THE LARGEST COLLECTION OF JOBS ON EARTH
company:(health net inc)
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Position Purpose: The Membership Retention Specialist will play an important role on our expanding Medicare call center retention team. These team members are vital to strengthening our Medicare customer relationships..
Position Purpose: Triage inbound calls, gather information, select appropriate triage guidelines, and disposition and care advice based on database protocols and department policies and procedures for a 24 hour per..
Position Purpose: Act as the repository for all regional denial and appeal letters, be the liaison between Medical Management, Quality, NCQA and State requirements and responsible for ensuring that all..
Position Purpose: Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial..
Description:nPosition Purpose: Perform care management duties to assess, plan andncoordinate all aspects of medical and supporting services across thencontinuum of care for select members to promote quality, costnneffective care.n* Assess..
Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. Provide advanced analytical support for business..
Position Purpose: Respond to customer inquiries via telephone and written correspondence in a timely and appropriate manner. Respond to telephone or written correspondence inquiries from members and/or providers within established..
Position Purpose: The Field Retention Representative is responsible for retaining current membership in an assigned territory and must meet the daily production metrics designed to achieve higher membership retention. The..
Description:nPosition Purpose:nManage multiple small to medium sized technical and business orientednprojects for the Information Technology organizationnEstablish client relationships, integrate requirement definition, plannprojects, and direct resources ensuring corporate and IT projectnportfolio..
Position Purpose: The Enrollment and Retention Representative supports the education and enrollment of prospective Health Net Medicaid members statewide by providing benefit, eligibility and Health Net information and assistance for..
Description:nPosition Purpose: Oversee operations, and business strategy utilizingncross-functional departments to meet strategic objectivesnnPosition Responsibilities:n* Develop and manage methodologies for tracking, identifying andnnproblem-solving issues, interpreting and presenting programnresults and insights, and..
Description:nPosition Purpose: Responsible for the entire implementation processnnand drive definition of business needsn* Responsible for the entire implementation process and drivenndefinition of business needsn* Lead cross functional teams through the..
Description:nPosition Purpose:nLearn various job functions within the Managed Care industry andnexplore various career opportunitiesnApply academic knowledge and learn new skills by contributing tonvarious projectsnResearch various legal, regulatory, and other topics..
Position Purpose: Identify special needs members through the completion of health screens and other resourcesWork with community outreach/member advocates to coordinate member careEducate providers and community resources on program components..
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost..
Description:nPosition Purpose: The Senior Call Center Retention Representative isnresponsible for retaining current membership specializing in long termncare, senior programs and HARP products. They must meet the dailynproduction metrics designed to..
Position Purpose: Act as an advocate for the Member and a liaison between the Health Plan and Provider(s) to ensure availability and access to care. Establish a community presence, promote..
Description:nPosition Purpose: Recruit physician, hospital and ancillary servicenproviders to sign network participation agreements that are innaccordance with Corporate, health plan and State guidelines. Ensurennthat all necessary documentation and information are..
Description:nPosition Purpose: Responsible for the auditing of systems entry,nnperformance metrics and work processes for assigned functionn* Compile audit findings and report to management, makingnnrecommendations for modifications and improvements to operations,nnsystems..