Top 131 Authorization representative Jobs in Londonderry Nh

SCO Care Navigator - Lawrence - Khmer preferred
Fallon Health —Lawrence, MA
- $28 - $30 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Bachelor of Science
Accessibility Technician
National Seating & Mobility, Inc. —Bow, NH
- Full-time
- Background check
- Mid-level
- Residential
- Dental insurance
- Paid time off
Quick Apply
Central Refill Technician Representative
Greater Lawrence Family Health Center —Lawrence, MA
- $21.28 - $23.64 an hour
- Full-time
- Computer literacy
- Internal Medicine
- High school diploma or GED
- Tuition reimbursement
Quick Apply
Quality Manager
TTM Technologies —Salem, NH
- Full-time
- Microsoft Excel
- 6 years
- Engineering
- Health savings account
- Paid holidays
Medical Assistant/Scribe - Haverhill/North Andover, MA
Northeast Dermatology Associates —Haverhill, MA
- $22 - $23 an hour
- 10 hour shift
- Surgery
- Ability to walk for extended periods
- Ability to climb stairs
Quick Apply
12d
Senior Cybersecurity Engineer
Raytheon —Tewksbury, MA
- $86,800 - $165,200 a year
- Full-time
- Computer Science
- 5 years
- Office
- Paid holidays
- Disability insurance
Front Desk Agent
Hampton Inn & Suites Exeter —Exeter, NH
- $18.75 an hour
- Ability to walk for extended periods
- Hotel
- US work authorization
- Wellness program
- Commuter assistance
Quick Apply
Visiting Nurse Association- Intake Representative- Administration- Per Diem
Elliot Health System —Manchester, NH
- Part-time
- Office
- High school diploma or GED
- Entry level
- Disability insurance
- Health insurance
4d
Patient Service Representative- Elliot 1-Day Surgery Center- Per Diem
Elliot Health System —Manchester, NH
- Part-time
- High school diploma or GED
- Perioperative Care
- Entry level
Patient Service Representative - Gastroenterology - Full Time
Elliot Health System —Manchester, NH
- Full-time
- High school diploma or GED
- Entry level
- Disability insurance
- Health insurance
Patient Service Representative - Float Pool - Per Diem
Elliot Health System —Manchester, NH
- Part-time
- High school diploma or GED
- Entry level
- Disability insurance
- Health insurance
Senior Scientist - Bioanalysis
Merck KGaA —Billerica, MA
- $94,600 - $144,100 a year
- Doctor of Philosophy
- Neurology
- US work authorization
- Health insurance
- Paid time off
Patient Service Representative - Internal Medicine at Londonderry - Full Time
Elliot Health System —Londonderry, NH
- Full-time
- Internal Medicine
- High school diploma or GED
- Entry level
- Disability insurance
- Health insurance
Associate Director, Project Representative/Lab Manager
Merck KGaA —Billerica, MA
- $164,600 - $246,800 a year
- English
- Doctor of Philosophy
- Neurology
- Health insurance
- Paid time off
Patient Service Representative - Vascular Surgery- Full Time
Elliot Health System —Manchester, NH
- Full-time
- Surgery
- 3 years
- High school diploma or GED
- Tuition reimbursement
- Pet insurance
Patient Service Representative- Elliot 1-Day Surgery Center- Full Time (32 hours/week)
Elliot Health System —Manchester, NH
- Full-time
- Hospital
- Word processing
- High school diploma or GED
- 403(b) matching
- Dental insurance
10d
Patient Service Representative - Family Medicine at Londonderry - Full Time
Elliot Health System —Londonderry, NH
- Full-time
- High school diploma or GED
- Entry level
- Disability insurance
- Health insurance
Patient Service Representative - Endocrinology - Full Time
Elliot Health System —Bedford, NH
- Full-time
- Microsoft Office
- High school diploma or GED
- Entry level
- Disability insurance
- Health insurance
Patient Service Representative - Family Medicine Hooksett - Full Time
Elliot Health System —Hooksett, NH
- Full-time
- Microsoft Office
- High school diploma or GED
- Entry level
- Disability insurance
- Health insurance
Office Coordinator
Merrimack Health —Lawrence, MA
- Spanish
- Surgery
- English
12d

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SCO Care Navigator - Lawrence - Khmer preferred

Fallon Health -
Lawrence, MA

Apply Now

Job Details

Full-time
$28 - $30 an hour

Qualifications

Microsoft Excel
Microsoft Outlook
Driver's License
Driving
Motivational interviewing
Working with individuals from diverse cultural backgrounds
Experience working with individuals from underserved communities
Experience working with individuals with language barriers
Medical terminology
Home visits (communication methods)

Full Job Description

Overview:

About us:

Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary of purpose:

The Navigator–Care Management is part of an interdisciplinary care team that coordinates care, improves access, and supports quality outcomes for NaviCare members. The Navigator builds relationships with members/caregivers via phone and in person, conducts home visits as needed, helps implement care plan interventions, and works to remove barriers to care. In partnership with the Nurse Case Manager, the Navigator updates care plans and provides holistic case management for low-, moderate-, and high-risk members.

