13 jobs found in cypress

Beacon Health Options Job Category: Operations - Customer Service General Req #: CUSTO01472 Schedule: Full Time Location: CA - Cypress We Help People Live their Lives to the Fullest Potential! For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a 'world-class' candidate experience from the moment you click 'Apply'! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise. Do you have a passion for helping others? If so, we are looking for you! Beacon is currently seeking a Customer Service Representative I to join our team at our Cypress, CA office. Under the direction of the Customer Service Management Team, the Customer Service Representative (CSR) for answering and responding to a high volume of telephone inquiries from members and providers. The incumbent's responsibilities include providing accurate and thorough interpretation of benefits, eligibility, provider participation, claims payment and interpretation inquiries, resolving customer inquiries, facilitating problem resolution, and acting as a member/provider advocate by meeting or exceeding customers' expectations. The CSR is expected to take complete responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention and satisfy corporate customer service goals and objectives. Shift : M- F 11:00am - 8:00pm (schedule may vary) What does a typical day look like? Essential Duties and Responsibilities: The CSR will perform the following duties in a typical call center environment, which means a high volume of calls will handled while located at a desk. Which requires adherence to schedules and extended periods of time on the phone. Provide timely, accurate, and courteous responses to a high volume of telephone inquiries from both members and providers.Meet daily production standards as indicated by management to meet overall ASA/ABA and client PG's: includes attendance, adherence to schedules, ACW, calls per day, turnaround times.Maintain adherence to schedule enabling the team to meet client satisfaction levels. Adherence to work schedule including time spent on break/lunch.Achieve and maintain productivity and quality performance expectations; minimum 95%Interpret and effectively communicate benefits and eligibility and claims payment information to our customers.Document all critical information related to contacts responded to in the appropriate in house healthcare systemsDemonstrate professionalism, empathy and a sense of urgency on each and every member and provider call/transactionEffectively navigate through multiple complex systems/screens.Have the knowledge around handling escalated callsProvide timely follow-up with other internal departments to expedite resolution of difficult/aging inquiries, and when necessary escalate those issues to management for further handling.Keep abreast of all system, contractual, compliance standard changes and policy updates, and attend additional training sessions and department meetings as necessary.Complete daily assigned tasks by management such as website inquiries, COB coordination of benefit updates, and authorization for disclosure forms, authorization updates, and correspondence.Perform additional duties and/or work additional hours as needed. Overtime and working holidays may be required based on business needs.Comply with all the HIPAA Compliance regulations. What you Contribute? Education : A high school/GED diploma is required. An Associate's Degree or equivalent related experience is preferred. Licensure : N/A Knowledge, Skills & Abilities: 6 months - 1 year experience in Customer Service, Health Care or Health Insurance is required. Previous experience in an ACD call center environment is preferred. Strong interpersonal skills and good written and verbal communication skills. Computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint. What Makes Us Different? Here, it's not just a job - it's an opportunity to change lives. Our employees are learners, innovators and original thinkers. Our mission and values guide the way we treat our members, providers and each other. What We Have to Offer: Healthcare benefits available starting day 1! Health & wellbeing incentives, such as gym membership reimbursement 401K with company match to help reach your future financial goals Generous PTO, because we know life happens outside of work Tuition reimbursement so you can keep reaching your fullest potential If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started! Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD PI113665027

Beacon Health Options Job Category: Provider & Network - Relationship Mgt Req #: PROVI01374 Schedule: Full Time Location: CA - Cypress ABOUT THE POSITION We are currently seeking a dynamic Provider Relations Rep II to join our team at our office in Cypress, CA. The Provider Relations Representative II routinely interfaces with existing providers and providers' office staff to develop a solid business relationship. Conducts outreach to providers to assist in education of Beacon policies and procedures or to resolve issues. He/she coordinates, develops and processes a multitude of reports related to the provider network. Assists Manager in conducting provider meetings, education and training classes, as well as, any special projects. Establishes timely action plans and guidelines to service new and current providers, assists with network development, investigates non-standard requests and problems, and provides explanations and information to others on topics within area of expertise. Position Responsibilities: 1. Act as a resource for providers about Beacon, its contracts, policies and procedures. Provide accurate and timely responses to provider inquiries, issues and requests. 2. Regularly interact and establish solid working relationships with Customer Service, Clinical, Claims, Network Operations, IT and Contracting in resolving provider and other operational issues. 3. Remain current on regulatory and company policy that impacts the provider network and related issues. 4. Engage providers in Beacon's quality improvement activities. 5. Help to secure completed contracts and credentialing materials from key providers who have been invited to join the network. 6. Strategize with members of the management team to ensure access and availability of providers meets current standards. 7. Be the liaison between providers and other Beacon departments. 8. Plan and facilitate trainings using various technology solutions, including new applications and procedures. 9. Lead classroom-style training sessions remotely, in-person and via WebEx/video conference. 10. Conduct provider site visits and other audits to ensure provider compliance with Beacon policies and NCQA accreditation standards. 