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: Responsible for promoting and enrolling eligible individuals in Medicare and Individual Health Plan products through outbound and inbound calls, individual appointments, community events, and educational seminars. KEY RESPO...
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: The Population Health Nurse Case Manager supports Population Health Management (PHM) by assessing member needs, coordinating care, and promoting improved health outcomes. This role works with members, caregivers, providers, a...
JOB SUMMARY: The Delphi Software Engineer is responsible for maintaining and modernizing the legacy Delphi application portfolio while leading migration to the new target environment: Azure cloud-native solutions built on C# (Function App...
JOB SUMMARY: The Registered Nurse (RN) for Stars Quality plays a critical role in promoting, protecting, and improving the health of the health plan's members. This role involves developing and implementing initiatives to manage chronic c...
JOB SUMMARY: Responsible for processing advanced enrollment and membership transactions, such as report review, transaction reconciliation, renewal and PCP routes, new group audits, system updates, correspondence, notices, prior coverage re...
JOB SUMMARY: The Analyst provides analytical support for all departments, including analysis, pricing, capitation, network and provider specific reporting. Analytical support includes creating and executing beginner and intermediate level...
Overview: The Medical Assistant (MA) – Multi-Specialty position presents an exciting opportunity for Medical Assistants to expand their knowledge and skill set in a Multi-Specialty Clinic environment. Under direction of licensed medical a...
JOB SUMMARY: The Senior Claims Examiner is responsible for reviewing and examining claims that require additional analysis prior to adjudication. Using established resources, technical knowledge, and sound judgment, the Senior Claims Exam...