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Showing page 1 of 15 matching jobs
CUSTOMER CARE ASSOCIATE- MEDI-CAL
  Posted 6 days ago    Magellan Health    San Diego, CA

This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards.Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls. Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality. Resolves customer adm

Source: Talroo

SYSTEM NAVIGATOR, EFMP
  Posted 6 days ago    Magellan Health    Fort Lee, VA

The System Navigator is responsible for daily coordination with the installation client manager to ensure the facilitation of connections between families who have special needs and the systems of required care. Assigned functions of the position include intake; identification of the Family members needs assessment, referral, follow-up, advocacy, and monitoring of outcomes; and collaboration with military and civilian community resources.Briefs family readiness staff and others upon request.Represents the program at installation coordinating committees.Manages the Soldiers and Family member records in accordance with DoD and Service regulation.Transfers records to the appropriate program personnel when transitions occur.Collects and analyzes data for planning, reporting, and program improvement.Ensures all designated reports are submitted to Service Headquarters as required.Remains informed regarding recent research and poli

Source: Talroo

MANAGER, CLINICAL PHARMACISTS (PRIOR AUTHORIZATION)
  Posted 6 days ago    Magellan Health    San Diego, CA

Oversees day-to-day operations of a team of call-center pharmacists to ensure department objectives and contractual service levels are met. Ensures adherence to standard operating procedures. Triages client and internal requests to resource assignment. Responsible for staff and schedules.Manages the prior authorization program and monitors adherence to client's established clinical criteria. Manages appeal and physician resources, follows contractual obligations, maintains National Committee for Quality Assurance (NCQA) accreditation, maintains Utilization Review Accreditation Commission (URAC) accreditation, and follows State and Federal regulations.Manages staff resources, resource allocation, and staff schedules to ensure adequate work coverage. Regularly communicates necessary information including personnel relations activity including employment, termination, performance reviews, salary reviews and disciplinary actions. Implements quality assura

Source: Talroo

PART TIME ID CARD SPECIALIST (PA II), NAVY ICA
  Posted 6 days ago    Magellan Health    Philadelphia, PA

Provides professional military personnel support services to the U.S. Navy s Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.Issu

Source: Talroo

SENIOR IT ANALYST
  Posted 1 week ago    Magellan Health    Houston, TX

Looking for a remote Sr. IT Analyst who will be responsible for analyzing, evaluating and redesigning business, IT or operational processes using scientific approaches such as Critical Thinking, Lean Management, ITIL, Design Thinking and structured systems analysis and design. Work quickly and independently while delivering high-quality outputs. Use strong organizational skills for tracking multiple deliverables simultaneously and be able to synthesize the results. Pay meticulous attention to detail; the ability to juggle many tasks in parallel without lowering the quality bar. Collaborate with Software Engineers to understand features and technical implementation and ensure highest quality product delivery. Develop deep understanding of the business/technical domain. Candidate should have experience in gathering, defining and documents requirements as well as serving as a liaison between various business groups.Ideal candidate will have IT Eligibility experience, and working k

Source: Talroo

EAP CONSULTANT - FOH
  Posted 1 week ago    Magellan Health    Oklahoma City, OK

Provides direct support to organizations and their employees through the delivery of assessment, consultation, education and triage services. Uses knowledge of federal regulations to assist organizations in their appropriate handling of employee concerns and problems. Consults with employees and organizations on variety of workplace and work based issues. Provides clinical expertise in order to restore employees with diminished performance to healthy functioning.Provides employee consultation related to specific personal problems and concerns. Provides crisis assessment and intervention as needed.Completes clinical and administrative documentation and required forms in a clear and concise manner. Manages caseload and other tasks to meet both qualitative and quantitative performance expectations.Provides behavioral health assessments, accurate clinical diagnoses, and referral to appropriate level of care. Provides expert consultation to employees and/or supervi

Source: Talroo

MILITARY FAMILY LIFE COUNSELOR
  Posted 1 week ago    Magellan Health    Arlington, VA

This position is in support of Arlington National Guard, VA. Candidates must be local to Arlington or be willing to relocate to become local. Candidates must be licensed at the independent level in the state of Virginia as a Social Worker, Therapist, or Mental Health Counselor (LCSW, LPC, LMFT or PSYCH).Primary responsibility of providing the full breadth of MFLC (military family life counseling) counseling services to military service members and their families at military installations. Services include non-medical, short-term, walk-around counseling, training/health and wellness presentations, provision of health fairs, and consultation to installation command regarding behavioral health issues. Works closely with the installation and military branch Points of Contact (POC) to assure that the program is provided within scope and meets the needs of the installation.Provides non-medical, short-term, solution focused, walk-around counseling directly to service and famil

Source: Talroo

PART TIME INTERMITTENT ID CARD SPECIALIST, NAVY ICA
  Posted 1 week ago    Magellan Health    Virginia Beach, VA

Provides professional military personnel support services to the U.S. Navy s Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.Issu

Source: Talroo

MASTER RESILIENCE TRAINER - PERFORMANCE EXPERT, ARD-TS
  Posted 1 week ago    Magellan Health    Fort Sill, OK

Master Resilience Trainer Performance Experts (MRT-PE) support government client s program at multiple locations. MRT-PEs teach mental skills, resilience and performance enhancement techniques to military Soldiers, Families and DA Civilians. Teaching is conducted in group and individual settings and includes general education in human performance along with personalized training on how to acquire and apply specific mental skills and techniques that cultivate the mental and emotional strength necessary to thrive in an environment of overwhelming demands and persistent conflict. The mental skills and techniques taught by the program include: Building Confidence, Goal Setting, Attention Control, Energy Management, Integrating Imagery and Team Building. Using these principles, MRT-PEs help the clients to become high performing tactical athletes and help foster high performing unit teams in preparation for, during, and following combat operations. Specifically, MRT-PEs teach performance psy

Source: Talroo

ID CARD SPECIALIST (PERSONNEL ASSISTANT II), NAVY ICA
  Posted 1 week ago    Magellan Health    Norfolk, VA

Provides professional military personnel support services to the U.S. Navy s Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.Issu

Source: Talroo

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