Healthcare Member Services Specialist

Must be proficient in UMK2, QNXT and Pega platforms Must be able to manage multiple health plans and lines of business, and hold familiarity with all state regulatory requirements that Molina is present in Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and...

Job Description Job Summary Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. Knowledge/Skills/Abilities - Day to Day Management (both...

**Job Description** **Job Summary** Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. **Knowledge/Skills/Abilities** + · Day to Day...

Job Summary Provides customer support and stellar service to meet the needs of our Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values in their actions. Provides product and service information and identifies opportunities to improve our member and provider...

Job Duties - Responsible for all Member and Provider Services, including Workforce Management, Reporting, Data & Analytics, Quality Assurance, Business Solutions, Vendor Performance and Telephony across Medicaid, Medicare and Marketplace. - Develops and drives strategic initiatives, including operational excellence, in order to support growth as well as...

Job DescriptionJob Description Job Summary Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. Knowledge/Skills/Abilities Day to Day...

Job Summary Responsible for reviewing and resolving member & provider complaints and communicating resolution to members (or authorized) representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid. KNOWLEDGE/SKILLS/ABILITIES Enters denials and requests for appeal into information system and...

**RENOVO SOLUTIONS**: Our vision is to be a leading provider of Healthcare Asset Management Services and Life Science Asset Management Service, providing innovative services and effective solutions to the evolving challenges of modern medical equipment. To achieve this vision our **mission** is to foster a supportive work environment that encourages...

The Commercial Member Acquisition marketing team is looking for a dynamic marketing professional to join us as the Marketing Campaign Specialist, Senior - Member Acquisition. The team are passionate marketers at heart - driven to create the most compelling member experience so that Blue Shield is the health plan carrier of choice during open enrollment. The...

The Commercial Member Acquisition marketing team is looking for a dynamic marketing professional to join us as the Marketing Campaign Specialist, Senior - Member Acquisition. The team are passionate marketers at heart driven to create the most compelling member experience so that Blue Shield is the health plan carrier of choice during open enrollment. The...

Our client, a managed care company, is seeking a SALES SPECIALISTLocation: Long Beach, CA/ RemotePosition Type: ContractJob Responsibilities:The Sales Specialist role is responsible for assisting the sales team with performance updates. Performance updates include, but are not limited to field agent CRM documentation, lead management, Co-op, and submitting...

Mental Health America of Los Angeles (MHALA) has been a pioneer in mental health service, advocacy, innovation, and training for nearly a century, working to ensure that people with mental health needs achieve meaningful, healthy lives in their communities. MHALA is among the largest and most comprehensive nonprofit mental health agencies in Los Angeles...

Mental Health America of Los Angeles (MHALA) has been a pioneer in mental health service, advocacy, innovation, and training for nearly a century, working to ensure that people with mental health needs achieve meaningful, healthy lives in their communities. MHALA is among the largest and most comprehensive nonprofit mental health agencies in Los Angeles...

Covenant Physician Partners is hiring a Fulltime Patient Services Specialist at The De La Pena Eye Clinic located in Long Beach, CA.Please note the pay range for this position is$18-$20/hr.About the OpportunityWorkingMonday through Friday, 8:00 am to 5:00 pm, you have the opportunity to join a multi-site, multispecialty, state of the art group of providers...

**_Marketing Specialist II/Print Production Specialist (REMOTE)_** **Position Summary**: The Print Production Specialist is responsible for supporting the growth marketing operations team in developing mail plans and execution for prospect and member mailings. The Specialist will work closely with the Print Production Manager and cross-functionally with...

Job Description JOB DESCRIPTION Job Summary Manages the activities of the Data Analytics and Operations team. Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents reports and makes recommendations based on relevant...

Job DescriptionJob Description Job Summary Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings....

Job DescriptionJOB DESCRIPTIONJob Summary Answers telephonic calls from potential members who are interested in applying for Medicaid benefits. Assists by assessing the federal guidelines to see if the potential member qualifies for Medicaid benefits in the state of residence. Makes outbound calls to potential members who have submitted a request for...

Covenant Physician Partners is hiring a Fulltime Patient Services Specialist at The De La Pena Eye Clinic located in Long Beach, CA. Please note the pay range for this position is$18-$20/hr. About the Opportunity WorkingMonday through Friday, 8:00 am to 5:00 pm, you have the opportunity to join a multi-site, multispecialty, state of the art group of...

Job DescriptionJob DescriptionMental Health America of Los Angeles (MHALA) has been a pioneer in mental health service, advocacy, innovation, and training for nearly a century, working to ensure that people with mental health needs achieve meaningful, healthy lives in their communities.MHALA is among the largest and most comprehensive nonprofit mental health...