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Position Purpose: Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regu

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose: Acts as a resource and supports the prior authorization request process to ensure that all authorization requests are addressed properly in the contractual timeline. Supports utilization management team to document authorization requests and obtain accurate and timely documentation

Position Purpose: Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regu

Candidates must reside in Mississippi. Standard schedule is Monday through Friday. Reviews inpatient admissions and elective procedures to determine medical necessity. Supports the Utilization Management team for Magnolia Health Plan. Position Purpose: Performs concurrent reviews, including determin

Position Purpose: Oversee operations, and business strategy utilizing cross-functional departments to meet strategic objectives. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not

Position Purpose: Conduct analysis, pricing, and risk assessment to estimate financial outcomes while supporting the Risk Adjustment team through data analytics, risk adjustment modeling, and complex data validation initiatives. Key Details: Candidates must have either 7+ years of actuarial experien

Position Purpose: The Senior Director, Healthcare Analytics leads analytic service delivery by aligning strategic objectives with the development of tools and capabilities and appropriate deployment of supporting analytic teams. The director serves in a leadership function spanning the needs of mult

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose: Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/careg

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose: Develop and maintain strategic partnerships between the health plan and contracted provider networks to advance value-based care initiatives, improve provider performance, and enhance member outcomes. Serve as a trusted advisor to providers and internal stakeholders by delivering d

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose:The Public Programs Coordinator is responsible for triaging and resolving member access to care issues and coordinating services with programs that are "carved out" of the health plan contract with the Department of Health Care Services, i.e. California Children's Services and Regio

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Key Details: This remote position

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through hom

Position Purpose: Apply all cash receipts into various systems and databases. Assist all major functions of the company including Accounts Payable and Billing. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship