Specialist, Patient Programs Job at Cencora (East Maitland)

Behavioral Health Specialist, House Calls Program

The House Calls Behavioral Health Specialist is a key resource for the At-Home C...

Location

United States , Lancaster

Salary:

60522.00 - 129615.00 USD / Year

CVS Health

Expiration Date

July 16, 2026

Requirements

Comfort and ability to work in a variety of environments, including patients' homes
Demonstrated ability to collaborate effectively in a team setting
Comfort supporting patients who are facing significant health, psychosocial and/or mental health issues
Experience with performing comprehensive biopsychosocial health, mental health and substance abuse disorder assessments
Experience with assessment and treatment planning for those with common mental health and/or substance use disorders and complex psychosocial needs
Working knowledge of differential diagnosis and psychosocial treatments of common mental health and/or substance use disorders
Familiarity with brief, structured intervention techniques (e.g., Motivational Interviewing, Behavioral Activation)
Proficient PC skills
US work authorization

Job Responsibility

Collaborate with OSH At-Home providers and Psychiatric Consult to identify and intervene with patients with psychosocial, community resource, and/or behavioral health needs
Function as the behavioral health and community resource expert on the OSH At-Home care team and actively contribute during team meetings
Facilitate goals of care and advance care planning discussions with patients and families in collaboration with their medical providers
Manage referrals for patients requiring specialized services through resource connections
Actively manage the shared BH registry to track individual patient progress of treatment toward target
Prepare and attend weekly registry review sessions with Psychiatric consult
Screen and assess patients for common mental health and substance use disorders
Develop care plans and facilitate referrals to external resources
Provide short-term counseling and evidence-based treatments within the Collaborative Care Model
Accurate and timely documentation of patient encounters in Oak Street's electronic medical record

What we offer

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources

Fulltime

RN Perinatal Safety Specialist

As our Perinatal Safety Specialist RN, you will lead the implementation, promoti...

Location

United States , Long Beach

Salary:

48.96 - 74.06 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

Bachelors Of Science Nursing
Minimum of 5 years as a clinician in Women’s Services
2 years of project experience in Women and Infants Perinatal Safety
Experience with quality improvement/process improvement techniques
Project/program management experience
Registered Nurse: CA, upon hire
AHA - CPR, upon hire
Neonatal Resuscitation Program upon hire
One of the following Certifications required upon hire: Certification in nursing specialty

Job Responsibility

Lead the implementation, promotion, and oversight of perinatal patient safety and quality of care initiatives and programs
Ensure adherence to national clinical standards
Disseminate crucial safety information
Facilitate educational programs
Conduct safety rounds
Actively contribute to quality improvement initiatives
Champion a culture of safety by monitoring clinical outcomes
Analyze adverse events
Develop education plans
Collaborate with multidisciplinary teams to ensure high-quality, compliant care for mothers and babies

What we offer

Health/dental/vision
FSA
Matching retirement plans
Paid time off
Tuition assistance
Adoption assistance

Fulltime

Outbound Enrollment Specialist

As an Outbound Enrollment Representative, you will be responsible for making out...

Location

United States

Salary:

40000.00 - 50000.00 USD / Year

Pomelo Care

Expiration Date

Until further notice

Requirements

Ability to work Monday-Friday, 8:30am - 5:00pm CT
Strong, empathetic communication skills
Motivated by goals, metrics, and monthly bonus program
Passionate about changing the current landscape of healthcare
Strong organizational and time-management skills
Ability to work independently and as part of a team
Willing to work occasional overtime hours
Are internet-connected, able to work remotely

Job Responsibility

Conduct high volume outbound calls to patients to provide information and education about Pomelo Care services and resources
Achieve member enrollment goals as driven by company KPIs
Support patients by answering their questions, addressing their concerns, and providing guidance on how Pomelo can support their needs
Document all interactions and maintain timely, accurate records of patient outreach activities
Collaborate internally and externally with healthcare providers, community organizations, and other stakeholders to ensure patients receive appropriate care and services
Work with families to schedule appointments and follow-up care as needed
Participate in training and development opportunities to stay current on healthcare trends and regulations
Manage inbound calls from potential patients

What we offer

Competitive healthcare benefits
Generous vacation policy
Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)
Uncapped performance bonus paid out monthly

Fulltime

Health Insurance Specialist

The purpose of the Patient Relations Analyst (PRA) at Oak Street Health is to ed...

