Job Summary: The Stars Manager is responsible for leading the design, implementation, and continuous improvement of strategies to achieve and maintain superior CMS Star Ratings. This role serves as the key driver of cross-functional initi...
Overview: In collaboration with patients, families (as defined by the patient) and staff across all disciplines and departments is responsible for performing selected clinical duties including administrative/clerical duties, basic patient...
JOB SUMMARY: The Medical Records Clerk Intern’s primary responsibility will be to submit records requests and retrieve medical records for risk adjustment and as needed for HEDIS projects. The records clerk monitors and documents record r...
Overview: In collaboration with patients, families (as defined by the patient), and staff across all disciplines and departments will work with the Clinical Nutrition Manager to plan, implement, and evaluate diabetes related nutrition ser...
Overview: The Charge Review Specialist Senior works a part of a centralized Revenue Cycle team to process accurate code assignments for paper and /or electronic claims and required billing data elements prior to charges being processed fo...
JOB SUMMARY: The Senior Risk Adjustment Analyst leads advanced analytics, data governance, and operational processes that support accurate, compliant, and optimized risk-adjusted revenue across Medicare Advantage and ACA populations. This...
Overview: In collaboration with patients, families (as defined by the patient) and staff across all disciplines and departments is responsible for providing assistance in dispensing prescription medications to patients. Responsibilities: ...
JOB SUMMARY: Responsible for completing out-bound calls and other member outreach opportunities to select members and documenting efforts. This role spends 100% of time on quality program activities. May require extended, or multiple, pho...
JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other mem...
JOB SUMMARY: Responsible for maintaining and supporting the Help Desk and new systems, which includes network installations, personal computers support and maintenance, and infrastructure development. Provides support for Telecommunicatio...