The Innovations Care Manager provides proactive intervention and coordination of care for members to ensure appropriate assessment and service delivery. They work with multidisciplinary teams to develop person-centered care plans, manage transitions, and resolve barriers to health and community-based services.
The PCS Assessor Registered Nurse conducts needs-based assessments and eligibility determinations for Medicaid beneficiaries receiving personal care services. They are responsible for scheduling appointments, submitting service authorization requests, and collaborating with healthcare professionals to ensure accurate care planning.
The PCS Assessor Registered Nurse conducts needs-based assessments and eligibility determinations for Medicaid beneficiaries receiving personal care services. They are responsible for scheduling appointments, performing home visits, and submitting service authorization requests on behalf of providers.
The PCS Assessor Registered Nurse conducts needs-based assessments and eligibility determinations for Medicaid beneficiaries receiving personal care services. This role involves scheduling appointments, performing both telephonic and face-to-face assessments, and submitting service authorization requests.
The PCS Assessor Registered Nurse conducts needs-based assessments and eligibility determinations for Medicaid beneficiaries receiving personal care services. They are responsible for scheduling appointments, performing home visits, and submitting service authorization requests on behalf of providers.
The ETL Developer designs, architects, and implements complex data solutions using Azure and Microsoft Fabric to support rural health transformation initiatives. They are responsible for monitoring data quality, managing pipeline performance, and collaborating with functional teams to meet business requirements.
The Application Product Developer designs, architects, and implements custom applications while collaborating with functional teams to meet business needs. They are responsible for the full lifecycle of applications, including planning, development, security compliance, and ongoing maintenance.
The ACCESS Member Services Specialist handles telephonic requests for services by linking members to appropriate providers and conducting screenings. They also manage customer service inquiries, maintain electronic documentation, and collaborate with clinicians to ensure appropriate care linkage.
The ACCESS Member Services Specialist conducts telephonic screenings to link members with appropriate healthcare services and providers. They also manage customer service inquiries, maintain accurate electronic documentation, and collaborate with clinicians to address urgent member needs.
The specialist assists network providers with inquiries regarding claims, contracts, and benefits while ensuring accurate documentation of all interactions. They also perform initial triage of incoming calls and provide navigational support for provider resources.
The Transition Coordinator provides proactive intervention and coordination services to help individuals transition from institutional settings to community-based living. They are responsible for developing transition plans, managing caseloads, and collaborating with community providers to ensure continuity of care.
The TCL Community Liaison provides education to stakeholders regarding the Transitions to Community Living program and the RSVP process. They also identify service gaps, facilitate community meetings, and ensure accurate documentation of member interventions.
