better Job at Magellan Health Services Inc

Initial Clin Reviewer - RN Requisition ID 5835 Full/Part Time Full-time Location Maryland Heights MO Description JOB SUMMARY This position functions in a clinical review capacity to evaluate all cases, which do not pass the authorization approval process at first call while promoting a supportive team approach with call center staff. Clinical reviewers are supported by peer clinical review staff (MDs) in the utilization management determination process. ESSENTIAL FUNCTIONS Approve all services that

5 years of progressively more responsible health care administration experience finance contract administration physician...

Clinical Pharmacist - PH8108EP Requisition ID 6016 Full/Part Time Full-time Location Houston TX Description JOB SUMMARY Performs prospective and/or retrospective drug utilization review. Participates in the distribution of clinical drug information and educates providers and staff regarding the appropriate use of pharmaceutical treatment regimens. Complies with all corporate and facility standard operating procedures, policies, guidelines, and work instructions. ESSENTIAL FUNCTIONS Improves the quality

Experience 5 8 years Health Care Sales 3...Experience Preferably in a sales capacity within the Be havioral Health Care arena...

Customer Svc Supvr -CMC - CS7103ES Requisition ID 6080 Full/Part Time Full-time Location Maryland Heights MO Description JOB SUMMARY: This position is responsible for the coaching and development of Customer Service Associates (CSAs). It is responsible for ensuring CSAs follow appropriate guidelines and processes in delivering a high caliber, efficient level of service to members and providers. The Customer Service Supervisor must create a team environment which motivates CSAs and contributes to operational

study Instructional Systems Design Human Resources Health Care or related field of study or...

Associate Medical Director, Care Management Center Requisition ID 6006 Full/Part Time Part-time Location Newtown PA Description JOB SUMMARY This position will be scheduled to work from 20-29 hours per week based on department needs. Along with the Regional Medical Director and Clinical Director, the Associate Medical Director defines the clinical vision of the CMC and implements programs to support this vision. This may include oversight of UM and QI programs, as well as providing an interface with the

Recognized as the country s foremost specialty health care management company Magellan Health Services is making changes that matter...customer service capacity preferably within a health care environment to provide front line service...customer service capacity preferably within a health care environment to provide front line service...

in a psychiatric or substance abuse health care setting Current independent State licensure Ability...join us as we improve the health care outcomes for individuals and families fighting...

Field Network Coordinator - NW8803EB Requisition ID 6075 Full/Part Time Full-time Location New York NY Description JOB SUMMARY: Under direction of Field Network Director/Manager, the incumbent is responsible for the support of all activities related to developing and maintaining the physician, practitioner, group, and/or facility, MPPS and organization services delivery system in small to mid-size market defined by membership, number of providers in de- livery system, number of business operating units and

Specific 5 yrs of broad based Health Care experience including account management experience Experience...

customer client service experience in a health care call center environment via direct interaction...

District EAP Consultant - CN8819EB Requisition ID 6063 Full/Part Time Full-time Location Miami FL Description Job Summary Insure that a full breadth of EAP Core Technology services are provided to each USPS district and its employees. Assumes overall responsibility for marketing the program within their district. Provides EAP brief counseling services. Provides consultative services to union and management representatives. Provide: case management, critical incident responses and training to the USPS. Collaborates

IT Proj Manager, Lead - IT6810EI Requisition ID 6060 Full/Part Time Full-time Location Maryland Heights MO Description JOB SUMMARY Responsible for providing direction to a team of IT Project Managers, as well as managing cross-functional projects. Responsibilities for the managing of cross-functional projects include: providing senior-level expertise to management from various I.T. departments. Works directly with the CEO, President and Executive Officers on highly visible, strategic projects. Experienced

Experience Experience in a Customer Service Health Care environment...

Industry Behavioral Health Care Job Specific Minimum of five years managerial experience in an appropriate professional area...PREFERRED QUALIFICATIONS Experience Experience preferred in a sales or account management capacity within the Behavioral Health Care arena...

10 yrs of broad base of Health Care experience including account management and or...background in a for profit corporate health care environment...

join us as we improve the health care outcomes for individuals and families fighting...

join us as we improve the health care outcomes for individuals and families fighting...

join us as we improve the health care outcomes for individuals and families fighting...

JOB SUMMARY Provides project-based and other administrative support to the SVP and members of the Legal department. Manages confidential materials that require broad and comprehensive knowledge of the organization s policies and operations. Responsibilities require discretion, judgment, tact and poise. ESSENTIAL FUNCTIONS: (Tasks critical to completion of daily workload) A. Coordinates and independently completes special projects according to manager s general instructions. Assist managers or other staff

Experience Experience in a Customer Service Health Care environment...

