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Pharmacy Services Specialist (Clinical Programs - Stars) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Pharmacy Services Specialist (Clinical Programs - Stars) and help shape the future of healthcare where you'll be an integral part of our Pharmacy Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Full Telework. 
<ul>
<li> If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum. </li>
</ul>
 You will utilize specialized pharmacy knowledge and expertise to assist participating pharmacies, members, providers, CalOptima Health departments, health networks and other entities in assuring the efficient, timely and effective provision of pharmaceutical products and services to CalOptima Health members. You will interact with other department staff throughout the organization, as well as external contacts daily. You will be responsible for ongoing public contacts including, but are not limited to, members, individual pharmacies, member advocates, family members, health networks, Public Guardian's Office, Regional Center and other agencies. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>85% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Conducts outbound calls to members, pharmacies, and providers in an effort to improve Star measure performance for medication adherence and other Star programs as needed.</li>
<li>Using a pharmacy computer program, retrieves drug-specific technical data and information necessary for the completion of departmental and interdepartmental pharmacy-related functions and operations.</li>
<li>Assists with resolution of provider and member pharmacy issues requiring specialized technical and professional knowledge and expertise, including pharmacy authorizations.</li>
<li>Supports the department with claims disputes between providing pharmacies, the pharmacy claims administrator, CalOptima Health Claims Department and other entities as necessary.</li>
<li>Interprets and articulates Pharmacy Management program policies and procedures to pharmacy providers, other providers, other CalOptima Health staff, external agencies and others as required.</li>
<li>Assists in the processing of pharmaceutical prior authorization and appeals requests as per the CalOptima Health Prior Authorization Guidelines as needed.</li>
<li>Establishes and maintains key contacts both internally and externally to assure appropriate coordination and provision of pharmacy services to CalOptima Health Members.</li>
<li>Accepts referrals from Member Services and work in conjunction with employees from this department to resolve all pharmacy-related member complaints, including those related to the pharmacy authorization process.</li>
<li>Assists pharmacies and health plans in resolving member-specific pharmacy services access issues, removing barriers to access to pharmaceutical services.</li>
<li>Identifies pharmacy-related resources and recommend new procedures, processes or activities that help assure the efficient provision of pharmacy services to members. </li>
</ul>
</li>
<li>10% - Administrative Support
<ul>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Maintains documentation of the Stars adherence program and other Stars program outreach according to the internal guidelines. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>High School diploma or equivalent PLUS 1 year of experience as a pharmacy technician required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Associate degree in a health-related field. </li>
<li>Pharmacy Technician Certification Board (PTCB). </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese). </li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>A current, valid, unrestricted California Pharmacy Technician license required.</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 301 - $47,840 - $64,584 ($23.00 - $31.0500). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6827274&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is January 13, 2026 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6827274" target="_blank">https://jobs.caloptima.org/jobs/pharmacy-services-specialist-clinical-programs-stars-505-city-parkway-west-california-united-states</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-a4c910d8a384f94e85311a8402a7ab2c

Pharmacy Services Specialist (Clinical Programs - Stars)

<h3>Job Description</h3>
Job Description
EyeCare Partners is the nation's leading provider of clinically integrated eye care. Our national network of over 300 ophthalmologists and 700 optometrists provides a lifetime of care to our patients with a mission to enhance vision, advance eye care and improve lives. Based in St. Louis, Missouri, over 650 ECP-affiliated practice locations provide care in 18 states and 80 markets, providing services that span the eye care continuum. For more information, visit <a href="http://www.eyecare-partners.com" target="_blank">www.eyecare-partners.com</a>.
JOB TITLE: Referral Specialist COMPANY: Shoreline Vision LOCATION: Muskegon, MI

PERKS
<ul>
<li>Full Benefits Package - Medical, Vision, Dental and Life Insurance </li>
</ul>
<ul>
<li>401k + Employer Matching </li>
</ul>
<ul>
<li>Paid Time Off (PTO) and Paid Holidays </li>
</ul>
<ul>
<li>Paid Maternity Leave </li>
</ul>
<ul>
<li>Employee Discounts </li>
</ul>
<ul>
<li>Competitive Base Pay </li>
</ul>

SUMMARY
The Referral Specialist will serve as the primary referral personnel to provide a positive first contact experience to patients while projecting a professional telephone image through phone interaction. The Referral Specialist will demonstrate sensitivity to patient's needs, and follow the Patient Privacy Act, through demonstrating exceptional telephone and interpersonal skills. 

ESSENTIAL DUTIES AND RESPONSIBILITIES  
<ul>
<li>Assist patients in scheduling appointments based on individual needs and Physician's schedules while partnering with other departments and external Physician's offices to ensure smooth patient flow, including the checking of patient eligibility. </li>
</ul>
<ul>
<li>Handle all incoming and outgoing local referral networks and both paper and faxed referrals while coordinating aid from Patient Relations team members. </li>
</ul>
<ul>
<li>Primarily address incoming and outgoing referrals while also acting as backup to the Contact Center by promptly answering, screening, and processing calls to appropriate person(s) and department(s) per protocol. Determine the management of emergent calls in accordance with company policy. </li>
</ul>
<ul>
<li>Maintain patient chart demographics and the Patient Portal for EMR (Electronic Medical Record) software. </li>
</ul>
<ul>
<li>Respond to Live Chat and Cataract Self-Test inquiries. </li>
</ul>
<ul>
<li>Reply to and compose emails to team members. </li>
</ul>
<ul>
<li>Cooperate with the Patient Relations team to accomplish the established goals of the department. </li>
</ul>
<ul>
<li>Work closely with provider liaison to establish and guarantee successful and efficient relationships with referring providers and offices. </li>
</ul>
<ul>
<li>Assist in Referral Department reporting and perform special projects and other duties as assigned. </li>
</ul>
<ul>
<li>Run real-time eligibility queries upon scheduling. </li>
</ul>
<ul>
<li>Adhere to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service. </li>
</ul>
<ul>
<li>Perform other duties that may be necessary or in the best interest of the organization. </li>
</ul>

QUALIFICATIONS
<ul>
<li>Professional in appearance and actions. </li>
</ul>
<ul>
<li>Logical and Critical thinking skills. </li>
</ul>
<ul>
<li>Customer-focused with excellent written, listening and verbal communication skills. </li>
</ul>
<ul>
<li>Enjoys learning new technologies and systems. </li>
</ul>
<ul>
<li>Detail-oriented, professional attitude, reliable. </li>
</ul>
<ul>
<li>Exhibits a positive attitude and is flexible in accepting work assignments and priorities. </li>
</ul>
<ul>
<li>Meets attendance and tardiness expectations. </li>
</ul>
<ul>
<li>Management and organizational skills to support the leadership of this function. </li>
</ul>
<ul>
<li>Ability to follow or provide verbal and written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations.</li>
</ul>
<ul>
<li>Interpersonal skills to support customer service, functional, and teammate support need. </li>
</ul>
<ul>
<li>Able to communicate effectively in English, both verbally and in writing. </li>
</ul>
<ul>
<li>Ability for basic to intermediate problem solving, including mathematics. </li>
</ul>
<ul>
<li>Travel to other site locations may be necessary. Thus, those needing to travel for work must have access to dependable transportation, and driving record must meet company liability carrier standards. </li>
</ul>
<ul>
<li>Specialty knowledge of systems relating to job function. </li>
</ul>
<ul>
<li>Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines. </li>
</ul>
EDUCATION AND/OR EXPERIENCE  
<ul>
<li>High School Diploma or GED equivalent required </li>
</ul>
<ul>
<li>Previous medical office experience preferred; previous ophthalmic experience strongly preferred. </li>
</ul>

