JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines. • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. • Processes requests within required timelines. • Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. • Requests additional information from members or providers as needed. • Makes appropriate referrals to other clinical programs. • Collaborates with multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required Qualifications - At least 2 years MCG experience - Concurrent review and prior authorization experience in an MCO setting preferrerd - Multitasking in a fast-paced environment - Ability to operate Microsoft Office - Ability to navigate an online Sharepoint - Fast learner - Remote work experience Must obtain NV RN Licensure within 90 days of hire. 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

Role Description Are you passionate about delivering exceptional customer service? At ACC Premiere, we provide outstanding service experiences for consumers of well-known brands through phone, social media, live-chat, and email. We pride ourselves on our promote-from-within culture, fostering communication, and creating an employee-centric work environment. We offer paid training and supply the equipment you will need. If you have healthcare scheduling, customer service, and/or call center experience, we want to hear from you! We are hiring for remote positions in the following states: AL, AR, GA, ID, IA, KS, NC, OH, OK, PA, SC, TN, TX, and WV! Pay rate $11.50/hour Responsibilities - Deliver exceptional customer service while handling escalated or complex member interactions - Consult with members to understand their needs and identify the most appropriate transportation options - Communicate clearly and professionally using strong verbal communication skills - Adapt your approach to support a wide range of member personalities, needs, and situations - Use positive, empathetic language to represent yourself and the company in a professional manner Work Environment and Workspace - A dedicated home office workspace, ideally a separate room with its own door - Sufficient space to properly set up the workstation - Ability to hardwire internet with a direct connection from the router to the laptop, along with a stable and reliable high-speed internet connection - Three available power connections — either three outlets or a power strip - Remote employees must maintain the same level of availability, professionalism, and focus as expected in an on-site work environment - Remote work is not a substitute for child or elder care; employees are expected to have appropriate caregiving arrangements during scheduled work hours - No personal disruptions during scheduled hours (e.g., loud music, non-work-related phone calls, or interruptions from household members) to ensure a quiet, distraction-free environment - Ability to adhere to a 40-hour workweek without leaving the home office for personal reasons outside of scheduled lunch or break times - Employees must be able to participate in video or phone meetings and remain reachable during scheduled work hours Preferred Skills - Minimum of 2 years’ customer service experience in a call center environment - Experience with diagnosing and troubleshooting technology Required Skills - Excellent written and verbal communication skills; both internally and externally, ensuring clarity and courtesy in every interaction - Adaptable and open to change; embracing new challenges and having the willingness to learn and grow with the company - Professionalism in all aspects of work; including how we present ourselves, maintaining a positive attitude, and demonstrating respect towards colleagues and clients - Accountability to take ownership of tasks and responsibilities; including meeting deadlines, delivering quality work, adhering to schedules, and being proactive in addressing any issues that may arise Training Includes - Systems Training - Live Remote Training - Dayshift Training - 100% attendance is required during training period Schedule - 8-hour shift - Full-time only - First shift (mornings and afternoons) - Second shift (mid mornings and late afternoon) - Schedules will include a weekend shift - Client-assigned breaks (changes daily, based on the clients' needs) - Schedules are assigned in the interview process and will remain permanent Benefits - Health, dental, vision, and life insurance - 401(k) - Daily Pay - Employee assistance program - Gym membership subsidy - Referral Program If you require alternative methods of application or screening, you must approach the employer directly to request this as Indeed is not responsible for the employer's application process. Ready to make a difference? Apply today and join a team that values your skills and contributions!

Position Description The position is full-time and 40 hours a week. The shift will be five 8-hour shifts between the hours of 11AM-7PM EST Monday through Friday with rotating Sunday’s. While the organization will do its best to keep you in your scheduled shifts, schedules are subject to change, or you may be required to ‘float’ to other service lines based on business needs. The RN VPC Staff Member is part of the telehealth clinical team, which is devoted to the delivery care services in an online and fast-paced setting. The RN supports MD Live providers and clinical operations. Strong telephone triage, assessment, communication skills, and computer skills required. Essential Job Functions - Apply Professional Standards: Utilize current evidence‑based nursing practices and the ANA Code of Ethics in all aspects of patient care. - Provide Telehealth Support: Use MD Live technology to assess patient needs, determine telehealth appropriateness, and coordinate care with providers. - Triage & Assess: Conduct comprehensive telephone triage, gather pertinent information, and recognize escalation cues. - Coordinate Patient Care: Serve as a liaison between patient and provider; address post‑consultation questions and concerns. - Resolve Medication Issues: Assist with pharmacy questions or medication‑related concerns in partnership with providers. - Ensure Quality Documentation: Accurately document and maintain the patient’s electronic medical record. - Promote Safety: Identify, report, and help resolve patient safety or quality issues. - Advocate for Patients: Support optimal health outcomes through education, guidance, and empathetic communication. - Manage Difficult Interactions: De‑escalate challenging situations while maintaining professionalism and patient focus. - Other Duties: Perform additional responsibilities as assigned. Required Knowledge/Skills/Abilities - Critical thinking and data synthesis. - Empathetic - Triage and assessment skills. - Knowledge of Primary Care, Urgent Care, and ER settings. - Effective communication skills over various mediums. - Multi-tasking in a fast-paced environment. - Strong interpersonal