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California Licensed Clinical Review Nurse
Key Responsibilities Performs concurrent reviews to assess member health and appropriateness of care Evaluates quality and continuity of care, including discharge planning and resource usage Collaborates with healthcare providers and leadership toCalifornia Operations Support Manager
Key Responsibilities Manage operational teams for care review, case management, and health management activities Oversee team performance, provide coaching, and ensure staff training and development Facilitate interdepartmental collaboration to enhance...plan settings Managed Care operations experience is preferredNon-Clinical Appeals Specialist
finalize resolution letters while ensuring compliance with policies and procedures Required Qualifications Bachelor's degree from an accredited institution or relevant work experience High school diploma or GED with proven work experience in Managed Care...or Health Insurance Experience in appeals processing or claims processing is preferred Familiarity with care management systems, such as Salesforce or TruCare Demonstrated critical thinking and decision-making competenciesCalifornia Licensed Pediatric Nurse Manager
Key Responsibilities: Deliver coordinated, patient-centered virtual Care Management by telephone and video to improve Company outcomes Create impactful care plans with members and the care team to achieve desired goals Assist members in navigatingProduct Management Director
product roadmap, ensuring alignment with strategic goals Collaborate with cross-functional teams to translate requirements into actionable tasks and maintain product documentation Required Qualifications Bachelor's degree in Engineering, Business Administration..., Public Health, or a related field (Master's preferred) At least 5 years of experience as a Product Manager, preferably in the digital health sector Strong understanding of product management principles and Agile methodologies Experience in stakeholderMississippi Licensed Care Manager
resources Required Qualifications Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing 2 - 4 years of related experience Registered Nurse (RN) State Licensure and/or Compact State Licensure required Experience with foster care...and behavioral health preferredOklahoma Licensed Care Management Supervisor
Key Responsibilities Supervises the care management team and coordinates care for behavioral health members Monitors documentation for compliance and assigns caseloads based on requirements and member needs Evaluates team performance, provides feedback..., and assists with onboarding and training of team members Required Qualifications Master's degree or graduation from an accredited nursing school 4+ years of related experience in care management Licensed Clinical Behavioral Health ProfessionalOhio Licensed Psychiatry Manager
years of sales experience in the biotech/pharmaceutical industry, including 5+ years in sales management Demonstrated success in building sales teams in specialty pharmaceuticals, particularly in psychiatry or neurology Experience in Community Mental Health...Clinics, Long Term Care, or specialty pharmacy distribution is preferred Proven sales performance and experience with business systems and salesforce automation platforms Valid driver's license in good standingNew York Licensed Clinical Review Nurse
Key Responsibilities Performs concurrent reviews to determine member's overall health and appropriate level of care Reviews quality and continuity of care, including acuity level and discharge planning Collaborates with healthcare providers and MedicalQuality Program Strategist
resources and tools for HEDIS, CAHPS, and/or HOS to enhance member and provider experiences Required Qualifications Bachelor's degree in Nursing, Public Health, or a related field; Master's degree preferred 4+ years of clinical experience in managed care...or health insurance required; 2+ years of quality experience preferred Registered Nurse (RN), Licensed Practical Nurse, Licensed Vocational Nurse, or Licensed Clinical Social Worker (LCSW) preferred CPHQ certification preferred Must reside in EST
