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Results based on filters ( 8 jobs found )

Care Manager II

Keystone First
Southfield, MI
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Role Overview: The Care Manager II is responsible for managing and ...
Details
Summary
About the job:
coordinating care, services, and social determinants of health for medically fragile members with acute, chronic, medically complex, and/or behavioral health conditions, as well as other health needs. Serves as the primary point of contact for the care team, including members, caregivers, physicians, and community support, to guide members toward their optimal level of health. Utilizes strong assessment and communication skills, critical thinking, and clinical knowledge to identify issues, gaps in care, and barriers to care....
Location:
Southfield, MI
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
Associate Degree in Nursing
Certified Registered Nurse
National Committee for Quality Assurance
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Supervisor Integrated Care Management

Keystone First
Baton Rouge, LA
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Role Overview: The Supervisor, Integrated Case Management, oversees the ...
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Summary
About the job:
daily operations of the Case Management unit, providing clinical direction, guidance, and oversight of case management services. Work Arrangement: - Remote - Associate must reside in Louisiana (LA) Responsibilities: - Provide daily oversight and clinical direction for the Complex Case Management unit. - Supervise and support staff conducting case management, care coordination, and screening activities. - Monitor team performance, productivity, and quality to ensure compliance with organizational and regulatory standards -...
Location:
Baton Rouge, LA
Job Type:
Full-Time
Permanent
Occupation:
Facilities Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

DIRECTOR of FINANCE/CHIEF FINANCIAL OFFICER

Keystone First
Dublin, OH
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Role Overview: The Director of Finance/Chief Financial Officer is ...
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Summary
About the job:
responsible for overseeing all accounting and financial operations for the health plan. This role provides strategic and operational financial leadership, ensuring the accuracy, integrity, and compliance of financial reporting while supporting organizational goals through budgeting, forecasting, cost management, and financial analysis. The Director is a key member of the leadership team, partnering closely with leadership, corporate finance, operational leaders, and external stakeholders to support informed decision-making and...
Location:
Dublin, OH
Job Type:
Full-Time
Permanent
Occupation:
Treasurers and Controllers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
Certified Public Accountant
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Community Educator

Keystone First
Manchester, NH
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Role Overview: AmeriHealth Caritas New Hampshire (ACNH) is seeking a ...
Details
Summary
About the job:
passionate and community-driven Community Educator to join our outreach team and help connect vulnerable and diverse populations across the state to essential healthcare resources. Based out of our Manchester Wellness Center and traveling statewide, this role promotes AmeriHealth Caritas programs through community events and site visits, identifies and guides potential Medicaid and uninsured individuals to appropriate services, and educates them on enrollment processes. The Community Educator also coordinates outreach...
Location:
Manchester, NH
Job Type:
Full-Time
Permanent
Occupation:
Community and Social Service Specialists, All Other
Career Level / Education:
Bachelor's degree
Salary:
Middle Income Jobs ($30K-$49K)
From:
Keystone First
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Clinical Quality Performance Specialist

Keystone First
Located in Ohio
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Role Overview: The Quality Performance Specialist – Clinical supports the ...
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Summary
About the job:
Quality Management (QM) team by leading and coordinating clinical quality reviews of member concerns and medical records, ensuring adherence to established standards of care. This role plays a key part in quality improvement initiatives, accreditation readiness, and annual medical record reviews, including Healthcare Effectiveness Data and Information Set (HEDIS) and Clinical Practice Guidelines. Work Arrangement: - Remote - Fully remote position; may be performed from any location within the United States -...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Regulatory Affairs Specialists
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Keystone First
Certifications / Licenses:
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Community Health Educator

Keystone First
Gaylord, MI
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Role Overview: The Community Health Educator, Senior supports the ...
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Summary
About the job:
development and execution of outreach strategies within an assigned territory to improve health outcomes, reduce healthcare costs, and increase member engagement. This role delivers health education, supports community-based programming, assists with Social Determinants of Health (SDOH) surveys, and documents outreach activities and outcomes in Jiva. The position operates in both field-based and wellness center settings (brick-and-mortar and mobile) and serves as a senior-level resource for community education initiatives. Work...
Location:
Gaylord, MI
Job Type:
Full-Time
Permanent
Occupation:
Community and Social Service Specialists, All Other
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Keystone First
Certifications / Licenses:
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Behavioral Health Utilization Management Reviewer

Keystone First
Located in Ohio
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Role Overview Under the direction of the Supervisor, the Behavioral Health ...
Details
Summary
About the job:
Utilization Management (BHUM) Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and experience, the clinician reviews provider requests for inpatient and outpatient services, working closely with members and providers to collect all information necessary to perform a thorough medical necessity review. It is within the BH UM Reviewer’s discretion to retain requests for additional information and/or request clarification. The BH UM Reviewer will use professional judgment to...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Keystone First
Certifications / Licenses:
Licensed Master Social Worker
Licensed Social Worker
Licensed Clinical Social Worker
Licensed Independent Clinical Social Worker
Licensed marriage and family therapist
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Manager Medical Economics & Business Process

Keystone First
Located in Ohio
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Role Overview : The Manager, Medical Economics & Business Process leads a ...
Details
Summary
About the job:
team responsible for delivering healthcare data and medical economics analyses across a variety of data sources, including claims, authorizations, member, and provider data. This role partners closely with cross ‑ functional teams to structure and execute analyses, generate insights, and identify opportunities to improve medical costs, operational performance, and overall business outcomes. This is a hands-on role, which combines team leadership with active analytic contributions to core workstreams. Work Arrangement: -...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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