11. Strategize with members of the management team to ensure access and availability of providers meets current standards. 12. Participate in development and maintenance of plans to meet performance guarantees. 13. Assists in the identification of service level gaps and works with Manager of Provider Relations and Contracts Managers to address recruitment opportunities 14. Prepare reports and analyze data as directed by the Manager of Provider Relations or other members of the management team. 15. Solid technical writing skills with a demonstrable ability to translate technical jargon and information into business-friendly language. 16. Manage multiple, simultaneous, and complex projects. Position Requirements: Education: • High school diploma or GED required. Bachelor's degree preferred. Knowledge, Skills & Abilities: • Minimum 3 years' experience in the HealthCare field. • Customer Service experience required; provider relations experience required. • Must be detail oriented and able to work independently in a fast changing environment. • Strong understanding of managed care and health care operations. Behavioral health experience preferred. • Must be able to work collaboratively with internal staff and external providers. • Must be well organized. Requires excellent communication and writing skills. • Have a professional demeanor and good public relations abilities. • Advanced level of PC skills required in Word and Excel. Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD $NFD PM16 PI113638674

Beacon Health Options Job Category: Provider & Network - Relationship Mgt Req #: PROVI01374 Schedule: Full Time Location: CA - Cypress ABOUT THE POSITION We are currently seeking a dynamic Provider Relations Rep II to join our team at our office in Cypress, CA. The Provider Relations Representative II routinely interfaces with existing providers and providers' office staff to develop a solid business relationship. Conducts outreach to providers to assist in education of Beacon policies and procedures or to resolve issues. He/she coordinates, develops and processes a multitude of reports related to the provider network. Assists Manager in conducting provider meetings, education and training classes, as well as, any special projects. Establishes timely action plans and guidelines to service new and current providers, assists with network development, investigates non-standard requests and problems, and provides explanations and information to others on topics within area of expertise. Position Responsibilities: 1. Act as a resource for providers about Beacon, its contracts, policies and procedures. Provide accurate and timely responses to provider inquiries, issues and requests. 2. Regularly interact and establish solid working relationships with Customer Service, Clinical, Claims, Network Operations, IT and Contracting in resolving provider and other operational issues. 3. Remain current on regulatory and company policy that impacts the provider network and related issues. 4. Engage providers in Beacon's quality improvement activities. 5. Help to secure completed contracts and credentialing materials from key providers who have been invited to join the network. 6. Strategize with members of the management team to ensure access and availability of providers meets current standards. 7. Be the liaison between providers and other Beacon departments. 8. Plan and facilitate trainings using various technology solutions, including new applications and procedures. 9. Lead classroom-style training sessions remotely, in-person and via WebEx/video conference. 10. Conduct provider site visits and other audits to ensure provider compliance with Beacon policies and NCQA accreditation standards. 11. Strategize with members of the management team to ensure access and availability of providers meets current standards. 12. Participate in development and maintenance of plans to meet performance guarantees. 13. Assists in the identification of service level gaps and works with Manager of Provider Relations and Contracts Managers to address recruitment opportunities 14. Prepare reports and analyze data as directed by the Manager of Provider Relations or other members of the management team. 15. Solid technical writing skills with a demonstrable ability to translate technical jargon and information into business-friendly language. 16. Manage multiple, simultaneous, and complex projects. Position Requirements: Education: • High school diploma or GED required. Bachelor's degree preferred. Knowledge, Skills & Abilities: • Minimum 3 years' experience in the HealthCare field. • Customer Service experience required; provider relations experience required. • Must be detail oriented and able to work independently in a fast changing environment. • Strong understanding of managed care and health care operations. Behavioral health experience preferred. • Must be able to work collaboratively with internal staff and external providers. • Must be well organized. Requires excellent communication and writing skills. • Have a professional demeanor and good public relations abilities. • Advanced level of PC skills required in Word and Excel. Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD $NFD PM16 PI113629427

Beacon Health Options Job Category: Provider & Network - Contracting Req #: CONTR01431 Schedule: Full Time Location: CA - Cypress We Help People Live their Lives to the Fullest Potential! For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a 'world-class' candidate experience from the moment you click 'Apply'! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise. Do you have a passion for helping others? If so, we are looking for you! Beacon is currently seeking a Contract Development Manager to join our team at our Cypress, CA office. The Contract Development Manager leads all territory network development and contract management activities for a growing and complex managed behavioral health care organization. The position is responsible for network development, recruiting for new business, contracting, and rate negotiations for their assigned territory. Duties include identifying and contracting new/ re-contracting existing providers around Beacon's need for services, negotiating rates, drafting provider services and facility agreements, sending and receiving credentialing applications, overseeing the resolution of language changes and securing executed contracts with providers, developing recruitment plans and reports and ensuring rates negotiated are within established guidelines. What does a typical day look like? Negotiates rates and contract terms with currently contracted providers and facilities.In conjunction with internal and external stakeholders, secure executed agreements with identified out of network providers for inclusion in the Beacon Health network.Performs