Magellan Health jobs

This position is responsible for comprehensive management and ownership of fraud, waste and abuse investigations including development and presentation of investigative results. This individual carries out analytical and process management tasks with a high degree of autonomy. This individual serves as a corporate resource on fraud, waste and abuse issues and recommends cost containment projects with an emphasis on fraud prevention. INVESTIGATIONS Prioritize, triage and manage workload to meet internal performance metrics, regulatory and contractual requirements Use independent judgment to create investigative work plans and develop case strategies based upon analysis of referral data and contractual/regulatory requirements Analyze data and select audit samples using various sampling methodologies Plan and conduct desk audits, field audits and/or site visits Collect and analyze information to evaluate facts and circumstances through an extensive review of data from professional and facility providers, member data, contractual relationships, payment policies, Medicaid/Medicare rules and statutes, etc. Conduct research on medical policies and practices, provider characteristics, and related topics Interview patients, providers, provider staff, and other witnesses/experts Prepare correspondence Obtain and preserve physical and documentary evidence to support investigations Maintain comprehensive case files FRAUD, WASTE AND ABUSE DETECTION Triage and prioritize leads from internal and external sources Use knowledge of healthcare coding conventions, fraud schemes, and general areas of vulnerability, reimbursement methodologies, and relevant laws to find suspicious patterns in claims data, provider enrollment data, and other sources Remain up to date on published fraud cases, schemes, investigative techniques and methodologies, and industry trends PACKAGING OF FINDINGS AND RECOMMENDATIONS Organize data and prepare a written summary of investigative steps, conclusions, recommendations with attention to detail and a high level of accuracy Prepare clear and concise investigatory reports to support findings of potential fraud, waste and abuse CASE RESOLUTION Identify, communicate and recover losses as deemed appropriate Present case to internal department(s), law enforcement and/or regulatory agencies Support legal proceedings as needed, including testifying in court or working with law enforcement personnel to prepare cases for civil or criminal actions Negotiate settlement agreements with subjects and/or attorneys Assist in preparation, execution, and follow-up of settlement agreement terms CUSTOMER INTERACTIONS Make presentations to customers, prospects, conference audiences, and law enforcement Collaborate, consult, and coordinate regularly with clients on the status and direction of assignments Develop and maintain contacts/liaisons with law enforcement, regulatory agencies, task force members, other company SIU staff and external contacts involved in fraud investigation, detection and prevention MISCELLANEOUS DUTIES Represent client at industry task force meetings and meetings with regulatory agencies Measure and report performance metrics Identify opportunities and make recommendations for reduction of exposure to fraud, waste and abuse Consult on anti-fraud policies and procedures 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 Minimum of five years of experience in fraud investigations, related behavioral or medical healthcare insurance experience in claims, clinical, auditing, compliance, provider networks, management, or project planning. Demonstrated abilities in time management and establishing priorities. Strong listening and observation skills. Impeccable work ethic, completely dependable, and proactive; a problem solver. Proven ability to effectively handle cases of fraud and abuse in a discreet, confidential, and professional manner. Demonstrated strategic and analytical thinking skills, with ability to effectively communicate conclusions and recommendations to management. Comprehensive, practical knowledge of complex and diverse fraud investigative techniques and methodologies utilized in program audits. Understanding of insurance terms and policy interpretation. Ability to work to tight timelines when necessary. Works independently; collaborates well with peers and customers. Demonstrated ability to manage and prioritize case load with limited supervision. Strong computer skills consisting of Microsoft Excel, Access, Outlook, Word, and Power Point. General Job Information Title SIU Program Integrity Investigator - Remote (In Idaho) Grade 24 Work Experience - Required Fraud Investigations 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 AHFI - Accredited Healthcare Fraud Investigator - EnterpriseEnterprise, CFE - Certified Fraud Examiner - EnterpriseEnterprise, CPC - Certified Professional Coder - EnterpriseEnterprise, LSSBB - Lean Six Sigma Black Belt Certification - EnterpriseEnterprise, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare Mgmt 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.

