The Re-Entry Care Coordinator manages care transition activities for justice-involved individuals preparing for release from detention facilities. This role develops transition plans, aligns services across providers, and addresses barriers to ensure successful community integration.
The Re-Entry Care Coordinator manages transition activities for justice-involved individuals preparing for release from correctional facilities. This role involves developing transition plans, aligning services across community partners, and resolving barriers to ensure successful continuity of care.
The Occupational Therapy Assistant supports individuals in improving functional abilities by implementing treatment plans and assisting with clinical assessments. They monitor patient progress, document therapy activities, and provide training on adaptive techniques and equipment.
The Re-Entry Care Coordinator manages transition activities for justice-involved individuals preparing for release from correctional facilities. This role involves developing transition plans, aligning services across providers, and resolving barriers to ensure successful community integration.
The Care Manager serves as the primary point of contact for members, coordinating whole person-centered care across multidisciplinary teams. They are responsible for conducting comprehensive assessments and developing, implementing, and monitoring individualized care plans to address physical, behavioral, and social needs.
The Care Management Specialist I provides support to Care Managers by conducting member outreach, facilitating health literacy programs, and assisting with care plan implementation. They are responsible for scheduling services, documenting health updates, and connecting members to community-based resources.
The Utilization Management Specialist III performs clinical reviews of service authorization requests to determine the appropriate level of care. They also provide clinical consultation to providers and internal teams while participating in appeals and administrative hearings.
The Innovations Waiver Care Manager provides complex care coordination and monitoring for members with intellectual or developmental disabilities. They utilize person-centered planning to assess needs, educate members on rights, and facilitate access to community and Medicaid-funded services.
The Peer Support Specialist provides support and care coordination for individuals transitioning from incarceration to the community, focusing on behavioral health and social service needs. They work with care teams to facilitate linkages to housing, employment, and treatment services while utilizing person-centered planning strategies.
The Contract Specialist is responsible for drafting, reviewing, and coordinating contracts and agreements to ensure they meet organizational and regulatory requirements. They also monitor contract performance, track lifecycle activities, and verify contractor compliance.
The Compliance Specialist III conducts clinical reviews of pre- and post-payment claims to ensure adherence to regulatory and coverage requirements. They also manage compliance cases from intake through resolution, including investigating non-compliance and directing corrective actions.
The Medical Economics Analyst II performs analysis on rate trends and develops insights into key financial drivers for behavioral and physical health services. They are responsible for implementing payer analytics strategies and communicating findings to stakeholders to support rate initiatives.
The Systems Engineer II administers, maintains, and supports enterprise IT infrastructure, including network, server, storage, and data environments. They are responsible for monitoring system performance, implementing infrastructure upgrades, and ensuring business continuity through effective backup and recovery processes.
The Post Care Transitions Specialist provides comprehensive care coordination, including treatment planning, assessment, and monitoring for individuals with complex behavioral and physical health needs. They collaborate with clinical teams to facilitate successful transitions from inpatient units and adult care homes to community-based settings.
The Claims Specialist III manages and coordinates claim issues from providers and members via phone, email, and ticketing systems. They are responsible for researching claims, providing technical assistance, and drafting communications to ensure timely resolution of inquiries.
The Peer Support Specialist provides care coordination and support to individuals with behavioral health or intellectual disabilities transitioning from incarceration back into the community. They educate members on navigating social and justice systems while facilitating linkages to housing, employment, and treatment services.
The Compliance Specialist I manages records, processes internal and external requests, and maintains documentation to ensure regulatory compliance. They also respond to inquiries regarding confidentiality and assist with the coordination of compliance-related meetings.
The Licensed Supervisor oversees a team providing integrated, person-centered care coordination within a managed care environment. Responsibilities include staff supervision, performance management, training facilitation, and ensuring compliance with regulatory standards.
The Claims Specialist II performs data analysis, auditing, and finalizes adjudication results for claims designated for pre-payment and post-payment review. They also provide technical assistance to providers and communicate with stakeholders to facilitate efficient claims resolution.
The Claims Manager leads claims, analysis, and enrollment operations while ensuring team performance, data integrity, and regulatory compliance. This role directs claims adjudication, reporting, and reimbursement activities while coordinating cross-functional efforts to improve operational efficiency.
The Population Health Program Nurse identifies and enrolls members into population health programs using data informatics to improve clinical outcomes. They work within an interdisciplinary team to develop interventions, provide health education, and coordinate care plans for members with complex needs.
The Care Manager provides complex care coordination and monitoring for members with intellectual or developmental disabilities, mental health needs, or substance use disorders. They utilize person-centered planning to assess needs, ensure adherence to waiver requirements, and facilitate multi-disciplinary collaboration.
The Occupational Therapist leads clinical operations and provides supervision to staff to ensure effective service delivery and rehabilitation outcomes. They conduct clinical assessments and provide recommendations to support care planning while ensuring compliance with regulatory standards.
The Care Manager serves as the primary point of contact for members, conducting comprehensive assessments and developing individualized care plans. They coordinate services across providers and community resources to ensure quality care while maintaining alignment with regulatory requirements.
The Peer Support Specialist provides care coordination and transition support for individuals with behavioral health or intellectual/developmental disabilities exiting incarceration. They educate members on navigating social and justice systems while facilitating linkages to community resources like housing, employment, and treatment services.
