- Sharecare (Phoenix, AZ)
- **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 (Phoenix, AZ)
- …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
- IQVIA (Phoenix, AZ)
- …real world. **Position Summary:** AllCare Plus Pharmacy, an IQVIA company, is seeking a Care Manager ! Responsibilities will vary by program and its lifecycle. ... Care Manager 's may be responsible for contacting...assistance programs and/or varied adherence support. This is a ** remote ** position. **Hours:** Must be available for an 8… more
- CenterWell (Phoenix, AZ)
- …a part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a remote , telephonic environment, will be a vital part ... Nurse with a Bachelor of Science in Nursing (BSN) to join our team as a Care Manager , Telephonic Nurse 2. In this pivotal role, you will play a crucial part in… more
- System One (Phoenix, AZ)
- …sure to include the exact job title and job location in your email message. REMOTE WORK ( Eastern Time Zone business hours ) IBM PEM (Partner Engagement Manager ... Support Engineer : - Support integration and configuration of IBM Partner Engagement Manager (PEM) across the organization - Support and manage a system serving… more
- Prime Therapeutics (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …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
- Sedgwick (Phoenix, AZ)
- …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 (Phoenix, AZ)
- **Job Description** **Job Summary** The Lead Risk and Quality Performance Manager supports Molina's Risk & Quality Solutions (RQS) team by overseeing large programs ... quality strategies and solutions to close quality and risk care gaps. * Identify potential risks and execute mitigation...mastery of the drivers of value in managed health care as well as in-depth knowledge of the healthcare… more
- Molina Healthcare (Phoenix, AZ)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... through sequential transformations and identify opportunities to close quality and risk care gaps. * Proactively communicate risks and issues to stakeholders and… more
- Molina Healthcare (Phoenix, AZ)
- **Job Description** **Job Summary** The Sr Risk & Quality Performance Manager is a tactical execution role that will lead specific projects to support Molina's Risk ... through sequential transformations and identify opportunities to close quality and risk care gaps. * Identify potential risks and execute mitigation strategies. *… more
- The Cigna Group (Phoenix, AZ)
- …a defined territory of Colorado & Arizona with travel required in-region.** The Broker Manager at Individual and Family Plans (IFP) will be a critical team member ... health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the… more
- Highmark Health (Phoenix, AZ)
- …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 (Phoenix, AZ)
- …experience. + Operational Process Improvement experience. + 2-3 years of Managed Care experience. + Experience with Microsoft Project, Excel, Teams, PowerPoint and ... : * 5-7 years of Program and/or Project management experience.* Managed Care experience. * Experience working in a cross functional highly matrixed organization.… more
- SMBC (Phoenix, AZ)
- …policies and procedures for fraud review, as well as partner with Customer Care to establish similar policies and procedures around fraud interactions + As Fraud ... SME and advisor to Customer Care , build and maintain programs that incorporate best practices and adhere to applicable regulations: Red Flags, Identity Theft… more
- Molina Healthcare (Phoenix, AZ)
- …+ Understanding of complex configuration solutions + Advanced knowledge of health care benefits. + Advanced knowledge of healthcare claims and claim processing from ... receipt through encounter submission. + Ability to adopt and utilize work tracking software + Strong business writing skills; proficient user of Microsoft Products including Word, Excel, Outlooks, Teams, SharePoint, PowerPoint, and Visio + Advanced knowledge… more
- Molina Healthcare (Phoenix, AZ)
- …Education** Advanced clinical degree or advanced public health or health care administration degree **Preferred Experience** * State QI experience * Medicaid ... and/or Medicare QI + **Databricks** + **Development leading indicators and data visualization** + **Informatics** + **SQL** + **Power BI** **Preferred License, Certification, Association** * Black Belt in Lean/Six-Sigma To all current Molina employees: If you… more
- Sharecare (Phoenix, AZ)
- …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