At t account manager platform solutions boston ma jobs in the Insurance industry

MOLINA HEALTHCARE - PHARMACY BENEFITS MANAGER Job Summary In collaboration with the MHI's Clinical Pharmacists and under the supervision of the MHI's VP of Pharmacy Services will monitor and manage the operational aspects of the contract between MHI and the PBM (Pharmacy Benefits Manager) to assure contract compliance and maximize the PBM's value to MHI. Essential Functions • Oversee, support and ...
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Are you self-directed and motivated? Want to work for a company that cares about its employees and clients? Regional Reporting, Inc. (RRI) is one of the largest independently-owned providers of loss control to the property and casualty insurance industry. Our business is built on the belief that our clients deserve a competent, respected and knowledgeable service provider that will represent their...
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Remote position, not telephonic, must provide 10 home visits and live in the El Paso area Provides case management services to members with chronic or complex conditions including: Proactively identifies members that may qualify for potential case management services. Conducts assessment of member needs by collecting in-depth information from Molina's information system, the member, member's famil...
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Location: Naperville, IL Relocation Provided: No Education Required: Not Indicated Experience Required: At least 1 year Position Description: BASIC FUNCTION: This position is responsible for identifying, analyzing and evaluating requirements for implementation; developing written test plans from requirements document; developing and executing test cases; reporting and communicating issues/ discrep...
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Location: Chicago, IL Relocation Provided: No Education Required: Not Indicated Experience Required: Not Indicated Position Description: BASIC FUNCTION: This position is responsible for participating in needs analysis and assessment; participating in the recommendation of learning solutions and designing solutions; facilitating delivery of solutions; evaluating solutions; and overseeing projects. ...
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Location: Chicago, IL Education Required: Not Indicated Experience Required: At least 5 years Position Description: *LI-SS1 BASIC FUNCTION: This position is responsible for the analysis, development, modification, installation, testing and maintenance of operating systems software and/or software tools. Possesses a strong understanding of systems programming, graphical user interfaces and control ...
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ManageAbility Inc, is growing!!!! We are a Michigan based company located in Novi, MI. We are looking to fill a couple of positions available. We are seeking an experienced, licensed RN Case Manager to handle Worker's Compensation and Auto No Fault cases in the Detroit, MI area. Knowledge of local employers, providers, WC and No Fault is helpful. Case Management certification preferred. We are als...
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Assistant Office Manager Responsibilities include: · Compile data and prepare miscellaneous reports · Verify the accuracy of invoices and other accounting documents · Recommends actions to resolve discrepancies · Investigates questionable data · Attend meetings/minute taking · Assist in meeting preparation · Maintenance and support of internal Recruiting database · Formatting resumes · Miscellaneo...
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Print / Interactive Design Manager The Print/Interactive Design Manager is a professional faculty member in Oregon State University's Extended Campus, which is a fast-growing, entrepreneurial organization that administers Ecampus (OSU degrees online) and Summer Session. The Print/Interactive Design Manager oversees the design and visual identity of all Extended Campus marketing and communication m...
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Location: Houston, TX Education Required: Not Indicated Experience Required: Not Indicated Position Description: BASIC FUNCTION: This position is responsible for ensuring continued and increased growth by negotiating renewals or selling products and services to existing customers, understanding customer needs, and providing customer support. JOB REQUIREMENTS: 1) General Lines Agent Life, Health, a...
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Job Description Job Summary Responsible for safely and effectively transitioning Molina members from acute or inpatient care to lower levels of care and/or home in a cost efficient manner. Provides assessment, planning, implementation, coordination, monitoring, and evaluation of services for Molina members as they transition care and follows them for at least 30 days. Conducts an onsite hospital d...
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POSITION SUMMARY: Manages submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members and related outside agencies as a part of the integrated Healthcare Services Team. Conducts pertinent research, evaluates, responds and completes appeals and other inquiries accurately, timely and in accordance with all established regulatory guidelines. Prepares appeal s...
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Location: Tulsa, OK Relocation Provided: No Education Required: Not Indicated Experience Required: At least 1 year Position Description: BASIC FUNCTION: This position is responsible for rating and approving new business submissions and renewals and approving enrollment exceptions for regulated Small Market Accounts (cases with 2-50 employees) or non-regulated Small Market Accounts (cases up to 150...
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Job Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations...
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Location: Chicago, IL Education Required: Not Indicated Experience Required: At least 2 years Position Description: BASIC FUNCTION: This position is responsible for identifying members to participate in a Behavioral Health Case Management program and is responsible for going on-site at participating facilities to meet with members, discuss their Case Management benefit, and enroll those interested...
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Location: Oklahoma City, OK Education Required: Not Indicated Experience Required: At least 2 years Position Description: BASIC FUNCTION: This position is responsible for assisting in HCSC property management functions within assigned state location, including Safety; and overseeing or assisting in all aspects of the efficient operation of HCSC facilities. JOB REQUIREMENTS: 1) Bachelor Degree and ...
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The Florida Office of Insurance Regulation currently has an opportunity for an experienced Actuary. Responsibilities include: · Analyzing the adequacy of health claim reserves using various loss development methods for health insurers or managed care organizations. · Anticipates insurance practices by monitoring legislative activity at the federal and state levels, and changes in insurance practic...
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