CenterWell Senior Primary Care

Administration

• Handling initial requests for services, gathering necessary information, and communicating with relevant parties.
• Assisting with the prior authorization process by gathering information, preparing documentation, and tracking requests.
• Maintaining and organizing patient records, ensuring accurate and up-to-date information is available for reviews.
• Facilitating communication between healthcare providers, patients, and other stakeholders regarding UM processes.
• Accurately entering data into systems, generating reports, and tracking key performance indicators related to UM activities.
• Managing the generation and distribution of various letters related to UM decisions and processes.
• Providing general administrative support to the UM team, including scheduling meetings, managing calendars, and preparing presentations.

Administration Coordinator II

Procurement

• Inspect and validate vendor partners to ensure and enforce alignment with CenterWell and Humana’s mission and business objectives.
• Defines performance standards, inspection models, and escalation expectations that vendors are accountable to execute against.
• Owns and enforces vendor escalation standards for critical business impacting events, ensuring appropriate urgency, routing, and leadership awareness.
• Collaborate cross-functionally with internal teams (e.g., Operations, Compliance, Finance, Training, Procurement and Legal) to ensure vendor solutions meet evolving business and compliance needs.
• Owns the design and alignment of performance scorecards and inspection routines across Service, RxE, and Specialty.
• Validates vendor training effectiveness through audit outcomes, quality performance, and execution controls rather than training completion or content review.
• Prepares leadership for clear decisions by framing risk, readiness, and accountability.
• Contribute to strategic initiatives including RFP development, cost optimization, and member experience enhancements.
• Represent CenterWell Rx Education in enterprise-wide vendor forums and cross-functional workstreams.

Senior Vendor Management Professional

Data Engineer

• Create scalable data processing architectures and solutions
• Ingest data from internal and external sources using cloud-native platforms
• Develop tools and solutions using artificial intelligence, machine learning, and big data techniques
• Help shape departmental strategy and make decisions regarding technical approaches to complex project components

Therapist

• Plan and administer prescribed physical therapy treatment for patients
• Assess and document patients' physical strengths
• Develop and implement a rehabilitation program consistent with physician's Plan of Treatment
• Provide PTAs and Home Health Aides with clear written care instructions
• Document patient observations, interventions, and evaluations promptly and thoroughly
• Report patient progress to the physician, Clinical Manager, care team, patient, and family

Home Health Physical Therapist

Systems Engineer

• Support and configure revenue cycle applications utilized for billing and claims management.
• Identify and implement process improvements to reduce denials and accelerate reimbursements.
• Collaborate with FSU, IT and vendors to troubleshoot and resolve system issues and coordinate upgrades or integrations.
• Monitor revenue cycle metrics such as errors, rejections and denial rates.
• Utilize dashboards and reports to track and identify billing and collections trends.
• Provide actionable insights to leadership for decision-making.
• Ensure systems align with CMS, HIPAA, and payer requirements.
• Manage, analyze, and optimize electronic data transactions (837, 835, 270/271, etc.) between the FSU and external vendors.
• Collaborate with clearinghouses and payers to resolve transmission, billing and adjudication errors.
• Ensure timely submission of claims and receipt of remittance advice.
• Partner with internal and external teams to ensure system functionality supports departmental and company goals.
• Work with finance to reconcile payments and resolve discrepancies.
• Evaluate current workflows and recommend enhancements to improve efficiency, reduce costs, and ensure accurate and timely billing.

Healthcare Revenue Cycle EDI Systems Analyst

Administrative Assistant

• Follows established procedures and guidelines to provide timely and effective secretarial support
• Answers telephones, screens calls, and takes messages
• Performs advanced administrative/operational/customer support duties
• Transcribes, types, formats, and proofreads a variety of material
• Coordinates internal and external meetings
• Manages the appointments and schedules of applicable staff
• Uses office equipment such as photocopiers, faxes, and printers
• Distributes incoming mail, prepares outgoing mail, filing, maintaining office supplies or other inventory
• Exercises discretion and judgment in prioritizing requests

Administration Coordinator II

Senior Vendor Management Professional

Data Engineer

Home Health Physical Therapist

Healthcare Revenue Cycle EDI Systems Analyst

Market Administrative Assistant