Our PurposeWe work to connect and power an inclusive, digital economy that benefits everyone, everywhere by making transactions safe, simple, smart and accessible. Using secure data and networks, partnerships and passion, our innovations and solutions help individuals, financial institutions, governments and businesses realize their greatest potential. Our decency quotient, or DQ, drives our culture and everything we do inside and outside of our company. We cultivate a culture of inclusion for all employees that respects their individual strengths, views, and experiences. We believe that our differences enable us to be a better team - one that makes better decisions, drives innovation and delivers better business results.Job TitleSenior Data ScientistWho is Mastercard?Mastercard is a global technology company in the payments industry. Our mission is to connect and power an inclusive, digital economy that benefits everyone, everywhere by making transactions safe, simple, smart, and...
Jan 25, 2021
Our PurposeWe work to connect and power an inclusive, digital economy that benefits everyone, everywhere by making transactions safe, simple, smart and accessible. Using secure data and networks, partnerships and passion, our innovations and solutions help individuals, financial institutions, governments and businesses realize their greatest potential. Our decency quotient, or DQ, drives our culture and everything we do inside and outside of our company. We cultivate a culture of inclusion for all employees that respects their individual strengths, views, and experiences. We believe that our differences enable us to be a better team - one that makes better decisions, drives innovation and delivers better business results.Job TitleSenior Data ScientistWho is Mastercard?Mastercard is a global technology company in the payments industry. Our mission is to connect and power an inclusive, digital economy that benefits everyone, everywhere by making transactions safe, simple, smart, and...
We have new training classes, starting on February 16th and March 15th! Experian is the leading global information service company, providing data and analytical tools to clients, and support for consumers to understand and manage their credit. Experian unlocks the power of data to create opportunities for consumers, businesses, and society. At life's big moments - from buying a home or car to sending a child to college to growing a business exponentially by connecting it with new customers - we empower consumers and our clients to manage their data with confidence so they can maximize every opportunity. We gather, analyze, and process data in ways others can't. We help individuals take financial control and access financial services, businesses make smarter decisions and thrive, lenders lend more responsibly, and organizations prevent identity fraud and crime. We're investing in new technologies, talented people, and innovation so we can help create a better tomorrow....
Jan 24, 2021
We have new training classes, starting on February 16th and March 15th! Experian is the leading global information service company, providing data and analytical tools to clients, and support for consumers to understand and manage their credit. Experian unlocks the power of data to create opportunities for consumers, businesses, and society. At life's big moments - from buying a home or car to sending a child to college to growing a business exponentially by connecting it with new customers - we empower consumers and our clients to manage their data with confidence so they can maximize every opportunity. We gather, analyze, and process data in ways others can't. We help individuals take financial control and access financial services, businesses make smarter decisions and thrive, lenders lend more responsibly, and organizations prevent identity fraud and crime. We're investing in new technologies, talented people, and innovation so we can help create a better tomorrow....
The Opportunity: A seasoned professional with wide-ranging experience. Deals with diverse and often times complex issues, where analysis may require in-depth evaluation of many factors. Exercises judgment in evaluating methods and determines criteria for obtaining solutions. Collaborates with a broad group of internal and external stakeholders, often coordinating the activities of other employees. Networks with senior internal and external personnel in the area of expertise as well as some key contacts outside the area of expertise. Specialized in selling and promoting complex medical diagnostics capital equipment for a particular product line to customers in the territory. Implements sales plans designed to achieve established revenue and financial goals. Responsible for significant key partner relationship management and development. Responsible for IT strategy execution and evolution as market dynamics change. Works in coordination with Account Executives to call on...
Jan 23, 2021
The Opportunity: A seasoned professional with wide-ranging experience. Deals with diverse and often times complex issues, where analysis may require in-depth evaluation of many factors. Exercises judgment in evaluating methods and determines criteria for obtaining solutions. Collaborates with a broad group of internal and external stakeholders, often coordinating the activities of other employees. Networks with senior internal and external personnel in the area of expertise as well as some key contacts outside the area of expertise. Specialized in selling and promoting complex medical diagnostics capital equipment for a particular product line to customers in the territory. Implements sales plans designed to achieve established revenue and financial goals. Responsible for significant key partner relationship management and development. Responsible for IT strategy execution and evolution as market dynamics change. Works in coordination with Account Executives to call on...
