Posted - May 19, 2022
Under general supervision, and in collaboration with other members of the c...
Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and subst...
Posted - May 19, 2022
Under general supervision, and in collaboration with other members of the c...
Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and subst...
Posted - May 19, 2022
Remote Position in United States: This below description is more relevant...
Remote Position in United States: This below description is more relevant to the position than the above Job Description. Position Purpose: Develo...
Posted - May 19, 2022
Remote Position in United States: This below description is more relevant...
Remote Position in United States: This below description is more relevant to the position than the above Job Description. Position Purpose: Develo...
Posted - May 19, 2022
Family Advocacy Program Assistants (FAPAs) provides administrative, technic...
Family Advocacy Program Assistants (FAPAs) provides administrative, technical, and prevention services under the direction of the site Family Advocacy...
Posted - May 19, 2022
Family Advocacy Program Assistants (FAPAs) provides administrative, technic...
Family Advocacy Program Assistants (FAPAs) provides administrative, technical, and prevention services under the direction of the site Family Advocacy...
Posted - May 19, 2022
Remote position, preferably in Eastern or Central time zone. Overall manag...
Remote position, preferably in Eastern or Central time zone. Overall management of assigned book of business for the company's products and services...
Posted - May 19, 2022
Remote position, preferably in Eastern or Central time zone. Overall manag...
Remote position, preferably in Eastern or Central time zone. Overall management of assigned book of business for the company's products and services...
Posted - May 19, 2022
This position is a front-line service position providing assistance to Mage...
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures....
Posted - May 19, 2022
This position is a front-line service position providing assistance to Mage...
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures....
Posted - May 19, 2022
This position is a front-line service position providing assistance to Mage...
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures....
Posted - May 19, 2022
This position is a front-line service position providing assistance to Mage...
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures....
Posted - May 19, 2022
This position is in support of West Point. Candidates must be local to the...
This position is in support of West Point. Candidates must be local to the base or be willing to relocate to become local. Candidates must be licensed...
Posted - May 19, 2022
This position is in support of West Point. Candidates must be local to the...
This position is in support of West Point. Candidates must be local to the base or be willing to relocate to become local. Candidates must be licensed...
Posted - May 19, 2022
This position is in support of Birmingham Army National Guard. Candidates m...
This position is in support of Birmingham Army National Guard. Candidates must be local to the bases or be willing to relocate to become local. Candid...
Posted - May 19, 2022
This position is in support of Birmingham Army National Guard. Candidates m...
This position is in support of Birmingham Army National Guard. Candidates must be local to the bases or be willing to relocate to become local. Candid...
Posted - May 19, 2022
This position is in support of Birmingham Army National Guard. Candidates m...
This position is in support of Birmingham Army National Guard. Candidates must be local to the bases or be willing to relocate to become local. Candid...
Posted - May 19, 2022
This position is in support of Birmingham Army National Guard. Candidates m...
This position is in support of Birmingham Army National Guard. Candidates must be local to the bases or be willing to relocate to become local. Candid...
Posted - May 19, 2022
Provides professional military personnel support services to the U.S. Navy'...
Provides professional military personnel support services to the U.S. Navy's Identification Card Administration (ICA) program at Navy installations de...
Posted - May 19, 2022
Provides professional military personnel support services to the U.S. Navy'...
Provides professional military personnel support services to the U.S. Navy's Identification Card Administration (ICA) program at Navy installations de...
Posted - May 19, 2022
This is a fully remote FTE position for a Principal IT Project Manager, whi...
This is a fully remote FTE position for a Principal IT Project Manager, which allows you to work from home from anywhere in the US. This position is...
Posted - May 19, 2022
This is a fully remote FTE position for a Principal IT Project Manager, whi...
This is a fully remote FTE position for a Principal IT Project Manager, which allows you to work from home from anywhere in the US. This position is...
Posted - May 19, 2022
This position is a front-line service position providing assistance to Mage...
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures....
Posted - May 19, 2022
This position is a front-line service position providing assistance to Mage...
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures....
Posted - May 19, 2022
This position is a front-line service position providing assistance to Mage...
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures....
Posted - May 19, 2022
This position is a front-line service position providing assistance to Mage...
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures....
Posted - May 19, 2022
Master Resilience Trainer - Performance Experts (MRT-PE) support government...
Master Resilience Trainer - Performance Experts (MRT-PE) support government client's program at multiple locations. MRT-PEs teach mental skills, resil...
Posted - May 19, 2022
Master Resilience Trainer - Performance Experts (MRT-PE) support government...
Master Resilience Trainer - Performance Experts (MRT-PE) support government client's program at multiple locations. MRT-PEs teach mental skills, resil...
Posted - May 19, 2022
This position may require travel to surrounding offices to cover as needed....
This position may require travel to surrounding offices to cover as needed. Provides professional military personnel support services to the U.S. Nav...
Posted - May 19, 2022
This position may require travel to surrounding offices to cover as needed....
This position may require travel to surrounding offices to cover as needed. Provides professional military personnel support services to the U.S. Nav...
Posted - May 18, 2022
This position may require travel to surrounding offices to cover as needed....
This position may require travel to surrounding offices to cover as needed. Provides professional military personnel support services to the U.S. Nav...
Posted - May 18, 2022
This position may require travel to surrounding offices to cover as needed....
This position may require travel to surrounding offices to cover as needed. Provides professional military personnel support services to the U.S. Nav...
Posted - May 18, 2022
Performs the basic duties of a pharmacy technician in all designated sites....
Performs the basic duties of a pharmacy technician in all designated sites. Including and not limited to, prescription data entry, as well as communic...
Posted - May 18, 2022
Performs the basic duties of a pharmacy technician in all designated sites....
Performs the basic duties of a pharmacy technician in all designated sites. Including and not limited to, prescription data entry, as well as communic...
Posted - May 18, 2022
The Sr. Director of Data Governance incrementally builds out a data governa...
The Sr. Director of Data Governance incrementally builds out a data governance program and manages its operational components, influencing maturity of...
Posted - May 18, 2022
The Sr. Director of Data Governance incrementally builds out a data governa...
The Sr. Director of Data Governance incrementally builds out a data governance program and manages its operational components, influencing maturity of...
Posted - May 18, 2022
Plan, develop, and ensure completion of all documentation elements in a sta...
Plan, develop, and ensure completion of all documentation elements in a standardized, timely manner, and communicate all changes in documentation to a...
Posted - May 18, 2022
Plan, develop, and ensure completion of all documentation elements in a sta...
Plan, develop, and ensure completion of all documentation elements in a standardized, timely manner, and communicate all changes in documentation to a...
Posted - May 18, 2022
Provide support to all eligible Families with expectant parents and parents...
Provide support to all eligible Families with expectant parents and parents of children from birth to 3 years of age. This program seeks to support yo...
Posted - May 18, 2022
Provide support to all eligible Families with expectant parents and parents...
Provide support to all eligible Families with expectant parents and parents of children from birth to 3 years of age. This program seeks to support yo...
Posted - May 18, 2022
Reviews requests for authorization for specific medications by reviewing me...
Reviews requests for authorization for specific medications by reviewing medical records and documents related to the Medi-Cal program. Considers each...
Posted - May 18, 2022
Reviews requests for authorization for specific medications by reviewing me...
Reviews requests for authorization for specific medications by reviewing medical records and documents related to the Medi-Cal program. Considers each...
Posted - May 17, 2022
Family Support Coordinator - R00000050856 DESCRIPTION/RESPONSIBILITIES:Seek...
Family Support Coordinator - R00000050856 DESCRIPTION/RESPONSIBILITIES:Seeking candidates with two years of family peer support/advocacy work experien...
Posted - May 17, 2022
Family Support Coordinator - R00000050856 DESCRIPTION/RESPONSIBILITIES:Seek...
Family Support Coordinator - R00000050856 DESCRIPTION/RESPONSIBILITIES:Seeking candidates with two years of family peer support/advocacy work experien...
Posted - May 17, 2022
Authorizes and reviews utilization of autism services, including Applied Be...
Authorizes and reviews utilization of autism services, including Applied Behavioral Analysis (ABA). Collects and analyzes utilization data. Assists wi...
Posted - May 17, 2022
Authorizes and reviews utilization of autism services, including Applied Be...
Authorizes and reviews utilization of autism services, including Applied Behavioral Analysis (ABA). Collects and analyzes utilization data. Assists wi...
Posted - May 17, 2022
The On-Call/Substitute MFLC Counselor, will provide coverage in short-term,...
The On-Call/Substitute MFLC Counselor, will provide coverage in short-term, surge and on demand situations resulting from the Military needs such as a...
Posted - May 17, 2022
The On-Call/Substitute MFLC Counselor, will provide coverage in short-term,...
The On-Call/Substitute MFLC Counselor, will provide coverage in short-term, surge and on demand situations resulting from the Military needs such as a...
Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data. Assists with discharge planning and care coordination. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.
Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
Provides telephone triage, crisis intervention and emergency authorizations as assigned.
Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience.
In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.
Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
Participates in quality improvement activities, including data collection, tracking, and analysis.
Maintains an active work load in accordance with National Care Manager performance standards.
Works with community agencies as appropriate. Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
Participates in network development including identification and recruitment of quality providers as needed.
Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.
Other Job Requirements
Responsibilities
Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements.
One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN.
Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.
Strong organization, time management and communication skills.
Knowledge of utilization management procedures, mental health and substance abuse community resources and providers.
Knowledge and experience in inpatient and/or outpatient setting.
Knowledge of DSM V or most current diagnostic edition.
Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.
General Job Information
Title
Public Sector After hours Care Manager
Grade
23
Work Experience - Required
Clinical
Work Experience - Preferred
Education - Required
Associates - Nursing, Bachelors - Social Work, Masters - Social Work
Education - Preferred
License and Certifications - Required
CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Remote Position in United States:
This below description is more relevant to the position than the above Job Description.
