Health Advocates Remote jobs - 27 jobs

Service Operations Supervisor, Healthcare Claims Department
Health Advocate West 4.5
Remote
Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company. Join our award winning team! 2025: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2024: Excellence in Customer Service Awards: Organization of the Year (Small) Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) As part of Teleperformance in the US, we were also named #95 in the 2024 ‘Fortune 100 Best Companies to Work For ' in the USA by Great Places to Work (GPTW ) BASIC FUNCTION Responsible for overseeing the daily tasks and workflow of assigned team of associates/ specialists by providing direction and structure and aiding to answer questions using knowledge of services and benefits to help guide employees and perform necessary on the job training. Job Responsibilities: Responsible for the administrative functions and supervision of an operations unit. This includes backlog and quality management for a team of Operations/Customer Service associates Provide organization, direction and staffing for all assigned service calls and case load assignments to ensure all calls are answered in accordance with Health Advocate's policies and procedures. Monitor calls and audit case files daily to ensure the proper target resolution is identified and that, if possible, the case is closed at or near the target resolution. Ensure assigned staff members meet or exceed the standards, results, and responsibilities of their respective positions. Coach, mentor, and evaluate the performance of an assigned team. Assist in the selection, counseling, and discipline of all staff on the team. Provide oversight and direction to staff for assigned cases. Responsible for problem-solving issues and coordinating efforts with internal departments and subject matter experts. Provide healthcare benefit and claims consultation and support when appropriate to all internal departments. Routinely evaluate and monitor service calls and case management procedures to recommend any necessary changes to the Operations Manager. Escalate cases through the appropriate channels in accordance with Health Advocate's policies and procedures. Team Interfaces/Customer Service - Establish and maintain a professional relationship with internal/external customers, team members and department contacts * Cooperate with team members to meet goals or to complete tasks * Provide quality customer service that exceeds customer expectations and improves level of service being provided * Treat all internal/external customers, team members, and department contacts with dignity/respect * Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided Mental and Physical Requirements *This position will be exposed mainly to an indoor office environment and will be expected to work near or around computers, telephones, and printers *The nature of the work in this position is sedentary and the incumbent will be sitting most of the time. *Essential physical functions of the job include fingering, grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware continuously throughout the work day *Essential mental functions of this position include concentrating on tasks, reading information, and verbal/written communication to others continuously throughout the work day Related Duties as Assigned - * The job description documents the general nature and level of work but is not intended to be a comprehensive list of all activities, duties, and responsibilities required of job incumbents * Consequently, job incumbents may be asked to perform other duties as required * Also note, that reasonable accommodations may be made to enable individuals with disabilities to perform the functions outlined above * Please contact your local Employee Relations representative to request a review of any such accommodations Minimum Qualifications Call center experience preferred Management or supervisory experience in healthcare benefits or claims processing preferred Strong leadership skills and the ability to build effective teams Effective communication skills to interact with members, physicians, and insurance carrier representatives, with an emphasis on ability to communicate both verbally and in writing Assertive, self-confident, and resilient Basic computer skills Ability to search and identify resources through the internet Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals Education Bachelor's Degree or applicable work experience Other * Basic knowledge of MS Word and Excel required * Must score acceptably on job related testing * Ability to pass standardized interview * Based on assignment may need to be bilingual in English, Spanish, etc. * Knowledge of the following is preferred: COBRA Medicare A, B, MediGap, Supplement plans, Medicare Advantage, Medicare Part D plans High deductible health plans including Health Reimbursement Accounts (HRAs) and Health Saving Accounts (HSAs) Flex Spending Accounts (FSA) , including limited FSAs Coordination of benefits and which plan is primary - simple cases (commercial plans, Medicare plans) Summary Plan Documents (SPDs) and Certificates of Coverage (COCs) Government programs, resources and legislation and mandates including but not limited to Affordable Care Act, FMLA, Medicaid, CHIP Group Health Plans (fully insured and self-insured) Pharmacy benefits including injectable medications Individual Health Plans and Marketplace/Exchanges plans A successful incumbent in the job will be able to demonstrate the following skills and abilities: Strong communication skills and phone etiquette Ability to explain complex issues to members Highly effective listening skills Strong problems solving/issue resolution skills Excellent customer service and customer resolution skills Strong Organizational and administrative skills Ability to work in a team environment Why Health Advocate? At Health Advocate, we don't just resolve claims-we build trust and provide peace of mind. Here's what you'll gain by joining us: Purpose-Driven Work: Be a key player in simplifying healthcare for members and making a real difference in their lives. Tools for Success: Access advanced systems, comprehensive training, and the support of a collaborative team. Competitive Pay: Annual salary starting at $55,000 Comprehensive Benefits: Enjoy competitive pay, robust medical, dental, and vision coverage, 401(k) with company match, PTO, and more. A Culture of Care: Join a team that values empathy, innovation, and teamwork. Your Next Move Ready to transform challenges into resolutions and make healthcare easier for those we serve? Apply today and take the first step toward a rewarding career with Health Advocate! Physical Requirements: This position is primarily sedentary, requiring prolonged sitting while performing administrative tasks. The role involves extensive use of a computer for typing, mouse navigation, and reading information on a screen for extended periods. Frequent phone use is required for communication with team members, clients, or external parties. Essential physical functions include fingering, grasping, pulling hand-over-hand, and repetitive motions necessary for navigating software, entering data, and interacting with electronic documents. Mental and Cognitive Requirements: The role requires strong concentration, attention to detail, and the ability to complete tasks accurately. Critical thinking and problem-solving skills are essential to address issues that may arise in day-to-day duties. Effective verbal and written communication skills are needed for responding to inquiries and collaborating with others. Work Environment: This position is fully remote and requires a home office environment with appropriate lighting, a computer, and phone access. The workspace should be free from distractions to ensure effective focus and productivity during work hours. Company Overview Health Advocate is the nation's leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need. Learn more Health Advocate https://www.healthadvocate.com/site/ Facebook https://www.facebook.com/healthadvocateinc/ Video https://vimeo.com/386733264/eb447da080 Awards: 2025: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2024: Excellence in Customer Service Awards: Organization of the Year (Small) Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2023: National Customer Service Association All-Stars Award: Service Organization of the Year. Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2022: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Excellence in Customer Service Awards: Organization of the Year (Small) Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2021: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Silver Winner Stevie Awards for Sales & Customer Service: Most Valuable Response by a Customer Service Team (COVID-19). Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2020: National Customer Service Association All-Stars Award: Organizations of 100 or Greater, Runner-Up Communicator Award of Distinction: October 2019 Broker News MarCom Awards: Gold, COVID Staycation Ideas brochure MarCom Awards: Platinum, 2021 Well-being Calendar Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium category (Silver) VEVRAA Federal Contractor requesting appropriate employment service delivery systems, such as state workforce agencies and local employment delivery systems, to provide priority referrals of protected veterans. PAY TRANSPARENCY NONDISCRIMINATION PROVISION The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-I.35(c)
$55k yearly Auto-Apply 52d ago

