Position Summary. The Population Health and Care Coordinator plays a critical role in overseeing chronic disease management, care coordination, complex case management, and programs aimed at improving quality of life and closing gaps in care for members within the manage care system. This position is responsible for coordinating, educating, and providing expertise to members across the continuum of care, from managing complex medical conditions t...
Position Summary. The Population Health and Care Coordinator plays a critical role in overseeing chronic disease management, care coordination, complex case management, and programs aimed at improving quality of life and closing gaps in care for members within the manage care system. This position is responsible for coordinating, educating, and providing expertise to members across the continuum of care, from managing complex medical conditions t...
Position Summary. The Population Health and Care Coordinator plays a critical role in overseeing chronic disease management, care coordination, complex case management, and programs aimed at improving quality of life and closing gaps in care for members within the manage care system. This position is responsible for coordinating, educating, and providing expertise to members across the continuum of care, from managing complex medical conditions t...
Position duties will be primarily performed in a specified territory. Position Summary. The Community Engagement Representative will directly assist the Director of Community Engagement in expanding Community Care Plans presence and brand awareness. This position will engage with community leaders, community, and faith-based organizations to collaboratively create meaningful and intentional engagement for the benefit of both the community and Com...
Job Details. Level. Entry. Job Location. Community Care Plan - Sunrise, FL. Position Type. Full Time. Salary Range. Undisclosed. Job Shift. Day. Position Summary. The Care Coordinator Aide (CCA) or Healthcare Navigator will play a crucial role in supporting the Care Coordination team within a health insurance plan by assisting in coordinating care, navigating healthcare services, and helping enrollees understand their health benefits. This positi...
Position Summary. The Manager of Health Equity and Population Insights plays a critical role in addressing healthcare disparities, improving health outcomes, and aligning organizational initiatives with value-based care objectives. This position leverages advanced analytics, program management expertise, and community partnerships to optimize outcomes for diverse populations, supporting the organizations mission to promote healthier communities. ...
P. OSITION. S. UMMARY. . This position is responsible for performing pre-payment audits and ensuring timely and accurate claim payments utilizing analytic reporting and coding software tools. E. SSENTIAL. D. UTIES AND. R. ESPONSIBILITIES. . Facilitates pre-payment audit reporting and payment posting process to ensure accuracy of payments being made to providers and facilities. Review and process claim audit coding reports on a daily basis to ensu...
Job Details. Level. Experienced. Job Location. Community Care Plan - Sunrise, FL. Salary Range. Undisclosed. Job Shift. Day. Description. Position Summary. Population Health Social Worker facilitates the psychosocial care of patients to ensure quality outcomes and appropriate utilization of health care resources. Is a key member of a multi-disciplinary team whose primary objective is to provide care coordination services to high-risk enrollees th...
Job Details. Level. Experienced. Job Location. Community Care Plan - Sunrise, FL. Position Type. Full Time. Salary Range. Undisclosed. Job Shift. Day. Description. Position Summary. The Utilization Management Nurse (UMN) works under general supervision of the Director and/or Manager/Supervisor of Medical Management, and in collaboration with the interdisciplinary team. The primary responsibilities are to perform the review of requests for servic...
Job Details. Level. Senior. Job Location. Community Care Plan - Sunrise, FL. Salary Range. Undisclosed. Job Shift. Day. Description. Position Summary. The Senior Business Intelligence Analyst (SBIA) is responsible for developing complex projects using T-SQL language with tools such as Microsoft SQL Server Reporting Services (SSRS). This role focuses on creating and deploying reports, dashboards, and visualizations to meet the organization’s repor...
Job Details. Level. Experienced. Job Location. Community Care Plan - Sunrise, FL. Salary Range. Undisclosed. Job Shift. Day. Description. Position Summary. Responsible for both the negotiation of provider contracts and ongoing education to the provider network in assigned market areas by performing the following duties. Essential Duties and Responsibilities. . Engage in open face to face dialogue with physicians to communicate/educate important i...
Job Details. Level. Management. Job Location. Community Care Plan - Sunrise, FL. Salary Range. Undisclosed. Job Shift. Day. Description. POSITION SUMMARY. The Manager of Utilization Management (UM) is a Registered Nurse (RN) who is responsible for all aspects of compliance related to utilization management and prior authorization across the continuum of care. Directly responsible for the supervision of the Utilization Management Nurses and Referr...