LICENSES AND CREDENTIALS  
<ul>
<li>Minimum Required: None   </li>
</ul>
SYSTEMS AND TECHNOLOGY   
<ul>
<li>Basic to intermediate computer operation </li>
</ul>
<ul>
<li>Proficient in Microsoft Excel, Word, PowerPoint, Outlook </li>
</ul>
<ul>
<li>Prior experience with NextGen software or other EMR is preferred   </li>
</ul>
PHYSICAL REQUIREMENTS
<ul>
<li>This role requires a variety of physical activities to effectively perform essential job functions. The position involves frequent walking (75%), sitting (50%), and standing (50%), with regular bending, stooping, and reaching (25–50%). Employees must be able to lift, carry, push, and pull items up to 25 lbs. Strong fine motor skills and full use of hands are essential, as the role demands constant grasping, writing/typing, and use of technology. Visual and auditory acuity—including color, depth, peripheral vision, and the ability to adjust focus—is required 100% of the time. Occasional driving or climbing may also be necessary.  </li>
</ul>
  
If you need assistance with this application, please contact (636) 227-2600. Please do not contact the office directly – only resumes submitted through this website will be considered.
  
EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Referral Specialist

<h3>Job Description</h3>
Job Description
Are you passionate about expanding access to healthcare and supporting patients on their wellness journey? Do you thrive in a dynamic, people-centered environment where compassion and teamwork make a daily impact? Join our Federally Qualified Health Center (FQHC) as a Referral Specialist and help us advance our mission of transformative healthcare for all.
???? About the Role
The Referral Specialist provides essential administrative and patient support to our clinical and community programs. This team member is often the first point of contact for our patients—playing a critical role in creating a welcoming, supportive, and seamless experience.
If you’re someone who enjoys helping others, stays organized in a fast-paced environment, and takes pride in excellent customer service, we’d love to meet you!
???? Key ResponsibilitiesPatient &amp; Client Support
<ul>
<li>Serve as the receptionist—warmly greet patients, distribute forms, and support a positive patient experience.</li>
<li>Handle inbound/outbound calls, provide accurate information, and direct individuals to the right services.</li>
<li>Deliver exceptional customer service to patients, staff, and community members.</li>
</ul>
Registration &amp; Scheduling
<ul>
<li>Register patients by collecting and verifying demographic, insurance, financial, and eligibility information.</li>
<li>Schedule both new and follow-up appointments.</li>
<li>Prepare, maintain, and file patient health records following program and service standards.</li>
</ul>
Administrative Operations
<ul>
<li>Maintain patient flow during clinic sessions.</li>
<li>Enter, store, and retrieve information using electronic systems; assist with routine reporting and data entry.</li>
<li>Manage office supply inventory and ensure materials are stocked and organized.</li>
<li>Collect service fees, process payments, and complete daily reconciliation.</li>
<li>Participate in community outreach activities representing the organization.</li>
<li>Perform additional tasks to support department needs.</li>
<li>May require occasional evenings or weekends.</li>
</ul>
???? Qualifications
<ul>
<li>Education: High school diploma or GED required.</li>
<li>Experience: No previous experience required—we provide comprehensive on-the-job training.</li>
<li>Background Check: Required.</li>
<li>Certificates/Licenses: Not required.</li>
<li>Bilingual candidates encouraged! If the role requires bilingual ability, the incumbent must be able to communicate effectively in the specified non‑English language with patients and staff.</li>
</ul>
???? Why Join Us?
At our FQHC, you’ll be part of a mission-driven team dedicated to improving the health and well‑being of our community. We believe everyone deserves access to high‑quality, compassionate care—and you can help make that possible
 Dayshift.

<h3>Job Description</h3>
Job Description
Home Health and Hospice Referral Specialist
At Aegis Healthcare we are expanding our Home Health &amp; Hospice Nursing Teams and are seeking a dynamic and experienced individual for the role of Home Health and Hospice Referral Specialist who shares our desire to make healthcare better for everyone. 
Why do people LOVE &amp; Feel Supported at Aegis Healthcare?
Our company culture is grounded in our core values of Character, Experience &amp; Trust, which we live every day (you'll know when you meet us). We enrich the lives of those we serve, nurture and support our team's long-term career development, and focus on ensuring everyone feels valued and empowered.