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Flu Shot Nurse
Health Advocate West 4.5
Remote
Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company. Join our award winning team! 2025: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2024: Excellence in Customer Service Awards: Organization of the Year (Small) Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) As part of Teleperformance in the US, we were also named #95 in the 2024 ‘Fortune 100 Best Companies to Work For ' in the USA by Great Places to Work (GPTW ) Position Overview At Health Advocate, we are committed to providing our customers with expertise and services that improve the health, well-being and productivity of their employees. Responsibilities Include: • Administer Flu Shots Desired skills, requirements and interests: • Minimum of 1 year clinical experience in performing venipuncture required. • Current CPR certification • Proficient in vaccine administration and understand flu shot protocol • Knowledge of proper vaccine handling procedures • Function as part of a wellness team • Professional presentation and excellent communication skills • Embrace and believe in a healthy lifestyle • Ability to work in a team based environment required. Company Overview Health Advocate is the nation's leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need. Learn more Health Advocate https://www.healthadvocate.com/site/ Facebook https://www.facebook.com/healthadvocateinc/ Video https://vimeo.com/386733264/eb447da080 Awards: 2025: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2024: Excellence in Customer Service Awards: Organization of the Year (Small) Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2023: National Customer Service Association All-Stars Award: Service Organization of the Year. Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2022: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Excellence in Customer Service Awards: Organization of the Year (Small) Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2021: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Silver Winner Stevie Awards for Sales & Customer Service: Most Valuable Response by a Customer Service Team (COVID-19). Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2020: National Customer Service Association All-Stars Award: Organizations of 100 or Greater, Runner-Up Communicator Award of Distinction: October 2019 Broker News MarCom Awards: Gold, COVID Staycation Ideas brochure MarCom Awards: Platinum, 2021 Well-being Calendar Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium category (Silver) VEVRAA Federal Contractor requesting appropriate employment service delivery systems, such as state workforce agencies and local employment delivery systems, to provide priority referrals of protected veterans. PAY TRANSPARENCY NONDISCRIMINATION PROVISION The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-I.35(c)
$54k-80k yearly est. Auto-Apply 40d ago
Customer Success Manager
Radnet 4.6
Somerville, MA jobs
Job Description Responsibilities Job Title: Customer Success Manager Reports to: Commercial Leader FLSA Status: Exempt A Customer Success Manager (CSM) is responsible for ensuring customers achieve success and satisfaction with products and services. The CSM provides a voice, support, guidance, and knowledge resources to help customers achieve their business objectives and improve patient care through effective use of our products and services. Our CSMs create and implement customer strategies that work, resulting in high customer satisfaction and retention. The CSM should have extensive product knowledge, problem-solving skills, and the ability to develop trusted relationships. The CSM is also responsible to act as a liaison between the customer and internal teams, advocating for the customer while driving continuous improvement in our offerings. Essential Duties and Responsibilities Relationship Management: Build and maintain strong relationships with key stakeholders within customer organizations. Regularly engage with customers to understand their challenges, goals, and ensure satisfaction. Presents solutions that meet customer objectives Provides prospect/client guidance through short- and long-term strategic planning; continuously being mindful of where we may make a contribution to the client's long-term business success. Product Expertise: Develop a deep understanding of the company's product/service offerings. Use this expertise to provide guidance, best practices, and recommendations to customers. Customer Advocacy: Act as the voice of the customer within the company. Advocate for customer needs, communicate feedback to relevant internal teams, and work towards solutions that address customer concerns. Retention and Growth: Proactively identify opportunities for upselling or cross-selling based on the customer's needs and usage patterns. Aim to increase customer retention and expansion of services. Identifies at-risk client relationships and leads the team to correcting any identified issues. Issue Resolution: Address customer concerns and issues effectively and efficiently. Coordinate with internal teams to provide timely resolutions. Data Analysis: Utilize customer data, product adoption data, lifecycle stage and feedback to derive insights, identify trends, and suggest improvements to enhance the customer experience. Manages and documents Quarterly Business Review process and scheduled meetings with customers. Serve as a communication interface between the client, the sales team, services teams, and any other internal division involved with the accounts under your responsibility. PLEASE NOTE: This is not an exhaustive list of all duties, responsibilities and requirements of the position described above. Other functions may be assigned and management retains the right to add or change duties at any time. Minimum Qualifications, Education and Experience 2+ years of experience in a CSM role, especially in an MSP environment, technology, or a health care setting Bachelor's degree in Healthcare, Business Administration, and/or Marketing and/or a related field medical/pharma/science field (or equivalent level of practical technical experience in radiology) Proven experience in a customer-facing role, preferably in Customer Success, Account Management, or Sales. Excellent communication and interpersonal skills. Strong problem-solving abilities and a customer-centric approach. Proficiency in CRM and/or CSM software and data analysis tools. Ability to multitask, prioritize, and manage time effectively. A minimum of 3 years working experience as a radiographer/application specialist/MRI specialist or mammographer within a clinical setting. Strong relationship-building skills Strong attention to detail. Ability to work independently (home office) and as a team player. Proven ability to build and maintain influential customer relationships. Superb verbal and written presentation and communication skills Teamwork: Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit. Time Management: Plans how to achieve key priorities weekly; Reviews results of time plans weekly; Schedules time realistically; Achieves key priorities daily; Balances personal and professional objectives. Ability to travel national incidentally internationally Preferred Qualifications: Experience in Healthcare and/or Healthcare IT. Understanding of radiology workflow Familiarity with Salesforce CRM, Google Suite, Microsoft Suite, Healthcare Applications/Products Physical Demands This position often requires sitting for long periods of time, standing, walking, bending, twisting, reaching with hands and arms, using hands and fingers, handling, or feeling, speaking, listening, and high-level cognitive thinking. Must be able to use a computer and other office machinery including copiers, scanners and computer software. Working Environment Representatives work remotely with the need to travel domestically or internationally 25-50%. NOTE: This position is not eligible for visa sponsorship
$78k-115k yearly est. 5d ago
Remote Medical Scheduler
Radnet 4.6
Port Saint Lucie, FL jobs
Job Description Responsibilities Launch Your Healthcare Career with RadNet Virtual Job Fair - Wednesday January 7th, 2026 9:00 AM - 3:00 PM EST Looking to start a meaningful career in healthcare? Join us at RadNet Radiology's Virtual Job Fair on Wednesday January 7th, 2026, and explore our Remote Medical Scheduler openings. Position: Scheduler As a Medical Scheduler, you'll be the first point of contact for patients scheduling important imaging appointments. You'll: Schedule, reschedule, and manage appointments Provide friendly and professional customer service Support patient care across our network of imaging centers Why RadNet? $16.00 hourly rate, PLUS monthly incentive/bonus opportunity! Full benefits: Medical, Dental, Vision, HSA, 401(k) with Match Free imaging services for you and your immediate family In-office role with real impact Room to grow your career in a stable, supportive environment You Bring: Strong customer service, communication and phone skills Strong basic computer and data entry skills A customer-first attitude and attention to detail Call Center or Medical Experience a plus! An ability to work onsite when needed and work remotely Location Info: Must be able to train at 1825 SE Tiffany Avenue, Suite 104, Port St Lucie Fl 34952 and reside within 50 miles of our office Whether you're changing careers or just starting out, this is your chance to join a mission-driven team that values your growth. Register now to reserve your spot: *************************************************************************** Take the next step toward a rewarding future in healthcare with RadNet!
$16 hourly 22d ago
Sales Executive, BH/Employer - Remote
Magellan Health 4.8
Remote
This is a regular full time position. Salary will commensurate with experience with a base salary rate, additionally, will be eligible for a uncapped commission opportunity. Builds and maintains strong business relationships with new or existing customers to meet or exceed established sales goals, quotas, targets or objectives for assigned area of responsibility. Drives new sales opportunities for growth, while ensuring that customer needs are exceeded. Involved in both pre- and post-sales activities to build strong relationships with customers and drive product adoption, retention, account expansion and renewals. Identifies and attracts prospective customers to build the Behavioral Health Employer market customer base. Grows current customer base through product expansion. Develops and maintains long-term strategic relationships with each customer. Oversees lead management and tracking. Grows and maintains a robust pipeline. Performs territory management and account planning. Refines and enhances the prospecting process, including segmentation, prioritization, sales plans and collateral. Executes direct sales presentations and discussions at all levels of prospect organizations, including remote web presentations and onsite discussions. Collaborates with internal stakeholders on proposals or promotional materials for assigned area of responsibility. Identifies and recommends to management process improvements that reduce workloads or improve quality for assigned area of responsibility. Maintains knowledge on current and emerging developments or trends for assigned area of responsibility, assesses the impact, and collaborates with management to incorporate new trends and developments in current and future solutions. Maintains sales call data in appropriate systems and completes sales reports as directed. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities Bachelor's Degree required, preferably in a clinical or business discipline or additional sales experience in lieu of degree. 3+ years' experience in complex solution sales. Healthcare sales experience. Excellent computer technology knowledge. A proven track record in exceeding sales targets. Outstanding interpersonal skills and prior success dealing directly with customers at all levels within an organization. Ability to successfully handle many parallel customers, each with independent issues and timelines. Excellent analytical abilities, critical thinking and organizational skills. Experience in defining and tracking metrics and developing processes to improve department performance. Experience providing weekly reporting to management, implementing feedback in a timely and quality fashion. Strong sense of pride in the production of quality products and team efficiencies. General Job Information Title Sales Executive, BH/Employer - Remote Grade 25 Work Experience - Required Healthcare, Sales Work Experience - Preferred Education - Required A Combination of Education and Work Experience May Be Considered., Bachelor's Education - Preferred License and Certifications - Required License and Certifications - Preferred Salary Range Salary Minimum: $64,285 Salary Maximum: $102,855 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$64.3k-102.9k yearly Auto-Apply 46d ago