Exemption Status:United States of America (Exempt)$110,982 - $155,376 - $199,769 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.” This position is not eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! Job Description Summary Using the industry's best practices for project management along with a solid working knowledge of the system development life cycle and IT Infrastructure deployment, the GPS Technical Project Manager III plans, directs, and coordinates Information Technology projects and programs related to Government Programs products and services to ensure that project goals are accomplished within prescribed time frames. The position is responsible for ensuring project goals and requirements are met on schedule, within budget and are successfully completed The Technical Project Manager III adheres and adapts to current processes. Identifies and recommends improvements to current practices. Manages escalated issues and demonstrates appropriate escalation of issues as needed. Leads the efforts of a multi-disciplinary project team through various stages of the project lifecycle, including vision and scope, requirements analysis, solution, design, development, and implementation. Requires close partnership with internal/external client counterparts, Information Technology (IT), Government Programs and Services, the Enterprise and GPS Project Management Offices, Operations, Health Services, and other departments as needed throughout the duration of the project. The position works in partnership with the centralized GPS Department as well as with enterprise-wide functional leaders, stakeholders and project team members to manage complex Information Technology projects across multiple programs, including Medicaid programs (State FFS program, Medicare/Medicaid Program (MMP), Medicaid Managed Care (MMCO), Children's Health Insurance Plan (CHIP) as well as other public federally-facilitated or state-based programs. Essential Duties and Responsibilities include the following. Other duties may be assigned. Initiation Defines project objectives/goals; determines the scope of each project as well as the project charter. Coordinates with key project personnel for requirements, technical analysis, design, and documentation of solutions to meet business requirements and drive technical problem resolution. Facilitates and manages vendor selection process and vendor onboarding process. Planning/Development Develops and coordinates the project plan by identifying project deliverables, milestones, scheduling, and required tasks. Uses planning and analytical skills in support of requirements gathering, writing functional specifications, SQL queries and test plan development activities. Helps ensure solution design meets standard architecture considerations and approval to include Standard database structures, (2) Code standards (3) Common components and reusable programs, (4) Security and Performance levels, (5) System interfaces and dependencies. Helps ensure that infrastructure design meets standard architecture considerations for high availability, redundancy, and disaster recovery. Working with stakeholders and Resource Management, determines staffing requirements and allotment of available resources to each project phase. Works with assigned project staff and/or clients to gather and document project requirements. Communicates with project team to outline work plan, assign duties, responsibilities, and scope of authority. Ensures that all responsibilities are clearly communicated, from requirements gathering to working with QA department to ensure solid quality assurance plan. Production/Execution Facilitates regular project status meetings to assess progress versus milestones and identify areas of potential concern in adequate time in order to mitigate risk. Tracks projects and issues closely, fosters collaboration from both the business and technology groups and leads issue resolution meetings during projects. Manages risks throughout the project by identifying, communicating, tracking, and mitigating. Meets with project personnel to provide technical advice and to resolve problems. Ensures all follow-up action items are owned and closed out by the relevant owners Monitors/Controls Manages and monitors project status by establishing a regular meeting schedule with project teams. Directs and coordinates activities of project personnel to ensure project progress is on schedule and outstanding items or issues are successfully resolved. Creates and communicates regular status reports for management, clients, and the project team. Provides formal and ad-hoc updates to management as required. Prepares project status reports and keeps clients and others informed of project status and related issues. Ensures completeness of all project documentation throughout the project lifecycle and for obtaining appropriate approvals at each phase of the project. Participates in reviewing, monitoring, and gaining appropriate approvals for project documentation throughout the project lifecycle including Vision and Scope, Technical Specifications, Architecture Specifications and Objectives of the Project. Ensures completeness of all project documentation throughout the project lifecycle and for obtaining appropriate approvals at each phase of the project. Monitors and manages project constraints including scopes, cost, timeline, resources, and risks. Closing Assumes responsibility for delivery by ensuring all components of the project are successfully completed (including lessons learned documentation. Coordinates and interfaces with other departments for project transition. Other Mentor less experienced project managers. Strong emphasis on strategic thinking as it relates to the management of assigned projects and on-going use of the solution. Communicates well with technical and business stakeholders. Builds and maintains good working relationships with team members, vendors and other departments involved in projects. Supervisory Responsibilities No supervisory responsibilities Client Responsibilities This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience BS/BA and 8+ years' experience or equivalent combination of education and experience, and 4 years of SME in