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Quality Improvement Project Manager (Provider - 360)
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Quality Improvement Project Manager (Provider-360) - (Maine/New Jersey/New Hampshire/Connecticut) (2001332) Location: (Connecticut, Maine, New Jersey, New Hampshire) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement...
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Date
2020-02-26
Company
Universal American
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Location
Portland, ME
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About the job:
Quality Improvement Project Manager (Provider-360) - (Maine/New Jersey/New Hampshire/Connecticut) (2001332) Location: (Connecticut, Maine, New Jersey, New Hampshire) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement Supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies that impact plan compliance to regulatory and accreditation standards. Drives key quality improvement projects requiring the ability to work effectively in a matrix environment in order to receive needed data that reflects...
Location:
Portland, ME
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Certified Practical Nurse, Long-term care
National Committee for Quality Assurance
Certified Professional in Healthcare Quality
Six Sigma certification
Certified Registered Nurse
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

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Quality Improvement Project Manager (Provider - 360)
Quick view
Quality Improvement Project Manager (Provider-360) - (Maine/New Jersey/New Hampshire/Connecticut) (2001332) Location: (Connecticut, Maine, New Jersey, New Hampshire) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement...
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Date
2020-02-26
Company
Universal American
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Location
Hamden, CT
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About the job:
Quality Improvement Project Manager (Provider-360) - (Maine/New Jersey/New Hampshire/Connecticut) (2001332) Location: (Connecticut, Maine, New Jersey, New Hampshire) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement Supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies that impact plan compliance to regulatory and accreditation standards. Drives key quality improvement projects requiring the ability to work effectively in a matrix environment in order to receive needed data that reflects...
Location:
Hamden, CT
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Certified Practical Nurse, Long-term care
National Committee for Quality Assurance
Certified Professional in Healthcare Quality
Six Sigma certification
Certified Registered Nurse
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Quality Improvement Project Manager (Provider - 360)
Quick view
Quality Improvement Project Manager (Provider-360) - (Maine/New Jersey/New Hampshire/Connecticut) (2001332) Location: (Connecticut, Maine, New Jersey, New Hampshire) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement...
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Date
2020-02-26
Company
Universal American
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Location
Manchester, NH
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About the job:
Quality Improvement Project Manager (Provider-360) - (Maine/New Jersey/New Hampshire/Connecticut) (2001332) Location: (Connecticut, Maine, New Jersey, New Hampshire) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement Supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies that impact plan compliance to regulatory and accreditation standards. Drives key quality improvement projects requiring the ability to work effectively in a matrix environment in order to receive needed data that reflects...
Location:
Manchester, NH
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Certified Practical Nurse, Long-term care
National Committee for Quality Assurance
Certified Professional in Healthcare Quality
Six Sigma certification
Certified Registered Nurse
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

Quality Improvement Project Manager (Provider - 360)
Quick view
Quality Improvement Project Manager (Provider-360) - (Maine/New Jersey/New Hampshire/Connecticut) (2001332) Location: (Connecticut, Maine, New Jersey, New Hampshire) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement...
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Date
2020-02-26
Company
Universal American
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Location
Newark, NJ
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About the job:
Quality Improvement Project Manager (Provider-360) - (Maine/New Jersey/New Hampshire/Connecticut) (2001332) Location: (Connecticut, Maine, New Jersey, New Hampshire) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement Supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies that impact plan compliance to regulatory and accreditation standards. Drives key quality improvement projects requiring the ability to work effectively in a matrix environment in order to receive needed data that reflects...
Location:
Newark, NJ
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Certified Practical Nurse, Long-term care
National Committee for Quality Assurance
Certified Professional in Healthcare Quality
Six Sigma certification
Certified Registered Nurse
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

