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The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed. You can have life-changing impact on our Dual Eligible Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand DSNP to change lives in new markets across the country. Requires a New York state RN with unrestricted & active
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
This position is a full time remote teleworking role. This position is responsible for entering service authorization requests on behalf of our Case Management team. Service Authorization Associates promotes/supports quality effectiveness of healthcare services. Responsible for utilizing Aetna systems to review Plan of Cares, build authorizations and notify service providers. Maintains accurate and complete documentation of information and tasks completed to meet contractual and regulatory requirements.
Location: REMOTE o Manages the day-to-day activities of one complex project or multiple business-sponsored IT projects to deliver tasks on time, within budget, and within scope. o Responsible for the success of the project o Responsible for managing, directing and planning one complex or multiple less complex projects o Develops and manages all key project governance documents, such as the Project Charter, Workplan, Communications Plan, and Risk Mitigation Strategy o Manages the project budget, and reports project cost information in an accurate and timely manner o Proactively evaluates project activities, builds contingency plans, executes corrective action, and monitors issue resolutions to mitigate risks such as scope and/or budget variances o Monitors and reports tangible and intangible benefits, and conducts team and individual end-of-project performance reviews
Location: Tampa, FL (will service in Hillsborough, Highlands, Polk, Hardee, and Manatee 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.
Location - Newark DE. We are seeking a Material handler who will Perform activities related to the timely and efficient movement of materials (receipt, handling, storage, shipment) in a fast-paced production environment. Maintain a clean and safe work environment, consistently meet productivity metrics, and adhere to all company and departmental policies.
We are seeking a Paralegal who will work under the supervision of the Contracting Solutions Lead (CSL), work independently, reviewing, writing, and revising contract language consistent with internal guidance and assigned deadlines. Coordinate drafting, execution, and tracking of certain contract types as part of a large-scale project.
A Customer Service Representative will be responsible for answering incoming calls and emails from customers, assisting with order inquiries or issues, processing returns or exchanges, updating customer account information, and escalating more complex issues to the appropriate department if needed.
Location : Albany OR USA 97322 A Customer Service Representative will be responsible for answering incoming calls and emails from customers, assisting with order inquiries or issues, processing returns or exchanges, updating customer account information, and escalating more complex issues to the appropriate department if needed.
We are seeking a highly skilled Data Scientist with 10+ years of industry experience to join our team. The successful candidate will have a strong background in data analysis, statistical modeling, and data visualization, as well as excellent communication skills. Minimum Years of Experience: 10 +
Seeking a strong System / Machine Learning Engineer to join, an organization focused on making research breakthroughs in AI. Responsibilities includes Developing deep learning libraries that support large-scale distributed training, open sourcing high quality code and reproducible results for the community, and bringing the latest research to Meta products for connecting billions of users. The chosen candidate will work with a diverse and highly interdisciplinary team of scientists, engineers, and cross-functional partners, and will have access to cutting edge technology, resources, and research facilities.
We are seeking a highly skilled Data Engineer to join our team and provide data engineering support for the Enterprise Solutions organization. The successful candidate will have experience in data modeling design and implementation, ETL pipeline building, metrics design and creation, and dashboard/visualization building.