Role Description We are seeking a motivated and detail-oriented LVN/LPN to join our Chronic Care Management team. In this role, you will play a critical role in patient care by: - Conducting comprehensive assessment calls - Developing and educating patients on care plans - Performing Behavioral Health Integration (BHI) assessments - Assisting patients with medical device troubleshooting Qualifications - Active LPN/LVN Compact License required - Passionate about patient care, possessing the ability to relate with empathy and compassion - Strong communication and organizational skills - Proficient with computers, EMRs, and telehealth tools - 1–2 years of clinical experience in a GI or gastroenterology setting (preferred) - Experience triaging high-volume GI-related patient calls (preferred) - Familiarity with common GI conditions (preferred) - Knowledge of GI-specific medications and protocols (preferred) - Ability to de-escalate distressed or difficult GI patients telephonically (preferred) Requirements - Minimum fiber internet speed of 50 Mbps download / 10 Mbps upload - Hardwired internet connection required - Speed test submission required during the offer process - Private, HIPAA-compliant workspace Benefits - Competitive base pay: $24-$26/hr - Shift Differentials: - Evening Differential: +$1.50/hour for hours worked after 7:00 PM ET - Late-Night Differential: +$2.00/hour for hours worked after 10:00 PM ET - Weekend Differential: +$1.50/hour for all hours worked Saturday and Sunday - Sign-On Bonus: $1,500 paid after 120 days of continuous employment - Monthly Bonus Potential: Up to $1,500 - 5% Bilingual Pay Allowance - 11 Paid Company Holidays annually - Paid Time Off (PTO) - Medical, Dental, Vision, and supplemental insurance options - 401(k) Plan with 3.5% Company Match - Company-provided equipment

Role Description We have an immediate opening for a New Patient Liaison to join our remote team at US Fertility. Schedule: Monday through Friday, 8:00 AM to 5:00 PM Eastern Time Compensation: $22.00 to 25.00 per hour (commensurate with experience) This role provides the opportunity to grow within a nationally respected organization while remaining closely connected to the patients and teams you support every day. In this role, the New Patient Liaison will: - Prioritize time to generate increased new patient appointments by performing over the phone prospective customer consultations and closing new business. - Use a “soft sell” and empathetic approach to convert prospective customers into very satisfied customers by responding to questions and explaining in detail the features and benefits of choosing US Fertility. - Coordinate with USF offices and supervisors to ensure a seamless transition for prospective customers referred medical diagnosis and treatment, especially when unusual conditions are present. - Prepare and report on the metrics on the inside sales results and make recommendations to the leadership team on how to improve processes and increase sales. - Accurately maintain customer database that tracks all relevant program information, including individual progress of prospective customers. - Notate all unusual circumstances and document conversations with the potential customers in the database to ensure that complete, current and accurate information is available to everyone in the department. Qualifications - Bachelor’s degree preferred. - Five years customer service experience with at least two-three years inside sales experience. - Competency in active listening and relationship building, and ability to communicate with empathy. - Ability to build deep personal connections with callers who may be very emotional about the challenges they face in their effort to build a family. - Ability to communicate accurately and concisely. - Excellent interpersonal and telephone skills. Bilingual would be a plus. - Ability to function in a self-directed manner, organize work tasks and information efficiently, monitor quality/effectiveness, collaborate within and across teams and execute timely and accurate follow through. - Working knowledge of healthcare services/fertility is a plus. Requirements - More important than any single credential, however, is the right person. Team members who are most successful at US Fertility embrace our mission, live our values, and remain committed to continuous improvement—for themselves, their colleagues, and the patients we serve. Benefits - Full-Time Employees (30+ hours/week): - Medical, dental, and vision insurance. - 401(k) with company match. - Tuition assistance and professional development support. - Performance-based bonus opportunities. - Generous paid time off, paid holidays, and paid parental leave. - Life and disability benefits. - Fertility Discount Program. - Employee wellness and recognition programs. - Part-Time Employees: - 401(k) with company match. - Performance-based bonus opportunities. - Employee wellness and recognition programs. - Per Diem Employees: - 401(k) with company match. - Employee wellness and recognition programs. Company Description US Fertility is proud to provide a competitive, comprehensive benefits package designed to support our team members—professionally and personally—across all employment types. Our Commitment to Inclusion and Opportunity: - US Fertility and its network partners believe that a diverse workforce is essential to fulfilling our mission of expanding patient access to the highest standards of fertility care. - We are committed to equitable and inclusive hiring practices that ensure our clinical and operational teams reflect and support the diverse communities and patients we serve. - Across our national footprint, US Fertility is a leader in offering clinical, administrative, and operational career opportunities at locations throughout the United States. - We are equally committed to developing individual strengths, promoting from within, and supporting long-term career growth. This is a moment of growth, innovation, and impact. Take the next step in your career with US Fertility—and help shape the future of fertility care.