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Pharmacy Support Clerk
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Pharmacy Support Clerk (1908635) Assists staff in a variety of tasks that help maintain proper work flow and meet time sensitive deadlines within the pharmacy department. Essential Functions: - Labels / assigns incoming faxes in RightFax (or...
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Date
2020-02-26
Company
Universal American
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Location
Detroit, MI
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About the job:
Pharmacy Support Clerk (1908635) Assists staff in a variety of tasks that help maintain proper work flow and meet time sensitive deadlines within the pharmacy department. Essential Functions: - Labels / assigns incoming faxes in RightFax (or equivalent application) to help ensure critical pharmacy turnaround time frames are met. - Sends faxes on behalf of WellCare pharmacy to appropriate parties within designated service level agreements. (SLA's) - Organizes and prioritizes a variety of administrative and clinical job tasks in order of importance and impact on members and providers. -...
Location:
Detroit, MI
Job Type:
Full-Time
Permanent
Occupation:
Office and Administrative Support Workers, All Other
Salary:
Upper Middle Income Jobs ($50K-$79K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
3

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Sr Mgr, Clinical Care, Registered Nurse*
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Sr Mgr, Clinical Care, Registered Nurse* (2001309) Department: PHS Clinical Care Reports to: Director, Clinical Care Location: Houston, TX Oversees the day to day operations for inpatient utilization, outpatient utilization and prior authorization...
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Date
2020-02-26
Company
Universal American
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Location
Houston, TX
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About the job:
Sr Mgr, Clinical Care, Registered Nurse* (2001309) Department: PHS Clinical Care Reports to: Director, Clinical Care Location: Houston, TX Oversees the day to day operations for inpatient utilization, outpatient utilization and prior authorization management activities for multiple markets designed to achieve quality and service driven objectives. Essential Functions: - - Manages and optimizes workflows to achieve successful quality outcomes and benefit maximization within the scope of responsibilities. - Serves as an instrumental partner in monitoring and tracking key performance indicators...
Location:
Houston, TX
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Associate's degree
Certifications/Licenses:
Federal legislation
Certified Registered Nurse
Preferred WorkKeys®
Applied Math
5
Graphic Literacy
4
Workplace Documents
5

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Benefit Consultant - Medicare
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Benefit Consultant - Medicare (2001307) To learn more about this position to see a video. "PLEASE NOTE: THIS IS A LICENSED SALES POSITION" Prospects for and enrolls eligible leads into the Medicare Advantage plans. Meets the minimum enrollment goal...
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Date
2020-02-26
Company
Universal American
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Location
Houston, TX
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About the job:
Benefit Consultant - Medicare (2001307) To learn more about this position to see a video. "PLEASE NOTE: THIS IS A LICENSED SALES POSITION" Prospects for and enrolls eligible leads into the Medicare Advantage plans. Meets the minimum enrollment goal of new members using approved presentation materials and sales techniques. Department: Sales Report To: Manager, Medicare Sales Location: Houston, TX 77081 Essential Functions: - Utilizes territorial model philosophy to maximize marketing efforts in attaining new enrollments. - Generates referrals utilizing community resources, supplied company...
Location:
Houston, TX
Job Type:
Full-Time
Permanent
Occupation:
Insurance Sales Agents
Salary:
Upper Middle Income Jobs ($50K-$79K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
Driver's License
Federal legislation
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
5
Workplace Documents
5

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Licensed Health Insurance Agent
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Licensed Health Insurance Agent (2001305) To learn more about this position to see a video. "PLEASE NOTE: THIS POSITION IS A LICENSED OUTSIDE SALES POSITION" Prospects for and enrolls eligible leads into the Medicare Advantage plans. Meets the...
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Date
2020-02-26
Company
Universal American
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Location
Baton Rouge, LA
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About the job:
Licensed Health Insurance Agent (2001305) To learn more about this position to see a video. "PLEASE NOTE: THIS POSITION IS A LICENSED OUTSIDE SALES POSITION" Prospects for and enrolls eligible leads into the Medicare Advantage plans. Meets the minimum enrollment goal of new members using approved presentation materials and sales techniques. Reports To: Manager, Medicare Sales Department: Sales Location: Baton Rouge, LA 70816 Essential Functions: - Utilizes territorial model philosophy to maximize marketing efforts in attaining new enrollments. - Generates referrals utilizing community...
Location:
Baton Rouge, LA
Job Type:
Full-Time
Permanent
Occupation:
Insurance Sales Agents
Salary:
Upper Middle Income Jobs ($50K-$79K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
Driver's License
Federal legislation
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
5
Workplace Documents
5