reimbursement analysis on providers/facilities that are outside of the targeted rate schedule or performance standards and develop strategies for cost reductions, member needs and increasing quality.Identifies opportunities for cost savings and process improvements related to the contracting process.Review, draft and document suggested language changes, and oversee resolution of all proposed changes to the provider services agreement.Ensures that Contract Language is in compliance with plan agreements and within all state and federal regulatory and NCQA standards.Gather, review and submit credentialing applications, as required, for network development and management.Provides general support to all network development activities and support Director with implementation requirements.Strategizes with other members of the management team and client/plan to ensure access and availability of providers meets current standards.Collaborates with other departments to address and resolve operational issues as related to negotiated contract language.Prepares reports and analyze data as directed by the Director of Provider Relations or other members of the management team.Adheres to all Beacon policies and procedures and standards of operations.Completes all required and assigned trainings.Attends all mandatory company or department meetings.Reports to each scheduled shift and commence work and perform essential job function at the start of each schedule shift.Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.Acts as a mentor to junior team members by leading by example and guiding with a sense of integrity and team work.Assists management with identifying opportunities for staff improvement, high performing team members, and training needs of team members.Assist team members and offers suggestions to improve processes, culture, or work environment.Performs special projects and other duties as assigned and required. What you Contribute? Education : A high school/GED diploma is required. Bachelor's Degree or equivalent related experience is preferred. Licensure : N/A Knowledge, Skills & Abilities: At least 3 years' experience rate & contract language negotiation to include facility and higher level of care experience; In-depth knowledge of provider reimbursement methodologies- behavioral health experience a plus. Knowledge of managed care contract requirements to include state and federal regulatory requirements for Medicare and Medicaid plans and CMS guidelines. 2 (two) years of provider contracting, provider relations or similar experience Strong interpersonal skills and good written and verbal communication skills. Computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint. Ability to travel What Makes Us Different? Here, it's not just a job - it's an opportunity to change lives. Our employees are learners, innovators and original thinkers. Our mission and values guide the way we treat our members, providers and each other. What We Have to Offer: Healthcare benefits available starting day 1! Health & wellbeing incentives, such as gym membership reimbursement 401K with company match to help reach your future financial goals Generous PTO, because we know life happens outside of work Tuition reimbursement so you can keep reaching your fullest potential If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started! Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD PI113629258

Beacon Health Options Job Category: Provider & Network - Relationship Mgt Req #: PROVI01488 Schedule: Full Time Location: CA - Cypress We Help People Live their Lives to the Fullest Potential! For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a 'world-class' candidate experience from the moment you click 'Apply'! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise. Do you have a passion for helping others? If so, we are looking for you! Beacon is currently seeking a Provider Relations Representative I to join our team at our Woburn, MA office. Under the general supervision of the Supervisor of Provider Relations, provides internal support and follow-through in completion of the Provider Relations function. This position conducts research, resolves problems follows up on a variety of provider issues that may arise. The job also coordinates activities with other internal Beacon Health Options departments to provide optimal customer service to network providers and internal customers. The Providers Relations Representative I routinely interfaces with existing providers and providers' office staff to develop a solid business relationship. What does a typical day look like? Answer general provider questions about Beacon, its contracts, policies and procedures.Perform research and problem resolution on issues related to provider complaints, claims reported to have been processed incorrectly, coordinating credentialing paperwork, provider communications, or verification of information as requested.Remain current on regulatory and company policy that impacts the provider network and related issues.Answer practitioner/facility recruitment questions regarding joining Beacon's network.Provide assistance in compilation and mailing of provider recruitment mailings, general information, and educational materials to network practitioners as required.Conduct outreach to providers for information, research or compliance with Beacon policies or programs including access and availability standards.Provide follow up with key practitioners and facilities for the return of completed credentialing and re-credentialing applicationsProvide general support to all network development activities.Respond to provider calls transferred by the Provider Services Line as well as emails, voicemails and faxes.Actively outreach and train providers to increase the rate of electronic transactions.Perform active outreach to ensure compliance with access and availability.Work with providers and network operations to ensure provider data submission and accuracy.Participate in the coordination and processing of all Network department mailings.Review claim reports for denial rates and work with providers to improve claim submissions.Build collaborative relationships with client health plan counterparts to ensure seamless customer service.Assists with network reporting activities. What you Contribute? Education : High School diploma or GED required. Some college preferred Licensure : N/A Knowledge, Skills & Abilities: Minimum 2- 3 years' experience in the HealthCare field. Strong interpersonal skills and good written and verbal communication skills. Computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint. Shift: M-F 8:30am - 5:00pm PST What Makes Us Different? Here, it's not just a job - it's an opportunity to change lives. Our employees are learners, innovators and original thinkers. Our mission and values guide the way we treat our members, providers and each other. What We Have to Offer: Healthcare benefits available starting day 1! Health & wellbeing incentives, such as gym membership reimbursement 401K with company match to help reach your future financial goals Generous PTO, because we know life happens outside of work Tuition reimbursement so you can keep reaching your fullest potential If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started! Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD PI113629331

