mcs

Regular Exempt **GENERAL DESCRIPTION:** Carries out nursing functions in performing care management process, organizational determinations, and transitional care, including, but not limited to, health assessments, biopsychosocial needs assessment, and barriers for policyholders with medical conditions to develop a comprehensive and customized...

Regular Non-Exempt **GENERAL DESCRIPTION:** The Executive Secretary is responsible for supporting and managing administrative processes in the assigned department, in accordance with established company guidelines, policies, and procedures. **ESSENTIAL FUNCTIONS:** - Answers, makes, and forwards telephone calls within the department. -...

Regular Exempt **GENERAL DESCRIPTION:** Assists in investigating cases for resolution in compliance with the applicable regulations, guidelines, and contractual agreements. Participates in the implementation processes of the special networks, prompt payment, and directory complaints, which entails analyzing the operational impact, validations,...

Regular Non-Exempt **GENERAL DESCRIPTION:** Responsible for providing frontline support within the Human Resources Services function by responding to employee inquiries and processing routine HR transactions throughout the employee lifecycle. Ensures transactions are completed accurately, timely, and in compliance with established policies,...

Regular Exempt **GENERAL DESCRIPTION:** Serves as a liaison between the company and extended care home administration to coordinate, refer, and manage documents and/or services related to the company’s Home Health Program. Responsible for handling, channeling, and resolving service situations related to complaints, claims, and operational...

Regular Exempt **GENERAL DESCRIPTION:** Performs health risk assessments (HRA’s) to determine if the member is eligible for Special Supplemental Benefits for the Chronically Ill (SSBCI). Reviews the member's individualized care plan and performs specific interventions to monitor the member's health status. **ESSENTIAL FUNCTIONS:** -...

**FBMG-022 | Fort Buchanan Microgrid | Contingent opportunity** **WORK LOCATION: HYBRID - remote planning/program review; ON ISLAND for integration, FAT/SAT, functional tests, training, and warranty support** | | | | --- | --- | | **REQUISITION** | FBMG-022 | | **CSS CAM LCAT** | 640 - Senior Engineer/IT Staff Member (Microgrid Integration) | | **DUTY...

**FBMG-016 | Fort Buchanan Microgrid | Contingent opportunity** **WORK LOCATION: HYBRID - remote design/submittal review; ON ISLAND during OSP installation, termination, cutover, testing, and QC activities** | | | | --- | --- | | **REQUISITION** | FBMG-016 | | **CSS CAM LCAT** | 140 - Senior Technical Staff Member (Telecommunications) | | **DUTY...

Temporary - AEP Non-Exempt **GENERAL DESCRIPTION:** Coordinates and collaborates with the sales team through the processing of sales documents, reporting, data entry, inventory management, and other additional tasks related to the smooth running of the office and membership sales department. **ESSENTIAL FUNCTIONS:** - Assists with issues...

Regular Non-Exempt **GENERAL DESCRIPTION:** Promotes MCS Classicare products and services by participating in events and/or formal and informal activities approved by the Medicare Center and Medicaid Services (CMS). Ensure compliance with the requirements established by the regulatory agency. Carries out the pre-qualification process for...

Regular Non-Exempt **GENERAL DESCRIPTION:** Promotes MCS Classicare products and services by participating in events and/or formal and informal activities approved by the Medicare Center and Medicaid Services (CMS). Ensure compliance with the requirements established by the regulatory agency. Carries out the pre-qualification process for...

Regular Non-Exempt **GENERAL DESCRIPTION:** Promotes MCS Classicare products and services by participating in events and/or formal and informal activities approved by the Medicare Center and Medicaid Services (CMS). Ensure compliance with the requirements established by the regulatory agency. Carries out the pre-qualification process for...

Regular Non-Exempt **GENERAL DESCRIPTION:** Promotes MCS Classicare products and services by participating in events and/or formal and informal activities approved by the Medicare Center and Medicaid Services (CMS). Ensure compliance with the requirements established by the regulatory agency. Carries out the pre-qualification process for...

Regular Exempt **GENERAL DESCRIPTION:** Responsible for evaluating and managing the credentialing and recredentialing processes for healthcare professionals and facilities participating in the provider network across all lines of business. Ensures compliance with regulatory requirements, accreditation standards, and company policies, maintaining...

Regular Exempt **GENERAL DESCRIPTION:** Responsible for identifying, analyzing, and implementing impactful health services network management initiatives focused on enhancing service quality, driving process improvements, and ensuring contractual compliance. Translates strategic plans into actionable initiatives, effectively operationalizing them...

Regular Non-Exempt **GENERAL DESCRIPTION:** Responsible for receiving and initiating phone calls regularly in alignment with the strategies and special projects of the Medicare Stars Program. Ensures the call volume and service quality meet the productivity targets and supports the attainment of Stars-related goals. Solves and forwards situations...

Regular Non-Exempt **GENERAL DESCRIPTION:** Oversees interventions and/or calls to clients (beneficiaries, providers, pharmacies) to promote the correct use of medications and follow the prescription to increase adherence in the identified population, which results in a significant impact on the star rating for the company. Participates in the...

**GENERAL DESCRIPTION:** The Customer Service Representative I – SC is responsible for assisting customers and prospects with information about the company's products and services. They address and clarify any questions from beneficiaries who have concerns. Resolves service needs by following established operational processes and service guidelines and...

Regular Exempt **GENERAL DESCRIPTION:** Responsible for optimizing the processes within the unit, leading efforts to streamline internal workflows, reduce inefficiencies, and ensure that our providers operations administration are aligned with regulatory requirements and organizational goals. Analyzes market trends and regulations to implement...

El puesto de Oficinista Coordinación Recursos Clínicos tiene como propósito asistir en las operaciones diarias del departamento de Servicios Clínicos/HHA, sirviendo de enlace principal tanto con la red externa de recursos clínicos como con recursos clínicos empleados, facilitando, coordinando y apoyando al personal clínico que brinda...