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Provider Relations Rep - Bowling Green, Kentucky
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Provider Relations Rep - Bowling Green, Kentucky (2001127) To learn more about this position to see a video. Manages provider Network performance for assigned territory with an account management approach. Achieves market performance targets...
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Date
2020-02-25
Company
Universal American
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Location
Bowling Green, KY
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About the job:
Provider Relations Rep - Bowling Green, Kentucky (2001127) To learn more about this position to see a video. Manages provider Network performance for assigned territory with an account management approach. Achieves market performance targets through the implementation and execution of Network transformation strategies in order to improve overall Network performance. Essential Functions: - - Owns and manages contractual relationship and performance of assigned in-network provider groups. Serves as primary point of contact for assigned providers. - Evaluates provider performance via Enterprise...
Location:
Bowling Green, KY
Job Type:
Full-Time
Permanent
Occupation:
Business Operations Specialists, All Other
Salary:
Upper Middle Income Jobs ($50K-$79K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A

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Benefit Consultant - Medicare
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Benefit Consultant - Medicare (2000954) To learn more about this position to see a video. Prospects for and enrolls eligible leads into the Medicare Advantage plans. Meets the minimum enrollment goal of new members using approved presentation...
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Date
2020-02-25
Company
Universal American
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Location
Chicago, IL
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About the job:
Benefit Consultant - Medicare (2000954) To learn more about this position to see a video. Prospects for and enrolls eligible leads into the Medicare Advantage plans. Meets the minimum enrollment goal of new members using approved presentation materials and sales techniques. Essential Functions: - - Utilizes territorial model philosophy to maximize marketing efforts in attaining new enrollments. - - Generates referrals utilizing community resources, supplied company tools, event planning and community networking. - Prospects for leads and converts leads into appointments. - Converts...
Location:
Chicago, IL
Job Type:
Full-Time
Permanent
Occupation:
Insurance Sales Agents
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
Driver's License
Federal legislation
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
5
Workplace Documents
5

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Chief Medical Officer - State
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Chief Medical Officer - State (2001278) Department: HI Health Services -State Reports to: State President Location: 949 Kamokila Boulevard Kapolei, HI 96707 The CMO is the senior physician leader in a WellCare Market. The main responsibilities will...
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Date
2020-02-25
Company
Universal American
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Location
Kapolei, HI
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About the job:
Chief Medical Officer - State (2001278) Department: HI Health Services -State Reports to: State President Location: 949 Kamokila Boulevard Kapolei, HI 96707 The CMO is the senior physician leader in a WellCare Market. The main responsibilities will be to improve the quality and cost of care for the members in the markets. Specifically, they work directly or in a matrix to ensure all members receive quality healthcare as measured by HEDIS and STARS. Additionally, they work with shared services and market staff to facilitate the care continuum for their members. The physician leader is an...
Location:
Kapolei, HI
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Board Certified
National Committee for Quality Assurance
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

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Financial Analyst
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Financial Analyst (2001293) In coordination with the Pharmacy Finance Team Lead, the Pharmacy Financial Analyst is responsible for compiling, analyzing, trending, tracking and interpretation of pharmacy data. This position will be responsible for...
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Date
2020-02-25
Company
Universal American
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Location
Tampa, FL
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About the job:
Financial Analyst (2001293) In coordination with the Pharmacy Finance Team Lead, the Pharmacy Financial Analyst is responsible for compiling, analyzing, trending, tracking and interpretation of pharmacy data. This position will be responsible for the support of the maximum allowable cost (MAC) program, including market surveillance, pricing analysis, and on-going, weekly updates. Report on development, benchmarking and other financial reporting activities that contribute to corporate reporting objectives, business solutions and recommendations. Department: Finance - Pharmacy Finance Reports...
Location:
Tampa, FL
Job Type:
Full-Time
Permanent
Occupation:
Financial Analysts
Salary:
Upper Middle Income Jobs ($50K-$79K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
5
Graphic Literacy
4
Workplace Documents
5

