• Healthcare Specialist

    Actalent (Redlands, CA)


    Job Title: Healthcare Specialist

     

    For immediate consideration, please apply directly to this job posting AND email biacosta @actalentservices.com with the following:

     

    1) Word copy of resume

     

    2) 2-3 professional references

     

    3) 4-5 brief bullet points highlighting technical qualifications

    Job Description

    As a Healthcare Specialist, you will be responsible for managing member outreach, handling provider requests, and creating authorizations. Your role involves reviewing clinical information from health plan members, employers, providers, and health plans to assess and make authorizations, ensuring compliance with relevant regulatory agencies to maintain plan licensing.

    Responsibilities

    + Handle inquiries from members, employers, providers, and health plan coordinators.

    + Manage member outreach and notifications.

    + Project a professional, helpful demeanor to all patients and providers.

    + Consistently provide accurate and thorough information to patients.

    + Use available resources to research and resolve moderately complex issues.

    + Accurately document notes.

    Essential Skills

    + Care management

    + Managed care

    + Healthcare industry

    + Health administration

    + Troubleshooting

    + Medical terminology

    + Case management

    + Customer service

    + Data entry

    Additional Skills & Qualifications

    + High school diploma or GED required.

    + Knowledge of medical terminology.

    + Experience in Managed Care Coordination, Medical Assisting, and/or CNA preferred.

    + Experience working in a managed care environment preferred.

    + Experience with Independent Physician Associations (IPAs), Managed Care, and/or Utilization Management.

    Work Environment

    This is a remote position with a standard schedule of Monday to Friday, 8 AM to 5 PM, with a one-hour lunch break. Early morning shifts may be necessary with prior approval from the director if workload demands it.

    Pay and Benefits

    The pay range for this position is $23.00 - $25.00/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 & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&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 remote position.

     

    Application Deadline

     

    This position is anticipated to close on Jun 7, 2025.

    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 [email protected] (%[email protected]) for other accommodation options.