COMPANY OVERVIEW At Harbor Health, we’re transforming healthcare in Texas through collaboration and innovation. We’re seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model. If you’re ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team! POSITION OVERVIEW *Candidate should reside in Texas Harbor Health is seeking a dedicated Utilization Management (UM) LVN. The UM LVN supports prior authorization and utilization review activities to ensure timely and appropriate access to care. This role collaborates with the UM team, providers, and members to facilitate authorization processes, coordinate clinical information, support medical necessity determinations, and maintain regulatory compliance. The UM LVN also provides ongoing communication and coordination support for high-need and high-cost members to promote appropriate utilization and continuity of care. Shifts and Business Hours This position is fully remote Monday-Friday 8am - 5pm with the exception of Saturday coverage once every 5 weeks on rotation for 4 hours. POSITION DUTIES & RESPONSIBILITIES: - Coordinate and manage prior authorization workflows in collaboration with the Utilization Management (UM) team. - Monitor incoming authorization requests via fax and phone and ensure timely case entry into the designated tracking system and UM platform. - Review submitted clinical documentation and verify CPT codes to determine prior authorization requirements. - Prepare and submit applicable cases to the contracted utilization review (UR) vendor for medical necessity determinations. - Maintain accurate case documentation and track status to ensure compliance with regulatory turnaround times. - Draft provider, facility, and member notification letters based on determination outcomes. - Coordinate mailing and faxing of approved determination letters to appropriate parties and ensure proper documentation. - Obtain and coordinate concurrent clinical documentation from hospitals, post-acute facilities, and other treating providers. - Communicate with providers and facilities regarding required or missing clinical information to facilitate timely review. - Provide clear communication to members and requesting providers regarding authorization status and documentation needs. - Support high-need and high-cost members through ongoing communication and coordination to promote appropriate utilization and continuity of care. - Assist with transitions of care and post-discharge coordination as applicable. - Perform all duties in compliance with organizational policies and applicable state and federal regulatory requirements. - Provide direct support to members with chronic diseases, ensuring continuity of care across chronic care pathways. - Communicate regularly with members to assess progress, resolve barriers to care, and promote adherence to treatment plans. DESIRED PROFESSIONAL SKILLS & EXPERIENCE: - Current, unrestricted LVN license. - Minimum of 2–3 years of clinical experience; prior Utilization Management or Case Management experience preferred. - Knowledge of Texas social service programs for members in need both local and state-wide preferred - Familiarity with NCQA processes and requirements - Knowledge of CPT codes and prior authorization requirements. - Familiarity with utilization review processes and medical necessity determinations. - Strong organizational and workflow management skills. - Excellent written and verbal communication skills. - Ability to assess member needs, provide education, and escalate concerns appropriately. - Proficiency in Google Workspace, EHR systems and electronic UM platforms - Ability to manage multiple cases while meeting regulatory timelines - Ability to work independently and within a team-based model to deliver excellent care. WHAT WE OFFER: - The opportunity to make a meaningful impact on utilization management and member outcomes. - A collaborative and innovative work environment committed to member-centered care. - An organization passionate about improving healthcare delivery in Austin and beyond. - Competitive salary and comprehensive benefits package. - Professional development and opportunities for career growth. - A transparent, supportive, and inclusive culture that values every team member’s contributions. Harbor Health is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. We are committed to creating an inclusive environment for all clinicians and teammates and actively encourage applications from people of all backgrounds.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves supporting a leading AI research lab working on next-generation machine learning systems by applying real-world administrative management expertise. - Create structured deliverables based on common requests within the administrative services and operations management domain - Contribute professional expertise to help diagnose and solve real-world operational management challenges - Review peer-developed deliverables to improve research quality and domain accuracy - Provide detailed written explanations reflecting real administrative and operational workflows - Ensure tasks reflect authentic management scenarios and organisational decision-making processes Qualifications - 4+ years of professional experience in administrative services management, operations management, or related roles - Strong understanding of organisational operations, administrative systems, and internal management processes - Excellent written communication skills with strong grammar and clarity - Ability to translate real-world administrative workflows into structured tasks and scenarios - Strong attention to detail and ability to articulate operational reasoning Requirements - Background in Business Administration, Management, Operations, Public Administration, or related fields preferred Benefits - Contribute administrative management expertise to cutting-edge AI research initiatives - Help improve AI systems understanding of real organisational and operational workflows - Work with leading AI labs advancing next-generation machine learning systems - Flexible remote work with competitive hourly compensation Contract Details - Independent contractor role - Fully remote with flexible scheduling - Expected workload: ~30 hours per week (potential to scale up to 40 hours) - Project duration: approximately 3–4 weeks - Competitive rates between $90–$110/hour depending on expertise - Weekly payments via Stripe or Wise - Projects may extend or adjust depending on scope and performance

• Assist with day-to-day office operations and documentation management • Maintain accurate electronic and physical records for audit and compliance purposes • Support invoicing, refunds, and cancellation processes in line with company procedures • Maintain clear, professional communication with clients, brokers, insurers, and internal teams • Build and maintain strong working relationships that support long-term portfolio growth • Ensure all administrative activity meets quality standards and regulatory requirements • Contribute to efficient office processes aligned with business targets • Work closely with account executives and underwriters on portfolio movements • Meet productivity expectations and contribute to continuous improvement within the team

• Build, configure, and maintain outbound dialer campaigns, including pacing, dispositions, campaign logic, and list strategies. • Monitor campaign performance and telephony KPIs, identifying issues or trends and escalating findings to Telephony leadership as needed. • Own and oversee SIP trunk configurations, carrier integrations, and call routing changes under the direction of Telephony leadership. • Execute and maintain call masking, branded caller ID, and spam-mitigation configurations. • Oversee and ensure compliance with number registration and TCPA/DNC compliance processes, including management of National and State Do Not Call lists. • Document telephony configurations, call flows, routing logic, and procedures to support consistent execution, troubleshooting, and knowledge sharing. • Drive the design, implementation, and optimization of call strategies across voice, SMS, and email channels in partnership with Operations and Workforce Management (WFM). • Own and direct with Five9 API usage and other integrations to enable automation, reporting, and connectivity between telephony and adjacent systems. • Collaborate with Workforce Management, QA, Operations, Compliance, and IT to ensure telephony configuration supports staffing models, performance goals, and regulatory requirements. • Lead telephony platform enhancements, system consolidations, and transitions (e.g., migrations into Five9) through configuration, testing, documentation, and operational readiness activities. • Build and troubleshoot escalated telephony issues related to call routing, dispositions, softphone configuration, and agent-level problems. • Participate in testing and quality assurance of new dialer campaigns, call flows, integrations, or system changes prior to production deployment.