COMPENSATION: $20-$24 / hourly DOE
STATUS: Full - Time
SCHEDULE: Mon-Fri 8am-5pm
LOCATION: 7227 E. Baseline Rd #129 Mesa, AZ 85209

Highlights of working for Aegis Healthcare 
<ul>
<li>Support in your Role: Enjoy comprehensive onboarding and continuous training</li>
<li>Career Longevity: Our average tenure is 5 years.</li>
<li>Meaningful Work: We serve a vulnerable population.</li>
<li>Growth opportunities: With 7 divisions there are paths for advancement.</li>
<li>Employee Experience: Fun Perks, Rewards, and Recognition Programs!</li>
<li>Great Benefits Package: A generous 22 days of PTO + Medical, Dental, Vision, 401(k) + Matching, Life, accident and disability insurance options, and referral bonuses!</li>
</ul>

At Aegis Healthcare our approach to treating patients, our staff, and the community is rooted in our core values of Character, Experience &amp; Trust. To ensure consistently seamless, high-quality care we have developed a continuum of services including Mobile Primary Care, Home Health, Palliative Care, Hospice, Outpatient Therapy, DME, and Medical Transport. By integrating these services, we address the diverse needs of our patients and support our mission to: "Enrich Every Life We Encounter from our employees to our patients and those who love and care for them."

Job Summary
As a Home Health and Hospice Referral Specialist at Aegis Healthcare, you will play a vital role in delivering outstanding home health and end-of-life care to our patients. If you are dedicated to providing exceptional service and eager to challenge yourself daily to positively impact the lives of those we serve, we invite you to join our team. The Home Health and Hospice Referral Specialist is responsible for responding to phone calls and delivering courteous and professional assistance to physicians and patients, Initiating authorization requests for hospice and home health, Verify eligibility and benefits, track referrals to ensure compliance, ensure compliance with federal, state, and local regulations and standards, accept and perform other related duties and responsibilities as required. 
Join Aegis Healthcare today and feel supported and appreciated in a patient-first environment.

Desired Skills &amp; Qualifications
<ul>
<li>Adaptive problem-solving skills</li>
<li>Knowledge of medical terminology and medical insurance terminology</li>
<li>Previous experience in home health and hospice. </li>
<li>Keen attention to detail</li>
<li>Service oriented mindset</li>
<li>Minimum of 2 years of related experience preferred</li>
<li>Valid driver's license, clean driving record, and reliable automobile</li>
<li>Proof of current automobile insurance </li>
<li>Negative TB test</li>
<li>Must be at least (18) years of age</li>
</ul>

Make a Difference with Aegis Healthcare! If you're seeking a supportive environment that values your contributions, apply to join Aegis Healthcare today!

Aegis Healthcare is a part of the Aegis Healthcare Family. Aegis Healthcare Celebrates Diversity and is committed to creating an inclusive environment for all employees, underscored by a Zero Tolerance policy for discrimination. Aegis Healthcare is an equal opportunity employer welcoming applicant without regard to race, color, religion, age, sex, national origin, disability status, genetics, veteran status, sexual orientation, gender identity, or any other characteristic protected by law.

 
Ability to pass a criminal background check.

<h3>Job Description</h3>
Job DescriptionDescription:

The Referrals Specialist is responsible for managing all incoming referrals for services, ensuring that requests are processed accurately, promptly, and in compliance with agency and state requirements. This role serves as a key liaison between families, service coordinators, and internal departments to support smooth transitions and timely access to services.
Key Responsibilities
Referral Management
Communication &amp; Coordination
<ul>
<li>Communicate with service coordinators, families, and providers to confirm referral details and next steps.</li>
<li>Conduct Customer interviews.</li>
<li>Collaborate with HR, Connections, and leadership to ensure referred Direct Support Professionals (DSPs) and customers are matched effectively.</li>
<li>Provide timely updates on the status of referrals.</li>
</ul>
Compliance &amp; Documentation
<ul>
<li>Ensure referrals are processed in accordance with state and agency guidelines.</li>
<li>Maintain accurate and confidential documentation of all referral activity.</li>
<li>Support audit readiness by ensuring records are complete and up to date.</li>
</ul>
Customer Service
<ul>
<li>Provide clear and compassionate communication to families and customers regarding the referral process.</li>
<li>Resolve questions or issues related to referrals with professionalism.</li>
</ul>
Collaboration
<ul>
<li>Partner with internal teams to anticipate staffing needs related to referrals.</li>
<li>Assist with reporting referral trends and outcomes to support workforce planning and program development.</li>
</ul>
Qualifications
<ul>
<li>High school diploma or equivalent required; Associate’s or Bachelor’s degree in Human Services, Healthcare, or related field preferred.</li>
<li>Previous experience in referrals, scheduling, care coordination, or a related administrative role.</li>
<li>Strong organizational and multitasking skills with attention to detail.</li>
<li>Excellent verbal and written communication abilities.</li>
<li>Ability to work independently and as part of a team in a fast-paced environment.</li>
</ul>
Preferred Skills
<ul>
<li>Experience in healthcare, developmental disability services, or social services setting.</li>
<li>Familiarity with state referral processes, Medicaid Waiver services, or case management systems.</li>
<li>Bilingual skills (English/Spanish) a plus.</li>
</ul>
Work Environment
<ul>
<li>Office-based with potential for hybrid flexibility.</li>
<li>Requires frequent communication with families, providers, and state agencies.</li>
</ul>
Benefits:
<ul>
<li>Dental insurance</li>
<li>Health insurance</li>
<li>Paid time off</li>
<li>Vision insurance</li>
</ul>
Schedule:
<ul>
<li>8 hour shift</li>
<li>Monday to Friday</li>
</ul>
Job Type: Full-time
Benefits:
<ul>
<li>401(k)</li>
<li>401(k) matching</li>
<li>Dental insurance</li>
<li>Employee assistance program</li>
<li>Health insurance</li>
<li>Paid time off</li>
<li>Parental leave</li>
<li>Retirement plan</li>
<li>Vision insurance</li>
</ul>
Work Location: In person
Requirements:

<h3>Job Description</h3>
Job Description
Join a Team That Makes a Difference at Optimus Health Care!
Are you passionate about providing high-quality, patient-centered care? Optimus Health Care the largest provider of primary health care services in Fairfield County is looking for dedicated professionals to join our team! With multiple locations in Bridgeport, Stratford, and Stamford, our mission is to be a lifelong health care partner, dedicated to achieving optimal wellness for the communities we serve.
Join our team-based model of care delivered in a kind and compassionate manner.
We are currently recruiting for a Full Time Referral Specialist for our location in Bridgeport, CT

 The Referral Specialist ensure that referrals are entered in the system for follow up and tracking in accordance with the Referral Process.
ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES
<ol>
<li>Oversee the referral coordination to specialty services.</li>
<li>Coordinate appointments for specialty services as requested by primary care physician</li>
<li>Collect proper supporting data for each referral before sending to specialist</li>
<li>Provide reports as needed to the Practice Manager(s)</li>
<li>Be the point of contact for hospitals and specialty offices</li>
<li>Respond to inquiries as to current status of referral by assessing the request and evaluating the circumstances to provide the correct information </li>
<li>Verify prior authorizations with insurance companies via phone, in writing or electronically </li>
<li>Inform patient of appointment date, time and required documentation needed prior to appointment </li>
<li>Provide patient teaching prior to appointment</li>
<li>Review logs on weekly basis to ensure patient kept his/her appointment</li>
<li>Open and review flags regarding consults</li>
<li>Document entry in EMR as a non-billable encounter and enter the specialty appointment in the Referral log</li>
<li>Log any No shows and flag the referring physician for follow up with patient</li>
<li>Direct patient to outside resources when needed as requested by primary care physician</li>
</ol>
Professional positive attitude, vision, understanding of customer service principals, trustworthiness, and excellent interpersonal skills to successfully accomplish tasks necessary to meet high standards of ethical and social responsibility required by this position. 

