JOB DESCRIPTION Job Summary Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for someone with a social services or human services background to join our team. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS Program and the TMG IRIS Consultant Agency. While your office will be home-based, you will have regularly scheduled visits with IRIS participants in their home and community. As an IRIS Consultant (IC), you will build relationships with the people you partner with and help them navigate and get the most out of the Wisconsin IRIS program – a Medicaid long-term care option for older adults and people with disabilities. You can learn more about the IRIS program on the Wisconsin Department of Health Services website here. Together, you will identify the long-term care goals of the people enrolled in IRIS, and find creative ways to achieve those goals. ICs play an important role in helping people of various backgrounds and abilities live the lives that they choose. In fact, people constantly tell us how supportive our ICs are and what a positive impact our ICs have had on their lives! Successful candidates for this position will be compassionate, genuine, resourceful partners with an eye for high quality work, and who are excited to work side-by side with people enrolled in IRIS. As an IC, you will connect people to the resources available in their community. You will also help them develop customized IRIS plans for achieving their goals related to employment, housing, health, safety, community membership, transportation, and lasting relationships. While you will have a routine for the work that you do, no two days are alike! TMG wants to find the best possible candidates, so we created this Realistic Job Preview to provide you with an inside look at the position and our organization. Find out more about the IRIS Consultant position by clicking on the link and then reviewing the job posting below. TMG is committed to maintaining a diverse and inclusive workforce and prioritizes helping staff have a good work/life balance. Even though the position is remote, you’ll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today! KNOWLEDGE/SKILLS/ABILITIES - Required to meet in person with the IRIS participant a minimum of four times per year, with one required annual visit in the home of the participant. Because IRIS is a self-directed program, it is important for ICs to be available upon the request of the participant. - Responsible for providing program orientation to new participants. During this time, participants will learn their rights and responsibilities as someone enrolled in the IRIS program, including verifying legal documents, completing employee paperwork and the responsible use of public dollars. - Explore a broad view of the participant's life, including goals, important relationships, connections with the local community, interest in employment, awareness of the Self-Directed Personal Care option, and back-up support plans. - Assist participants in identifying personal outcomes and ensure those outcomes are being met on an ongoing basis, all while staying within the participant's IRIS budget and within the requirements of the IRIS program determined by the Department of Health Services (DHS). - Responsible for documenting all orientation and planning activities within the IRIS data system (WISITs) within 48 business hours of the visit with the participant. - Research community resources and natural supports that will fit the individual outcomes for each participant and share that information with them as it becomes available. - Responsible for documenting progress and changes as needed within the plan and the data system anytime a modification is requested by a participant. - Budget Amendment or One-Time Expense paperwork may be required depending upon factors associated with the participant and their individual IRIS budget. - Educate participants on how to read and interpret their monthly budget reports to ensure that participants operate within their budget. Being a liaison between the Fiscal Employer Agency and the IRIS Consultant Agency is also a large part of the position, which includes assisting participants with provider billing, seeking support brokers, tracking receipts, ensuring their workers are paid and mitigating areas of potential risk or conflicts of interest. - Responsible to develop engaged and trusting relationships with participants and communicate program changes and compliance effectively. - Responsible to maintain confidentiality and HIPPA compliance. - Work collaboratively with other IRIS Consultant Agency staff in order to ensure a successful implementation of participants' plans. - Attend in-person monthly team meetings with other ICs and their supervisor. In addition, weekly IC and IRIS Consultant Supervisor phone check-ins may occur, along with other duties as assigned. Required Qualifications • At least 2 years experience in health care, preferably in care coordination, and at least 1 year of experience serving target groups of the IRIS program (adults with intellectual/physical disabilities or older adults), or equivalent combination of relevant education and experience. • Bachelor’s degree in a social work, psychology, human services, counseling, nursing, special education, or a closely related field (or four years of commensurate experience if no degree). • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements unless otherwise required by law. • Ability to develop positive and effective work relationships with coworkers, clients, participants, providers, regulatory agencies and vendors. • Ability to work independently with minimal supervision and demonstrate self-motivation. • Demonstrated knowledge of long-term care programs. • Familiarity with principles of self-determination. • Problem-solving and critical-thinking skills. • Excellent time-management and prioritization skills. • Ability to focus on multiple projects simultaneously and adapt to change. • Ability to develop and maintain professional relationships and work through challenging situations. • Comfortable working within a variety of settings with ability to adjust style as needed to work with diverse populations, various personalities, and personal situations. • Demonstrated knowledge of community resources. • Proactive and detail-oriented. • Excellent verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