Bigger challenges. Bolder ideas. Global impact. At Viasat, we're on a mission to deliver connections with the capacity to change the world. We're the company behind the world's fastest satellite internet service, with technology that's helping to bridge the digital divide and improve life for our customers around the globe. By providing powerful new ways for people to connect with one another, gain greater access to education, entertainment, medical research, commerce, and much more, our team is empowering millions of customers worldwide.We're looking for passionate, innovative professionals to join our team and connect the world to more. You'll work in a collaborative and inclusive environment that values diverse perspectives and continuous learning, and provides industry-leading benefits with unmatched opportunities for career growth. Our team is fearless in the pursuit of new ideas and uncompromising in our quest to become the world's first truly global Internet Service Provider....
Jan 23, 2021
Bigger challenges. Bolder ideas. Global impact. At Viasat, we're on a mission to deliver connections with the capacity to change the world. We're the company behind the world's fastest satellite internet service, with technology that's helping to bridge the digital divide and improve life for our customers around the globe. By providing powerful new ways for people to connect with one another, gain greater access to education, entertainment, medical research, commerce, and much more, our team is empowering millions of customers worldwide.We're looking for passionate, innovative professionals to join our team and connect the world to more. You'll work in a collaborative and inclusive environment that values diverse perspectives and continuous learning, and provides industry-leading benefits with unmatched opportunities for career growth. Our team is fearless in the pursuit of new ideas and uncompromising in our quest to become the world's first truly global Internet Service Provider....
Position Purpose: Receive, review and process Outpatient Treatment Requests (OTR) from providers as it relates to eligibility, benefits and authorization of services. Resolve issues and educate providers on policies and procedures. Review OTR for accuracy and completeness of data and interact with providers Perform research for OTR discrepancies as identified by providers Create member authorizations for approved outpatient therapy services Verify member eligibility and provider contracting/credentialing status prior to authorizing services Coordinate outpatient treatment requests with Care Coordination staff for out-of-network providers Coordinate with eligibility staff for member eligibility discrepancies and update system as necessary Coordinate outpatient treatment requests with Medical Management team for medical necessity Modify authorizations as needed to ensure transfer into claims payment system Identify and refer provider status discrepancies to Provider...
Jan 23, 2021
Position Purpose: Receive, review and process Outpatient Treatment Requests (OTR) from providers as it relates to eligibility, benefits and authorization of services. Resolve issues and educate providers on policies and procedures. Review OTR for accuracy and completeness of data and interact with providers Perform research for OTR discrepancies as identified by providers Create member authorizations for approved outpatient therapy services Verify member eligibility and provider contracting/credentialing status prior to authorizing services Coordinate outpatient treatment requests with Care Coordination staff for out-of-network providers Coordinate with eligibility staff for member eligibility discrepancies and update system as necessary Coordinate outpatient treatment requests with Medical Management team for medical necessity Modify authorizations as needed to ensure transfer into claims payment system Identify and refer provider status discrepancies to Provider...
Position Purpose: Manage the compliance department functions, including but not limited to, periodic monitoring and auditing activities based on established compliance program, policies, and practices to ensure and maintain compliance with federal, state, and local regulatory, contractual and legal requirements. Manage approval and submission of timely and accurate contract and regulatory required report deliverables Oversee all contracts updates including creating new and updating existing contracts with Health Plans, States and consultants/vendors Conduct periodic assessments to ensure compliance against contract requirements Oversee creation and implementation of corrective action plans to reduce or eliminate risk resulting from non-compliance with contract requirements or performance deficiencies Collaborate with Health Plans and States, where applicable, to maintain/improve customer satisfaction specific to delegated functions and compliance with contract...
Jan 23, 2021
Position Purpose: Manage the compliance department functions, including but not limited to, periodic monitoring and auditing activities based on established compliance program, policies, and practices to ensure and maintain compliance with federal, state, and local regulatory, contractual and legal requirements. Manage approval and submission of timely and accurate contract and regulatory required report deliverables Oversee all contracts updates including creating new and updating existing contracts with Health Plans, States and consultants/vendors Conduct periodic assessments to ensure compliance against contract requirements Oversee creation and implementation of corrective action plans to reduce or eliminate risk resulting from non-compliance with contract requirements or performance deficiencies Collaborate with Health Plans and States, where applicable, to maintain/improve customer satisfaction specific to delegated functions and compliance with contract...
Position Purpose: Oversee business operations, procurement opportunities, new product implementations and complex initiatives for business development utilizing cross-functional business units and corporate teams to meet business unit and corporate strategic objectives. Partner with multiple stakeholders and leadership to establish strategic visions, operational objectives, and policies and procedures ensuring compliance with state contracts, related laws, regulations and executive orders. Monitor and report achievement of committed action plans to senior management. Direct the development and implementation of operational work processes and systems with direct oversight for multiple departments within the business unit. Accountable for budget, revenue targets, and Profit & Loss. Lead and oversee new business implementation and procurement activities for all products and complex projects, including RFP responses. Evaluate program opportunities and recommendations for...
Jan 23, 2021
Position Purpose: Oversee business operations, procurement opportunities, new product implementations and complex initiatives for business development utilizing cross-functional business units and corporate teams to meet business unit and corporate strategic objectives. Partner with multiple stakeholders and leadership to establish strategic visions, operational objectives, and policies and procedures ensuring compliance with state contracts, related laws, regulations and executive orders. Monitor and report achievement of committed action plans to senior management. Direct the development and implementation of operational work processes and systems with direct oversight for multiple departments within the business unit. Accountable for budget, revenue targets, and Profit & Loss. Lead and oversee new business implementation and procurement activities for all products and complex projects, including RFP responses. Evaluate program opportunities and recommendations for...
Position Purpose: Oversee the Compliance Department Conduct compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements. Represent the key leadership position for compliance at the health plan, oversee communication, coordinate of policy development and ensure accurate and timely communication to all departments. Investigate instances of suspected fraud within the health plan and report to appropriate management and regulatory entities. Assist management with enforcement and discipline in appropriate instances of non compliance. Regularly inform health plan's Board of Directors of the status of and activities pertaining to compliance. Education/Experience: Bachelor's degree in related field or equivalent experience. 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State...
Jan 23, 2021
Position Purpose: Oversee the Compliance Department Conduct compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements. Represent the key leadership position for compliance at the health plan, oversee communication, coordinate of policy development and ensure accurate and timely communication to all departments. Investigate instances of suspected fraud within the health plan and report to appropriate management and regulatory entities. Assist management with enforcement and discipline in appropriate instances of non compliance. Regularly inform health plan's Board of Directors of the status of and activities pertaining to compliance. Education/Experience: Bachelor's degree in related field or equivalent experience. 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State...
Experian's client services delivery team is seeking a talented Senior Project Manager. This role will work closely with all departments during all stages of acquiring and onboarding enterprise customers. The Senior Project Manager will be responsible for working closely with our internal and external groups to ensure the customer's smooth transition from Sales to ongoing Account Development. About us, but we'll be brief Experian is the world's leading global information services company, unlocking the power of data to create more opportunities for consumers, businesses and society. We are thrilled to share that FORTUNE has named Experian one of the 100 Best Companies to work for . In addition, for the last five years we've been named in the 100 "World's Most Innovative Companies" by Forbes Magazine. Experian Partner Solutions helps businesses protect their consumers by building enterprise-level (1) identity, (2) credit, and (3) data breach cybersecurity SaaS...
