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Case Manager- Health Homes Job ID 2013-22671 # Positions 1 Location US-NY-New York Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 5/8/2013 Additional Locations .. More information about this job: Summary: JOB SUMMARY : Responsible for managing members experiencing complex or catastrophic illness, high risk pregnancy, injury and/or specialty illnesses such as diabetes, HIV, transplant, behavioral health conditions, etc., to ensure cost effective and efficient utilization of health services. Conducts continuous skills assessment, planning, implementation, coordination,... more ->
Corporate Trainer II Job ID 2013-22632 # Positions 1 Location US-TX-Houston Search Category Human Resources Type Regular Full-Time (30+ hours) Posted Date 4/18/2013 Additional Locations .. More information about this job: Summary: Trains, coaches and mentors associates on their technical, professional and communication skills. Responsible for the development and delivery of initial and ongoing technical and professional skills training programs at all locations in the organization including, but not limited to Claims, the National Customer Care Center, Provider Relations, and the Health... more ->
Mgr Customer Care Job ID 2013-22526 # Positions 1 Location US-NY-Brooklyn US-NY-New York Search Category Customer Service Type Regular Full-Time (30+ hours) Posted Date 4/9/2013 Additional Locations US-NY-New York More information about this job: Summary: Provides leadership and direction for assigned Customer Service teams. Responsible for the achievement and maintenance of all performance goals for the assigned teams and contributing towards the attainment of business unit and Customer Service goals and objectives. Supports and develops supervisory team to manage, develop and retain staff.... more ->
Medical Director - Behavorial Health Job ID 2013-22785 # Positions 1 Location US-TX-Houston Search Category Medical Director Type Regular Full-Time (30+ hours) Posted Date 5/7/2013 Additional Locations .. More information about this job: Summary: AMERIGROUP CORPORATION MEDICAL DIRECTOR BEHAVORIAL HEALTH Houston Amerigroup is a Fortune 500 company serving approximately 2 million members in 14 states. Nationwide, we serve one out of every 35 Medicaid recipients and one out of every 25 kids covered by CHIP. We improve access to quality health care for our members while lowering costs for... more ->
Sr Case Specialist-Quality Management Job ID 2013-22663 # Positions 1 Location US-NY-New York Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 4/24/2013 Additional Locations .. More information about this job: Summary: Provide manage care and services to members. Coordinates services by facilitating, scheduling, and arranging a variety of treatment and services Completes authorizations, correspondence and manages phone queues within the designated department. Acts as resource to more junior Case Specialists Responsibilities: 1. Coordinates daily activities of the... more ->
Provider Relations Rep I Job ID 2013-22578 # Positions 1 Location US-TX-Houston Search Category Customer Service Type Regular Full-Time (30+ hours) Posted Date 4/15/2013 Additional Locations .. More information about this job: Summary: Serves as liaison to providers and is responsible for performing activities designed to establish and maintain positive and productive relationships with AMERIGROUP network providers. These activities include responding to inquiries from providers to clarify issues related to member benefits, claim resolution, appeal status, provider recruitment, and... more ->
Claims Processing Coach Job ID 2013-22624 # Positions 2 Location US-FL-Tampa Search Category Customer Service Type Regular Full-Time (30+ hours) Posted Date 5/2/2013 Additional Locations .. More information about this job: Summary: *Claims processing experience required* This position functions as a technical advisor for assigned customer service departments and supports management by assisting with training, coaching staff and monitoring performance and attendance. As the subject matter expert within the assigned unit, this position provides assistance to handle escalated and complex issues.... more ->
Mgr Health Care Mgmnt Services (OB/PEDI) Job ID 2013-22839 # Positions 1 Location US-TX-Houston Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 5/13/2013 Additional Locations .. More information about this job: Summary: Responsible for providing clinical supervision to a team responsible for coordinating member service, utilization, access, and concurrent review to ensure cost effective care management, utilization of health, mental health, and substance abuse services. Responsibilities: 1. Manages and oversees teams responsible for various HCMS functions including... more ->
Medical Coding Analyst Auditor-CPC Certified Job ID 2013-22662 # Positions 1 Location US-NY-New York Search Category Customer Service Type Regular Full-Time (30+ hours) Posted Date 4/24/2013 Additional Locations .. More information about this job: Summary: Provide development and maintenance of rules, policies and procedures, and educational processes focused on ensuring organizational compliance with industry standard coding practices. Interpret and apply National Uniform Billing Compliance rules, guidelines, laws and industry trends to support, provider reimbursement, system configuration... more ->
Mgr Claims Job ID 2013-22674 # Positions 1 Location US-TX-Houston Search Category Customer Service Type Regular Full-Time (30+ hours) Posted Date 4/24/2013 Additional Locations .. More information about this job: Summary: Provides leadership and day-to-day direction for production-related claims activities across all markets within the claims department, to include: claims processing and payment, management reporting and management and development of staff. Develops and implements policies, procedures and processes that ensure the timely payment of claims in accordance with contractual, State... more ->