Position Purpose:
Develop, maintain, document, and improve the organizational Information Security (IS) policies and standards for certification and compliance, driven by changes in new regulations, contract requirements, and internal IS changes. Manage the day-to-day activities related to IS policies and standards and assist in developing organizational IS Governance, Risk & Compliance (IS GRC) strategy, frameworks, goals, and targets.
Education/Experience:
Bachelor's degree in Computer Science, Business Administration, Law, or related field or equivalent experience. 5+ years of IS, IS risk, or IS compliance related operations experience. Demonstrated understanding of Security and IS Governance and Risk as they relate to compliance and legal support. Knowledge of IS, access controls, application and platform controls, data protection, operations security, network and internet security, disaster recovery and physical security controls.
[Noted Frameworks: primarily focused on NIST 800-53 (CSF, 800-37, 800-171), HITRUST, HIPAA, SOC 2, FedRAMP, FIPS 140-2, CMS MARSE 2.0]
Recommended Licenses/Certifications:
CISSP, CISM, CGEIT [Other relevant licenses or certifications include: JD, CIPP/US, CISA, CRISC, CCSP] preferred but not required
Responsibilities
Assists to develop, document, and maintain enterprise IS policies and standards for certification and compliance.
Determines if IS policy and standard updates are needed due to changes in regulations, business processes, and best practices; assists in managing IS policy management process in IS Governance, Risk & Compliance.
Maintains an awareness of existing and proposed state and federal legislation and regulations pertaining to organization IS policies and standards. Identifies changes that will affect IS policies, standards, and procedures, and recommends appropriate changes.
Collaborates with IS Governance team to develop and manage the organizational rationalized framework, identify compliance controls, test procedures, compliance standards, etc.
Monitors current IS policies and provides oversight to meet strategic IS targets and goals.
Supports IS risk analysis, evaluations and education on organizational assets and processes as it pertains to compliance, security, Policy Exception Requests, and risk management policies and standards.
Reviews compliance regulations and manages the creation and maintenance of organizational policy initiatives and standards.
Supports leadership by creating presentations regarding IS policy metrics, IS risks, and key accomplishments, key initiatives, and other metrics.
Manages enterprise-wide response to user inquiries, and performs additional duties, as assigned.
Promotes a positive security culture for the organization by protecting the confidentiality, integrity, and availability of data and assets while assisting the company to successfully meet its strategic goals. Leads the engineering, implementation, and maintenance of security processes and solutions throughout the enterprise according to policy and risk. This role will lead the design, development, and maintenance of the security environment and architecture to ensure the assets are protected. Be a champion to their team and other business units to promote a secure organization through positive knowledge sharing, training, influences, and conduct. Serve as a senior member of the Information Security team providing senior level expertise from various IT disciplines with focus in information security.
Leads efforts to ensure adequate security processes and solutions to mitigate or remediate identified risks sufficiently to meet business objectives, contractual and/or regulatory requirements.
Leads incident response activities, ensuring security incidents are properly contained, eradicated, and recovered.
Drives development of security policies, standards and plans to ensure the protection of corporate data against unauthorized use, access, modification and destruction.
Ensures proper security logs are generated and sent to the organization's Security Information and Event Management (SIEM) system.
Researches and implements emerging technologies to enhance the security portfolio.
Persistently evaluates adherence with defined policies and standards.
Leads efforts with identifying, remediating, and/or mitigating vulnerabilities in the environment, ensuring appropriate response to high risk and aged findings.
Leads the development, design, implementation, and maintenance of a secure environment for Magellan Health.
Ensures Magellan security processes and solutions are protected against a failure or attack that reduces the organization's ability to respond to security incidents.
Ensures Magellan processes and solutions are maintained securely and highly available to protect the confidentiality, integrity and availability of assets
Monitors and ensures systems revisions and patches are up to date.
Manages and performs changes to the solutions and remove unnecessary services.
Understands risks and impact to systems in the corporate environment and their interconnectivity
Builds cross function team unity by supporting other Magellan team members to understand security risks and impact to all corporate solutions
Performs forensic analysis and risk assessments for the entire environment.
Designs and manages enterprise high-availability solutions running a complex arrangement of operating systems, including system updates, log analysis, access controls and backup.
Performs changes to the solution configurations to add new services, adapt existing services, and removes unnecessary services.
Monitors, remediates and mitigates security violations for network, devices, servers and other assets
Designs, implements and maintains security guidelines and a security infrastructure for Magellan Health.
Develops technical solutions to autonomously verify compliance with required technical controls.
Other Job Requirements
Responsibilities
7+ years of IT experience required.
Minimum of 5 years of experience in Information Security.
May substitute 2 or more relevant certifications for a year of experience.
Demonstrated knowledge and experience in each of the following information security principles: risk assessment and management, threat and vulnerability management, incident response, and identity & access management.
Understand network protocols and packet analysis tools such as TCPDUMP and Wireshark.
Knowledge of and experience with security-related systems and applications, firewalls, load balancers, intrusion detection/prevention, and web content filtering.
Familiarity with information security publications (e.g., NIST 800-53), incident response, problem resolution, vulnerability remediation, computer forensic techniques and eDiscovery, reviewing automated security test results, and network and host-based firewalls.
Ability to work with multi-discipline teams and cross-functional management.
Excellent verbal and written communication skills with the ability to collaborate effectively with other groups.
Able to effectively manage evolving and competing objectives.
Possesses a mastery of the use of information security tools and techniques.
Has strong leadership, communication, and negotiation skills.
Results driven with a bias for action.
General Job Information
Title
Lead InfoSec Governance Analyst -- Policy Development & Management (InfoSec GRC) - Fully Remote
Grade
29
Work Experience - Required
Information Security, IT
Work Experience - Preferred
Education - Required
Education - Preferred
Bachelors - Computer and Information Science
License and Certifications - Required
License and Certifications - Preferred
CEH-Certified Ethical Hacker - Enterprise, CISSP - Certified Information Systems Security Professional - Enterprise, GISP-GIAC Information Security Professional - Enterprise, GSEC-SANS GIAC Security Essentials - Enterprise, Network+ - Enterprise, Security+ - Enterprise
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Family Advocacy Program Assistants (FAPAs) provides administrative, technical, and prevention services under the direction of the site Family Advocacy Officer (FAO). FAPAs will support all components of the FAP to include providing administrative assistance, records management, computer support, meeting preparation, assisting in research and evaluation, and assisting in administering and scoring instruments related to secondary prevention. FAPAs with the skill set to assist with prevention services and under direction of the site FAO, may assist with New Parent Support Program and FAP Outreach activities.
Provides administrative, technical, and prevention services under the direction of the site FAO.
Supports all components of the FAP to include providing administrative assistance, records management, computer support, meeting preparation, assisting in research and evaluation, and assisting in administering and scoring instruments related to secondary prevention.
Assists with prevention services and under direction of the site FAO, may assist with New Parent Support Program and FAP Outreach activities.
Other Job Requirements
Responsibilities
Associate's degree in Education or Teacher Certification Program, Social Behavior, Human Behavior, or Health Care.
Experience developing an education curriculum with learning objectives and outcomes are essential.
Critical the FAPA have a high proficiency in Microsoft Office and various database and software programs.
Shall be able to obtain and maintain a National Agency Check with Inquiries (NACI) Tier 1 Clearance.
Must be able to operate general office equipment including but not limited to computer, phones and related media and information devices on most or all workdays.
Ability to communicate and interact with others, both in person and/or by telephone to conduct business.
Able to work under time pressure and rapidly for long periods to meet deadlines.
Before starting work, FAP personnel working with Military Treatment Facilities shall provide proof of immunization from the following diseases according to CDC guidelines: Hepatitis B, measles, mumps, rubella, varicella, and influenza, and proof of a negative TB skin test (completed within the past 12 months (if positive, proof of negative chest X-ray within the past 12 months).
Basic Life Support Certification: At a minimum, all FAP personnel working within a Military Treatment Facility must maintain current certification in either the American Heart Association Basic Life Support Course (BLS) (Course C) or the American Red Cross Cardiopulmonary Resuscitation (CPR)/BLS (Heart Saver) Course.
General Job Information
Title
Family Advocacy Program Assistant (Secretary II), AFMRA
Grade
WDNAFMRAFAPA
Work Experience - Required
Work Experience - Preferred
Education - Required
Associates
Education - Preferred
License and Certifications - Required
BLS - Basic Life Support - Care Mgmt
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Remote position, preferably in Eastern or Central time zone.
Overall management of assigned book of business for the company's products and services in order to achieve profitable retention of accounts.
Supports in the development and maintenance of a strategic business plan that fully reflects the customer's business objectives and how the company solutions align to those objectives and specifically guides our operational, financial, network, clinical and relationship initiatives.
Understands the customer's structure and demonstrates the ability to apply this knowledge in business and retention planning for the client.
Ensures Service Level Agreement performance.
Owns overall internal account satisfaction within the company as well as satisfaction with all specific areas particularly account management.
Develops strong relationships which penetrate the customer at various levels involving other internal company staff to maintain multiple connections and strengthen the overall relationship.
Develops strong internal relationships and contacts within the company that are supportive of the achievement of customer service requirements including attainment of performance guarantees and minimization of performance penalty expense.
Ensures all Customer and Account-Facing services are provided in a consistent and timely fashion.
Supports the Internal Customer Operating Model.
Resolves or appropriately escalates customer service issues in conjunction with operations (claims, service, and systems).
Provides mentoring to Account Support Specialists in effective problem solving and servicing of the account.
Executes the customer governance process.
Builds relationships and alliances with matrix partners.
Coordinates with the compliance department on knowing and understanding regulations and the implication to customer impact.
Maintains a client audit schedule to ensure a proactive approach in supporting critical client compliance.
Coordinates all customer audit preparation and execution.
Proactively communicates to internal and external contacts.
Demonstrates contract understanding and detailed knowledge of business requirements.
Assists in the coordination with legal to ensure contract compliance.
Supports the account management team in the definition of customer reports and ensures coordination with the client.
Oversees reporting calendar to ensure timely submission.
Analyzes data and reporting, and supports executive summary development.
Prepares and supports presentations of customer reports with meaningful analytics, trending and recommendations for program improvement based on findings.
