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Jobs (576 Matches)
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1. Apply   (Fulltime)15 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1401794Provide support and project coordination for the quality improvement functional area . *LI-CW1Essential Functions: Provides support for the quality improvement functional area. Completes special projects or assignments as needed to meet initiatives and/or objectives of department. Assists and coordinates QI projects as needed. Maintains all department files in ...
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2. Apply   (Fulltime)15 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1401795Conducts oversight and management of Accreditation initiatives, state and regulatory quality compliance, HEDIS and quality improvement initiatives for PiPs, QiPs, QIA’s, delegation audits and external quality reviews . Applies medical knowledge and analytical skills to effectively and efficiently coordinate quality activities and improve performance metrics of organizational goals. ...
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3. CA-Long Beach   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: CA-Long BeachLocation: true1401785Provides 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 medical record documentation and appropriate coding. Supports the development and ...
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4. Apply   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1403457Location: Tampa, FL 33634 Department: Health Services, Appeals & Grievances Reports To: Manager, Quality & Audit Schedule: Monday - Friday, with a start time between 7:00am - 9:30am, and then work an 8 hour day Performs complex and routine quality audits in Appeals for one of the following teams; par ...
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5. Apply   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1401456Supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies impacting plan compliance to regulatory and accreditation standards. Interfaces with a diverse range of clinical and administrative professionals, resolves complex issues, and performs data analytic and reporting activities. *LI-CW1Essential Functions: Monitors quality ...
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6. IL-Chicago   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: IL-ChicagoLocation: true1403118Leads in the development of complex adhoc reports to enable process and trend analysis. Provides recommendations on the implementation of new/revised operational and/or reporting processes. Conducts special projects requiring a high degree of confidentiality and expert knowledge of multiple departments within the company. May provide project guidance and ...
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7. Enrollment and Eligibility Coordinator New York, NY   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: Enrollment and Eligibility Coordinator New York, NYLocation: NY-Manhattantrue1401767The Enrollment and Eligibility Coordinator tracks and maintains member enrollment, eligibility and program rosters. Essential Functions: Conducts telephone screening of applicants to determine eligibility and provide ...
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8. Marketing Outreach Specialist (League City/Houston)   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: Marketing Outreach Specialist (League City/Houston)Location: TX-Houstontrue1403037Develops, plans and implements the outreach (community and member) programs, and marketing strategy for events, activities and out reach to interested candidates and members in compliance with CMS regulations for Medicare/Medicaid and according to the prescribed rules and regulations of the Medicare/Medicaid Contract. ...
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9. Teleservices Quality Auditor (Call Center Member Operations)   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: Teleservices Quality Auditor (Call Center Member Operations)Location: FL-Tampatrue1402752Works with outsouced call center vendor to ensures quality, customer service and adherence to policies and procedures and WellCare standards. Provides information and data to marketing operations team to support field programs and activities. Ensures effective operations of call center ...
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10. Apply   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1402454Develops, plans and implements the outreach (community and member) programs, and marketing strategy for events, activities and out reach to interested candidates and members in compliance with CMS regulations for Medicare/Medicaid and according to the prescribed rules and regulations of the Medicare/Medicaid Contract. Implements community programs throughout ...
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11. Apply   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1305429Sterling Insurance was established in 1958 and is a growing company dedicated to innovation and teamwork. In 1999, Sterling contracted with its sister company, Olympic Health Management Systems, Inc. and has grown to over 1,000 talented and diversified people. Today, Sterling offers a variety of products and services ...
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12. HI-Oahu-Honolulu   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: HI-Oahu-HonoluluLocation: true1402907Coordinates, monitors and ensures that appropriate and timely primary, acute and long-term care services are provided to members across the continuum of care with a focus on medically complex/medically fragile cases. Assists in coordinating services with federal and state programs, and other community services to the member. Promotes ...
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13. FL-Tampa   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: FL-TampaLocation: true1402605Department: Operations Reports to: Sr. Claims Manager Manage, lead, motivate and develop training team members. Develop, implement, test and support the curriculum for the claims training program for both internal and external claims associates. Work closely with claims management to ensure claims training programs and processes are functioning ...
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14. Apply   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1402034Position based in Orlando, FL Supervises staff, ensures appropriate workload distribution and oversees day to day workflow processes. Ensures team is compliant with all model of care regulatory requirements, and produces optimal clinical, socio economic and resource outcomes. Ensures the case management process of assessing, ...
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15. Apply   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1400371Coordinates the socio economic needs and services 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 manage members with severe mental illness who have high ...
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16. GA-Atlanta   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: GA-AtlantaLocation: true1403343 Manages physician contracting, network development and provider relations functions for developing, executing and maintaining a provider network strategy. Works in concert with medical management and sales developing actions to meet market growth and medical cost targets. Provides service and education to network physicians/providers. ...
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17. Apply   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1402160Manages the activities of supervisory associates and their subordinate work group(s), and/or exempt individual contributors for assigned area of responsibility. Works with the Care Managers to assess, plan, implement, coordinate, monitor and evaluate services and outcomes to maximize the health of the member. Essential Functions: Manages and develops ...
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18. Marketing Outreach Specialist - Ocala   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: Marketing Outreach Specialist - OcalaLocation: FL-Ocalatrue1401205 DEPARTMENT: FL Medicaid HIRING MANAGER: Vice President, Sales Develops, plans and implements the outreach (community and member) programs, and marketing strategy for events, activities and out reach to interested candidates and members in compliance with CMS and ACHA regulations for Medicaid and ...
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19. Apply   (Fulltime)16 hour(s) ago
WellCare - Nationwide - United States - Not rated
Title: ApplyLocation: Re-applytrue1300967 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 Collaborative and Wellcare. Provides data analytics assistance to all levels within Quality Improvement at both ...
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20. Hospital Services Specialist (Hospital/Institutional Relations)   (Fulltime)16 hour(s) ago
WellCare - United States, MT, Wolf Point - Not rated
Title: Hospital Services Specialist (Hospital/Institutional Relations)Location: FL-Tampa-Rocky Pointtrue1402916DEPARTMENT NAME: Provider Relations/Hospital ContractingHIRING MANAGER: Senior Director, Hospital ContractingManages the relationship and all levels of operations support with network hospitals. Provides ongoing education to facilities regarding health plan operations. Identifies and implements process improvements and enhancements. Essential Duties: Establishes and ...
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