Duties:    • The primary purpose of the job is to:• As an individual contributor, the Behavioral Health Care Manager is responsible for the daily functions of the clinical department including triage of calls, care coordination and utilization management. • The Care Man...
Location: New Jersey, USA
Care Manager II Feb-20-2019
Duties: • Under the Supervision of the Manager of Care Management, the Care Manager is responsible for the overall accountability for the identification of members appropriate for care management services.  • Completes a comprehensive Initial Assessment and gathers pertinent informati...
Location: District of Columbia, USA
Care Manager II Mar-15-2019
The primary purpose of the job is to:• Under the Supervision of the Manager of Care Management, the Care Manager is responsible for the overall accountability for the identification of members appropriate for care management services.  • Completes a comprehensive Initial Assessment an...
Location: Pennsylvania, USA
Duties: • Under the direct supervision of the Supervisor, Pharmacy Services Call Center, the Pharmacy Call Center Technician is responsible for providing knowledgeable and courteous customer assistance and response to members, providers and Pharmacy Call Center Technician inquiries.  Princ...
Location: Pennsylvania, USA
Duties: • Describe the primary (most important) purpose of the job in no more than a paragraph to provide a solid overview of the essence of the job in seven sentences or less.• Performs administrative duties to support the Talent Acquisition team and the talent acquisition process, includ...
Location: Pennsylvania, USA
Software Development & Testing:• Develops using enterprise wide standard programming language(s)• Maintains existing code base and implements new features• Unit and system tests software to assure quality• Analysis & Design• Carries out systematic problem identificat...
Location: Pennsylvania, USA
Duties:• Under the general supervision of the Supervisor of Pharmacy Prior Authorization Technicians, the Pharmacy Services Technician I assist in the prior authorization process.• Reviews and approves physician inquiries for pre-authorization and medical necessity requests based on establ...
Location: Pennsylvania, USA
Duties: • Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. • Using clinical knowledge and nursing experience, the nurse reviews provider requests for inpatient and outpatient services, working closely with membe...
Location: Pennsylvania, USA
Care Connector May-08-2019
Duties: • The Care Connector is responsible for supporting the daily operations of integrated care management and utilization management program interventions.  • The Care Connector performs in a contact center environment, effectively processing calls from Members, Providers and othe...
Location: Delaware, USA
HR Assistant May-20-2019
Job Responsibilities: •  Maintains confidentiality at all times concerning all HR associates and activities.  • Performs HR customer service support by answering employee requests and questions via HRSC telephone or the HRSC mailbox. •  Serves as a contact for Associate...
Location: Pennsylvania, USA