Magellan Health jobs - 176 jobs

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.

Exemption Status:United States of America (Exempt)$85,356 - $115,232 - $145,107 “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 Account Executive I or II- Hospital & Health-Systems (Self-Insured) Account Executive I - $82,074 - $110,800 - $139,526 Account Executive II - $98,327 - $135,200 - $172,073 The Scoop: The Account Executive is responsible for the success of the overall client business relationship of Complex Accounts, Strategic Key Accounts, and entire assigned book of business. Provides proactive and strategic support for achieving financial goals resulting from successful oversight of client deliverables, renewals and upsell activity. Manages all aspects of business relationships with minimal management involvement and exhibits a track record of performance that exceeds expectations. Ensures customer satisfaction, and effectively leads the account client team focusing on service, revenue, and operational efficiency as identified in strategic plans for the client and MedImpact. This position operates with a very high level of autonomy on complex business issues while requiring minimal management oversight. What You Get To Do: Level I Manage book of business in pursuit of fiscal revenue targets as set by management Develop and manage the account team annual strategic plan for assigned book of business to address all aspects of client lifecycle, including but not limited to service, financial, growth and clinical initiatives based on an understanding of each client's business needs Ensure high degree of client satisfaction and retention through demonstrable results and by effectively leading the service team to achieve client service goals Effectively utilize MedImpact forums and resources to proactively address client needs and to escalate issues where appropriate Provide timely feedback of strategic plan performance and outcomes to the management to ensure service and growth opportunities are maximized and incorporated into the organizational strategy planning process Provide oversight of projects and client initiatives and assists in the interpretation and context of client requests Maintain the integrity of the annual strategic business plan and manage the fiscal revenue plan Manage client renewal process, including participation in development and review of proposal of pricing terms in lieu of the fiscal revenue plan, mitigate organizational risks with respect to performance guarantees, and unveil opportunities for MedImpact product usage as well as client growth and expansion Lead renewal presentations. Utilize all internal pro-forma financial tools and forums to ensure preparedness and success Support the implementation process for assigned clients, including oversight of implementation and contract terms Negotiate and manage client contract throughout the lifecycle of the account Build strong and positive internal relationships with your account service matrix team in order to realize the full potential of the assigned book of business Coordinate with MedImpact subject matter experts to increase knowledge of MedImpact products, services, and industry information to be incorporated into and strengthen client relationship Organize and lead client business planning meetings, quarterly and annual executive pharmacy briefings, client leadership councils and internal team strategy planning discussions Demonstrate proficiency in Excel, Word and PowerPoint, organizational web-based tools in support of these functions Supports and assists in sales and prospect presentations Develops and maintains effective relationships with client consultants as appropriate Level II Develops and manages client specific, strategic, financial, and business relationship plans that encompass client's goals, performance expectations and growth in membership and profitability in pursuit of meeting department and organizational business metrics Manages large, highly complex clients that have complex business needs Consistently ensure that deliverables are on time, within budget, and meet the quality levels expected by MedImpact's internal and external customers Optimizes potential for sustainable growth and profitability for assigned book of business Develops and maintains solid business relationships with clients at the executive level and with critical decision-makers Determines where to make “focused investments” for each account Utilize financial and pricing models to analyze and present business and clinical scenarios to client illustrating different benefit strategies and advantages of adoption Organizes and leads client business planning meetings, financial performance reviews, leadership summits and internal strategy planning discussions Researches and understands market trends and competitive practices to in order to share opportunities based on client needs and strategic objectives Mentors new Account Executives through on boarding process Proactively monitors client service continuum to identify and address service delivery issues and escalate concerns appropriately Collaborates with internal leaders throughout other business units for problem solving, planning and successful outcomes Demonstrates ability to manage challenging situations in a positive and constructive manner Ensures client retention and oversee client contract renewals including managing the RFP and negotiation process Manages and prioritizes elements of negotiations within scope of total client relationship Organizes and develops assigned Book of Business presentations Maintains thorough understanding of clients' business and financial goals and the relationship to MedImpact goals in sustaining a profitable partnership Provides regular feedback of strategic plan performance and outcomes to management to ensure service and growth opportunities are maximized and incorporated into the organizational strategy planning process Provides oversight of projects and client initiatives and assist in the interpretation and context of client requests Provide support to matters escalated by the client team Participates in and support the implementation process for new clients assigned, including collaboration with the Sales and Implementation teams on contract terms Supports and assists in sales and prospect presentations, including participation in and travel to Best and Final meetings Develops and maintains effective relationships with client consultants as appropriate Completes assignments, Salesforce cases and training including stretch assignments Supervisory Responsibilities This job has no supervisory responsibilities. Education and/or Experience For consideration candidates will need: Level I: Bachelor's Degree from four-year college or university Three (3) to seven (7) years related PBM experience, or equivalent combination of education and experience Self-Insured - Experience in the Self-Insured benefits arena, 340B or clients with owned & operated pharmacies, preferably with Hospitals and Health Systems. Level II: Bachelor's degree from four-year college or university Seven (7) to ten (10) plus years related experience in a PBM environment, or equivalent combination of education and experience Self-Insured - Experience in the Self-Insured benefits arena, 340B or clients with owned & operated pharmacies, preferably with Hospitals and Health Systems. Computer Skills Intermediate to advanced skill set in MS Office, Word, Excel, PowerPoint, Project, Salesforce and Outlook. Certificates, Licenses, Registrations Other Skills and Abilities Outstanding knowledge of the health benefits arena, government prescription programs, preferably in pharmacy benefits management. Strong consultative selling and negotiation skills, Strong computer, and analytic skills, including experience creating and delivering client presentations using MS Office programs and use of internal system reporting tools and databases. Knowledge of healthcare products and contracts preferred. Strong verbal, written, interpersonal, presentation, persuasion and consulting skills required. Excellent communication, writing and public presentation skills essential. Travel This position may require domestic travel up to 35% of the time, with little or no advance notice and depending on client contractual requirements. The Perks: Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays 401K with Company match Life and Disability Insurance Tuition Reimbursement Employee Referral Bonus This position is eligible for Employee Referral Bonus at Level I 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/Veterans OSHA/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 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)$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.