Financial Talent Acquisition Sourcer - Contract Position/Remote
Magellan Health 4.8
Remote
Talent Acquisition Sourcing for Personal Financial Counseling Positions. Seeking someone with experience sourcing for CFP's, AFC's and CHFC's. Contract position up to 6 months. Fully Remote. What is Talent Acquisition at Magellan? It may not be what you think. We operate with one goal in mind, to share our unique brand far and wide. We are thought leaders in health care and masters of networking. This position is ideal for recruitment partners with exceptional ability to find and engage passive candidates, utilize market intelligence and influence key business leaders. In this position, you are a. . . . Digital Citizen You use digital technology purposefully and confidently to communicate, find information and come up with effective solutions. You are a Super User of our Candidate Relationship Management (CRM) technology and use it to automate the candidate communication process, encourage engagement and improve the candidate experience. You fully leverage our CRM methodology and technology to effectively manage talent pipelines, work efficiently and engage in new ways of finding candidates. You understand that technology will improve results and appreciate the way cutting edge systems can differentiate Magellan. Marketer You understand Magellan's vision, hiring goals and business needs. You live and give life to our brand and share it throughout our networks. You speak, write and listen combining empathy with business savvy. Career Coach You create authentic relationships with hiring managers, candidates and colleagues. You understand and balance the hiring need with the candidate's career goals. You manage conflicting situations, such as salary level vs. skill set, with professionalism and objectivity. Design Thinker You construct talent acquisition strategies infused with market, industry and labor intelligence in order to understand how best to personalize candidate engagement and attract the talent needed. Data-Based Decision Maker You use data to ask questions, seek answers and gain accurate insights. You use data to help candidates, managers and business leaders make better decisions. Why join Magellan? Working at Magellan is more than a job. It's a calling to make a difference for our most vulnerable populations - we're leading humanity to healthy, vibrant lives. You're a key part of our purpose, you're not just filling vacancies. Through best in class processes and technology solutions, and a commitment to what makes us uniquely Magellan, you'll find the talent we need to lead our organization into the future. Come join us! The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities To be successful in this role, you should have the following skills and experience: At a minimum, 3 years or more of recruitment/recruitment coordinator/HR experience and a bachelor's degree OR 5 years or more of recruitment/recruitment coordinator/HR experience and an associate's degree Demonstrated ability using CRM technology or sophisticated ATS technology. Understand and drive the full life cycle recruitment process. Strong understanding of marketing and branding principles and how to effectively use them to hire talent. Ability to manage high volume recruitment and meet deadlines for hiring. Ability to attend career fairs and other hiring events. Ability to establish relationships and partner effectively with candidates, HR business partners, managers and peers. Ability to be flexible and work in a sometimes ambiguous and changing environment and able to juggle shifting priorities and manage time effectively. General Job Information Title Financial Talent Acquisition Sourcer - Contract Position/Remote Grade 25 Work Experience - Required Talent Acquisition/Recruiting Work Experience - Preferred Education - Required A Combination of Education and Work Experience May Be Considered., Bachelor's Education - Preferred Master's License and Certifications - Required License and Certifications - Preferred Salary Range Salary Minimum: $64,285 Salary Maximum: $102,855 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$64.3k-102.9k yearly Auto-Apply 6d ago
Youth Support Navigator - Certified Youth Peer Support Specialist
Magellan Health 4.8
Remote
Work remote from home in the Las Cruces area with extensive community based travel. This position provides non-clinical, evidence-based peer support services, serves as a youth advocate, shares coping skills, and provides recovery information for youth members ages 14 - 21. This position performs a wide range of tasks designed to assist youth members in developing independence through individual recovery planning, wellness self-management, and strengthening resilience to improve personal health outcomes. This position will role model competency in recovery, resiliency, and wellness practices. Direct Peer Support & Recovery Planning: Provide one-to-one peer support for youth with mental health or substance use needs. Guide youth in developing wellness plans using an evidence-based framework. Facilitate use of the 8 Dimensions of Wellness to set whole-health goals. Assist with transitions from inpatient, residential, and alternative care settings to community-based recovery supports. Support youth in building empowerment, self-advocacy, and problem-solving skills and maintaining progress toward recovery through community participation and role modeling wellness. (50%) Administrative Responsibilities: Maintain accurate, timely, and complete documentation to ensure records meet compliance, audit, and reporting requirements. Participate in supervision, training, and ongoing professional development. Travel within the community to meet youth members. (40%) Engagement & Education: Initiate proactive outreach to youth to build engagement and facilitate successful enrollment into the peer support program. Educate providers, internal staff, and youth on resiliency and recovery practices. (10%) Other Job Requirements Responsibilities Self-identified person in recovery with lived experience of youth/young adult mental health or substance use services. Completed training and certification as a Youth Peer Support Specialist. Reliable vehicle and ability to travel in the community. Working knowledge of Microsoft Office Suite and comfort using mobile apps and web-based platforms. Strong interpersonal, verbal, and written communication skills. Ability to document accurately and maintain timely records. Knowledge of local mental health, substance use and community systems, recovery and resiliency principles, wrapround, and tools such as wellness planning and the 8 dimensions of wellness. Experience representing member strengths and needs in clinical or interdisciplinary settings. Ability to analyze complex situations and make independent decisions. Proven ability to work both independently and as part of a team in a fast-paced environment. General Job Information Title Youth Support Navigator - Certified Youth Peer Support Specialist Grade 19 Work Experience - Required Lived Experience With Mental Health/Substance Use Recovery, Peer Specialist Work Experience - Preferred Education - Required GED, High School Education - Preferred Associate, Bachelor's License and Certifications - Required YPSS - Youth Peer Support Specialist - Care Mgmt License and Certifications - Preferred Salary Range Salary Minimum: $37,725 Salary Maximum: $56,595 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$37.7k-56.6k yearly Auto-Apply 60d+ ago
Military and Family Life Counselor - Short Term Assignments or On Demand for On Site
Magellan Health 4.8
Remote
The Assignment Ready Counselor (ARC) will provide coverage in short-term, surge and on demand situations resulting from the Military needs such as a post-deployment event or to cover an existing assignment for counselors who are absent. The Summer ARC counselor position covers assignments during the May 15th through September 15th time period, coinciding with the school summer break. With minimal guidance and oversight, provides the full breadth of Adult or Child and Youth Behavioral (CYB) counseling services to military service members and their families at military installations. These services may include non- medical counseling, training/health and wellness presentations, consultation with parents, personnel at child daycare centers and schools, and consultation to installation command regarding behavioral health issues affecting military personnel and their family members. ARC CYB counselors may be assigned to DoDEA schools and community schools and will need to have experience working in a school setting to qualify for ARC role in backing up a school position. CYB counselors may also be assigned to youth programs, summer camps, and on demand assignments. ARC adult counselors may be assigned to support MFLC services in a variety of military community and readiness centers, as well as on-demand and surge assignments. The counselors work closely with the installation and military branch Points of Contact (POC) to assure that the program is provided within scope and meets the needs of the installation. Provides non-medical, short term, solution focused, counseling directly to adults, children, and youth of service members. Services include assessment, brief counseling and consultation, action planning, referral to resources (assuring linkage as appropriate), and follow-up as indicated. CYB counselors will also have a focus on supporting the staff and personnel of CDCs, DoDEA and community schools, youth programs and summer camps as well as providing parent training and guidance. Provides training and health and wellness presentations, participate in health fairs and other base/installation activities. Enters counselor activity data daily through smart phone or web application assure that reporting is accurate from assigned installation while maintaining confidentiality and anonymity of service / family member. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities Master's Degree from an accredited graduate program in a mental health related field, or social work. With short notice, willing to accept assignments of undefined periods to include weekends. Can cover, on a full-time basis, assignments of varying length from a weekend to two weeks. Quickly builds rapport with service personnel clients, family members, students, parents and co-workers. Adaptable to new working conditions, varying location rules, etc.; adjusts working style to align with each work environment. Able to work effectively with minimal instruction and guidance. Listens carefully to instructions provided. With minimal notice, participates in regular in-services/training, Quality Improvement committees or other contract activities as assigned. Requires ability to quickly engage and communicate with military members, spouses or children as assigned, in order to accomplish job functions, and to respond quickly to emergent situations in any physical location on a military installation and/or within a school setting, which includes the need to traverse short and/or long distances within the base to both indoor and outdoor locations, to maneuver through rugged, outdoor or uneven locations (e.g., steep inclines, stairs, grass), and work in outdoor weather and other military base conditions. Due to the nature of working on military installations or related worksites, counselors may need to comply with various site-specific requirements to work at designated locations. For example, for some assignments, counselors will need to have certain current immunizations or vaccinations and provide record of receipt. Ability to prove US Citizenship and must be fluent in English. Advanced knowledge of brief therapy and solution-focused counseling methods. Prior military service/military family member and/or strong familiarity with military culture desired. For CYB positions must meet the Magellan MFLC CYB criteria for experience with children and youth and specialty in child and adolescent development/psychology. Creates a presence on the installation in which the service and family members feel comfortable approaching the counselor and recognize the program to be confidential; for CYB counselors -- creates a presence in child and youth settings, is available to children, youth, and staff. When working with children, counselor must abide by line of site protocol. Establishes and maintains working relationships with community resources and provides appropriate linkages. Partners with POC to provide Adult and CYB services in a manner that addresses the needs of the installation/facility. Develops an excellent working relationship with the installation/facility POC. Manages duty to warn and restricted reporting situations according to DoD protocol and staffs the cases with Regional Supervisor/Regional Director. Communicates with Regional Supervisors and participate in regular individual and group supervision, sharing information regarding trends and issues on the installations and in facilities to which they are assigned for substitute or on call services. Responds to critical incidents and special requests as directed by the POC and approved by the OSD program manager. General Job Information Title Military and Family Life Counselor - Short Term Assignments or On Demand for On Site Grade MFLC ARC Work Experience - Required Clinical Work Experience - Preferred Education - Required Master's - Behavioral Health, Master's - Social Work Education - Preferred License and Certifications - Required Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care MgmtCare Mgmt, DL - Driver License, Valid In State - OtherOther, LPC - Licensed Professional Counselor - Care MgmtCare Mgmt, Must be an independently licensed behavioral health clinician - Care MgmtCare Mgmt License and Certifications - Preferred Salary Range Salary Minimum: $59,922 Salary Maximum: $100,280 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$32k-41k yearly est. Auto-Apply 60d+ ago
Care Coordinator- Remote in NM
Magellan Health 4.8
Remote
within NM, candidates need to reside in New Mexico. Coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes. Duties are performed virtually or face-to-face based on contractual requirements. Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Assists with orientation and mentoring of new team members as appropriate. Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple, clinical, social and community resources. Conducts in depth health risk assessment and/or comprehensive needs assessment which includes, but is not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters. Communicates and develops the care plan and serves as point of contact to ensure services are rendered appropriately, (e.g., during transition to home care, backup plans, community-based services). Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes. Develops, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for member`s care needs by identifying and addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan. Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes. Collects clinical path variance data that indicates potential areas for improvement of case and services provided. Works with members and the interdisciplinary care plan team to adjust plan of care, when necessary. Educates providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost-effective delivery to quality care and services. Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, member`s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long-term care services. Utilizes licensed care coordination staff as appropriate for complex cases. Provides assistance to members with questions and concerns regarding care, providers or delivery system. Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources. Generates reports in accordance with care coordination goal. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities 3-5 years' experience in Social Work, Nursing, or Healthcare-related field, or relevant experience in lieu of degree., Experience in utilization management, quality assurance, home or facility care, community health, long term care or occupational health required. Experience in analyzing trends based on decision support systems. Business management skills to include, but not limited to, cost/benefit analysis, negotiation, and cost containment. Knowledge of referral coordination to community and private/public resources. Requires detailed knowledge of cost-effective coordination of care in terms of what and how work is to be done as well as why it is done, this level include interpretation of data. Ability to make decisions that require significant analysis and investigation with solutions requiring significant original thinking. Ability to determine appropriate courses of action in more complex situations that may not be addressed by existing policies or protocols. Decisions include such matters as changing in staffing levels, order in which work is done, and application of established procedures. Ability to maintain complete and accurate enrollee records. Effective verbal and written communication skills. Ability to work well with clinicians, hospital officials and service agency contacts. General Job Information Title Care Coordinator- Remote in NM Grade 22 Work Experience - Required Clinical, Quality Work Experience - Preferred Education - Required GED, High School Education - Preferred Associate, Bachelor's License and Certifications - Required DL - Driver License, Valid In State - OtherOther License and Certifications - Preferred CCM - Certified Case Manager - Care MgmtCare Mgmt, LCSW - Licensed Clinical Social Worker - Care MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare Mgmt Salary Range Salary Minimum: $50,225 Salary Maximum: $75,335 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$50.2k-75.3k yearly Auto-Apply 1d ago
Personal Financial Counselor, Assignment Ready Counselor, PFC- 180th Fighter Wing, OH
Magellan Health 4.8
Remote
This position will provide coverage in short-term, surge and on demand situations resulting from the Military needs such as a post-deployment event or to cover an existing assignment for counselors who are absent. Primary responsibilities include the full breadth of personal financial counseling services to military service members and their families at military installations. Services include education and counseling addressing financial services that may include, but are not limited to, one-on-one counseling, consultation with a commander or with another provider or staff, conducting briefings and presentations, or providing referral resources to a participant outside the context of a counseling session. Works closely with the installation and military branch Points of Contact (POC) to assure that the program is provided within scope and meets the needs of the installation. Provides personal financial counseling and management services directly to service members and their families. Assists service members in establishing a spending plan for extended absences. Develops and makes available informational financial materials to service members and families. Coordinates, publicizes and provides a wide variety of Personal Financial Management classes/workshops, e.g., topics across the military lifecycle, including, but not limited to, arrival at first duty station, pre- and post-deployment, and personal and career events outlined in DoDI 1322.34. Responds to requests for age-appropriate classes or seminars. Possess the skills to effectively utilize virtual counseling or other electronic modes of communication, such as web based, secure online chat, or video-based communications and secure video teleconference sponsored by the customer. Virtual PFC support may only be authorized by OSD FINRED Program office. Manages duty to warn situations according to Department of Defense (DoD) protocol. Communicates with leadership and participates in regular individual and group supervision, sharing information regarding trends and issues on the installations to which the counselor is assigned. Participates in regular in-services/training, quality improvement committees or other contract activities as assigned/appropriate. All other duties as assigned. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities Bachelor's degree required. May consider applicants with an associate degree plus 4 years' experience in lieu of bachelor's degree. May consider applicants with a high school diploma plus 6 years' experience in lieu of a bachelor's degree. 3+ years of financial counseling experience. Must be a U.S. citizen and speak fluent English. If required by the contract, must be bilingual in English and Spanish. Be able to obtain a favorably adjudicated Tier 2 investigation. Must be able to pass the Congressionally Mandated Disclosures for Organizational Conflicts of Interest (OCI) process. Must have one of the following certifications: Accredited Financial Counselor (AFC), Certified Financial Planner (CFP), or Chartered Financial Consultant (ChFC). General Job Information Title Personal Financial Counselor, Assignment Ready Counselor, PFC- 180th Fighter Wing, OH Grade 23 Work Experience - Required Financial Counseling Work Experience - Preferred Education - Required A Combination of Education and Work Experience May Be Considered., Bachelor's Education - Preferred License and Certifications - Required AFC - Accredited Financial Counselor - EnterpriseEnterprise, CFP - Certified Financial Planner - EnterpriseEnterprise, ChFC - Chartered Financial Consultant - EnterpriseEnterprise, DL - Driver License, Valid In State - OtherOther License and Certifications - Preferred Salary Range Salary Minimum: $53,125 Salary Maximum: $84,995 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$53.1k-85k yearly Auto-Apply 60d+ ago
Senior Expense Reimbursement Coordinator, Federal (Expense Reports, Costpoint Experience Preferred)) - Remote
Magellan Health 4.8
Remote
