MagnaCare Jobs in United States

The research assistant will handle mail and packages, manage outgoing mail, log incoming checks, oversee check printing and distribution processes, · Receive, sort and distribute incoming mail and packages. · Manage outgoing mail. · ...

About The Role...MagnaCare provides Utilization Review/ Case Management/ Medical Management/Claims Review services to its clients. Care Coordinators facilitate care management and utilization review by performing data collection & data entry... · ...

Magnacare seeks an onsite Las Vegas-based Director of Customer Service to lead multi-channel customer service operations. · Plan, direct, and oversee contact center operations. · Establish policies, procedures, goals, and service standards. · ...

The Research Assistant will assist with various tasks such as mail handling, check processing, and documentation. · Receive, sort, and distribute incoming mail and packages to appropriate people/department. · Manage outgoing mail, including running items through postage machines ...

The Clinical Appeal and Grievance Nurse conducts daily clinical reviews in a quality-focused environment. They review medical necessity cases using member-specific benefit information. This role reports directly to the Clinical Appeal Manager. · ...

A healthcare services company seeks a UM Denials Coordinator in Chapel Hill, NC. This full-time entry-level role involves reviewing and preparing denial correspondence for Utilization Management. Candidates should possess healthcare administrative support experience, a high schoo ...

About This Role · MagnaCare is seeking a Senior Data Engineer to lead our Data Infrastructure group. · Designing and maintaining scalable data pipelines for ingestion, transformation, delivery across multiple sources. · ...

Eligibility Enrollment Specialist I Job Description · We are seeking an Eligibility Enrollment Specialist I to join our team at Magnacare. · Verify member or group data into the enrollment database & update with changes · Respond to member eligibility questions & verify enrollmen ...

We are seeking an Eligibility Enrollment Specialist I who will verify new member or group data into the enrollment database and respond to eligibility questions. The ideal candidate should have a Bachelor's Degree preferred or High School diploma / GED (or higher) OR 10+ years of ...

The UM Coordinator is responsible for coordinating all aspects of the prior authorization process, · including member eligibility and benefit verification, · gathering necessary clinical information from electronic medical record, · and timely communication with members, provider ...

The Utilization Review Nurse will perform prospective and retrospective utilization reviews for members using evidenced-based guidelines. They must have current licensure as a Registered Nurse (RN) with state licensure and proficiency in Microsoft Office. · Perform prospective, c ...

Job Title: Customer Service Supervisor · MagnaCare seeks a hands-on On-Site Customer Service Supervisor for our high-volume call center. · ...

The Director of Training & Learning Development oversees planning design implementation continuous improvement of organization's training programs evaluates trainer performance develops training learning development strategies uses KPIs performance metrics to evaluate effectivene ...

Eligibility Enrollment Specialist I · This role requires a strong understanding of managed care, labor and commercial carrier enrollment and eligibility procedures. Key responsibilities include verifying new member or group data, responding to membership inquiries, reconciling di ...

Primary Responsibilities include Mail Handling and Check Processing. The role also involves Process Documentation and Compliance, Training and Cross-Coverage, and Other Administrative Tasks. · ...

Brighton Health Plan Solutions is seeking an experienced Account Executive with deep expertise in commercial, self-insured employer benefit plans, PPO network strategies, and Third-Party Administration (TPA) organizations. · ...

The Utilization Review Nurse will perform prospective, concurrent and retrospective utilization reviews and first level determination approvals for members using evidenced-based guidelines. · ...

Job Description · Maintain accurate records in Excel or internal systems. · Batch scan documents. · Familiarize yourself with departmental forms and procedures through training sessions. · , Participate in workshops to enhance your understanding of our processes · , Assist collea ...

Brighton Health Plan Solutions busca a un médico director part-time para apoyar su equipo de enfermeras, trabajadores sociales y coordinadores. Se requiere experiencia en gestión de utilización y caso manejado. · ...

+ Serve as the primary liaison and trusted advisor for the client · + Develop long-term client strategy in partnership with client key stakeholders · + Prepare reports to Trustee Board meetings+ Build Client Plan outlining priorities objectives risks opportunities · Essential Qu ...