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

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.

We are seeking a compassionate and organized Transition of Care Clinical Support team member to support patients as they move from hospital to home. In this role, you will conduct post-discharge phone interviews to assess patient needs, identify potential barriers to recovery, and help schedule timely follow-up appointments to reduce hospital readmissions. Ideal candidates are patient-focused, detail-oriented, and comfortable with phone-based patient interactions in a fast-paced healthcare environment. Must have a clinical background, RN, LPN, CMA etc. 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

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.

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

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.

Exemption Status:United States of America (Exempt)$101,277 - $139,256 - $177,234 “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 The Principal, Government Programs represents MedImpact's Government Program and Services Department to key government customers and prospects. Leveraging past experiences, this position establishes and builds solid work relationships with MCO and State fee for service (FFS) executive and operational leaders. Acts as the enterprise lead Subject Matter Expert (SME) in Medicaid, Medicare/Medicaid (MMP) and Marketplace plans for assigned regions. Reviews and interprets current and future policies, develops relationships as necessary with state, federal, and regional stakeholders for purposes of educating oneself and internal staff members. Participates in enhancing existing enterprise strategies, business development opportunities, products and services relative to MedImpact's Medicaid, Medicaid/MMP and Marketplace lines of business based on impending public policy changes and other market demands. Essential Duties and Responsibilities include the following. Other duties may be assigned. Participates in the development and implementation of short and long term strategies in order to gain access to prospective MCO and State leadership for purposes of improving the prospect's knowledge of MedImpact's differentiated products and services, as well as MedImpact's proven capability to manage drug spend. Drives networking activities; participates in conferences, speaking opportunities, state-specific Medicaid leadership meetings. Participates in the development and implementation of short and long term strategies to increase new government program business. Maintains awareness of current and future industry trends, including the regulatory environment, customer needs, opportunities and issues. Transforms knowledge into results-generating strategies and business development plans. Supports the sales process for all Medicaid, MMP and Marketplace MCOs, actively participates in prospect meetings and best and final presentations. Serves as the key MedImpact SME for Medicaid, MMP and Marketplace, utilizing a deep understanding of these programs as they relate to prescription drug benefit management. Represents MedImpact to key government customers regarding policy information while working closely with corporate compliance to ensure consistent application of law, rules and regulations relative to program development and deployment. Meets with assigned clients on a routine basis to review regulatory changes and associated MedImpact solutions and support. Ensures an effective, positive representation of the corporate image. Maintains a thorough understanding of MedImpact's programs and services provided to Medicaid, MMP and Marketplace customers. Provides direction on the potential impact of new or potential regulatory requirements relative to these business lines. Works closely with key business units to review complex regulatory and legislative issues that may impact MedImpact's business services and operational processes. Works with Government Programs & Services management to provide information on business requirements of potential program or business development opportunities that align with both client and MedImpact business goals, specific regulated program objectives, performance metrics and financial goals. Reviews new and pending legislation and regulatory materials relative to Medicaid, MMP and Marketplace with an emphasis on prescription drug management. Builds strong customer, industry consultant and vendor relationships. Develops relationships with federal and state agencies and other key stakeholders Education and/or Experience Bachelor's degree (or equivalent combination of education and experience); Advanced degree preferred ( Ph.D., MBA, M.S., MPA, MPH). 