Beacon Health Options Job Category: Provider & Network - Relationship Mgt Req #: PROVI01489 Schedule: Full Time Location: CA - Cypress We Help People Live their Lives to the Fullest Potential! For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a 'world-class' candidate experience from the moment you click 'Apply'! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise. Do you have a passion for helping others? If so, we are looking for you! Beacon is currently seeking a Provider Relations Representative I to join our team at our Woburn, MA office. Under the general supervision of the Supervisor of Provider Relations, provides internal support and follow-through in completion of the Provider Relations function. This position conducts research, resolves problems follows up on a variety of provider issues that may arise. The job also coordinates activities with other internal Beacon Health Options departments to provide optimal customer service to network providers and internal customers. The Providers Relations Representative I routinely interfaces with existing providers and providers' office staff to develop a solid business relationship. What does a typical day look like? Answer general provider questions about Beacon, its contracts, policies and procedures.Perform research and problem resolution on issues related to provider complaints, claims reported to have been processed incorrectly, coordinating credentialing paperwork, provider communications, or verification of information as requested.Remain current on regulatory and company policy that impacts the provider network and related issues.Answer practitioner/facility recruitment questions regarding joining Beacon's network.Provide assistance in compilation and mailing of provider recruitment mailings, general information, and educational materials to network practitioners as required.Conduct outreach to providers for information, research or compliance with Beacon policies or programs including access and availability standards.Provide follow up with key practitioners and facilities for the return of completed credentialing and re-credentialing applicationsProvide general support to all network development activities.Respond to provider calls transferred by the Provider Services Line as well as emails, voicemails and faxes.Actively outreach and train providers to increase the rate of electronic transactions.Perform active outreach to ensure compliance with access and availability.Work with providers and network operations to ensure provider data submission and accuracy.Participate in the coordination and processing of all Network department mailings.Review claim reports for denial rates and work with providers to improve claim submissions.Build collaborative relationships with client health plan counterparts to ensure seamless customer service.Assists with network reporting activities. What you Contribute? Education : High School diploma or GED required. Some college preferred Licensure : N/A Knowledge, Skills & Abilities: Minimum 2- 3 years' experience in the HealthCare field. Strong interpersonal skills and good written and verbal communication skills. Computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint. Shift: M-F 8:30am - 5:00pm PST What Makes Us Different? Here, it's not just a job - it's an opportunity to change lives. Our employees are learners, innovators and original thinkers. Our mission and values guide the way we treat our members, providers and each other. What We Have to Offer: Healthcare benefits available starting day 1! Health & wellbeing incentives, such as gym membership reimbursement 401K with company match to help reach your future financial goals Generous PTO, because we know life happens outside of work Tuition reimbursement so you can keep reaching your fullest potential If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started! Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD PI113629359

Beacon Health Options Job Category: Clinical - Care Mgmt Req #: UMCAR01497 Schedule: Full Time Location: CA - Cypress About The Position: Beacon Health Options is currently seeking a dynamic UM Care Manager to join our Outpatient team in Cypress, CA or remotely! The UM Care Manger Outpatient Licensed Clinician is a position in fast-paced environment that serves the members population seeking behavioral health services. The Care Manager is responsible for screening and triaging members to appropriate level of care and providing resources and referrals. This is an Evergreen requisition designed to gather a talent pool for current or future open positions. It is a way for Beacon Health Options to build a network of qualified, interested candidates for a specific job function in order to expedite the hiring process when there is a need to fill that type of role. By applying to an Evergreen requisition, you are expressing your interest for a particular job function within Beacon Health Options. In addition to submitting your resume to an Evergreen requisition, we encourage you to create a job search agent to be alerted when positions in your areas of interest become available. Position Responsibilities: Responds to screening and triaging members telephonically to determine appropriate level of care Utilization Review with providers based on claims trigger data and 6 month reviews Work collaboratively to coordinate a supportive environment and clear communication; Maintaining accurate information in Beacon's clinical documentation systems as directed Telephonic collaboration with provider and county agencies regarding members in treatment Participation in systems meetings as needed Collaborate with Primary Care Physician (PCP), Behavioral Health Professionals (BHP), and other members of the health care team, including health plan medical care managers and others to arrange and coordinate services for the member and optimize the member's ability to engage in the appropriate plan of care; Assist with NCQA and URAC initiatives Respond to urgent calls Telephonic collaboration with Members Treatment Record Reviews Attend Clinical meetings Adheres to all Beacon policies and procedures and standards of operations. Completes all required and assigned trainings. Attends all mandatory company or department meetings. Reports to each scheduled shift and commence work and perform essential job function at the start of each schedule shift. Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment. Acts as a mentor to junior team members by leading by example and guiding with a sense of integrity and team work. Assists management with identifying opportunities for staff improvement, high performing team members, and training needs of team members. Assist team members and offers suggestions to improve processes, culture, or work environment. Performs special projects and other duties as assigned and required. Telecommunicating an option Position Requirements: Education: Bachelor of Science in Nursing (BSN) or master's degree in mental health related discipline. Licenses: Licensed behavioral health clinician/nurse (LCSW, LMFT, LPCC, RN, Ph.D. or PsyD.) required in the state of California, certification as a Care Manager is preferred. Relevant Work Experience: 3 years behavioral health clinical practice required Knowledge, Skill, & Abilities: Educated in current principles and procedures of behavior health care. Knowledge of managed care and state specific expertise preferred. Demonstrated work experience to influence and negotiate to effectively manage patient care and health care outcomes. Demonstrated work experience meeting strict deadlines and established cycle times through effective prioritization and follow-up. Strong interpersonal skills and good written and verbal communication skills. Advanced computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint. To Apply: Click below on " Apply for this Position " to create a profile and apply for the position Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD PM16 PI113595817

Beacon Health Options Job Category: Operations - General Req #: REGIO01455 Schedule: Full Time Location: CA - Cypress About the Position: We are currently seeking a dynamic Regional Operations Analyst for Region 4 to join our team at our office in Cypress, California . The Regional Ops Analyst is responsible to Deliver top-notch client operations experience for designated clients that generates strong customer satisfaction, delivers against SLAs, and contributes to double-digit annual EBITDA growth. Under the direction of the AVP/VP Regional Operations, the Analyst Regional Operations is a key contributor to the Ops Pod: a team of customer-facing cross-functional operations experts tasked with ensuring that designated clients receive consistent, high-quality operations support. Each Ops Pod will manage an average of 4-5 clients, but may be dedicated to a single client or span as many as 8 depending on client size, geography, and complexity. The Analyst will work to proactively identify client operational issues, participate in a regular prioritization process, and lead root cause analysis to create scalable, lasting solutions to operational problems. Position Duties and Responsibilities: • Support onboarding of clients onto Beacon's new regional model, including interfacing with client teams and Beacon Account Partnerships teams to ensure incoming client operational issues are directed to the Pod. • • Contributes to team discussions and development of solutions for client operational issues assigned to the team, always with the intention to leverage the range of expertise on each team in order to generate high quality, scalable and lasting solutions. • • Develop and maintain effective working relationships with Corporate Services, Service Centers, and Regional Clinical/Quality in order to deliver against client service needs • • Contribute to the reduction of client turnaround time by creatively and collaboratively resolving applicable issues up front, and delivering high-quality, pre-solutioned tickets to Central Operations when an issue cannot be resolved within the Pod. • • Develop and implement effective processes to improve operational performance against client Service Level Agreements (SLAs) and Performance Guarantees (PGs) • • Develop strong client relationships built on trust and collaboration. Manage client expectations throughout the solutioning cycle via regular communication on designated topics or issues. • • Actively participates in cross-training with other team members, each educating on their area of expertise as well as learning other areas through training provide by other team members, with the overall goal to develop a strong, cross-functional team prepared to address a wide variety of client-generated operational issues. • • Contribute to the development of a repeatable model for operational issue resolution, for example by collaborating with other Ops Pod Team Members to synthesize patterns across clients with the goal of developing a "playbook" containing a range of client contexts, problem types, steps to effective resolution (including key internal and external personnel), and watch-outs • • Lead periodic forums with other Ops Pods to ensure consistency in issue resolution model across clients and across regions, as assigned • • Collaborate with Regional Operations Monitoring function to proactively identify operational issues with designated clients and support ongoing improvement of Beacon's Operations Monitoring capability by providing insight on common issues and value-added metrics to track Position Qualifications: • Education: Bachelor's degree in a related field preferred. • Three (3) years of professional level experience in a technical operations role in a healthcare environment may be substituted for the degree, in addition to the work experience required below. • Relevant Work Experience: Minimum three (3) years of progressively responsible professional experience, with at least two (2) of those years in a client-facing operations job. • One (1) of those years in a managed care environment is strongly preferred. Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. PI113591313

