in accordance with federal and state mandates, and credentialing criteria as outlined in the CommunityCare Managed Healthcare Plans...
and distributing materials. Communication and interpersonal skills need to represent CommunityCare’s brand and image. Performs...
and structure of CommunityCare’s utilization and care management programs. Serves as principal clinical advisor for medical...
JOB SUMMARY: The Medical Records Clerk Intern’s primary responsibility will be to submit records requests and retrieve medical records for risk adjustment and as needed for HEDIS projects. The records clerk monitors and documents record r...
JOB SUMMARY: Supervise and lead the Cost Containment team (which includes COB, TPL, Reinsurance, Refunds and Recoupments) and the Recalculations team, including management of performance, work schedules and related metrics. Resolve comple...
JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibi...
JOB SUMMARY: The Medical Records Clerk Intern’s primary responsibility will be to submit records requests and retrieve medical records for risk adjustment and as needed for HEDIS projects. The records clerk monitors and documents record r...
JOB SUMMARY: This position is a part of a team that provides support to Brokers via email and phone communication. Support is provided for billing/invoice inquiries, eligibility inquiries, claims inquiries, and benefit verification. As a ...
JOB SUMMARY: This position is a part of a team that provides support to Brokers via email and phone communication. Support is provided for billing/invoice inquiries, eligibility inquiries, claims inquiries, and benefit verification. As a ...
JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibi...
JOB SUMMARY: Supports the Company in the development and execution of business strategies through detailed research, data analysis, and strategic recommendations. This individual will work closely with cross-functional teams to assess mar...
JOB SUMMARY: The Provider Performance Specialist plays a key role in strengthening relationships between the health plan and its provider network by offering education, support, and guidance on performance improvement initiatives. This po...
The Compensation Analyst is responsible for supporting the development, implementation, and maintenance of the company's compensation programs. This role involves conducting market analysis, administering salary structures, preparing compen...
JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibi...
JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibi...
JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibi...
JOB SUMMARY: Responsible for being the first point of contact for all membership related questions, requests and concerns and for providing outstanding service to our customers. You will answer queries regarding customer benefits, eligibi...
JOB SUMMARY: Responsible for maintaining and supporting the Help Desk and new systems including network installations, personal computers support and maintenance, and infrastructure development. KEY RESPONSIBILITIES: Maintain help des...
JOB SUMMARY: Focus on the development and support of new and existing Database Management Systems (DBMS). Responsible for the design, development and implementation of new applications as well as maintaining and updating existing programs...
JOB SUMMARY: The Quality Improvement Stars Specialist is an integral part of the team, focusing on enhancing the performance of quality programs. This role requires a proactive individual who is adept at working collaboratively with provi...