skills with that encompass cultural, ethical, economic and access to health care resource understanding when interacting with the patient. - Knowledge of electronic medical records and e-prescribe. - Maintain competencies for telehealth nursing. - Demonstrates proficiency with the following software: Microsoft Word, Excel, PowerPoint, and Outlook. - Must be able to obtain a RN license in all 50 U.S. states and territories. Education and Experience - Must have a Compact Nursing license with the ability to obtain licensure in all US states and territories. - RN Licensure with at least two years of experience working in Primary Care, Urgent Care, or ER setting. At least one year of experience must be in a Primary Care setting. Physical Demands While performing the duties of this job, the employee is required to stand, walk, or sit; use a keyboard and computer mouse; reach with hands and arms; balance, stoop, kneel, bend talk, and hear. The employee must occasionally lift and/or move up to 25 pounds. The physical demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Work Environment Remote position. Employees are expected to have a quiet and professional setting in which to work. Travel Requirements None/Minimal Position Location Remote Security Roles and Responsibilities MD Live employees may have access to Protected Health Information and/or Personally Identifiable Information that is subject to privacy regulations by state and federal statutes. All employees must comply with all applicable regulations and all MD Live policies and procedures for the security and privacy of such information. EEO Statement MD Live is proud to be an equal opportunity employer committed to hiring a diverse and inclusive workforce. MD Live provides equal employment opportunities to all employees and employment applicants without regard to unlawful considerations of sex, sexual orientation, gender (including gender identity and/or expression), pregnancy, race, color, creed, national or ethnic origin, citizenship status, religion, disability, marital status, age, genetic information, veteran status or any personal attribute or characteristic that is protected by applicable local, state or federal laws. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 31 - 47 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Position Description The Registered Nurse is an integral member of the Telehealth Clinical Team, delivering high‑quality patient care in a fast‑paced virtual environment. This full‑time role consists of 40 hours per week, scheduled in 10‑hour shifts. The hours for this role are 4:00pm-2:00am EST and requires flexibility in scheduling, including the ability to begin shifts up to two hours earlier as operational needs require. Weekday schedules vary and include rotating weekends. While the organization will do its best to keep you in your scheduled shifts, schedules are subject to change, or you may be required to ‘float’ to other service lines based on business needs. The RN supports MD Live providers through telephone triage, assessment, care coordination, and patient education. This role requires strong clinical judgment, exceptional communication skills, and proficiency in navigating digital health platforms to ensure safe, efficient, and patient‑centered care Essential Job Functions - Apply Professional Standards: Utilize current evidence‑based nursing practices and the ANA Code of Ethics in all aspects of patient care. - Provide Telehealth Support: Use MDLIVE technology to assess patient needs, determine telehealth appropriateness, and coordinate care with providers. - Triage & Assess: Conduct comprehensive telephone triage, gather pertinent information, and recognize escalation cues. - Coordinate Patient Care: Serve as a liaison between patient and provider; address post‑consultation questions and concerns. - Resolve Medication Issues: Assist with pharmacy questions or medication‑related concerns in partnership with providers. - Ensure Quality Documentation: Accurately document and maintain the patient’s electronic medical record. - Promote Safety: Identify, report, and help resolve patient safety or quality issues. - Advocate for Patients: Support optimal health outcomes through education, guidance, and empathetic communication. - Manage Difficult Interactions: De‑escalate challenging situations while maintaining professionalism and patient focus. - Other Duties: Perform additional responsibilities as assigned. Required Knowledge/Skills/Abilities - Critical thinking and data synthesis. - Empathetic - Triage and assessment skills. - Knowledge of Primary Care, Urgent Care, and ER settings. - Effective communication skills over various mediums. - Multi-tasking in a fast-paced environment. - Strong interpersonal skills with that encompass cultural, ethical, economic and access to health care resource understanding when interacting with the patient. - Knowledge of electronic medical records and e-prescribe. - Maintain competencies for telehealth nursing. - Demonstrates proficiency with the following software: Microsoft Word, Excel, PowerPoint, and Outlook. Education and Experience - Must have a Compact Nursing license with the ability to obtain licensure in all US states and territories. - RN Licensure with at least two year of experience working in Urgent Care, Primary Care, or ER setting. Physical Demands While performing the duties of this job, the employee is required to stand, walk, or sit; use a keyboard and computer mouse; reach with hands and arms; balance, stoop, kneel, bend talk, and hear. The employee must occasionally lift and/or move up to 25 pounds. The physical demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work Environment Remote at‑home work environment requiring a quiet, professional, HIPAA‑compliant space. Travel Requirements None/Minimal Position Location Remote Security Roles and Responsibilities MD Live employees may have access to Protected Health Information and/or Personally Identifiable Information that is subject to privacy regulations by state and federal statutes. All employees must comply with all applicable regulations and all MD Live policies and procedures for the security and privacy of such information. EEO Statement MD Live is proud to be an equal opportunity employer committed to hiring a diverse and inclusive workforce. MD Live provides equal employment opportunities to all employees and employment applicants without regard to unlawful considerations of sex, sexual orientation, gender (including gender identity and/or expression), pregnancy, race, color, creed, national or ethnic origin, citizenship status, religion, disability, marital status, age, genetic information, veteran status or any personal attribute or characteristic that is protected by applicable local, state or federal laws. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 31 - 47 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.