10+ years' progressive experience in a healthcare related Managed Care Organization and/or State Agency including 8 years as a subject matter expert. Must have in-depth knowledge of governmental programs (CMS, Medicaid, Medicare, and Market Place/Public Exchanges). Prior work experience within the Centers for Medicare and Medicaid Services (CMS) a plus. 4 years of supervisory experience required. Supervisory experience may be substituted with 5 years of MedImpact experience plus an external leadership training program and internal mentorship with a seasoned leader (VP+ level) that must completed within the first 12 months in the new position. Computer Skills Solid computer skills with Microsoft Office/Outlook, industry-related databases and use of the internet. 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 Collections Specialist I - Medicaid is responsible for performing collection follow-up on outstanding insurance balances, identifying claim issues, and ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective communication with insurance payers, documentation of account activity, and adherence to applicable regulations to support revenue cycle operations. As a Collections Specialist I at Community Health Systems (CHS) - SSC Nashville, 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, dental and vision, insurance, and 401k. Essential Functions Performs follow-up on outstanding insurance balances within the required timeframe, obtaining payment confirmation or required documentation. Documents all actions taken on accounts within the appropriate system, ensuring a clear and traceable resolution process. Makes the required number of outbound calls to insurance payers while maintaining professional and courteous communication. Handles and resolves incoming correspondence within five days of receipt, updating the system with relevant information. Analyzes assigned accounts using AS400, Meditech, Accurint, Cerner, directory assistance, and credit reports to maximize collection efforts. Processes inbound and outbound calls professionally, providing exceptional customer service while resolving outstanding balances. Ensures proper application of account dispositions and follows self-pay policies and procedures. Adheres to all local, state, and federal laws and regulations, including FDCPA, TCPA, FCRA, CFPB, PCI, UDAAP, and HIPAA compliance standards. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications H.S. Diploma or GED required Associate Degree in Business, Finance, Healthcare Administration, or a related field preferred 0-2 years of experience in medical collections, accounts receivable, billing, or healthcare revenue cycle operations required Experience working with insurance follow-up, claim resolution, and payer communication in a healthcare setting preferred Knowledge, Skills and Abilities Strong understanding of medical collections processes, payer reimbursement policies, and insurance claim resolution. Proficiency in electronic medical record (EMR) systems, patient accounting systems, and collections software. Knowledge of insurance contracts, denials management, and accounts receivable workflows. Excellent problem-solving and analytical skills to research and resolve outstanding claims. Effective verbal and written communication skills to interact with insurance payers, patients, and internal teams. Strong attention to detail with the ability to document account activity accurately. Ability to work independently in a fast-paced environment while meeting productivity and quality standards. Knowledge of regulatory compliance, including HIPAA, FDCPA, and applicable healthcare finance laws. 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 Shared Services Center - Nashville provides business office support functions like billing, insurance follow-up, call center customer service, data entry and more for hospitals and healthcare providers. But we're not only about work. We know employing a skilled and engaged team of professionals is vitally important to our success, so we make sure to offer competitive benefits, recognition programs, professional development opportunities and a fun and engaging team environment. 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.

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 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.

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.

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- Ohio 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.

