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Health Net
- Rochester, NY
Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past and present treatment plan and services, prognos
Posted 4 days ago
Program Specialist I (Social Work) (1099883) Position Purpose Identify special needs members through the completion of health screens and other resources Work with community outreach/member advocates to coordinate member care Educate providers and community resources on program components and available support services Educate members with special needs to foster compliance with program and positi
Posted 18 days ago
Military Family Life Counselor (0091K) Position Purpose The Counselor is a licensed mental health professional who exercises discretion and independent judgment to provide appropriate information, coaching, training, and education to Service Members and their families. Partners with and augments activities of Service Family Centers, Guard and Reserve programs (including Inter Service Family Assist
Posted 24 days ago
Military Family Life Counselor (0091J) Position Purpose The Counselor is a licensed mental health professional who exercises discretion and independent judgment to provide appropriate information, coaching, training, and education to Service Members and their families. Partners with and augments activities of Service Family Centers, Guard and Reserve programs (including Inter Service Family Assist
Posted 24 days ago
Referral Specialist I (1099236) Position Purpose Assist in monitoring utilization of medical services to assure cost effective use of medical resources through processing prior authorizations. Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list. Route to appropriate staff when needed. Verify eligibility and benefits Answer phone que
Posted 29 days ago
Care Manager I (RN) (1097843) Position Purpose Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member's current health status, resource utilization, past a
Posted 1 month ago
Analyze health management programs including data collection, validation and outcome measurement. May include o Financial, pharmacy, claims, provider, and member data o IRS, CMS, HHSC, HEDIS reporting o Internal data cleansing and data reconciliation analysis o Trend analysis in various functional areas of health care management. Create and generate reports through MS Excel, MS Access, and SQL usi
Posted 2 months ago
Sales Representative (Specialty Pharmacy) (1094303) Position Purpose Develop new prospects and interact with existing customers to gain additional accounts within assigned area. Perform sales related activities on company's specialist pharmacy programs for designated providers within an assigned area. Develop and maintain relationships with designated providers within assigned area utilizing curre
Posted 2 months ago
Program Specialist I (Social Work) (1091803) Position Purpose Identify special needs members through the completion of health screens and other resources Work with community outreach/member advocates to coordinate member care Educate providers and community resources on program components and available support services Educate members with special needs to foster compliance with program and positi
Posted 2 months ago
Military Family Life Counselor (1088092) Position Purpose This description should be used exclusively with the SPA Salary Structure. The Counselor is a licensed mental health professional who exercises discretion and independent judgment to provide appropriate information, coaching, training, and education to Service Members and their families. Partners with and augments activities of Service Fami
Posted 4 months ago
Child Youth Military Family Life Counselor (1088096) Position Purpose This description should be used exclusively with the SPA Salary Structure. The Counselor is a licensed mental health professional who exercises discretion and independent judgment to provide appropriate information, coaching, training, and education concerning military connected children to service members and or child developme
Posted 4 months ago
Military Family Life Counselor (1083426) Position Purpose This description should be used exclusively with the SPA Salary Structure. The Counselor is a licensed mental health professional who exercises discretion and independent judgment to provide appropriate information, coaching, training, and education to Service Members and their families. Partners with and augments activities of Service Fami
Posted 5 months ago
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