NewBusiness Analyst Sr TriWest Healthcare AllianceBusiness Analyst SrCharleston, SCRemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. The position collaborates to ensure relevant analysis and complete, timely reporting is provided to meet TriWest business needs and Government's Healthcare requirements.
Senior Human Capital Generalist TriWest Healthcare AllianceSenior Human Capital GeneralistCharleston, SCRemoteFull timeTechnical Skills: Advanced collaboration, listening, consulting, and conflict resolution skills; experience conducting investigations; in-depth knowledge of TriWest Human Capital policies and procedures; knowledge of Human Resources management concepts; Federal, state, and local employment law; ability to maintain the confidentiality of information and maintain safeguards; presentation skills. Coaches leaders on Triest Human Capital policies and procedures, including employee relations, leadership development, exit interviews, turnover analysis, performance appraisal system, leadership training, and investigations.
NewSenior Buyer TriWest Healthcare AllianceSenior BuyerCharleston, SCRemoteFull timeAssists departments in obtaining pricing and other information from vendors as well as reviews contracts and assists business units in the management of contractual obligations of the vendor to ensure that all terms and conditions are met. Act as SME in support of Procurement, Contract Management, DHA/ VA Contract Modification, Finance and business teams in support of pricing efforts including ROMs, RFIs/ RFPs, contracts, and licensing agreements.
NewProvider Reimbursement Analyst TriWest Healthcare AllianceProvider Reimbursement AnalystCharleston, SCRemoteFull timeThis role requires knowledge of healthcare coding and reimbursements, strong analytical skills, ability to work with large multi-dimensional sets, an ability to identify negative and positive trends, and strong communication skills that enable clear communications to leadership regarding findings. • Works closely with Provider Services and Finance leadership and SMEs on process and quality improvement strategies and/or provider education efforts, resulting from claims data analyses and findings.
NewCustomer Service Representative (AR, IL, IA, KS, LA, MO, MN, NE, ND, OK, SD & WI) only TriWest Healthcare AllianceCustomer Service Representative (AR, IL, IA, KS, LA, MO, MN, NE, ND, OK, SD & WI) onlyCharleston, SCRemoteFull timeAccurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
NewDirector, Referral Management TriWest Healthcare AllianceDirector, Referral ManagementCharleston, SCRemoteFull timeCollaborates with Utilization Management Director, MVS Directors, network providers, Military Treatment Facilities and TRICARE Regional Office West regarding TriWest's RM program initiatives including submission, review, optimization and return of clinical documentation processes. In collaboration with our Military & Veteran Services (MVS) leadership team and the Clinical Operations Utilization Management team, the Director develops strategies for achieving annual Referral Management goals and objectives, including input on system configuration and process development.
Utilization Clinical Reviewer TriWest Healthcare AllianceUtilization Clinical ReviewerCharleston, SCRemoteFull timeApplies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.
Dir, Bus Design & Prod Mgmt TriWest Healthcare AllianceDir, Bus Design & Prod MgmtCharleston, SCRemoteFull timeThis position requires in-depth knowledge and expertise in all aspects of TriWest's business contracts and provides cross-functional leadership and design as needed to adjust to a constantly changing environment. The Director of Business Design and Product Management oversees multiple operational support teams including Business Design and Integration (BDI) and Product Management.
Salesforce Health Cloud Architect TriWest Healthcare AllianceSalesforce Health Cloud ArchitectCharleston, SCRemoteFull timeTechnical Skills: General knowledge of data communication architectures, design, and support; General knowledge of the technology impacts on business and how to integrate technical plans to support enterprise business function; Business problem-solving skills; Understanding of project management concepts and techniques, including metrics. Works directly with Salesforce Health Cloud development teams, administrators and 3rd party vendor partners to provide expert technical direction, instruction, and leadership around complex technical concepts.
Customer Service Rep - Spanish Fluency Required TriWest Healthcare AllianceCustomer Service Rep - Spanish Fluency RequiredCharleston, SCRemoteFull timeAccurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
South Carolina Teleradiologist | Remote Neuro & Body Roles | High Earnings MedAtlantic Healthcare SolutionsSouth Carolina Teleradiologist | Remote Neuro & Body Roles | High EarningsCharleston, South CarolinaRemoteThis fast-growing, Joint Commission-accredited teleradiology group is seeking South Carolina -based (or South Carolina -licensed) physicians for: Body Imaging (Fellowship-trained). We’ve been successfully partnered with this client since 2021 , and their flexibility is consistently the #1 reason past South Carolina hires recommend them.