Beacon Health Options Job Category: Clinical - General Req #: ABACL01493 Schedule: Full Time Location: CA - Cypress About the Position: We are currently seeking a dynamic ABA Clinical Services Assistant II to join our Utilization Management team in Cypress, CA! The ABA Clinical Care Services Assistant II serves as central point of contact and communication for members, families, providers, insurers and members of the ABA team in the linkage of care for Applied Behavioral Analysis (ABA) services. Addresses a broad spectrum of needs and/or concerns in a professional, friendly, and efficient manner. Performs a variety of customer service and unit-operations activities to assist clinical and administrative staff to meet operational and business performance metrics. Position Responsibilities: Assist members and providers with all levels of inquiries, problem solving, insurance information and general customer service, which could include: Customer material requests and member registration Benefit and Eligibility information Physician assignments Authorization for treatment Billing and Payment issues Explanation of Benefits (EOB)/Explanation of Payments (EOP) Clinical Care Management system usage Staff all Call Center queues and adhere to performance requirements for call center response times, abandonment rates, and other productivity, schedule, and quality standards or metrics that may be established. Receive, respond and resolve questions about accessing ABA services. Analyze data and identify appropriate level of care to expedite linkage to care to ABA services. Gather required clinical and financial information care for members and enter data into clinical care management system. Monitor the data in the clinical care management system, collaborating with provider community; escalate issues and concerns regarding care management to Senior Care Managers according to policies and procedures. Act as a liaison with parents and the health community to ensure continuum of care and support for members. Participates in corporate quality improvement functions. Assists with special projects and administrative tasks as assigned. Performs other duties as required. Position Requirements: Education: High School diploma or GED equivalent required Relevant Work Experience: 5 years' general working experience with 2 years' of Customer Services experience required Knowledge, Skills, & Abilities: Previous experience in a call center environment within the healthcare preferred Knowledge or ability to learn state and federal laws and regulations applicable to the call center required Strong analytical, problem solving and organizational skills required Strong interpersonal skills needed to frequently interact with members, families, providers and insurance representatives required General knowledge of clinical documentation, preferably electronic health records/medical records systems preferred Ability to learn, master, and incorporate use of variety of clinical and administrative automated systems and software into daily work required Bilingual in English and Spanish preferred To Apply: Click below on " Apply for this Position " to create a profile and apply for the position Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD PI113591331

Beacon Health Options Job Category: Clinical - Care Mgmt Req #: UMCAR01497 Schedule: Full Time Location: CA - Cypress About The Position: Beacon Health Options is currently seeking a dynamic UM Care Manager to join our Outpatient team in Cypress, CA or remotely! The UM Care Manger Outpatient Licensed Clinician is a position in fast-paced environment that serves the members population seeking behavioral health services. The Care Manager is responsible for screening and triaging members to appropriate level of care and providing resources and referrals. This is an Evergreen requisition designed to gather a talent pool for current or future open positions. It is a way for Beacon Health Options to build a network of qualified, interested candidates for a specific job function in order to expedite the hiring process when there is a need to fill that type of role. By applying to an Evergreen requisition, you are expressing your interest for a particular job function within Beacon Health Options. In addition to submitting your resume to an Evergreen requisition, we encourage you to create a job search agent to be alerted when positions in your areas of interest become available. Position Responsibilities: Responds to screening and triaging members telephonically to determine appropriate level of care Utilization Review with providers based on claims trigger data and 6 month reviews Work collaboratively to coordinate a supportive environment and clear communication; Maintaining accurate information in Beacon's clinical documentation systems as directed Telephonic collaboration with provider and county agencies regarding members in treatment Participation in systems meetings as needed Collaborate with Primary Care Physician (PCP), Behavioral Health Professionals (BHP), and other members of the health care team, including health plan medical care managers and others to arrange and coordinate services for the member and optimize the member's ability to engage in the appropriate plan of care; Assist with NCQA and URAC initiatives Respond to urgent calls Telephonic collaboration with Members Treatment Record Reviews Attend Clinical meetings Adheres to all Beacon policies and procedures and standards of operations. Completes all required and assigned trainings. Attends all mandatory company or department meetings. Reports to each scheduled shift and commence work and perform essential job function at the start of each schedule shift. Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment. Acts as a mentor to junior team members by leading by example and guiding with a sense of integrity and team work. Assists management with identifying opportunities for staff improvement, high performing team members, and training needs of team members. Assist team members and offers suggestions to improve processes, culture, or work environment. Performs special projects and other duties as assigned and required. Telecommunicating an option Position Requirements: Education: Bachelor of Science in Nursing (BSN) or master's degree in mental health related discipline. Licenses: Licensed behavioral health clinician/nurse (LCSW, LMFT, LPCC, RN, Ph.D. or PsyD.) required in the state of California, certification as a Care Manager is preferred. Relevant Work Experience: 3 years behavioral health clinical practice required Knowledge, Skill, & Abilities: Educated in current principles and procedures of behavior health care. Knowledge of managed care and state specific expertise preferred. Demonstrated work experience to influence and negotiate to effectively manage patient care and health care outcomes. Demonstrated work experience meeting strict deadlines and established cycle times through effective prioritization and follow-up. Strong interpersonal skills and good written and verbal communication skills. Advanced computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint. To Apply: Click below on " Apply for this Position " to create a profile and apply for the position Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD PM16 PI113591355