works with internal and external customers as well as program leadership to ensure all are kept up-to-date on the accuracy and timeliness of reimbursements according to contract specific requirements and for problem solving as needed. The senior expense coordinator position provides ongoing Costpoint assistance to program leaders, supervisors, and employees as needed to ensure timely and accurate expense reimbursement. Tracks Employee Expense Reports as they move through the Expense Report System. Identifies and resolves problems and inconsistencies and suggests appropriate corrective procedures. Ensures expenses are charged to correct accounts, project codes, and organizations by reviewing voucher edit report. Follows up with employees on aging expense reports in draft status, as well as with managers for expense reports waiting for approval. Works closely with billing to resolve expense reimbursement discrepancies, errors and/or questions. Assists employees and managers with making corrections to expense reports as needed. Assists with business travel account reconciliations to ensure all company paid expenses are accounted for in the expense report system. Reviews receipts and travel documentation for required information and accuracy and performs the function of recording attachments in Deltek Time & Expense. Collaborates with travel team members and regional staff regarding expense reporting and required documentation. Maintains up-to-date knowledge of the Joint Federal Travel Regulations and contract requirements and allowability of expenses. Maintains tracking spreadsheet & ensures all notes are up to date and action items are completed. Assists with creating expense reimbursement training documents and policy review. Participates in monthly live expense reimbursement employee training sessions. Supports ongoing projects or other duties as needed. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities 2+ years of experience in Federal Joint Travel expense reimbursement reporting OR 1+ years of experience with expense reporting and 1+ years of experience in accounts payable invoicing coding in a Federal Regulated environment. Direct experience in General Services Administration (GSA) and Joint Travel Regulations (JTR). Proficiency in Excel. Working knowledge of Ten-Key by Touch. Detail Oriented. General Job Information Title Senior Expense Reimbursement Coordinator, Federal (Expense Reports, Costpoint Experience Preferred)) - Remote Grade 21 Work Experience - Required Accounting, Accounts Payable Work Experience - Preferred Education - Required Education - Preferred Associate License and Certifications - Required License and Certifications - Preferred Salary Range Salary Minimum: $45,655 Salary Maximum: $68,485 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$45.7k-68.5k yearly Auto-Apply 9d ago
Network Management Specialist (Contract Specialist)
Magellan Health 4.8
Remote
The Network Contract Specialist will be responsible for creating and maintaining behavioral health provider contracts across the New Mexico territory for Presbyterian Health Plan with Medicaid, Medicare, and Commercial lines of business. This role includes managing provider contracting activities in coordination with the Network team and processing all necessary contract-related updates. Key responsibilities include handling contract changes, Statements of Work, amendments, rate updates, Letters of Direction, and other required modifications. The specialist will also ensure all contract updates are compliant with internal policies and New Mexico-specific regulatory requirements. Strong collaboration with internal departments is essential to maintain network accuracy, provider data integrity, and overall operational efficiency. Detailed tracking and documentation of all contract activities and provider communications are critical components of this role. Support and maintain behavioral health provider contracts for Medicaid, Medicare, and Commercial lines of business across the New Mexico territory Perform provider contracting functions in collaboration with the Network team Process contract-related updates including: Exhibits Contract changes SOS Amendments Rate updates Letters of Direction (LODs) NCQA/CAQH Ensure compliance with internal standards and state-specific requirements Collaborate with internal departments to support network accuracy, provider data integrity, and operational efficiency Maintain thorough documentation and tracking of all contract activity and communications This position is responsible for the support of all activities related to developing and maintaining the physician, practitioner, group, and/or facility, MPPS and organization services delivery system in small to mid-size market defined by membership, number of providers in delivery system, number of business operating units and lines of business. Interacts with all areas of organization to coordinate network management and network administration responsibilities. Assesses network needs, analyzes network composition, and using organization databases, application of regulatory requirements, accreditation entities and other resources, recruits individual, group and/or organizational providers to meet network adequacy standards and assure quality network. Conducts and coordinates contracting and amendment initiatives. Provides issue resolution and complex trouble shooting for providers. Conducts provider education and provider relation activities, providing necessary written materials. Conducts administrative provider site visits and coordinates report development and completion according to contractual requirements or ad hoc requests. Coordinates Public Policy Research Center (PPRC) activities to assure maintenance of current credentialing status, and evaluation and appropriate actions of quality of care issues and complaints against providers. Conducts and manages ongoing audits of provider compliance with Magellan policies and procedures as well as contractual obligations for multiple customers. Develops work plans to address audit requirements. Works with management to draft, clarify and recommend changes to policies which impact network management. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities Knowledge of National Committee for Quality Assurance (NCQA) requirements. Ability to work independently and prioritize activities. Intermediate knowledge of Microsoft Office Suite, specifically Excel. Strong presentations skills using PowerPoint. Minimum of 1 year experience in related position/field. General Job Information Title Network Management Specialist (Contract Specialist) Grade 21 Work Experience - Required Network Work Experience - Preferred Education - Required Education - Preferred Bachelor's License and Certifications - Required License and Certifications - Preferred Salary Range Salary Minimum: $45,655 Salary Maximum: $68,485 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$45.7k-68.5k yearly Auto-Apply 60d+ ago
Family Support Navigator
Magellan Health 4.8
Remote
This position provides non-clinical, evidence-based peer support services and serves as a member and family advocate. The FSN brings their life experiences and skills to deliver assistance to the family as they explore the goals they would like to achieve and offers interventions to the family to increase engagement and empowerment within a variety of service delivery systems. Provides peer support to family/caregivers of children with mental health and substance use conditions identified as requiring intensive wellness support and recovery-oriented interventions. Guides families in creating Wellness Recovery Action Plans (WRAP ) for themselves and their family to recognize strengths and identify wellness self-management and crisis prevention strategies. Utilizes the 8 dimensions of wellness to help parents/caregivers identify their social determinants of health needs, determine their whole health goals and objectives in order to address their own challenges and those of their child. Guides and empowers family members to understand and participate in all decisions related to the treatment process, the support plan, service choices, and transitions in care. Coaches and role-models regarding a parent's perspective and lessons learned from life experience. Facilitates support and education to families who have questions, concerns or specific needs related to mental health or substance use and their relationship to Magellan and child serving agencies. Strategically shares their lived experience to inspire hope, empowerment, and positive action. Performs ongoing interventions to engage families and members in traditional and nontraditional health services and supports, as well as community and social support networks including community-based peer, parent, and family support services. Facilitates a team approach to member care including with the Magellan care coordination team. Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes. Acts as an advocate for family and member`s needs by identifying and addressing gaps in services and supports. Educates providers, supporting staff, members, and families on resiliency and recovery-oriented principles, practices, strategies, and tools. Documents all interactions according to company standards. Maintains professional responsibility to maximize supervision, respond appropriately to personal stressors that impact ability to perform job duties, and recognize crisis situations or risks to the member's safety and respond appropriately. Travels to meet families within the community. Other duties as assigned. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities 2+ years' experience working as a family peer specialist. Peer Specialist certification as required by the state. CFPS/National Peer Support Credential required within one year of hire. Must be or have been a parent or caregiver of a child who is or who has in the past received services from a child-serving agency for mental health related issues. Applicants must be able to draw from their own personal experience of parenting or caregiving for a child or youth with significant mental health or substance use challenges; negotiating services and supports for their child and family; be familiar with key resources for children, youth and families in the community; be able to transcend personal events to provide unconditional support and assistance to families. Positive attitude that communicates hope and a recovery and resiliency orientation; approachable and empathetic; strong people skills. Must have a vehicle in good, working condition with the ability to travel within the community regularly. Working knowledge of Microsoft Office Product Suite. Ability to make decisions that require significant analysis of solutions, and quick, original, and independent thinking. Ability to determine appropriate courses of action in complex situations that may not be addressed by existing policies or protocols. Knowledge of local mental health, substance use, and community systems; wellness strategies, resiliency and recovery principles, practices, and tools, such as system of care, Wellness Recovery Action Plans (WRAP), wraparound process, and community-based peer, family and parent support organizations and services. Strong interpersonal and organizational skills and effective verbal and written communication skills. Ability to represent strengths and needs of families and members in clinical settings. Ability to summarize and document findings and maintain complete and accurate records. Must be able to work effectively, independently and in a team, and prioritize in a fast-paced environment to meet the demands of the organization. General Job Information Title Family Support Navigator Grade 19 Work Experience - Required Lived experience as parent/caregiver of a child with mental health challenges, Peer Specialist Work Experience - Preferred Education - Required Education - Preferred Associate License and Certifications - Required CPRS/CPS/CPSS/CRPS/PRSS, Peer Specialist, State Requirements - Care MgmtCare Mgmt, DL - Driver License, Valid In State - OtherOther License and Certifications - Preferred NCPS - National Certified Peer Specialist - Care MgmtCare Mgmt Salary Range Salary Minimum: $37,725 Salary Maximum: $56,595 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$37.7k-56.6k yearly Auto-Apply 60d+ ago
CISC Care Coordinator, Licensed
Magellan Health 4.8
Remote