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Care Coordinator - (Healthcare Call Center experience - Bi
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Care Coordinator-(Healthcare Call Center experience-Bi-lingual English/Spanish preferred) (2000961) Provides administration and department support for care management and clinical teams. Coordinates services and performs administrative functions....
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Date
2020-02-25
Company
Universal American
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Location
Phoenix, AZ
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About the job:
Care Coordinator-(Healthcare Call Center experience-Bi-lingual English/Spanish preferred) (2000961) Provides administration and department support for care management and clinical teams. Coordinates services and performs administrative functions. Assists in completing activities related to various cross functional projects in support of departmental goals. DEPARTMENT: FL -PHS Management REPORTS TO: Supervisor, Care Coordination LOCATION: Phoenix, Arizona Essential Functions: - Responds to phones as assigned or team coverage as directed by Supervisor. - Provides technical and administrative...
Location:
Phoenix, AZ
Job Type:
Full-Time
Permanent
Occupation:
Medical Secretaries
Salary:
Middle Income Jobs ($30K-$49K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
3
Graphic Literacy
4
Workplace Documents
5

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Director, Collaborative Health System (CHS)
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Director, Collaborative Health System (CHS) (2001242) This position is responsible for the operational and financial performance for two or more Markets or Programs, including the following key areas: Achieving profit and loss goals for CHS...
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Date
2020-02-24
Company
Universal American
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Location
Houston, TX
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About the job:
Director, Collaborative Health System (CHS) (2001242) This position is responsible for the operational and financial performance for two or more Markets or Programs, including the following key areas: Achieving profit and loss goals for CHS Programs through delivery system transformation, establishing the local system of care and operational integration, prioritizing the health care transformation topics to fit local conditions, creating a lasting engagement with the CHS providers, enabling them to use data effectively to coordinate care and reduce inappropriate care, Leveraging CHS provider...
Location:
Houston, TX
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

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Business Analyst, Assoc
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Business Analyst, Assoc (2000753) Develops ad-hoc reports for data analysis to support initiatives. Identifies operational improvement opportunities through reporting, process and trend analysis. Regularly interacts with management to build skill...
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Date
2020-02-24
Company
Universal American
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Location
Detroit, MI
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About the job:
Business Analyst, Assoc (2000753) Develops ad-hoc reports for data analysis to support initiatives. Identifies operational improvement opportunities through reporting, process and trend analysis. Regularly interacts with management to build skill set to recommend next-level operational strategies. Report to: Sr Mgr, Cust Svcs Operations Department: RX - Call Center Location :777 Woodward Ave Detroit, MI Essential Functions: - Develops ad-hoc reports to conduct data analysis and validation. - Researches methodologies and conducts metric reporting. - Analyzes trends to recommend process and/or...
Location:
Detroit, MI
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
4

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Quality Improvement Sr. Project Manager (Provider 360) - Louisville, KY
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Quality Improvement Sr. Project Manager (Provider 360) - Louisville, KY (2001226) Location: (Louisville, KY) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement Supports the development and implementation of quality...
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Date
2020-02-24
Company
Universal American
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Location
Louisville, KY
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About the job:
Quality Improvement Sr. Project Manager (Provider 360) - Louisville, KY (2001226) Location: (Louisville, KY) Department: HS-Quality & Analytics Reports to: Sr. Director, Quality Improvement Supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies that impact plan compliance to regulatory and accreditation standards. Drives key quality improvement projects requiring the ability to work effectively in a matrix environment in order to receive needed data that reflects the overall health of the plan. Essential Functions: - -...
Location:
Louisville, KY
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
National Committee for Quality Assurance
Certified Registered Nurse
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

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Sr Mgr, Regulatory Affairs
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Sr Mgr, Regulatory Affairs (2001175) Provides strategic and tactical oversight and leadership to the managing of the regulatory needs of the Medicare/Medicaid Product Line across multiple states and regions. Oversees the coordination of the...
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Date
2020-02-24
Company
Universal American
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Location
Louisville, KY
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About the job:
Sr Mgr, Regulatory Affairs (2001175) Provides strategic and tactical oversight and leadership to the managing of the regulatory needs of the Medicare/Medicaid Product Line across multiple states and regions. Oversees the coordination of the day-to-day relationship with CMS/state Medicaid agencies, including, but not limited to, material development, submission and approvals, inquiry resolution, communication coordination and dissemination, compliance monitoring and auditing, policy and procedure development and maintenance, audit preparation and supervision, regulatory analysis, regulatory...
Location:
Louisville, KY
Job Type:
Full-Time
Permanent
Occupation:
Regulatory Affairs Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

