Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating
Job Summary: The Clinical Care Manager-Massachusetts at CareSource/Commonwealth Care Alliance (CCA) is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs.
Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating
Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating
Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating
Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating
Job Summary: The Clinical Care Manager-Massachusetts at CareSource/Commonwealth Care Alliance (CCA) is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs.
Remote Prior Authorization Pharmacist Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe
Essential Duties and Responsibilities: - Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data. - Enter coded data into a system
Essential Duties and Responsibilities: - Lead and execute sensitive, high-risk investigations (e.g., harassment, discrimination, retaliation, serious misconduct), including matters involving senior leaders and significant organizational risk; gather evidence, conduct interviews, assess credibility, and document findings. -
Essential Duties and Responsibilities: - Lead the development and implementation of advanced sourcing and category management strategies through the RFx process. - Oversee the negotiation and development of contracts with new suppliers and/or renegotiate existing contracts to
Essential Duties and Responsibilities: - Make outbound calls and emails to military veterans and service members. Communicate with veterans and service members in a clear and empathetic manner, addressing their questions or concerns and keeping them