Care Coordinators manage a caseload of members to create individualized care plans and coordinate the delivery of medical and social services. They also provide education on benefits and partner with physicians and providers to ensure quality member care.
Care Coordinators manage a caseload of members to create individualized care plans and coordinate the delivery of medical and social services. They also provide education on benefits and serve as a primary contact for members to address questions and concerns.
The role involves conducting medical record reviews, clinical audits, and data abstraction to ensure compliance with regulatory and accreditation standards. It also requires providing clinical and coding expertise to support quality programs and educate internal and external partners.
The Strategic ACO Contract Manager is responsible for negotiating, drafting, and managing complex provider contracts to ensure competitive network performance and financial alignment. They also build and maintain strong relationships with healthcare providers while overseeing the full contract lifecycle and resolving disputes.
The Technology Delivery Manager oversees the end-to-end delivery of technical solutions by bridging the gap between software engineering, product teams, and business stakeholders. This role is responsible for managing workflows, resolving complex technical issues, mentoring staff, and ensuring projects are completed on time and within budget.
The coordinator performs intake, case entry, and routing for member and provider appeals and grievances to ensure timely and accurate processing. They also provide information regarding procedures and timelines while maintaining compliance with regulatory and organizational standards.
Care Coordinators manage a caseload of members to create individualized care plans and coordinate the delivery of medical and social services. They also serve as a primary contact for members, providing education on benefits and partnering with providers to track member progress.
The Coding Analyst II performs high-level coding, auditing, and analysis to ensure accurate application of medical coding standards within claims and operational workflows. They also collaborate with cross-functional teams to resolve coding-related issues and support data integrity and payment accuracy.