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MGR, QUALITY IMPROVEMENT
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Mgr, Quality Improvement (2001128) Conducts oversight and management of Accreditation initiatives, state and regulatory quality compliance, HEDIS and quality improvement initiatives for PiPs, QiPs, QIA's, delegation audits and external quality...
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Date
2020-02-24
Company
Universal American
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Location
Chicago, IL
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About the job:
Mgr, Quality Improvement (2001128) Conducts oversight and management of Accreditation initiatives, state and regulatory quality compliance, HEDIS and quality improvement initiatives for PiPs, QiPs, QIA's, delegation audits and external quality reviews. Applies medical knowledge and analytical skills to effectively and efficiently coordinate quality activities and improve performance metrics of organizational goals. Department: Health Services Location: Chicago, IL Reports To: Senior Manager Quality Improvement Essential Functions: - - Develops, implements and maintains a standardized quality...
Location:
Chicago, IL
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Federal legislation
Certified Registered Nurse
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

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Care Coordinator
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Care Coordinator (2001208) Provides administration and department support for care management and clinical teams. Coordinates services and performs administrative functions. Assists in completing activities related to various cross functional...
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Date
2020-02-24
Company
Universal American
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Location
Tampa, FL
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About the job:
Care Coordinator (2001208) Provides administration and department support for care management and clinical teams. Coordinates services and performs administrative functions. Assists in completing activities related to various cross functional projects in support of departmental goals. DEPARTMENT: PHS - Case Mgmt. REPORTS TO: Supv., Care Coordination WORK SCHEDULE: Training will be Monday-Friday 8am - 5pm for 5 - 6 weeks; once successfully completed the work schedule would be Monday - Friday 9am - 6pm. Essential Functions: - Responds to phones as assigned or team coverage as directed by...
Location:
Tampa, FL
Job Type:
Full-Time
Permanent
Occupation:
Medical Secretaries
Salary:
Middle Income Jobs ($30K-$49K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
3
Graphic Literacy
4
Workplace Documents
5

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Business Technical Analyst, Sr - *Project Management - SQL*
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Business Technical Analyst, Sr - *Project Management - SQL* (2001156) Provides in-depth business knowledge and advanced technical support to one or more business areas through developed and ad hoc analysis/reporting , as well as designing and...
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Date
2020-02-24
Company
Universal American
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Location
Tampa, FL
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About the job:
Business Technical Analyst, Sr - *Project Management - SQL* (2001156) Provides in-depth business knowledge and advanced technical support to one or more business areas through developed and ad hoc analysis/reporting , as well as designing and programming complex, new processes/reports. Acts as subject matter expert for department or business unit on business systems/applications. Analyzes company functions, processes, and activities to improve computer-based business applications for the most effective use of money, materials, equipment, and people. Performs application/system design and...
Location:
Tampa, FL
Job Type:
Full-Time
Permanent
Occupation:
Computer Systems Analysts
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
4

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Provider Resolution Specialist
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Provider Resolution Specialist (2001158) Position is primarily responsible for answering escalated claim adjustment requests and resolving issues received through transferred provider phone calls, customer service management and miscellaneous...
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Date
2020-02-24
Company
Universal American
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Location
Phoenix, AZ
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About the job:
Provider Resolution Specialist (2001158) 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: Ops-Claims I Reports to: Supv. Operations Location: Phoenix, AZ Essential Functions: - - Answers CSR claim inquiries via live transfer and resolves issues real time - Thoroughly researches post payment claims and takes appropriate action to resolve them within turnaround time requirements and quality standards - Acts as...
Location:
Phoenix, AZ
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Salary:
Middle Income Jobs ($30K-$49K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
4

