaching, you will support members enrolled in the Wisconsin Family Care Program providing essential care coordination, support, and education. You will make a difference in the lives of those you serve and within your own community. You will: - Assess members, focusing on health and safety needs, to develop a comprehensive Member Care Plan (MCP). - Conduct regular health assessments - Coordinate with acute and primary care providers. - Educate members on disease processes and related risks, nutrition, exercise and lifestyle modifications to support informed decision-making while respecting each person's autonomy. - Document in member files within required DHS contract timeframes. - Participate in member monthly phone contacts and travel to attend in person visits in members setting. - Work remotely from your home and travel approximately 40% of the time to visit your members. Use your skills to make an impact Required Qualifications - Associate degree in nursing - Licensed Registered Nurse in the state of Wisconsin Preferred Qualifications - Previous Care Management experience. Additional Information - Location: Jefferson County, WI (Fort Atkinson, Whitewater, Jefferson, Watertown, etc) - Travel- up to 40% - Typical Work Days/Hours: Monday through Friday, 8:00 am – 4:30 pm CST. Driving This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. Mileage reimbursement is provided for work-related travel. Eligible mileage includes: - Travel from your home to your first work location of the day. - Travel between client or assignment locations during the workday. - Travel from your final work location back to your home. WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. - Satellite, cellular and microwave connection can be used only if approved by leadership. - Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Per Diem Physician to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: - Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes - Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs - Work with Signify Health as a clinician colleague, fulfilling the requirements of the specified role - Be flexible to travel locally and within licensed states, as needed - Conduct virtual visits as needed - Provide all Signify Health services as indicated including Diagnostic & Preventive Services products (i.e., spirometry, DEE, etc.) A Note on Our Work Environment: As an in-home clinician, your primary workplace is the private residence of health plan members. We are dedicated to meeting health plan members where they are, wherever they call home. These environments are diverse and may present a variety of conditions. Candidates must be able to comfortably and safely perform their duties in homes that may contain household pets, secondhand smoke and other potential airborne allergens or irritants. Why Clinicians Enjoy Working with Signify Health “Many of the people I see are shocked that a physician is coming to their home to visit with them one-on-one. When you sit down and have an unhurried conversation about their health, they are impressed, happy, and understand that their health plan and care team cares about them.” - M.L., MD “The primary care physician gets a snapshot of a person in an office setting, but with Signify Health, we see things like the number of steps to enter their home, the state of disrepair those steps may be in, and the person’s ability to function comfortably and with ease in their own home. We can make referrals to the individual’s health plan, encourage the participation of their loved ones, and ensure their PCPs are aware of their health and overall quality of life.” - C.H., MD Per diem employees qualify for: - Hourly base rate, plus additional incentive structure (i.e., per visit completed, other incentives may apply) - Malpractice insurance coverage (during Signify Health-related activities) - Supplies and other perks Required & Preferred Qualifications (MDs and DOs) - Active, unrestricted license(s) in coverage area(s) - Multi-state licenses (preferred) - Able to cover the following primary locations: Bradford and surrounding area. Anticipated Weekly Hours 12 Time Type Part time Pay Range The typical pay range for this role is: $83.69 - $180.25 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: 12/31/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Scheduled Hours 40 Position Summary Performs advanced follow-up on insurance billing and collection activities, makes collection calls, verifies the accuracy and completeness of insurance records, and claims, contacts insurance companies and/or collection agencies as well as other related duties to expedite payments from various payers for physician services. Job Description Primary Duties & Responsibilities: - Performs insurance follow-up billing and collection duties on various financial classifications to ensure timely and accurate payment of physician charges. - Reviews patient accounts to verify the accuracy of information including insurance, eligibility, invoice resolution, correspondence, remittances, requests for additional information, or other appropriate handling. - Utilizes Epic, system tools, and payer websites for claim submission, claim status, attachments, eligibility, and authorization/referral inquiry. - Makes collection calls to insurance companies and/or patients to ensure timely payment of claims. - Contacts insurance companies regarding posting payments and collection agencies regarding payment reports. - Supports customer service unit in answering billing and collection questions. - Assists with training new staff. - Consistently meets the Quality Assurance (QA) and meaningful efficiency standards of working invoices each day and follows best practices for one-touch resolution as established within the department. - Interacts with management and staff members to discuss issues. - May act as Team Lead. - Assists with special projects. - Performs other duties as assigned by the supervisor and/or manager. Working Conditions: Job Location/Working Conditions - Normal office environment Physical Effort - Typically sitting at desk or table - Repetitive wrist, hand or finger movement (PC typing) Equipment - Office equipment The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time. Required Qualifications Education: High school diploma or equivalent high school certification or combination of education and/or experience. Certifications/Professional Licenses: No specific certification/professional license is required for this position. Work Experience: Billing Or Insurance (3 Years) Skills: Not Applicable Driver's License: A driver's license is not required for this position. More About This Job WashU seeks highly motivated individuals who are able to perform duties in a manner consistent with our core mission and guiding principles. Preferred Qualifications Education: Associate degree Certifications/Professional Licenses: No additional certification/professional licenses unless stated elsewhere in the job posting. Work Experience: No additional work experience unless stated elsewhere in the job posting. Skills: Claims Resolution, Collections Strategies, Communication, Computer Literacy, Confidential Data Handling, Epic EHR, Health Insurance Billing, Health Insurance Portability & Accountability Act (HIPAA), ICD-10 Procedure Coding System, Insurance Follow Up, Medical Billing and Coding, Medical Terminology, Microsoft Excel, Microsoft Word, Office Equipment, Team Leadership, Telephone Communications Grade C08-H Salary Range $20.57 - $30.84 / Hourly The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget. Questions For frequently asked questions about the application process, please refer to our External Applicant FAQ. Accommodation If you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request. All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship. Pre-Employment Screening All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening. Benefits Statement Personal - Up to 22 days of vacation, 10 recognized holidays, and sick time. - Competitive health insurance packages with priority appointments and lower copays/coinsurance. - Take advantage of our free Metro transit U-Pass for eligible employees. - WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%. Wellness - Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more! Family - We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We’ve got you covered. - WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us. For policies, detailed benefits, and eligibility, please visit: https://hr.wustl.edu/benefits/ EEO Statement Washington University in St. Louis is committed to the principles and practices of equal employment opportunity. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, citizenship (where prohibited by federal law), age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.