Experience 3 yrs experience post degree in psychiatric and or substance abuse health care setting including uti lization review...

SIU Investigator - CL8301EB Requisition ID 6045 Full/Part Time Full-time Location Columbia MD Description JOB SUMMARY This position is responsible for preventing and/or recovering inap- propriate health benefit payments due to claims processing and/or abusive and fraudulent practices, as well as lead the complex and confidential claims audits through investigation, developing case strategies, and complying with state and federal regulatory com- pliance and fraud reporting requirements. ESSENTIAL FUNCTIONS

the utilization and or quality of Health Care services...Policy DHCFP related to UM trends health care policies and makes recommendations that impact...

IT Quality Assurance Analyst Sr Requisition ID 6028 Full/Part Time Full-time Location Maryland Heights MO Description JOB SUMMARY This position is responsible to develop thorough test plans for me- dium to complex systems to ensure a smooth transition from a de- velopment environment to a production environment. Responsible for mentoring of Quality Assurance Analyst and Associate Quality Assurance Analyst. Responsible for testing, reviewing and learn- ing medium to complex functionality of software applications

Clinical Reviewer - CMC - QA8111ES Requisition ID 6026 Full/Part Time Full-time Location Maryland Heights MO Description JOB SUMMARY Conducts treatment record and case management record reviews. Trends and analyzes findings for internal and external reporting. ESSENTIAL FUNCTIONS (Tasks critical to completion of daily workload) A. Reviews charts and analyzes clinical record documentation. B. Conducts ongoing activities which monitor established quality of care standards in the participating provider

Lead Programmer/Analyst-RPG Requisition ID 6018 Full/Part Time Full-time Location Maryland Heights MO Description JOB SUMMARY Analyzes problems in terms of detailed requirements. Designs de- tailed flow charts. Verifies program logic by preparing tests data for trial runs. Tests and debugs programs. Prepares run sheets for routine programs. May also do coding from flow charts, assist in determining the causes of computer or program malfunctions, and confer with technical personnel in systems analysis and

Case Mgmt Integration Specialist RN - CN8225EN Requisition ID 6017 Full/Part Time Full-time Location Parsippany NJ Description JOB SUMMARY The Case Management Integration Specialist will be co-located at the customer location all or part of the time and will serve as an integral part of the medical case management team as the behavioral health expert. The Case Management Integration Specialist (CMIS) will provide support for members who are at risk for significant behavioral events or have severe and

IT Quality Assurance Analyst - IT8242EI Requisition ID 6014 Full/Part Time Full-time Location Rancho Cordova CA Description JOB SUMMARY This position is responsible to develop thorough test plans for me- dium (relating to complexity) systems to ensure a smooth transition from a development environment to a production environment. Responsible for mentoring of Associate Quality Assurance Analyst. Responsible for testing, reviewing and learning medium (relating to complexity) functionality of software applications

IT Project Mgr, Sr - IT6802EI Requisition ID 6004 Full/Part Time Full-time Location Glen Allen VA Description JOB SUMMARY Serves as the senior member of a cross-functional project team consisting of individuals from various I.T. departments and busi- ness units. Provides senior level specialty expertise to manage- ment from various I.T. departments. The successful candidate will have the ability to effectively deal with evolving and competing ob- jectives and possess a mastery of project management tools

Therapist - CN8402EB Requisition ID 5988 Full/Part Time Part-time Location Chicago IL Description JOB SUMMARY This position is part time - 20 hours per week Provides direct clinical service to covered members: individuals, couples, families and groups. Facilitates referral for appropriate care if necessary. May provide services to employers such as supervisor consultation, educational presentations or critical inci- dent stress debriefing as assigned. ESSENTIAL FUNCTIONS (Tasks critical to completion of

Project Assistant I - AD9108NB Requisition ID 5942 Full/Part Time Full-time Location Columbia MD Description JOB SUMMARY Provides project-based and other administrative support to the SVP and members of the Legal department. Manages confidential materials that require broad and comprehensive knowledge of the organization s policies and operations. Responsibilities require discretion, judgment, tact and poise. ESSENTIAL FUNCTIONS: (Tasks critical to completion of daily workload) A. Coordinates and independently