Role Description Person will work Pacific Standard Time (PST) to work primarily with behavioral health provider community during their business hours 8 am to 5 pm PST in California and other Western US States which may include but not be limited to Idaho, Nevada, and Utah. - Activities include recruitment and contracting functions for the building and ongoing maintenance of a high quality, competitive behavioral health network (outpatient and facility providers) that meets all access & availability and regulatory standard/requirements. - Accountable for all system updates associated with California and other state commercial, Medicare and Medicaid contract negotiations/network changes/addition of new providers and programs, including fee schedule negotiations and fee schedule development and maintenance. - Responsible for end recruitment and contracting, including end-to-end contracting processes for new programs and products and serving as a contracting subject matter expert for assigned states, lines of business and programs within those states. - Will serve as contracting back-up to peers for other assigned states and will learn to learn those states too. - Attendance at the various internal and extern meetings with State customers/regulators, Provider and Health Plan stakeholders in assigned states. - Regular interface and leadership role with health plan leadership, account managers, internal behavioral health functional leadership including finance and underwriting, provider leadership, and state regulators. - Work with behavioral health economics, legal, finance and underwriting in development, maintenance and monitoring of provider payment arrangements. - Presents and reports verbally and in writing to state regulators via conference calls about Medicaid contracting, provider contracting, network adequacy, recruitment development and related topics. - Works with behavioral health CPT, DRG, per diem and RBRVS and per member per month reimbursement methodologies. - Uses higher-level discernment and decision-making abilities that enable someone to support and work with upper level-management and state regulators. - When interacting with providers, manages health plan’s clear expectations to providers about timelines for contracting, credentialing, reimbursement levels and methodology, site audits, and the like. - Develops and maintains primary network contracting relationships with external (e.g., behavioral health providers, behavioral health groups, behavioral health agencies/community mental health agencies/federally qualified health clinics, facilities, provider associations, tribal government and other tribal organizations, government agencies) and internal customers; these relationships will be positive and productive. - Issues provider applications, agreements and related documents to providers. - Gathers completed provider applications and other documents that accompany the application, other documents required by state law and/or company policy; review these documents for completeness, accuracy, organize, and submit documents for credentialing. - Assembles provider agreements consisting of base agreements, appendices and addendums, fee schedules and related documents. - Coordinates and follows-up with provider relations advocates to ensure timeliness of submission of applications and related documents. - Is continually engaged; promptly responds to external and internal customer inquiries; responsible for remaining engaged with external and internal customers until tasks are complete; responsible for proactively keep external and internal customers updated about status of requests; communicates with external and internal customers via phone and email and using each appropriately to develop strong working relationships, this includes being prepared for scheduled calls with customers and writing professional communications. - Understands our provider contracts and contract language, terms and conditions and occasionally review provider’s proposed language changes and occasionally draft counter language for review by supervisor and legal counsel. - Models personal responsibility, dependability, reliability and flexibility in being able to meet the needs of the team and business; accepts responsibility and accountability for actions; continually learns and retains/absorbs knowledge, information and skills to perform the position as you work independently. - Models integrity and honesty; behaves in an honest, fair, and ethical manner; if says work is complete, it truly is complete and accurate according to standards. Takes the “higher road” when it comes to conflict and conflict resolution. - Models stewardship of recourse and documents; is efficient and effective with use of work time; archives and saves fully executed agreements, current fee schedules and related documents in appropriate locations; responsible with public (Medicaid and Medicare) and private funds when negotiating reimbursement in provider agreements. - Reports to the Director of Outpatient Behavioral Health Contracting of the Western U.S.; Keep Director updated on timely basis about provider network development, contracting developments, rate negotiations, rate increase requests, emerging issues and the like; actively participates in Western U.S. Outpatient Behavioral Health Contracting Team Meetings and collaborates with peers. - Use proprietary and other software programs for sending, updating and storage of provider/agency/group/facility contracts and numerous fee schedules and related contractual documents. - Actively participates in scheduled and ad hoc joint Provider Relations - Outpatient Behavioral Health Contracting Meetings to ensure continuity of communication and coordination between; proactively copies provider relations colleagues on provider communications to keep them in the loop about provider communications. - Actively participates on a regular basis with a variety of internal meetings with various functional areas including but not limited to provider services/provider relations, network strategy, legal, other contracting teams, project managers, health care economics, finance, underwriting, clinical, clinical operations, compliance, claims, consumer affairs, information technology, and sales. - Communicates throughout each workday via emails and phone communication with