respective areas This position requires experience with Medicaid or Government health, with a strong preference for Medicaid Fee-For-Service experience. Computer Skills Proficient with Microsoft Office (Word/Excel/PowerPoint), MS Outlook and MS Project. Must be proficient with Project Scheduling Software. Familiarity with MedImpact developed applications helpful (MedAccess, MedResponse, etc.) Certificates, Licenses, Registrations None required; PMP certification is highly desired Other Skills and Abilities Experience in all phases of software development lifecycle and IT infrastructure deployments preferred Prior experience in PBM, pharmaceutical, or managed healthcare industry is a plus Must have good negotiation skills, well-developed facilitation and collaboration skills Proven leader and team player Strong client management skills Ability to work in a matrix management organization Driven and committed to overcome obstacles and deliver the project on time Delivery-focused, yet flexible and creative when called upon Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to define problems, collect data, establish facts, and draw valid conclusions. Mathematical Skills Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. Language Skills Ability to read, analyze, and interpret the most complex documents. Ability to respond effectively to the most sensitive inquiries or complaints. Competencies To perform the job successfully, an individual should demonstrate the following competencies: Composure Decision Quality Organizational Agility Problem Solving Customer Focus Drive for Results Peer Relations Time Management Dealing with Ambiguity Learning on the Fly Political Savvy Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Work Location This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders. Working Hours This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonably meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, at weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm. Travel This position requires no travel however attendance maybe required at various local conferences and meetings. The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to ************************* MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA: To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Exemption Status:United States of America (Exempt)$130,148 - $182,208 - $234,267 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.” This position is not eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! Job Description Essential Duties and Responsibilities include the following. Other duties may be assigned. Manages Account Executive development of client-specific business plans focused on the client's goals, performance expectations, growth in membership and profitability. Ensures that deliverables are on time, within budget, and meet the quality levels expected by MedImpact's internal and external customers. Provides direction and management over Key and LAMP Account Management teams to monitor the quality of products and services being offered to the client. Trains new staff members and provides on-going coaching to existing Account Management teams. Optimizes potential for sustainable growth and profitability. Identifies and aligns required resources to achieve business goals in book-of-business. Develop and maintain solid business relationships with region's clients at the executive and key decision-maker levels. Determines where to make “focused investments” for each account. Utilizes financial and pricing models to analyze and present business and clinical scenarios to client illustrating different benefit strategies and advantages of adoption. Researches and analyzes market trends and competitive practices to ensure client strategy is placed in context of client's industry and marketplace. Monitors client service continuum including proactive and reactive components. Resolves escalated issues, while ensuring ongoing issues are resolved expeditiously. Performs 360o review of performance on account, from operational service delivery to relationship management. Identifies gaps and sources of corrective action to ensure milestones are met. Collaborates with leaders in Operations, IT, Health Services and the other Directors. Supervisory Responsibilities Manages assigned staff in the segment area. Responsible for the overall direction, coordination, and evaluation of this unit. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner, taking corrective action whenever necessary. Client Responsibilities This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience Bachelor's degree (Master's degree preferred) and a minimum of ten (10) years related experience and eight (8) years of SME in respective area(s); (or equivalent combination of education and experience) with at least eight (8) years leading individual contributors, leaders, and leaders of leaders; which may be substituted with an appropriate mix of leadership experience and 10 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader (VP+ level) that must completed within 12 months in new position Required experience depends on assigned book of business. Self-Insured - Experience in the Self-Insured benefits arena, experience with health plans/white label required. Location - Remote - Eastern or Central Region Computer Skills Intermediate to advanced computer skills; proficient with MS Office/Outlook and client databases Certificates, Licenses, Registrations None currently required. Other Skills and Abilities: Working knowledge of the health benefits arena, government prescription programs, preferably in pharmacy benefits management required; knowledge of healthcare products and contracts preferred; Consultative selling and negotiation skills; Demonstrated experience creating and delivering client presentations using; Strong verbal, written, interpersonal, presentation, persuasion and consulting skills required; Good interpersonal skills, excellent communication, writing and presentation skills essential; Other Qualifications Outstanding knowledge of the health benefits arena, preferably in pharmacy benefits management “PBM” or other managed healthcare services to national and regional managed care organizations, insurance companies, and other health related entities. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Mathematical Skills Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry Language Skills Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Competencies To perform the job successfully, an individual should demonstrate the following competencies: Business Acumen Directing Others Organizational Agility Conflict Management Drive for Results Political Savvy Customer Focus Innovation Management Strategic Agility Decision Quality Managerial Courage Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is frequently required to use hands to finger, handle, or feel and reach with hands and arms. The employee is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is occasionally exposed to moving mechanical parts; fumes or airborne particles and risk of electrical shock. The noise level in the work environment is usually moderate. Work Location This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders. Working Hours This is an exempt level position requiring one to work the hours needed to get the job done. Therefore one must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. This may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm, often supporting multiple time zones depending on assigned book of business. Travel This position requires domestic travel of up to 50% of the time with little or no advance notice. The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to ************************* MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA: To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Exemption Status:United States of America (Non-Exempt)$19.11 - $24.65 - $30.19 “Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.” This position is not eligible for Sponsorship. MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team! Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare. At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution! Job DescriptionMedImpact's Managed Care Pharmacy Residency Program is a one-year program that develops future managed care leaders by building a strong foundation of knowledge in both clinical and managed care principles. By working across multiple teams serving all lines of business, the diverse experience gained will amply prepare the resident for a career in managed care pharmacy.The Managed Care Pharmacy Resident provides support to the Government Programs and Services (GPS) team and other departments through managed care learning experiences (rotations) and longitudinal projects. The rotations/projects will include a breadth of disciplines including clinical operations, utilization and formulary management, clinical account services, quality assurance and improvement, government program management, analytics and research.Essential Duties and Responsibilities include the following. Other duties may be assigned. Perform cost savings and member impact analyses after learning benefit design and utilization management strategies. Contribute to clinical quality programs, such as Drug Utilization Review (DUR), Transitions of Care and other initiatives to improve HEDIS and CMS Star Ratings. Support clients by developing and implementing quality and cost savings initiatives and managing custom formularies across all lines of business. Participate in the management of government programs to evaluate and facilitate regulatory programs. Perform quality program oversight and develop quality improvement initiatives while supporting oversight audits. Evaluate prior authorization requests and understand the regulatory requirements governing prior authorization reviews, which includes four hours of weekly staffing. Assist in P&T material preparation and weekly drug updates. Present at MedImpact P&T Committee meetings. Develop presentation skills to lead meetings while learning to manage projects and navigate corporate complexities. Conduct a longitudinal research project designed for presentation at AMCP Annual Meeting. Education and/or Experience PharmD from an ACPE-accredited school of pharmacy Minimum GPA of 3.0 Managed Care experience preferred Certificates, Licenses, Registrations Must obtain Registered Pharmacist license in state of residence and Kentucky by October 1st of the program year. Other Skills and Abilities Strong analytical and problem-solving capabilities Excellent communication and presentation skills Ability to work independently and as part of a team Knowledge of PBM operations, drug formulary systems, and healthcare regulations Reasoning Ability Ability to deal with nonverbal symbolism (formulas, scientific equations, graphs, musical notes, etc.,) in its most difficult phases. Ability to deal with a variety of abstract and concrete variables. Ability to define problems, collect data, establish facts, and draw valid conclusions. Language Skills - Choose up to 1 from each drop-down list. Ability to effectively present information to top management, public groups, and/or boards of directors. Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Competencies To perform the job successfully, an individual should demonstrate the following competencies: Composure Decision Quality Organizational Agility Problem Solving Customer Focus Drive for Results Peer Relations Time Management Dealing with Ambiguity Learning on the Fly Political Savvy Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic). Working Hours This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonable meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm. Travel This position requires domestic travel of up to 25% of the time. Please include Letter of Intent AND Curriculum Vitae (CV) in Workday along with submission of application. Official transcript must be emailed directly from pharmacy school to ******************************. Three letters of recommendation must be emailed directly from letter writers to ******************************. The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to ************************* MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets. Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA: To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

