- Sharecare (Jackson, MS)
- **Job Description:** **Job Summary:** The Care Manager supports the implementation of the Value Based Care Management program in an appropriate and efficient ... telephonic Case or Care Management with CareFirst members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary care … more
- Highmark Health (Jackson, MS)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization,… more
- Prime Therapeutics (Jackson, MS)
- …and drives every decision we make. **Job Posting Title** Cognos Framework Manager - Remote **Job Description** Deliver against business intelligence objectives ... of effort and task dependencies as assigned by the Manager . + Provides technical guidance on the creation of...for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded… more
- Prime Therapeutics (Jackson, MS)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Manager Financial Systems - Remote **Job Description** The Manager , Financial ... for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded...and work collaboratively to provide the highest quality of care and service to our members. If you are… more
- Prime Therapeutics (Jackson, MS)
- …our passion and drives every decision we make. **Job Posting Title** Employer Account Manager - Remote **Job Description** The Account Manager is responsible ... for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded...and work collaboratively to provide the highest quality of care and service to our members. If you are… more
- Prime Therapeutics (Jackson, MS)
- …our passion and drives every decision we make. **Job Posting Title** Pharmacist Account Manager - New York Remote **Job Description** + Leads the development of ... and operational framework. + Revenue Generation - Works jointly with Account Manager to ensure revenue goals, administrative expenses are managed. + Develops strong… more
- Molina Healthcare (Jackson, MS)
- **_ Remote and must live in Mississippi _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network ... Tighter knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts including but not… more
- Sedgwick (Jackson, MS)
- …Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Client Performance Manager | Dedicated Client | Remote **PRIMARY PURPOSE** **:** ... Taking care of people is at the heart of...of everything we do, and we start by taking care of you, our valued colleague. A career at...the right candidate for this or other roles.** **Taking care of people is at the heart of everything… more
- Molina Healthcare (Jackson, MS)
- …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care , ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
- Molina Healthcare (Jackson, MS)
- **_ Remote and must live in Mississippi _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... purposes of establishing a sufficient network of Participating Providers to serve the health care needs of the Plan's patients or members. * Oversees and leads the… more
- Molina Healthcare (Jackson, MS)
- **_ Remote and must live in Mississippi _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network ... discuss and resolve issues related to utilization management, pharmacy, quality of care , and correct coding. * Independently delivers training and presentations to… more
- Highmark Health (Jackson, MS)
- …in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to ... coordinate care , and identifying various resources to assist members in...for additional support. + For assigned case load, create care plans to address members' identified needs, remove barriers… more
- Molina Healthcare (Jackson, MS)
- …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
- Molina Healthcare (Jackson, MS)
- …health. **Preferred License, Certification, Association** Active, unrestricted Transitions of Care Sub-Specialty Certification and/or Certified Case Manager ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
- Sharecare (Jackson, MS)
- …and accurately explains the VBCM program and schedules appointments between member and Care Manager using shared calendar. + Utilizes email to communicate ... individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com… more
- CDM Smith (Jackson, MS)
- …CDM Smith office, in the US nationwide. We offer in office, hybrid, or remote working environments allowing for flexible work options.** We currently have an opening ... other duties as assigned. **Job Title:** Senior Contract Administrator (fully remote work options) **Group:** FAO - Contracts **Employment Type:** Regular **Minimum… more
- Prime Therapeutics (Jackson, MS)
- …and drives every decision we make. **Job Posting Title** Project Director - Remote **Job Description** The Project Program Manager manages programs with complex ... programs, adhering to Prime's program, project and governance processes. The Project Program Manager will work with core and extended project team members to develop… more
- Prime Therapeutics (Jackson, MS)
- …every decision we make. **Job Posting Title** Employer Account Executive - Remote **Job Description** The Employer Account Executive serves as the primary ... relationship manager for multiple employer/administrative services only (ASO) accounts. This...environment **Preferred Qualifications** + PBM, health plan, or health care experience **Minimum Physical Job Requirements** + Ability to… more
- Prime Therapeutics (Jackson, MS)
- …make. **Job Posting Title** Sr Perimeter Network Engineer - Palo Alto - Remote **Job Description** The Systems Engineer Senior IT is responsible for constructing ... + Experience with Palo Alto Prisma Access, Strata Cloud Manager and Cloud Identity Engine + Regulatory compliance requirements...PCI, etc.) + Previous experience in PBM / health care industry + Understanding of security implications of domain… more
- Prime Therapeutics (Jackson, MS)
- …Posting Title** Senior Compliance Analyst (Regulatory Complaints & Inquires) - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... or other highly regulated industry, including experience with Medicare, Medicaid, and the Affordable Care Act (ACA) + Must be eligible to work in the United States… more