OF POSITION The primary purpose of the PTHP Reconciliation Specialist is to reconcile and validate the CMS (Centers for Medicare & Medicaid Services) reports with our member records. They are responsible for meeting or exceeding turnaround time standard and quality expectations of Medicare Part C and D adjustments/reconciliations in accordance with service level agreements

To identify specific functions job requirements and work environment factors that could affect job performance. Check all factors that are present as essential job requirements and check whether the factor is performed. O = Occasionally = 0 33% of the work shift or 0 32 repetitions. F = Frequently = 34 66% of the work shift or 32 200+ repetitions. C = Constantly = 67 100%

The purpose of your position is to assist the department supervisor and with day to day operations within Networks, Credentialing and Contracting Departments. It is expected of the employee to develop, implement and maintain an accurate provider data base; analyze provider data, facilitate the preparation and follow up of the monthly activities of the Membership Services

Under the direction of the directors of surgical services, the surgical RN is responsible for the safety and planning of care of the patient while in the surgical department. The RN assists with surgical procedures in circulating and scrub duties. Assists in orientation, training and education of personnel. The RN takes call as assigned to meet department needs. PHYSICAL

OF POSITION The purpose of the Service Rep I is the primary contact with all enrollees, prospective enrollees, providers, brokers and companies and as such, must consistently relay the positive aspects of AultCare to every caller. The representative is responsible for accurately, courteously and promptly transacting all callers in a highly professional manner. RESPONSIBILI

OF POSITION The purpose of the Service Rep I is the primary contact with all enrollees, prospective enrollees, providers, brokers and companies and as such, must consistently relay the positive aspects of AultCare to every caller. The representative is responsible for accurately, courteously and promptly transacting all callers in a highly professional manner. RESPONSIBILI

OF POSITION The primary purpose of the Senior Contract Specialist is to support the Retention Department by functioning as liaison between Retention, Underwriting, Enterprise Risk Management (ERM), Technical Support, Claims and Customer Service, Information Systems, and Pharmacy in the creation of the Electronic Benefit Specifications (EBS) checklist to ensure that client

OF POSITION The primary purpose of the Data Reporting Analyst Intern is to get familiar the AultCare systems, data, and business as well as develop their Microsoft SQL Server Management Studio Services skills. QUALIFICATIONS Education Currently enrolled in an accredited university or college and working towards earning a Bachelor's Degree in Data Analytics, Management Info

OF POSITION The Director of Clinical Quality, Disease Management and Case Management reports to the Vice President of Quality and works closely within the Quality team and in collaboration with other operational and clinical teams in order to administer the organizations Quality program and workplan in order to meet all quality of care and quality of service goals of the o

OF POSITION The primary purpose of the Benefit Plan Technical Specialist is to maintain groups and plans in the claims payment system (QNXT). The Benefit Plan Technical Specialist will accomplish this goal by working with Retention and Underwriting departments to obtain approved plan benefit information. RESPONSIBILITIES & EXPECTATIONS Modifies or implements new configurat