The Quality Coordinator-Transitions of Care is dedicated to managing quality assurance processes and ensuring compliance with industry standards. This role involves coordinating with various departments to integrate quality systems, facilitating continuous improvement initiatives, and maintaining comprehensive documentation to support assessments and audits. The Quality Coordinator plays a crucial role in fostering a culture of quality and excellence within the organization, driving efforts to meet and exceed quality targets. Essential Functions Implements and monitors quality improvement initiatives to ensure adherence to best practices, policies, and regulatory requirements. Supports teams as a subject matter expert on quality-related workflows, ensuring staff adherence to established procedures. Coordinates and tracks patient outreach efforts to close gaps in care, ensuring timely follow-up on quality attribution reports. Optimizes provider schedules by ensuring appointments address preventive care and chronic disease management gaps. Monitors and analyzes key performance indicators (KPIs) related to quality measures, providing feedback and accountability to stakeholders. Conducts regular rounding with providers and staff to reinforce best practices and identify workflow improvement opportunities. Assists in medical record audits, ensuring compliance with payer requirements and timely submission of quality-related documentation. Facilitates training sessions and provides ongoing support to enhance staff competency in quality care initiatives. Collaborates with data analytics and population health teams to ensure accurate reporting and performance tracking. Maintains compliance with all payer-specific quality programs, ensuring proper documentation and adherence to incentive program requirements. Performs other duties as assigned. Complies with all policies and standards. Qualifications Associate Degree in Healthcare Administration, Nursing, Public Health, or a related field required Bachelor's Degree in Nursing or a related field preferred 2-4 years of experience in quality improvement, population health, or clinical operations within a healthcare setting required Experience in working with payer quality programs and regulatory reporting preferred Knowledge, Skills and Abilities Strong knowledge of quality improvement methodologies and healthcare regulatory requirements. Proficiency in electronic medical records (EMR) systems and quality reporting tools. Excellent communication and interpersonal skills to collaborate effectively with providers, staff, and leadership. Ability to analyze data, identify trends, and develop action plans for performance improvement. Strong organizational skills and attention to detail to ensure compliance with quality initiatives. Ability to adapt to evolving healthcare regulations and payer requirements. Strong problem-solving skills and the ability to drive accountability in a healthcare setting. Licenses and Certifications Certified Medical Assistant (CMA)-AAMA preferred or LPN - Licensed Practical Nurse - State Licensure preferred or RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred CPHQ - Certified Professional in Healthcare Quality preferred

