Jobs at BMC HealthNet Plan

Under the direction of the Manager of Business Intelligence, the Business Intelligence Developer II position is responsible for developing standard reports that serve the needs of our business users. This position must understand business requirements and use business intelligence tools to build high quality, standard reports. Key Functions/Responsibilities: Develops, tests and deploys standard re...
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Provides business support to all departments in the proper use and processing guidelines of CPT/HCPCS codes. The Coding Specialist is responsible for ensuring the Plan’s transaction processing system accurately reflects active CPT-4, HCPCS, ICD-9, ICD-10 and other transaction code sets to ensure HIPAA Compliance. As part of the Payment Compliance team, the Coding Specialist will facilitate necessa...
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The Regional Manager of Integrated Care Management will provide regional oversight for multiple integrated care management teams dedicated to coordinating care, services and health benefits for selected dual eligible member populations. The Regional Manager will monitor and promote effective utilization of resources through clinical variance and benefits management. The Manager serves as both a le...
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Create and maintain documentation related to products and benefits that will serve as a resource to the company to help interpret and support benefit administration, implementation of new and revised benefits, and product integrity. Support the development and submission of product filings as needed, as well as support the full implementation of product and benefit changes and ensure regulatory an...
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Create and maintain documentation related to products and benefits that will serve as a resource to the company to help interpret and support benefit administration, implementation of new and revised benefits, and product integrity. Develop and submit product filings as needed, oversee full implementation of product and benefit changes and ensure regulatory and product compliance with all laws in ...
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Responsible for accurate set up of provider records in order to assure proper payment for providers. Handles all implementation steps to enroll providers in the Plan to ensure timely access for members and accurate payment for providers. Key Functions & Responsibilities: Manages the interaction with providers and office managers to ensure that all necessary information is collected and analyzed so...
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