THE LARGEST COLLECTION OF JOBS ON EARTH
company:(health net inc)
Supports PDF, DOC, DOCX, TXT, XLS, WPD, HTM, HTML files up to 5 MB
Senior Compliance Analyst The candidate will assist in maintaining Centene Corporation’s Compliance Program. Will provide regulatory interpretation, perform compliance reporting, lead special projects, and develop and implement compliance auditing and..
Position Purpose: Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and..
Position Purpose: Perform duties related to the day-to-day operations of the Service Management functions for Foster Care members to achieve the highest possible levels of functioning and wellness by ensuring..
Education Bachelor's Degree Skills Marketing Develop and coordinate materials and marketing activities company wide. Develop, coordinate and promote new programs for existing and new business initiatives, including marketing materials research..
Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate. Perform training, orientation and coaching for performance improvement within the network and assist with..
Contract Negotiator I (Ancillary Providers) (1134750) Position Purpose: Recruit physician, hospital and ancillary service providers to sign network participation agreements that are in accordance with Corporate, health plan and State..
Position Purpose: n Implements and manages programs in compliance with contracts and regulations and monitors ongoing program performance to maintain compliance.nn Develops strategies and policies to deliver C&L services and..
Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.Initiate authorization requests for output or input services in keeping with the prior authorization..
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..
Position Purpose: Responsible for analytic data needs of the business unit. Manage multiple, variable tasks and data review processes, as well as mass data entry, maintenance, and update projects.n Complete..
Manager, Health Policy (1140358) Position Purpose: Support corporate development and research, evaluate and report on the impacts of regulations, legislation and contractual provisions in new and existing markets. Develop and..
Education Bachelor's Degree Develop and maintain collaborative relationships with Health & Family Services, government agencies, community resource and advocacy groups, to build additional community support for current and potential members...
Position Purpose: Work with Marketing & Community Relations Manager to develop and implement community outreach plan for the Health Plan. Participate as a member of the Marketing team in developing..
Position Purpose: The Clinician Specialist provides clinical and operational support, guidance, and direction to the department related to utilization management and/or case management. The position is responsible to develop, implement,..
Position Purpose: Responsible for developing and conducting a variety of training programs and/or auditing tools for member services contact center employees. Primary focus will be executing training for Complex Health..
Education Bachelor's Degree Skills SQL Project Implementation Project Management Business Intelligence Data Warehouse Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a..
Position Purpose: Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician..
Position Purpose: Our Medicare SalesRepresentatives for our Allwell Medicare plans ensurethat Allwell is the choice for Medicare-eligible individualsin their assigned territory. They use a consultative sales approach to encourage enrollment..
Education Bachelor's Degree Skills Leadership Experience Management Experience Benefits Health Savings Account Retirement Plan Flexible Spending Account Dental Insurance Health Insurance Position Description: Health Net of West Michigan has been..