Job(s) 1 to 14 of 14
5/1/2016
Louisville, KY
Not Provided
Federal Contractor
Mgr, Kentucky State Pharmacy (1502900) Provides clinical pharmacy direction for the health plan including, but not limited to Disease Management, Pharmacy, Utilization and Quality Management. Provides drug utilization review and intervention while targeting high utilizing physicians and reviewing pr ...
Federal Contractor
Human Resources Business Partner III (1600166) Responsible to independently support one or more client groups of higher complexity to develop and execute human resource strategies, programs, services and solutions that are designed to enable the Company to successfully meet business goals. Areas of ...
Recently Posted
Federal Contractor
Clinical HEDIS Practice Advisor (1602280) Provides education and consultation to providers' and provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Serves as the market clinical subject matter, expert in the field, for HEDIS measures, appropriate ...
5/20/2016
Louisville, KY
Not Provided
Federal Contractor
Provider Operations Coordinator (1602139) Supports the Provider Relations Field Representative to achieve department goals. Answer incoming telephone inquiries from providers and assist with problem resolution of issues. Coordinate submission of provider to internal departments via contract maintena ...
5/20/2016
Louisville, KY
Not Provided
Federal Contractor
Clinical Social Worker (1602172) Coordinates the socio economic needs and service of selected member populations across the continuum of illness. Interviews, coordinates and plans activities and behavioral routines to meet the social and medical needs of members and their families. May manages membe ...
5/12/2016
Bowling Green, KY
Not Provided
Federal Contractor
Field Services Coordinator RN (1601994) "PLEASE NOTE THIS POSITION CAN BE LOCATED IN ANY OF THE FOLLOWING COUNTIES PULASKI, LAUREL, CASEY ADAIR, RUSSELL OR WAYNE" Works with Care Coordination MVP Team members to assess, plan, implement, coordinate, monitor, and evaluate services and outcomes to maxi ...
Federal Contractor
Manager, Network Management (Behavioral Health) (1600666) Manages IPA networks and Network Development Specialists by developing and maintaining network of risk bearing IPAs. Achieves company targets through aggressive IPA primary care, specialty and ancillary provider contracting and risk contract ...
5/4/2016
Louisville, KY
Not Provided
Federal Contractor
Qualifications Candidate Education Required A High School or GED Candidate Experience Required 2 years of experience in a clinical setting with general nursing exposure in UM to include pre authorization, utilization review, concurrent review, discharge planning, CM w/review, and/or skilled nursing ...
4/30/2016
Louisville, KY
Not Provided
Federal Contractor
Business Technical Analyst (1601673) Provides functional business knowledge and technical support to the business unit through developed and ad hoc analysis/reporting , as well as designing and programming new processes/reports. Acts as subject matter expert for department or business unit on busine ...
4/27/2016
Louisville, KY
Not Provided
Federal Contractor
Quality Improvement Analyst (1601844) Coordinates complex assignments involving cross functional teams in the fullfillment of contract deliverables, regulatory and accreditation requirements with focus on data analytics and performance improvement. Models and promotes the core values of the Collabor ...
3/31/2016
Lexington, KY
Not Provided
Federal Contractor
Clinical HEDIS Practice Advisor (1601465) Provides education and consultation to providers' and provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Serves as the market clinical subject matter, expert in the field, for HEDIS measures, appropriate ...
Federal Contractor
Quality Improvement Care Gap Coordinator (1601046) Conducts telephonic outreach to members who are identified as needing preventive services in support of quality initiatives and regulatory/contractual requirements. Provides education to members regarding the care gaps they have. Assists in scheduli ...
3/19/2016
Louisville, KY
Not Provided
Federal Contractor
Business Analyst (1505273) Identifies and recommends operational improvement opportunities through reporting, process and trend analysis. Develops ad hoc reports for data analysis to support initiatives. Interacts with Management to recommend next level operational strategies. REPORTS TO MANAGER, BU ...
Federal Contractor
Field Services Coordinator RN/Inpatient/Discharge Planner Louisville, KY (1601154) Works with Care Coordination MVP Team members to assess, plan, implement, coordinate, monitor, and evaluate services and outcomes to maximize the health of the Member. Coordinates, monitors and ensures that appropriat ...