You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT Position Purpose: Acts as a resource and supports the prior authorization request process to ensure that all authorization requests are addressed properly in the contractual timeline. Supports utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access. - Aids the utilization management team and maintains ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines - Supports the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination - Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment - Performs data entry to maintain and update various authorization requests into utilization management system - Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer - Remains up-to-date on healthcare, authorization processes, policies and procedures - Performs other duties as assigned - Complies with all policies and standards Education/Experience: Requires a High School diploma or GED Requires 1 – 2 years of related experience Knowledge of medical terminology and insurance preferred. Pay Range: $17.84 - $28.02 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Applicants for this job have the flexibility to work remote from home and preferably reside in New York or within the tri-state area. Position Purpose: Maintains relationships with physicians, hospitals, ancillary providers and Health Net's internal Provider Network Management Dept. Acts as first line contact for providers/hospitals on claims projects and other non-routine claim issues. Oversees, in conjunction with the Adjustment and New Day Unit Supervisors, resolution of project issues and is responsible to communicate final resolution to the provider/hospital or other business units and/or managers, as needed and/or as required. Assists with policy and procedure interpretation. Researches, analyzes and resolves complex problems with claims development and finalization. - Assists with complex claim issues and acts as the first line contact for providers on large projects and non-routine claim issues - Manages projects in conjunction with assigned adjusters and/or regional units for research, analysis and resolution - Responds directly to the providers with final resolution of the issues, up to and including: root cause documentation/feedback, necessary corrective action plans and/or process improvement initiatives - Conducts routine periodic site visits to providers/physicians/facilities - Participates with Network Management in Joint Operating Committee (JOC’s). - Coordinates with Provider Network and Provider Data Management for contract data corrections - Identifies and reports to Provider Network Management contracting opportunities with problematic provider contracts based on root cause analysis - Interprets Health Net’s Policy and Procedures as it relates to claim issues, providing interpretation and clarification on contracts and benefits - Coordinates with Provider Network Management (PNM) if unable to resolve with provider and internal departments - Participates in process improvement activities working directly with the process improvement team to report root causes and facilitates corrective actions as needed - Prepares monthly reports to management to document issues, action plans, and resolutions of quality initiatives and provider relation improvement initiatives - Researches and responds to Shared Risk Discrepancies from Participating Provider Groups - Performs other duties as assigned - Complies with all policies and standards Education/Experience: Bachelor’s degree in Health Services, Health Care/Hospital Administration, a related field or any combination of education and/or work experience providing equivalent background required. Minimum of two years experience in medical claims review and/or claims appeal required. Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

King & Spalding is a leading global law firm with a commitment to excellence, innovation, and the seamless delivery of legal services. We harness innovative technology and exceptional talent to meet the complex needs of our clients in a fast-paced and dynamic legal landscape. We are seeking a Conflicts & Ethics Specialist to join our Conflicts & Business Review Department, which is part of the Firm’s General Counsel’s Office. This is an opportunity to join a collaborative team focused on supporting the Firm’s new business intake function. KEY RESPONSIBILITIES: - Conduct comprehensive reviews of new business intake forms, conflict reports, and engagement terms to identify and resolve potential business and ethical conflicts, ensuring full compliance with Firm policies prior to matter initiation. - Draft and review waiver letters, engagement letters, and communicate with lawyers and staff on any changes or additional information that may be necessary before the Firm can accept the new business. - Provide advice to attorneys in connection with conflicts of interest analysis, engagement letters, conflicts waivers, and Firm policies related to new business intake. - Oversee the onboarding of transferring matters for lateral partners. - Work closely with the Associate Director of New Business Intake and a team of Conflicts & Ethics Attorneys. QUALIFICATIONS: - Previous conflicts experience including reviewing conflict reports, researching corporate affiliations, drafting waivers, advising Firm lawyers on conflict or relationship issues and relevant Firm policies, and knowledge of conflicts rules across U.S. and non-U.S. jurisdictions is preferred but not required. - Excellent oral and written communication skills, exceptional critical thinking and problem-solving skills, and a working knowledge of the rules of professional conduct. - Responsive, demonstrate sound judgment, and can work well under pressure. - Ability to adapt to changing priorities, maintain a fast pace, meet deadlines, and manage a heavy workload. - Other duties may be assigned by the Associate Director of New Business Intake or Director of Conflicts & New Business Intake. OTHER: - Primary availability is required during business hours from 9:00 am to 5:30 pm or 11:00 am to 7:30 pm (EST) with flexibility to work outside of this standard schedule as needed. - This position is part of a required periodic on-call rotation. Occasional travel to the Atlanta office may be required. The firm offers a generous total compensation package with bonuses and raises awarded in recognition of individual merit-based performance. All full-time Business Services employees may participate in King & Spalding’s comprehensive benefit program including health and wellness plan, life and disability insurance, flexible spending accounts and a health savings account, a 401(k) plan, profit sharing plan, and a substantial Paid Time Off (PTO) program. Pay Transparency Range: New York, Washington, DC, Chicago, Denver, Sacramento, Los Angeles, San Francisco, Silicon Valley : Full-time annualized salary range $110,000-$135,000. The salary offer will be contingent upon various factors, including but not limited to, relevant experience, internal equity, market data, job location, and other job-related factors permitted by law.  Qualified candidates with arrest or conviction records will be considered for employment in accordance with the following laws if applicable: City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, San Francisco Fair Chance Ordinance, the California Fair Chance Act. King & Spalding LLP (K&S) is committed to providing equal employment opportunity to all applicants and employees in full compliance with all state, federal, and local laws prohibiting discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, age, disability or any other status protected by applicable law. We are proud of our remarkably cohesive culture, which now encompasses more than 2,500 lawyers and business professionals worldwide. We seek to attract and develop the very best talent to work with us.