Ensures all client reports have an executive summary and explanation of data.
Supports the account management team ensuring revenue goals are met, cost of care and administrative expenses are managed and segment profit targets are achieved for assigned account (s).
Demonstrates a thorough knowledge of Cost of Care and implications internally and for the client.
Supports the account management team to ensure performance standards are measurable and realistic to achieve and/or exceed to avoid penalties. Partners with Operations and Network on monitoring. Manages methodology, reporting and communications.
Directly participates and supports manager on all renewal activities.
Manages risks and develop opportunities associated with underwritten rates.
Analyzes account benefits and has the ability to apply this knowledge to growth.
Supports up-sell and renewal activities across assigned account(s).
Where applicable, achieves objectives regarding the EAP re-seller agreement.
Supports health plan with behavioral health retail sales.
Identifies products and services that bring solutions to the customer based on a thorough understanding of the customer's strategic business goals and the business needs.
Demonstrates knowledge of the company products and how multiple products are interdependent within the customer contract deliverables and clinical outcomes.
Other Job Requirements
Responsibilities
Based on client contract, may require clinical licensure in good standing (RN, LCSW, LMHC, LPC, Pharmacist) for state in which work is performed.
General Job Information
Title
Client Account Manager - Specialty Health
Grade
22
Work Experience - Required
Account Management, Sales
Work Experience - Preferred
Education - Required
A Combination of Education and Work Experience May Be Considered., Bachelors
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards.
Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls.
Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
Assists efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
Assists in the mentoring and training of new staff.
Assumes full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal).
Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.
Demonstrates flexibility in areas such as job duties and schedule in order to aid in better serving members and help Magellan achieve its business and operational goals.
Educates providers on how to submit claims and when/where to submit a treatment plan.
Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved.
Informs providers and members on Magellan's appeal process.
Leads or participates in activities as requested that help improve Care Center performance, excellence and culture.
Links or makes routine referrals and triage decisions not requiring clinical judgment.
Performs necessary follow-up tasks to ensure member or provider needs are completely met.
Provides information regarding Magellan's in-network and out-of-network reimbursement rates and states multiple networks to providers.
Refers callers requesting provider information to Provider Services regarding Magellan's professional provider selection criteria and application process.
Refers patients/EAP clients to the Magellan's Care Management team for a provider, EAP affiliate, or Facility.
Responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
Support team members and participate in team activities to help build a high-performance team.
Thoroughly documents customers' comments/information and forwards required information to the appropriate staff.
Other Job Requirements
Responsibilities
Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.
Responsible for meeting call handling requirements and daily telephone standards as set forth by management.
Must agree to observing service for the purpose of training and quality control.
Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.
Must be able to maneuver through various computer platforms while verifying information on all calls.
Must be able to talk and type simultaneously.
General Job Information
Title
Customer Care Associate I
Grade
16
Work Experience - Required
Customer Service
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
Associates, Bachelors
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards.
Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls.
Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
Assists efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
Assists in the mentoring and training of new staff.
Assumes full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal).
Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.
Demonstrates flexibility in areas such as job duties and schedule in order to aid in better serving members and help Magellan achieve its business and operational goals.
Educates providers on how to submit claims and when/where to submit a treatment plan.
Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved.
Informs providers and members on Magellan's appeal process.
Leads or participates in activities as requested that help improve Care Center performance, excellence and culture.
Links or makes routine referrals and triage decisions not requiring clinical judgment.
Performs necessary follow-up tasks to ensure member or provider needs are completely met.
Provides information regarding Magellan's in-network and out-of-network reimbursement rates and states multiple networks to providers.
Refers callers requesting provider information to Provider Services regarding Magellan's professional provider selection criteria and application process.
Refers patients/EAP clients to the Magellan's Care Management team for a provider, EAP affiliate, or Facility.
Responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
Support team members and participate in team activities to help build a high-performance team.
Thoroughly documents customers' comments/information and forwards required information to the appropriate staff.
Other Job Requirements
Responsibilities
Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.
Responsible for meeting call handling requirements and daily telephone standards as set forth by management.
Must agree to observing service for the purpose of training and quality control.
Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.
Must be able to maneuver through various computer platforms while verifying information on all calls.
Must be able to talk and type simultaneously.
General Job Information
Title
Customer Care Associate I
Grade
16
Work Experience - Required
Customer Service
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
Associates, Bachelors
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This position is in support of West Point. Candidates must be local to the base or be willing to relocate to become local. Candidates must be licensed at the independent level in the state of New York as a Social Worker ( LCSW ), Therapist ( LMFT ), or Mental Health Counselor ( LMHC) .
Provides the full breadth of MFLC consultation and counseling services to the command structure and military service members and their families as an embedded counselor assigned to a dedicated military unit. Responsible for providing MFLC services including non-medical, short term, walk around counseling, training/health and wellness presentations, and consultation to the brigade/regiments command regarding behavioral health issues with a unique understanding of the particular military unit, cultural and mission.
Provides non-medical, short-term, solution focused, walk-around counseling directly to service and family members of a dedicated military unit (brigade, wing or regiment) as an embedded counselor. Services include assessment, brief counseling and consultation, action planning, referral to resources (assuring linkage as appropriate), and follow-up as indicated. Delivers training and health and wellness presentations and activities as requested/ directed.
Enters counselor activity data on a daily basis through smart phone or web application to assure that reporting is accurate from assigned installation, while maintaining client / service member confidentiality.
Cultivates and maintains direct relationships with commanders and personnel within the assigned military unit, utilizing relationship management skills and recognizing the unique structure and mission of the assigned military unit. Responsible for development of an effective and professional working relationship with the installation POC (Point of Contact), command, and the command POC.
Creates a presence within the brigade/regiment in which the service and family members feel comfortable approaching the counselor, recognizing the program to be confidential. Establish and maintain working relationships with community resources and provide appropriate linkages for service members and their families. Partners with POC to provide MFLC services in a manner that addresses the needs of the brigade/regiment.
Provides MFLC response to critical incidents, surge, and special requests as directed by the POC and approved by the Office of Secretary of Defense (OSD) program manager. Counselor will flex schedule to respond to urgent requests as needed.
Manages duty to warn and restricted reporting situations according to Department of Defense (DoD) protocol and staffs the cases with Regional Supervisor/Regional Director.
Communicates with Regional Supervisors and participates in regular individual and group supervision, sharing information regarding trends and issues on the installations to which the counselor is assigned.
Participates in regular in-services/training, Quality Improvement committees or other contract activities as assigned/appropriate.
Other Job Requirements
Responsibilities
Master's Degree from an accredited Graduate Program in a Mental Health related field.
Valid unrestricted counseling license from a State, District of Columbia, US Territory or Commonwealth that grants authority to provide counseling services as an independent practitioner.
For assignments in the 50 states, counselors shall be licensed or certified in the state in which the client is receiving services.
A minimum two years of post licensure counseling experience.
Requires ability to engage and communicate with military members or children as assigned, in order to accomplish job functions, and to respond quickly to emergent situations in any physical location on a military installation and/or within a school setting, which includes the need to traverse short and/or long distances within the base to both indoor and outdoor locations, to maneuver through rugged, outdoor or uneven locations (e.g., steep inclines, stairs, grass), and work in outdoor weather and other military base conditions. May require travel to locations outside of a military base in a variety of physical environments. Due to the nature of working on military installations or related worksites, counselors may need to comply with various site specific requirements to work at designated locations. For example, for some assignments, counselors will need to have certain immunizations or vaccinations and provide record of receipt.
Ability to prove US Citizenship and must speak fluent English.
Understanding, sensitivity and empathy for service members and their families. Ability to develop trusting, helping relationships. Ability to work effectively with individuals and families from diverse racial, ethnic, and socioeconomic backgrounds.
Pass a National Agency Check and Inquiries (NACI) Clearance and an Installation Records Check (IRC), Criminal History Background Check and FBI Fingerprints Check.
Some units require a secret level clearance in addition to the previously stated requirements.
Vehicle Operator's License Requirement: Unless specifically waived by the FEDSIM COR, all contractor personnel providing counseling support at Government locations shall possess a valid U.S. state vehicle operator's license. As a condition for employment under this contract, contractor personnel may be required to pass all tests for and obtain a U.S. military vehicle operator's permit for commercial sedans and similar, for use at Temporary Duty (TDY) locations, if required.
General Job Information
Title
Military and Family Life Counselor-Embedded
Grade
MFLC Tier 3
Work Experience - Required
Clinical
Work Experience - Preferred
Education - Required
Masters - Behavioral Health, Masters - Social Work
Education - Preferred
License and Certifications - Required
Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, DL - Driver License, Valid In State - Other, Must be an independently licensed behavioral health clinician - Care Mgmt
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This position is in support of Birmingham Army National Guard. Candidates must be local to the bases or be willing to relocate to become local. Candidates must be licensed at the independent level in the state of Alabama as a Social Worker ( LCSW ), Therapist ( LMFT ), or Mental Health Counselor ( LPC ).
Provides the full breadth of MFLC consultation and counseling services to the command structure and military service members and their families as an embedded counselor assigned to a dedicated military unit. Responsible for providing MFLC services including non-medical, short term, walk around counseling, training/health and wellness presentations, and consultation to the brigade/regiments command regarding behavioral health issues with a unique understanding of the particular military unit, cultural and mission.
Provides non-medical, short-term, solution focused, walk-around counseling directly to service and family members of a dedicated military unit (brigade, wing or regiment) as an embedded counselor. Services include assessment, brief counseling and consultation, action planning, referral to resources (assuring linkage as appropriate), and follow-up as indicated. Delivers training and health and wellness presentations and activities as requested/ directed.
Enters counselor activity data on a daily basis through smart phone or web application to assure that reporting is accurate from assigned installation, while maintaining client / service member confidentiality.
Cultivates and maintains direct relationships with commanders and personnel within the assigned military unit, utilizing relationship management skills and recognizing the unique structure and mission of the assigned military unit. Responsible for development of an effective and professional working relationship with the installation POC (Point of Contact), command, and the command POC.
