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Perform and lead various analysis and interpretation to link business needs and objectives for assigned function and implement process improvements. Lead the support of business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems Lead the identification and analysis of user requirements, procedures, and problems to improve exi
Posted 6 days ago
Provider Data Management Analyst I (1096496) Position Purpose Perform provider data management related activities based on plan and contract specifications and standard business rules includes data analysis and entry, review of data via internet sites and other systems, and usage of multiple systems and applications to validate data is complete and accurate. Enroll providers and practitioners into
Posted 20 days ago
Serve as a liaison between Customer Service Representatives CSRs), management and other various departments. Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner. Investigate and resolve complex claims matters in coordination with health plan and/or corporate departments Coordinate the day to day work functions, acting as a "go to" person and inves
Posted 20 days ago
Care Manager II (RN) Columbia, SC (1096457) Position Purpose Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term
Posted 24 days ago
Lead Account Manager (1095955) Position Purpose Lead sales and business development opportunities and the development of RFP's and expansion of new business. Lead the implementation, execution, termination, and transition of client accounts. Serve as the primary contact for complex and high dollar accounts, interacting with client contacts to facilitate problem resolution, and promote high client
Posted 1 month ago
Perform in home respiratory assessments to patients and educate them on the physician's treatment plan and medication regimen. Plan, perform and document the delivery of patient education services in accordance with policies and procedures Perform the initial respiratory assessment, environmental assessment, education presentation and basic respiratory questionnaire Perform follow up assessment an
Posted 1 month ago
Administrative Assistant III (1093999) Position Purpose Provides administrative and staff support to an organizational unit. Schedules appointments and travel arrangements, gives information to callers, and takes dictation Composes memos, transcribes notes, and researches and creates presentations Administers programs, projects, and/or processes specific to the operating unit served Communicates a
Posted 2 months ago
Care Manager I (RN) (1084036) Position Purpose Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past an
Posted 2 months ago
Care Manager II (RN) Columbia (1083433) Position Purpose Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goa
Posted 3 months ago
Field Care Manager I (RN) (1085894) Position Purpose Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, p
Posted 3 months ago
Care Manager I (RN) (1068724) Position Purpose Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past an
Posted 3 months ago
Care Manager I (RN) (1083435) Position Purpose Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past an
Posted 4 months ago
Care Manager I (RN) (1082425) Position Purpose Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past an
Posted 4 months ago
Health Net
- North Charleston, SC
Clinical Nurse Liaison (1078419) Position Purpose Serve as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams Implement and manage procedures for tracking, identifying and problem solving operational issues Interpret and present program results and develop data driven analysis and metrics used to measure effectiveness and ROI
Posted 6 months ago
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