Location : North Miami, FL. Case Management Coordinator is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Case Management Coordinator will effectively manage a caseload that includes supportive and complex members. Develop a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Case Management Coordinators will determine appropriate services and supports due to member’s health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports. Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports.

Location (mandatory): Newark, DE 19713 Facilitate the authorization process by obtaining timely authorizations; sends Admit Forms to Admitting Department to confirm insurance; schedule patients for imaging procedures including submitting referral information; prepares documents for Multidisciplinary Clinic (MDC) and enters in the EMR.

Location: Woonsocket, RI 02895 (Hybrid) Responsible for developing and executing comprehensive marketing strategies that drive growth and enhance brand visibility and value perception for B2B stakeholders of Retail Pharmacy. This role involves people management, significant cross-functional collaboration, plus insight and evidence development to create effective marketing and sales materials that will resonate with target audiences.

Location: REMOTE in OH State Work Schedule: Schedule is Monday – Friday, 8am-5pm, standard business hours. No required holidays or weekends This role serves as the "Front desk" to the plan. This individual will work on a variety of administrative tasks to assist the Care Coordination department that may include but are not limited to, the inbound care management queue line, responding to questions and inquiries from both members/guardians or parties assisting with services. They will be responsible for taking referrals, confirming their Medicaid eligibility and processing the referral. This role will also complete Health Risk Assessments for all members assigned. It is imperative that the CMA must be able to practice both a high level of professionalism and compassion at all times when interacting with various departments or member representatives. The CMA will also support administrative needs that involve comfortability with working in complex data systems, an Electronic Record System and/or Excel at any given time. Tasks can change with little notice to meet the demands of the health plan requiring flexibility.

Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.

Case management experience required long term care experience preferred Microsoft Office including Excel competent

Location: Arlington and surrounding areas & SE Dallas and surrounding areas in TEXAS This role is working remotely; this position will require travel to meet in person with members around Service Delivery Area 75% of the time. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes

Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to the start of the assignment. Assist the HEDIS department with outreach calls to our Social Risk Factors population to close gaps in care.

Participates in the audit/overead of the medical record collection and review process for HEDIS quality reporting. Training will be provided prior to the start of the assignment. This position audits and interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and audits data populated within a data collection tool to support compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with databases and with conducting 100% of work activities on the computer.

Utility infrastructure upgrades - distribution voltages, Project management skills, budget and forecasting experience, communication. Utility, infrastructure, or construction type experience required. Electric utility experience preferred Experience with financial forecasting, managing a budget, contract management, reviewing plans, planning, scheduling, communicating, updating records and databases.

Location: San Antonio, TX 78251 Physician Assistants will work in collaboration with a dedicated clinical care team to provide evidenced-based care to a panel of patients. The clinical care team will work with the provider daily to drive better outcomes for entire panel of patients. This will include accurate assessment, diagnosis, treatment, management of health problems, health counseling, and disposition planning.

Location: San Antonio, TX 78251 The clinical care team will work with the provider daily to drive better outcomes for entire panel of patients. This will include accurate assessment, diagnosis, treatment, management of health problems, health counseling, and disposition planning. This role will be reported to the practice manager.