Jan 23, 2021
Experian's client services delivery team is seeking a talented Senior Project Manager. This role will work closely with all departments during all stages of acquiring and onboarding enterprise customers. The Senior Project Manager will be responsible for working closely with our internal and external groups to ensure the customer's smooth transition from Sales to ongoing Account Development. About us, but we'll be brief Experian is the world's leading global information services company, unlocking the power of data to create more opportunities for consumers, businesses and society. We are thrilled to share that FORTUNE has named Experian one of the 100 Best Companies to work for . In addition, for the last five years we've been named in the 100 "World's Most Innovative Companies" by Forbes Magazine. Experian Partner Solutions helps businesses protect their consumers by building enterprise-level (1) identity, (2) credit, and (3) data breach cybersecurity SaaS...
Senior Site Reliability Engineer for Analytics & TradingRole/Department DescriptionThe SRE team is an exclusive group made up of some of the best engineers at FactSet, following the principles and practices laid out by Google and other hyper-scale technology organizations. These engineers provide critical assistance during widespread incidents as well as defining and building the key infrastructure, policies and processes required to further improve ongoing product stability at FactSet.Embedded SRE members focus on a specific Business Unit or Horizontal within FactSet. They work closely with the core SRE team to understand the tools, principles and processes being established and then work within their assigned business unit to apply them. The main responsibilities of this role are to drive the stability culture, assist with SBU specific critical events where appropriate and ensure we have an experienced dedicated resource within the business unit that can use their specific...
Jan 23, 2021
Senior Site Reliability Engineer for Analytics & TradingRole/Department DescriptionThe SRE team is an exclusive group made up of some of the best engineers at FactSet, following the principles and practices laid out by Google and other hyper-scale technology organizations. These engineers provide critical assistance during widespread incidents as well as defining and building the key infrastructure, policies and processes required to further improve ongoing product stability at FactSet.Embedded SRE members focus on a specific Business Unit or Horizontal within FactSet. They work closely with the core SRE team to understand the tools, principles and processes being established and then work within their assigned business unit to apply them. The main responsibilities of this role are to drive the stability culture, assist with SBU specific critical events where appropriate and ensure we have an experienced dedicated resource within the business unit that can use their specific...
Bayer Corporation
4537 S IH 35 Frontage Rd, Austin, TX 78744, USA
YOUR TASKS AND RESPONSIBILITIES The primary responsibilities of this role, Technical Agronomist IV, are to: Plan and execute field scale testing programs that include field testing of commercial Bayer seed products and ground breaker trials for new product launches from all platforms; Collaborate with seed dealers/growers to plant trials, collect required data, maintain and harvest trials; Provide technical support and training for seed dealers and Bayer sales team; Work with Bayer sales team to achieve local business objectives through technical support, consultation and training; Provide seed dealer support provided strategically based on business priorities; Establish and execute effective communication and training strategies with seed dealers; Provide technical information for seed, trait and chemistry products; Communicate agronomic positioning and benefits of seed and trait products and the benefits and uses of crop protection products;...
Jan 22, 2021
YOUR TASKS AND RESPONSIBILITIES The primary responsibilities of this role, Technical Agronomist IV, are to: Plan and execute field scale testing programs that include field testing of commercial Bayer seed products and ground breaker trials for new product launches from all platforms; Collaborate with seed dealers/growers to plant trials, collect required data, maintain and harvest trials; Provide technical support and training for seed dealers and Bayer sales team; Work with Bayer sales team to achieve local business objectives through technical support, consultation and training; Provide seed dealer support provided strategically based on business priorities; Establish and execute effective communication and training strategies with seed dealers; Provide technical information for seed, trait and chemistry products; Communicate agronomic positioning and benefits of seed and trait products and the benefits and uses of crop protection products;...
DLR Group is an integrated design firm that aspires to be the most creative enterprise on the planet. Our brand promise is to elevate the human experience through design. If that challenge is appealing, you're at the right place.
DLR Groupis seeking a National Business Development Leader for the Workplace Studio.