APPLICANT MUST RESIDE IN THE GREATER ATLANTA AREA Schedule: Monday - Friday (40 hrs/wk) 10:30 AM to 7:00 PM Eastern Time Note: Travel may be required on the weekends in preparation of or return from a business trip. *This is a Work from Home position. However, initial onsite training may be required. Department: Transportation, National - 231 Primary Purpose: Works independently to maximize the overall transportation plans and routing within a specific geographic region. Also, manages inventory of courier supplies. Works closely with our transportation vendors and airlines, including FedEx. Trains couriers and/or vendor representatives on the proper procedures and protocols required to ensure that medical specimens are handled appropriately, efficiently, and in a timely manner. Resolves issues with courier noncompliance regarding pickup, client interaction, route documentation, packaging, shipping, and communication with clients and ARUP workforce. About ARUP: ARUP Laboratories is a national clinical and anatomic pathology reference laboratory and an enterprise of the University of Utah and its Department of Pathology. Based in Salt Lake City, Utah. ARUP proudly hires top talent to create a work environment of diversity, professional growth and continuous development. Our workforce is committed to the important service we provide to over one million patients each month. We always strive for excellence and have a strong desire to have involvement with the advances in medicine and the role laboratory services plays within each patient’s life. We never forget that there is a patient behind every specimen we receive. We are looking for individuals who want to contribute to ARUP's culture of accountability, integrity, service, and excellence. Consider joining our dynamic team. Essential Functions Develop and analyze geographic market transit plans regularly via OAG flight software, Transportation App scan data, Shipment Tracking data, airline cargo hours, Salesforce pickup schedules, etc. Train courier vendor representatives on the procedures and protocols required to ensure that clients’ patient specimens are received at ARUP according to ARUP, DOT, FAA, IATA, and other regulatory policies and procedures. Resolve issues with courier vendor noncompliance to regulatory and ARUP guidelines. Act as liaison between vendors and all ARUP departments and personnel. Onboarding new vendors with comprehensive training onsite to include optimal and standardized packaging of Category B and Category A infectious medical specimens. Schedule and host conference calls with vendors. Represent the National Transportation Department on ARUP Sales team and/or ARUP client calls. Specifically, speaking to transportation related problems and/or resolutions to those problems. Coordinate transportation activities within the geographical region assigned, including set up of new routes, edit of existing stops and routes, auditing routes for compliance of set pickup times, ARUP service standards, investigate errors and ensure proper corrective and preventative action, and provide retraining as necessary. Review and reconcile invoices for courier, supply, and air freight services within the assigned region. Look for ways to reduce waste and optimize operational effectiveness and reduce overall transportation costs. Properly use and care for ARUP company equipment used during travel. Understand thoroughly all processes relative to the receiving efforts of incoming shipments to ARUP. Help establish the best method for transportation of incoming shipments. Prioritize shipments, as needed. Represent ARUP and meet client needs quickly, courteously, and efficiently. Obtain as much information as possible regarding the person calling, who they represent, time of call, purpose of call, immediacy of action required, and all other needed information. Work during your designated shift. Be able to cover/fill in whenever necessary (i.e. sick, PTO, or other emergencies) for coworkers when issues arise. Respect and build unity with the other Transportation employees both local and national. Support the Lab Support Supervisor of National Transportation by implementing and supporting all policy and procedural changes. Attend all Department meetings, as designated. Craft and distribute severe weather notices to the Sales team, regarding hurricanes, winter storms, and wildfires for example. Act as resource to Client Services for all National Transportation education. Resolve CRM nonconformance cases and/or calls pertaining to compromised specimens during transit. Monitor ARUP online training videos with IFL, for accuracy and up to date information. Manage yellow box inventory with 3rd party vendor for proper fulfillment of courier supplies. Other duties as assigned. Physical and Other Requirements: Stooping: Bending body downward and forward by bending spine at the waist. Reaching: Extending hand(s) and arm(s) in any direction. Mobility: The person in this position needs to occasionally move between work sites and inside the office to access file cabinets, office machinery, etc. Communicate: Frequently communicate with others PPE: Biohazard laboratory environment that requires use of personal protective equipment in accordance with CDC and OSHA regulations and company policies. ARUP Policies and Procedures: To conduct self in compliance with all ARUP Policies and Procedures. Medium Work: Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. Fine Motor Control: Picking, pinching, typing or otherwise working, primarily with fingers rather than with the whole hand as in handling. Vision: Having close, far, and peripheral visual acuity to perform a variety of tasks such as make general observations of depth and distance. Climbing: Using hands and feet to pull one's self upward, such as using a ladder. Lifting: Raising objects from a lower to a higher position or moving objects horizontally from position-to-position Vision: Having close, far, and peripheral visual acuity to perform a variety of tasks such as make general observations of depth and distance. Color Vision: Perception of and ability to distinguish colors. Continuing Education: Continual assessment of current literature and best practices. Valid Utah Driver’s License: 1) No moving violations within the previous two years 2) No alcohol/drug-related violations on record with the Driver’s License Division 3) Class D or CDL