JOB QUALIFICATIONS/REQUIREMENTS 
 EDUCATION: High School Diploma/GED required. Graduated from an accredited Medical Assistant Program, preferred. Intimate knowledge of language and culture of a sizeable segment of community served by the Health Center. 
EXPERIENCE: 2+ years’ experience in a clinical setting preferred.
LANGUAGE SKILLS: Bilingual preferred – Spanish, Portuguese and/or Haitian-French Creole
 SKILLS: Microsoft Excel and Word. Must have organizational skills, excellent communication skills, and ability to work under pressure.
 REASONING ABILITY: Critical thinking, analytical and problem solving skills
 LICENSURE / CERTIFICATION: None

To be part of our organization, every employee should understand and share in Optimus’ Vision, support our Mission, and live our Values. These values-outstanding, patient-centered, trustworthy, integrity, multicultural, understanding, and supportive -help guide what we do, as individuals and professionals, every day.
<ul>
<li>OHC provides a fun, fast-paced working environment, where our commitment to quality is present in every job function.</li>
<li>Excellent health &amp; welfare benefit </li>
<li>Competitive Compensation</li>
<li>Optimus and its caring and multi-lingual staff proudly serve hundreds of thousands of our neighbors, in a caring patient-centered environment.</li>
</ul>

 Optimus is committed to providing equal employment opportunities to all applicants and employees as protected by applicable federal and/or state law.

<h3>Job Description</h3>
Job Description

Referrals Specialist
📍 South Central Los Angeles 
&amp;#x1F4B0; Pay: $21-23/hour
🕐 Schedule: Full-Time | must be flexible to work Monday-Saturday, between 7am-6pm 
🏥 Setting: Outpatient Clinic / Medical Office
Job Overview
Fast-paced medical office in South Central Los Angeles is seeking a detail‑oriented Referrals Specialist to join their team for a short-term contract opening. This role is ideal for someone who enjoys administrative workflows, coordination of care, and working closely with providers and insurance teams to ensure timely patient services.
Responsibilities
<ul>
<li>Process outbound and inbound medical referrals to specialists and diagnostic facilities</li>
<li>Verify insurance information and obtain prior authorizations as needed</li>
<li>Follow up on referral status and communicate updates to patients and providers</li>
<li>Maintain accurate documentation in the EHR system</li>
<li>Assist with general MA duties as needed (vitals, rooming patients, chart prep)</li>
<li>Collaborate with clinical and administrative staff to ensure smooth patient flow</li>
</ul>
Requirements
<ul>
<li>6+ months of experience as a Medical Assistant, preferably in an outpatient setting</li>
<li>Prior experience working with referrals and authorizations (required or strongly preferred)</li>
<li>Familiarity with EHR systems</li>
<li>Strong organizational and communication skills</li>
<li>Reliable, punctual, and patient‑focused</li>
<li>MUST BE FLEXIBLE TO WORK A 3-MONTH CONTRACT</li>
</ul>
Why This Role?
<ul>
<li>Competitive hourly pay at $21-$23/hour</li>
<li>Stable weekday schedule</li>
<li>Centrally located South Central workplace with easy transit access</li>
<li>Supportive team environment and consistent workflow</li>
</ul>
Job Type &amp; Location
This is a Contract position based out of Los Angeles, CA 90011.
Pay and Benefits
The pay range for this position is $21.00 - $23.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental &amp; vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life &amp; AD&amp;D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully onsite position in Los Angeles,CA 90011.
Application Deadline
This position is anticipated to close on Jan 24, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email <a href="mailto:actalentaccommodation@actalentservices.com" target="_blank">actalentaccommodation@actalentservices.com</a> for other accommodation options.

