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Confidential
A company is looking for a Care Connector, Medicare. Key Responsibilities Provide program interventions and screen identified Members based on health management program guidelines Assist Members in accessing care and community resources, and...
Confidential
A company is looking for a Utilization Management Nurse (MLTC Focus) to perform clinical reviews for Managed Long-Term Care members. Key Responsibilities Conduct standard and expedited UM clinical reviews for inpatient, outpatient, and custodial...
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A company is looking for a HealthCare HEDIS Reporting Lead. Key Responsibilities Implement and monitor HEDIS project plans, ensuring compliance with NCQA and regulatory reporting requirements Collaborate with management to develop and manage...
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A company is looking for a Utilization Review Nurse - LPN (Remote). Key Responsibilities: Conduct concurrent and continued stay Utilization Management reviews, ensuring accurate data tracking, evaluation, and reporting Lead or participate...
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A company is looking for a Medicare Product Development Manager. Key Responsibilities Manage the creation and refresh of performance metrics, goals, and targets for Medicare Evaluate Medicare product development and new business opportunities...
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A company is looking for a Utilization Management Technician for weekends and off hours, working remotely. Key Responsibilities Coordinate, generate, and track incoming and outgoing correspondence, faxes, and authorizations related to...