Disease Mgmt Health Coach - DM8201EB Requisition ID 5860 Full/Part Time Full-time Location Columbia MD Description JOB SUMMARY: This is a 37 hour/week position that requires at least 2 evenings per week and 2 Saturdays/month. Disease Management Health Coaches will provide support to members who are at risk for significant behavioral events or have severe and/or chronic behavioral/medical health conditions that need to be Managed. Health Coaches are responsible for providing condition care management to

Appeals Coordinator - CN9101NS Requisition ID 5825 Full/Part Time Full-time Location Miami FL Description JOB SUMMARY Coordinate appeals process as assigned, attends to risk manage- ment issues associated with case management and processes ap- peal requests. ESSENTIAL FUNCTIONS: (Tasks critical to completion of daily workload) A. Maintains a caseload and monitors day to day compliance of appeal decision time frames. B. Reviews inpatient and outpatient medical records for com- pleteness and determines

Data and Report Analyst-CMC - QA8114ES Requisition ID 5812 Full/Part Time Full-time Location Miami FL Description GRADE: 34 JOB SUMMARY This position works with the Senior Program Analyst to support CMC Leadership with data collection, data management, data analysis and reporting, and decision management tool design and development. This position takes a lead role in ensuring appropriate tools and re- positories are available to support CMC report development including QI, Compliance and Operations reports

Experience Managed health care and accreditation processes...

Data Research & Reporting Analyst - CMC - OP8110EB Requisition ID 5421 Full/Part Time Full-time Location Newtown PA Description JOB SUMMARY Assists in the development and implementation of protocols, coordinates data collection, conduct data analysis and prepare and distribute reports. ESSENTIAL FUNCTIONS Coordinate data collection and perform analysis and reports findings. Develop and maintain databases for analysis of findings, including the development of project specific applications. *

Recognized as the country s foremost specialty health care management company Magellan Health Services is making changes that matter...And we re looking for behavioral health care professionals to join our team...in a psychiatric or substance abuse health care setting for candidates at the Masters...

Services is the nation s specialty health care leader providing unsurpassed management of behavioral...join us as we improve the health care outcomes for individuals and families fighting...

join us as we improve the health care outcomes for individuals and families fighting...

join us as we improve the health care outcomes for individuals and families fighting...

20 Positions Available We are currently seeking 20+ Clinical Pharmacy Technicians for an exciting, new initiative at our Riverport location in Maryland Heights, MO. We are actively pursuing candidates to fill 20 positions with a scheduled start date of January 4th 2010. In addition, we anticipate the creation of additional 20 openings to begin February 1st. Apply today and start the New Year with a new, promising career! Job Description In this role, you will be responsible for:

perience in psychiatric and substance abuse health care for CMs with RN or Master...

records in accordance with the Arizona Health Care Cost Containment Administration AHCCCSA and Arizona...

Customer Care Coordinator - PH9101NB Requisition ID 6035 Full/Part Time Full-time Location Plantation FL Description JOB SUMMARY Under moderate supervision, responsible for intake of initial patient referrals, insurance benefits verification and coordination of new admissions with nursing and pharmacy. Additionally, responsible for preparing and managing paperwork and documentation required for billing and collections. ESSENTIAL FUNCTIONS Performs intake of initial patient referrals including collection

Clinical Pharmacy Tech - PH9206NB Requisition ID 6031 Full/Part Time Full-time Location Glen Allen VA Description ESSENTIAL FUNCTIONS Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. Determines appropriateness for medications. Communicates decision to physicians, physician s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes

Clinical Pharmacy Tech - PH9206NS Requisition ID 6023 Full/Part Time Full-time Location Maryland Heights MO Description ESSENTIAL FUNCTIONS: Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. Determines appropriateness for medications. Communicates decision to physicians, physician s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization

Clinical Project Manager Pharmacy - PH6206EP Requisition ID 6020 Full/Part Time Full-time Location AK Description JOB SUMMARY The Clinical Project Manager (PM) position plays a key role in various multi-functional projects critical to Magellan Health Services in achieving its clinical and operational goals and objectives. The Project Manager's responsibility is to develop, implement and monitor clinical specialty programs in the field. The PM's major responsibility is to serve as clinical liaison for

Senior Programmer/Analyst - IT8222E Requisition ID 6012 Full/Part Time Full-time Location Rancho Cordova CA Description JOB SUMMARY Analyzes problems in terms of detailed requirements. Designs de- tailed flow charts. Verifies program logic by preparing tests data for trial runs. Tests and debugs programs. Prepares run sheets for routine programs. May also do coding from flow charts, assist in determining the causes of computer or program malfunctions, and confer with technical personnel in systems analysis