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Quality Practice Advisor (Associate Level)
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Quality Practice Advisor (Associate Level) (2000953) Establishes and fosters a healthy working relationship between community physician and small provider practices and WellCare. Educates providers and supports provider practice sites in regards to...
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Date
2020-02-22
Company
Universal American
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Location
Houston, TX
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About the job:
Quality Practice Advisor (Associate Level) (2000953) Establishes and fosters a healthy working relationship between community physician and small provider practices and WellCare. Educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS. Reports to: VP, CHS Market Operations Department: Health Services, ACO...
Location:
Houston, TX
Job Type:
Full-Time
Permanent
Occupation:
Medical Records and Health Information Technicians
Salary:
Middle Income Jobs ($30K-$49K)
Career Level/Education:
Postsecondary nondegree award
Certifications/Licenses:
Licensed Practical Nurse
Acute Care Nurse Practitioner
National Committee for Quality Assurance
Licensed Vocational Nurse
Licensed Clinical Social Worker
Family therapy
Certified Professional in Healthcare Quality
Certified HIPAA Professional
Licensed marriage and family therapist
Certified Coding Specialist
Licensed Master Social Worker
Advanced Practice Registered Nurse
ICD-10 / ICD-9
Certified Registered Nurse
Preferred WorkKeys®
Applied Math
3
Graphic Literacy
4
Workplace Documents
4

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CHS Network Development Mgr
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CHS Network Development Mgr (2000572) The Network Development Manager will be responsible for the recruitment of Primary Care Physicians, and Healthcare Specialists, and Ancillary Partners into the market programs. This role will be responsible for...
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Date
2020-02-22
Company
Universal American
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Location
Chevy Chase, MD
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About the job:
CHS Network Development Mgr (2000572) The Network Development Manager will be responsible for the recruitment of Primary Care Physicians, and Healthcare Specialists, and Ancillary Partners into the market programs. This role will be responsible for significantly growing market share and also for managing the contracting process to ensure compliance within CMS guidelines. The successful candidate will also lead marketing initiatives to current participants within the network that include creating and updated market-specific collateral to support the market growth plan, planning physician and...
Location:
Chevy Chase, MD
Job Type:
Full-Time
Permanent
Occupation:
Marketing Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
7
Graphic Literacy
5
Workplace Documents
5

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WorkKeys®

CHS Network Development Mgr
Quick view
CHS Network Development Mgr (2000572) The Network Development Manager will be responsible for the recruitment of Primary Care Physicians, and Healthcare Specialists, and Ancillary Partners into the market programs. This role will be responsible for...
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From LocalJobNetwork
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Date
2020-02-22
Company
Universal American
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Location
Baltimore, MD
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About the job:
CHS Network Development Mgr (2000572) The Network Development Manager will be responsible for the recruitment of Primary Care Physicians, and Healthcare Specialists, and Ancillary Partners into the market programs. This role will be responsible for significantly growing market share and also for managing the contracting process to ensure compliance within CMS guidelines. The successful candidate will also lead marketing initiatives to current participants within the network that include creating and updated market-specific collateral to support the market growth plan, planning physician and...
Location:
Baltimore, MD
Job Type:
Full-Time
Permanent
Occupation:
Marketing Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
7
Graphic Literacy
5
Workplace Documents
5

Display

Recommended

WorkKeys®

CHS Network Development Mgr
Quick view
CHS Network Development Mgr (2000572) The Network Development Manager will be responsible for the recruitment of Primary Care Physicians, and Healthcare Specialists, and Ancillary Partners into the market programs. This role will be responsible for...
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From LocalJobNetwork
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Date
2020-02-22
Company
Universal American
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Location
Frederick, MD
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About the job:
CHS Network Development Mgr (2000572) The Network Development Manager will be responsible for the recruitment of Primary Care Physicians, and Healthcare Specialists, and Ancillary Partners into the market programs. This role will be responsible for significantly growing market share and also for managing the contracting process to ensure compliance within CMS guidelines. The successful candidate will also lead marketing initiatives to current participants within the network that include creating and updated market-specific collateral to support the market growth plan, planning physician and...
Location:
Frederick, MD
Job Type:
Full-Time
Permanent
Occupation:
Marketing Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
7
Graphic Literacy
5
Workplace Documents
5

Display

Recommended

WorkKeys®

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