Provider Relations Rep II Job ID 2013-22338 # Positions 3 Location US-NY-New York Search Category Customer Service Type Regular Full-Time (30+ hours) Posted Date 3/21/2013 Additional Locations .. More information about this job: Summary: Serves as liaison to providers (including physicians, hospitals, and/or ancillary providers) and internal departments at the health plan. Responsible for performing activities designed to establish and maintain positive and productive relationships with AMERIGROUP network providers for Medicaid and Medicare products. These activities include responding to... more ->
Outreach Associate - Star Plus - El Paso, Texas Job ID 2013-22801 # Positions 1 Location US-TX-El Paso Search Category Customer Service Type Regular Full-Time (30+ hours) Posted Date 5/8/2013 Additional Locations .. More information about this job: Summary: JOB SUMMARY : The Member Outreach Associate is responsible for providing support for Medicare quality initiatives and regulatory/contractual requirements. Support includes telephonic and in-person outreach to members who are identified as requiring outreach services. May provide assistance to quality management, and performance data... more ->
Utilization Manager RN Job ID 2013-22800 # Positions 1 Location US-NJ-Iselin Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 5/8/2013 Additional Locations .. More information about this job: Summary: JOB SUMMARY : Performs technical and administrative work required to evaluate the necessity, appropriateness and efficiency of the use of medical services procedures and facilities. Licensed RN responsible for clinical review of all acute and subacute services for appropriateness based on Interqual medical criteria. This individual is responsible for the management of... more ->
Case Manager RN Job ID 2013-22787 # Positions 1 Location US-NJ-Iselin Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 5/7/2013 Additional Locations .. More information about this job: Summary: JOB SUMMARY : The Case Manager RN is responsible for managing LEVEL III members experiencing complex or catastrophic illness, injury and/or specialty illnesses such as diabetes, HIV, transplant, etc., to ensure cost effective and efficient utilization of health services. She/he acts as a member advocate, seeking and coordinating creative solutions to member's health care needs... more ->
Behavioral Health Case Manager Job ID 2013-22757 # Positions 1 Location US-FL-Tampa Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 5/3/2013 Additional Locations .. More information about this job: Summary: *Licensed LCSW, LMHC, or RN required* Responsible for managing members experiencing complex or catastrophic illness, high risk pregnancy, injury and/or specialty illnesses such as diabetes, HIV, transplant, behavioral health conditions, etc., to ensure cost effective and efficient utilization of health services. Conducts continuous skills assessment, planning,... more ->
Mgr Health Care Mgmnt Services Job ID 2013-22255 # Positions 1 Location US-TX-Houston Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 4/22/2013 Additional Locations .. More information about this job: Summary: Responsible for providing clinical supervision to a team responsible for coordinating member service, utilization, access, and concurrent review to ensure cost effective care management, utilization of health, mental health, and substance abuse services. Responsibilities: 1. Manages and oversees teams responsible for various HCMS functions including utilization... more ->
AVP Quality Management - Plan Job ID 2013-22670 # Positions 1 Location US-NY-New York Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 4/24/2013 Additional Locations .. More information about this job: Summary: The AVP of Quality Management provides leadership in the development, coordination, implementation, and evaluation of the continuous quality improvement initiatives throughout the company in the areas of quality of care, quality of service, and provider/member satisfaction. Provides direction, leadership and education for compliance with NCQA standards to achieve... more ->
Case Manager RN (PEDI) Job ID 2013-22595 # Positions 1 Location US-TX-Houston Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 4/15/2013 Additional Locations .. More information about this job: Summary: Responsible for managing members experiencing complex or catastrophic illness, high risk pregnancy, injury and/or specialty illnesses such as diabetes, HIV, transplant, behavioral health conditions, etc., to ensure cost effective and efficient utilization of health services. Conducts continuous skills assessment, planning, implementation, coordination, monitoring and... more ->
Manager Health Care Management Services - Utilization Manager Job ID 2013-22592 # Positions 1 Location US-GA-Atlanta Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 4/15/2013 Additional Locations .. More information about this job: Summary: Responsible for providing clinical supervision to a team responsible for coordinating member service, utilization, access, and concurrent review to ensure cost effective care management, utilization of health, mental health, and substance abuse services. Responsibilities: 1. Manages and oversees teams responsible for various HCMS... more ->
Coordinator Quality RN- Fair Hearings Job ID 2013-22128 # Positions 1 Location US-NY-New York Search Category Nursing Type Regular Full-Time (30+ hours) Posted Date 4/26/2013 Additional Locations .. More information about this job: Summary: The Coordinator Quality Management RN - Plan is responsible for developing, coordinating, implementing, and evaluating the continuous quality improvement activities for assigned populations(s) according to the established Quality management program. In collaboration with and under the direction of either Plan or Corporate Quality leadership, this position... more ->