Role Description At Enlyte, we connect injured workers with quality healthcare through our innovative networks and solutions. Our Specialty Networks team plays a crucial role in ensuring timely access to specialized care that helps patients recover and return to work. The Medical Services Support Specialist serves as a vital connection point between injured workers and essential medical services. In this role, you'll process and coordinate orders for various medical services and equipment, ensuring injured workers receive the care they need in a timely manner. You'll work within our clinical team to deliver exceptional service while maintaining accuracy and efficiency. Location: 100% Remote Compensation: $20 per hour Schedule: Monday-Friday, 11:00 AM - 8:00 PM Eastern Time Key Responsibilities - Handle inbound calls, faxes, and emails to process orders for medical services and equipment (including home health, durable medical equipment, and physical medicine services) - Perform order triage based on priority, ensuring urgent needs receive prompt attention - Interact professionally with healthcare providers, claims professionals, and other stakeholders - Complete accurate data entry and document verification according to established protocols - Manage high volumes of transactions efficiently while adhering to quality standards - Follow contractual guidelines, company policies, and healthcare regulations - Make outbound calls as needed to obtain missing information or clarify requirements Qualifications - High school diploma or equivalent - 2+ years' experience in a call center or customer service environment - 2+ years' experience performing data entry with demonstrated accuracy - Excellent verbal and written communication skills - Strong multitasking abilities in a fast-paced environment - Proficiency with Microsoft Office and ability to learn proprietary systems - Reliable internet connection and dedicated workspace for remote work Requirements - Associate's or Bachelor's degree - 2+ years' experience in healthcare, workers' compensation, or insurance - Experience with medical terminology and healthcare coordination - Background in administrative healthcare roles or medical office settings Benefits - Medical, Dental, Vision - Health Savings Accounts / Flexible Spending Accounts - Life and AD&D Insurance - 401(k) - Tuition Reimbursement - An array of resources that encourage a lifetime of healthier living Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $13.08 - $20.00 hourly, and will be based on a number of additional factors including skills, experience, and education. The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability. Don’t meet every single requirement? Studies have shown that women and underrepresented minorities are less likely to apply to jobs unless they meet every single qualification. We are dedicated to building a diverse, inclusive, and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles.

Behavioral Health Medical Director- Child Psychiatrist Full time Location: - CA-WALNUT CREEK, 2121 N CALIFORNIA BLVD, 7TH FL, United States of America - CA-COSTA MESA, 3080 BRISTOL ST, STE 200 - CA-WOODLAND HILLS, 21215 BURBANK BLVD - CO-DENVER, 700 BROADWAY - NV-LAS VEGAS, 9133 W RUSSELL RD - WA-SEATTLE, 705 5TH AVE S, STE 300 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered.   Schedule: Fulltime position, Monday through Friday.   The Behavioral Health Medical Director- Child Psychiatrist is responsible for completing medical necessity reviews for general child psychiatry cases as well as Applied Behavioral Analysis cases supporting commercial and Medicaid business lines.   How you will make an impact: - Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations, and patients’ office visits with providers and external physicians. - Applies clinical knowledge and skills to utilization review processes. - Adheres to medical policies and clinical guidelines. - As assigned, engage in clinical and non-clinical activities that impact health care quality cost and outcomes - If requested, provides guidance for clinical operational aspects of a program. - May be required to serve on internal and/or external committees. - May develop and propose new medical policies based on changes in healthcare. - As assigned, engage in clinical and non-clinical activities that impact health care quality cost and outcomes. - Identifies and develops opportunities for innovation to increase effectiveness and quality.   Minimum Requirements: - Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). - Must possess an active unrestricted medical license to practice medicine or a health profession. - Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US. - Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. - For Health Solutions and Carelon organizations (including behavioral health) only, minimum of 5 years of experience providing health care is required. Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency.   Preferred Qualifications: - Willing to obtain a California medical license. - Board Certified in Child & Adolescent psychiatry strongly preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $250,236 to $428,976. Locations:  California, Nevada, Colorado, Washington In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

