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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..
Job ID 21000KZ6Available Openings 1 PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. Functions ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
Job Information Centerwell Healthcare Account Executive in Kennebunk Maine ... Maine As a Home Health Specialist , you will: Call on ... source audience is required. Previous healthcare sales experience..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
