Assist with care management for high medical risks / needs members with comorbid behavioral health needs As a Care Coordinator Assess members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered

Own the service experience of customers at the field level by working with the Regional Service Team and other matrix partners as required to ensure issues are resolved promptly and accurately meeting the customer's expectations Develop and maintain solid relationship with internal partners in Service Team to manage customer service experience Fully accountable for suppor

Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers Analyze financial impact of provider contracts (e.g., facility; physician; ancillary). Analyze financial impact of corporate initiatives (e.g., policy changes; healthcare affordability) or external regulations (e.g., healthcare reform) Analyze payment app

Assist with care management for high medical risks / needs members with comorbid behavioral health needs As a Care Coordinator Assess members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered

Contribute to strategic projects, ETL design and architecture, performance tuning activities, etc Responsible for supporting the architecture and design of the data warehouse, data marts and BI reports which will support various data initiatives Development of ETL code with our current toolset, Informatica, PL/SQL, Snowflake Stored Procedures, Azure Data Factory Perform a

Contribute and oversee strategic projects, ETL design and architecture, performance tuning activities, Code Reviews, and Best Practices Responsible for approving and certifying the architecture and design of the data warehouse, data marts and BI reports which will support various data initiatives Supervision of development of ETL code with our current toolset, Informatica

Are you a registered nurse looking for a unique opportunity focused on Home Health? We’re offering a six month paid residency with clinical training, mentorships, classroom training, and in field training for the role of Home Health Case Manager. There will be open positions throughout the year based on the needs of the agency. Primary Responsibilities Classroom tra

Work Life Balance/$10,000 Sign-On Bonus/Excellent Benefits/Fortune 5 Company!

Telecommute within Boston, MA/Fortune 5 Company/Excellent Compensation Package!

Assess, plan and implement care management interventions that are individualized for each member and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals for both healthcare and community based services; including but not limited to financial, psychosocial, community and state supportive services Develop and implement care

Build and maintain solid relationships with key brokers and others as necessary within the assigned territory Develops action plans and strategies to optimize Medicare sales Partner with the Community Developer (CD) and Sales Director (SD) to identify and develop relationships with individuals and organizations that influence the buying behavior of our target consumer (e.

Supervise the daily operations of NMC staff Be available to assist staff with risk calls or calls requiring additional consultation Coach and train current staff, deliver information to NMC team regarding new and changed procedures, policies, etc. Monitor and manage individual and team performance; offer constructive and positive feedback to team members and coaching for

Mainly handling inbound calling, NO knocking on doors Answer incoming phone calls from prospective members and identify the type of assistance and information the customer needs with the goal to convert the caller to a qualified lead and ultimately sale Ask appropriate questions and listen actively to identify specific questions or issues while documenting required inform

Work closely with Finance, Actuarial, and Affordability partners to develop financial projections and forecasts of expected savings from key affordability programs. Also, build comparisons of actual to expected results and develop explanations of variances Provide management with unbiased advice regarding medical cost strategy, including review of affordability programs s

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e