-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: St. George, US-UT
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:50
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Bennington, US-VT
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:49
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Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Salt Lake City, US-UT
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:48
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Burlington, US-VT
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:47
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Dallas, US-TX
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:47
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:46
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:45
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:44
-
Create an outstanding customer experience through exceptional service.
Establish and maintain a safe and clean environment that encourages our customers to return.
Assist the department manager in reaching sales and profit goals established for the department and monitor all established quality assurance standards.
Embrace the Customer 1st strategy and encourage associates to deliver excellent customer service.
Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety of others.Based in Wisconsin, Pick ‘N Save merged with The Kroger Company in 2015.
Today, we're proudly serving Pick ‘N Serve customers in 89 stores throughout the state.
As part of the Kroger family of companies, we take pride in bringing diverse teams with a passion for food and people together with one common purpose: To Feed the Human Spirit.
With a history of innovation, we work tirelessly to create amazing experiences for our customers, communities AND each other, with food at the heart of it all.
Here, people matter.
That's why we strive to provide the ingredients you need to create your own recipe for success at work and in life.
We help feed your future by providing the value and care you need to grow.
If you're caring, purpose-driven and hungry to learn, your potential is unlimited.
Whether you're seeking a part-time position or a new career path, we've got a fresh opportunity for you.
Apply today to become part of our Pick ‘N Save family!
If you are in need of reasonable accommodation to complete a job application or to otherwise participate in the application or pre-hiring process, please call 844-849-7136 or contact the location's management.
What you'll receive from us:
The Kroger Family of Companies offers comprehensive benefits to support your Associate Well-Being, including Physical, Emotional, Financial and more.
We'll help you thrive, with access to:
* A wide range of healthcare coverage, including affordable, comprehensive medical, dental, vision and prescription coverage, through company plans or collective bargaining agreement plans.
* Flexible scheduling in full- and part-time roles with paid time off, including holiday and sick pay based on eligibility and length of service.
* Emotional and financial support with free counseling through our Employee Assistance Program and free, confidential financial tools and coaching with Goldman Sachs Ayco.
* Valuable associate discounts on purchases, including food, travel, technology and so much more.
* Up to $21,000 in tuition reimbursement over your career, through our industry-leading Continuing Education program.
* Vast potential for growth, through an abundance of industry-leading training programs and diverse career pathways.
For more information about benefits and eligibility, please visit our Benefits Page ! Minimum Position Qualifications:
* Customer Service skills
* Effective communication skills
* Knowled...
....Read more...
Type: Permanent Location: Marshfield, US-WI
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:44
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: San Antonio, US-TX
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:43
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Newport, US-RI
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:42
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Columbia, US-SC
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:41
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Charleston, US-SC
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:40
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Rapid City, US-SD
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:40
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Providence, US-RI
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:39
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Sioux Falls, US-SD
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:38
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Pittsburgh, US-PA
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:37
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Tulsa, US-OK
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:37
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Eugene, US-OR
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:36
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:35
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Cleveland, US-OH
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:34
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Portland, US-OR
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:34
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Oklahoma City, US-OK
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:33
-
Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Columbus, US-OH
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:32
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Description & Requirements
Maximus is currently hiring for a Sr.
Admin - Appeals to join our QIC Part C team.
This is a remote opportunity.
The Sr.
Admin is responsible for reviewing appeals from Medicare enrollee's with a Part C plan and working the appeal from start to finish.
This includes reviewing requests and provided information, reaching out for additional information when needed, and at its conclusion, writing and uploading a decision letter.
The Sr.
Admin will specifically handle lock-in and cost sharing cases.
This position will require a federal suitability clearance post-hire as mandated by the client.
This clearance is required in order to access client-specific systems as needed to complete the job duties.
Essential Duties and Responsibilities:
- Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position
- Function as a Subject Matter Expert in one or more process areas.
- Analyze data submitted for Independent Medical Review.
- Collect and analyze incoming data and reports from treatment providers, facilities, participants, labs and health plans to input necessary information into the system.
- Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
Minimum Requirements
- Associate degree with 2+ years' experience.
- Experience in lieu of an Associate degree (HS Diploma or GED and 4+ years of experience) also considered.
- Ability to commit to a 2 week training schedule of 8:30am - 5:00pm EST Monday - Friday required.
Please note: This position requires the use of your personal device for the duration of training.
After training, equipment will be provided.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
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 candidate's 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...
....Read more...
Type: Permanent Location: Minot, US-ND
Salary / Rate: Not Specified
Posted: 2025-12-13 08:05:31