<h3>Job Description</h3>
Job Description
THIS IS A PART-TIME ENTRY LEVEL POSITION BUT LOOKING FOR A CANDIDATE THAT WANTS TO PROGRESS TO A FULL-TIME SALES CAREER IN THE INSURANCE INDUSTRY AND WILL TAKE THE STEPS NEEDED TO GET INSURANCE LICENSED IN PROPERTY &amp; CASUALTY AND LIFE &amp; HEALTH.
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This part-time entry level position offers the potential for advancement within the company based on both need and experience. As our company continues to grow, there will be full-time opportunities to take on additional responsibilities. We value internal talent and prioritize promoting from within whenever possible. Your dedication and performance will be recognized, allowing you to progress and develop your career within our expanding insurance office. Working for our growing insurance office is an exciting opportunity that offers both challenges and rewards. Our team culture is supportive and collaborative, making it a fun place to work. We value innovation and creativity, encouraging you to bring fresh ideas to the table.
Starting pay will be determined by experience level and could be more than what is quoted on this site.
Responsibilities
<ul>
<li>Establish customer relationships and follow up with customers, as needed.</li>
<li>Develop leads, schedule appointments, identify customer needs, and market appropriate products and services.</li>
<li>Maintain a strong work ethic with a total commitment to success each and every day.</li>
<li>Attention to detail, the ability to handle rejection, offer rebuttals, and a friendly and professional demeanor are essential for success in this call center role.</li>
<li>Obtain Texas Property/Casualty and Life/Health license within first few months of hire.</li>
</ul>
As an Agent Team Member, you will receive...
<ul>
<li>Hourly pay</li>
<li>Valuable experience</li>
<li>Growth potential/Opportunity for advancement within my agency</li>
</ul>
Requirements
<ul>
<li>Bilingual - Spanish preferred</li>
<li>Property and Casualty license (must be able to obtain)</li>
<li>Life and Health license (must be able to obtain)</li>
<li>Available to work a 4-hour shift M-F 9am-1pm or 1pm - 5pm in office (as entry level part-time position)</li>
<li>Must maintain individual daily/weekly&nbsp;quotas.</li>
<li>Interest in marketing products and services based on customer needs</li>
<li>Excellent interpersonal skills</li>
<li>Excellent communication skills - written, verbal and listening</li>
<li>Excellent phone communication skills, objection handling, appointment setting</li>
<li>People-oriented</li>
<li>Self-motivated</li>
<li>Detail oriented</li>
<li>Dedicated to customer service</li>
<li>Ability to work in a team environment to meet quotas</li>
<li>Ability to effectively relate to a customer</li>
<li>Reliable transportation</li>
</ul>
If you are motivated to succeed and can see yourself in this role, please complete our application. We will follow up with you on the next steps in the interview process.
This position is with a State Farm independent contractor agent, not with State Farm Insurance Companies. Employees of State Farm agents must be able to successfully complete any applicable licensing requirements and training programs. By accepting this position, you are not guaranteed an agency position with State Farm Insurance Companies. As an agent team member, you will still need to go through the regular State Farm agent selection process when you are ready to pursue an agency opportunity. State Farm agents are independent contractors who hire their own employees. State Farm agents’ employees are not employees of State Farm.
Company DescriptionWe are an established, growth-oriented agency in Schertz, TX. Our team works hard to reach our goals together in a team environment. Attention to excellent customer service and detail is important. If you want to work in an environment that is challenging yet fun and rewarding, then Bill Hicks - State Farm Agency may be the right fit for you. 
<h3>Company Description</h3>
We are an established, growth-oriented agency in Schertz, TX. Our team works hard to reach our goals together in a team environment. Attention to excellent customer service and detail is important. If you want to work in an environment that is challenging yet fun and rewarding, then Bill Hicks - State Farm Agency may be the right fit for you.

