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This position covers the state of NJ and requires the candidate to reside in that state. Position Purpose: Perform day to day duties of assuring that providers are set up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple stat

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose: The Program Manager IV is responsible for coordinating the implementation of new regulatory requirements, including the REAL Health Providers Act, Medicaid Mega Rule, state-specific directory regulations, and ongoing compliance reporting activities such as RARR. The role also serve

Position Purpose: The Consumer Experience Analyst Sr. is responsible for utilizing a variety of analytical techniques, current system applications, consumer research data, call center and other ad hoc and system generated reports and other data sources within the organization to address business obj

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose:The Health Benefit Representative (HBR) is responsible for educating and assisting individuals with enrolling in affordable health insurance coverage through the NY State of Health Marketplace. This includes Medicaid (NYM), Child Health Plus (CHP), Essential Plan (EP), Qualified Hea

Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care. Develops a personalized care

Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care. Develops a personalized care

Position Purpose: Performs care management duties to assess, plan and coordinate aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality and cost effective care. Completes medication review for pre-admission and post-discharge reconciliat

Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care. Develops a personalized care

Position Purpose:Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care. Develops a personalized care p

Position Purpose:Participate in the development of strategic business plans, coordinate and communicate the product strategy and determine key priorities, policies and procedures for product lines and programs. Key Details: Identify and advance growth, innovation, and member experience opportunities

Position Purpose: Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective healthcare outcomes. Evaluates member service needs and develops or contribu

Position Purpose: Represent the company to all prospective and existing clients. Monitor client satisfaction and recommend changes to enhance satisfaction. Key Details: Due to travel requirements of the role, we are seeking candidates who live within an hour of Raleigh, North Carolina or Richmond, V

Position Purpose: Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. Learn various job functions within the Managed Care industry and explore various career opportunities Apply academic knowle

Position Purpose: Lead provider network strategy, development, contracting, and performance management across Missouri. Assess market and provider performance, identify network and cost improvement opportunities, develop market strategies, and lead complex negotiations with hospitals, health systems

Position Purpose: Oversee business operations, procurement opportunities, new product implementations and complex initiatives for business development utilizing cross-functional business units and corporate teams to meet business unit and corporate strategic objectives. Partner with multiple stakeho

Position Purpose: Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. We're seeking curious, collaborative problem-solvers who are passionate about technology and innovation. Interns may suppor

Position Purpose:Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. We are seeking curious, collaborative, and analytical students who are interested in using financial insights to support bus

Position Purpose: Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. We are seeking curious, collaborative, and analytical students who are interested in using financial insights to support bu