Creates a presence within the brigade/regiment in which the service and family members feel comfortable approaching the counselor, recognizing the program to be confidential. Establish and maintain working relationships with community resources and provide appropriate linkages for service members and their families. Partners with POC to provide MFLC services in a manner that addresses the needs of the brigade/regiment.
Provides MFLC response to critical incidents, surge, and special requests as directed by the POC and approved by the Office of Secretary of Defense (OSD) program manager. Counselor will flex schedule to respond to urgent requests as needed.
Manages duty to warn and restricted reporting situations according to Department of Defense (DoD) protocol and staffs the cases with Regional Supervisor/Regional Director.
Communicates with Regional Supervisors and participates in regular individual and group supervision, sharing information regarding trends and issues on the installations to which the counselor is assigned.
Participates in regular in-services/training, Quality Improvement committees or other contract activities as assigned/appropriate.
Other Job Requirements
Responsibilities
Master's Degree from an accredited Graduate Program in a Mental Health related field.
Valid unrestricted counseling license from a State, District of Columbia, US Territory or Commonwealth that grants authority to provide counseling services as an independent practitioner.
For assignments in the 50 states, counselors shall be licensed or certified in the state in which the client is receiving services.
A minimum two years of post licensure counseling experience.
Requires ability to engage and communicate with military members or children as assigned, in order to accomplish job functions, and to respond quickly to emergent situations in any physical location on a military installation and/or within a school setting, which includes the need to traverse short and/or long distances within the base to both indoor and outdoor locations, to maneuver through rugged, outdoor or uneven locations (e.g., steep inclines, stairs, grass), and work in outdoor weather and other military base conditions. May require travel to locations outside of a military base in a variety of physical environments. Due to the nature of working on military installations or related worksites, counselors may need to comply with various site specific requirements to work at designated locations. For example, for some assignments, counselors will need to have certain immunizations or vaccinations and provide record of receipt.
Ability to prove US Citizenship and must speak fluent English.
Understanding, sensitivity and empathy for service members and their families. Ability to develop trusting, helping relationships. Ability to work effectively with individuals and families from diverse racial, ethnic, and socioeconomic backgrounds.
Pass a National Agency Check and Inquiries (NACI) Clearance and an Installation Records Check (IRC), Criminal History Background Check and FBI Fingerprints Check.
Some units require a secret level clearance in addition to the previously stated requirements.
Vehicle Operator's License Requirement: Unless specifically waived by the FEDSIM COR, all contractor personnel providing counseling support at Government locations shall possess a valid U.S. state vehicle operator's license. As a condition for employment under this contract, contractor personnel may be required to pass all tests for and obtain a U.S. military vehicle operator's permit for commercial sedans and similar, for use at Temporary Duty (TDY) locations, if required.
General Job Information
Title
Military and Family Life Counselor-Embedded
Grade
MFLC Tier 3
Work Experience - Required
Clinical
Work Experience - Preferred
Education - Required
Masters - Behavioral Health, Masters - Social Work
Education - Preferred
License and Certifications - Required
Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, DL - Driver License, Valid In State - Other, Must be an independently licensed behavioral health clinician - Care Mgmt
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This position is in support of Birmingham Army National Guard. Candidates must be local to the bases or be willing to relocate to become local. Candidates must be licensed at the independent level in the state of Alabama as a Social Worker ( LCSW ), Therapist ( LMFT ), or Mental Health Counselor ( LPC ).
Provides the full breadth of MFLC consultation and counseling services to the command structure and military service members and their families as an embedded counselor assigned to a dedicated military unit. Responsible for providing MFLC services including non-medical, short term, walk around counseling, training/health and wellness presentations, and consultation to the brigade/regiments command regarding behavioral health issues with a unique understanding of the particular military unit, cultural and mission.
Provides non-medical, short-term, solution focused, walk-around counseling directly to service and family members of a dedicated military unit (brigade, wing or regiment) as an embedded counselor. Services include assessment, brief counseling and consultation, action planning, referral to resources (assuring linkage as appropriate), and follow-up as indicated. Delivers training and health and wellness presentations and activities as requested/ directed.
Enters counselor activity data on a daily basis through smart phone or web application to assure that reporting is accurate from assigned installation, while maintaining client / service member confidentiality.
Cultivates and maintains direct relationships with commanders and personnel within the assigned military unit, utilizing relationship management skills and recognizing the unique structure and mission of the assigned military unit. Responsible for development of an effective and professional working relationship with the installation POC (Point of Contact), command, and the command POC.
Creates a presence within the brigade/regiment in which the service and family members feel comfortable approaching the counselor, recognizing the program to be confidential. Establish and maintain working relationships with community resources and provide appropriate linkages for service members and their families. Partners with POC to provide MFLC services in a manner that addresses the needs of the brigade/regiment.
Provides MFLC response to critical incidents, surge, and special requests as directed by the POC and approved by the Office of Secretary of Defense (OSD) program manager. Counselor will flex schedule to respond to urgent requests as needed.
Manages duty to warn and restricted reporting situations according to Department of Defense (DoD) protocol and staffs the cases with Regional Supervisor/Regional Director.
Communicates with Regional Supervisors and participates in regular individual and group supervision, sharing information regarding trends and issues on the installations to which the counselor is assigned.
Participates in regular in-services/training, Quality Improvement committees or other contract activities as assigned/appropriate.
Other Job Requirements
Responsibilities
Master's Degree from an accredited Graduate Program in a Mental Health related field.
Valid unrestricted counseling license from a State, District of Columbia, US Territory or Commonwealth that grants authority to provide counseling services as an independent practitioner.
For assignments in the 50 states, counselors shall be licensed or certified in the state in which the client is receiving services.
A minimum two years of post licensure counseling experience.
Requires ability to engage and communicate with military members or children as assigned, in order to accomplish job functions, and to respond quickly to emergent situations in any physical location on a military installation and/or within a school setting, which includes the need to traverse short and/or long distances within the base to both indoor and outdoor locations, to maneuver through rugged, outdoor or uneven locations (e.g., steep inclines, stairs, grass), and work in outdoor weather and other military base conditions. May require travel to locations outside of a military base in a variety of physical environments. Due to the nature of working on military installations or related worksites, counselors may need to comply with various site specific requirements to work at designated locations. For example, for some assignments, counselors will need to have certain immunizations or vaccinations and provide record of receipt.
Ability to prove US Citizenship and must speak fluent English.
Understanding, sensitivity and empathy for service members and their families. Ability to develop trusting, helping relationships. Ability to work effectively with individuals and families from diverse racial, ethnic, and socioeconomic backgrounds.
Pass a National Agency Check and Inquiries (NACI) Clearance and an Installation Records Check (IRC), Criminal History Background Check and FBI Fingerprints Check.
Some units require a secret level clearance in addition to the previously stated requirements.
Vehicle Operator's License Requirement: Unless specifically waived by the FEDSIM COR, all contractor personnel providing counseling support at Government locations shall possess a valid U.S. state vehicle operator's license. As a condition for employment under this contract, contractor personnel may be required to pass all tests for and obtain a U.S. military vehicle operator's permit for commercial sedans and similar, for use at Temporary Duty (TDY) locations, if required.
General Job Information
Title
Military and Family Life Counselor-Embedded
Grade
MFLC Tier 3
Work Experience - Required
Clinical
Work Experience - Preferred
Education - Required
Masters - Behavioral Health, Masters - Social Work
Education - Preferred
License and Certifications - Required
Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, DL - Driver License, Valid In State - Other, Must be an independently licensed behavioral health clinician - Care Mgmt
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Provides professional military personnel support services to the U.S. Navy's Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.
Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).
Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).
Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.
Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.
Issues and strictly controls Armed Forces identification and privilege cards for all eligible personnel, (i.e., active duty military, retired military, 100% Disabled American Veteran (DAV) and respective dependents and verified contractors.
Operates and maintains RAPIDS workstations, processes CACs, assists customers with questions concerning identification card eligibility, application requirements and DEERS, and answers telephone inquiries.
Accomplishes DEERS enrollment and updates for all eligible beneficiaries, reconciles erroneous DEERS information, performs PIN resets, verifying and updating PKI certificates, and provides other ICA services as necessary.
May also be certified by DMDC as Site Security Manager (SSM) with responsibility for the safekeeping, storing, and accountability of the CAC and related consumable materials.
Maintains RAPIDS equipment within the physical parameters and configurations established at the time of installation.
Performs -User Maintenance on RAPIDS equipment.
Other Job Requirements
Responsibilities
High School diploma or equivalent.
1+ years' experience in a Customer Service environment.
HR background in one of the following disciplines: Military Pay, Military Personnel, Travel Claims or Navy Transportation.
Substitutions for HR background can be from similar experience gained in either the private sector or other Federal Agency.
Proficient in both oral and written communication to communicate effectively and explain complex actions regarding military entitlements, allowances and collections.
Working knowledge of Microsoft Office Products, i.e. Word, Excel, Power Point.
Working knowledge of standard office equipment such as computers, electric typewriters, copiers, fax machines, scanners and other office automation systems.
Must be U.S. citizen and possess favorably adjudicated Tier 3 (NACLC) security investigation.
General Job Information
Title
Part Time ID Card Specialist, Navy ICA
Grade
WDNICAPAII
Work Experience - Required
Customer Service
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This is a fully remote FTE position for a Principal IT Project Manager, which allows you to work from home from anywhere in the US.
This position is responsible for providing direction to a team of IT Project Managers. Responsibilities include the administrative duties of hiring, purchasing of equipment, conducting employee reviews, staffing and other resource management tasks. Provides guidance and mentoring to staff. Participates in budget preparation and tracking.
This position is responsible for providing direction to a team of IT Project Managers. Responsibilities include the administrative duties of hiring, purchasing of equipment, conducting employee reviews, staffing and other resource management tasks. Provides guidance and mentoring to staff. Participates in budget preparation and tracking.
Provides direction to a team of IT Project Managers.
Performs administrative duties of hiring, purchasing of equipment, conducting employee reviews, staffing and other resource management tasks.
Provides guidance and mentoring to staff.
