Bayer's Cardiorenal division is undergoing an impressive growth trajectory and significant R&D investment. Bayer is committed to improving cardiorenal health both in the US and globally with currently available products and products in development, including investigational treatments for Chronic Kidney Disease (CKD), heart failure with reduced and preserved ejection fraction, and renal anemia. Given the profound burden of CKD in Type 2 Diabetes (T2D), Bayer is making significant investments in developing a treatment option for the disease. YOUR TASKS AND RESPONSIBILITIES The primary responsibilities of this residence-based role, Cardiorenal Sales Consultant - Detroit, MI, are to: Build and develop professional relationships with (but not limited to) cardiology, nephrology, endocrinology, primary care and pharmacy staff, within assigned customers; Drive appropriate utilization of approved cardiovascular (CV) products; Work closely with other Bayer commercial...
Jan 27, 2021
Bayer's Cardiorenal division is undergoing an impressive growth trajectory and significant R&D investment. Bayer is committed to improving cardiorenal health both in the US and globally with currently available products and products in development, including investigational treatments for Chronic Kidney Disease (CKD), heart failure with reduced and preserved ejection fraction, and renal anemia. Given the profound burden of CKD in Type 2 Diabetes (T2D), Bayer is making significant investments in developing a treatment option for the disease. YOUR TASKS AND RESPONSIBILITIES The primary responsibilities of this residence-based role, Cardiorenal Sales Consultant - Detroit, MI, are to: Build and develop professional relationships with (but not limited to) cardiology, nephrology, endocrinology, primary care and pharmacy staff, within assigned customers; Drive appropriate utilization of approved cardiovascular (CV) products; Work closely with other Bayer commercial...
YOUR TASKS AND RESPONSIBILITIES The primary responsibilities of this role, Precision Medicine Account Lead, are to: Lead a high-performance multidisciplinary account team to deliver an impactful customer experience in order to accelerate adoption, maximize access and drive revenue growth for VITRAKVI; Set performance objectives aligned to organizational and brand priorities, monitoring achievement of goals and ensure cross-functional alignment to achieve effective pull-through in targeted accounts; Champion collaboration and break down boundaries to mobilize the resources and solutions to deliver the vision, including engaging proactively Oncology Account Managers, Targeted Medicine sales team, Sales Leadership, Brand marketing, Access Strategy, Medical Affairs, GPO/Channel Directors, Payer Account Directors, Contract Strategy, Diagnostics, Field Reimbursement, Advocacy and Nurse Educators; Align and engage cross-functional team (incorporating medical,...
Jan 26, 2021
YOUR TASKS AND RESPONSIBILITIES The primary responsibilities of this role, Precision Medicine Account Lead, are to: Lead a high-performance multidisciplinary account team to deliver an impactful customer experience in order to accelerate adoption, maximize access and drive revenue growth for VITRAKVI; Set performance objectives aligned to organizational and brand priorities, monitoring achievement of goals and ensure cross-functional alignment to achieve effective pull-through in targeted accounts; Champion collaboration and break down boundaries to mobilize the resources and solutions to deliver the vision, including engaging proactively Oncology Account Managers, Targeted Medicine sales team, Sales Leadership, Brand marketing, Access Strategy, Medical Affairs, GPO/Channel Directors, Payer Account Directors, Contract Strategy, Diagnostics, Field Reimbursement, Advocacy and Nurse Educators; Align and engage cross-functional team (incorporating medical,...
Bayer's Cardiorenal division is undergoing an impressive growth trajectory and significant R&D investment. Bayer is committed to improving cardiorenal health both in the US and globally with currently available products and products in development, including investigational treatments for Chronic Kidney Disease (CKD), heart failure with reduced and preserved ejection fraction, and renal anemia. Given the profound burden of CKD in Type 2 Diabetes (T2D), Bayer is making significant investments in developing a treatment option for the disease. YOUR TASKS AND RESPONSIBILITIES The primary responsibilities of this residence-based role, Cardiorenal Sales Specialist - Detroit E, MI, are to: Build and develop professional relationships with (but not limited to) cardiology, nephrology, endocrinology, primary care and pharmacy staff, within assigned customers; Drive appropriate utilization of approved cardiovascular (CV) products; Work closely with other Bayer commercial...
Jan 26, 2021
Bayer's Cardiorenal division is undergoing an impressive growth trajectory and significant R&D investment. Bayer is committed to improving cardiorenal health both in the US and globally with currently available products and products in development, including investigational treatments for Chronic Kidney Disease (CKD), heart failure with reduced and preserved ejection fraction, and renal anemia. Given the profound burden of CKD in Type 2 Diabetes (T2D), Bayer is making significant investments in developing a treatment option for the disease. YOUR TASKS AND RESPONSIBILITIES The primary responsibilities of this residence-based role, Cardiorenal Sales Specialist - Detroit E, MI, are to: Build and develop professional relationships with (but not limited to) cardiology, nephrology, endocrinology, primary care and pharmacy staff, within assigned customers; Drive appropriate utilization of approved cardiovascular (CV) products; Work closely with other Bayer commercial...
Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census. Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member's attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs. Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the...
Jan 26, 2021
Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census. Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member's attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs. Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the...
Position Purpose : Provides facilitation, assessment, content development, teaching and monitoring of educational programs. Essential Functions: Teaches, facilitates and assesses training programs for in office and remote settings. Employs a variety of training methodologies, techniques, concepts, learning tools, and practices to ensure maximum effectiveness of training program. Manages group dynamics through the use of "learner focused" environment and adult accelerated learning methods. Produces professional presentations and training materials including facilitation guides, training aids, assessments, training activities and role play scenarios using MS Word, PowerPoint and other desktop publishing software. Revises existing training materials and programs based on audit results, questionnaires, changing procedures and feedback from internal/ external customers, subject matter experts, program sponsors and trainers. Coordinates and organizes enrollment of students,...
Jan 26, 2021
Position Purpose : Provides facilitation, assessment, content development, teaching and monitoring of educational programs. Essential Functions: Teaches, facilitates and assesses training programs for in office and remote settings. Employs a variety of training methodologies, techniques, concepts, learning tools, and practices to ensure maximum effectiveness of training program. Manages group dynamics through the use of "learner focused" environment and adult accelerated learning methods. Produces professional presentations and training materials including facilitation guides, training aids, assessments, training activities and role play scenarios using MS Word, PowerPoint and other desktop publishing software. Revises existing training materials and programs based on audit results, questionnaires, changing procedures and feedback from internal/ external customers, subject matter experts, program sponsors and trainers. Coordinates and organizes enrollment of students,...
Position Purpose :This position will provide the Health Plan Systems with a platform for real-time stream processing by performing application and production support to help ensure the availability of streaming services and the continuous flow of data. Contribute to the development and maintenance of real-time processing applications Contribute to the creation and maintenance of optimal data pipeline architectures Conduct maintenance and support for core infrastructure health, system upgrades, monitoring, CI/CD and logging Research streaming best practices and proper stream architecture Collaborate with team members to better understand existing data requirements and validation rules Analyze trends in data sets and contribute to the development of algorithms in order to improve upon the usefulness of raw data Education/Experience: Bachelor's degree in Computer Science, Computer Engineering, Software Engineering, related field or equivalent experience. Master's degree...
Jan 23, 2021
Position Purpose :This position will provide the Health Plan Systems with a platform for real-time stream processing by performing application and production support to help ensure the availability of streaming services and the continuous flow of data. Contribute to the development and maintenance of real-time processing applications Contribute to the creation and maintenance of optimal data pipeline architectures Conduct maintenance and support for core infrastructure health, system upgrades, monitoring, CI/CD and logging Research streaming best practices and proper stream architecture Collaborate with team members to better understand existing data requirements and validation rules Analyze trends in data sets and contribute to the development of algorithms in order to improve upon the usefulness of raw data Education/Experience: Bachelor's degree in Computer Science, Computer Engineering, Software Engineering, related field or equivalent experience. Master's degree...
Position Purpose: This position will provide the Health Plan Systems with a platform for real-time stream processing by performing application and production support to help ensure the availability of streaming services and the continuous flow of data. Execute streaming best practices and proper stream architecture Design, develop and maintain real-time processing applications Design, develop and maintain real-time data pipelines Develop tooling to monitor core infrastructure health. Perform system upgrades. Implement CI/CD and logging Analyze new streaming technologies from proof of concept to implementation Implement automation and self-service tools to streamline interaction with shared service infrastructure Education/Experience : Bachelor's degree in Computer Science, Computer Engineering, Software Engineering, related field or equivalent experience. Master's degree in Computer Science or Computer Engineering preferred. 3+ years of experience in Computer...
Jan 23, 2021
Position Purpose: This position will provide the Health Plan Systems with a platform for real-time stream processing by performing application and production support to help ensure the availability of streaming services and the continuous flow of data. Execute streaming best practices and proper stream architecture Design, develop and maintain real-time processing applications Design, develop and maintain real-time data pipelines Develop tooling to monitor core infrastructure health. Perform system upgrades. Implement CI/CD and logging Analyze new streaming technologies from proof of concept to implementation Implement automation and self-service tools to streamline interaction with shared service infrastructure Education/Experience : Bachelor's degree in Computer Science, Computer Engineering, Software Engineering, related field or equivalent experience. Master's degree in Computer Science or Computer Engineering preferred. 3+ years of experience in Computer...
