- Martin's Point Health Care (Portland, ME)
- …MD works collaboratively with other plan functions that interface with Medical Management such as Health Management , Compliance and Appeals, , Network ... member + Performs medical necessity reviews of requests for health plan -covered services ( benefits ). Reviews...management and strategic deployment. + Provides support to Health Plan risk adjustment activities as needed.… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... large complex project/program with Internal and external teams preferred. About At Brighton Health Plan Solutions, LLC, our people are committed to the… more
- Brighton Health Plan Solutions, LLC (Raleigh, NC)
- …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... About The Role Brighton Health Plan Solutions is seeking an...Account Executive with deep expertise in PPO networks, self-insured benefit plans, and Third-Party Administration (TPA) organizations. This role… more
- Brighton Health Plan Solutions, LLC (Las Vegas, NV)
- …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... and understanding union labor benefits and Taft-Hartley plan administration. + Project management , process improvement,... management and CBA knowledge. About At Brighton Health Plan Solutions, LLC, our people are… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... will have worked in-depth in healthcare payer domain or Health Plan Administration ( Benefits &...to meet business needs. + Develop and integrate requirements management to the delivery approach and schedule; Assist product… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …healthcare payer domain in Multi-employer Trust (Hours & Eligibility management ), Health Plan Administration ( Benefits & Claims Administration, Vendor ... cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... chat, and voice. + Previous multi-channel experience is a plus. About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... a passionate, results-oriented Business Analyst in the healthcare payer domain with Health Plan administration experience of self-funded clients who excels in… more
- Magellan Health Services (San Diego, CA)
- …team approach, including all participants of the Interdisciplinary Care Plan team, Health Plan Medical Care Management where appropriate, to ensure ... implement solutions that directly influence quality of care. Understanding of plan benefit structures, psychiatric/medical terminology, call center terminology… more
- Deloitte (Tallahassee, FL)
- …payors, pharmacies and patients. + Prepare self-insured financial projections and support health plan management , including financial reporting, premium rate ... Pharmacy Benefit Manager/ Health & Group Benefits...content. + Demonstrated knowledge of at least three US health & welfare benefit plan ...at least three US health & welfare benefit plan types (such as life, disability,… more