Participates in budget preparation and tracking.
Estimates feasibility, time and effort of projects and tasks via the Project Portfolio Management committee.
Supports projects through appropriate resource assignments.
Guides and monitors projects and tasks to successful completion.
Maintains procedures and processes to ensure quality control.
Sets team goals and prioritizes tasks to align with company and department objectives and communicates these goals to team members.
Measures progress and results of team performance.
Ensures that project managers understand and follow best practices for software development and project management.
Recommends, develops and implements repeatable project management processes and best practices.
Manages all aspects of team staffing including hiring, employee retention, employee development and training.
Assists staff in maintaining constant communication with customers, both internal and external, to facilitate analysis and troubleshooting to ensure the highest levels of customer satisfaction.
Provides status reports to Management as appropriate, highlighting risks and issues.
Helps prepare and manage budget.
Agile:
Coaches and mentors other IT Project Managers in lean/Agile methods.
Drives servant leadership and coaches other IT Project Managers on this quality.
Empowers the teams to be self-organizing.
Empowers the teams and stakeholders to make decisions.
Measures and reports progress frequently using agile metrics.
Creates Product Roadmap and Release Plan in partnership with POs and IMs.
Leads coordinating practices in Agile methods such as Release Planning, Iteration Planning, Grooming etc.
Coaches and assists Product Owners in prioritization, 3-Amigo Reviews and other PO activities.
Leads and facilitates Scrum of Scrums with related projects/teams.
Traditional:
Develops and maintains project charters, detailed project plans, weekly status updates and provides problem resolution.
Creates and maintains WBS, RACI, Stakeholder Register and detailed Project Management plan.
Manages dependencies across projects.
Performs Root Cause Analysis.
Leads in the establishment and facilitation of internal IT project.
Other Job Requirements
Responsibilities
10+ years related experience including a minimum of 3+ years of planning, leading and maintaining high quality, projects.
Critical thinker.
Demonstrated problem solving techniques.
Strong verbal and written communication skills.
General Job Information
Title
Principal IT Project Manager - Fully Remote
Grade
29
Work Experience - Required
IT, Project/Program Management
Work Experience - Preferred
Education - Required
Education - Preferred
Bachelors - Computer and Information Science
License and Certifications - Required
License and Certifications - Preferred
CSM - Certified Scrum Master - Enterprise, PMP - Project Management Professional - Enterprise
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards.
Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls.
Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
Assists efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
Assists in the mentoring and training of new staff.
Assumes full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal).
Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.
Demonstrates flexibility in areas such as job duties and schedule in order to aid in better serving members and help Magellan achieve its business and operational goals.
Educates providers on how to submit claims and when/where to submit a treatment plan.
Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved.
Informs providers and members on Magellan's appeal process.
Leads or participates in activities as requested that help improve Care Center performance, excellence and culture.
Links or makes routine referrals and triage decisions not requiring clinical judgment.
Performs necessary follow-up tasks to ensure member or provider needs are completely met.
Provides information regarding Magellan's in-network and out-of-network reimbursement rates and states multiple networks to providers.
Refers callers requesting provider information to Provider Services regarding Magellan's professional provider selection criteria and application process.
Refers patients/EAP clients to the Magellan's Care Management team for a provider, EAP affiliate, or Facility.
Responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
Support team members and participate in team activities to help build a high-performance team.
Thoroughly documents customers' comments/information and forwards required information to the appropriate staff.
Other Job Requirements
Responsibilities
Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.
Responsible for meeting call handling requirements and daily telephone standards as set forth by management.
Must agree to observing service for the purpose of training and quality control.
Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.
Must be able to maneuver through various computer platforms while verifying information on all calls.
Must be able to talk and type simultaneously.
General Job Information
Title
Customer Care Associate I
Grade
16
Work Experience - Required
Customer Service
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
Associates, Bachelors
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This position is a front-line service position providing assistance to Magellan's members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards.
Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls.
Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
Assists efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
Assists in the mentoring and training of new staff.
Assumes full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal).
Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.
Demonstrates flexibility in areas such as job duties and schedule in order to aid in better serving members and help Magellan achieve its business and operational goals.
Educates providers on how to submit claims and when/where to submit a treatment plan.
Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved.
Informs providers and members on Magellan's appeal process.
Leads or participates in activities as requested that help improve Care Center performance, excellence and culture.
Links or makes routine referrals and triage decisions not requiring clinical judgment.
Performs necessary follow-up tasks to ensure member or provider needs are completely met.
Provides information regarding Magellan's in-network and out-of-network reimbursement rates and states multiple networks to providers.
Refers callers requesting provider information to Provider Services regarding Magellan's professional provider selection criteria and application process.
Refers patients/EAP clients to the Magellan's Care Management team for a provider, EAP affiliate, or Facility.
Responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
Support team members and participate in team activities to help build a high-performance team.
Thoroughly documents customers' comments/information and forwards required information to the appropriate staff.
Other Job Requirements
Responsibilities
Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.
Responsible for meeting call handling requirements and daily telephone standards as set forth by management.
Must agree to observing service for the purpose of training and quality control.
Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.
Must be able to maneuver through various computer platforms while verifying information on all calls.
Must be able to talk and type simultaneously.
General Job Information
Title
Customer Care Associate I
Grade
16
Work Experience - Required
Customer Service
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
Associates, Bachelors
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Master Resilience Trainer - Performance Experts (MRT-PE) support government client's program at multiple locations. MRT-PEs teach mental skills, resilience and performance enhancement techniques to military Soldiers, Families and DA Civilians. Teaching is conducted in group and individual settings and includes general education in human performance along with personalized training on how to acquire and apply specific mental skills and techniques that cultivate the mental and emotional strength necessary to thrive in an environment of overwhelming demands and persistent conflict. The mental skills and techniques taught by the program include: Building Confidence, Goal Setting, Attention Control, Energy Management, Integrating Imagery and Team Building. Using these principles, MRT-PEs help the clients to become high performing -tactical athletes- and help foster high performing -unit teams- in preparation for, during, and following combat operations. Specifically, MRT-PEs teach performance psychology to further promote excellence and efficiency during physical, technical and tactical training, as well as during the challenges of combat operations. MRT-PEs also provide tailored education to facilitate Wounded Warriors in their transition back to their units or to civilian life. The program teams are comprised of 5-10 MRT-PEs and led by a seasoned Site Manager with prior military experience.
Attends training exercises and field operations as requested by individual units to serve as a performance enhancement consultant and to coach the clients and leaders on the acquisition of performance psychology techniques and their application to individual military tasks and unit operations.
Provides tailored educational programs and workshops to help Families and Civilians living and working in demanding environments achieve success and accomplish personal, professional and family goals.
Recommends improvements to all aspects of the program operations.
Performs routine program operational duties.
Conducts assessment, assists in program evaluation and supports research projects being conducted locally.
Assists or provides program overview briefings to VIPs and high-ranking leaders when required.
Develops and maintains professional development relating to all aspects of performance enhancement, academic proficiency and military-related knowledge.
Other Job Requirements
Responsibilities
Master's or Doctoral degree from an accredited college or university in the field of Psychology or Kinesiology with a specialized emphasis in sport and/or performance psychology.
Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices on most or all workdays.
Ability to communicate and interact with others, both in person and/or by telephone to conduct business.
Experience and ability to work under time pressure.
Working rapidly for long periods to meet deadlines.
Must be able to travel as needed and adhere to AFSC travel policies and procedures.
Must be able to enter private homes that may or may not provide easy access for those with physical disabilities or those recovering from physical rehabilitation or post-recovery mobility.
Position requires ability to transport self from office locations to private homes, other offices and facilities where training and other program activities occur.
Physical requirements can typically be characterized as active: Lifting, bending, sitting on the floor, climbing may be required in the position. Requires lifting or moving various pieces of equipment, maximum 40 lbs. Position may require work on hands and knees to conduct program activities.
Ability to manage multiple concurrent tasks and perform under stress.
Requires reading and comprehension proficiency.
Requires effective writing and problem solving skills.
Ability to maintain confidentiality.
Customer contact expertise.
Travel requirement: 25%.
General Job Information
Title
Master Resilience Trainer- Performance Expert, ARD-TS
Grade
22
Work Experience - Required
Work Experience - Preferred
Education - Required
Masters - Kinesiology, Masters - Psychology
Education - Preferred
PhD
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This position may require travel to surrounding offices to cover as needed.
Provides professional military personnel support services to the U.S. Navy's Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.
Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).
Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).
Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.
Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.
Issues and strictly controls Armed Forces identification and privilege cards for all eligible personnel, (i.e., active duty military, retired military, 100% Disabled American Veteran (DAV) and respective dependents and verified contractors.
Operates and maintains RAPIDS workstations, processes CACs, assists customers with questions concerning identification card eligibility, application requirements and DEERS, and answers telephone inquiries.
Accomplishes DEERS enrollment and updates for all eligible beneficiaries, reconciles erroneous DEERS information, performs PIN resets, verifying and updating PKI certificates, and provides other ICA services as necessary.
May also be certified by DMDC as Site Security Manager (SSM) with responsibility for the safekeeping, storing, and accountability of the CAC and related consumable materials.
Maintains RAPIDS equipment within the physical parameters and configurations established at the time of installation.
Performs -User Maintenance on RAPIDS equipment.
Other Job Requirements
Responsibilities
High School diploma or equivalent.
1+ years' experience in a Customer Service environment.
HR background in one of the following disciplines: Military Pay, Military Personnel, Travel Claims or Navy Transportation.
Substitutions for HR background can be from similar experience gained in either the private sector or other Federal Agency.
Proficient in both oral and written communication to communicate effectively and explain complex actions regarding military entitlements, allowances and collections.
Working knowledge of Microsoft Office Products, i.e. Word, Excel, Power Point.
Working knowledge of standard office equipment such as computers, electric typewriters, copiers, fax machines, scanners and other office automation systems.
Must be U.S. citizen and possess favorably adjudicated Tier 3 (NACLC) security investigation.