LOCATION: THIS POSITION CAN SIT ANYWHERE IN THE U.S. AS LONG AS YOU HAVE AN ACTIVE, VALID, NO RESTRICTIONS NURSING LICENSE. Position Purpose: Perform review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations. Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews. Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, to coordinate member care Conduct discharge planning Educate providers on...
Jan 23, 2021
LOCATION: THIS POSITION CAN SIT ANYWHERE IN THE U.S. AS LONG AS YOU HAVE AN ACTIVE, VALID, NO RESTRICTIONS NURSING LICENSE. Position Purpose: Perform review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations. Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews. Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, to coordinate member care Conduct discharge planning Educate providers on...
Position Purpose : Perform review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations. Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews. Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, to coordinate member care Conduct discharge planning Educate providers on utilization and medical management processes Provide clinical knowledge and act as a clinical resource to non-clinical team staff Enter and...
Jan 20, 2021
Position Purpose : Perform review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations. Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews. Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, to coordinate member care Conduct discharge planning Educate providers on utilization and medical management processes Provide clinical knowledge and act as a clinical resource to non-clinical team staff Enter and...
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Jan 20, 2021
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Candidate must live in one of the following counties: Wayne, Macomb, Monroe, Lenawee, or Washtenaw. Preferably Wayne county. Position Purpose: Establishes and fosters a healthy working relationship between community physician and small provider practices and WellCare. Educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS. Under general guidance form Senior Quality Practice Advisors and management, educates community physician and small provider practices in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements. Collects, summarizes and trends provider performance data to...
Jan 20, 2021
Candidate must live in one of the following counties: Wayne, Macomb, Monroe, Lenawee, or Washtenaw. Preferably Wayne county. Position Purpose: Establishes and fosters a healthy working relationship between community physician and small provider practices and WellCare. Educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS. Under general guidance form Senior Quality Practice Advisors and management, educates community physician and small provider practices in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements. Collects, summarizes and trends provider performance data to...
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Jan 20, 2021
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Position Purpose: Identify special needs members through the completion of health screens and other resources. Work with community outreach/member advocates to coordinate member care. Educate providers and community resources on program components and available support services. Educate members with special needs to foster compliance with program and positively impact outcomes. Conduct site visits as appropriate for programs and provide support to other special programs. Assist with modification and management of care plans under the direction of a Registered Nurse in conjunction with member, medical consenter or caregiver, Department of Family and Protective Services (DFPS) caseworker and family, if applicable, as well as the managing physician. Provide support to medical, behavioral and social support staff to determine needs, eligibility and services for members. Conduct screening and risk assessment interventions per program guidelines. Education/Experience:...
Jan 20, 2021
Position Purpose: Identify special needs members through the completion of health screens and other resources. Work with community outreach/member advocates to coordinate member care. Educate providers and community resources on program components and available support services. Educate members with special needs to foster compliance with program and positively impact outcomes. Conduct site visits as appropriate for programs and provide support to other special programs. Assist with modification and management of care plans under the direction of a Registered Nurse in conjunction with member, medical consenter or caregiver, Department of Family and Protective Services (DFPS) caseworker and family, if applicable, as well as the managing physician. Provide support to medical, behavioral and social support staff to determine needs, eligibility and services for members. Conduct screening and risk assessment interventions per program guidelines. Education/Experience:...
Position Purpose: The Data Analyst (Healthcare Analytics) will have the opportunity to make a significant impact through the discovery, development, and implementation of leading-edge analytics that answer important business questions. The analyst will collaborate with key corporate and health plan business partners for the purpose of identifying and delivering robust reporting and analytics capabilities to drive improved business performance. Interpret and analyze data from multiple sources including claims, provider, member, and encounters data. Identify and assess the business impact of trends Develop, maintain, and troubleshoot complex scripts and reports developed using SQL, Microsoft Excel, or other analytics tools Contribute to the planning and execution of large-scale projects with limited direction from leadership Assist in the design, testing, and implementation of process enhancements and identify opportunities for automation Identify and perform...
Jan 20, 2021
Position Purpose: The Data Analyst (Healthcare Analytics) will have the opportunity to make a significant impact through the discovery, development, and implementation of leading-edge analytics that answer important business questions. The analyst will collaborate with key corporate and health plan business partners for the purpose of identifying and delivering robust reporting and analytics capabilities to drive improved business performance. Interpret and analyze data from multiple sources including claims, provider, member, and encounters data. Identify and assess the business impact of trends Develop, maintain, and troubleshoot complex scripts and reports developed using SQL, Microsoft Excel, or other analytics tools Contribute to the planning and execution of large-scale projects with limited direction from leadership Assist in the design, testing, and implementation of process enhancements and identify opportunities for automation Identify and perform...
