Group Health Cooperative of Eau Claire Jobs

Position Purpose. The Vendor Relations Manager leads and coordinates the Cooperative’s vendor management activities, ensuring compliance with federal and state regulations, contractual obligations, and internal policies. This role will coordinate vendor and contract reviews, conduct new vendor assessments, manage supplemental oversight activities, and lead First-Tier, Downstream, and Related Entity (FDR) oversight processes. Essential Functions. ...

Position Purpose. To proactively identify and engage potential clients and brokers. This is a dual role, specializing in highlighting the advantages of our commercial health plans, with opportunities to promote our Medicare Advantage offerings. The main goal of our Sales Representative is to close deals as well as increase our Medicare membership and expand our Medicare broker network. Essential Position Functions. Conduct all phases of the sales...

Position Purpose. The IT Helpdesk employee plays a crucial role assisting in the support, troubleshooting, and maintenance of IT systems. This position actively participates in daily Scrum stand-ups, collaborates with cross-functional team members, and follows Agile principles to contribute to efficient problem resolution and continuous improvement. IT Helpdesk staff provides assistance in diagnosing and resolving user issues, ensures adherence t...

Position Purpose. The IT Helpdesk employee plays a crucial role assisting in the support, troubleshooting, and maintenance of IT systems. This position actively participates in daily Scrum stand-ups, collaborates with cross-functional team members, and follows Agile principles to contribute to efficient problem resolution and continuous improvement. IT Helpdesk staff provides assistance in diagnosing and resolving user issues, ensures adherence t...

Position Purpose. With minimal supervision, assists to coordinate resources and educate the members that are enrolled in a disease management program. Relates effectively with others for continuity of care. maintains satisfactory relations with others, maintains accurate and complete records. Essential Position Functions. Makes outbound calls to members in a disease management program to provide support, education and assistance as the member mov...

Position Purpose. This position is responsible for promoting appropriate, effective and efficient use of health care resources via prior authorization review. The scope of this position includes using criteria sets and policy and procedures to review clinical care and treatment plans and out of network referrals to determine appropriateness. Essential Position Functions. Applies clinical experience, health plan benefit structure, health managemen...

Position Purpose. This position is responsible for promoting appropriate, effective and efficient use of health care resources via prior authorization review. The scope of this position includes using criteria sets and policy and procedures to review clinical care and treatment plans and out of network referrals to determine appropriateness. Essential Position Functions. Applies clinical experience, health plan benefit structure, health managemen...

Position Purpose. With minimal supervision. plans, directs, and evaluates total managed care options for members and functions as part of an interdisciplinary team in accordance with established philosophy. The population of membership includes those with chronic medical conditions as well as mental health and AODA issues. Relates effectively with others for continuity of care. maintains satisfactory relations with others, maintains accurate and ...

Position Purpose. With minimal supervision. plans, directs, and evaluates total managed care options for members and functions as part of an interdisciplinary team in accordance with established philosophy. The population of membership includes those with chronic medical conditions as well as mental health and AODA issues. Relates effectively with others for continuity of care. maintains satisfactory relations with others, maintains accurate and ...