Role Description We are currently seeking a per diem Inpatient Care Management Medical Director to join our Optum team. This team is responsible for conducting acute level of care and length of stay reviews for medical necessity for our members being managed within the continuum of care. Our clients include local and national commercial employer, Medicare, and state Medicaid plans. The Medical Directors work with groups of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Participate in telephonic outreach for collaboration with treating providers, including discussion of evidence-based guidelines, opportunities to close clinical quality/service gaps, and care plan changes that can impact health care expenses. - Collaborate with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations. - Grounded in the use and application of evidence-based medicine (EBM) such as InterQual care guidelines and criteria review. - Occasionally participate in periodic market oversight meetings with Chief Medical Officers, network contractors, nurse management, and other internal managers. - Participate in rotational holiday and call coverage. - Maintain proficiency in all required software and platforms. - Complete all required training within 30 days from start date. - Collaborate with peers, nurse managers, and non-clinical employees from across the country. - Involved with change design and management, if interested. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Qualifications - MD or DO with an active, unrestricted medical license. - Current Board Certification in an ABMS or AOA specialty. - 3+ years of clinical practice experience post residency. - Technical proficiency in computer software and systems. - Private home office and access to high-speed Internet. - Ability to complete all required training within 30 days from start date. - Ability to work a minimum of 10 hours per week. Requirements - 2+ years of managed care, quality management experience and/or administrative leadership experience (preferred). - UM experience (preferred). - Clinical experience within the past 2 years (preferred). - All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Benefits - Compensation generally ranges from $119.47 - $179.33 per hour. - Total cash compensation includes base pay and bonus based on several factors including local labor markets, education, work experience, and may increase over time based on productivity and performance. - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase and 401k contribution (subject to eligibility requirements). - A far-reaching choice of benefits and incentives. Application Deadline This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

Role Description PSI Medical Monitors provide medical input to global clinical studies and advise the teams and business partners, while always focusing on patients' safety and well-being. Home-Based in the United States. Responsibilities: - Acts as the primary point of contact for all parties on all trial-specific medical and safety-related questions. - Provides input for responses to regulatory authorities and Institutional Review Boards (IRBs)/Independent Ethics Committees (IECs) on trial-specific medical and safety-related questions. - Monitors trial participant safety. - Participates in trial participant recruitment boost and retention activities. - Presents on medical matters at kick-off and investigator meetings. - Trains trial team in the therapeutic area and medical aspects of the protocol. - Develops and reviews trial-specific documents within the scope of medical monitoring. - Manages ongoing trial risks related to medical monitoring. - Performs ongoing medical review of the operational clinical trial database; provides support to Medical Reviewer(s) assigned to the trial. - Reviews protocol deviations. - Reviews RAE reports, writes and/or reviews SAE narratives, supports Pharmacovigilance team with outstanding safety queries, interacts with sponsor on site safety issues. - Reviews IND/SUSAR Safety Reports, updates/amendments to essential trial records, and annual IND reports with sponsor data (per sponsor request). - Participates in management of trial-related committees (e.g., independent data monitoring committee (IDMC)/adjudication committees) as described in the corresponding trial-specific charter(s). - Supports Pharmacovigilance, Medical Data Review and Data Management with reconciliation of safety and operational clinical trial databases. - Reviews clinical study reports (CSRs), including safety narratives and tables, figures, and listings (TFLs). - Provides medical expertise on an as-needed basis in trials where medical monitoring is not a contract deliverable. - Prepares for and participates in trial audits, follows up on audit findings. - Participates in feasibility assessment of potential and ongoing trials in the country/region. - Participates in bid defense meetings and other interactions with clients. - Acts as a medical expert and provides therapeutic expertise to other PSI departments. Qualifications - Medical Doctor degree required. - US Board Certification in Gastroenterology required. - Experience as a practicing Gastroenterologist (minimum of 10 years). - Clinical Research experience preferred. - Proficiency with MS Office applications. - Communication, presentation and analytical skills. - Problem-solving, team and detail-oriented. Benefits - As part of PSI's Medical Monitoring team, you will join our international group of medical professionals. - Build a career on the frontline of medical science. - Use your knowledge and expertise to help bring new medications to patients that need them.