We are expanding our remote operations team and seeking a highly organized Travel Logistics Specialist to oversee booking coordination, scheduling management, and reservation accuracy for our clients. This role plays a key part in ensuring every detail is confirmed, documented, and executed smoothly from inquiry to final confirmation. The ideal candidate is proactive, detail-driven, and confident managing multiple timelines while maintaining clear and professional communication. This is a fully remote opportunity designed for someone who thrives in structured systems and values precision. What Youll Do: - Coordinate reservations, booking timelines, and scheduling logistics - Review confirmations to ensure accuracy and completeness - Communicate with clients to gather required information and provide updates - Track pending items and proactively follow up on outstanding details - Maintain organized digital records within established systems - Ensure a seamless handoff between inquiry, booking, and confirmation stages What Were Looking For: - Strong organizational and time-management skills - Clear, professional written and verbal communication - Ability to manage multiple client timelines simultaneously - Comfortable working independently in a remote environment - Tech-comfortable and confident navigating online booking platforms - Customer service, scheduling, or administrative experience (preferred, not required) Eligibility Requirement: Must be a citizen of the United States, United Kingdom, Mexico, Spain, Australia, or LATAM. Why This Role Is a Great Fit: - Fully remote flexibility - Structured training and ongoing mentorship - Access to established systems and operational support - Clear pathway for growth within a supportive team environment

***** Experience in Health Insurance, Surgical cases and CPT codes Shift; Days Location: Remote Miami, FL Full-Time Financial Clearance Center (FCC) Summary Authorization & Clearance Specialist plays a critical role in ensuring that medical services provided to patients are covered by the patient's insurance providers. They are responsible for obtaining pre-authorizations, initiating authorizations, extending concurrent authorization, verifying insurance coverage for medical procedures, treatments, hospital stays, initiating retroactive authorization modifications, and discharge notifications as appropriate. Responsibilities Identifies and confirms valid coverage for an episode of care and/or specific service: contacts insurance companies and/or reviews electronic response summary and coverage discovery information to ensure the appropriate coverage coordination are on the patient's record. Initiates authorization with patient insurance by submitting necessary clinical documentation, continues to follow up, obtain and validate authorization/referrals/notifications with appropriate CPT, ICD-10 codes, Tax ID and NPI #s within the appropriate timelines. Works daily work queues according to department directives, to identify patients requiring authorization for services scheduled and non-scheduled appropriately prioritizing work assignments based on scheduled appointment date/time, medical severity, payer assignments, dollar value etc. Verifies that the services the patient is set to receive is a covered benefit, validates benefit package restrictions, and completes quality assurance checks on authorization patient type, facility, etc. Understands patient deductibles, out of network referrals, out of pocket limitations, and lifetime/event caps on liability. Refers patients to appropriate Financial Counselor, Prior Authorization or Billing based on financial coverage, financial situation, employment status, liability and/or patient concern. Uses insurance discovery tools available to attempt to validate any and all insurance coverage, ensure correct insurance coordination of benefits are listed on patient's record, follows up with patient/next of kin/Social Work/Case Management in order to obtain insurance coverage information. Verify all insurance and obtain pre-certification/authorization for services, as warranted, and notifying patient and referring physician in the event of failed eligibility and/or authorization. Follows up with and escalates as appropriate to physician's office/clinical teams/Case Management for any pending clinical documentation, including peer-to-peer requests. Diligently follows up on any pending authorizations to ensure information is processed with the insurance payer within appropriate timelines. Works directly with JHS medical services to ensure procedures, diagnoses, level of care, are sufficient for each case by following CMS and payer guidelines and communicating with medical team for corrections. Maintain knowledge base of all programs offered by JHS for Charity and Financial Assistance and the requirements to qualify, with the process for Charity Care clearance of scheduled procedures and coverage. Calculates patients' financial responsibility based on patient benefits using the estimator tools and includes communication with the patients on the out of pocket due at service. Coordinate Self-pay Package pricing by utilizing tools available and escalating to Managed Care team to obtain appropriate package price amounts not found on list or complex contracts. Receives and processes all patient payments in accordance with JHS Collections Policy and Procedure, issues receipt and maintains the integrity of all payments. Scans/uploads all required documents into the appropriate folder in the documenting imagining system in a timely manner to assure maximum reimbursement and compliance. Assist in supporting go lives of new systems and different department initiatives, including onboarding and training team members. Cross-trained in multiple areas/service lines/payers to substitute all staff positions as needed. Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise). Performs other related job duties as assigned. Experience Generally requires 0 to 3 years of related experience. Financial clearance experience is strongly preferred. Education High school diploma is required. Bachelor's degree in related field is strongly preferred. Skill Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines. Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with critical thinking and professional composure. Ability to understand and follow instructions. Ability to exercise sound and independent judgment. Knowledge and skill in use of job appropriate technology and software applications. Credentials Valid license or certification is required as needed, based on the job or specialty. Unit Specific Credential Working Conditions Physical Requirements - Job function is sedentary in nature and requires sitting for extended periods of time. Function may require frequent standing or walking. Must be able to lift or carry objects weighing up to 20 pounds. Jobs in this group are required to have close visual acuity to perform activities such as: extended use of computers, preparing and analyzing data and analytics, and other components of a typical office environment. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC). Environmental Conditions - Jobs in this group are required to function in a fast paced environment with occasional high pressure or emergent and stressful situations. Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Possible exposure to various environments such as: communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment. May wear Personal Protective Equipment (PPE) such as gloves or a mask when exposed to hospital environment outside of office. Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together. Designs and executes high level actuarial processes involving valuation, financial modeling, and management information. Leads and participates on cross-functional teams. Develops and recommends actuarial tools and techniques to manager. Maintains, enhances, and documents actuarial tools and techniques required for project or production work. Assists with training team members on how to use actuarial tools and techniques. Essential Functions: - Leads the analyzing and refining of EMCNL’s financial model by proposing implementing changes and ensuring changes are documented and tested. - Leads the quarterly and annual financial projection project. Gathers information from investment and accounting teams. Enters information into financial model and run a series of projections. Analyzes results of project to make recommendation on necessary amount of additional reserves. - Ensures the completion of financial and Asset Liability Management (ALM) projections using the financial model to project short- and long-term profitability - Collaborates with manager on product development/pricing projects using actuarial modeling software AXIS - Develops highly-automated tools and systems which maintain the data integrity necessary to produce accurate results while also maintaining the flexibility to report data broken down by many factors such as product, gender, underwriting class, face amount, etc. to help with mortality and lapse studies - Develops and evaluates new and existing tools and works on projects to improve the management information capabilities of the actuarial team, such as data reporting. Analyzes data and provides report insights based on results to stakeholders throughout EMCNL. - Makes recommendations based on analysis and communicates them as appropriate to EMCNL teams. - Develops and recommends actuarial tools and techniques that support the actuarial process, such as evaluation and rate study. - Leads and/or participates on cross-functional teams, such as the interest rate team and product implementation team Leads and conducts independent research and analysis and provides input and findings to various teams. Education & Experience: - Bachelor’s degree in actuarial science or math or related field - Five years of actuarial experience - 4-5 exams or equivalent relevant experience - Additional experience, exams or graduate level coursework may be considered in meeting the requirements Knowledge, Skills & Abilities: - Excellent knowledge of statistics, probability and computer programming - Strong ability to perform modeling, pricing, financial reporting and reserving skills - Thorough knowledge of actuarial terminology, concepts and theory - Thorough computer skills, including knowledge of Excel and Word - Thorough knowledge of at least one computer language, such as R, SAS or SQL (SQL is preferred) - Excellent analytical, investigation and problem-solving abilities - Strong ability to effectively lead a team and special projects The hiring salary range for this position will vary based on geographic location, falling within either of the following: $85,799 - $118,545 or $94,826 - $130,394A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers. Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.