Coordinator, Managed Care I

Job Overview:We are seeking a dedicated Managed Care Coordinator I to support our team in delivering exceptional healthcare services. This role is primarily remote, with an initial training period conducted onsite. The successful candidate will possess strong computer skills and the ability to manage multiple tasks efficiently.Key Responsibilities:Evaluate...

We are currently hiring for a (RN) Managed Care Coordinator I UM to join BlueCross BlueShield of South Carolina. In this role as an (RN) Managed Care Coordinator I UM, you will review and evaluate medical or behavioral eligibility regarding benef Care Coordinator, Coordinator, Medical Director, Processing, Health, Clinical, Healthcare

Job OverviewWhy consider a career with BlueCross BlueShield of South Carolina? For over seventy years, we have established ourselves as a cornerstone of the health insurance landscape in South Carolina. Our strong presence in the community and our A.M. Best rating of A+ (Superior) underscores our commitment to excellence. As the largest health insurance...

Overview of the Care Coordinator RoleThe Care Coordinator role is pivotal in delivering care coordination services to individuals eligible for 1915(i) programs as outlined by the North Carolina Department of Health and Human Services. This position entails proactive engagement, comprehensive assessment, and effective care coordination to guarantee that...

Job Description: Required to be onsite the 1st week of training and then will go remote, will provide equipment no more than 2 hours from the client location. Monday-Friday, 8:30am - 5:00pm manager will conduct MS teams’ interviews Skill sets/qualities: Must have at least 2 years hospital experience, any other utilization review experience is great,...

Job Description: Mon-Fri 8:30-5. REMOTE Teams interview with two department members 1-week onsite training. NICE TO HAVE skill sets/qualities: Computer and typing skills are a must as we use several different programs and work remotely. Detail Oriented, Good Communication Skills, Time Management, Organization, Team Oriented, but able to work independently. ...

Job Overview:This position involves working Monday through Friday from 8:30 AM to 5:00 PM in a remote capacity. Candidates will participate in a virtual interview process with two members of the department, followed by a week of on-site training.Preferred Qualifications:Proficient computer and typing skills are essential, as multiple software applications...

Duties Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement,...

Duties Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement,...

Key ResponsibilitiesConducts assessments and evaluations of medical or behavioral eligibility for benefits and clinical criteria by leveraging clinical expertise, administrative policies, and established guidelines to service requests or implement health management interventions. Employs clinical knowledge and claims analysis to assess, plan, implement,...

Overview of the Care Coordinator RoleThe Care Coordinator position is essential for delivering care coordination services to individuals qualified for 1915(i) programs as designated by the North Carolina Department of Health and Human Services. This role encompasses proactive engagement, evaluation, and management of care to guarantee that members access the...

The Quality/Ticket Coordinator I, as part of a 24x7 Service Desk, perform the activities associated with the management of dedicated ticket queues to include prioritization of work and assignment to technical resources for resolution of end user concerns while ensuring service levels and objectives are met. Responsibilities include: -Monitoring dedicated...

Job Overview:This position involves working Monday through Friday from 8:30 AM to 5:00 PM in a remote capacity. Candidates will participate in a Teams interview with two members of the department, followed by a week of onsite training.Key Qualifications:Proficiency in computer usage and typing is essential, as multiple software applications are utilized in...

The Quality/Ticket Coordinator I, as part of a 24x7 Service Desk, perform the activities associated with the management of dedicated ticket queues to include prioritization of work and assignment to technical resources for resolution of end user concerns while ensuring service levels and objectives are met. Responsibilities include: -Monitoring dedicated...

Job DescriptionJob DescriptionPhoenix Home Care and Hospice is a leading provider of home care services in the Hospital & Health Care industry. We are currently seeking a motivated and compassionate In Home Care Coordinator to join our dedicated team in Columbia, Mo!As an In Home Care Coordinator, you will play a key role in ensuring the delivery of...

Job DescriptionJob DescriptionPhoenix Home Care and Hospice is a leading provider of home care services in the Hospital & Health Care industry. We are currently seeking a motivated and compassionate In Home Care Coordinator to join our dedicated team in Columbia, Mo!As an In Home Care Coordinator, you will play a key role in ensuring the delivery of...

Key Responsibilities:Project Planning and CoordinationCompile and analyze project requirements from clients and stakeholders to identify design process needs and schedule information flow.Monitor project progress to ensure timely issuance of deliverables.Site Visit ManagementAttend site visits to gather relevant information for proposal preparation.Ensure...

Empower Health. Serve with Empathy. Make an Impact.Position OverviewOversees targeted patient demographics to ensure efficient and effective healthcare delivery by adhering to Case Management standards as defined by the Case Management Society of America.Involves the coordination, facilitation, monitoring, and evaluation of interventions to achieve desired...

About the RoleWe are seeking a compassionate and skilled Registered Nurse to join our care team as a Nurse Care Coordinator. In this role, you will be responsible for evaluating patients and creating personalized care plans, while communicating effectively with patients, families, and the care team.Key ResponsibilitiesEvaluate patients and develop...

Position Overview:As a key member of the 24x7 Service Desk team, the Quality Coordinator I is responsible for overseeing the management of dedicated ticket queues. This role involves prioritizing tasks and allocating them to technical personnel to address end-user issues while ensuring that service levels and objectives are consistently achieved.Key...