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Health Plan Nurse Coordinator I Jobs

Coordinator - Health Plan, Remote- Fl, Florida
By TotalMed, Inc. At Florida, United States

Job Description We are seeking a Health Plan Coordinator for an assignment in Remote FL Florida. Administrative Coordinators perform clerical tasks including typing documents, compiling and ...

Coordinator - Health Plan, Remote- Tx, Texas
By TotalMed, Inc. At Texas, United States

Job Description We are seeking a Health Plan Coordinator for an assignment in Remote TX Texas. Administrative Coordinators perform clerical tasks including typing documents, compiling and filing ...

Mds Nurse - Care Plan Coordinator (Rn)
By Opportunities In Senior Care At , Oklahoma City, 73110
Must demonstrate the knowledge and skills necessary to prove care appropriate to the age-related needs of the residents served.
Must have, as a minimum, six (6) months training experience in rehabilitative and restorative nursing practices.
Remarkable benefits our staff can expect:
Perform administrative duties such as completing medical forms, reports, evaluations, studies, etc., as necessary.
Develop, implement, and maintain an ongoing quality assurance program for the resident assessment/care plans.
Assist the resident and Discharge Planning Coordinator in completing the care plan portion of the resident’s discharge plan.
Health Plan Nurse Coordinator I - Behavioral Health
By CenCal Health At , Santa Barbara, 93110 $69,681 - $104,522 a year
Demonstrate strong multi-tasking, organizational, and time-management skills.
1-2 years of experience in crisis or risk assessment or case management
Adhere to Health Plan, Medical Management and Health Services policies and procedures.
Function as a collaborative member of Medical Management/Health Services’ multi-disciplinary medical management team
Identify and report quality of care concerns to management and as directed, to appropriate CenCal Health department for follow up.
Understand basic case and disease management concepts, principles and practices as described in the Case Management Society of America
Public Health Nurse I
By County of Santa Cruz At ,
The County of Santa Cruz
invites you to apply for the position of
To view the full job announcement:
Health Plan Accreditation Coordinator - Remote (Ak, Az, Id, Or, & Wa)
By Moda Health At United States
One (1) year of program management experience {is required/preferred}.
Works with all areas of the health plan, e.g., leadership, senior management, clinical, network, and quality improvement.
Three (3) years of experience in a Managed Care Organization (MCO), large hospital or healthcare system {is required/preferred}.
Experience implementing accreditation standards for a Managed Care Organization (MCO) such as Medicaid and the Affordable Care Act is preferred.
Coordinates with establishing set guidelines to meet NCQA accreditation requirements.
Assists with training and coaching to support understanding of accreditation standards and requirements.
Health Education Coordinator I
By The University of Texas Health Science Center at Tyler (UT Health) At Tyler, TX, United States
Navigation for individuals participating in screening services offered by UTHSCT and UTHET.
Strong communication skills verbally and in writing
navigation for individuals participating in screening services offered by UTHSCT and UTHET.
The Coordinator will provide instructions regarding screening guidelines and will deliver clinical service
Speak to community groups/ organizations to promote utilization of cervical cancer screening services and other healthy lifestyle activities.
Target individuals and populations who are at an increased risk of cervical cancer diagnosis.
Health Plan Analyst - Student Position
By Healthee At New York, NY, United States
Developing various reports, presentations and summarizing key findings from data analysis and communicating them to the management team.
Strong analytical skills and proficiency in data analysis tools
Excellent written and verbal communication skills, with the ability to present complex information in a clear and concise manner.
Detail-oriented with the ability to manage multiple tasks and prioritize effectively.
The job is 100% remote (it may be required to arrive to the Tel Aviv office as needed).
Compiling, organizing and analyzing health plan data to assist in delivering essential health plan information to users
Plan Reviewer I - Range 12 / Amea
By Municipality of Anchorage At Anchorage, AK, United States
Experience utilizing Anchorage's Current Title 23.10, the Administrative Chapter of the Building Code.
Minimum Qualifications / Substitutions / Preferences
Valid State of Alaska driver's license by the time of hire.
Flexible Spending Accounts – Health and Dependent Care
State of Alaska Public Employee Retirement System (PERS) Program
401(k) and 457 Savings Plans
Public Health Nurse I
By Dept of State Health Services At , Pampa, 79065, Tx $4,522 - $4,634 a month