Beacon Health Options Job Category: Operations - General Req #: REGIO01288 Schedule: Full Time Location: CA - Cypress About the Position: We are currently seeking a dynamic Regional Operations Analyst to join our team at our office in Cypress, CA . Under the direction of the AVP/VP Regional Operations, the Regional Operations Analyst is a key contributor to the Ops Pod: a team of customer-facing cross-functional operations experts tasked with ensuring that designated clients receive consistent, high-quality operations support. Each Ops Pod will manage an average of 4-5 clients, but may be dedicated to a single client or span as many as 8 depending on client size, geography, and complexity. The Analyst will work to proactively identify client operational issues, participate in a regular prioritization process, and lead root cause analysis to create scalable, lasting solutions to operational problems. Each member of the Ops Pod team will have an extensive background in at least one operational area, with the interest and desire to develop cross-functional operations capabilities and become a true "ops athlete" - capable of driving to solutions across any number of root causes. Although the Regional Operations Analyst does not have direct supervisory responsibilities, this individual is responsible for driving the cross-functional process necessary to deliver high-quality, pre-solutioned tickets to Service Centers and Central Operations. Strong performance in this role requires the ability to leverage the collective range of experiences across the Ops Pod team, as well as engage cross-functional teams across the enterprise as necessary to resolve client operational issues efficiently and effectively. Throughout the solutioning process, the Analyst Regional Operations will also need to engage the client in ongoing communication to manage expectations and problem solve, as necessary. Successfully managing both internal and external stakeholders will result in faster turnaround time on client operational issues, improved transparency and accountability, and improved client satisfaction. Along with delivering top-notch operations experience for designated clients, the Analyst Regional Operations plays a critical role in improving Beacon's regional operations model. All members of the Ops Pod team must collaborate to develop a repeatable model for issue resolution by documenting and sharing best practices. The Analyst Regional Operations will periodically be tasked with sharing learnings across pods and across regions in order to drive strong client operations performance enterprise-wide. Similarly, the Analyst Regional Operations will coordinate with the Regional Operations Monitoring team and support the ongoing improvement of Operations Monitoring by providing insight on common issues and metrics to support our client operations experience. This role is critical in operationalizing and driving improvement to Beacon's client account services model. Position Duties and Responsibilities: Support onboarding of clients onto Beacon's regional model, including interfacing with client teams and Beacon Account Partnerships teams to ensure incoming client operational issues are directed to the Pod. Contributes to team discussions and development of solutions for client operational issues assigned to the team, always with the intention to leverage the range of expertise on each team in order to generate high quality, scalable and lasting solutions.Develop and maintain effective working relationships with Corporate Services, Service Centers, and Regional Clinical/Quality in order to deliver against client service needs.Contribute to the reduction of client turnaround time by creatively and collaboratively resolving applicable issues up front, and delivering high-quality, pre-solutioned tickets to Central Operations when an issue cannot be resolved within the Pod.Develop and implement effective processes to improve operational performance against client Service Level Agreements (SLAs) and Performance Guarantees (PGs).Develop strong client relationships built on trust and collaboration. Manage client expectations throughout the solutioning cycle via regular communication on designated topics or issues.Actively participates in cross-training with other team members, each educating on their area of expertise as well as learning other areas through training provide by other team members, with the overall goal to develop a strong, cross-functional team prepared to address a wide variety of client-generated operational issues.Contribute to the development of a repeatable model for operational issue resolution, for example by collaborating with other Ops Pod Team Members to synthesize patterns across clients with the goal of developing a "playbook" containing a range of client contexts, problem types, steps to effective resolution (including key internal and external personnel), and watch-outs.Lead periodic forums with other Ops Pods to ensure consistency in issue resolution model across clients and across regions, as assigned.Collaborate with Regional Operations Monitoring function to proactively identify operational issues with designated clients and support ongoing improvement of Beacon's Operations Monitoring capability by providing insight on common issues and value-added metrics to track.Adheres to all Beacon policies and procedures and standards of operations.Completes all required and assigned trainings.Attends all mandatory company or department meetings.Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.Travel to all company sponsored events, trainings, and locations based on business needs.Performs special projects and other duties as assigned and required. Position Qualifications: Education: High School diploma or GED required. Bachelor's degree in related field preferred. Three (3) years of professional level experience in a technical operations role in a healthcare environment may be substituted for the degree, in addition to the work experience required below. Relevant Work Experience: Minimum three (3) years of progressively responsible professional experience, with at least two (2) of those years in a client-facing operations job. One (1) of those years in a managed care environment is strongly preferred. Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #LI-7CF1 $NFD #CB #GD PI113591271