Location

United States , Richmond

Salary:

21.10 - 40.90 USD / Hour

CVS Health

Expiration Date

May 25, 2026

Requirements

Computer Skills: Ability to quickly navigate and use multiple computer programs to include, but not limited to: Gmail, MS Word or Google Docs, Excel, etc.
US work authorization

Job Responsibility

Assist patients with navigating medicare and insurance issues which includes coverage, benefits, summaries, eligibility and getting the most out of their plan
Serve as internal resource in the clinic on insurance questions for providers and staff
Assist patients in navigating the healthcare system, help patients resolve medical bills inside and outside of Oak Street Health (advocate for the patient)
Gain the trust of Oak Street Health patients in an effort to properly advise them in their healthcare coverage
Manage the welcome visit and orientation process for new Oak Street Health patients
Educate patients on how to apply for public benefits, such as Public Aid, and Extra Help for prescription drugs
Support the clinic management team on operational activities as needed, including scheduling and billing
Provide exceptional customer service
Foster patient engagement through the design and execution of events, including center tours
Other duties as assigned

What we offer

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources

Fulltime

Patient Programs Monitoring Specialist

Trained in the delivery of client services relating to patient monitoring progra...

Location

Philippines , Makati City; Remote; Quezon City Metro Manila

Salary:

Not provided

Cencora

Expiration Date

Until further notice

Requirements

Professional education or University degree in Life Science, preferably Nursing or Health Science related
At least 2 years in a health-oriented role or health science related discipline
Patient focused background
Highly developed phone skills
Problem-solving skills
Attention to detail
Process driven
Strong computer skills including Microsoft Office suite (Word, Excel and Outlook)
Preferably exposure to working with databases

Job Responsibility

Patient Programs phone line and email coverage
Detect and report Adverse Events and Product Quality Complaints
Manage Patient Programs as defined in project-specific documents
Data entry and Quality Control
Perform reconciliation with clients and applicable partners
Interact with customers as needed (e.g. meetings, client visits, day to day case processing, etc.)
Complete monthly/quarterly metrics and Key Performance Indicators in Excel spreadsheets
Support the Program Manager or Team Lead with all necessary information related to the specific project/program, as needed
Writing/Review of procedural documents such as Working Instructions, Standard Operating Procedures, Working Procedures, Templates etc. for PharmaLex Cencora Patient Program projects
Program Management Support

Fulltime

Senior Field Reimbursement Specialist

Under general supervision of a Senior Manager, the Sr Field Reimbursement Specia...

Location

United States , Remote

Salary:

100700.00 - 155100.00 USD / Year

Cencora

Expiration Date

Until further notice

Requirements

Experience related and progressively responsible in a medical practice, private or third-party reimbursement arena, or pharmaceutical industry in sales, managed care, or clinical support
Experience within healthcare provider support such as a physician practice, patient assistance program or similar pharmaceutical/biological support program experience preferred
Bachelor’s degree preferred
Minimum of 7 years of experience
Candidates must possess a Prior Authorization Certification Specialist (PACS) credentials from an industry approved licensing body, or obtain certification within the first six months of employment
Ability to effectively manage multiple client relationships and customer
Ability to manage and support external meetings, presentations, and client interactions
Ability to lead and work in a matrix environment
Proven teamwork and collaboration skills with a demonstrated record of accomplishment of working in highly matrixed and cross-functional organizations
Ability to manage multiple tasks, timelines, expenses, and other activities necessary to fulfill the roles and responsibilities of a Field Reimbursement Specialists

