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Position Purpose: Develops, assess and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective healthcare outcomes. Evaluates member service needs and de
Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Key Details:
Position Purpose: Lead the coordination of the office services activities and support services while providing administrative support to the entire corporation. Coordinate the day-to-day work function of Office Services, acting as lead person to include the overflow from Office S
Position Purpose: Leads the strategy, development, and execution of product, customer experience, digital and operational capabilities for the ICHRA business. Responsible for translating customer and market insights into scalable solutions, driving digital innovation, operational
Position Purpose: Supports community connection activities including connecting members to community resources to support their care management journey and provide necessary care resources in a cost-effective manner. Provides members with known community resources and supports th
Position Purpose: Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. - Learn various job functions within the Managed Care industry and explore various career opportunitie
Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Key Details:
Position Purpose: Direct and oversee regulatory compliance operations to ensure fully compliance with all applicable laws and regulations for assigned products/services. Key Details: The role is fully remote. Must be authorized to work in the U.S. without the need for employment
Position Purpose: Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and
Position Purpose: With the Corporate Quality and Affordability Initiatives Finance team, you will analyze complex financial information and translate data into meaningful insights that support business decisions. Independently lead financial projects and initiatives, partnering w
Position Purpose: Supervises the care coordination team that serves long-term care members to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management issues related to members or providers. Key Details: This is a remote pos
Position Purpose: Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits. Perform community activities related to clinical initiatives such as health fairs and communicate with agencie
Position Purpose: The Consumer Experience Analyst Sr. is responsible for utilizing a variety of analytical techniques, current system applications, consumer research data, call center and other ad hoc and system generated reports and other data sources within the organization to
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 care plans/service plans for long-term care members and educa
Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their fami
Position Purpose: Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical appropriateness. Monitors clinical effectiveness and efficiency of member's care in accordance with ABA guidelines. Key Details: Must
Position Purpose: Provide sales coverage and develop best possible market penetration for all products to present and prospective accounts in his/her assigned territory in accordance with company's policies and programs. Provide greater access to health insurance, by providing ed
Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their fami
Position Purpose: Support the product teams focus on offering quality, competitive product solutions for growth and retention of our Ambetter marketplace members. Support the annual Product Development Life Cycle for the Commercial Marketplace (Ambetter) products in all states, w
This position has a field component and requires the individual to live in TX. Position Purpose: Maintain partnerships between the health plan and the contracted provider networks serving our communities. Build client relations to ensure delivery of the highest level of care to