General Job Information
Title
Part Time Intermittent ID Card Specialist (Personnel Assistant II), NAVY ICA
Grade
WDNICAPAII
Work Experience - Required
Customer Service
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
This position may require travel to surrounding offices to cover as needed.
Provides professional military personnel support services to the U.S. Navy's Identification Card Administration (ICA) program at Navy installations designated as Defense Enrollment Eligibility Reporting System (DEERS) and Real-time Automated Personnel Identification System (RAPIDS) sites.
Serves as ID Card/Common Access Card (CAC) customer service specialist trained and certified by the Defense Manpower Data Center (DMDC).
Delivers ID Card services to all personnel assigned to support customer commands, other military service personnel, retirees and their dependents, and contractors verified through the Trusted Associate Sponsorship System (TASS).
Performs as a Verifying Official (VO) on DEERS/RAPIDS terminal and ensures inputted data for accuracy and correctness.
Verifies the identity and eligibility of authorized DoD beneficiaries, issues DoD Identification Cards and performs DEERS updates in accordance with DoD regulations and AFI 36-3026.
Issues and strictly controls Armed Forces identification and privilege cards for all eligible personnel, (i.e., active duty military, retired military, 100% Disabled American Veteran (DAV) and respective dependents and verified contractors.
Operates and maintains RAPIDS workstations, processes CACs, assists customers with questions concerning identification card eligibility, application requirements and DEERS, and answers telephone inquiries.
Accomplishes DEERS enrollment and updates for all eligible beneficiaries, reconciles erroneous DEERS information, performs PIN resets, verifying and updating PKI certificates, and provides other ICA services as necessary.
May also be certified by DMDC as Site Security Manager (SSM) with responsibility for the safekeeping, storing, and accountability of the CAC and related consumable materials.
Maintains RAPIDS equipment within the physical parameters and configurations established at the time of installation.
Performs -User Maintenance on RAPIDS equipment.
Other Job Requirements
Responsibilities
High School diploma or equivalent.
1+ years' experience in a Customer Service environment.
HR background in one of the following disciplines: Military Pay, Military Personnel, Travel Claims or Navy Transportation.
Substitutions for HR background can be from similar experience gained in either the private sector or other Federal Agency.
Proficient in both oral and written communication to communicate effectively and explain complex actions regarding military entitlements, allowances and collections.
Working knowledge of Microsoft Office Products, i.e. Word, Excel, Power Point.
Working knowledge of standard office equipment such as computers, electric typewriters, copiers, fax machines, scanners and other office automation systems.
Must be U.S. citizen and possess favorably adjudicated Tier 3 (NACLC) security investigation.
General Job Information
Title
Part Time Intermittent ID Card Specialist (Personnel Assistant II), NAVY ICA
Grade
WDNICAPAII
Work Experience - Required
Customer Service
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Performs the basic duties of a pharmacy technician in all designated sites. Including and not limited to, prescription data entry, as well as communicate and coordinate with all parties necessary to insure timely shipping and delivery of prescription orders. Pulls and labels medication for pharmacist verification. Packs medications appropriately and affixes a shipping label after the order has been verified by a pharmacist. Performs all basic duties of a pharmacy technician allowable by legal licensure and registration.
Under the supervision of a pharmacist, picks and affixes labels to packages of prepackaged and unit dose drugs in accordance with the dispensing order. Prepares and affixes shipping labels to the individual patient shipping containers.
Answers external phone calls pertinent to department assignment.
Assembles and packages medications, supplies and equipment in appropriate shipping containers.
Assists with maintaining accurate inventory through pulling expirations.
Attends designated department meetings as scheduled.
Communicates and coordinates internally with customer service, billing, pharmacy, and shipping departments to move patient orders through the system and meet the promised delivery date.
Communicates by phone and fax as necessary with patient, physician office, and insurance to make sure pharmacy has most updated prescription and prior authorization information on file.
Creates pre-packages supply items.
Maintains necessary licensure needed for pharmacy technicians.
Maintains the pharmacy department according to state and federal regulations.
Picks supplies and equipment for patient orders as indicated on the delivery ticket.
Prepares delivery tickets including prescription and supply items as necessary.
Prints delivery tickets, collates and triages delivery tickets according to excursion data.
Receives and processes data entry of new and refill prescriptions in the pharmacy computer system.
Recognizes and identifies various classifications of medications, dosage form and routes of administration.
Verifies prescription elements are present on all prescriptions.
Other Job Requirements
Responsibilities
Must have pharmacy intern license as required by applicable state laws OR:
Must have an active pharmacy technician licensure or registration in accordance with state requirements.
If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
Excellent written and verbal communication skills.
Ability to identify and trouble-shoot problematic issues.
Pharmacy technician experience in prescription entry, picking, labeling and preparing medication orders for pharmacist verification.
General Job Information
Title
PHARMACY TECHNICIAN I
Grade
17
Work Experience - Required
Pharmacy
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
License and Certifications - Required
CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy, Pharmacy Intern - Pharmacy
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
The Sr. Director of Data Governance incrementally builds out a data governance program and manages its operational components, influencing maturity of practices and solutions. The candidate will provide leadership, guidance, direction, and oversight for solutions to secure data including Data Classification, Data Retention, and Data Loss Prevention (DLP) for structured and unstructured data. This includes environments for cloud (AWS, AZURE), Unix, Windows, Linux and Databases.
The candidate must have a technical background and be able to influence and lead in a highly matrixed environment, bringing people across Magellan together around the shared mission. A successful candidate will have both an end state vision and maturity to help the organization progress towards that vision incrementally and purposefully.
Responsibilities
Leads, mentors, and guides the Organizations data governance program buildout and its individual components.
Ensures the integrity and usefulness of data assets by supporting their consistent definition, documentation, and appropriate use.
Directs the development, implementation, administration, and evaluation of data governance initiatives.
Partners with members of Information Security, Information Technology, Privacy, Compliance, and Legal.
Monitors trends and developments in the field of data governance and recommends strategic directions and priorities to leadership.
Directs solutions such as O365 and Varonis to manage risks associated with data.
Serves as the subject matter expert regarding the interpretation, implementation and compliance with data governance policies and regulations. Formulates and proposes policies, documentation, instructions, usage agreements and other guidance documents.
Establishes, designs, builds, nurtures, and maintains the data governance program with culturally appropriate formal structures and processes.
Provides training and support to Data Trustees, Data Stewards, Data Custodians, and Users.
Develop reporting, control processes, and establish meaningful metrics to demonstrate progress, manage risk, and ease of visibility.
Competencies
Ability to apply data classification schemas to structured and unstructured datasets as necessary to fulfill contractual or regulatory requirements, including for example HHS/HIPAA, PCI, GDPR and CCPA.
Ability to navigate through ambiguity and lack of structure and process to develop a strategy and recommend solutions to meet strategic goals while addressing immediate term issues.
Demonstrate knowledge of data governance concepts, techniques, processes, and applications.
Extensive knowledge of security administration and computer security tools; successful experience in retrieving, analyzing, and reporting.
Demonstrated ability to work effectively with technical and non-technical managerial, professional, and executive staff.
Understands data privacy principles and coordinates with Compliance, Legal, and
Affinity for learning and staying on top of trends and evolution of data governance practices, risks, and methodologies.
Affinity and appreciation for plan-do-check-act model for change
Skills
Strong project planning and leadership skills.
8+ years of experience in Information Security or related area, with at least 4 years of experience in building out data governance programs iteratively, focusing on the people aspect of maturity and culture change.
This is a fully remote position, allowing you to work from the comfort of your own home from anywhere in the US.
This position manages a functional area within the office of the CISO and will take a practical and risk-based approach to manage, maintain, and deploy security solutions throughout the enterprise network. They will contribute to the design, development and maintenance of the network security environment and architecture regarding data and voice communications to ensure efficient information flow in a secure systems environment.
Accountable for the oversight and management of all elements of a functional area within the office of the CISO, including supervision and mentorship of subordinates.
Partner with Information Technology leaders to facilitate compliance of security controls with Magellan information systems regarding HIPAA, PCI, and other applicable regulatory and contractual requirements, ensuring effective security operations of Magellan systems, networks, business partner agreements, and interconnections.
Partner with business and IT leaders in security methodology, ensuring new and existing business relationships adequately address information security risk through vendor management and assessment processes and procedures. Provide leadership for the enterprise high-availability firewalls running a *nix based operating system, including system updates, log analysis, access controls and backup. Perform changes to the firewall policy to add new network services, adapt existing services, and remove unnecessary services.
Support the development and implementation of effective and reasonable policies and practices to secure sensitive data and ensure security and compliance with contracts, regulatory requirements, and industry standards.
Support the coordination and tracking of all information technology and security related audits including scope of audits, business units involved, timelines, and outcomes.
Provide guidance, evaluation and advocacy on audit responses.
Support the office of the CISO in establishing annual and long-term Information Security goals, defining security strategies, metrics, reporting mechanisms, and maintaining the Information Security maturity model.
Support in the design, development, and deployment of proactive security initiatives around information security awareness and branding that contribute to an improved security posture for the organization (e.g. protecting against identity theft, mobile social media security, phishing, online reputation program).
Oversee incident response activities, ensuring security incidents are properly identified, contained, eradicated, and recovered from. - Provide leadership for the management and maintenance of endpoint security solution(s) in use for Magellan Health information technology assets, including but not limited to application whitelisting, host-base intrusion prevention, system integrity monitoring, and anti-virus protection.
Review projects and provide security standards to the technology, prescribing appropriate protection configurations that will balance business requirements with enterprise technology standards to arrive at the optimal solution.
Develop and continuously refine overall security architecture, including critical areas such as security and audit related matters in addition to setting technology strategy.
Participate in the strategic sourcing process for acquiring infrastructure security assets and infrastructure services, including selection, negotiations and contract finalization.
Develop and ensure successful implementation of security policies, standards and plans to ensure the protection of corporate data against unauthorized use, access, modification and destruction.
Lead forensic analysis and risk assessments for the entire infrastructure.
Monitor compliance with information security policies and procedures.
Monitor network, devices and servers for security violations.