Independently coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes. Duties performed are either during face-to-face home visits or facility based depending on the assignment. Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Assists with orientation and mentoring of new team members as appropriate. May act as a team lead for non-licensed care coordinators. Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple, clinical, social and community resources. Conducts in depth health risk assessment and/or comprehensive needs assessment which includes, but is not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters. Communicates and develops the care plan and serves as point of contact to ensure services are rendered appropriately (e.g., during transition to home care, back up plans, community based services). Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes. Develops, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for members' care needs by identifying and addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan. Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes. Collects clinical path variance data that indicates potential areas for improvement of case and services provided. Works with members and the interdisciplinary care plan team to adjust plan of care, when necessary. Educates providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services. Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, member`s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Utilizes licensed care coordination staff as appropriate for complex cases. Provides assistance to members with questions and concerns regarding care, providers or delivery system. Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources. Generates reports in accordance with care coordination goals. Other Job Requirements Responsibilities Associate's Degree in Nursing required for RNs, or Master's Degree in Social Work or Healthcare-related field, with an independent license, for Social Workers. Licensed in State that Services are performed and meets Magellan Credentialing criteria. 2+ years' post-licensure clinical experience. Experience in utilization management, quality assurance, home or facility care, community health, long term care or occupational health required. Experience in analyzing trends based on decision support systems. Business management skills to include, but not limited to, cost/benefit analysis, negotiation, and cost containment. Knowledge of referral coordination to community and private/public resources. Requires detailed knowledge of cost-effective coordination of care in terms of what and how work is to be done as well as why it is done, this level include interpretation of data. Ability to make decisions that require significant analysis and investigation with solutions requiring significant original thinking. Ability to determine appropriate courses of action in more complex situations that may not be addressed by existing policies or protocols. Decisions include such matters as changing in staffing levels, order in which work is done, and application of established procedures. Ability to establish strong working relationships with clinicians, hospital officials and service agency contacts. Computer literacy desired. Ability to maintain complete and accurate enrollee records. Effective verbal and written communication skills. General Job Information Title CISC Care Coordinator, Licensed Grade 24 Work Experience - Required Clinical Work Experience - Preferred Education - Required Associate - Nursing, Master's - Social Work Education - Preferred License and Certifications - Required DL - Driver License, Valid In State - Other, LISW - Licensed Independent Social Worker - Care Mgmt, LMHC - Licensed Mental Health Counselor - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, LPN - Licensed Practical Nurse - Care Mgmt, PSY - Psychologist - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt License and Certifications - Preferred Salary Range Salary Minimum: $58,440 Salary Maximum: $93,500 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$58.4k-93.5k yearly Auto-Apply 60d+ ago
Principal IT Analyst
Magellan Health 4.8
Remote
This position will analyze, evaluate and design/redesign business, IT or operational processes using scientific approaches such as Critical Thinking, Lean Management, ITIL, Design Thinking and structured systems analysis and design. Provide leadership to more junior IT Analysts through all aspects of the software development cycles. Be a hands-on analyst who can define user stories and acceptance criteria, assist with problem solving, root cause analysis, trouble shooting and coaching of junior it analysts on the team and ensure that requirements and acceptance criteria satisfy business needs. Demonstrate a high level of expertise in the `IT Analyst` craft. Help the team work through impediments. Clear impediments and escalate issues when needed. Drive usability and quality of the software developed within the area. Help the team manage changes. Plan, prioritize and deliver the detail behind enhancements. Work on a variety of enterprise applications and problems. Develop relationships with senior stakeholders across partner teams, addressing concerns and removing roadblocks to drive projects forward. Ensure that requirements and acceptance criteria satisfy business needs. Deploy business requirements through reliable business system configuration updates to enterprise applications. Help the team work through impediments. Clear impediments and escalate issues when needed. Drive usability and quality of the software developed within the area. Helps the team manage changes. Plan, prioritize and deliver enhancements. Work on a variety of enterprise applications and problems. Develop relationships with senior stakeholders across partner teams, addressing concerns and removing roadblocks to drive projects forward. Analyze issues with focus on identifying root cause and prevention. Help the team arrive at innovative solutions. Other duties as assigned. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities - 6+ years related experience including a minimum of 3+ years of delivering requirements and testing in support of high quality, secure software in IT. - Good presentation and communication skills. - Highly collaborative. - Ability to execute on strategies to solve complex and open-ended business problems. - Lead prototyping of potential solutions. - Perform implementation reviews. - Lead support of resolution of technical challenges. - Proactive, can-do attitude. - Take responsibility for ensuring success of all implementation. - Technically proficient and hands-on. - Mastery of QA methodology and problem solving tools/techniques. - Experience with applying Design Thinking Techniques. - Critical Thinker. - Strong presentation skills. - Creativity and show initiative. General Job Information Title Principal IT Analyst Grade 29 Work Experience - Required IT Work Experience - Preferred Education - Required A Combination of Education and Work Experience May Be Considered., Bachelor's - Computer and Information Science Education - Preferred License and Certifications - Required License and Certifications - Preferred Salary Range Salary Minimum: $93,955 Salary Maximum: $159,725 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$94k-159.7k yearly Auto-Apply 9d ago
Director, Clinical Care Services - New Mexico, Remote
Magellan Health 4.8
Remote
This is a remote position supporting New Mexico. Candidate needs to be licensed in the State where they reside. Maintains accountability for medical management functions to achieve the business and clinical outcomes for the health plan, meeting contract requirements, National Committee of Quality Assurance (NCQA) accreditation standards, and supporting initiatives with providers and members to manage cost of care. Oversees utilization management and criteria-based reviews of care, clinical appeals regarding medical necessity, and the interaction with claims payment policies and processes. Also oversees the health plans 24/7 Nurse Line program and the clinical management of crisis calls. Depending on SBU/product supported, supports goals, contracts, and accreditation requirements of health plan in conducting reviews of clinical interactions and clinical documentation including reviews of case management, utilization management, vendor, and provider records. Collects data following established procedures and analyzes findings for purposes of continuous quality improvement and for internal and external reporting. Interacts with multiple stakeholders internally and externally. Conduct staff audits, process audits and pre-delegation and delegation activities. Reviews audit results with appropriate stakeholder and manages trainings in conjunction with the trainer for individual and/or for unit learning gaps. Directs, coordinates and evaluates efficiency and productivity of utilization management functions. Works closely with SBU and vendors to assure integration, oversight, and efficiency of utilization management and appeals processes and for delegated functions. In collaboration with the national clinical team, assures that all utilization management-related activities meet the standards required for the state contract and NCQA. Leads and organizes the ongoing evaluation of the utilization management program against quality and utilization benchmarks and targets. Identifies opportunities for improvement; organizes and manages cost of care initiatives. Collaborates with local and national leaders including Quality Improvement, Analytics, Finance, Network, and other areas to assure a comprehensive approach to managing quality of care, service, and cost of care. Provides expert input to Finance regarding patterns of utilization and cost and high cost cases. Assures staff selection, training, and evaluation to promote the development of a high quality team and effective transitions of care with the clinical care teams. Works closely with and provides input to national health plan clinical team on program design, policies, procedures, workflows, and correspondence. Collaborates with Network leaders to design and implement successful methods for working with hospitals, home health, and other services providers. Ensures integration and efficiency of Network strategy and vendor relationships with utilization management and claims processes. Works closely with network on the training and evaluation of providers as well in resolving provider related issues. Directs staff who assure quality, inter-rater reliability and standards are met in daily operations. Responsible for resolution and communication of utilization management issues and concerns and corrective action plan activities and reporting. Participates as a member of health plan Quality Insurance Committee and co-chair health plan Utilization Management Committee. Collects, analyzes and prepares record/documents information for projects related to assessing the efficiency, effectiveness and quality of the delivery of managed care services. Prepares monthly performance reports with audit results. Presents findings at provider, customer, UM and CM meetings as needed. Audits and reviews case manager, Health guide, UM staff, vendor, and provider documentation and telephone interactions against health services quality monitoring standards, regulations, accreditation standards and contract requirements. Reviews vendor and/or provider records against clinical and procedural established standards and contract requirements. Leads and conducts ongoing activities which monitor established quality of care standards in the participating provider network, vendors, UM staff, Health Guides, and for case managers. Assists in the planning and implementation of activities to improve delivery of services and quality of care including the development and coordination of in-service education programs for vendors, providers, UM staff, and case managers. Makes recommendations as to required training based upon audit results. Responsible for monitoring and validating internal audit results and/or corrective action plans. Other duties as assigned. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities 3+ years in utilization management operations. 5+ years in health care quality improvement. Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following current, active licenses are required: BCBA, LCMFT, LCSW, LMHP, LPC, LPT, LOT or RN. Must have experience overseeing contractual performance standards. Experience with reporting and analyzing managed care utilization data. Strong verbal and written communications skills. General Job Information Title Director, Clinical Care Services - New Mexico, Remote Grade 30 Work Experience - Required Clinical, Management/Leadership, Quality, Utilization Management Work Experience - Preferred Education - Required Bachelor's - Nursing, Bachelor's - Occupational Therapy, Bachelor's - Physical Therapy, Master's - Behavioral Health Education - Preferred License and Certifications - Required BCBA - Board Certified Behavior Analyst - Care MgmtCare Mgmt, LCMFT - Licensed Clinical Marriage and Family Therapist - Care MgmtCare Mgmt, LCSW - Licensed Clinical Social Worker - Care MgmtCare Mgmt, LMFT - Licensed Marital and Family Therapist - Care MgmtCare Mgmt, LMHP - Licensed Mental Health Professional - Care MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare Mgmt, OT - Occupational Therapist, State Licensure - Care MgmtCare Mgmt, PT - Physical Therapist, State Licensure - Care MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare Mgmt License and Certifications - Preferred Salary Range Salary Minimum: $105,230 Salary Maximum: $178,890 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$105.2k-178.9k yearly Auto-Apply 15d ago
