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: ...
Overview: Responsible for being a support person and/or first point of contact for patients, staff, and guests presenting at the clinic, and performing all the administrative tasks associated with patient check in as well as administrativ...
Overview: The RN Triage position is responsible for conducting triage assessments for patients by seeking advice and medical services and assists in determining predictable healthcare needs of patients in a community healthcare center se...
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 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...
JOB SUMMARY: The Provider Relations Representative is the external-facing liaison between the health plan and its contracted providers. This role is responsible for onboarding new providers and delivering education on health plan policies...
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 being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibi...
JOB SUMMARY: In compliance with federal, state, and accreditation requirement, this position is responsible for overseeing activities and personnel involved in the day to day operations of grievance and appeals for all lines of business. ...