- Manage and lead the ABA credentialing team to ensure timely completion of credentialing and recredentialing tasks. - Maintain and develop relationships with insurance payers, providers, and regulatory agencies. - Stay current on ABA credentialing standards, payer policies, and regulatory requirements. - Identify and implement process improvements to increase efficiency. - Provide training and support for credentialing staff to uphold best practices. - Monitor credentialing metrics and generate regular compliance reports. - Coordinate with HR and leadership on provider onboarding and terminations relating to credentialing. - Handle audits and respond to credentialing inquiries from external entities.

Job Description: Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member’s case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources. Participates in a cross functional, multi-disciplinary team to identify and implement member-centric interventions to ensure optimal and cost-effective health outcomes. Collaborates with interdisciplinary care team to develop a comprehensive care plan to identify key strategic interventions to address member’s needs, health goals and mitigate health care cost drivers. Essential Accountabilities: Level I • Handles behavioral health member clinical management programs. • Maintains knowledge of current Case Management Society of America (CMSA) Standards, NCQA Standards, Case Management Program activities, and performs the activities as directed by departmental policy and leadership, current NYS DOH, CMS regulations and standards if managing members of Medicare programs, and other regulatory requirements as applicable. • Carries out job responsibilities in accordance with departmental, corporate, state, federal and accreditation standards, as well as licensure, certification and scope of practice requirements for each specific health-related field/specialty, • Maintains confidentiality and conducts information management procedures per corporate and departmental policy. • Implements the Case Management Process per department policies, procedures and guidelines. The process includes case identification, case opening, member assessment, education and support intervention opportunities, developing care plans, conducting member-centric interventions, measuring member outcomes during re-assessment, case closure, and case reviews. • Screens members that fall within the defined populations served, referred to the department, either by data analysis or by internal or external referral sources. Applies case management criteria and professional clinical judgment to determine a member’s appropriateness for case management services. • Initiates case management, as outlined in the Case Management Program Description. Opens appropriate cases timely and effectively. Using motivational interviewing, assures essential information relating to case management is disclosed to members, thus increasing the opportunity for success in meeting member health goals. • Works in collaboration with members’ physicians and other health care providers to assess the needs of the member, facilitate development of an interdisciplinary care plan, coordinates services, evaluates effectiveness of services and modifies the member care plan as necessary. Maintains positive working relationships within this arena. • Assesses member/caregiver knowledge of his/her illness and initiates appropriate education interventions to address knowledge deficits. • Collaborates with member/caregiver to determine specific objectives, goals and actions to address member needs and barriers to meeting health goals identified during assessment. • Provides appropriate resources and assistance to members with regards to managing their health across the continuum of care. Maintains updated information related to appropriate community resources and serves as a source of information for providers and other members of the healthcare team. Acts as a liaison between providers and community resources. • Participates in inter-disciplinary coordination and collaboration to ensure delivery of consistent and quality health care services. Examples may include Utilization Management, Quality, Behavioral Health, Pharmacy, Registered Dietitian and Respiratory Therapist • Accepts responsibility for continuing education relative to professional growth. Meets or exceeds the minimum continuing education requirements as set forth by departmental and corporate policy, and by individual professional certification standards, if applicable. • Participates in and promotes other health plan programs, such as, Preventive Health, use of web-based tools for self-management of conditions and engagement in digital health programs and applications. • Work collaboratively with all Case Managers, especially those with varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse, Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity and coordination of care. • May work with internal and external stakeholders for value-based payment programs, such as accountable cost and quality arrangements (ACQA). • Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs. • Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. • Regular and reliable attendance is expected and required. • Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) • Handles all member clinical condition management programs. • Offers process improvement suggestions and participates in the solutions of more complex issues/activities. • Mentors junior staff and assists with coaching whenever necessary. • Consistently meets/exceeds all productivity and performance metrics, including positive results of audits. • Works independently in coordinating and collaborating with members and providers, resulting in improving member and community health. • Manages more complex assignments and/or larger caseloads. • Displays leadership skills and serves as a positive role model to others in the department. • Participates in the orientation of new staff. Level III (in addition to Level II Accountabilities): • Process Management and Documentation – o Identifies, recommends, and evaluates new processes as necessary to improve productivity and gain efficiencies. o Assists in updating departmental policies, procedures and desk-top manuals relative to the CM functions. o Identifies and develops processes and guidelines for performance improvement opportunities for the Case Management Department. • Expert and resource for escalations. Serves as subject matter expert and if called upon, works directly with the operation and clinical staff to resolve issues and escalated problems. • Mentors and provides guidance and leadership to the daily activities of the Case Management Department clinical staff. Acts as resource to Case Management staff, members, and providers. • Provides backup for the Supervisor/Manager, whenever necessary by: o Participating in the orientation of new staff and/training opportunities for all staff. Assists staff to identify opportunities to successfully engage members into care. o Acting as a liaison for activity