MFLC Assignment Ready Counselor
Magellan Health 4.8
Remote
This position requires you to be licensed at the independent level in any state as an Mental Health Counselor, Therapist, or Social Worker. This position would work in support of On Demand Events, Surges, Summer Camps, and Backfills supporting the MFLC program. The Assignment Ready Counselor (ARC) will provide coverage in short-term, surge and on demand situations resulting from the Military needs such as a post-deployment event or to cover an existing assignment for counselors who are absent. The Summer ARC counselor position covers assignments during the May 15th through September 15th time period, coinciding with the school summer break. With minimal guidance and oversight, provides the full breadth of Adult or Child and Youth Behavioral (CYB) counseling services to military service members and their families at military installations. These services may include non- medical counseling, training/health and wellness presentations, consultation with parents, personnel at child daycare centers and schools, and consultation to installation command regarding behavioral health issues affecting military personnel and their family members. ARC CYB counselors may be assigned to DoDEA schools and community schools and will need to have experience working in a school setting to qualify for ARC role in backing up a school position. CYB counselors may also be assigned to youth programs, summer camps, and on demand assignments. ARC adult counselors may be assigned to support MFLC services in a variety of military community and readiness centers, as well as on-demand and surge assignments. The counselors work closely with the installation and military branch Points of Contact (POC) to assure that the program is provided within scope and meets the needs of the installation. Provides non-medical, short term, solution focused, counseling directly to adults, children, and youth of service members. Services include assessment, brief counseling and consultation, action planning, referral to resources (assuring linkage as appropriate), and follow-up as indicated. CYB counselors will also have a focus on supporting the staff and personnel of CDCs, DoDEA and community schools, youth programs and summer camps as well as providing parent training and guidance. Provides training and health and wellness presentations, participate in health fairs and other base/installation activities. Enters counselor activity data daily through smart phone or web application assure that reporting is accurate from assigned installation while maintaining confidentiality and anonymity of service / family member. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities Master's Degree from an accredited graduate program in a mental health related field, or social work. With short notice, willing to accept assignments of undefined periods to include weekends. Can cover, on a full-time basis, assignments of varying length from a weekend to two weeks. Quickly builds rapport with service personnel clients, family members, students, parents and co-workers. Adaptable to new working conditions, varying location rules, etc.; adjusts working style to align with each work environment. Able to work effectively with minimal instruction and guidance. Listens carefully to instructions provided. With minimal notice, participates in regular in-services/training, Quality Improvement committees or other contract activities as assigned. Requires ability to quickly engage and communicate with military members, spouses or children as assigned, in order to accomplish job functions, and to respond quickly to emergent situations in any physical location on a military installation and/or within a school setting, which includes the need to traverse short and/or long distances within the base to both indoor and outdoor locations, to maneuver through rugged, outdoor or uneven locations (e.g., steep inclines, stairs, grass), and work in outdoor weather and other military base conditions. Due to the nature of working on military installations or related worksites, counselors may need to comply with various site-specific requirements to work at designated locations. For example, for some assignments, counselors will need to have certain current immunizations or vaccinations and provide record of receipt. Ability to prove US Citizenship and must be fluent in English. Advanced knowledge of brief therapy and solution-focused counseling methods. Prior military service/military family member and/or strong familiarity with military culture desired. For CYB positions must meet the Magellan MFLC CYB criteria for experience with children and youth and specialty in child and adolescent development/psychology. Creates a presence on the installation in which the service and family members feel comfortable approaching the counselor and recognize the program to be confidential; for CYB counselors -- creates a presence in child and youth settings, is available to children, youth, and staff. When working with children, counselor must abide by line of site protocol. Establishes and maintains working relationships with community resources and provides appropriate linkages. Partners with POC to provide Adult and CYB services in a manner that addresses the needs of the installation/facility. Develops an excellent working relationship with the installation/facility POC. Manages duty to warn and restricted reporting situations according to DoD protocol and staffs the cases with Regional Supervisor/Regional Director. Communicates with Regional Supervisors and participate in regular individual and group supervision, sharing information regarding trends and issues on the installations and in facilities to which they are assigned for substitute or on call services. Responds to critical incidents and special requests as directed by the POC and approved by the OSD program manager. General Job Information Title MFLC Assignment Ready Counselor Grade MFLC ARC Work Experience - Required Clinical Work Experience - Preferred Education - Required Master's - Behavioral Health, Master's - Social Work Education - Preferred License and Certifications - Required Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care MgmtCare Mgmt, DL - Driver License, Valid In State - OtherOther, LPC - Licensed Professional Counselor - Care MgmtCare Mgmt, Must be an independently licensed behavioral health clinician - Care MgmtCare Mgmt License and Certifications - Preferred This is a Service Contract Act (SCA) covered position. The pay rate and health and welfare allowance are specified in the applicable wage determination agreement. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$31k-58k yearly est. Auto-Apply 43d ago
Edifecs Lead Software Engineer - Remote USA
Magellan Health 4.8
Remote
Create/update maps, guidelines and profiles using Edifecs tools such as EDIFECS SpecBuilder, Map Builder, EAM as per functional logic. Create maps and guidelines (xml, DFF, PFF) for Healthcare EDI transactions like 837, 834, 835, 820 transactions. Responsible for design, development, and implementation of Edifecs solution. Excellent understanding of technical and business challenges relating to EDI product upgrades. Able to configure the Edifecs tools, and understand systems integration, application, technical behavior, and business / technical requirements. Experience with Edifecs Healthcare 9.x suite, and Healthcare Payer systems. Detailed understanding of EDI Healthcare transaction sets, e.g. 270/271, 820, 834, 837 I/P/D, 835. Knowledge of software development / implementation processes. Able to explain technical solutions and fixes to stakeholders. Responsible for any configuration changes in XEngine configuration files for any TP specific validation. Responsible for monitoring and troubleshooting the transmissions in Edifecs Transaction manager. Must fit in the Agile development environment. Configure Severity files to perform custom error validation. Coordinate with other application teams and provide needed support to QA team. Experience with development of Groovy Script. This position services as an expert technical and industry resource to management, clients and development staff in new uses of information technology in all phases of major system and subsystem development. Provides consultation on internal and industry IT technical and business domain process capabilities including leadership in the identification and recommendation of new IT opportunities and business operations as it relates to application development. Formulates, contributes to, and directs task identification, work effort estimates, and work schedules for research, prototype, and proof-of-concept IT activities. Directs and participates in all aspects of development tasks including data management, application architecture and business architecture. Provides guidance to staff on complex assignments and mentors on new technologies. Works with to break down a complex system into smaller components and coach/lead a team of software engineers to design and develop these components. Functions as primary practitioner coach on the team to grow the capabilities of other engineers on the team. Integrates systems to databases and other applications using middleware such as SnapLogic, REST based services, etc. Understands the relationship between applications and infrastructure. Acts as a leader in the developer community within Magellan and performs demo, knowledge sharing sessions. Writes technical blogs and be active in Open Source Community. Agile, DevOPS and Cloud: Acts as expert for automated testing strategies, including TDD and ATDD. Works on Agile software development projects. Understands advanced concepts of Containers, Micro-Services, Continuous Integration Develops highly scalable applications in AWS cloud using tools like Cloud Formation Templates, EC2, SWF, ELB, Lambda, S3, RDS/Dynamo DB and others. Identifies track key metrics produced by the application. Performs load and performance testing on the applications and have advanced troubleshooting ability to tune the application to scale. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities 4+ years related experience including a minimum of 2+ years designing, building and deploying software in IT. Critical thinker. Demonstrated problem solving techniques. Strong verbal and written communication skills. General Job Information Title Edifecs Lead Software Engineer - Remote USA Grade 28 Work Experience - Required IT Work Experience - Preferred Education - Required A Combination of Education and Work Experience May Be Considered., Bachelor's, Bachelor's - Computer and Information Science Education - Preferred License and Certifications - Required License and Certifications - Preferred Salary Range Salary Minimum: $83,890 Salary Maximum: $142,610 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$83.9k-142.6k yearly Auto-Apply 49d ago