Design, implement and maintain network security guidelines and a security infrastructure for Magellan Health.
Ensure adequate security solutions are in place to mitigate identified risks sufficiently to meet business objectives and regulatory requirements.
Research emerging technologies in support of IT security enhancement and development efforts.
Assist in formalizing and updating security policies, procedures and technical standards.
Develop technical solutions to autonomously verify compliance with required technical controls.
Persistently evaluate adherence with defined standards.
Drive remediation and/or mitigation efforts for all vulnerabilities in the environment, ensuring appropriate response to high risk and aged findings.
Other Job Requirements
Responsibilities
10+ years of IT experience with 8+ in Information Security.
May substitute 2 or more relevant certifications for a year of experience.
Proven in-depth knowledge of network protocols and packet analysis tools such as TCPDUMP and Wireshark.
Detailed knowledge on network and host- based firewalls and intrusion prevention systems. Detailed knowledge on proxy servers, SSL inspection techniques, load- balancers, reverse proxy servers, and web application firewalls.
Proven ability to develop custom threat signatures in response to zero-day and emerging security threats. Strong consensus builder who builds credibility through targeted, accurate, and effective communication. Demonstrated operational and technical skills relating to information security.
Detailed knowledge with security-related systems and applications, firewalls, packet analysis tools, intrusion detection/prevention, and web content filtering.
Detailed digital forensics and eDiscovery skills and experience. Detailed knowledge of network infrastructure, including routers, switches, firewalls. Knowledge of information security publications (e.g., NIST 800-53, 53A, 37). Detailed knowledge of incident response, problem resolution, and vulnerability remediation. Detailed knowledge of automated security testing.
Demonstrated ability to lead/manage direct reports and develop staff.
Ability to communicate and engage effectively with a diverse audience, including front line technical staff, non-technical staff, management, executives, and vendors/providers.
Demonstrated in-depth knowledge of PCI, HITRUST, and/or other industry standards.
Self-starter with the ability to lead tasks with demonstrated ability to work independently.
Strong verbal and written communication skills with the ability to collaborate effectively with other groups.
General Job Information
Title
Sr. Director, Data Governance - Remote
Grade
32
Work Experience - Required
Information Security, IT
Work Experience - Preferred
Education - Required
A Combination of Education and Work Experience May Be Considered., Bachelors - Information Security
Education - Preferred
Masters
License and Certifications - Required
CISSP - Certified Information Systems Security Professional - Enterprise
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Plan, develop, and ensure completion of all documentation elements in a standardized, timely manner, and communicate all changes in documentation to appropriate management. Types of documentation included in the scope of this position are Standard Operating Procedures, training materials, account presentations, RFPs, and other documentation as needed.
Writes documentation, obtain appropriate approvals of completed documentation, and distribute to appropriate end users.
Edits documentation language to ensure compliance with requirements and to ensure readability and user-friendly communication to targeted audience. Standardize delivery of documentation.
Meets with appropriate staff and other subject matter experts throughout Magellan to develop documentation, review, and analyze requirements for accurate and compliant documentation.
Coordinates with trainers and assure training documentation is current and accurate.
Maintains documentation change control process for revisions and archiving of historical documentation.
Oversees daily updates on Magnet site, ensuring documentation is posted timely and easily accessible to users.
Other Job Requirements
Responsibilities
Bachelor's degree required plus five years of experience. Will consider four additional years of direct experience in lieu of degree for a total of 9 years of experience.
Strong working knowledge of MS Office Suite.
Excellent writing and organizational skills.
Ability to analyze documentation to determine customer requirements.
Ability to translate directions, processes, and customer requirements into effective desk top reference text and job aids.
Ability to work closely with staff to develop documentation.
Minimum 3 years of managed healthcare experience writing and documenting detailed procedures.
General Job Information
Title
Sr Technical Writer
Grade
24
Work Experience - Required
Healthcare, Technical Writing
Work Experience - Preferred
Education - Required
A Combination of Education and Work Experience May Be Considered., Bachelors - Technical Writing
Education - Preferred
Masters - Technical Writing
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Provide support to all eligible Families with expectant parents and parents of children from birth to 3 years of age. This program seeks to support young military Families which directly contribute to military mission readiness, support Family members' adaptation to military life, enhance the knowledge and skills for healthy relationships that can provide safe, nurturing environments for children to prevent family violence. Provide activities and services including information and referrals, parenting programs, respite care for children, and supervised play time for children. Families with children prenatal to 3 years old who have been assessed as being at risk for child maltreatment and/or Family violence can benefit from additional, more-intensive support from these services.
Provides effective, timely and confidential services for Families who have been assessed as being at risk for child maltreatment and/or Family violence.
Protects the privacy and confidentiality of client information.
Identifies and reports suspected child abuse and neglect and domestic abuse.
Assesses developmental milestones and referral procedures for indicators of special needs or developmental delays.
Assesses and strengthening adaptation to parenthood.
Assesses and strengthening parental capacity for problem-solving, building and sustaining trusting relationships, and seeking help when necessary.
Promotes developmentally appropriate parenting skills and disciplinary techniques, and parent and child communication skills.
Facilitates informal and formal community networks to build positive relationships and reduce social isolation.
Develops relationships with local community and military installation officials and organizations that can maximize program effectiveness.
Utilizes community-based services and formal and informal community networks to provide concrete support for families who may be in crisis.
Utilizes methods for screening for, assessing, and addressing protective and risk factors associated with child abuse and neglect using a strengths-based Family centered developmental approach.
Keeps tracking system up to date with case status.
Participates in monthly conference calls and annual training events.
Other Job Requirements
Responsibilities
Qualified candidates must have at least two (2) years of direct work experience in child abuse or domestic abuse, or maternal or child health or medical social work.
Must hold a current and active license as an LCSW, LMFT or RN.
Licensed Clinical Social Workers must possess a current, valid, unrestricted clinical license and a master's degree in Social Work to practice social work independently.
Registered Nurses must have at least a bachelor's degree in nursing, a current unrestricted license in one of the States or U.S. territories, and at least two (2) years of direct work experience with child abuse or domestic abuse, maternal or child health, public/community health, or mental health.
Must have home visitation experience.
Must have a valid driver's license, auto insurance and ability to operate a motor vehicle.
Must have working knowledge of basic computer skills and be able to use Microsoft Word, Power Point, and Excel programs.
Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices on most or all workdays.
Ability to communicate and interact with others, both in person and/or by telephone to conduct business.
Working under time pressure.
Working rapidly for long periods to meet deadlines.
Must be able to travel as needed and adhere to AFSC travel policies and procedures.
Must be able to enter private homes that may or may not provide easy access for those with physical disabilities or those recovering from physical rehabilitation or post-recovery mobility.
Position requires ability to transport self from office locations to private homes, other offices and facilities where training and other program activities occur.
General Job Information
Title
New Parent Support Program Child and Family Specialist, FASS
Grade
21
Work Experience - Required
Child Welfare
Work Experience - Preferred
Education - Required
Bachelors - Nursing, Masters - Counseling, Masters - Social Work
Education - Preferred
License and Certifications - Required
LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Reviews requests for authorization for specific medications by reviewing medical records and documents related to the Medi-Cal program. Considers each prior authorization request and collects evidence and patient information to support the decision. Communicates with the prescriber and pharmacy to obtain additional information if needed. Ensures the authorization meets contractual obligations. May also require coordinating with administrators and healthcare providers to gain necessary information and ensures that patients receive authorized prescriptions.
As a key clinical member of the service center team, interacts with prescribers and pharmacy staff to review prior authorization requests and make appropriate determinations.
Consults with physicians/providers as necessary, interprets clinical guideline criteria, and renders/reviews coverage determination for prior authorization cases.
Consults with pharmacy staff regarding use of medications and recommend appropriate formulary alternatives when requested.
Gathers complex clinical information, coverage policy and criteria information and works within regulatory guidelines to make coverage determinations.
Performs all duties and functions in compliance with state and federal pharmacy laws and regulations.
Conforms with and supports department quality assurance and improvement guidelines.
Other Job Requirements
Responsibilities
Current/Active, unrestricted RN license in the State of California.
Minimum of 5 years of clinical nursing experience in a hospital, acute care, home health/hospice, or direct care environment.
Experience interpreting medical guidelines and drug compendia.
Experience with drug classes, dosages and usage.
Experience with medical terminology and diagnoses.
Intermediate to advanced computer skills and ability to quickly learn and adapt to new technology.
Proficient with Microsoft Office (Outlook, Word, Excel) and web-based navigation.
