Medical Assistant Health Coach to a ssists with health management activities/programs for members. Provides health coaching or intervention telephonically or in person for assigned health programs. Utilizes all data systems containing patient information and documents information appropriately. Assists with the identification of areas for which there is a need for health

The CRC Communications Coordinator position will provide coordination and support to the following state cultural commissions located with the Indiana Civil Rights Commission Position duties include the following 1. Social media content creation; graphics; social listening 2. Website content management 3. Meeting minutes and notices 4. Event coordination administrative; ph

We are seeking a dedicated and detail oriented individual to join our team as a Janitor. The primary responsibility of this role is to ensure that vacated apartments are thoroughly cleaned and prepared for new occupants. The ideal candidate will have a keen eye for cleanliness, excellent time management skills, and the ability to work independently. Responsibilities Clean

The Member Health Assessor engages with the member to establish an effective, professional relationship with primary responsibility to conduct their health risk assessment. Essential Functions Participate in the Integrated Care Coordination Team as needed. Coordinate logistics to support care plan goals and interventions as needed to address immediate member concerns. Ver

Conduct assessments to understand clients' needs. Collaborate with other healthcare professionals, such as psychiatrists, psychologists, and social workers, to provide comprehensive care. Maintain accurate and confidential client records. Adhere to ethical guidelines and legal regulations. Participate in ongoing professional development to stay abreast of current research

Researches the substance of complex appeal or retrospective review requests including pre pay and post payment review appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in compliance with applicable regulations or standards. Perf

The Clinical Appeals Nurse is responsible for the completion of clinical appeals and state hearings from all states. Essential Functions Responsible for the completion of clinical appeals and state hearings from all states Review and complete all provider clinical appeals within required timeframes. Review and complete member clinical appeals within required timeframes. Re

The Community Well Care Coordination Manager must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC). The Care Coordination Manager must, at a minimum, be a registered nurse or simil

Performs routine facility maintenance tasks to ensure company employees have a safe and properly conditioned work environment. Assemble, relocate, and repair free standing or modular office furniture and equipment. Perform general maintenance tasks. Clean equipment, mechanical rooms, and work sites as directed. Perform preventative inspections. Respond to emergency calls

Seeking an RN Care Manager with experience working with high risk OB members to perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members. This position is fully remote. The work schedule is M F 8 00am 5 00pm. You MUST be a Licensed RN that is good standing and residing in t

Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement. Essentials Understanding of basic medical terminology Call center experience Good customer service skills Ability to problem solve basic computer issues Managing Excel spread sheets Work with multiple computer system Good verb

Seeking a Registered Nurse with current in state license, with Utilization review or quality management experience. This position is fully remote. Work schedule is Mon Fri, 8 00am 5 00pm. Must have at least 3 years' experience in a clinical setting. InterQual experience desired. Must have basic PC skills, beginner knowledge of Microsoft Word and Excel.

Manage administrative intake of members Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review

PME is looking for a Healthcare Case Manager I (RN, LCSW, LMSW) experienced in Case Management working with complex medical and mental illness cases. The position will require field visits 3 days a week and the rest will be from home. Schedule M F 8 30am 5 00pm CST. MUST live in within 30 minutes of ARLINGTON HEIGHTS, BARTLETT, HANOVER PARK, BARRINGTON, ELGIN, MOUNT PROSP

Seeking an RN Care Manager II to p rovide Care Management duties to include telephonic outreach to members, assess members for complex medical needs, develop and update care plans, assess members current health , resource utilization , assess progress to goals , assist member with coordinating services and appointments , provide member education, assist with access to com