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Care Coordinator
Magellan Health - United States of America
Coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes. Duties are typically performed during face-to-face home visits. Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member sati...
Care Manager (BH) - Health Plan - Remote
Magellan Health - United States of America
This position is responsible for the assessment, reassessment, care planning and coordination of care and services including ongoing monitoring of an appropriate and effective person-centered care plan, member education and care management. Conducts initial and concurrent review for prior authorization of higher levels of care against medical necessity criteria. Responsible for the development ...
Lead Scrum Master - Fully Remote
Magellan Health - United States of America
Interested in fully remote opportunity as a Lead Scrum Master while working for an innovative healthcare company where you can have an impact on people's lives? Apply today and come join us at Magellan Health as we empower people to lead healthier, more vibrant lives. Must have experience executing as a scrum master in an agile transformation As a Lead Scrum Master...
Care Coordinator
Magellan Health - United States of America
Coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes. Duties are typically performed during face-to-face home visits. Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member sati...
Air Force EAP Manager
Magellan Health - United States of America
Manages and provides administrative and clinical supervision of the Onsite employee assistance program (EAP) field Clinicians. Leverages and coordinates Magellan resources in support of Magellan Federal EAP business objectives. Responsible for delivery of quality services to members and managers in alignment with EAP Core Technologies, maintaining account satisfaction, with promotion of the ful...
Sr. Care Manager - BH or RN
Magellan Health - United States of America
Authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up activity; provides member assistance with mental health and substance abuse issues, and participates in quality improvement projects. May be assigned additional spec...
Administrative Support -Care Worker
Magellan Health - United States of America
Facilitates department workflow by supporting clinical team with administrative care coordination support. Locates community services and other referral locations for enrollees, arranges access to care, supports communication with hospitals, and providers. Provides non-clinical support to workflows involving utilization management, case management, disease management, and health promotio...
Senior Care Manager- BH
Magellan Health - United States of America
Authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up activity; provides member assistance with mental health and substance abuse issues, and participates in quality improvement projects. May be assigned additional spec...
Senior Billing Specialist
Magellan Health - United States of America
Experience with CPT coding Experience with Cost point Experience with Government submission platforms. For example: WAWF, IPP Strong ability to work independently Responsible for timely and accurate client record maintenance. Supports client billing and remittance. Researches and resolves questions, complaints and grievances and ensures information in all databases is ac...
Director Learning and Development Programs - Clinical- Remote US
Magellan Health - United States of America
Seeking Healthcare/Clinical and training leadership experience with a Masters in Counseling or comparable degree with requisite HealthCare Training experience preferred. Remote position, ability to travel when required. This position liaises with multiple stakeholders across Magellan Healthcare to provide specialized training programs to meet the learning and development requirements of...
Compliance Coordinator
Magellan Health - United States of America
Responsible for completing activities that organize the department's ability to conduct auditing and monitoring along with other compliance related activities. Gathers, audits, and monitors documentation and data from compliance and/or operational reports. Assists with analyzing and reporting privacy incidents. Conducts compliance related verification activities to ensure...
Senior Billing Specialist
Magellan Health - United States of America
Experience with CPT coding Experience with Cost point Experience with Government submission platforms. For example: WAWF, IPP Strong ability to work independently Responsible for timely and accurate client record maintenance. Supports client billing and remittance. Researches and resolves questions, complaints and grievances and ensures information in all databases is ac...
Sr Contracts Manager, Federal
Magellan Health - United States of America
Responsible for day-to-day contract administration for U.S. Government contracts to ensure contract compliance while protecting company's goals and interests. This position is responsible for aspects of contract strategy development; compliance with contract terms and conditions, US laws, regulations, and executive orders; conflict of interest oversight; operational compliance; and risk mitigat...
Sr Contracts Manager, Federal
Magellan Health - United States of America
Responsible for day-to-day contract administration for U.S. Government contracts to ensure contract compliance while protecting company's goals and interests. This position is responsible for aspects of contract strategy development; compliance with contract terms and conditions, US laws, regulations, and executive orders; conflict of interest oversight; operational compliance; and risk mitigat...
Quality Clinical Reviewer
Magellan Health - United States of America
This position is contingent on a contract award. Conducts reviews of clinical interactions and clinical documentation including reviews of case management records and provider treatment records. Collects data following established procedures and analyzes findings for purposes of continuous quality improvement and for internal and external reporting. Interacts with multiple stakeholders in...
