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American multinational healthcare company
Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's…
Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service…
Position Purpose: Manage and support the development of network performance analytics. Design and build solutions that create, maintain, interface, or transform data in order to support a complete business need around…
Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved.…
Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical…
Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of value,…
Position Purpose: Lead the development, coordination, and execution of operational strategies and process improvements across shared services to support enterprise and market‑level product growth, implementation, and…
Position Purpose: Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to…
Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. Key Details: Must be authorized to work in the U.S. without the need…
Position Purpose: Plan, organize, monitor, oversee and lead multiple, concurrent resultant projects for Centene's executive coaching program. Promote increased program efficiency, service levels, and value by…
Position Purpose: Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality,…
Position Purpose: Direct the implementation and administration of clinical program pilot research and development. Oversee integration of internal operations needed to ensure compliance with developed clinical programs…
Position Purpose: Manage vendor relationships and ensure vendor compliance with established internal and/or regulatory performance metrics. Accumulate, monitor, and report on vendor performance metrics to business unit…
Position Purpose: Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. Must be authorized to work in the U.S.…
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