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.

Coordinate and collaborate with Prison Facilities via in person. Knowledge of community resources that help support incarcerated population. 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 typically performed during face-to-face home visits. 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, (i.e. 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 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 - Transition of Care 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.

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.

Benefits We Offer: + Comprehensive health, prescription, dental, vision, life, and disability plans + Competitive pay rates + Referral opportunities ? Refer a friend & Cash in! + Travel reimbursement and per diem allowances + Employee discounts + Educational opportunities Health Advocates Network was founded based on a shared aspiration to improve the way healthcare staffing is done. We are a company founded by healthcare professionals and built for healthcare professionals. As your true advocates, we will always help you thrive and pave the path forward in your career. Our talented staffing team is committed to providing exceptional customer service, great opportunities with top pay and benefits. From Per Diem to Travel Contracts, miles away or local to you, Health Advocates Network can find you just what you are looking for. Allow us to get you to you next adventure! Health Advocates Network, Inc. is an equal opportunity employer. All qualified applicants shall receive consideration for employment without regard to any legally protected basis under applicable federal, state or local law, except where a bona fide occupational qualification applies. EOE including Veterans/Disability

The Scheduling Specialist is responsible for creating, maintaining, and distributing clinician schedules for assigned hospital facilities. This role ensures schedules are accurate, open shifts are filled promptly, and clinician hours and compensation are tracked for payroll processing. The Scheduling Specialist fosters strong communication with clinicians and leadership while ensuring compliance with organizational policies and budgetary constraints. As a Scheduling Specialist I at Community Health Systems (CHS) - SSC Sarasota, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical insurance, dental insurance, vision insurance, PTO, 401K, sick time, holidays, and bonus where eligible. Essential Functions: Develops and maintains hospital schedules based on workload demands, ensuring timely publication and accuracy in scheduling software. Communicates with clinicians via phone, text, and email to address scheduling needs, manage call-offs, and handle emergency openings. Supports Medical Directors and site-specific scheduling needs, including contracted schedules, orientation, and shadowing arrangements for new providers. Verifies clinician credentials and enrollments to ensure readiness to work at assigned facilities. Tracks clinician hours using scheduling software, prepares reports, and collaborates with payroll for accurate and timely processing. Updates recruitment and staffing reports, such as "Have vs. Needs," to provide real-time data to recruiting teams. Monitors performance metrics and financial data, assisting management with staffing and scheduling performance reports. Works closely with credentialing, recruiting, and enrollment teams to ensure seamless coordination and scheduling support. Provides flexible hours and availability to assist Directors, VPs, and facilities with scheduling and related tasks as needed. Performs other duties as assigned. Complies with all policies and standards. This is a remote position. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Required: Education: H.S. Diploma or GED Experience: 1-3 years of experience in scheduling, operations, or healthcare administration Preferred: Education: Bachelor's Degree in Healthcare Administration, Business Administration, or a related field Experience: 1-3 years 1-3 years of Physician and Advanced Practice Provider scheduling experience (or relevant scheduling experience such as surgical or patient) Knowledge, Skills and Abilities: Proficiency in scheduling software and Microsoft Office Suite. Excellent verbal and written communication skills. Strong problem-solving skills and attention to detail. Knowledge of healthcare industry standards and protocols. Strong organizational and multitasking abilities. Ability to work in a fast-paced and dynamic healthcare environment. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Sarasota SSC operates in support of our hospitals and patients and our commitment is to provide them with exemplary revenue cycle services defined by outstanding customer service and superior revenue cycle performance. SSC Sarasota support facilities located primarily in Florida, Georgia, Indiana, and Pennsylvania. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. INDSSFLRCSC

Health Advocates Network is urgently hiring X-ray Tech in the Cleveland, OH area. Must have 2 years of X-ray Tech experience. + Pay Rate: $2,288 weekly + Specialty: X-ray Tech + Shift: Night + 13 Week Contracts and more available! Qualification and Requirements: + Authorized to work in the United States. + 2 years of experience as an X-ray Tech + American Heart Association BLS, ARRT + An active, current (OH) state license Apply for this job now or to find out more about other opportunities with **Health Advocates Network, Inc.** reply to this posting, contact us at allied@hanstaff.com or call/text 704-817-3427. We can provide you unparalleled access to exciting career opportunities. Benefits We Offer: Competitive pay rates, Referral Bonus, Medical, Dental, Vision and 401k. Travel reimbursement and per diem allowances, Employee discounts, educational opportunities, and more! Who We Are: Health Advocates Network matches highly skilled applicants to positions at the best healthcare companies on a temporary and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well-matched to your skills - helping you advance in your career. Our experience, combined with our client relationships, makes Health Advocates Network a great resource for your career. Health Advocates Network, Inc. is an equal-opportunity employer. All qualified applicants shall receive consideration for employment without regard to any legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Refer a Registered Nurse for a $1000.00 bonus opportunity! Health Advocates Network, Inc. is an equal opportunity employer. All qualified applicants shall receive consideration for employment without regard to any legally protected basis under applicable federal, state or local law, except where a bona fide occupational qualification applies. EOE including Veterans/Disability