Benefits Specialist
Health Advocate West 4.5
Remote
Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company. Join our award winning team! 2025: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2024: Excellence in Customer Service Awards: Organization of the Year (Small) Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) As part of Teleperformance in the US, we were also named #95 in the 2024 ‘Fortune 100 Best Companies to Work For ' in the USA by Great Places to Work (GPTW ) Join Us as a Benefits Specialist (fully remote) Make a difference. Simplify healthcare. Empower members. At Health Advocate, we're on a mission to make healthcare easier to understand and easier to use. As a Benefits Specialist, you'll become a trusted guide for members who are navigating benefit choices, open enrollment decisions, and plan questions. Your expertise-and your empathy-will help people make informed decisions with confidence. If you enjoy problem-solving, love helping others, and want to grow your career in benefits and healthcare, this fully remote position could be the perfect fit. What You'll Do: Your Roadmap to Impact In this role, you'll support members by: Helping Members Understand Their Benefits Answer incoming calls and respond to benefit questions with clarity and compassion. Explain medical, dental, vision, pharmacy, life, disability, FSAs/HSAs, and other plans in easy-to-understand terms. Guiding Open Enrollment & Life Event Decisions Support members as they choose benefits during open enrollment, as new hires, or when their life circumstances change. Compare and contrast plan options so members feel confident in their selections. Providing Expert Navigation Across Coverage Types Discuss Marketplace/exchange plans, COBRA, Medicare, and individual plans. Help members understand costs, coverage, provider choices, and plan rules. Solving Benefit Issues with Care & Accuracy Research benefit concerns thoroughly and follow through until resolved. Document all cases accurately while maintaining strict confidentiality. Ensure compliance with HIPAA, COBRA, ACA, and all federal regulations. Delivering Outstanding Member Experiences Build trust quickly over the phone. Provide objective, empathetic guidance-no sales, no quotas, just real support. Who You Are: The Advocate We're Looking For: A Clear Communicator & Compassionate Problem Solver You're a great fit if you have: Experience That Makes a Difference 1-2 years of customer service and benefits experience Familiarity with health plans, COBRA, Medicare, HSAs/FSAs (preferred) Strong Communication & Listening Skills Ability to explain complex benefits clearly and patiently Professional, supportive phone presence Technical & Organizational Skills Comfortable using MS Word, Excel, and internal systems Strong documentation, accuracy, and time-management skills A Heart for Service You enjoy helping people You thrive in a collaborative, remote environment Why Health Advocate? At Health Advocate, we don't just support our members-we support you. Here's what you'll get: ✅ Work from home opportunity ✅ Comprehensive Training & Equipment: We set you up for success with thorough onboarding, ongoing development, and all necessary work equipment. ✅ Competitive Pay: We offer a starting hourly rate of $17.50. ✅ Comprehensive Benefits: Enjoy robust medical, dental, and vision coverage, 401(k) with company match, PTO, and professional development opportunities. ✅ A Culture of Purpose & Impact: You'll be part of a team that values empathy, innovation, and a shared mission to simplify healthcare for all. ✅ Career Growth & Development: Whether you're starting fresh or looking to expand your expertise, we provide mentorship, training, and growth opportunities to help you advance. This is more than a job-it's a chance to guide people through some of their most important and personal decisions. Your Next Move Ready to help people navigate their health benefits with confidence? If you're passionate about supporting others and want to grow your career in healthcare and benefits, we'd love to meet you. Apply today to join Health Advocate as a fully remote Benefits Specialist. Company Overview Health Advocate is the nation's leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need. Learn more Health Advocate https://www.healthadvocate.com/site/ Facebook https://www.facebook.com/healthadvocateinc/ Video https://vimeo.com/386733264/eb447da080 Awards: 2025: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2024: Excellence in Customer Service Awards: Organization of the Year (Small) Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2023: National Customer Service Association All-Stars Award: Service Organization of the Year. Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner 2022: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner Excellence in Customer Service Awards: Organization of the Year (Small) Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2021: Stevie Awards for Sales & Customer Service: Customer Service Department of the Year - Healthcare, Pharmaceuticals, and Related Industries, Silver Winner Stevie Awards for Sales & Customer Service: Most Valuable Response by a Customer Service Team (COVID-19). Bronze Winner Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium and large category (Silver) 2020: National Customer Service Association All-Stars Award: Organizations of 100 or Greater, Runner-Up Communicator Award of Distinction: October 2019 Broker News MarCom Awards: Gold, COVID Staycation Ideas brochure MarCom Awards: Platinum, 2021 Well-being Calendar Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium category (Silver) VEVRAA Federal Contractor requesting appropriate employment service delivery systems, such as state workforce agencies and local employment delivery systems, to provide priority referrals of protected veterans. PAY TRANSPARENCY NONDISCRIMINATION PROVISION The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-I.35(c)
$17.5 hourly Auto-Apply 6d ago
CISC Member, Caregiver and Stakeholder Engagement Manager
Magellan Health 4.8
Remote
Responsible for the development, strategy, and implementation of community outreach programs in conjunction with the Clinical and Administrative departments. Leads the development of strategic plans for engagement, within assigned territories, regions or communities, that nurture and retain positive relationships between the health plan, members and caregivers, the community, and provider organizations. Leads resource assessments within assigned region to identify potential partnerships to serve our members through enhanced access, improved community awareness of programs, and participation with established community advisory boards. Provides information about health care services, preventative care, as well as information related to health, welfare, and social services or social assistance programs offered by the state or local communities. Organizes and attends community events and health fairs. Serves as the liaison to community organizations. Conducts member, community, and organizational trainings. Completes face-to-face outreach. Ensures compliance with all state and federal marketing requirements. Drives engagement in care by facilitating a robust engagement strategy, which may include leveraging community relationships and developing opportunities to present and educate in front of members, caregivers, and other interested parties. Develops and implements promotional plans for new outreach opportunities. Distributes educational materials to community and provider organizations. Presents the program and offerings in group settings. Consistently achieves member engagement strategies while meeting quality performance standards. Attends provider and community meetings and participates in special projects. Conducts consumer and community surveys as needed. Provides training on programs to staff and agencies as necessary. Collaborates with multiple departments, including peers, business development, marketing, network contracting, and provider liaison teams. Participates as a member of the Clinical team in developing and implementing strategies to engage stakeholders. Develops and implements promotional plan for new outreach opportunities. Maintains thorough knowledge of healthcare programs and community resources. May act as a subject expert on Medicaid programs and benefits for internal and external stakeholders. Develops a resource guide for assigned territory (such as community-based organizations, service agencies, housing, food pantries, churches etc.), and cultivates relationships and identifies potential collaboration opportunities. Plans and implements territory monthly action plan and consistently meets and/or exceeds outreach targets. Produces summary reports on outreach activities. Participates in cross functional teams and quality improvement initiatives. Responsible for identifying, developing and maintaining strategic relationships with community contacts and organizations to pursue outreach engagements for multiple regions. Distributes written material to community and provider organizations. May schedule and facilitate marketing events, both formal and informal, with stakeholders that meets contract requirements. Identifies and attends community and health events. Identifies and coordinates outreach activities and necessary materials at community and health events. Organizes staff and other resources in the participation and the support of select community events and activities. Responsible for post-event follow up and maintenance of relationships for future and recurring events. Other Job Requirements Responsibilities 5+ years of community outreach and engagement experience with 1 year working with government-sponsored population, particularly Medicare and Medicaid. Self-starter with the ability to work with limited supervision. Excellent verbal and written communication skills. Must exhibit sensitivity towards the target population. 2+ years of experience working with individuals with adverse childhood experiences. General Job Information Title CISC Member, Caregiver and Stakeholder Engagement Manager Grade 23 Work Experience - Required Community Relations/Outreach Work Experience - Preferred Education - Required Associate Education - Preferred Bachelor's, Master's License and Certifications - Required DL - Driver License, Valid In State - Other License and Certifications - Preferred CPRS/CPS/CPSS/CRPS/PRSS, Peer Specialist, State Requirements - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt Salary Range Salary Minimum: $53,125 Salary Maximum: $84,995 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
$53.1k-85k yearly Auto-Apply 60d+ ago

Health Advocates Remote jobs - 27 jobs

Service Operations Supervisor, Healthcare Claims Department

Flu Shot Nurse

Customer Success Manager

Remote Medical Scheduler

Sales Executive, BH/Employer - Remote

Financial Talent Acquisition Sourcer - Contract Position/Remote

Youth Support Navigator - Certified Youth Peer Support Specialist

Military and Family Life Counselor - Short Term Assignments or On Demand for On Site

Care Coordinator- Remote in NM

Personal Financial Counselor, Assignment Ready Counselor, PFC- 180th Fighter Wing, OH

Senior Expense Reimbursement Coordinator, Federal (Expense Reports, Costpoint Experience Preferred)) - Remote

Network Management Specialist (Contract Specialist)

Family Support Navigator

CISC Care Coordinator, Licensed

Principal IT Analyst

Director, Clinical Care Services - New Mexico, Remote

MFLC Assignment Ready Counselor

Edifecs Lead Software Engineer - Remote USA

Benefits Specialist

CISC Member, Caregiver and Stakeholder Engagement Manager

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