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Job Description: PREFERRED SKILLS: SAS Coding/Programming Healthcare Claims background Provides in-depth business knowledge and advanced technical support to one or more business areas through developed and ad hoc analysis/reporting ,..
Job Description: To learn more about this position Click Here to see a video. Community Health Workers (CHWs) are frontline public health workers who are trusted members of and/or have..
SunIRef:Nurse:titlenField Care Manager (RN Nurse Case Manager -Pediatric Experience)nWellCaren1,370 reviewsn-nMiami Gardens, FL 33055nWellCaren1,370 reviewsnRead what people are saying about working here.nnDo your best work. Live your best life. If you..
Job Description: The Workforce Management Analyst works to improve workforce management effectiveness by advanced scheduling, budgeting and forecasting in the Customer Service Department. Successful candidates will also implement, optimize, and..
Quality Improvement Project Manager (Provider 360) - Atlanta, GA at WellCare Location Atlanta, GA Date Posted March 22, 2020 Category Quality Management Job Type Full-time Description Manages and monitors clinical..
Assists with the implementation of policies, procedures, and practices designed to ensure compliance with the requirements set forth in federal and state Plan contracts, laws, regulations, and health care program..
Quality Improvement Project Manager (Provider 360) - Atlanta, GAnat WellCarenLocationnAtlanta, GAnDate Posted March 22, 2020nCategory Quality ManagementnJob Type Full-timenDescriptionnManages and monitors clinical quality studies to include receipt and analysis of..
Job Description: Oversees the care for long term support services / long term care populations and provides coordination of care services for lower acuity individuals living in the community or..
Job Description: To learn more about this position Click Here to see a video. Report to: Sr Dir, Field Sales and Market Department: Medicare Operations Location: Chicago, IL Prospects for..
Job Description: Research and resolve all escalations from Members and Providers, as well as complaints coming from other escalated areas such as MET, Grievances, Compliance, Vendors, Appeals, Utilization Management and..
Job Description: Position is primarily responsible for answering escalated claim adjustment requests and resolving issues received through transferred provider phone calls, customer service management and miscellaneous special project work. Department:..
Job Description: Department: TX-PR-M’Care-State Reports to: Director, Network Management Location: Richardson, TX WellCare is seeking a successful Provider Relations Manager for the Dallas/Fort Worth, Texas market. This is a fantastic..
Job Description: Provides support and project coordination for the field quality improvement team. Responsibilities include establishing working relations with both corporate partners and field Quality Improvement (QI) staff as well..
SunIRef:itnSenior Business Technical AnalystnWellcaren1,371 reviewsn-nDetroit, MI 48226nWellcaren1,371 reviewsnRead what people are saying about working here.nCompany DescriptionnCentene (Parent Company) offers affordable and high-quality products to nearly 1 in 15 individuals across..
Job Description: RN Register Nurse License Preferred Oversees the care for long term support services / long term care populations and provides coordination of care services for lower acuity individuals..
SunIRef:Nurse:titlenClinical Claims Review NursenWellCaren1,373 reviewsn-nDetroit, MI 48226nWellCaren1,373 reviewsnRead what people are saying about working here.nnAt WellCare, we are a passionate team with a strong mission and a focused purpose: to..
Job Description: KEY DETAILS Considering registered nurses with long-term support services / long term care population experience. This is a field-based and remote role providing transitional case management services for..
Job Description: Manages physician contracting and network development for an assigned region. Responsible for developing, executing and maintaining a provider network strategy. Continuously evaluates network to ensure cost effective, optimal..
Job Description: Provides functional knowledge and technical support to the design, implementation and customization of departmental applications, systems and databases to meet the customer's requirements and system needs. Debugs and..
SunIRef:itnBusiness Technical Analyst, SrnWellCaren1,373 reviewsn-nDetroit, MI 48226nWellCaren1,373 reviewsnRead what people are saying about working here.nnAt WellCare, we are a passionate team with a strong mission and a focused purpose: to..
Job Description: Support the Business Development team and area business units by conducting research and analysis on key business development projects and related initiatives including, but not limited to, early..