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AMERIGROUP Corporation-Omaha, NE, 68182, USA
JOB SUMMARY: The Director of Quality Management is responsible in conjunction with the plan QM leader, the Plan Medical Director and CEO for developing, coordinating, and implementing quality initiatives within the health plan; to include indicators for monitoring and evaluation of quality of care/service, appropriateness, continuous improvement, member satisfaction, and results of actions across the continuum of care to members. Coordinates the quality management program activities throughout the functional areas of the health plan and provides education in the area of quality management. ...
AMERIGROUP Corporation Jobs
AMERIGROUP Corporation | Virginia Beach, VA, 23452, USA | 5
Job Title: Clinical Pharmacist - SSO Job ID: 10710 Location:Virginia Beach, VA Full/Part Time: Full-Time Regular/Temporary: Regular Grade: 21 JOB SUMMARY: This position will report directly to the National Medical Director of the Senior and Special Services Organization (SSO) with a dotted line to corporate Pharmacy department. The individual will be the pharmacotherapy subject matter expert on the Medicare Advantage Special Needs Plan Model of Care (MoC) Interdisciplinary Care Team (IDCT). The individual will work closely with other health care professionals on the IDCT, staff in the Ameri...
Amerigroup Corporation | Austin, TX, 73301 | >5
JOB SUMMARY: Serves as liaison to providers (including physicians, hospitals, and/or ancillary providers) and internal departments at the health plan. Responsible for performing activities designed to establish and maintain positive and productive relationships with AMERIGROUP network providers for Medicaid and Medicare products. These activities include responding to inquiries from providers regarding benefits, claim resolution, appeal status, and authorization or referral information. Also may be responsible for recruiting providers to ensure network access and service adequacy. Provides ...
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