This is a remote position working part time /20hrs per week, therefore the compensation range would be an hourly rate based on .5 /half of the anticipated base salary range listed below. Work schedule is: Monday through Friday 8:30AM-12:30PM EST. Flexibility is preferred for a few events and other requests throughout the year. Need to reside near/around the Yardley, PA area. ***Website design experience is preferred to manage weekly responsibilities for website design and updates. This position works closely with and assists leadership in marketing, social and communications strategy, planning and execution to achieve agreed upon goals. Works across a wide range of internal and external constituents. Provides team coordination support. Provides support and assistance in planning, developing, producing, and delivering marketing programs and projects. Collaborates with other departments and engages with key vendors in the development, production, and distribution of promotional and collateral materials Participates in research on key topics, stakeholders and best practices and makes recommendations Develops clear, concise and compelling content targeting a variety of audiences through Magellan`s key channels. Proofreads content for accuracy, branding and compliance. Supports the coordination of team activities including management of the editorial calendar to help ensure appropriate amplification and timely execution of programs and initiatives Coordinates key team activities and provides support with scheduling meetings, calendars, travel arrangements and other general departmental administrative support as needed. Regularly communicates status updates to Marketing and Communications leadership. Completes special projects 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 in marketing, communications or related field. Creative, quick thinker with strong writing, verbal and interpersonal communication skills. Excellent project management and organizational skills. Ability to multitask and prioritize accordingly. Proactive and flexible self-starter with impeccable attention to detail. Willingness to jump in and assist where needed. Comfortable with Microsoft Office software programs and tools. General Job Information Title Marketing & Communications Coordinator - Remote PA, Grade 21 Work Experience - Required Communications, Public Relations or Related Field, Marketing 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: $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.

This position is responsible for the development of the provider network, assuring network adequacy and appointment access, development of network resources in response to unmet needs, and adequacy of the provider network to provide member choice of providers, and contracting with qualified service providers in compliance with federal and state laws. This role will lead Magellan's strategy and planning in the successful development of the provider network including network development, contracting, credentialing and provider communications for existing or emerging markets, as assigned. Role is responsible for the annual network development plan as well as key business development activities as assigned. Leads network planning and strategy efforts to support the successful implementation or transformation of the various delivery systems, including assisting in all network related activities during new contract implementations Conducts market research for emerging markets and develops Capture Strategy specific to the provider network - SWOT Analysis of each Tier 1 Priority State specific to the current provider delivery system as applicable. Operates as a Network SME for all active proposals, work with the existing national network team to drive solutions, actively storyboard solutions to identified problems, and assist in preparing content post RFP release. Travel to identified opportunity, facilitating meetings in the market with providers, provider associations etc. and develop comprehensive summaries of all provider engagement as needed Contribute to comprehensive work plans geared towards understanding the Network, building out a comprehensive list of all provider types including training, qualifications, and cost requirements. Plans, develops and ensures implementation and positive outcomes of the Annual Network Development Plan including network adequacy and appointment access, development of network resources in response to unmet needs, contracting with qualified service providers and compliance with Federal and State laws. Leads and provides direction to the Magellan Network team including all development responsibilities. Leads provider recruitment activities and ensures compliance with contracting, credentialing and privileging policies and procedures. Ensures the Network Transition Plan is successful meeting all established timeframes. Other network related activities 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 8+ years managed healthcare experience. Significant experience in progressive network management and development. Knowledge of NCQA requirements. General Job Information Title Director, Network Development - Clinical Background Required Grade 30 Work Experience - Required Network 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: $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.

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.

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.

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.

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-Appleton, WI 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.

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.

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.