$1,000 Sign-On Bonus! Field Registered Nurse - (Hybrid Remote - Massachusetts)
Maximus · Centralia, WA
Job description
Essential Duties and Responsibilities: - Responsible for completing medical and/or behavioral health assessments within contract requirements - Conducts on-site, video call and/or telephonic assessments to determine an individuals needs for services and supports, eligibility, level of care or related outcome - Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures. - Travel may be required based on program contract requirements - Performs other related duties as assigned. -Conduct assessments using standardized tools (UCA, TTT) to identify medical, functional, and social needs -Develop and manage service plans for complex or high-acuity members, coordinating with healthcare providers, case managers, and community resources -Evaluate eligibility for recommended referrals to other professionals or agencies -Maintain compliance with state and federal regulations, Medicaid/LTSS program guidelines, and electronic health record systems -Collaborate with care teams to revise care plans as needs change, ensuring alignment with member goals -Provide education to members, families, and caregivers on available services and options -Document assessments and care activities accurately to support billing, compliance, and quality reporting -Advocate for members to help them remain in preferred living environments and maintain independence Minimum Requirements - Current Registered Nurse (RN) license valid in the state of practice is required - High School Degree or equivalent required - Minimum 2 years of clinical experience required - An active, unencumbered Registered Nurse (RN) license in the state of Massachusetts. - Minimum of two (2) years of relevant post-graduate clinical experience as a Registered Nurse. - Experience working with vulnerable populations, including individuals with behavioral health needs, intellectual and developmental disabilities (I/DD), and those requiring long-term services and supports (LTSS). - Experience conducting clinical or functional assessments in home or community-based settings, such as behavioral health evaluations, level of care determinations, or utilization reviews. - Knowledge of community-based services, care coordination, and person-centered care planning. - Familiarity with MassHealth programs, LTSS, and Home and Community-Based Services (HCBS) waiver programs. - Proficiency in Microsoft Office applications. - Experience documenting assessments in electronic systems. Home Office Requirements - Maximus provides company-issued computer equipment - Reliable high-speed internet service - Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity - Minimum 5 Mpbs upload speeds - Private and secure workspace EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidates education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximuss total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicants salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment processincluding accessing job postings, completing assessments, or participating in interviews,please contact People Operations at applicantaccom@maximus.com.
More jobs in Centralia, WA
$85k–$110k/yr
$85 - $110K /Yr! Hiring CDL-A Truck Drivers - Quick Apply!
Hiring Drivers Now · Centralia, WA
Now Hiring CDL-A Truck Drivers! Apply today and within 24 hours you'll receive multiple job offers. Earn $.60 - $.80+ CPM and up per year based on position. Simply select the driving job that offers you what is most important. Higher pay, increased benefits or more home-time: You choose. Avg. Company Driver Job Offers Salary: $85,000-$110,000+ Avg. Owner Operator Job Offers Salary: $200,000-$325,000+ Apply now to receive your job offers!
Class A CDL Truck Driver Job Hiring Now! (Up to $110/YR!)
Hiring Drivers Now · Centralia, WA
Class A CDL Truck Driver Job Hiring Now! (Up to $110/YR!) Apply today and within 24 hours you'll receive multiple job offers. Up to $110/YR based on position/location. Simply select the driving job that offers you what is most important. Higher pay, increased benefits or more home-time: You choose. Salary: Up to $110/YR Apply now to receive your job offers!