Position Purpose: Learn various job functions within the Managed Care industry and explore various career opportunities Apply academic knowledge and learn new skills by contributing to various projects Research various legal, regulatory, and other topics within functional area and industry Attend training and development presentations to enhance professional competencies Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. Experience/Experience: High school diploma or equivalent. Must be enrolled in an undergraduate program at an accredited university or college, preferably in a field related to the hiring department through the internship period. Preferred Qualifications: Experience with Microsoft Outlook; Excel; PowerPoint; Project Management. Enrollment in Healthcare Administration, Public Health, Population Health or similar health related program....
Jan 20, 2021
Position Purpose: Learn various job functions within the Managed Care industry and explore various career opportunities Apply academic knowledge and learn new skills by contributing to various projects Research various legal, regulatory, and other topics within functional area and industry Attend training and development presentations to enhance professional competencies Learn about various processes and functions within the Managed Care industry and develop professionally by contributing to projects that support the business. Experience/Experience: High school diploma or equivalent. Must be enrolled in an undergraduate program at an accredited university or college, preferably in a field related to the hiring department through the internship period. Preferred Qualifications: Experience with Microsoft Outlook; Excel; PowerPoint; Project Management. Enrollment in Healthcare Administration, Public Health, Population Health or similar health related program....
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Jan 20, 2021
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Position Purpose: Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters Provide assistance to members and/or providers regarding website registration and navigation Educate members and/or providers on health plan initiatives Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiries Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application Process written customer correspondence and provide the appropriate level of follow-up in a timely manner Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment Identify trends related to member and/or provider inquiries...
Jan 20, 2021
Position Purpose: Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters Provide assistance to members and/or providers regarding website registration and navigation Educate members and/or providers on health plan initiatives Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiries Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application Process written customer correspondence and provide the appropriate level of follow-up in a timely manner Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment Identify trends related to member and/or provider inquiries...
Position Purpose: Assists with communication projects and provided administrative support ensuring accuracy, quality and compliance with state and federal guidelines. Candidate Education: Required A High School or GED Essential Functions: * Execute the day-to-day activities between the Managers, Communications Specialists and the Member & Provider Communications department to ensure project and material development expectations are met. * Open and close job tasks in communication workflow * Track and provide status of ICS, business owner and regulatory recommendations and approvals * Archive final versions of plan communications upon completion * Proof communications to ensure quality and brand standards are met * Maintain strong, positive, working relationships with business partners and Member & Provider communications colleagues. * Maintain a working knowledge of WellCare's state and federal contracts, products and benefits to ensure compliance and accuracy in...
Jan 20, 2021
Position Purpose: Assists with communication projects and provided administrative support ensuring accuracy, quality and compliance with state and federal guidelines. Candidate Education: Required A High School or GED Essential Functions: * Execute the day-to-day activities between the Managers, Communications Specialists and the Member & Provider Communications department to ensure project and material development expectations are met. * Open and close job tasks in communication workflow * Track and provide status of ICS, business owner and regulatory recommendations and approvals * Archive final versions of plan communications upon completion * Proof communications to ensure quality and brand standards are met * Maintain strong, positive, working relationships with business partners and Member & Provider communications colleagues. * Maintain a working knowledge of WellCare's state and federal contracts, products and benefits to ensure compliance and accuracy in...
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Jan 20, 2021
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Position Title: Guide the team on how to leverage Agile/Scrum practices and values to maximize the delivery of business value. Support and educate the Product Owner in applying the scrum framework and agile principles, and in particular the importance of refining and maintaining the product backlog. This is for one team. Manage the team to develop, capture and analyze metrics to facilitate team improvements. Protect the team from ant patterns. This is for one team. Train team on foundational team related ceremonies, mindset and best practices related to the team. This is done in the classroom setting and in groups for a team. Work with a Sr Scrum Master to learn from others experiences on your journey Facilitate and coordinate and encourage participation from all team members in scrum ceremonies (Scrum, Backlog Refinement, Sprint Planning, Sprint Review, and Retrospective) and longer term planning exercises (Road Mapping, Release Planning) and participation in ART ceremonies...
Jan 20, 2021
Position Title: Guide the team on how to leverage Agile/Scrum practices and values to maximize the delivery of business value. Support and educate the Product Owner in applying the scrum framework and agile principles, and in particular the importance of refining and maintaining the product backlog. This is for one team. Manage the team to develop, capture and analyze metrics to facilitate team improvements. Protect the team from ant patterns. This is for one team. Train team on foundational team related ceremonies, mindset and best practices related to the team. This is done in the classroom setting and in groups for a team. Work with a Sr Scrum Master to learn from others experiences on your journey Facilitate and coordinate and encourage participation from all team members in scrum ceremonies (Scrum, Backlog Refinement, Sprint Planning, Sprint Review, and Retrospective) and longer term planning exercises (Road Mapping, Release Planning) and participation in ART ceremonies...