internal and external customers, including supervisor and team members. - Works in a fast-paced work environment with multiple, every-changing competing priorities. - Required to work office hours of 8:00 am to 5:00 pm PST as a telecommuter in order to respond to internal and external customers; this is a salaried position and will require more than 40 hours per week at times to keep up with work or complete work assignments. Qualifications - 3+ years of health care/managed care experience that includes the following: - Significant hands-on experience with medical / facility and/or behavioral health provider contracting in the California market. - Working at a health plan / managed care organization contracting with medical and/or behavioral health outpatient and facility providers. - Negotiating behavioral health contracts between behavioral providers and health plans / managed care providers for commercial, Medicare and/or Medicaid lines of business. - Working with both outpatient and facility reimbursement codes and methodologies. - Interacting with behavioral health professionals and/or behavioral health organizational leaders when working with prospective providers. - Solid working knowledge of California geography, counties, cities and providers (hospitals, clinics and other providers by location) as well as geography and behavioral health provider markets of in Western US. - Proficiency using Excel to develop and analyzing behavioral health fee schedules using Excel. - Proficiency with MS Word, Excel, PowerPoint and Access. - Understanding and experience with health plan reimbursement, finance and underwriting principles. - Ability to use tact and diplomacy; use superior discernment in stakeholder and provider communications; communicate effectively, professionally and comfortably with staff at multiple levels and from multiple functional areas and from various professional fields within provider/agency/group/facility organizations. - Experience contracting with providers for commercial, Medicare and Medicaid lines of business. Preferred Qualifications - 2+ years of experience with two or more of the following: - Experience working with health plan finance and/or underwriting staff developing provider payment strategies, reimbursement amounts, fee schedules and payment tables. - Experience working with health plan legal counsel reviewing contract language modifications. - Commercial, Medicare and/or Medicaid behavioral health provider contracting experience. - High level of proficiency working with Excel spreadsheets, analyzing fee schedules, developing and maintaining fee schedules, and analyzing provider reimbursement increase requests. - Behavioral health contracting experience in Idaho, Nevada and Utah a plus. - Basic understanding of role of California health plan regulatory framework in California and other states. - Knowledge of Medicare and CMS regulations and state Medicaid regulations. - Exceptional verbal and written communications. - Use appropriate demeanor, wear business appropriate dress, body language during interpersonal communications via video conference calls and in-person meetings. - Use appropriate business language in written communications (emails, memos and letters) that are tailored to the situation and immediate audience / personalities. - Foresee potential distribution and use of written (especially email) communications to audiences if later shared elsewhere by the recipient (e.g., executives, providers, regulators and media). - Ability to use tact and diplomacy when applicable, and use superior discernment in both internal and external stakeholder in both verbal and written communications on topics when communicating on a sensitive topic. - Ability to confidently interact and communicate with individuals-internally and externally-in a variety of organizations levels and roles. - Ability to always be courteous and professional (“taking the higher road”) when interacting internal or external stakeholders regardless of how they behave or act. - Ability to work with providers/agencies/groups and tell them “no” to various contract and reimbursement requests with respect and tact and confidence. - Always treat external and internal stakeholders with dignity and respect. - Solid internal and external customer service skills. - Demonstrated track record of successful behavioral health contracting negotiation skills. - Solid internal resource negotiation skills. - Exceptionally well-organized self-starter who is able to learn quickly and often on own, work with minimal supervision and keep up with workload. - Ability to work in a very fast-paced work environment with multiple, competing priorities; follow-through with assignments and tasks is a MUST with both internal and external customers; keep up with heavy workload; learn the position and begin performing the work quickly; navigate complex, challenging external and internal stakeholder relationships without it interfering with ability to accomplish job duties and work directives in effective and efficient manner; negotiate contract language modifications with providers and work with legal counsel; manage multiple projects and assignments while juggling various internal and external conference calls and respond to providers, internal customers via email and phone on a timely basis and update fee schedules, and process rate increase requests, and issue contacts and amendments on timely basis. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase. - 401k contribution (all benefits are subject to eligibility requirements). - Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. - The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. 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 Provides 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. - 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. Qualifications - At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Ability to prioritize and manage multiple deadlines. - Excellent organizational, problem-solving and critical-thinking skills. - Strong written and verbal communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Certified Professional in Healthcare Management (CPHM). Benefits Molina Healthcare offers a competitive benefits and compensation package. Company Description Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.