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1 - 10 of 32 matches in 0.005 seconds
Senior Customer Service Representative (JC147979416)
Last Updated: 2019-09-20
Employer: Centene Corporation
Location: Burr Ridge, IL

HourlyPosition Purpose: Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner.

Using current reference materials, answer inquiries from members and/or providers regarding claims, eligibility, covered benefits, authorizations and pharmacy related matters

Provide assistance to members and/or providers regarding website registration and navigation

Educate members and/or…

Program Specialist II - Social Work (JC148156886)
Last Updated: 2019-09-19
Employer: Centene Corporation
Location: Burr Ridge, IL

HourlyPosition Purpose:

+ Identify special needs members through the completion of health screens and other resources

+ Work with community outreach/member advocates to coordinate member care

+ Educate providers and community resources on program components and available support services

+ Educate members with special needs to foster compliance with program…

Program Coordinator II (JC148156896)
Last Updated: 2019-09-19
Employer: Centene Corporation
Location: Westmont, IL

HourlyPosition Purpose: Perform duties to assist in activities related to the medical and psychosocial aspects of utilization and coordinated care.

+ Initiate authorization requests for output or input services in keeping with the prior authorization list. Maintain integrity of PHI. Maintain working relationships with other departments. Research claims inquiry…

Program Specialist I - Social Work (JC148095247)
Last Updated: 2019-09-19
Employer: Centene Corporation
Location: Burr Ridge, IL

Hourly

Position Purpose:

Identify special needs members through the completion of health screens and other resources

Work with community outreach/member advocates to coordinate member care

Educate providers and community resources on program components and available support services

Educate members with special needs to foster compliance with program and positively impact…

Medical Director, Behavioral Health (JC148095216)
Last Updated: 2019-09-19
Employer: Centene Corporation
Location: Westmont, IL

ProfessionalPosition Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.

+ Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and…

HEDIS Coordinator (JC148095243)
Last Updated: 2019-09-19
Employer: Centene Corporation
Location: Westmont, IL

ProfessionalPosition Purpose: Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement opportunities. Assist with quality improvement initiatives in the service and clinical areas.

+ Coordinate, complete, and update management on clinical quality metrics and HEDIS processes and results

+ Establish and maintain an action plan…

Supervisor, Care Management (JC148095253)
Last Updated: 2019-09-19
Employer: Centene Corporation
Location: Burr Ridge, IL

ProfessionalPosition Purpose: Responsible for day-to-day oversight of the Integrated Care Managers and coordination of necessary resources for members. This may include adequate clinical, behavioral, acute/chronic, and social care services.

+ Ensure staff is able to facilitate member and provider needs through entire care management cycle.

+ Partner with internal staff…

Supervisor, Operations (JC148002101)
Last Updated: 2019-09-17
Employer: Centene Corporation
Location: Westmont, IL

ProfessionalPosition Purpose: The Supervisor Operations provides direct supervision to entry and/or processing staff and provides hiring, training, evaluation, development and performance management. Monitors and directs workflow to ensure timely and accurate processing to meet organizational objectives and contractual requirements. Develops policies and procedures to improve efficiencies and to support new…

Concurrent Review Nurse I (JC147827285)
Last Updated: 2019-09-16
Employer: Centene Corporation
Location: Westmont, IL

HourlyPosition Purpose:

+ Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations

+ Complete medical necessity and level of care reviews for requested…

Claims Liaison I (JC147827286)
Last Updated: 2019-09-16
Employer: Centene Corporation
Location: Burr Ridge, IL

HourlyPosition Purpose: Serve as a liaison between the plan, claims, providers and various departments to effectively identify and resolve claims issues

+ Audit check run and send claims to the claims department for corrections

+ Identify any system changes and work notify the Plan CIA Manager to ensure its implementation

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