This position is responsible for performing LPN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care under the direction/supervision of an RN. Performs duties and types of care management as assigned by management. Responsibilities Performs the following job responsibilities under the direc

This position is responsible for helping to identify, secure, and maintain community based housing for MLTSS/SNP/Medicaid Members and for developing, articulating, and implementing a broader housing strategy within the Contractor to expand housing availability/options. The Housing Specialist(s) shall act as the Contractors central housing expert(s)/resource(s), providing

The Mgr, Health & Network Solutions (HNS) Implementation is responsible for leading implementation projects across multiple functional teams while ensuring delivery excellence, driving key business initiatives and solutions across the project while developing standard methodologies to improve efficiencies This individual will manage a team and serve as the primary point o

This position is responsible for managing, monitoring, supporting, and participating in the development/enhancements of distributive system management platforms. Job Description Resolve issues through level 3 in server, operating systems or other software under the control of the Distributed Systems management team Provide guidance to junior infrastructure analysts and fo

Under limited direction, this position is accountable for contributing to the efficiency of departmental operations through the performance of various administrative functions. This position reports to an officer of the company and may provide leadership to the departmental administrative team. Responsibilities Handle and disperse appropriate matters (i.e. email, memos, i

This position is responsible for resolution of escalated issues and audits of daily operations of the HR Shared Services Center. This position serves as back up to HR Shared Services Manager and will maintain confidential employee records on the Workday Human Resources Information System (HRIS). This position will provide HRMS support, customer service to employees, as we

This position ensures excellent customer service by responding in a timely, accurate and thorough manner to general requests. In addition this position is accountable for assisting in the preparation and analysis of data and for maintenance and initial reconciliation of accounts. Coordinate with Service and Billing to address customer inquiries related to Account Receivab

This position is responsible for performing behavioral health duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management. Responsibilities Assesses patient's behavioral health clinical need against established guidelines and/

Responsible for all workforce functions including budgeting, capacity planning, forecasting, scheduling and real time monitoring. Own and manage creation of leveryday tactical workload forecasting while continuously improving forecasting accuracy taking into consideration new hire classes, meetings, coaching product releases and key disruptions. Provide strategic insight

Responsible for conducting file audits for all areas of clinical operations. These audits review daily business practice compliance to regulatory compliance relative to NCQA, URAC and CMS. Responsibilities Conduct quarterly file audits for all lines of business against business Process Flows to determine compliance with regulatory standards according to NCQA, URAC and CMS

The Manager of Clinical Analytics is a managerial position requiring excellent leadership, communication, and data analytics technical skills. The position is a key team member collaborating in a multi disciplinary business environment with colleagues across the enterprise to support clinical performance analytics, development, and reporting that deliver actionable clinic

The Medical Economics Consultant provides support and consultation to the Medical Economics team through analyzing key business issues related to cost, utilization and revenue for all products at Horizon BCBS. This role will be responsible for the design and development of reports to monitor product performance and identify the root causes of medical cost trends. Responsi

The Financial/Accounting Analyst II will be assigned to the Corporate Finance department and will be responsible for Financial, Planning and Analysis and/or accounting responsibilities. The position will be accountable to support the management leadership team on multiples areas of the budgeting, forecasting and accounting areas. This includes working directly with large

Responsible for the daily management of staff and inventory to ensure delivery of exceptional customer service. Evaluate strengths and weaknesses of staff in order to foster a positive working environment which includes Daily evaluations, coaching and mentoring the business team in order to enhance staff performance levels for quality, production, and attendance while ens

Provide guidance and support including reviewing errors, and responding to audit inquiries for internal team members and outsourced staff. Conduct formal observations of business team members, while acting as a technical expert within the business unit. May serve as 'work leader'; mentor and coach new/more junior staff. May participate in on boarding, competency identific