Locations:
Dallas, TX
Austin, TX
Role Summary
The Workplace National Business Development Leader (NBDL) is a business development role first and foremost. This person will be successful in forming new client relationships and winning work with the leading Fortune 500 corporate clients, national real estate developers and rapidly expanding companies who appreciate how good design can help them achieve their goals. The NBDL is a natural team player, great communicator, eager to make new client outreaches and form new relationships, a strategist and is a true ambassador of DLR Groups brand promise Elevate the Human Experience through Design. The NBDL will focus on...
Jan 22, 2021
DLR Group is an integrated design firm that aspires to be the most creative enterprise on the planet. Our brand promise is to elevate the human experience through design. If that challenge is appealing, you're at the right place.
DLR Groupis seeking a National Business Development Leader for the Workplace Studio.
Locations:
Dallas, TX
Austin, TX
Role Summary
The Workplace National Business Development Leader (NBDL) is a business development role first and foremost. This person will be successful in forming new client relationships and winning work with the leading Fortune 500 corporate clients, national real estate developers and rapidly expanding companies who appreciate how good design can help them achieve their goals. The NBDL is a natural team player, great communicator, eager to make new client outreaches and form new relationships, a strategist and is a true ambassador of DLR Groups brand promise Elevate the Human Experience through Design. The NBDL will focus on...
Position Purpose: Supervise the day to day operations of the utilization and case management areas Supervise day to day activities of the Referral Services department including work flow, training, hiring, etc. Assist providers, members and/or internal customers with cases pertaining to referral questions, issues and authorizations Reconcile pended claim issues in a timely manner per health plan/department procedure Review and process denial letters, maintain logs, and coordinate decisions to external or internal personnel per plan procedures Receive and review incoming phone and case management log reports and determine course of action Work with analysts and programmers in adapting and testing programs and procedures to adhere to our standard operating procedures Education/Experience: High school diploma or equivalent. 3+ years of prior authorization, physician's office, customer service, claims processing or provider relations experience preferably in a managed care...
Jan 21, 2021
Position Purpose: Supervise the day to day operations of the utilization and case management areas Supervise day to day activities of the Referral Services department including work flow, training, hiring, etc. Assist providers, members and/or internal customers with cases pertaining to referral questions, issues and authorizations Reconcile pended claim issues in a timely manner per health plan/department procedure Review and process denial letters, maintain logs, and coordinate decisions to external or internal personnel per plan procedures Receive and review incoming phone and case management log reports and determine course of action Work with analysts and programmers in adapting and testing programs and procedures to adhere to our standard operating procedures Education/Experience: High school diploma or equivalent. 3+ years of prior authorization, physician's office, customer service, claims processing or provider relations experience preferably in a managed care...
Centenehas an exciting opportunity for an experienced Project Manager II to join ourteam! Therole of the PM II will be to manage and oversee the tasks needed to develop,monitor, and ensure that all HEDIS Behavioral Health measures and activitiesare timely and on target. Our ideal candidate will have previous project management experiencewithin healthcare to include HEDIS and quality measures within a large,matrixed organization. Position Purpose: Plans, organizes, monitors, and oversees projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives. Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment, and closure. Utilize corporate and industry standard project management tools and techniques to effectively manage projects. Assist with establishment and maintenance...
Jan 20, 2021
Centenehas an exciting opportunity for an experienced Project Manager II to join ourteam! Therole of the PM II will be to manage and oversee the tasks needed to develop,monitor, and ensure that all HEDIS Behavioral Health measures and activitiesare timely and on target. Our ideal candidate will have previous project management experiencewithin healthcare to include HEDIS and quality measures within a large,matrixed organization. Position Purpose: Plans, organizes, monitors, and oversees projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives. Manage the full project life cycle including requirements gathering, creation of project plans and schedules, obtaining and managing resources, managing budget, and facilitating project execution, deployment, and closure. Utilize corporate and industry standard project management tools and techniques to effectively manage projects. Assist with establishment and maintenance...