Customer Service Representative I (2796)
CaliforniaChoice · Centralia, WA
Purpose of Position: The Customer Service Representative I handles calls from customers to resolve, educate, follow-up and respond to questions regarding California Choice/Choice Builder plan administration and procedures groups, members, brokers and general agencies. Essential Functions: • Understanding of company policies and procedures as they apply to California Choice/Choice Builder plans. • Answers questions by telephone from groups regarding new hires, billings, rates, supplies, administrative procedures, etc. • Educates, via telephone, employees/dependents regarding PCP's, ID cards, RX problems, administrative procedures, dependent coverage, address changes, etc. • Follows-up on calls and emails from brokers regarding problems that their groups are experiencing with providers. • Ability to interact with brokers, general agents and sales representatives on a daily basis and must be able to answer questions regarding California Choice processes. • Responds to calls from providers to confirm eligibility and benefits. • Verifies enrollments and resolves issues with carriers. • Expedites processing of members enrollment with carrier if urgent services are needed. • Review and submit appeal requests from groups. • Review /Audit group billing and explain to clients in clear and accurate manner. • Document calls in call tracking system. • Departmental standard requires each Customer Service Representative to provide Service of Unequalled Excellence to all callers by maintaining an average of 90% or greater on Call Reviews. • Answer at least 100% of the daily call volume average. • Provide clear and explicit documentation while maintaining percentage at a level of 90% or higher daily. • Make busy time of 20 minutes or less per day. • Meet department standards for quality and quantity of work. • Meet department and team standards for turnaround times. • Adhere to all HIPAA (Health Insurance Portability and Accountability Act) and PHI (Personal Health Information) guidelines. • On-site regular attendance and punctuality are essential functions of the job. • Performs other business tasks or functions as assigned. Knowledge, Skills & Abilities Required: • At least two (2) years of customer service experience preferred. • Knowledge of the health insurance industry and customer service experience preferred. • Ability to handle irate customers in a courteous, patient, calm and positive manner while maintaining a high quality and quantity of work. • Experience in handling high call volume. • CA Life & Health license required. If successful applicant does not have insurance license, it is required to obtain one within six (6) months of date of hire. • Must have excellent verbal and written communication skills, especially under pressure. • Must be computer literate in Microsoft Word, Excel and Outlook. Accurate data entry skills a must. Typing at 55 WPM or more. • Must be able to work in a fast-paced environment where deadlines are a priority and handling multiple assignments simultaneously. • Problem Solving Skills required. • Must have a proficient knowledge of the English language. • Proficient knowledge of the Spanish language is a plus. If hired as a Bilingual representative, Language Assistance Certification is required every two (2) years. Additional Competencies: Action Oriented, Approachability, Customer Focus, Humor, Listening, Patience, Self-Knowledge, Technical Learning, Time Management, Written Communication In addition to the KSAs and Additional Competencies listed above, there are more competencies related to this position. Please refer to the Individual Contributor - Associate competency addendum. Educational Requirements: • High school diploma or equivalent required. Physical Requirements: Must be able to sit for extended periods of time and occasional standing and walking. Must have adequate hearing for phone work. Vision requirements include close vision and the ability to adjust focus. Must be able to communicate effectively in English. Must be able to use a keyboard and other office equipment. Ability to lift up to 10 pounds occasionally.
Service Center Associate
Eteam · Centralia, WA
Job Title: Service Center Associate Location: Seven Hills, OH REMOTE Duration: 9 months Duties: CANDIDATES WILL WORK REMOTE, PREFERRED CENTRAL OR EASTERN TIME ZONE. Training Schedule Starting Monday August 17th, 2026 Monday through Friday 8am-5pm EASTERN 2-week training After Training Hours of Operation: 10am-8pm EST, 7 days a week Rep will work 5 days (1 day will be a weekend day) 8 hour shifts including a 30 minute lunch. Possible Schedules: 10:00am-6:30pm EST 10:30am-7:00pm EST 11:00am-7:30pm EST 11:30am-8:00pm EST Weekends are required - has one weekend day off, one day off during the week Equipment will be provided (desktop, monitors, keyboard, mouse, headset) but they may need to use a personal device to attend at the start of training. This will depend on arrival of equipment. Must have broadband internet service. Must be able to have client computer, telephone and VPN devices plug directly into the router within their home. Must not work over WIFI connection in their home regardless of upload or download speed. Pre Screening Questions Have you ever worked in a call center before? What experience do you have working from home? How comfortable are you using the elements of Microsoft office and using multiple systems at once? If yes, can you give an example from your past experience? What do you like/dislike about your current work environment? Are you able to work a weekend day Have you worked with client before? Provide name of manager, duration, reason behind leaving? QUALIFICATIONS Education & Licensing High school diploma or GED required. Experience One (1) year of clerical or customer service experience or equivalent combination of education and experience preferred. Skills & Knowledge Excellent oral and written communication PC literate, including Microsoft Office products Good customer service skills Strong organizational skills Good interpersonal skills Ability to work in a team environment Ability to meet or exceed Performance Competencies PRIMARY PURPOSE: To expedite the Customer Service claims application process; to ensure correct case assignment; and to act as a customer liaison in assisting the customer with the correct contact person to resolve problems and/or questions. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Assigns new claims to the appropriate claims handler. Enters verbal and written application information that meets both the internal and external customers' requirements accurately into the claims management system. Contacts the customer by telephone, written correspondence and/or the claims system regarding documentation required to process a claim, required time frames and claim status. Communicates clearly and professionally with the customer by telephone and/or written correspondence regarding all aspects of claims process. Participates in and maintains a quality service culture within the Customer Service Team. Attendance during scheduled work hours is required. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s).