The IT Business Analyst implements and supports business information systems by collaborating with stakeholders to define requirements and deliver strategic solutions. They also manage Genesys Cloud configurations and oversee project documentation throughout the software development lifecycle.
The Appeals Coordinator is responsible for processing, researching, and documenting appeal cases while ensuring compliance with regulatory standards and organizational guidelines. They also interface with members, providers, and internal teams to facilitate timely resolution and accurate determinations.
The Clinical Network Manager drives provider performance improvement and value-based care initiatives by analyzing data and developing targeted improvement plans. They also serve as a clinical liaison to enhance collaboration and lead provider education and network development efforts.
The provider will conduct in-home patient visits to perform assessments, manage chronic conditions, and develop individualized treatment plans. They will collaborate with an interdisciplinary team to ensure coordinated care and maintain accurate EMR documentation.
The Care Manager Clinician coordinates and oversees behavioral health services to ensure members receive appropriate, high-quality care while promoting engagement and recovery. They act as a central point of contact to integrate care management, utilization management, and collaborative partnerships to optimize health outcomes.
The clinician provides utilization management and care management for behavioral health and ASD services to eligible members. They conduct assessments, coordinate care among providers and families, and perform medical necessity reviews to ensure effective treatment.
The provider will conduct in-home clinical assessments, medication reviews, and chronic condition management for patients. They will also collaborate with interdisciplinary teams to ensure coordinated care and maintain accurate documentation in the EMR.
The Senior Healthcare Data Analyst will lead risk adjustment analytics for Medicare Advantage and commercial programs while partnering with clinical and operational teams to drive performance. They are responsible for constructing analytic datasets, producing dashboards, and evaluating the financial impact of strategic initiatives.
The provider will conduct in-home visits to perform assessments, manage chronic conditions, and develop individualized treatment plans for patients. They will also collaborate with interdisciplinary teams to ensure coordinated care and maintain accurate EMR documentation.
The provider will conduct in-home visits to perform assessments, manage chronic conditions, and develop individualized treatment plans for patients. They will also collaborate with interdisciplinary teams and maintain accurate EMR documentation to ensure coordinated care.
The Care Manager coordinates and oversees behavioral health services to ensure members receive appropriate, high-quality care while promoting engagement and recovery. They act as a central point of contact to integrate care management, utilization management, and collaborative partnerships.
The Care Access Coordinator manages administrative tasks, processes authorizations, and ensures efficient access to behavioral health services. They serve as a frontline resource for members and providers while triaging cases for clinical teams.
The Medical Coding Auditor conducts concurrent and retrospective audits to ensure coding accuracy and compliance. They provide feedback and collaborate with stakeholders to improve coding practices.
The Data Informatics Analyst transforms complex clinical and payer datasets into actionable insights to drive data-informed decision-making. They lead analytical initiatives, ensure data quality, and contribute to the evolution of enterprise data architecture.