Position Purpose: Receive, review and process Outpatient Treatment Requests (OTR) from providers as it relates to eligibility, benefits and authorization of services. Resolve issues and educate providers on policies and procedures. Review OTR for accuracy and completeness of data and interact with providers Perform research for OTR discrepancies as identified by providers Create member authorizations for approved outpatient therapy services Verify member eligibility and provider contracting/credentialing status prior to authorizing services Coordinate outpatient treatment requests with Care Coordination staff for out-of-network providers Coordinate with eligibility staff for member eligibility discrepancies and update system as necessary Coordinate outpatient treatment requests with Medical Management team for medical necessity Modify authorizations as needed to ensure transfer into claims payment system Identify and refer provider status discrepancies to...
Jan 20, 2021
Position Purpose: Receive, review and process Outpatient Treatment Requests (OTR) from providers as it relates to eligibility, benefits and authorization of services. Resolve issues and educate providers on policies and procedures. Review OTR for accuracy and completeness of data and interact with providers Perform research for OTR discrepancies as identified by providers Create member authorizations for approved outpatient therapy services Verify member eligibility and provider contracting/credentialing status prior to authorizing services Coordinate outpatient treatment requests with Care Coordination staff for out-of-network providers Coordinate with eligibility staff for member eligibility discrepancies and update system as necessary Coordinate outpatient treatment requests with Medical Management team for medical necessity Modify authorizations as needed to ensure transfer into claims payment system Identify and refer provider status discrepancies to...
Position Purpose: Accountable for aligning human resources strategy with business strategy. Drives the HR agenda, partnering closely with Centers of Expertise (COEs), HR Operations and business unit leaders to effectively and efficiently deliver HR processes and initiatives for a business unit. Drive the planning, review and execution of HR strategies for a mid-sized to large or complex business unit Align people strategies to business strategies, partnering with COEs, HR Operations & local business leaders Accountable for coordinating with local HRBPs to ensure global HR strategies are translated accurately and effectively to business unit and local markets Responsible for organizational design, workforce planning and leadership development within business unit Identify capability gaps in current workforce and set strategy to help address local business needs Facilitate talent reviews and succession plans, ensuring necessary action is taken to develop successors...
Jan 20, 2021
Position Purpose: Accountable for aligning human resources strategy with business strategy. Drives the HR agenda, partnering closely with Centers of Expertise (COEs), HR Operations and business unit leaders to effectively and efficiently deliver HR processes and initiatives for a business unit. Drive the planning, review and execution of HR strategies for a mid-sized to large or complex business unit Align people strategies to business strategies, partnering with COEs, HR Operations & local business leaders Accountable for coordinating with local HRBPs to ensure global HR strategies are translated accurately and effectively to business unit and local markets Responsible for organizational design, workforce planning and leadership development within business unit Identify capability gaps in current workforce and set strategy to help address local business needs Facilitate talent reviews and succession plans, ensuring necessary action is taken to develop successors...
Position Purpose: Responsible for providing oversight of the Care Management team and coordination of necessary resources for members. This may include adequate clinical, behavioral, acute/chronic, and social care services. Ensure staff is able to facilitate member and provider needs through entire care management cycle. Manage coordination of care challenges experienced by all members of different lines of business. Oversee clinical practice coaching activities to enhance service delivery for individual members, including clinical practice coaching at provider agencies through Provider Clinical Practice Coaches. Identify opportunities for cost savings and improved member outcomes for members shared with other payers. Promote integration of physical and behavioral health practices. Manage the coordination of care and transition of care activities for individual members and their families to achieve and maintain performance standards that meet or exceed contract...
Jan 20, 2021
Position Purpose: Responsible for providing oversight of the Care Management team and coordination of necessary resources for members. This may include adequate clinical, behavioral, acute/chronic, and social care services. Ensure staff is able to facilitate member and provider needs through entire care management cycle. Manage coordination of care challenges experienced by all members of different lines of business. Oversee clinical practice coaching activities to enhance service delivery for individual members, including clinical practice coaching at provider agencies through Provider Clinical Practice Coaches. Identify opportunities for cost savings and improved member outcomes for members shared with other payers. Promote integration of physical and behavioral health practices. Manage the coordination of care and transition of care activities for individual members and their families to achieve and maintain performance standards that meet or exceed contract...