AV Systems Designer Amplify PeopleAV Systems DesignerCharleston, SCRemote$75,000–$85,000 / yearThe team designs and engineers AV, sound, and room control systems for hotels, resorts, and other commercial spaces throughout the coastal Carolinas and Georgia region, working with platforms including Crestron, BIAMP, Symmetrix, and QSC. The ideal candidate is easygoing and collaborative, comfortable working independently while staying closely connected to the team, and genuinely enjoys mentoring and sharing knowledge with others rather than gatekeeping expertise.
NewVice President of Sales JuliskaVice President of SalesNorth Charleston, South CarolinaRemoteReports to: CEO & Founder | Member of the Executive Committee DeGoods, Inc., the parent company of Juliska and Capucine De Wulf , is seeking an exceptional Vice President of Sales to lead the next chapter of commercial growth for our two distinctive premium lifestyle brands. The Ideal Candidate We are looking for a strategic, entrepreneurial and highly commercial leader with: Significant wholesale sales leadership experience within a luxury, premium or highly design-led consumer brand.
Customer Service Rep (AZ, CO, ID, MT, NM, NV, OR, UT & WA only) TriWest Healthcare AllianceCustomer Service Rep (AZ, CO, ID, MT, NM, NV, OR, UT & WA only)Charleston, SCRemoteFull timeAccurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Supervisor, Contact Center TriWest Healthcare AllianceSupervisor, Contact CenterCharleston, SCRemoteFull timeEnsures accurate completion of VA-approved medical authorizations, appointment scheduling, thorough documentation of all Veteran and provider encounters in the TriWest medical management system and receipt of timely medical documentation from network providers. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
NewBe Your Own Boss, Backed by a Team Griffin AgencyBe Your Own Boss, Backed by a TeamSummerville, SCRemoteClient Fulfillment: As a client advisor you will have access to our technology driven CRM to connect with clients who have requested a consultation, the automation will set a virtual appointment from home or anywhere to help them apply for the best plan for their needs. You may qualify for an agency contract, which gives you full ownership of your permanent residual income stream Expectations: This position is remote and combines the freedom and tax benefits of being an independent contractor, with the ongoing support and coaching from our team of experts who will help you every step of the way.
NewWorksite Executive Disability Re-Enrollment and Client Consultant Massachusetts Mutual Life Insurance CompanyWorksite Executive Disability Re-Enrollment and Client ConsultantCharleston, SCRemote$88,300–$115,900 / yearYour primary responsibility will be to work directly with our producers and existing customers to identify growth opportunities, support benefit re-enrollments and be stewards of key producer and client relationships. Networking opportunities including access to Asian, Hispanic/Latinx, African American, women, LGBTQIA+, veteran and disability-focused Business Resource Groups.
NewYour Income Shouldn't Have a Ceiling Griffin AgencyYour Income Shouldn't Have a CeilingMount Pleasant, SCRemoteClient Fulfillment: As a client advisor you will have access to our technology driven CRM to connect with clients who have requested a consultation, the automation will set a virtual appointment from home or anywhere to help them apply for the best plan for their needs. You may qualify for an agency contract, which gives you full ownership of your permanent residual income stream Expectations: This position is remote and combines the freedom and tax benefits of being an independent contractor, with the ongoing support and coaching from our team of experts who will help you every step of the way.
NewProvider Program Manager - APM TriWest Healthcare AllianceProvider Program Manager - APMCharleston, SCRemoteFull timeDevelops effective collaborative relationships with TriWest's inter and intra-departmental stakeholders and other SMEs, C-Suite executives, and other leaders in Operations, Health Care Services, Provider Network, and IT to ensure that TriWest meets contractual requirements and fulfills organizational objectives. The Provider Program Manager ensures that strategic, enterprise-wide programs are well defined, planned, tracked, and communicated in a consistent manner; is responsible for collaborating with C-Suite executives and other stakeholders; and is responsible for deliverables that meet defined requirements and for utilizing project management best practices.
New1099 Commission-Based Recruiter KC Elite Staffing1099 Commission-Based RecruiterNorth Charleston, South CarolinaRemote$50–$60 / hourCandidate Sourcing: Use your network, LinkedIn, job boards, and social media to identify qualified candidates for open roles across our split platform network. This role is built for self-directed recruiting professionals who want to maximize their earning potential on a flexible, fully remote schedule — with no cap on what you can earn.