generated by Customer Advocacy (CAU), Customer Service (CS), Special Investigations Unit (SIU), Provider Relations (PR), or Sales & Marketing. o Ensuring all regulatory requirements are being met, such as NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. • Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and educational needs to address established policies and procedures and job responsibilities. Minimum Qualifications: NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities. All Levels • Active NYS RN license required with three years’ behavioral health experience; or LMSW; or LCSW; or LMHC. • Minimum of three years of clinical experience required. Case Management experience preferred. • Must demonstrate proficiency with the Microsoft Office Suite. • Experience in interpreting managed care benefit plans and strong knowledge of government program contracts (Medicare and Medicaid) and benefits, preferred. • Strong written and verbal communication skills. • Ability to multitask and balance priorities. • Must demonstrate ability to work independently on a daily basis. • Deliver efficient, effective, and seamless care to members. - For incumbents aligned to the Federal Employee Program (FEP) line of business, Case Management Certification required within three (3) years of either hire and/or moving into this role supporting the FEP LOB. Level II (in addition to Level I Qualifications) • A minimum of 2 years in case management position. • Case Management Certification preferred • Delivers efficient, effective, and seamless care to members. • Demonstrates ability to escalate to management, as necessary. • Demonstrates proficiency in all related technology and documentation requirements. • Consistently meets or exceeds all performance metrics. Level III (in addition to Level II Qualifications) • Must have been in a current Case Management position or similar subject matter expert for at least 5 years. • Case Management Certification required • Broad understanding of multiple areas (i.e. UM and CM). At this level, incumbent is required to know multiple functional areas and supporting systems. • Expertise in Case Management area and able to handle complex assignments, challenging situations, and highly visible issues. • Ability to lead the training of new staff. • Demonstrated presentation skills. Physical Requirements: • Ability to travel and work long hours on a computer. • May require flexible hours to meet needs of member discussions. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Level I: E2: Minimum: $62,400 - Maximum: $ 96,081 Level II: E3: Minimum: $62,400 - Maximum: $ 106,929 Level III: E4: Minimum: $65,346 - Maximum: $117,622 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Bring more to life. Are you ready to accelerate your potential and make a real difference within life sciences, diagnostics and biotechnology? At Beckman Coulter Diagnostics, one of Danaher’s 15+ operating companies, our work saves lives—and we’re all united by a shared commitment to innovate for tangible impact. You’ll thrive in a culture of belonging where you and your unique viewpoint matter. And by harnessing Danaher’s system of continuous improvement, you help turn ideas into impact – innovating at the speed of life. As a global leader in clinical diagnostics, Beckman Coulter Diagnostics has challenged convention to elevate the diagnostic laboratory’s role in improving patient health for more than 90 years. Our diagnostic solutions are used in routine and complex clinical testing, and are used in hospitals, reference and research laboratories, and physician offices around the world. Every hour around the world, more than one million tests are run on Beckman Coulter Diagnostics systems, impacting 1.2 billion patients and more than three million clinicians per year. From uncovering the next clinical breakthrough, to rapid and reliable sample analysis, to more rigorous decision making—we are enabling clinicians to deliver the best possible care to their patients with improved efficiency, clinical confidence, adaptive collaboration, and accelerated intelligence. Learn about the Danaher Business System which makes everything possible. The Area Sales Manager will be responsible for - Drive Primary and Secondary Business, complete all assignments given from time to time. - Drive Profitable revenue growth - Customer Satisfaction - Achieving given Sales targets for Self - Maintain and review proper Sales funnel in SFDC on a weekly basis This position reports to the State Sales Manager – Ahemdabad and is part of the sales function located in Kolkata and will be fully remote. At Beckman coulter, our vision is to relentlessly reimagine healthcare, one diagnosis at a time. In this role, you will have the opportunity to: - Generate and grow business for the company by promoting product range and implementing Sales strategies - Build long term relationships with the end users and important stakeholders in the assigned territory by meeting customer needs - Work with Channel Partner for streamlining Inventory and Order Management - Take lead to collaborate with Customers and APPS / Marketing team to conduct PEP, Workshops, Education programs at Customer sites periodically, expand menu and wallet share - Work with multiple Stakeholders including team members from Marketing, Commercial Excellence, Marketing, Logistics and Distribution, Finance, HR, Product Managers, Legal etc. The essential requirements of the job include: - B.E / B. Sc. Degree / Any post graduate degree - Prior experience in laboratory Diagnostics (5+ years’ experience is a minimum) with knowledge of the local IVD market - Clinical and commercial driven individual with good knowledge of Funnel Management. - Fluent in English and the relevant local language with ability to build excellent relationships with the different stakeholders including end-users, purchasing agents, distributors etc. - Highly agile and flexible as extensive travel is required It would be a plus if you also possess previous experience in: - Distributor Relations Management and Key account management. - Work experience in CRMs like SFDC - Experience in MS Excel - Presentation Skills - Self-motivated, should be able to work independently. At Beckman Coulter Diagnostics we believe in designing a better, more sustainable workforce. We recognize the benefits of flexible, remote working arrangements for eligible roles and are committed to providing enriching careers, no matter the work arrangement. This position is eligible for a remote work arrangement in which you can work remotely from your home. Additional information about this remote work arrangement will be provided by your interview team. Explore the flexibility and challenge that working for Beckman Coulter Diagnostics can provide. Join our winning team today. Together, we’ll accelerate the real-life impact of tomorrow’s science and technology. We partner with customers across the globe to help them solve their most complex challenges, architecting solutions that bring the power of science to life. For more information, visit www.danaher.com.