Create/update maps, guidelines and profiles using Edifecs tools such as EDIFECS SpecBuilder, Map Builder, EAM as per functional logic. Create maps and guidelines (xml, DFF, PFF) for Healthcare EDI transactions like 837, 834, 835, 820 transactions. Responsible for design, development, and implementation of Edifecs solution. Excellent understanding of technical and business challenges relating to EDI product upgrades. Able to configure the Edifecs tools, and understand systems integration, application, technical behavior, and business / technical requirements. Experience with Edifecs Healthcare 9.x suite, and Healthcare Payer systems. Detailed understanding of EDI Healthcare transaction sets, e.g. 270/271, 820, 834, 837 I/P/D, 835. Knowledge of software development / implementation processes. Able to explain technical solutions and fixes to stakeholders. Responsible for any configuration changes in XEngine configuration files for any TP specific validation. Responsible for monitoring and troubleshooting the transmissions in Edifecs Transaction manager. Must fit in the Agile development environment. Configure Severity files to perform custom error validation. Coordinate with other application teams and provide needed support to QA team. Experience with development of Groovy Script. This position services as an expert technical and industry resource to management, clients and development staff in new uses of information technology in all phases of major system and subsystem development. Provides consultation on internal and industry IT technical and business domain process capabilities including leadership in the identification and recommendation of new IT opportunities and business operations as it relates to application development. Formulates, contributes to, and directs task identification, work effort estimates, and work schedules for research, prototype, and proof-of-concept IT activities. Directs and participates in all aspects of development tasks including data management, application architecture and business architecture. Provides guidance to staff on complex assignments and mentors on new technologies. Works with to break down a complex system into smaller components and coach/lead a team of software engineers to design and develop these components. Functions as primary practitioner coach on the team to grow the capabilities of other engineers on the team. Integrates systems to databases and other applications using middleware such as SnapLogic, REST based services, etc. Understands the relationship between applications and infrastructure. Acts as a leader in the developer community within Magellan and performs demo, knowledge sharing sessions. Writes technical blogs and be active in Open Source Community. Agile, DevOPS and Cloud: Acts as expert for automated testing strategies, including TDD and ATDD. Works on Agile software development projects. Understands advanced concepts of Containers, Micro-Services, Continuous Integration Develops highly scalable applications in AWS cloud using tools like Cloud Formation Templates, EC2, SWF, ELB, Lambda, S3, RDS/Dynamo DB and others. Identifies track key metrics produced by the application. Performs load and performance testing on the applications and have advanced troubleshooting ability to tune the application to scale. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities 4+ years related experience including a minimum of 2+ years designing, building and deploying software in IT. Critical thinker. Demonstrated problem solving techniques. Strong verbal and written communication skills. General Job Information Title Edifecs Lead Software Engineer - Remote USA Grade 28 Work Experience - Required IT Work Experience - Preferred Education - Required A Combination of Education and Work Experience May Be Considered., Bachelor's, Bachelor's - Computer and Information Science Education - Preferred License and Certifications - Required License and Certifications - Preferred Salary Range Salary Minimum: $83,890 Salary Maximum: $142,610 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Responsible for promoting integrated health practices through assessment, care planning and coordination of care and services. Includes ongoing monitoring of an appropriate and effective person-centered care plan, member education on health-related social needs, and care management. Entails coordination with PA HealthChoices physical health managed care organizations, members and community providers. This is a remote position, however, candidates need to reside in the Yardley, PA area for travel to providers offices in the vicinity. Responsible for the assessment, reassessment, care planning and coordination of care and services. Includes ongoing monitoring of an appropriate and effective person centered care plan, member education and care management. Regularly communicates with the members' PCPs and other providers, and integrates the member, caregiver and other provider feedback into the assessment and planning. Ensures continuity of care for newly enrolled members. Identifies and prioritizes the members' needs and preferences. Develops quantifiable goals and desired outcomes, and promotes the members' ability to self-manage to the greatest extent possible. Develops, implements and monitors the Person Centered Service Plan, assisting members in obtaining reasonable accommodations when appropriate. Manages case load, including risk stratification of members, monitoring reassessment needs and facilitating transitions of care settings. Serves as the primary point of member contact. Assesses member needs, manages care and services, and ensures effective communication among members, caregivers, providers and community supports. As the lead of the interdisciplinary team, facilitates the activities and communication within an interdisciplinary team of providers, vendors, facilities, discharge planners, field nurses, social workers, care coordinators, and member/caregivers to effectively manage care plans and transitions of care settings. Maintains timely, complete and accurate documentation using both hard copy and technology based solutions in compliance with regulatory policies and procedures. Gathers and summarizes data for reports. Supports initiatives of the Quality Assessment and Performance Improvement Committee. 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 Understands and is able to apply principles of Care Management and Person Centered Service Planning. Ability to apply Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines. Ability to understand and apply coverage guidelines and benefit limitations. Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses (depression, challenging behaviors, Alzheimer's disease and other disease-related dementias). Understands and adapts appropriately to issues related to communication, cognitive or other barriers. Ability to lead an interdisciplinary care team. Strong organizational skills and the ability to prioritize and follow through on multiple projects in a timely manner. Comfortable with conducting home visits and commuting within the service area. Minimum 3 years' clinical experience with focus in managed care, including disease or case management. General Job Information Title Care Manager BH/RN, Remote in PA Grade 25 Work Experience - Required Clinical Work Experience - Preferred Education - Required Associate - Nursing Education - Preferred Bachelor's - Nursing License and Certifications - Required RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare Mgmt License and Certifications - Preferred CCM - Certified Case Manager - Care MgmtCare Mgmt, CCP - Chronic Care Professional - Care MgmtCare Mgmt 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.