Beacon Health Options Job Category: Operations - Customer Service General Req #: CUSTO01424 Schedule: Full Time Location: CA - Cypress We Help People Live their Lives to the Fullest Potential! For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a 'world-class' candidate experience from the moment you click 'Apply'! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise. Do you have a passion for helping others? If so, we are looking for you! Beacon is currently seeking a Customer Service Representative I to join our team at our Cypress, CA office. Under the direction of the Customer Service Management Team, the Customer Service Representative (CSR) for answering and responding to a high volume of telephone inquiries from members and providers. The incumbent's responsibilities include providing accurate and thorough interpretation of benefits, eligibility, provider participation, claims payment and interpretation inquiries, resolving customer inquiries, facilitating problem resolution, and acting as a member/provider advocate by meeting or exceeding customers' expectations. The CSR is expected to take complete responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention and satisfy corporate customer service goals and objectives. Shift : M- F 11:00am - 8:00pm (schedule may vary) What does a typical day look like? Essential Duties and Responsibilities: The CSR will perform the following duties in a typical call center environment, which means a high volume of calls will handled while located at a desk. Which requires adherence to schedules and extended periods of time on the phone. Provide timely, accurate, and courteous responses to a high volume of telephone inquiries from both members and providers.Meet daily production standards as indicated by management to meet overall ASA/ABA and client PG's: includes attendance, adherence to schedules, ACW, calls per day, turnaround times.Maintain adherence to schedule enabling the team to meet client satisfaction levels. Adherence to work schedule including time spent on break/lunch.Achieve and maintain productivity and quality performance expectations; minimum 95%Interpret and effectively communicate benefits and eligibility and claims payment information to our customers.Document all critical information related to contacts responded to in the appropriate in house healthcare systemsDemonstrate professionalism, empathy and a sense of urgency on each and every member and provider call/transactionEffectively navigate through multiple complex systems/screens.Have the knowledge around handling escalated callsProvide timely follow-up with other internal departments to expedite resolution of difficult/aging inquiries, and when necessary escalate those issues to management for further handling.Keep abreast of all system, contractual, compliance standard changes and policy updates, and attend additional training sessions and department meetings as necessary.Complete daily assigned tasks by management such as website inquiries, COB coordination of benefit updates, and authorization for disclosure forms, authorization updates, and correspondence.Perform additional duties and/or work additional hours as needed. Overtime and working holidays may be required based on business needs.Comply with all the HIPAA Compliance regulations. What you Contribute? Education : A high school/GED diploma is required. An Associate's Degree or equivalent related experience is preferred. Licensure : N/A Knowledge, Skills & Abilities: 6 months - 1 year experience in Customer Service, Health Care or Health Insurance is required. Previous experience in an ACD call center environment is preferred. Strong interpersonal skills and good written and verbal communication skills. Computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint. What Makes Us Different? Here, it's not just a job - it's an opportunity to change lives. Our employees are learners, innovators and original thinkers. Our mission and values guide the way we treat our members, providers and each other. What We Have to Offer: Healthcare benefits available starting day 1! Health & wellbeing incentives, such as gym membership reimbursement 401K with company match to help reach your future financial goals Generous PTO, because we know life happens outside of work Tuition reimbursement so you can keep reaching your fullest potential If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started! Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you. #CB #GD PI113290069

True Religion Equal Employment Opportunity/M/F/disability/protected veteran status Location: Houston Premium City: Cypress State/Territory: TX Company Order Number: 9211 # of openings: 4 Description JOB TITLE: Sales Associate IMMEDIATE MANAGER: Store Manager DIRECT REPORTS: 0 DIRECT REPORTS TITLES: N/A JOB CLASSIFICATION: Non - Exempt BUDGET RESPONSIBILITY: N/A THE PURPOSE As a Sales Associate , you will maintain outstanding customer service as per company standards, achieve individual sales goals, drive team collaboration, maintain True Religion merchandising standards, and safeguard company assets. THE ROLE Greet and acknowledge every customer, maintaining solid product knowledge and all other aspects of customer service. Maintain an awareness of all promotions and advertisements. Assist in floor moves, merchandising, display maintenance, and housekeeping Assist in processing and replenishing merchandise and monitoring floor stock. Assist in completing price changes within the department. Operate a computerized point of sale cash register and inventory management system: including the accurate entering of sales information: receiving payment for products: processing credit card transactions; making correct change; processing refunds, exchanges and voids; and issuing gift certificates and credit slips. Reconcile daily sales and prepare deposits and end of day reports for management. Utilize a working knowledge of all retail merchandise including price, any special product considerations, and stock location in-store and in the back stockroom. Accurately perform all merchandise receipt processing, including processing in the POS system; merchandise inspection, tagging, stocking and display. Communicate all damages and wrong shipments to store management. Actively maintain the store appearance including keeping merchandise neatly organized and attractively displayed. Dust and clean shelves regularly, fold t-shirts and arrange merchandise to maintain the highest level of visual presentation. YOU ARE Retail Savvy: you understand the complexities that come with working in a luxury retail environment and its customers Goal Oriented: you work hard and strategize in order to achieve daily, monthly and yearly sales goals. Upbeat: you always have a positive and welcoming attitude towards peers and customers. Brand Knowledgeable: you know our brand like the back of your hand including all fits and styles. Fashionable: you are current with trends and are able to make styling recommendations to the customer. Fearless, Focused, Open and Fast! REQUIRED MINIMUM KNOWLEDGE, SKILLS & ABILITIES High School Diploma Must be over 18 years of age Minimum of 6 months of retail sales experience Ability to read, count, and write to accurately complete all documentation Ability to operate all equipment necessary to perform the job, including but not limited to standing, stooping, lifting 11 kilograms and climbing a ladder PI113286674