Location: The Villages, FL 32162 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.

Location: Callahan, FL 32011 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.

Location - Chattanooga, TN 37421. 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.

Location: Specific in OH area (Cincinnati - Butler, Clermont, Warren, & Hamilton Co. areas and Toledo region. Fulton, Wood, Ottawa, and Lucas Counties.) The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license

The ideal candidate will be reliable, thorough yet quick, and be comfortable with managing shipping supplies (ice, cooler boxes, gel packs, etc.).

The Care Management Associate supports comprehensive coordination of medical services including Care Team intake, screening and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services. This is a telework position and this position is assigned to Kentucky. Qualified candidates must reside in Kentucky. 5% - 10% travel is required to the Louisville office for meetings, training, and administrative duties.

Location: CAPE CORAL FL 33904 & ESTERO FL 33928 (FLOAT). This is a full-time contingent position, starting at 30 hours per week up to a possible 40 hours, and may require floating to other nearby locations and working alternating weekends.

Location: Remote in EST Time zone. •Works with internal staff across multiple departments to assist with data sources, processes and activities required to meet regulatory compliance requirements with a key focus on Utilization Review (UR) /Utilization Management (UM) • 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. •Data gathering requires navigation through multiple system applications. •Prior experience in performing data collection is preferred.

Location: Miami Dade, FL (ZIP CODES: 33010, 33012, 33013). Must be fluent in speaking Spanish, be able to have a full conversation The 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. The 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 support due to members’ health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and support.

Location: Trenton, NJ The care manager is responsible for assessing and evaluating members with potential care management needs through telephonic and face to face assessments in various settings, including the member’s private residence, hospitals, behavioral, and long-term nursing facilities. The care manager establishes a cost effective and member centric care plan in collaboration with the member, authorized care givers, and providers.

Profee coders who must know how to code ortho (with surgeries), cardio (with surgeries), ENT, primary care, and podiatry. E/M leveling & Injections/Infusions. A well rounded profee coder so they can pivot specialties as needed This type of coding involves evaluating and managing services provided in outpatient settings like physician offices, clinics, and other healthcare facilities. It focuses on services like office visits, consultations, preventive care, and follow-up appointments.

This position requires a bachelor's degree and 2-4 years of experience in healthcare administration, nursing, public health or in a related area. Managed care experience preferred. In collaboration with clinical and quality leaders, the Program Manager manages the implementation and administration of population health programs development, supports the state strategic pillars, drives improvements in health outcomes, and strengthens operational initiatives that are required under state contract, RFP, or other state/national standards. Reporting to Population Health Officer, the successful candidate will work directly with cross functional teams to ensure deliverables fall within the applicable scope, timeline and budget; coordinate with state, national and internal partners to ensure all programs are designed and delivered to meet goals, measures and outcomes with defined policies, procedures, workflow, training materials and reporting in accordance with corporate, state or other requirements.