Top 10 Tips for Success when Applying to Jobs at HHSC and DSHS

Rn Utilization Coordinator, Denver Health Medical Plan
By Denver Health At , Denver, 80204, Co $76,900 - $115,400 a year
1-3 years clinical experience in a hospital, acute care, home health/hospice, direct care or case management required.
1-3 years experience in care coordination or case management required.
Knowledge and understanding of case management/coordination of care principles, programs, and processes in either a hospital or outpatient healthcare environment.
Prefer experience in health plan case management, care coordination, or member navigation.
Home care/field based case management experience.
Support and collaborate with the UM and CM Managers and Supervisors in the implementation and management of UM/CM activities
Project Coordinator (Health Plan Operations)
By Better Health Group At Tampa, FL, United States
Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
Attend and participate in Core Operations team meetings, 1:1 meetings with Manager of Core Operations, and interdepartmental market meetings as required
At least 3 years of experience in a healthcare-related environment
Demonstrated resourcefulness, initiative, and results-oriented capabilities
Excellent written and verbal communication skills.
Are you looking for a career opportunity that will help you grow personally and professionally?
Coordinator, Health Plan Marketing
By Denver Health At , Denver, 80204, Co $50,600 - $73,300 a year
Develop and assist with regular review and maintenance of protocols and procedures related to position’s responsibilities. (5%)
1-3 years 1+ years of customer service, marketing or communications experience Required and
Previous association experience and/or working with healthcare providers and their teams preferred but not required.
Strong attention to detail, ability to demonstrate accuracy, efficiency, and follow-through, while working. Possess strong organizational and interpersonal skills.
Sound administrative strategies and tactics that promote excellence in responsibilities.
Act as a communications concierge to all Members and Providers. (10%)
Public Health Nurse I
By Texas Health and Human Services At Alpine, TX, United States
Work experience in Nursing, Public Health, Case management or infectious disease experience (2) years.
Experience in a medical clinical setting (2 years).
Travel requirements and possible working hours other than 8-5 are applicable and must be able to accommodate.
Registered Nurse by the State of Texas or a state that recognizes Reciprocity through the Nurse Licensure Compact.
Able to travel via Automobile and/or air with overnight stay 35% of the time.
Phone or TEAMS Video interview may be utilized.
Public Health Nurse I/Ii
By Kern County At Bakersfield, CA, United States
Possess and maintain a current American Heart Association Healthcare Provider Basic Life Support (BLS) card.
Possession of a valid Motor Vehicle Driver's License.
Possession of a valid California Motor Vehicle Driver's License.
Associate Health Plan Operations
By Imagine Pediatrics At United States
Demonstrates excellent project management skills, such as ability to develop high-quality materials, work on concrete deadlines, and deliver results independently.
Manage new market and partnership launch activities as opportunities progress through the business development pipeline.
Track and manage ongoing/post-implementation payer partnership milestones and delivery dates.
Develop / manage internal department SOPs, processes, and procedures.
2-3 years of experience managing complex projects
Experience in a healthcare environment, including health plans, medical groups, providers, clinics, or healthcare delivery organizations.
Service Coordinator Advanced Social Worker (Tyler/Longview/Jacksonville) - The Health Plan
By Texas Children's Hospital At Houston, TX, United States
Assures timely performance of utilization management processes to maintain compliance with Federal, State, and Managed Care contract regulations
CCM from Adult and Pediatric Integrated Case Management preferred
3 years’ experience in pediatrics particularly with patients with disabilities aged 0-20 preferred
Maintains current education and training to adeptly identify the Member's physical, behavioral, functional, and psychosocial needs
Knowledge of Microsoft Word, Excel and Outlook preferred
Plans and executes interdisciplinary and patient/family conferences as necessary to formulate and communicate the plan of care
Health Plan Management Consultant
By DataNet Systems Corp. At Washington, DC, United States

Sr. Consultant needed to support the DC Health Benefits Exchange in its Plan Management annual recertification process.

Strong verbal and written communication, critical thinking, and problem-solving skills.

Care Coordinator - Health Plan Member Services
By Included Health At , Remote
Proficiency with technology; experience with Google apps, Apple products, and customer relationship management software a plus
Bachelor’s degree or 5 years relevant experience in healthcare or benefits/insurance organization is highly preferred
Help members understand the benefits available to them and how to access them to best meet their healthcare needs
Demonstrate knowledge of proprietary software and other required technology
Indicators of high quality interactions (quality audits, member satisfaction surveys, documentation requirements)
Ability to help connect members who would benefit from clinical services to those services
Health Plan Nurse Coordinator I
By CenCal Health At , Santa Barbara, 93110, Ca $69,681 - $104,522 a year
Function as a collaborative member of Health Services' multi-disciplinary medical management team.
Identify and report quality of care concerns to management and, as directed, to the appropriate CenCal Health department for follow-up.
Support and work collaboratively with the Health Services management team in the implementation and management of the assigned unit's activities.
Depending on unit assignment: Prior UM, CM, DM, or QI experience in a managed care setting
Be abreast of clinical knowledge related to disease processes.
As required, actively participate in the implementation, assessment, and evaluation of quality improvement activities as it relates to job duties.