ABOUT CARESCOUT Join us on a mission to simplify and dignify the aging experience. We are the children, siblings, neighbors, and friends of those navigating the fragmented and confusing system of long-term care. Our team is ferociously curious and relentless in our pursuit of a better system – and we are deeply committed to a sense of belonging for all, in all phases of life. We’re creating a new experience for care seekers and their families, bringing together long-term care options, non-healthcare resources, education, and human support into one place. We work hard, we have fun, we care about each other, and we share the mission. If this sounds like a place where you could thrive, join us! CareScout is a wholly owned subsidiary of Genworth Financial, Inc, a Fortune 500 provider of products, services and solutions that help families address the financial challenges of aging. POSITION TITLE Field Network Education Manager POSITION LOCATION Remote U.S. YOUR ROLE As the Field Educational Manager for CareScout Services, you will play a critical role in the execution of CareScout Services strategic initiatives and tactical clinical activities. This role oversees educational and support needs of the clinical field team within the Field Partner Network and is responsible for providing support to clinicians within the United States with an overall goal to maintain highly engaged contracted clinical staff across all regions through open communication, robust training, and responsive support. Help motivate Field Team Partners to build cooperative relationships and provide the highest level of internal and external customer service. The position includes acting as a primary resource to ensure company policies and procedures are carried out. You will partner with leadership teams across CareScout to strategically expand and advance the Field Partner Network and will oversee initial and continued training the clinicians. You will also partner with our Regional Clinical Leaders to engage with new Field Team Partners and Providers include home health, Assisted Living Facilities, and Nursing Homes and support the ongoing relationships with care facilities. What you will be doing - Perform quality assessments, virtually and in person, for Providers as needed. - Support network growth opportunities as needed by each Regional Clinical Leader. - Drive implementation of assessment products through training and education Provide training of new and active contractors. - Liaison for clinical clarifications and quality assurance - Provide coaching and educational needs to the Field Team to support overall quality. - Responsible for assisting with user support of Field Network Portal platform. - Share clarification data, common Field team concerns, continued educational needs and results from the Network to leadership team. - Maintain open office hours for additional educational needs, questions, or 1:1 assistance. - Other duties and responsibilities as assigned by the manager that support business needs, changes, and new initiatives ​ - Prepare and analyze quality results reports and present regional impact - Up to 25% travel as required What you bring - Bachelor of Science in Nursing - Active and unencumbered state RN License - 3 – 5 years of supervisory experience - 10+ years of experience in case management, home care, acute care, and/or a rehabilitation setting preferably with a geriatric population - Understanding of single and cumulative medical conditions and their impact on the aging process - A positive, solution-oriented mindset with the ability to maintain composure in high pressure situations - Proven excellent analytical skills and business acumen - Ability to document and communicate analytical results to key decision makers - High level of organization and self-motivation - Strong interpersonal relations, rapport building, and emotional intelligence; adaptable to change - Experience interpreting data, analyzing trends, and developing action plans based on patterns and trends Preferred Qualifications - Project Management experience - Prior experience in training and/or education - Long Term Care / Insurance industry knowledge - Telephonic case management / Home Health Care experience - MBA or master’s degree What we offer Genworth employees make a difference in people’s lives every day. We’re committed to making a difference in our employees’ lives. - Competitive Compensation & Total Rewards Incentives - Comprehensive Healthcare Coverage - Multiple 401(k) Savings Plan Options - Auto Enrollment in Employer-Directed Retirement Account Feature (100% employer-funded!) - Generous Paid Time Off – Including 12 Paid Holidays, Volunteer Time Off and Paid Family Leave - Disability, Life, and Long-Term Care Insurance - Tuition Reimbursement, Student Loan Repayment and Training & Certification Support - Wellness support including gym membership reimbursement and Employee Assistance Program resources (work/life support, financial & legal management) - Caregiver and Mental Health Support Services