Job Responsibility

Plan and engage with customers, leveraging client approved resources, to educate on access and reimbursement topics relevant to assigned client’s product
Track progress and evaluate results of assigned activities
Recommends changes in procedures
Lead or direct more complex projects or certain aspects of projects
Operates with reasonable latitude for un-reviewed action or decision
Work within a matrix environment to collaborate with internal and external stakeholders to secure optimized patient access and provide appropriate education through a focused effort on healthcare providers in community, institutional, and academic medical settings
Manage daily activities that support appropriate patient access to our client’s products in the provider offices and healthcare institutions, working as a liaison to other patient assistance and reimbursement support services offered by our clients
Review patient insurance benefit options with appropriate authorizations
Validate prior authorization requirements
Understanding of Specialty Pharmacy processes

What we offer

medical
dental
vision care
comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness
support for working families
backup dependent care
adoption assistance
infertility coverage
family building support
behavioral health solutions

Fulltime

Pharmacy Insurance Clearance Specialist

This job description indicates the general nature and level of work expected of ...

Location

United States , Oakbrook Terrace; Milwaukee

Salary:

22.50 - 33.75 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

High School Graduate
Typically requires 1 year of experience in health care, insurance industry, call center, or customer service setting
Demonstrate ability to identify and understand issues and problems
Ability to problem solve in a high profile and high stress area
Mathematical aptitude, effective communication, and critical thinking skills
Ability to prioritize and organize workload
Excellent verbal and written communication skills
Knowledge of medical terminology
Demonstrated technical proficiency including experience with insurance authorization/eligibility tools, EPIC, Microsoft Office, Internet browser and telephony systems

Job Responsibility

Participates in department staff meetings and keeps abreast of continuing education
Data entry
Pre-registers and registers patients using established procedures
Ensures accurate entry of patient demographic and insurance information
Manages incoming and outgoing calls to complete pre-registration with patients
Communicates with physician and patients regarding status of authorization requests
Ensures completion of all established policies and procedures for identification and notification of the Primary Care Physician
Coordinates with patient and provider to ensure patient can select the most cost-effective options
Maintains knowledge of all stand-alone computer software programs to verify eligibility
Identifies and assists patients with access to internal and external financial assistance programs

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance
Premium pay such as shift, on call, and more
Incentive pay for select positions

Fulltime

Financial Advocate

Acts as a liaison between health services and the consumer to provide education ...

Location

United States , Grafton

Salary:

22.90 - 34.35 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Typically requires 2 years of experience in Patient Access, health care, insurance industry, or in a customer service setting
High School Graduate, or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED)
Ability to communicate clearly and proactively to management about issues involving customer service and process improvement opportunities
Ability to articulate explanations of HIPAA and EMTALA regulations as they relate to all patient interactions within the operational flow involving the Financial Advocate, either virtually or in person
Has solid knowledge of how various types of insurances operate related to denials and appeals processes
Basic medical coding knowledge
Understanding of insurances, billing and denials
Ability to use a combination of scripted notes and clear, written communication when documenting in patients’ accounts

Job Responsibility

Acts as a liaison between health services and the consumer to provide education on costs, funding possibilities and payment options
Educates consumers on the cost of care and assists them in the planning and management of their financial responsibility
Pre-screens self-pay patients to determine if they are eligible for coverage programs and assists patients or family members with completing financial assistance applications, as necessary
Calculates and provides patients with personalized estimates of their financial responsibility based on their insurance coverage prior to service
Communicates patient liability clearly and accurately while adequately explaining concepts such as deductibles, coinsurance, and/or copayments and how they may affect the cost of care
Explains how non-covered and out-of-network services factor into the out-of-pocket cost
Requests upfront payment toward self-pay amounts, including estimated out-of-pocket costs and outstanding previous balances
Establishes payment arrangements in advance of scheduled services when applicable, communicating due dates and the amount of each installment
Interviews uninsured patients to assess for qualifying financial needs
Identifies available assistance programs and coordinates with patient to complete paperwork and applications for any potential coverage(s)

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Specialist, Patient Programs

Cencora

Location:
Australia , East Maitland

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 20, 2026

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