Jobs: professional management enterprises

Job DescriptionJob DescriptionLooking for a Healthcare Case Manager III. Must be Bilingual (Chinese, Cantonese, Mandarin or Korean) and have MLTC, UAS Assessment and NY Medicaid policy experience. Must have a NY license. This position is fully remote, but the candidate MUST be licensed in the state of NY. The work schedule is M-F, 8:30am-5pm...

Job DescriptionJob DescriptionSeeking an RN with Managed Care and Utilization Management experience to review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria. This position is remote, but requires the candidate to reside in the state of S.C. and attend 1 week of mandatory training onsite, then it will be fully remote....

Job DescriptionJob DescriptionSeeking RN, LSW, LCSW, LPC or LCPC with LTSS experience to be responsible for health care management and coordination of members to achieve optimal clinical, financial and quality of life outcomes. MUST reside in the Springfield, IL area. This position is hybrid and will require field visits. Schedule M-F 8:00am-5:00pm.Day to...

Job DescriptionJob DescriptionPrimary Responsibilities:Selects, manages, develops, mentors and supports staff in designated department or regionDevelops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for resultsIn order to meet the unique needs of our members, have an intimate...

Job DescriptionJob DescriptionDescription:BKG Enterprises is seeking Medical Management Specialist to join our team This is a work-from home opportunity Responsible for providing non-clinical support to medical management operations, which includes handling the most complex file reviews and inquiries from members and providers. Provides mentoring and...

Job DescriptionJob DescriptionDescription:BKG Enterprises is seeking Medical Management Specialist to join our team This is a work-from home opportunity Responsible for providing non-clinical support to medical management operations, which includes handling the most complex file reviews and inquiries from members and providers. Provides mentoring and...

Job Description Job Description Seeking a RN to function as a Medical Affairs Coordinator . This position if fully remote. The schedule is M-F, 9am-5pm DUTIES: Ensures that the Local Coverage Determination (LCD) process adheres to contract instructions. Creates, implements, and maintains educational tools to help providers reduce the submission of claims for...

Job DescriptionJob DescriptionSeeking a Family Medicine Physician to conduct Chart Reviews via Telehealth. MUST LIVE IN SOUTH CAROLINA and be SOUTH CAROLINA board licensed in family medicine. Will be required to complete 2 hours per assigned NP per month for a total of 8 hours per month.DescriptionConduct a monthly Quality Chart reviews of a 10%...

Job DescriptionJob DescriptionSeeking a Recruiting Coordinator to partner with the TA Manager and the recruitment team to aid with hiring and on boarding of new employees. This is a remote position, but you MUST reside within the PST time zone. The work schedule is 8:00am to 4:30pm PST.Summary:ATS (ORC – Oracle Recruiting Cloud) admin. Support.Tier 1...

Job DescriptionJob DescriptionSeeking a Credentialing Specialist to be responsible for the completion of the initial credentialing and re-credentialing process of providers to the network. MUST Reside in SC. Fully remote after onsite training in Columbia, SC. The schedule is M-F 8:00a-4:30p.Job Essentials:Maintains credentialing database and ensures...

Job DescriptionJob DescriptionSeeking a Member Advocate to act as an advocate for the Member and a liaison between the Health Plan and Provider(s) to ensure availability and access to care. Establish a community presence, promote Member education, identify and resolve any systemic barriers that limit Members access to appropriate care. This is a hybrid...

Job DescriptionJob Description******************MUST LIVE IN INDIANA***************************We have an immediate need for some medical administrative coordinators.8-hour shift schedules during our normal business hours of 8:00am – 8:00pm EST, Monday – FridayPrimary Responsibilities:Manage administrative intake of membersWork with hospitals, clinics,...

Job DescriptionJob DescriptionSeeking a RN to function as a Medical Affairs Coordinator. This position if fully remote. The schedule is M-F, 9am-5pmDUTIES:Ensures that the Local Coverage Determination (LCD) process adheres to contract instructions. Creates, implements, and maintains educational tools to help providers reduce the submission of claims for...

Job DescriptionJob DescriptionPrimary Responsibilities:Selects, manages, develops, mentors and supports staff in designated department or regionDevelops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for resultsIn order to meet the unique needs of our members, have an intimate...

Job DescriptionJob DescriptionSeeking a Medical Assistant III to work under the supervision of the Clinic Administrator and to be cross trained to work in a variety of areas and functions, functions, including front office, back office, exam room support, and other areas as assigned. The schedule is M-F, 8-5 PST.Site location: MyHealth Everett15 SW...

Job DescriptionJob DescriptionWho we are:At NewStream Enterprises, LLC, we like to WIN, and have FUN doing so. We leverage our employee-owner mentality to continually improve our processes, our relationships, and our business. Transparency is one of our core company values. You will have the opportunity to see, learn, and understand all aspects of our...

Job DescriptionJob Description**Remote PositionWe are in need of a specialist with experience in medical referral experience to provide the following services:-Provide systems access to our client's Government associates, subcontractors, and government staff with appropriate on-line applications via security passwords and access levels to ensure system...

Job DescriptionJob Description**Remote PositionWe are in need of a specialist with experience in medical referral experience to provide the following services:-Provide systems access to our client's Government associates, subcontractors, and government staff with appropriate on-line applications via security passwords and access levels to ensure system...

Job DescriptionJob DescriptionDescription:Location: Indiana, USACompany: BKG EnterprisesAbout Us: BKG Enterprises is a leading healthcare organization committed to providing comprehensive care coordination services to our members. We are dedicated to optimizing member healthcare across the care continuum, ensuring individuals with chronic illnesses,...

Job DescriptionPrimary Responsibilities:Selects, manages, develops, mentors and supports staff in designated department or regionDevelops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for resultsIn order to meet the unique needs of our members, have an intimate understanding of...