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1 - 10 of 11 matches in 0.006 seconds
Senior Director Clinical Operation Care Coordinator (JC140709345)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job provides strategic direction by leading the effort to create and maintain program development, implementation and evaluation of the utilization management, case management, and disease management programs impacting health for individuals and populations. The initiatives incorporate the regulatory and…

Medical Director - Gateway Health Plan (Delaware) (JC140987462)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job plays a crucial role in the corporation’s success and works closely with all divisions and departments within the corporate structure to provide clinical consultation and support with regard to program development, compliance with accepted medical standards, and practitioner/provider…

VP, Executive Medical Director (GHP Clinical Services) (JC141613448)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job is accountable for the strategic direction, implementation and effective execution of physician-led functions within Clinical Services including, but not limited to, Utilization Review, Medical Policy, Member and Provider Appeals and Retrospective Review. In addition this leader will have…

Medical Case Manager - Group Health Plan (GHP) (JC140668078)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job assures that members with complex medical and/or psycho-social needs have access to high quality, cost-effective health care. Assists in the holistic assessment, planning, arranging, coordinating, monitoring, evaluation of outcomes and activities necessary to facilitate member access to healthcare…

Medical Case Manager - GHP (JC140709348)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

I. GENERAL OVERVIEW:

Assure that members with complex medical and/or psycho social needs have access to high quality, cost-effective health care. Assist in the holistic assessment, planning, arranging, coordinating, monitoring, evaluation of outcomes and activities necessary to facilitate member access to…

Clinical Quality Management Analyst (JC141757728)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job works with appropriate departments in the areas of compliance, process improvement and member/provider satisfaction for all product lines. Reviews, researches and responds to customer complaints relating to quality of medical care and service. Recommends and/or implements process improvements…

Senior Compliance Analyst - Medicaid (JC140537558)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Inc

Job Description :

JOB SUMMARY

This job partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental, contractual, and/or corporate entities. Provide consultation and analytic support to assigned functional areas. Continuously monitors regulatory changes, legislative efforts, industry trends, and/or contract changes.

Sales Consultant - HMIG (PA/WV/DE Territory) (JC141082868)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Hm Life Insurance Company

Job Description :

RESPONSIBILITIES:

• Generating new business revenue and retaining profitable business for HMIG’s Stop Loss line of business.

• Develop producers and prospects in the assigned territory and working with producers who represent employers in various group sizes.

• Manage activities…

Clinical Quality Mgt Analyst (JC141757730)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job works with appropriate departments in the areas of compliance, process improvement and member/provider satisfaction for all product lines. Reviews, researches and responds to customer complaints relating to quality of medical care and service. Recommends and/or implements process improvements…

Client Manager-Large Group Wilmington, DE (JC141681048)
Last Updated: 2019-05-25
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Bcbsd Inc.

Job Description :

I. GENERAL OVERVIEW:

Responsible for managing a book of business and the business relationship as a strategic consultant for existing accounts directly or through intermediaries. Responsible for renewing accounts and selling new products and services to existing accounts to ensure retention…

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