Position Purpose: Responsible for providing oversight of the Care Management team and coordination of necessary resources for members. This may include adequate clinical, behavioral, acute/chronic, and social care services. Ensure staff is able to facilitate member and provider needs through entire care management cycle. Manage coordination of care challenges experienced by all members of different lines of business. Oversee clinical practice coaching activities to enhance service delivery for individual members, including clinical practice coaching at provider agencies through Provider Clinical Practice Coaches. Identify opportunities for cost savings and improved member outcomes for members shared with other payers. Promote integration of physical and behavioral health practices. Manage the coordination of care and transition of care activities for individual members and their families to achieve and maintain performance standards that meet or exceed contract...
Jan 20, 2021
Position Purpose: Responsible for providing oversight of the Care Management team and coordination of necessary resources for members. This may include adequate clinical, behavioral, acute/chronic, and social care services. Ensure staff is able to facilitate member and provider needs through entire care management cycle. Manage coordination of care challenges experienced by all members of different lines of business. Oversee clinical practice coaching activities to enhance service delivery for individual members, including clinical practice coaching at provider agencies through Provider Clinical Practice Coaches. Identify opportunities for cost savings and improved member outcomes for members shared with other payers. Promote integration of physical and behavioral health practices. Manage the coordination of care and transition of care activities for individual members and their families to achieve and maintain performance standards that meet or exceed contract...
Position Purpose: Accurately enter and process member provider selection requests and all other administrative operational tasks. Track and process various change requests forms and doctor selection requests received through the member portal and other system queues timely and accurately Process provider termination requests by performing membership moves and initiate termination letter requests to affected membership Manually process provider selections for members unable to assign through the health plan's auto assignment systematic process Track and report provider selection errors demonstrated by call center representatives Retrieve and process all incoming returned mail and fax requests Process all provider member dis-enrollment requests. Education/Experience: High school diploma or equivalent. 1+ years of data entry or general office experience. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are...
Jan 20, 2021
Position Purpose: Accurately enter and process member provider selection requests and all other administrative operational tasks. Track and process various change requests forms and doctor selection requests received through the member portal and other system queues timely and accurately Process provider termination requests by performing membership moves and initiate termination letter requests to affected membership Manually process provider selections for members unable to assign through the health plan's auto assignment systematic process Track and report provider selection errors demonstrated by call center representatives Retrieve and process all incoming returned mail and fax requests Process all provider member dis-enrollment requests. Education/Experience: High school diploma or equivalent. 1+ years of data entry or general office experience. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are...
Position Purpose: Oversee the infrastructure that coordinates necessary resources for members. This infrastructure may include adequate clinical, behavioral, acute/chronic, and social care services. Coordinate and communicate on access issues, assessments, internal Managed Care Organization (MCO) protocols and other key information with external stakeholders. Develop and implement appropriate policies and procedures; ensure staff are able to facilitate member and provider needs through entire case management cycle. Partner with internal staff on key initiatives and outreach for members as needed Create effective organizational structure, roles and jobs. Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives. Compile and review multiple reports on work function activities for statistical purposes, financial tracking purposes and for process improvement to identify trends, assist in financial...
Jan 20, 2021
Position Purpose: Oversee the infrastructure that coordinates necessary resources for members. This infrastructure may include adequate clinical, behavioral, acute/chronic, and social care services. Coordinate and communicate on access issues, assessments, internal Managed Care Organization (MCO) protocols and other key information with external stakeholders. Develop and implement appropriate policies and procedures; ensure staff are able to facilitate member and provider needs through entire case management cycle. Partner with internal staff on key initiatives and outreach for members as needed Create effective organizational structure, roles and jobs. Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives. Compile and review multiple reports on work function activities for statistical purposes, financial tracking purposes and for process improvement to identify trends, assist in financial...