Responsibilities:

Primary Job Responsibilities

Member Education, Advocacy, and Care Coordination

Conduct phone and, as appropriate, in-person assessments, screenings, and visits using TruCare; update individualized care plans and aim for first-contact resolution in a culturally responsive manner.
Coordinate and follow up on care needs, including post-transition outreach, appointment scheduling, medication support, and service monitoring.
Educate members/representatives on benefits, coverage criteria, rights, appeals, authorizations, and evidence of coverage.
Identify and address gaps in care (e.g., PCP assignment, preventive screenings, vaccinations) per established protocols.
Screen for social determinants of health and refer to community resources (e.g., food, housing, fuel assistance, transportation); escalate clinical decisions to the Nurse Case Manager or PCP.
Advocate for members’ access to covered benefits and coordinate with community agencies for non-covered supports.

Provider Partnerships and Collaboration

Participate in—and as appropriate, lead—care plan meetings with providers, partners, and care team members.
Collaborate with the interdisciplinary team (e.g., LTC, behavioral health, advanced practitioners, community partners) to support coordinated care.
Build effective working relationships with community partners and providers (e.g., housing, ADH, assisted living, LTC facilities, PCPs) to support timely, member-specific communication.

Access to Care

Submit and track requests/authorizations for covered services; ensure accuracy and timeliness per program workflows.
Educate members and providers on authorization processes and help resolve authorization issues.
Facilitate access to medical, behavioral health, and social services, including arranging transportation when needed.

Care Team Communication

Communicate timely updates with members, caregivers, providers, and internal teams on care plans, service changes, and member status.
Partner with LTC and community teams during admissions, transitions, and discharges to ensure continuity of care.

Regulatory Requirements, Documentation, and Reporting

Complete required activities to meet CMS/State, NCQA, HEDIS, and other standards (e.g., welcome calls, screenings, care plans).
Document accurately and on time in TruCare and related systems; review and validate member panel data and reports.

Additional Responsibilities

Maintain knowledge of program benefits, policies, procedures, and community resources.
Support operations by covering assignments, adapting to priorities, and completing other duties as assigned.
Mentor or train staff on job-related processes and workflows, as assigned.

Qualifications:

Education

College degree (BA/BS in Health Services or Social Work) preferred

License/Certifications

License: N/A

Certification: Community Health Worker - preferred

Other: Satisfactory Criminal Offender Record Information (CORI) results

Driving your personal motor vehicle is an essential job function of this position and the following requirements apply:

Must possess a valid drivers’ license
Must attest to no disqualifiers per Driver Safety Policy
Must possess and provide proof of minimal state required auto insurance
Must have reliable transportation

Education

2+ years’ experience in managed care and/or community-based health and human services (e.g., home health, personal care management, independent living, ASAP, or relevant state agencies) preferred
Understanding of hospitalization and post-discharge needs required
Working knowledge of medical terminology, common conditions, and medical record documentation; able to identify triggers requiring RN intervention required
Motivational interviewing experience and ability to work effectively with diverse and non-English-speaking populations required
Understanding of social determinants of health required
Proficiency with Microsoft Office (Excel, Outlook, Word) required
Experience with face-to-face member visits and working with providers/community partners preferred
Experience working on a multidisciplinary care team within a managed care organization preferred

Pay Range Disclosure:

In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $28/hr - $30/hr which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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Refine Your Search

authorization representative jobs in londonderry nh

SCO Care Navigator - Lawrence - Khmer preferred

Accessibility Technician

Central Refill Technician Representative

Quality Manager

Medical Assistant/Scribe - Haverhill/North Andover, MA

Senior Cybersecurity Engineer

Front Desk Agent

Visiting Nurse Association- Intake Representative- Administration- Per Diem

Patient Service Representative- Elliot 1-Day Surgery Center- Per Diem

Patient Service Representative - Gastroenterology - Full Time

Patient Service Representative - Float Pool - Per Diem

Senior Scientist - Bioanalysis

Patient Service Representative - Internal Medicine at Londonderry - Full Time

Associate Director, Project Representative/Lab Manager

Patient Service Representative - Vascular Surgery- Full Time

Patient Service Representative- Elliot 1-Day Surgery Center- Full Time (32 hours/week)

Patient Service Representative - Family Medicine at Londonderry - Full Time

Patient Service Representative - Endocrinology - Full Time

Patient Service Representative - Family Medicine Hooksett - Full Time

Office Coordinator

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