General Job Information
Title
Senior Utilization Management and Prior Authorization Nurse
Grade
26
Work Experience - Required
Clinical, Utilization Management
Work Experience - Preferred
Health Plans, Medicaid, PBM (Pharmacy Benefit Management)
Education - Required
Associates - Nursing
Education - Preferred
Bachelors - Nursing
License and Certifications - Required
RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Family Support Coordinator - R00000050856 DESCRIPTION/RESPONSIBILITIES:Seeking candidates with two years of family peer support/advocacy work experience and national certification is preferred. CFPS/National Peer Support Credential will required within one year of hire. For this position it will require a valid State Driver's License and must have a vehicle in good, working condition with the ability to travel within the field regularly. * This position provides non-clinical, evidence-based peer support services and serves as a member advocate. The FSS brings their life experiences and skills to deliver assistance to the family as they explore the goals they would like to achieve and offers interventions to the family to increase engagement and empowerment within a variety of service delivery systems.* Provides peer support to family/caregivers of children with behavioral health conditions identified as requiring intensive wellness support and recovery-oriented interventions.* Guides families in creating Wellness Recovery Action Plans (WRAPR) for themselves and their family to recognize strengths and identify wellness self-management and crisis prevention strategies.* Conducts in depth social determinant needs determinations utilizing the 8 dimensions of wellness to help a family member identify their whole health goals and objectives to address their own challenges and those of their child.* Guides and empowers family members to understand and participate in all decisions related to the treatment process, the support plan, service choices, and transitions in care.* Coaches and role-models regarding a parent's perspective and lessons learned from life experience.* Facilitates support and education to families who have questions, concerns or specific needs related to behavioral health and their behavioral health relationship to Magellan and child serving agencies.* Strategically shares their lived experience to inspire hope, empowerment, and positive action.* Performs ongoing interventions to engage families and members in traditional and nontraditional health services and supports, as well as community and social support networks including community-based peer, parent, and family support services.* Facilitates a team approach to member care including with the Magellan care coordination team.* Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.* Acts as an advocate for family and member`s needs by identifying and addressing gaps in services and supports.* Educates providers, supporting staff, members, and families on resiliency and recovery-oriented principles, practices, strategies, and tools.* Documents all interactions according to company standards.* Maintains professional responsibility to maximize supervision, respond appropriately to personal stressors that impact ability to perform job duties, and recognize crisis situations or risks to the member's safety and respond appropriately.* Travels to meet families within the community.* Other duties as assigned. Other Job Requirements Responsibilities* 2+ years experience with child who is or has received services from a child-serving agency for mental health or cooccurring related issues, peer support* CPRS/CPS/CPSS/CRPS/PRSS, Peer Specialist as required by state.* CFPS/National Peer Support Credential required within one year of hire.* Must be or have been a parent of a child who is or who has in the past received services from a child-serving agency for mental health related issues.* Applicants must be able to draw from their own personal experience of parenting a child or youth with significant behavioral health challenges or co-occurring disorders; negotiating services and supports for their child and family; be familiar with key resources for children, youth and families in the community; be able to transcend personal events to provide unconditional support and assistance to families.* Positive attit
Authorizes and reviews utilization of autism services, including Applied Behavioral Analysis (ABA). Collects and analyzes utilization data. Assists with shaping of ABA services and assures coordination with other services providers such as medical, speech, occupational therapy, physical therapy and IEP services provided through the school setting. Works with ABA treatment team to shape care planning and provision and assures measurements of the child?s progress are ongoing. Assures overall case management with the inclusion of behavioral health services when required. Coaching and mentoring of less experienced Care Managers is required.
Performs concurrent reviews with treatment team providing ABA services.
Performs initial case requests for autism services, behavioral health and ABA.
Reviews all submitted materials and consultation with treatment team providers.
Reviews IEP, psych testing and other case evaluation materials.
Provides information to members and providers regarding mental health and autism benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
Interacts with the company's Medical and Associate Medical Directors and/or Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
Participates in quality improvement activities, including data collection, tracking, and analysis.
Leads or participates in activities as requested that help improve Care Center performance, excellence and culture.
Supports team members and participates in team activities to help build a high-performance team.
Demonstrates flexibility in areas such as job duties and schedule in order to aid Care Center in better serving its members and to help the company achieve its business and operational goals.
Assists Care Center efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
Maintains an active work load in accordance with Care Manager Performance Standards.
Works with community agencies as appropriate.
Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
Assists network by identifying gaps in the network and quality providers.
Advocates for the patient to ensure treatment needs are met.
Interacts with providers in a professional, respectful manner that facilitates the treatment process.
Other Job Requirements
Responsibilities
A minimum of six (6) years post degree experience in the provision of ABA services including oversight of paraprofessionals performing ABA services.
Behavioral Health license such as LCSW, LPC, LMFT, LSW or BCBA certification.
For the state of Pennsylvania, if only the BCBA certification is held, Behavioral Specialist License in the state of Pennsylvania is required.
Knowledge of DSM V or most current diagnostic edition.
Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.
General Job Information
Title
Care Manager Senior - Autism ABA, Remote TX, U.S.
Grade
24
Work Experience - Required
Clinical
Work Experience - Preferred
Education - Required
Masters
Education - Preferred
License and Certifications - Required
BCBA - Board Certified Behavior Analyst - Care Mgmt, BSL - Behavioral Specialist License - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, Must be an independently licensed behavioral health clinician - Care Mgmt
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
The On-Call/Substitute MFLC Counselor, will provide coverage in short-term, surge and on demand situations resulting from the Military needs such as a post-deployment event or to cover an existing assignment for counselors who are absent. The Summer On-Call counselor position covers assignments during the May 15th through September 15th time period, coinciding with the school summer break. With minimal guidance and oversight, provides the full breadth of Adult or Child and Youth Behavioral (CYB) counseling services to military service members and their families at military installations. These services may include non- medical counseling, training/health and wellness presentations, consultation with parents, personnel at child daycare centers and schools, and consultation to installation command regarding behavioral health issues affecting military personnel and their family members. On call CYB counselors may be assigned to DoDEA schools and community schools and will need to have experience working in a school setting to qualify for on call role in backing up a school position. CYB counselors may also be assigned to youth programs, summer camps, and on demand assignments. On call adult counselors may be assigned to support MFLC services in a variety of military community and readiness centers, as well as on-demand and surge assignments. The counselors work closely with the installation and military branch Points of Contact (POC) to assure that the program is provided within scope and meets the needs of the installation.
Provides non-medical, short term, solution focused, counseling directly to adults, children, and youth of service members. Services include assessment, brief counseling and consultation, action planning, referral to resources (assuring linkage as appropriate), and follow-up as indicated.
CYB counselors will also have a focus on supporting the staff and personnel of CDCs, DoDEA and community schools, youth programs and summer camps as well as providing parent training and guidance.
Provides training and health and wellness presentations, participate in health fairs and other base/installation activities.
Enters counselor activity data daily through smart phone or web application assure that reporting is accurate from assigned installation while maintaining confidentiality and anonymity of service / family member.
Other Job Requirements
Responsibilities
Master's Degree from an accredited graduate program in a mental health related field, or social work.
A minimum one year of post licensure counseling experience.
With short notice, willing to accept assignments of undefined periods to include weekends.
Can cover, on a full-time basis, assignments of varying length from a weekend to two weeks.
Quickly builds rapport with service personnel clients, family members, students, parents and co-workers.
Adaptable to new working conditions, varying location rules, etc.; adjusts working style to align with each work environment.
Able to work effectively with minimal instruction and guidance.
Listens carefully to instructions provided.
With minimal notice, participates in regular in-services/training, Quality Improvement committees or other contract activities as assigned.
Requires ability to quickly engage and communicate with military members, spouses or children as assigned, in order to accomplish job functions, and to respond quickly to emergent situations in any physical location on a military installation and/or within a school setting, which includes the need to traverse short and/or long distances within the base to both indoor and outdoor locations, to maneuver through rugged, outdoor or uneven locations (e.g., steep inclines, stairs, grass), and work in outdoor weather and other military base conditions. Due to the nature of working on military installations or related worksites, counselors may need to comply with various site-specific requirements to work at designated locations. For example, for some assignments, counselors will need to have certain current immunizations or vaccinations and provide record of receipt.
Ability to prove US Citizenship and must be fluent in English.
Advanced knowledge of brief therapy and solution-focused counseling methods.
Prior military service/military family member and/or strong familiarity with military culture desired.
For CYB positions must meet the Magellan MFLC CYB criteria for experience with children and youth and specialty in child and adolescent development/psychology.
Creates a presence on the installation in which the service and family members feel comfortable approaching the counselor and recognize the program to be confidential; for CYB counselors -- creates a presence in child and youth settings, is available to children, youth, and staff. When working with children, counselor must abide by line of site protocol.
Establishes and maintains working relationships with community resources and provides appropriate linkages.
Partners with POC to provide Adult and CYB services in a manner that addresses the needs of the installation/facility. Develops an excellent working relationship with the installation/facility POC.
Manages duty to warn and restricted reporting situations according to DoD protocol and staffs the cases with Regional Supervisor/Regional Director.
Communicates with Regional Supervisors and participate in regular individual and group supervision, sharing information regarding trends and issues on the installations and in facilities to which they are assigned for substitute or on call services.
Responds to critical incidents and special requests as directed by the POC and approved by the OSD program manager.
General Job Information
Title
Military Therapist Ft Campbell
Grade
MFLC Substitute
Work Experience - Required
Clinical
Work Experience - Preferred
Education - Required
Masters - Behavioral Health, Masters - Social Work
Education - Preferred
License and Certifications - Required
Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, DL - Driver License, Valid In State - Other, LPC - Licensed Professional Counselor - Care Mgmt, Must be an independently licensed behavioral health clinician - Care Mgmt
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Responsible for timely, accurate processing of accounts payable vouchers and employee expense claims for payment. Research and resolve questions and inquiries from Magellan employees, vendors and providers. Assist management with special projects or tasks as assigned.
Invoice Processing:
Review approved check requests for proper GL coding and approvals.
Review invoices for required information and accuracy.
Prepare invoices and PO invoices for processing.
Scan the prepared invoices into appropriate system. Verify all documents were scanned successfully, and that the populated fields match the information on the invoice. Manually enter missing required information or correct populated information.
Retrieve invoice output file, review the vendor and invoice information on the file, and format the file to import into appropriate system. Verify that the file was imported correctly, and make any necessary corrections to the invoices that were not imported.
Enter the PO detail or the PO invoices. Match the PO invoices to be released. Research any discrepancies between the PO information and the invoice information. Make the necessary adjustments. Contact the Purchasing team for assistance as needed.
File open invoices.
Review T&E's for appropriateness. Release for payment.
Customer Service:
Research inquiries and questions promptly.
In-depth research in Lawson AP and/or GL and OnBase to respond to the inquiry in a professional and accurate manner.
Take the necessary steps to correct errors.
Open communication with supervisor of issues that were not resolved.
Follow up on open issues and strive for timely resolution.
Understand and prioritize tasks to ensure that productivity remains high and there are no negative impacts on team members.
Other Job Requirements
Responsibilities
Strong communication skills (written and verbal) with a customer service attitude with all levels of employees and vendors.
Demonstrated ability to deal professionally with vendors and internal customers.
General to intermediate knowledge of Microsoft Office Suite, specifically Word and Excel.
Ability to easily learn new software.
Must be proactive on issues/problems.
Must be able to understand and prioritize tasks.
General Job Information
Title
Senior Accounting Coordinator
Grade
19
Work Experience - Required
Accounting
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.