Job Summary. The Community Based Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports and the population through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates care and service of the member through assessments, identificati...
Job Summary. The Community Based Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports and the population through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates care and service of the member through assessments, identificati...
Job Summary. The Community Based Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports and the population through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates care and service of the member through assessments, identificati...
Job Summary. The Community Health Worker participates as a member of the inter-disciplinary care team (ICT) to coordinate care for members. Essential Functions. Engage with the member in a variety of settings to establish an effective, professional relationship. Settings for engagement include but are not limited to. hospital, provider office, community agency, member's home, telephonic or electronic communication. Accompany members to appointmen...
Job Summary. The Community Based Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports and the population through culturally competent delivery of care and coordination of services and supports. Facilitates communication, coordinates care and service of the member through assessments, identificati...
Job Summary. The Health Plan Operations Analyst I reviews and analyzes the effectiveness and efficiency of existing market operation processes and systems and participates in development of solutions to improve or further leverage these functions. Essential Functions. Participates in the development of new market operation initiatives from concept to implementation and provide statistics measuring progress throughout. Market process issues. ID ca...
Job Summary. The Health Partner Engagement Manager is responsible for working closely with managers to build, manage and maintain health partner relationships. Essential Functions. Support Manager in meeting department financial cost savings goals. Prepare for and participate in various meetings (to include Joint Operating Committees, Operations Meetings and Association Meetings) with key health partners. develop and present data on health partne...
Job Summary. The Senior Manager, IT Digital Platform is responsible for shaping our Digital ecosystem. The role encompasses strategic oversight and hands-on management of critical people, processes, and tools that drive our Digital success. Essential Functions. Drive strong partnerships with our internal organizations aimed at enabling the Digital Solutions delivery teams. Partner with our Security experts and the Digital Solutions teams to make ...
The Quality Analyst II is responsible for analyzing and interpreting complex healthcare data. This role will collaborate with cross-functional teams, providing analytical insight to inform strategy and interventions to drive improved quality performance. HEDIS and Healthcare Experience Strongly Preferred. Essential Functions. Generate graphics that effectively describe, explore and summarize analyses for communication to appropriate parties. Resp...
Job Summary. The Manager, Medical Risk Adjustment Programs & Operations is responsible for managing performance, activities and SLAs of outside vendors who are partnered with for risk adjustment interventions. This position is full-time, remote. Essential Functions. Operates in a matrix environment influencing and managing collaborative risk adjustment initiatives with other internal functional groups. Manages day to day operations of internal Ri...
Job Summary. The Community Based Care Coordinator I - BH / SUD is the member concierge and is the single point of contact for assessment, person centered planning, service coordination (funded or unfunded), disease management, utilization management and transitions between all levels of care. Essential Functions. Understand and implement Person-Centered Thinking. Facilitate the Person-Centered planning process. Participate in person-centered care...
Job Summary. The Community Based Care Coordinator I - BH/SUD is the member concierge and is the single point of contact for assessment, person centered planning, service coordination (funded or unfunded), disease management, utilization management and transitions between all levels of care. Essential Functions. Understand and implement Person-Centered Thinking. Facilitate the Person-Centered planning process. Participate in person-centered care t...