About us Pomelo Care is the national leader in evidence-based healthcare for women and children. We deliver personalized, high-quality clinical interventions from reproductive care and pregnancy, infant care and pediatrics, to hormonal health through perimenopause and menopause, with long-term preventive care and condition management. Our model delivers 24/7 multispecialty care to address the medical, behavioral, and social factors that most significantly impact outcomes for women and children. We partner with payers, employers, and providers to expand access to quality healthcare across the system. Role Description Your North Star: Deliver direct patient care and clinical oversight that optimizes outcomes for individuals navigating perimenopause and menopause, through population-based implementation of evidence-based care. In this role you will: - Be accountable for improving clinical outcomes for empaneled patients, by overseeing their medical care - Review complex patient cases, develop care plans, and support other members of the clinical team in providing them with evidence-based care - Monitor adverse events and hold clinical retros to identify any areas for improvement in Pomelo’s protocols - Lead development and review of evidence-based medical protocols and algorithms related to menopause care - Participate in continuous quality improvement efforts to improve our ability to provide the highest quality care to patients Requirements - Must be licensed to practice as an APP in Massachusetts - A minimum of 3 years of menopause experience, including prescribing and managing hormone therapy (HT) - Committed to studying & sitting for the Menopause Society Certified Practitioner (MSCP) exam - Passionate about comprehensive women’s health, including perimenopause and menopause, with a strong desire to support patients through all stages of midlife care - Experience using data to drive patient engagement, activation, and clinical outcomes - Experience working with an interdisciplinary successful teams, with track record of outstanding collaboration and teamwork - A sense of urgency to improve outcomes coupled with exceptional organization and attention to detail - A growth mindset with the ability to approach process change and ambiguous situations with enthusiasm, creativity, and accountability - Facility using multiple tech platforms, with an eagerness for advising about platform improvements and adapting to new systems - Eager to thrive in a fast-paced, metric-driven environment - Phenomenal interpersonal and communication skills Education and training - CNM or WHNP with significant experience in menopause care - Active APP license and willingness to obtain licenses in all US states - Residence in PA or a nursing compact state Bonus points for - Menopause Society Certified Practitioner (MSCP) - Telehealth and/or remote monitoring experience Schedule Options - Day Shift - Monday - Friday, 9:00am - 6:00pm ET - Evening Shift - Monday - Friday, 1:00pm - 9:00pm ET Why you should join our team By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup where you will have a profound impact on the patients we serve. And you'll learn, grow, be challenged, and have fun with your team while doing it. We strive to create an environment where employees from all backgrounds are respected. We value working across disciplines, moving fast, data-driven decision making, learning, and always putting the patient first. We also offer: - Competitive healthcare benefits - Generous equity compensation - Generous PTO policy At Pomelo, we are committed to hiring the best team to improve outcomes for all patients, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status. Our salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. A reasonable estimate of the current salary range is $110,000-$135,000. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash. #LI-Remote Potential Fraud Warning Please be cautious of potential recruitment fraud. With the increase of remote work and digital hiring, phishing and job scams are on the rise with malicious actors impersonating real employees and sending fake job offers in an effort to collect personal or financial information. Pomelo Care will never ask you to pay a fee or download software as part of the interview process with our company. Pomelo Care will also never ask for your personal banking or other financial information until after you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All official communication with Pomelo Care People Operations team will come from domain email addresses ending in @pomelocare.com. If you receive a message that seems suspicious, we encourage you to pause communication and contact us directly at careers@pomelocare.com to confirm its legitimacy. For your safety, we also recommend applying only through our official Careers page. If you believe you have been the victim of a scam or identity theft, please contact your local law enforcement agency or another trusted authority for guidance.