<h3>Job Description</h3>
Job DescriptionReferral Authorization Specialist&nbsp; &nbsp;General Job Summary: &nbsp;&nbsp;The Referral Authorization Specialist will be responsible for managing referrals from the practice to other facilities or service providers and incoming action referrals from other service providers. (This is a full time position that will support the TPC at SouthPark, Monday to Friday 8 am to 5 pm) Primary Job Responsibilities: 
<ul>
<li>Complete all referrals for the clinics and ensure they are processed effectively, making sure they are sent to the correct department.</li>
<li>Responsible for prioritizing Stat Referral Authorizations.</li>
<li>Follow up on sent referrals.</li>
<li>Review patient benefits and eligibility to communicate with clinician and clinical staff pertaining to authorization. </li>
<li>Keep the system up to date with any changes in information.&nbsp; </li>
<li>Manage referral status to ensure clinics have all updated and current information.</li>
<li>Completes referrals for patients and coordinates with referring and receiving practices and/or departments.</li>
<li>Obtains and maintain prior authorizations for diagnostic and ancillary testing.</li>
<li>Handle sensitive information in a confidential manner.</li>
<li>All other duties as assigned.</li>
</ul>
 Clinic Support responsibilities include:
<ul>
<li>Compiles patients’ health information including patient symptoms and medical history, exam results, X-ray reports, lab tests, diagnoses, and treatment plans.
<ul>
<li>Ensures all related reports, labs and demographics are sent to the outside facility prior to their appointment. </li>
<li>Reviews to ensure all forms are completed, properly identified, and signed and that all necessary information in the EHR.</li>
</ul>
</li>
<li>Communicates as needed with physicians and other health care professionals to clarify diagnoses or obtain additional information.</li>
<li>Obtains lab/X-ray reports, hospital notes, referral information, etc.; </li>
<li>Verifies insurance coverage and patient demographics; </li>
<li>Updates charts to ensure that information is complete and filed appropriately.</li>
<li>Ensures timely delivery of outside mail and communication to the physician</li>
</ul>
 Requirements: Education, Experience and Certifications:
<ul>
<li>High School Diploma or GED required.</li>
<li>Minimum 2 years’ experience in a health coordination role.</li>
<li>Demonstrated understanding of industry guidelines and best practices.</li>
<li>Thorough understanding of insurance coverage and Medical Necessity policies.&nbsp; </li>
<li>Customer service experience required.</li>
<li>Knowledge of medical records software preferred.</li>
<li>Completion of Hepatitis B Vaccine and Flu Vaccine Form will be required.&nbsp; Candidate may decline vaccination through declination form or may provide record of vaccination from previous employer.</li>
</ul>
<ul>
<li>Completion of TB test will be required.</li>
</ul>
&nbsp;Physical Requirements:
<ul>
<li>Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.</li>
<li>Must be able to lift and support weight of 35 pounds </li>
<li>Ability to concentrate on details.</li>
<li>Use of computer for long periods of time.</li>
</ul>
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9Bk1MqfOGu

Referral Authorization Specialist

<h3>Job Description</h3>
Job DescriptionDescription:
What it means to be a Referral Specialist with Us
We value our families we serve, our communities and our team members. As a Referral Specialist you support a positive patient experience by efficiently processing requests for referrals, prior authorizations, and diagnostic imaging. 
Our Mission
At our offices, we do our best each day to provide high quality, compassionate health care to the families in our communities, treating each child as our own. Our staff and providers strive to make each encounter pleasant and informative while respecting the time and individual needs of our patients and families.
Benefits that Matter!
<ul>
<li>Paid Time Off</li>
<li>Matching 401K</li>
<li>Annual Merit Increases</li>
<li>Mental Health and Counseling Programs</li>
<li>Dental and Orthodontic Coverage</li>
<li>Vision Insurance</li>
<li>Health Care with Low Premiums</li>
<li>Short-term Disability</li>
<li>Access to Virtual Health &amp; Wellness</li>
</ul>
What a day looks like as a Referral Specialist
<ul>
<li>Facilitates outgoing referral requests which include obtaining prior authorization when necessary.</li>
<li>Obtains prior authorization for patient medications.</li>
<li>Schedules and obtains prior authorization for diagnostic imaging requests.</li>
<li>Meets position requirements and performs essential functions.</li>
<li>Completes all mandatory training as required.</li>
<li>Performs other duties as assigned.</li>
</ul>
Requirements:
Qualifications
<ul>
<li>High school diploma or equivalent required; associate or bachelor's degree preferred.</li>
<li>Minimum 1–2 years of credentialing experience, preferably in a pediatric or outpatient healthcare setting.</li>
<li>Knowledge of credentialing processes, insurance payers, and regulatory standards (e.g., CAQH, Medicare, Medicaid).</li>
<li>Strong organizational skills with high attention to detail.</li>
<li>Excellent written and verbal communication skills.</li>
<li>Proficiency with credentialing software, Microsoft Office (Word, Excel, Outlook), and practice management systems.</li>
<li>Ability to work independently and manage multiple deadlines simultaneously.</li>
</ul>
Working Conditions &amp; Physical Requirements
<ul>
<li>Indoor, temperature controlled, smoke free environment.</li>
<li>May at times work under stressful situations.</li>
<li>Handicapped accessible.</li>
</ul>
Pay is detemined by years of experience as well as location(s) of the office. We hope that you find this position as an exciting opportunity and look forward to the potential of speaking with you!

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